The remarks made in reference to the sources of error in the corresponding table in reference to scarlet fever apply with equal force to the present instance.

While the incidence of diphtheria among the colored people was less than among the whites, the fatality was much greater, viz, 23.36 among the colored, 16.15 among the whites, and 17.74 among the population taken as a whole. These figures are, however, in each instance less than they have been for any one of the three preceding years. A detailed statement showing the relative fatality in cases treated with diphtheria antitoxic serum and those treated without it will be found in the report of the medical sanitary inspector. The status of this article as a remedial agent seems to be too well established to require further discussion.

The examination of cultures from cases suspected of being diphtheria has been continued as during the two preceding years, the cost being paid from the meager appropriation for the enforcement of the act to prevent the spread of scarlet fever and diphtheria. The extent of the demand for this service is indicated by the presentation of 942 primary cultures (viz, cultures from cases suspected of being diphtheria) for purposes of diagnosis, as against 593 during the year preceding. In only 44.59 per cent of these cultures were specific diphtheria bacilli found. The total number of cultures examined, both primary and secondary, was 2,179.

Disinfecting service.-It is to be regretted that no appropriation has been made for the maintenance of the disinfecting service, the estabhshment of which was authorized by the act of March 2, 1895. As a result, the disinfection of infected premises has to be intrusted to the unskilled, and in many cases unwilling hands of the occupants, with correspondingly unsatisfactory results. Such movable articles as require steam disinfection have been removed to the disinfecting station and properly treated. There have been disinfected in this manner 1,051 pillows, 578 mattresses, 568 blankets, 210 rugs, and 1,248 miscellaneous articles, making 3,655 pieces in all. Many of these, however, have probably been immediately reinfected upon their return to the imperfectly cleansed apartments from which they were taken. The public must look to the proper disinfection of infected premises for its immunity from contagious disease quite as much as to the proper isolation of the sick. And as in nearly every instance the families in which such diseases occur neither have nor are able to secure trained assistants to perform such disinfection, it is necessary that means be provided at public expense whereby this work may be done. An appropriation for the maintenance of a disinfecting service is, therefore, respectfully recommended.

Ambulance for contagious diseases.-An important addition to the equipment of the health department has been made during the past year by the purchase of an ambulance for the transportation of patients suffering from scarlet fever and diphtheria to the hospital, when hospital accommodations can be secured. It has already been of service in a number of cases.

Isolation wards.—It is expected that another step in advance will be made during the coming year by the erection of wards for the treatment of patients suffering from minor contagious diseases, for which an appropriation of $30,000 is now available. The assistance rendered during the past year by those in charge of Providence Hospital in receiving and caring for cases of scarlet fever and diphtheria is gratefully acknowledged. The fact that in treating such cases there has

been no spread of either disease in the vicinity of the hospital, or even in the institution itself, although improved appliances for preventing it have not been available, should have influence in convincing the public that a hospital or ward for the treatment of these diseases is not a menace to health.

Legislation. The law under which the scarlet fever and diphtheria service has been maintained is seriously in need of amendment to make it more effective. It was proposed to accomplish this purpose by including the diseases named in the provisions of the bill introduced during the second session of the Fifty-fourth Congress to prevent the spread of the graver contagious diseases, as smallpox, yellow fever, Asiatic cholera, etc., but it was found inexpedient to do so. It is hoped that the needed legislation can be secured during the approaching session of. Congress.

Expenses of service.-The cost of the scarlet fever and diptheria serv ice has been approximately $5,000.

MAJOR CONTAGIOUS DISEASES.

While the District of Columbia has not been afflicted with any of the graver forms of contagious disease during the past year, and with reference to most of them not for many years, if at all, it was thought desir able to secure the authority necessary for the proper management of any cases which may hereafter occur. For this reason a bill to prevent the spread of such diseases in the District of Columbia was presented to Congress, and became a law on March 3, 1897. Having now secured the right to regulate the management of such diseases, it is essential that money for carrying the provisions of the law into effect be made available for immediate use, should occasion require. For this purpose I have asked for an appropriation of $25,000.

Under the present system the emergency fund is the only appropriation from which the expenses of suppressing an outbreak of any of the diseases named can be met. The amount of this appropriation is usu ally $8,000, and from this it is necessary to meet all emergencies which are not otherwise provided for. For instance, the expense of removing the bodies of dead horses from the Knox fire was paid from this appropriation; so, also, was the cost of the removal of debris from the streets which resulted from the severe storm of September 29, 1896. When subject to draft for such purposes, it is evident that the fund may be almost entirely exhausted early in the fiscal year, or at least long before its close, so that the sum remaining for the suppression of an outbreak of any contagious disease may be insignificant. On the other hand, with the creation of a fund for this specific purpose, there will be no additional expense, as it will probably lie idle most of the time, being available only for the one purpose; but if, on the other hand, it is needed, it will be ready without delay, and prompt action is of prime importance in such matters. The establishment of an epidemic fund is therefore urgently recommended.

INSPECTION OF FOREIGN VESSELS.

There were inspected and passed at the port of Washington between July 1, 1896, and June 9, 1897, 8 vessels from foreign ports, 5 coming from St. Johns, New Brunswick, with cargoes of laths, and the remainder bringing asphalt from Trinidad. The inspection of such vessels was

States Marine-Hospital Bureau established a quarantine station at Alexandria, Va., at which all inbound vessels must be inspected and passed before being permitted to proceed to this city.

CONTAGIOUS DISEASES OF ANIMALS.

During the past year the District has been entirely free from glanders, and has had but one case of hog cholera.

Seven cases of alleged rabies have been investigated in the laboratory of the Bureau of Animal Industry, upon request of this department, but in only one case was the disease found to be present.

PERMITS TO ROPE OFF STREETS AND ALLEYS.

Under the order of the Commissioners of August 23, 1883, intrusting to the health department the issue of permits to prevent the passage of vehicles in neighborhoods where persons are so seriously ill as to make such a step necessary, there have been issued 417 permits, an increase of 81 since last year. And not only has the number of permits increased, but the average time of obstruction in each case was greater, being 9.20 days, as compared with 7 days during 1896, and the number of physicians from whom certificates were received has increased from 252 to 318; that is, the number of permits has increased 24 per cent, the average time covered by each permit, 31 per cent, and the number of physicians certifying, 26 per cent. From the preceding figures it is apparent that the demand for the issue of these permits is increasing without any sufficient explanation therefor.

TABLE I.-Permits issued to rope off streets and alleys to cause temporary suspension of travel in consequence of serious illness, etc.

In fact, there would seem to be less real need in this city for such obstruction of traffic on account of the large extent of asphalt streets than in other cities not so favored, but the custom of issuing such permit for this purpose, or permitting it to be done, does not prevail elsewhere. The practice, therefore, can hardly be justified on the score of necessity, except possibly in very rare instances. The recommendations contained in the preceding report for its restriction are therefore respectfully renewed.

CHEMICAL LABORATORY.

Attention is invited to the fact that the annual appropriation which has usually been made for the support of the chemical laboratory was withdrawn during the past year, entailing a serious drain upon the

contingent fund of the office, which was not increased to meet it. The work of the laboratory was therefore correspondingly hampered; and while the salary of the sanitary and food inspector in charge of this laboratory has been increased so as to be slightly more in keeping with the degree of technical education required, no provision has been made for an assistant to relieve him of the mechanical work of caring for apparatus, etc. The absence of such an assistant, who might be secured for a salary of from $600 to $800 per annum, is in the end an extravagance, since it very much diminishes the amount of work which can be done and increases the relative cost by causing the time of the chemist, which must be paid for at the rate of $1,500 per annum, to be occupied with the performance of minor details of office work. The estimates which have been submitted have included, therefore, an appropriation for the services of an assistant.

There have been analyzed during the year 588 specimens, of which 258 were milk, 6 cream, 185 water, 107 foods (including candies), 17 drugs, and 15 miscellaneous articles. Of the analyses included under the last heading, 5 were of specimens received from and analyzed for the coroner. The consideration of the results of the analyses of the samples of milk and cream will be found in connection with the general consideration of milk inspection, and of those of foods and drugs in connection with the memoranda in relation to the inspection of those articles.

Of the 185 samples of water examined, 115 were from public wells and 65 from private wells, the remaining 5 being analyses of Potomac

water.

Well water. Of the samples of water from public wells, 14.7 per cent, and of those from private wells 49.2 per cent have been found impure. This difference is due partly to the greater care exercised in the construction and maintenance of public wells, but it is brought about to a certain extent by the fact that analyses were made of water from public wells from time to time, as a part of the ordinary routine of the office work, and in the absence of circumstances pointing directly to pollution, while in the case of private wells no such supervision is exercised, analy ses only being made upon request of the owner, or when the department has reason to believe that impurities are present.

As shown by the report of the engineer department, 11 public shallow wells were closed during the year, representing 7.64 per cent of the entire number, and leaving 133 in use. Twenty deep wells have been sunk, making a total of 21 such wells now in use. One well of this character was abandoned owing to the presence of sodium chloride in excess, even after considerable depth had been reached.

Potomac water.-The chemical analyses of Potomac water have not revealed the presence in excessive amount of any of those ingredients upon whose presence the chemist depends in order to determine its "potability." The fallacy of chemical tests alone, however, as criteria of the quality of water from a sanitary standpoint is now so generally admitted that the above findings can not be allowed to negative the fact that intestinal bacilli have been repeatedly found in Potomac water. And while no bacilli have been found, at least so far as the information of this department extends, which could be positively identified as those of typhoid fever, or other specific disease, the finding of such organisms in any public water supply is exceedingly rare, judgment being usually based upon the presence of allied bacilli. It has been pointed out that the presence of such bacilli in the Potomac water may be due to harmless sources of contamination; that is, other than drain

but in view of the large number of people living in these towns and the present knowledge as to the unreliability of "self-purification" of running streams as a means of destroying contamination from such sources, this seems to be the most probable origin.

Because of the conditions pointed out above, this department recommended, December 2, 1895, that the Potomac basin be surveyed with especial reference to the present and prospective sources of contamination of our water supply, with a view to determining what measures, if any, were necessary to remove, and to prevent the recurrence of, pollution resulting therefrom. Col. George H. Elliott, U. S. A., formerly in charge of the Washington Aqueduct, had already recommended, in his annual report for 1894, that provision be made for a systemic monthly chemical and bacteriological examination of the Potomac water as it is sent to the city from the distributing reservoir. An effort was made during the past year to put into effect both of these recommendations by a joint resolution (S. R. 191) to establish a commission to investigate the sources of contamination of the Potomac River, etc. This was subsequently replaced by a proposed amendment to the sundry civil bill (H. R. 10292) which gave the entire work into the control of the Marine-Hospital Service, together with similar work in reference to public water supplies throughout the country, but this amendment was not passed.

The entire matter rests, therefore, in the same place as at the time when the previous recommendation of this department was made, which recommendation is, therefore, respectfully renewed.

School hygiene.-The report of the chemist, which will be found in the appendix, contains much valuable information in reference to the heating and ventilating of our school buildings. Owing to the insufficiency of the apparatus in the possession of the department at the time the investigation was made, the results were not, however, as complete as it was desired they should be. The work will, therefore, be continued.

The sanitary condition of the public schools of this District was the subject of an investigation by a committee appointed by the House of Representatives February 20, 1882, and consisting of Col. John S. Billings, then Surgeon, United States Army, Mr. John Eaton, then Commissioner of Education, and Mr. Edward Clark, Architect of the United States Capitol. Its report was printed in Miscellaneous Document No. 35, Forty-seventh Congress, first session. The conclusions of this committee, which are, it is believed, of sufficient importance to justify their quotation at length, were as follows:

(1) All sides of the building shall be fully exposed to light and air, for which purpose they shall not be less than 60 feet distant from any opposite building.

(2) Not more than three of the floors-better only two-shall be occupied for class

rooms.

(3) In each class room not less than 15 square feet of floor area shall be allotted to each pupil.

(4) In each class room the window space should not be less than one-fourth of the floor space, and the distance of the desk most remote from the window should not be more than one and a half times the height of the top of the window from the floor.

(5) The height of the class room should never exceed 14 feet.

(6) The provisions for ventilation should be such as to provide for each person in a class room not less than 30 cubic feet of fresh air per minute, which amount must be introduced and thoroughly distributed without creating unpleasant drafts, or causing any two parts of the room to differ in temperature more than 2° F., or the maximum temperature to exceed 70° F. The velocity of the incoming air should not exceed 2 feet per second at any point where it is liable to strike on the person. (7) The heating of the fresh air should be effected by indirect radiation. (8) All closets for containing clothing and wraps should be thoroughly ventilated. (9) Water-closet accommodations for the pupils should be provided on each floor. (10) The building should not occupy more than half of the lot.