9.786; annual death rate, 15.0; deaths under 5 years, 2,458; percentage of deaths under 5 years to total deaths, 25.0; deaths at 70 years and over, 1,724; deaths from zymotic diseases per 1,000 deaths from all causes, 123; from cerebrospinal meningitis, 21; typhoid fever, 194; malarial diseases, 12; scarlet fever, 45; measles, 27; erysipelas, 13; whooping-cough, 31; croup and diphtheria, 256; diarrheal diseases, 598; acute respiratory diseases, 968; consumption, 1,038; puerperal diseases, 87; diseases of the digestive system (not acute diarrhea), 617; diseases of the urinary system, 791; diseases of the circulatory system, 1,038; diseases of the nervous system, 1,044; cancer, 456; accidents and violence, 668; old age, 369; not classified, 1,503.

Smallpox has existed in few places till recently, and no deaths from it have occurred in the State for several months. With the advent of colder weather it has developed more widely, and in some localities unsuspected prevalence has existed for several weeks. The question has come to the State Department several times of late as to whether an embargo shall be placed against an adjoining town in which smallpox is prevalent. It would no doubt be entirely justifiable so far as the affected town is concerned, in case it is lax in the proper care of its cases, to place guards on the highways and shut off all communication with it. Self-preservation would sometimes seem to require this. But it is not recommended; first, because in certain cases where we have seen it done it has not proved to be effective as a remedial protection. But the chief reason is that it turns the public mind away from a measure of protection which is absolute to the 'individual and, if general, to the community, i. e., vaccination. The public need to have this constantly enforced. There is no other means of protection that has any comparative value.

Save in one direction compulsory vaccination is not on the statute books of this State. It is a law, however, that all unvaccinated persons shall be excluded from the public schools. This law is strictly enforced in many of our municipalities. Its constitutionality has been affirmed by the courts of the State. This has been just recently declared in a notable decision handed down by the Appellate Division of the Supreme Court, so that no question can ever arise as to its legality. The State Department of Health would reaffirm that an unvaccinated person is a menace to the public health; and to have smallpox is a crime against the community.

New York City, 3.732,903. Total number of deaths, 5,123; annual death rate, 16.01: Borough of Manhattan, 1,917,676—

Deaths, 2,708; death rate, 16.6; Borough of the Bronx, 268,341, deaths 393; 17.2; Borough of Brooklyn, 1,219,597, deaths 1,710; 15.6; Borough of Queens, 182,681, deaths 208; 13.0; Borough of Richmond, 72,608, deaths 104; 16.3.

Record of Deaths by Accident.

Commissioner Greene, of the Police Department, December 4 made public a list of figures regarding the number of deaths in New York City streets during the year 1902, in confutation of figures that, he said, have been published. He said that some papers in this city and throughout the country have published that 535 persons had been killed in the streets during 1902. This, he said, he had found to be excessive. From the reports of the Health Department, the Commissioner had found that only 365 persons were killed. Of this number, the Commissioner said, he wished to point out that 172 were killed by street railway lines. Trucks and wagons had killed 146, while automobiles only killed 9. Bicycles killed 2 and runaway horses killed 7.

CALIFORNIA. For record of plague in San Francisco for calendar year 1902 see Public Health Reports No. 52, December 26, 1902. A summary of cases since March, 1900, when the first case was officially reported, is as follows: Calendar year 1900, cases, 22; deaths, 22. Calendar year 1901, cases, 30; deaths, 25. Calendar year 1902, cases, 41; deaths, 41. Total cases of plague from January 1 to December 11, 1903, 17. Total cases of plague same period 1902, 41. November, 1903, 4 cases; total to date, 109. Los Angeles, 135,000.-Health report for November: Deaths, 246-32 under 5 years; death rate, 18.22. From specific infectious diseases, 74; tuberculosis, 51-4 had lived here less than three months, 5 between two, three and six months, 3 between six and twelve months, 18 between one and five years, 2 between five and ten years, 14 over ten years, 2 life, unknown, 2."

COLORADO.-Denver, 175,000. Report for September: Deaths, 245; premature and still births, 7. Death rate, per annum, 16.80. Deaths from phthisis, 57-56 contracted elsewhere; typhoid fever, 106 cases, 13 deaths; smallpox, 9 cases; chickenpox, 3 cases; diphtheria, 50 cases, 2 deaths; scarlet fever, 24 cases, 5 deaths; measles, 3 cases; whooping-cough, I death. Deaths from heart diseases, 12; pneumonia, 9; bronchitis, 3; nephritis, 12; cancer, 8.

CONNECTICUT.-Bulletin for October: Deaths, 1,123; 37 less than in September and 10 less than in October of last year, and 14 more than the average number of deaths in October for the five years preceding. The death rate was 14.4 for the large towns; for the small towns, 13.8; for the whole State, 14.8. Deaths reported from infectious diseases, including diarrhea, 269-23.9 per cent. of the total mortality.

Cases of infectious diseases reported: Smallpox, Putnam, 8; measles, 255 cases in 20 towns; scarlet fever, 103 in 32 towns; diphtheria and croup, 14 in 36 towns; whooping-cough, 94 in 13 towns; typhoid fever, 165 in 38 towns; consumption, 25 in II

towns.

DISTRICT OF COLUMBIA, 295, 103-90,353 colored. Report for the week ended December 5: Deaths, 112-29 under 5 years; one more than in the previous week and 14 more than during the corresponding period of last year; 68 were white and 44 colored. Death rates, 17.3 for the whites, 25.3 for the colored, and 19.7 for the entire population; 18.3 for white, 22.4 for colored, and 19.6 for entire population were the death rates for the previous week, and 13.8, 24.3, and 17.1, respectively, were the rates for the corresponding period of 1902. The prevailing causes of death were: pneumonia, 15; diseases of heart, 13; consumption, 12; malignant growths, 9; diseases of the kidneys, 8; and apoplexy, 5. There were 5 accidental deaths-4 from burns and scalds and 1 from railroad accident.

Cases of typhoid fever continue to diminish, there being 16 reported and 30 discharged, leaving on hand at the close of the week 114, as against 289 at the corresponding period of last year. Of diphtheria, 3 new cases were reported and 2 were discharged, which increased the number under treatment to 19 in all, confined to 17 premises. Scarlet fever also was increased by 3 cases, there having been 7 new cases reported and 4 discharged, making a total of 37 under observation in 26 premises.-Smallpox, no new cases, 2 cases in hospital.

INDIANA State Board of Health bulletin, October, as compared with September.-Typhoid fever is the most prevalent disease, 78 counties reporting the disease present, and deaths were reported from 64 counties. It was also the most prevalent malady last month. Rheumatism was reported as second in area of prevalence, while diarrhea occupied this position last month, but it has

fallen this month to seventh place. The order of prevalence was: Typhoid fever, rheumatism, intermittent fever, bronchitis, tonsillitis, scarlet fever, diarrhea, diphtheria and croup, pneumonia, influenza, pleuritis, erysipelas, measles, dysentery, cholera morbus, inflammation of bowels, whooping-cough, cholera infantum, cerebrospinal meningitis.

Smallpox.-324 cases and I death in 38 counties. This is a decided increase in the number of cases and area as compared with the preceding month, but a decrease so far as deaths are concerned. In the corresponding month last year 298 cases were reported, with 19 deaths, in 35 counties. We have, therefore, to record an increase as far as cases and area is concerned, but a decided decrease in regard to deaths.

The total number of deaths from all causes reported was 2,573, a rate of 12. The city death rate was 15.4, and the country death rate was 10.3. Tuberculosis claimed 256 victims, the rate being 120 per 100,000. The city rate for this disease was 154, and the country rate 102.4. Typhoid fever, 160; diphtheria, 63; pneumonia, 132; influenza, 8; cerebrospinal meningitis, 25; puerperal septicemia, 10; cancer, 105; violence, 146.

Iowa State Board of Health Bulletin for November reports cutbreaks of infectious diseases for the preceding month: Chickenpox in Des Moines; diphtheria in 8 localities; measles in 2; scarlet fever in 13; typhoid fever in 2; smallpox, II cases in 6 localities.

We have received a large number of letters from Arlington and vicinity relative to an epidemic of smallpox there. One party reported 66 cases. The schools have been closed, public gatherings prohibited and business more or less demoralized. The burden of the correspondence is whether quarantine may not be “raised” at an earlier date than that prescribed by the Board. From outside. sources where persons have gone from Arlington and taken down with smallpox it is alleged that quarantine is but indifferently enforced and that the disease is called "Cuban itch."

Later.-A letter from Mayor Osborn states that the doctors did recognize the disease as smallpox and so reported it, and that it was promptly quarantined. The cause of its wide spread is to be accounted for.

"It is evident that the above does not fairly represent the actual number of outbreaks that have occurred throughout the State, as there must be many such outbreaks that are not reported to the

Secretary. Every such report is carefully registered by the Secretary and published in the Bulletin.”

ILLINOIS. Statement of mortality for the month of November, 1903, compared with the preceding month and with the corresponding month of 1902. Death rates computed on estimated midyear populations of 1,885,000 for 1903 and of 1,820,000 for 1902:

KENTUCKY.—Annual report of the Health Department of Louisville for the fiscal year ending August 31, 1903: Our population is now estimated at 225,053, of which 182,293 are white and 42,760 are colored. Total deaths for the year was 3,782. Of this number 2,722 occurred in the white and 1,060 in the colored population. Using these figures as a basis of calculation, it will be observed that our total death rate for the past year was 16.8 per 1,000 inhabitants. The death rate as occurring in the white population was 14.9, while it was 24.78 in the colored population. "I have accounted for the high death rate in our colored popula