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MORTALITY AND MORBIDITY REPORTS AND

REVIEWS.

HEALTH OF THE ARMY.

Report of the Surgeon-General of the United States Army for the

Fiscal Year Ending June 30, 1901. The health of the Army appears to have been exceedingly good during the calendar year 1900. The admission rate for all causes in the Army, volunteers and regulars, with a mean strength of 100,389 in 1900, was 2311.81 per thousand of strength, as compared with 2178.06 in the previous year; but during the year 1899 only 39,280 men out of a total of 105,546 were serving in the Philippines, while during the past year 66,882 of a total of 100,389 were thus serving. This is an important point to remember in considering the sick rates of the two years.

The troops serving in the United States during the year 1900 (mean strength 20,690) had an admission rate of 1510.97 per thousand of strength, as compared with 1677.51 during the previous year-1242.87 from disease and 268.10 from injury, as compared with 1496.84 and 180.67, respectively, during 1899. The ratio for discharge was 39.29 per thousand of strength, as compared with 26.95 during the previous year; 32.52 of this rate was for disease and 6.77 for injury. The death rate did not differ much from that of the previous year. It was 7.78 from all causes per thousand of strength, as compared with 7.89 in the previous year; 4.83 from disease, as compared with 6.56 and 2.95 from injury, as compared with 1.33

In the Philippine Islands, with a mean strength of 66,882, the admission rate was 2621.96, as compared with 2395.52 in the previous year, this increase being mainly due to disease among the volunteers, the ratio for which rose from 1859.21 to 2761.79. The regulars, on the other hand, showed a marked decrease in the ratio of admissions for disease, which fell from 2454.10 to 2197.73. Two-thirds of the admissions for disease were caused by malarial fevers and diarrhæal diseases. The discharge rate among the volunteers, 12.98 per thousand of strength, was smaller than that of the regulars-22.46—probably because the volunteers were in expectation of a return home for muster out at an early date. The deaths from all causes amounted to 28.75 per thousand of strength, as compared with 30.58 in the previous year. Disease occasioned 20.26 deaths, the principal cause of the fatalities being dysentery, which, with other intestinal diseases, gave a rate of 9.08. The rate from injury amounted to 8.49.

The death rate in China was large, 47.76 per thousand of strength, 23.62 from disease, and 24.14 from injury, but fortunately the mean strength for the year was small, 1,947 men.

From the close of the calendar year 1900 to the latest reports, the health of the troops in the Philippines has been steadily improving. The chief surgeon has reported a progressive diminution in the non-efficiency of the command from disease and injury. In July and August, 1900, the non-efficiency constituted 9.47 and 9.58 per cent of the strength. From January to June, 1901, the non-efficiency was less than 7 per cent., the lowest rate 6.12 per cent., having been recorded in March. Intestinal and gastric diseases, including dysentery and typhoid fever, gave 34.22 per cent. of the total sickness, malarial fevers 15.23 per cent., and venereal diseases 13.10 per cent. Typhoid fever, which scourged our camps in 1898, appeared only sporadically, constituting merely 1.78 of the total sickness. Most of the malarial cases were mild, and made little or no figure in the mortality returns. Smallpox, so prevalent and deadly in the early occupation of the islands, has almost entirely been suppressed. Dysentery, constituting 13.44 per cent. of all cases of sickness, is the dangerous disease. Bubonic plague, although a subject of importance to the medical officers, members of the Board of Health of Manila, and to those temporarily assigned for duty with the board as inspectors, on account of its prevalence among Chinese and Filipinos, appears to have given but little anxiety to medical officers serving with troops, as during the year only one case was reported as having occurred in the army, in the person of an enlisted Chinese cook of the Twenty-seventh Infantry at Camp Stotsenberg, near Manila, the infection having undoubtedly been contracted in the city. Quarantine and disinfection prevented any extension of the disease.

The health of the troops serving in Cuba was excellent during the year. With a mean strength of 8,690, the admission rate was 1873.07, as compared with 2749.74 in 1899, the rate for disease raving been 1586.19, as compared with 2537.98. Discharges for disability amounted to 16.57 per thousand of strength, as against 20.25 during the previous year; and the death rate from all causes was 9.78, as against 18.30 in 1899. Malarial diseases contributed 581.35 to the admission rate, but the death rate from these cases was only 1.04 per thousand of strength. Dysentery and diarThreal diseases constituted 166.75 of the admission rate, but only 0.58 of the death rate. But for the occurrence of yellow fever, the death rate in this command would have been only 4.72 per thousand of strength. One hundred and forty-four cases were reported, of which 32 were fatal, giving a death rate of 3.68 per thousand of strength, the rate for all diseases being 8.40 and for all diseases and injuries 9.78. Since the close of the calendar year the health of the troops has continued good. Under date of July 22, 1901, the chief surgeon reported that since November, 1900, the only cases of yellow fever that had occurred in our military garrisons were the nine cases in the persons of men who were experimentally inoculated by infected mosquitoes at Quemados.

Major V. Havard, surgeon, United States Army, chief surgeon, Department of Cuba, makes note of the fact that the admission rate for disease in the garrisons of the eastern half of the island of Cuba is nearly double that of the troops serving in the western half. This is due to the greater prevalence of malarial fevers and diarrhæal diseases in the eastern provinces.

Of the Prevalence of Special Diseases.—Cases of scarlet fever, diphtheria and cerebro-spinal fever were rare; measles and mumps, on the other hand, were of frequent occurrence. In the United States, measles had an admission rate of 11.36, the mean annual rate for the previous decade having been 8.46 per thousand of strength. It was imported into the Philippine Islands by almost every transport. The admission rate for volunteers in those islands was 8.18 per thousand of strength, and for the regulars, 1.61.

No epidemic of typhoid fever occurred during the year. In the Army as a whole, the admission rate was 9.74 per thousand of strength, and the death rate 1.63, as compared with the mean annual rates, 5.19 and 0.56 for the ten vears preceding the outbreak of the Spanish-American War.

Of yellow fever there were 144 cases, with 32 deaths—an admission rate of 1.43 and a death rate of 0.32 per thousand of strength.

Malarial feters were heavy, owing to their great prevalence in the Philippines and Cuba. The admission rate for the whole Army was 706.52, and the death rate 1.36, as compared with the !nean annual rates of the decade, 1889-1899, 174.29 and 0.58. The rates for the volunteers in the Philippines were 1108.75 and 1.98; for the regulars, 742.82 and 1.64, respectively, per thousand of strength.-Reports follow on the progress made in efforts for the prevention of malarial fever.

Tuberculosis of the Lungs.-Admission rate for the year 4.92 per thousand of strength, against the average of 2.66 only for the previous decade. The rate of discharge for disability was 1.36, as compared with 1.40 for the previous decade, and the death rate 0.96, as compared with 0.48 for the same period.

Venereal Diseases.—Admission rate for the whole Army was 133.97, and the discharge rate 2.36 per thousand of strength, as compared with 133 and 2.61 in 1899, and with 71.45 and 1.22, the mean annual rates 1889-1899. These large rates prevailed in all the commands except among the volunteer troops serving in the Philippines, the admission rate for these having been 79.94, and the rate of discharge 0.41 per thousand of strength. Among the regular troops in the Philippines the rates were respectively 138.88 and 0.96; among troops serving in the United States, 155.39 and 7.29. In China the admissions rose to 173.60, but there was no discharge for disability. In Cuba the admission rate reached 190.68, with 4.03 discharges per thousand of strength, and in Porto Rico the excessive admission rate of 367.88 was reached.

Alcoholism.-Admission rate in the Army as a whole during the year 1900 was 15.34 per thousand of strength, as compared with 14.49 in 1899 and with 28.67, the mean annual rate of the decade 1889-1899. Troops serving in the United States during the past year had 22.43 admissions per thousand of strength. The steady decrease of late years in the admissions for alcoholism among men of the Regular Army is a matter for congratulation. Military officers may be said to be unanimous in their opinion that this was mainly the result of the establishment of the post exchange or canteen at military posts. The following show's this gradual improvement: Mean annual admission rate of the decade ending with 1889, 56.68 per thousand of strength. Admission rate for 1889, 41.41; for 1890, 40.73; for 1891, 40.01; for 1892, 37.23 ; for 1893, 33.97; for 1894, 30.94; for 1895, 30.11; for 1896, 29.06, and for 1897, 27.86. In 1898 the altered conditions consequent on the Spanish-American War prevented further comparisons. There is less drunkenness among troops in active service than in a command doing garrison duty in times of peace. In the Philippines during the past year the admission rate for alcoholism among the volunteers was 8.68, and for regulars 12.41; for troops in China, 7.70. These statistics do not sustain the newspaper reports of drunkenness among the troops in the Philippines. In fact, medical officers report the habits of the enlisted men in the Philippines as very much the same as in the United States. Much of the evil effects of intemperance in the Philippines is attributed to the use of the native intoxicant, vino, which is a crudely distilled alcohol, causing rapid intoxication, which is readily recovered from when a moderate quantity is taken, but which, taken in excess, causes wild delirium and unconsciousness, and in habitual users induces a deterioration of the mental faculties.

NEW YORK.-Bulletin of the State Board of Health reports for October: Population, 7,268,000; total deaths, 9,738; death rate, 16.0; deaths under five years, 2,627; percentage of deaths under five years to total deaths, 27.0; from zymotic diseases per thousand, from all causes, 150; from cerebro-spinal meningitis, 25; typhoid fever, 235; malarial diseases, 40; small-pox, 14; scarlet fever, 38; measles, 20; erysipelas, 17; whooping cough, 53; croup and diphtheria, 260; diarrhæal diseases, 733; acute respiratory diseases, 916; consumption, 1,112; puerperal diseases, 59; diseases of digestive system (not diarèhæal), 659; urinary system, 792; circulatory system, 923; nervous system, 991; cancer, 424; accidents and violence, 527; old age, 425; unclassified, 1,475.

City of New York, 3,526,517: Total deaths, 5,189; death rate, 17.2; deaths under five years, 1,750; from cerebro-spinal meningitis, 13; typhoid fever, 109; malarial diseases, 27; small-pox, 11; scarlet fever, 31; measles, 17; erysipelas, 12; whooping cough, 28; croup and diphtheria, 142; diarrhaal diseases, 491; acute respiratory diseases, 538; consumption, 639; cancer, 199.

Borough of Manhattan, 1,873,562: Total deaths, 2,830; death rate, 17.8; deaths under five years of age, 973; from cerebro-spinal meningitis, 8; typhoid fever, 58; malarial diseases, 4; small-pox, 1; scarlet fever, 11; measles, II; erysipelas, 7; whooping cough, 13; croup and diphtheria, 75; diarrheal diseases, 239; acute respiratory diseases, 274; consumption, 326; cancer, 109.

Borough of the Bronx, 222, 124: Total deaths, 373; death rate, 20.0; deaths under five years, 84; cerebro-spinal meningitis, 1; typhoid fever, 6; malarial diseases, 9; small-pox, 10; scarlet fever, 1; croup and diphtheria, 4; diarrheal diseases, 18; acute respiratory diseases, 41; consumption, 102; cancer, 16.

Borough of Brooklyn, 1,209,064: Total deaths, 1,650; death rate, 16.0; deaths under five years, 584; from cerebro-spinal meningitis, 4; typhoid fever, 38; malarial diseases, 6; scarlet fever, 19; measles, 6; erysipelas, 4; whooping cough, 13; croup and diphtheria, 49; diarrhæal diseases, 102; acute respiratory diseases, 194; consumption, 178; cancer, 60.

Borough of Queens, 162,834. Total deaths, 233; death rate,

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