infancy increased from 83 to 130; those from trismus nascentium decreased from 24 to 11. An examination of the mortality tables shows a decrease in the number of deaths from organic brain diseases from 61 to 33. This decrease, however, is believed to be apparent rather than real and to be the result of changed methods of classification, as the number of deaths which have occurred in the Government Hospital for the Insane during the past year remains practically the same as during the year preceding.

Diseases of the circulatory system have been responsible for 565 deaths. The principal cause of deaths of this class has been valvular heart disease, 450 deaths, an increase of 76 since last year. The largest number of fatal cases from this affection occurred among persons between the sixty-first and the seventieth years of life, inclusive.

In considering diseases of the respiratory system, it is important to have in mind the fact that pulmonary tuberculosis is not classed with them, being regarded as one of the general diseases. With this understanding, diseases of the respiratory system caused 712 deaths. The principal factor in such morality has been pneumonia, 462 deaths. The greater part of these occurred between December and April, inclusive, the average mortality during these months being 58.2, while the average mortality during the remainder of the year was 18.43. Acute bronchitis caused 82 deaths, chiefly among children in the first five years of life. Chronic bronchitis caused 46 deaths, and, as distinguished from the acute form of this disease, prevailed chiefly among persons more than 50 years of age.

Seven hundred and thirty-six deaths were charged to diseases of the digestive system, of which 451 occurred among children less than 5 years old. There were no material variations in the number of deaths occurring from the individual diseases which go to make up this mortality. Diseases of the genito-urinary system were responsible for 365 deaths. Acute nephritis, reported as such, caused 47 deaths, and chronic nephritis 168, while Bright's disease was certified to under that name as the primary cause of death in 52 instances.

Pathological conditions incident to the puerperal state caused 48 deaths, diseases of the skin and cellular tissue 20, diseases of the organs of locomotion 14, and malformations 19. Four hundred and forty-one deaths were charged to conditions peculiar to infancy, premature births in 141 instances, marasmus in 98, and simple congenital debility in 71. Senile debility was recorded as the cause of 149 deaths, a decrease of 59; senile dementia as the cause of 12, an increase of 9. There have been during the year 189 deaths due to other than natural causes. Of these, 29 were suicidal, 143 accidental, 15 due to criminal homicide, and 2 due to legal execution. Of the decedents from these causes, 119 were white and 70 colored, 133 male and 50 female. There is the usual marked disproportion between the number of suicidal deaths which have occurred in the white and in the colored races, the former showing 25 and the latter but 4. The prevailing mode of self-destruction has been by poison, 9 having taken substances of this character by the mouth and 6 having inhaled illuminating gas. Suicidal gunshot wounds were responsible for 6 deaths, and hanging for 4. Two of those who committed suicide during the last year were between 10 and 20 years of age, both of whom died by poison. Among the accidental deaths, in 34 instances the cause was falls, in 34 burns or scalds, and in 20 drowning. The number of accidental deaths from

REPORT OF THE HEALTH OFFICER.

HEALTH DEPARTMENT, DISTRICT OF COLUMBIA,

Washington, June 30, 1900.

GENTLEMEN: I have the honor to submit the following statement relative to the operations of the bealth department and the condition of public health in the District of Columbia during the year ended June 30, 1900, being the twenty-first annual report of the department since it was first organized on its present basis.

VITAL STATISTICS.

POPULATION.

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The population of the District of Columbia as shown by the United States census taken in June, 1900, was 278,718. The average density of population is therefore 7.23 per acre, if we exclude the area covered by water; otherwise, 6.28 per acre. No computation has yet been made by the Census Bureau as to the distribution of population by race, age, or sex, and in view of the wide discrepancy between the total population as shown by the Federal census and the total population as calculated by this department on the basis of the latest police censuses and of the school enrollments, it has been deemed best not to undertake to calculate death rates for races, sexes, or ages on the basis of an estimated population, but rather to defer the compilation of such data until the returns from the recent census shall have been completed. As the Federal census was taken in June, 1900, while the middle of the year covered by this report occurred in December, 1899, it has been necessary to compute the probable population at the latter time, representing, as nearly as can be ascertained, the average daily population during the year. This has been done, therefore, upon the basis of a supposed increase of the population in a geometrical ratio since the latest police census, April, 1897, without considering any of the factors which may possibly have led to the presence of an unusual number of people in this District in December.

MORTALITY.

The total number of deaths from all causes which occurred during the fiscal year ended June 30, 1900, was 5,953, a decrease of 73 in the actual number of deaths since last year. The death rate was there

'The area of the District is 69.25 square miles, of which 9 square miles are covered by water.

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fore 21.37 per thousand, a decrease of 0.28. The average annual death rate during the past five years has been 20.95. Of the decedents 3,325 were white and 2,628 colored, the decrease in the former being 47 and in the latter 26. The population, number of deaths, and death rates in this District during the past quarter of a century are shown in the following table:

TABLE A.-Population, deaths, and death rates for the twenty-five years ended June 30, 1900, based upon results of police censuses, and of the United States census of June, 1900.

NOTE. This table is corrected to date. The returns of the Federal census of June, 1900, relating to the distribution of population by color, have not been received and the death rate by races can not be calculated at the present time, October 10, 1900.

Classifying by sex we find 3,056 of the deceased were males, a decrease of 148 since last year, and 2,897 were females, an increase of 75.

of

Distributed by age, 1,843, or 30.96 per cent of the total mortality, occurred during the first five years of life and 1,314, or 22.08 per cent, during the first year. Of all white decedents 795, or 23.90 per cent, were less than 5 years old, and 560, or 16.84 per cent, were less than 1 year of age. In the colored race the deaths of children under 5 years age amounted to 1,048, or 39.88 per cent of the total colored mortality, and those of children in the first year of life numbered 752, or 28.61 per cent. The average age of all decedents was 32 years, 2 months, and 24 days; of the whites alone, 39 years, 2 months, and 11 days, and of the colored, 25 years, 3 months, and 6 days. These figures do not vary materially from those of last year. Five persons were reported to have passed the century mark, 44 were over 90 years old, and 762 had lived beyond the allotted three score and ten.

The average number of deaths per week has been 114.02. During each of twenty-five weeks the number of deaths exceeded the average, and during each of twenty-seven weeks it was below. The largest number which occurred in any one week was 169, recorded during the

Full information as to the number of deaths which occurred each day, a general summary as to the daily character of such mortality with reference to disease and color, and a statement of the prevailing meteorological conditions, appear in the appendix. So also do data as to the distribution of mortality by locality.

TABLE B.-Deaths by classes, arranged by sex and color, with percentages and annual death rates, for the year ended June 30, 1900.

Total.

1,791 1, 534 1, 2651, 363 3, 325 2,628 5, 953 100.00 100.00 100.00 100. 00 21.36

The Bertillon system of classifying causes of death has been adopted during the past year, the chief reasons for doing so being the adoption of the system in many other places, and a desire on the part of this department to assist as much as possible in bringing about uniformity in vital statistics. It is recognized, however, that this classification is by no means perfect in its present form. The official classification as approved by the American Public Health Association, and an index thereto, are printed as an appendix to this report.

The first general subdivision of the Bertillon classification of causes of death is epidemic diseases, and includes typhoid fever, smallpox, measles, scarlet fever, whooping cough, diphtheria, and influenza (grippe). The total number of deaths due to diseases of this type was 667. There was an increased mortality from typhoid fever, measles,