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280 persons vaccinated during the epidemic, and of 408,825 found protected by one or more previous vaccinations, out of a total population of 2,147,179, leaving 1,335,039, or a little more than 62 per cent., unvaccinated. The actual cash expended from county and municipal treasuries on account of small-pox was $308,271, to say nothing of the expense to individuals. The reported loss from interference with business was $734,000. This does not include the great loss to transportation companies from interference with travel and commerce.

LOUISIANA.-New Orleans, 300,000 (80,000 colored). Report for October: Total deaths, 503 (198 colored); death rates, white, 16.63; colored, 29.72; total, 20.12; deaths under five years, 113 (52 colored); from typhoid fever, 12; malarial diseases, 17; scarlet fever, 2; erysipelas, 2; whooping cough, 3; croup and diphtheria, 8; diarrhoeal diseases, 24; acute respiratory diseases, 35; consumption, 77; cancer, 15. The "Times-Democrat" has frequently called attention to the remarkably good health New Orleans has enjoyed this summer, which is not only a record-breaker for the summer, but for any season of the year, and makes a better showing than any large city of the country for the hot season. What has been true of New Orleans is equally true of the State of Louisiana as a whole; indeed, we could make the statement even broader, and say that it is true of the entire South. The past summer has been phenomenal in the matter of the public health throughout the Gulf and South Atlantic States, and has been made the text for many congratulatory articles on the subject. The explanation would seem to be that the South has escaped the severe hot waves which caused so much suffering and loss of life north of the Ohio and Potomac.

To return to Louisiana, the State Board of Health remarks that "in the interior of the State, as well as the city of New Orleans, the public health has been exceptionally good."

The encouraging feature of this report is that it will convince the people of the beneficial results of a vigorous sanitary policy and encourage them to support the authorities in carrying out thorough sanitation. When they can see, as clearly as they can now, what drainage, quarantine, etc., have accomplished, how many hundreds of lives have been saved, they will not hesitate to give their cordial approval to the work under way, or such new work as may be necessary to put New Orleans and Louisiana in first-class order. It has been proved that there is no healthier

portion of the country than the South if it but show proper regard for the rules of hygiene and sanitation.

MARYLAND. Baltimore, 518,000. Report for October: Total deaths, 765; death rate, 17.72; deaths under five years, 249; from cerebro-spinal meningitis, 2; typhoid fever, 20; scurvy, I; measles, 1; scarlet fever, 3; whooping cough, 7; croup and diphtheria, 14; diarrhoeal diseases, 53; acute respiratory diseases, 88; consumption, 88; cancer, 30.

MASSACHUSETTS.-Boston, 573,579. Report for September: Total deaths, 931; death rate, 19.48; deaths under five years, 364; from cerebro-spinal meningitis, 6; typhoid fever, 17; small-pox, 2; scarlet fever, 6; measles, 3; whooping cough, 7; croup and diphtheria, 11; diarrhoeal diseases, 151; acute respiratory diseases, 65; consumption, 104; cancer, 43.

Lowell, November 10.-There are, as far as known, twenty-one families in which one or more members belonging to one of the schools are ill with diphtheria, and doubtless other cases, while no account was made of that large number who have not yet seen a physician. Five pupils belonging to the school have died during the past two or three weeks, and in two instances, at least, owing to some one's negligence, the teachers received no notification card until after the death and burial of the children.

MICHIGAN.-The secretary of the State Board reports for November, 1901, compared with the preceding month, influenza, pneumonia, pleuritis, diphtheria, small-pox, whooping cough, erysipelas and measles were more prevalent; and diarrhoea, typhoid fever, inflammation of bowels, dysentery, cholera morbus and cholera infantum were less prevalent. Reports from all sources show cerebro-spinal meningitis reported at 3 places less; measles at 3 places less; whooping cough at 2 places more; small-pox at 38 places more; diphtheria at II places more; typhoid fever at 67 places less; scarlet fever at 4 places less; and consumption at 4 places more, in the month of November, 1901, than in the preceding month.

Deaths returned to the Secretary of State for the month of November, 2,454; death rate, 12.5; 94 less than for the preceding month, and 7 less than for November, 1900. This total includes 30 deaths that resulted from the explosion in the Penberthy Injector Works of Detroit, and includes but six of the deaths,

variously estimated from 22 to 75 and upward, that occurred at the collision on the Wabash Railroad near Seneca on November 27th. Most of the deaths that occurred there were those of recent immigrants, Italians and Austrians, passing through this State from the East to the West, and, as they were not actually a part of the population of Michigan, the omission of the mortality from this source will not seriously affect the death rate for the month, as compared with preceding months of registration.

Of the total number of deaths reported, 346 were infants under 1 year of age, 177 were children aged 1 to 4 years, both inclusive, and 659 were deaths of persons aged 65 years and over. Deaths from pulmonary tuberculosis, 137; other forms of tuberculosis, 29; typhoid fever, 79; diphtheria and croup, 59; scarlet fever, 27; measles, 6; whooping cough, 8; small-pox, 2; anthrax, 2; pneumonia, 206; diarrhoeal diseases of children under two years of age, 42; influenza, II; cancer, 127; accidents and violence (exclusive of deaths at Wabash wreck), 188.

MINNESOTA.-Minneapolis, 240,000. Report for October: Total deaths, 175; death rate, 6.58; deaths under five years, 40; from typhoid fever, 8; whooping cough, 2; croup and diphtheria, 20; diarrhoeal diseases, 9; acute respiratory diseases, 10; consumption, 20; cancer, 13.

St. Paul, 165,000. Report for November: Total deaths, III; under five, 22; death rate, 8.06; from consumption, 21; pneumonia, 16; typhoid fever, 2; diphtheria, 5.

Total

MISSOURI.-St. Louis, 598,000. Report for October: deaths, 787; death rate, 15.79; deaths under five years, 213; from typhoid fever, 32; malarial diseases, 11; small-pox, 1; scarlet fever, 13; whooping cough, 5; croup and diphtheria, 20; diarrhoeal diseases, 39; acute respiratory diseases, 70; consumption, 79; cancer, 23.

NEW JERSEY.-Newark, 250,000. Report for three weeks ending November 16: Total deaths, 230; death rate, 15.94; deaths under five years, 63; from typhoid fever, 3; small-pox, 7; croup and diphtheria, 3; diarrhoeal diseases, 7; acute respiratory discases, 18; consumption, 33; cancer, 5.

Hudson County (Jersey City and environs), 386,048. Report for September: Total deaths, 582; death rate, 18.1; deaths under five years, 266; from typhoid fever, 13; malarial fevers, 2; measles,

2; scarlet fever, 3; whooping cough, 2; croup and diphtheria, 15; diarrhoeal diseases, 39; acute respiratory diseases, 44; consumption, 60.

NORTH CAROLINA.-The State Board of Health Bulletin reports for October: Total deaths in 24 towns, with an aggregate population of 140,000 (55,200 colored), 230 (114 colored); death rates, white, 16.3; colored, 24.8; total, 19.6; deaths under five years, 83; from typhoid fever, 21; scarlet fever, 4; malarial fever, 18; diphtheria, 6; whooping cough, 2; pneumonia, 4; consumption, 25; nervous diseases, 28; heart disease, 14; diarrhoeal diseases, 25; accidents and violence, 6; all other causes, 77.

OHIO.-Cleveland, 300,000. Report for October: Total deaths, 466; death rate, 14.33; deaths under five years, 151; from typhoid fever, 9; malarial fever, 2; scarlet fever, 4; croup and diphtheria, 24; diarrhoeal diseases, 27; acute respiratory diseases, 51; consumption, 17; cancer, 15.

PENNSYLVANIA. Philadelphia, 1,293,697. Report for five weeks ending November 30: Total deaths, 2,003; deaths under five years, 395; from typhoid fever, 24; malarial fever, 2; smallpox, 41; scarlet fever, 13; erysipelas, 3; measles, 2; whooping cough, 11; croup and diphtheria, 66; diarrheal diseases, 75; acute respiratory diseases, 305; consumption, 253; cancer, 68.

Vaccination. At a recent meeting of the State Board of Health the following resolutions were adopted:

"Resolved, That in view of the very natural public apprehension in regard to the possibility of tetanus following vaccination, as illustrated by recent cases of this accident in a neighboring State, this board desires to state its conviction, founded upon a careful study of the history of vaccination and of the cases referred to, that it has yet to be demonstrated that vaccine virus ever contains or becomes contaminated with the germs of tetanus. When such occurrences as those referred to take place, it is because owing to carelessness, usually on the part of the person vaccinated, the germs of tetanus have gained access to the wound on the arm, as they may to any other wound, abrasion, or scratch upon the surface.

"Resolved, That there is no reason for dreading, or abstaining from vaccination, because of these recent cases. This is sufficiently demonstrated by the fact that more than half a million

persons have been vaccinated in and around the city of Philadelphia within the past few months without the occurrence of a single case of tetanus.

"Resolved, That this board condemns in the strongest possible terms the use of any material or medicament administered by the mouth as a substitute for vaccination, and that any physician furnishing a certificate of successful vaccination based upon the administration of any such substance or remedy lays himself open to prosecution for violation of a State law."

Teachers Must Be Vaccinated.-In Common Pleas Court No. 4, Philadelphia, November 14, President Judge Arnold filed an opinion, refusing to grant an injunction in the proceedings recently begun by Mary Helen Lyndall against the Board of Education to have the defendants restrained from interfering with her continuance as a teacher in the Girls' High School. The court ruled as follows: "As school directors may, in the exercise of a sound discretion, exclude from the public schools pupils who have not been vaccinated, as was decided by the Supreme Court, so may they exclude teachers and other employees for the same reason. The protection which vaccination is believed to afford must be reciprocal; teachers and pupils are alike entitled to protection against contagious disease. Whether vaccination is a preventive of small-pox, this court has no power to investigate and decide. The Legislature has authorized, and the Supreme Court has legalized, regulations requiring vaccination, and therefore a court in the first instance is prohibited from inquiring into the efficacy of vaccination as a preventive of small-pox. The opinion of the plaintiff that vaccination is not a preventive, and that it is dangerous to her health, is not a sufficient reason to exempt her from obedience to the order of the Board of Public Education requiring vaccination; hence the offer of the plaintiff to show that she considered it dangerous to her health was irrelevant and immaterial and was properly rejected." The court further held that the Board had the power to make and enforce such a rule as was made, that Miss Lyndall had refused to comply with the regulation, and was therefore subject to suspension or dismissal.

Pittsburg, 332,000. Report for five weeks ending November 30: Total deaths, 610; death rate, 19.18; deaths under five years, 185; from cerebro-spinal meningitis, 2; typhoid fever, 30; malarial fever, I; scarlet fever, 16; measles, I; whooping cough, 3; croup and diphtheria, 30; diarrhoeal diseases, 19; acute respiratory diseases, 148; consumption, 35; cancer, 15.

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