RHODE ISLAND. The report ("Woonsocket Reporter") of the Special Legislative Committee on a State Sanitarium deserves the thoughtful attention of every resident of Rhode Island. The open-air treatment of consumptives is dealt with very succinctly. The recommendation that the State erect such a sanitarium as exists at Saranac Lake, N. Y., or at Rutland, Mass., is one that can heartily be made, without reservation. The discovery that the bacilli that cause tuberculosis are killed by pure air is a comparatively new one, but in the few years that this theory has been acted upon it has been shown to be the right one. Physicians who have recommended the dry atmosphere of Arizona and Colorado as a cure for consumptives have been justified in the experiment, because people could readily see that it was feasible to live outdoors in a dry climate. Later it was learned, however, that pure air, even if accompanied by the moisture which we in New England have so much of, even, in fact, if it were the still moister air of the British Isles, is yet efficacious in the destruction of these bacilli. The air of Woonsocket, if it be pure, is just as good as the air of any other locality for this purpose. Of course density of population gives larger chances for the carrying of the germs in the air, and consequently such a sanitarium is better located in the country-perhaps the further into the wilderness the better. Still, Dr. Swarts, of the State Board of Health, deemed the Woonsocket Isolation Hospital for Contagious Diseases, recently erected, an ideally located and arranged little home for the tuberculously affected.

Although the direct life-saving value of such a sanitarium is great, its indirect value is still greater in its teaching that pure air is sufficient for the salvation of those in the incipient stages of consumption. Pure air is about as near free to all as anything in this world can be. The treatment that is received in the sanitarium may be received in the home, especially in the country home.

With the record of the Rutland, Mass., institution of about 40 per cent. of cases "arrested"-practically that means cured-it will be conceded that the State can engage in no work which will save more lives and be a greater service to its people than to maintain such a home. Massachusetts and New York have such; New Jersey, Iowa, Illinois, Michigan, Maine and other States are preparing for their establishment. Eight hundred deaths a year from consumption in our little State has been the record for many

years.

The State of Rhode Island, which is in good financial condition, could not issue bonds for worthier purposes than for the creation of such an institution as is contemplated in the special committee's report.

WASHINGTON.-Seattle, 100,000. Report for October: Total deaths, 73; death rate, 8.76; deaths under five years, 13; from typhoid fever, 2; scarlet fever, 1; diphtheria, I; diarrhoeal diseases, 2; acute respiratory diseases, 8; consumption, 9; cancer, 4.

WISCONSIN.-Milwaukee, 295,000. Report for October: Total deaths, 275; death rate, 11.00; deaths under five years, 91; from typhoid fever, 6; croup and diphtheria, 10; diarrhoeal diseases, 21; acute respiratory diseases, 32; consumption, 37; cancer, 17.

PHILLIPINE ISLANDS and City of Manila, 250,000. Report for the week ending October 5: Total deaths, 173; death rate, 36.11; deaths under five years, 117; from malarial fevers, 1; smallpox, 1; dysentery, 3; plague, 2; beri-beri, 2; diarrhoeal diseases, 22; acute respiratory diseases, 15; consumption, 13.

CUBA.-Havana, 255,555. Major Gorgas, U. S. A., Chief Sanitary Officer, reports for October, 1901: The most prominent feature is the fact that there have been no deaths from yellow fever in the city, and not a single case. Three cases were reported, but these three cases were taken sick in September and carried forward into October. In the average past ten years, October has been one of the severest months for yellow fever. The maximum number of deaths from yellow fever since 1889, for this month, occurred in 1896, when we had 240 deaths; the minimum, in 1899, when we had 25 deaths; the average, 66.27 deaths; this year, no deaths and no cases. Last year, 1900, we had for October, 308 cases and 74 deaths.

This result adds another month as a practical demonstration of the truth of the mosquito theory of the transmission of yellow fever. The results attained are evidently due to disinfection on the lines commenced in February, as directed by the Military Governor with a view to killing infected mosquitoes. It has only occurred a few times since yellow fever became endemic in Havana, some century and a half ago, that an October day (and certainly never two successive days), has passed without a death

from yellow fever. This year, we passed the whole of October without a case or a death.

Since 1889, for these months, there have been on the average 362.16 deaths; the maximum, in 1896, 871; the minimum, in 1899, with 61; this year, o.

The change cannot be due to improvement in general hygiene, from the fact that last year, for this month, we had 74 deaths; this year, none. While there has been improvement in the general hygienic conditions, there could not have been so vast a difference as this would represent. The improvement in general hygiene is measured best by the general death rate. The death rate for October, 1900, was 24.33; this year, 1901, 20.17.

The general health of the city is most excellent-better than that of any past October-and compares favorably with other healthful cities of civilized communities. The death rate from month to month shows steady improvement, indicating generally amended conditions.

THE PLAGUE OF 1656 and now.

It is curious to note that there is hardly an order issued to-day by the Government relative to the plague that has just broken out in Naples that was not contained in the edicts of Alexander VII in 1656, when Rome was last visited by the pest, to say nothing of the penalties which he inflicted. Then, the moment news came that Naples was infected, the energetic Pontiff suspended all communication with the kingdom of the Two Sicilies on pain of death. Only letters were allowed to pass after such rigid disinfection that little of them was left. All persons belonging to the Papal States who found themselves in suspected districts were forbidden, also on pain of death, to return, while death was likewise the punishment for those who, coming into a city, did not present themselves at a certain office. Also hotel or inn-keepers, heads of convents, etc., who received any one not having the Papal guarantee, and who did not declare the names of their guests, ran the risk of five years' imprisonment. All this before there was one case in the Papal States. Reading the precautions then taken is like picking up a modern newspaper-lazarettos strictly guarded, isolation and disinfection, navigation of the Tiber forbidden and the churches closed, but all to no apparent purpose. At one time during that terrible year there was not one house in Trastevere (a thickly populated district of Rome) into which the plague did not

enter, so that it was cut off from the rest of the city by a high, thick wall. After twelve months the tide turned and the Eternal City was free, after losing 14,500 of her inhabitants, while at Naples the deaths were 40,000 and at Genoa 60,000.-"The Pall Mall Gazette."

SMALL-POX IN LONDON.-The London correspondent of the "Medical Record," November 15, 1901, says that from twelve to fourteen new cases a day have been reported during the week. One day there were sixteen. Comparison with the spread of the disease in the 1893-94 epidemic shows that the present one is taking the same course-pressing in the most crowded parts.

Of course, overcrowding must facilitate distribution. In 189394, shelters for the homeless played an important part in spreading infection.

The County Council has issued a return of all cases this year. Up to the 13th instant they numbered 673. Of these 574 were reported in the eleven weeks ending November 2d.

Much grumbling at the Asylums Board has been heard. They were warned by the medical superintendents of the hospitals in January, 1899, to prepare for an outbreak, but did nothing until it was upon them; so now they have to push on the erection of temporary buildings at all cost.

There is too much divided authority for effective sanitary control. We commit the lodging houses to the County Council; vaccination to the boards of guardians; the removal of cases to the borough councils, and the care of them, when they reach the hospitals, to the Asylums Board. But no one seems to be authorized to sequestrate contracts, and there are other points on which some legislation seems necessary.

Pity the poor anti-vacs. They had the annual meeting of the league on Wednesday, when thirty delegates assembled to hear the president, a lieutenant-colonel, declare that the recrudescence of small-pox is due to a resumption of vaccination!

BOOK REVIEWS.

THE PRINCIPLES OF HYGIENE: A Practical Manual for Students, Physicians, and Health Officers. By D. H. BERGEY, A.M., M.D., First Assistant, Laboratory of Hygiene. University of Pennsylvania. Octavo volume of 495 pages, illustrated. Philadelphia and London: W. B. SAUNDERS & COMPANY, 1901. Cloth, $3.00 net.

This book is intended to meet the needs of students of medicine in the acquirement of a knowledge of those principles upon which modern hygienic practices are based, and to aid physicians and health officers in familiarizing themselves with the advances made in hygiene and sanitation in recent years. The book is based on the most recent discoveries, and represents the practical advances made in the science of hygiene up to date.

Among the important subjects considered are Ventilation, Heating, Water and Water Supplies, Disposal of Sewage and Garbage, Food and Diet, Exercise, Clothing, Personal Hygiene, Industrial Hygiene, School Hygiene, Military and Naval Hygiene, Habitations, Vital Statistics, Disinfection, Quarantine, etc. The idea of the book is to give the reader a clear understanding of the general principles of this broad subject. It is a valuable addition to other recent works on the subject, showing gratifying evidence of the progress of sanitary knowledge and the demand for practical handbooks for inspectors and others in the public health service.

INDEX-CATALOGUE OF THE LIBRARY OF THE SURGEON-GENERAL'S OFFICE, UNITED STATES ARMY. Second Series, Vol. VI. G-Hernette, Washington: Government Print.

"This volume includes 15,589 author-titles, representing 5.865 volumes and 14,296 pamphlets. It also contains 5.962 subjecttitles of separate books and pamphlets, and 30,561 titles of articles in periodicals." It is gotten up in the excellent style common to the series.

ANNUAL REPORT OF THE BOARD OF REGENTS OF THE SMITHSONIAN INSTITUTION, for the year ending June 30, 1900. Washington, D. C.: Government Print.

Besides the report of the operating, expenditures and conditions of the Institution, it comprehends an appendix of some forty special papers and reports on scientific subjects. Especially notable