go, their sequence justifies the confidence expressed in my last letter
with reference to the feebleness of the present invasion of this pest.
There were recorded 170 cases of variolous disease from the begin-
ning of the epidemic to March 31, of which 8 were reported in No-
vember, 35 in December, 44 in January, 46 in February, and 37 in
March; figures which tell the same story of the decline of the
zymotic. But there were undoubtedly a number of cases which es-
caped registration, some persons shrinking from the notoriety of
having so loathsome a disease, and others fearing the inconvenience
of a visit from the health authorities, while the physician, if the case
was mild, risked, at his patient's solicitation, the danger of con-
cealment.
The cases were widely distributed over the city, being allotted
among two-thirds of the thirty-one wards into which Philadelphia
is divided; but the full force of the disease fell upon a group of three
contiguous wards (25th, 19th, and 31st), in the northern part of the
city, in which 107 of the 170 cases occurred; in an adjacent group
(28th, 29th, and 15th wards), 28 cases were reported, leaving 35 cases
to be divided among the fifteen remaining wards affected.

Of the 170 persons, who suffered from variolous disease, 94 had been vaccinated, 1 inoculated, and 1 both inoculated and vaccinated; 42 had been neither vaccinated nor inoculated, while the data were not given as regards 30. The statistics of the deaths from small-pox give a reverse proportion with reference to the numbers of victims vaccinated and unvaccinated, for of the 42 who died, 14 had never been vaccinated, 11 had been, while of 17 this point was not stated. Small though these figures are, they add their quota to the abundant testimony of the prophylactic power of vaccination, for it will be observed while the vaccinated who suffered from the disease were more than double the number of the unvaccinated, yet the deaths among the latter were much more numerous. Of those who died and were reported as having been vaccinated, only 3 bore good vaccinia cicatrices, in 6 the mark was indistinct, in 1 it could not be found, and concerning one person nothing was said on the subject.

To what degree the disease was checked by vaccination and other measures I will not venture a positive opinion, but the fact remains that there was an enormous number of vaccinations performed throughout the city. The vaccine physicians of the board returned for this quarter alone 10,171 cases successfully vaccinated, while by those physicians in private practice with whom I am acquinted, and of whom I have inquired on the subject, there was a very thorough vaccination or revaccination of the families under their charge. It is gratifying, as showing the increasing confidence of the people in sanitary measures, that the district physicans reported a much greater willingness on their part than in the past to accept and even to seek vaccination. And the hospital for contagious diseases seemed to be worked upon with more favor than in previous epidemics, since, compared with the whole number of cases reported, a much greater proportion than in former times left their homes to take shelter within its walls. With such feelings awakened in the masses, the applications of sanitary science must become easier with every year.

The mortality from measles, 61, is the outcome of a very extended epidemic of the disease in Philadelphia. I have no accurate data on which to base its exact prevalence, but from observation in my practice, and from conversation with other physicians, I am quite satisfied that the number of cases has been immense. The diffusion of the disease may be known by the wide distribution of the deaths, which were scattered through every ward in the city, save six. There was an aggregate, however, in the fifteenth ward, among a population of 48,472 inhabitants (according to the municipal census of 1876), of 11 deaths. The fatal cases were credited to the several months, as follows: January, 3; February, 20; March, 38; a sequence which gives no sign of the decrease of the zymotic. Past experience makes us look for the greater number of deaths in the second quarter of the year, so that it will not be surprising to find April, and perhaps the following months, furnishing a comparatively high mortality from this desease.

weather, and especially the unfavorable meteorological conditions of March.

The same disturbing influences were responsible for the augmented numbers of deaths from pneumonia and bronchitis, which were the chief factors in bringing up the mortality from local diseases to an aggregate more than 25 per cent. above that for the preceding quarter. This periodical increase in the number of deaths from these diseases should force upon our attention the wide field which is open for the broad-minded sanitarian from which to harvest and to scatter the truths which underlie the proper regulation of the agencies by which it is attempted to combat the baneful effects of cold. Its cultivation does not promise, perhaps, such brilliant results as the study of the means of stamping out zymotic diseases; but in the long run the yield must give the means of saving more lives to suffering humanity.

ABSTRACTS FROM CONSULAR REPORTS.

BORDEAUX, FRANCE.-The official report for the month of March gives a total of 457 deaths. Deducting 27 still-born, 7 suicides, and 7 from accidents, there remain 416 deaths from diseases. Of these 68, or 16.3 per cent., were from consumption; 24, or 5.8 per cent., from zymotic diseases; 93, or 22.3 per cent., from acute lung diseases. The population is not given, but the relative proportions indicate a very high rate of mortality from lung diseases."

PERNAMBUCO, BRAZIL.-United States Consul A. Cone, under date of April 8, reports that the general health of this city and the surrounding country is remarkably good. No infectious diseases are prevailing in epidemic form; there is always some small-pox, and a few cases of yellow fever occur among the shipping. Skin diseases are especially prevalent in Brazil, and pulmonary complaints are very fatal among the poorly fed lower classes.

SANTANDER, SPAIN.-Reports are received from this province, of 235,300 population, for the months of January and February. The following causes of death are reduced to the annual rate per 1,000 of population: Deaths from all causes for the two months, 1,251; rate, 31.9. Under 5 years, 388; rate, 9.9. Consumption, 171; rate, 4.36. Lung diseases, 178; rate, 4.54. Diphtheria and croup, 4 deaths; measles, 6; small-pox, 5; typhus and typhoid fevers, 9; whoopingcough, 10.

SPAIN. The official monthly bulletin gives statistics of 49 provinces, including a total population of 16,623,384. The number of births during the last four months of 1879 was 187,061, giving an annual The deaths in the same rate of 33.8 per 1,000 of population. The rate for conperiod were 171,509, or 30.9 per 1,000 per annum. sumption was only 1.36 per 1,000, the deaths being 7,574. Acute lung diseases, 14,887 deaths; rate 2.68. Deaths from small-pox, 5,398; measles, 2,948; scarlet fever, 851; diphtheria and croup, 3,267; whooping-cough, 1,801; enteric fever, 2,178, and malarial fevers, 3.49 per 1,000, small-pox being notably in excess as compared with 2,953. The total from these zymotic diseases was 19,396 deaths, or the United States. Deaths from dysentery 8,949, cholera 141, cholera infantum 3,164; total diarrheal diseases 12,254, or 2.20 per 1,000. Typhus fever caused 1,986 deaths, typhoid fever 2,178, and puerperal fever 3,291.

TURKS ISLANDS, WEST INDIES, April 15.-United States Consul F. P. Van Wyck observes that these islands enjoy a notable immunity from contagious diseases, which rarely spread when brought there from infected ports. The impregnation of the air with salt is considered of advantage to those suffering with chronic bronchial

affections.

MISCELLANEOUS.

Of

A report dated April 24 states that a fishing vessel arrived on the 20th from Yucatan, having on board a boy who was taken sick on the voyage. He was removed to hospital, and died two days after with black vomit. No yellow fever among the foreign shipping, and American masters are well disposed to adopt such measures of cleaning, fumigation, &c., as are suggested to them.

Allusion was made in my last letter to some cases of true typhus fever which had been brought to the almshouse hospital, and to the fact that one death from this disease had appeared in the mortality HAVANA, CUBA.-Advices to April 20 state that fifteen deaths from records. Now I have 6 deaths to chronicle, 1 in January, 1 in Feb-yellow fever occurred during the week ending on that day. ruary, and 4 in March. While to one acquainted with the diseases these six were in the city, and nine in the military hospital. Smallapt to prevail in Philadelphia, the rarity of typhus will excite suspox, which is never quite absent, is again increasing, and sixteen picion of the identity of cases so reported; yet there can be no deaths are reported for the week. doubt, from the reports of hospital physicians and from the investigations of Medical Inspector I. Howard Taylor, that there has been and there still remains typhus fever among us. But with the comparative absence of crowding in our population, and the comparatively good hygienic condition of the lower classes in Philadelphia, I do not think this conviction need lead to any alarm of a formidable appearance of this zymotic. Our board of health is exerting itself to have the cases isolated as they are reported, and to purify the dwellings and surroundings in which they are found. The origin of the cases, as traced by the inspector, has been among the shipping. The deaths from constitutional diseases were somewhat more numerous than in the previous quarter, owing to the greater fatality of tubercular diseases, especially consumption, which increased its mortality about 12 per cent. This advance, however, we are accustomed to anticipate at this season on account of the colder

NOTICE. All official communications to the National Board of Health should be addressed to the Secretary of the Board, Dr. T. J. Turner, U. S. N. Correspondents and others whose writing may be for publication are reminded that much inconvenience is caused by writing on both sides of the paper.

States and cities.

REPORT OF MORTALITY IN CITIES OF THE UNITED STATES FOR THE WEEK ENDING APRIL 24, 1880.
CITIES IN WHICH BURIAL PERMITS ARE REQUIRED.

REPORT OF MORTALITY IN CITIES OF THE UNITED STATES FOR THE WEEK ENDING APRIL 24, 1880-Continued. CITIES IN WHICH BURIAL PERMITS ARE REQUIRED.

NOTE.-Boston has 370,000 white, 5,000 colored; deaths, 147 white, 3 colored. Rate per 1,000, white 20.7, colored 31.3. Providence has 98,200 white, 3, 800 colored. deaths, 40 white, 1 colored. Rate per 1,000, white, 21.2, colored, 13.7. Wilmington, Del., has 38,000 white, 6,000 colored; deaths, 19 white, 2 colored. Rate per 1,00 white 26.1, colored 17.3. Baltimore has 343,715 white, 56,285 colored; deaths, 93 white, 34 colored. Rate per 1,000, white 13.9, colored 31.5. District of Columbia has 114,000 white, 56,000 colored; deaths, 27 white, 41 colored. Rate per 1,000, white 12.3, colored 38.4. Norfolk has 14,900 white, 11,300 colored; deaths, 5 white, 3 colored. Rate per 1,000, white 17.5. colored 13.8. Richmond has 46,000 white, 34.000 colored; deaths, 8 white, 14 colored. Rate per 1,000, white 9.0, colored 21.5. Lynchburgh has 10,000 white, 11,000 colored; deaths, 1 white, 6 colored. Rate per 1,000, white 5.2, colored 28.4. Wilmington, N. C., has 6,714 white, 10,286 colored; deaths, 2 colored. Rate in table. Charleston has 25,000 white, 32,000 colored; deaths, 8 white, 26 colored. Rate per 1,000, white 16.7, colored 42.4. Augusta has 16, 176 white, 10,824 colored: deaths, 1 white, 7 colored. Rate per 1,000, white 3.2, colored 33.7. Atlanta has 25,373 white, 16, 175 colored; deaths, 5 white, 4 colored. Rate per 1,000, white 10.2 colored 12.9. Jacksonville, Fla., has 7,000 white, 5,000 colored; deaths, 6 white, 1 colored. Rate per 1,000, white 44.7, colored 10.4. Mobile has 28,000 white, 12,000 colored, deaths, 7 white, 14 colored. Rate per 1,000, white 13.0, colored 65.8. Selma has 3,082 white, 3,988 colored; deaths 3 white, 2 colored. Rate per 1,000, white 50.8, colored 26.1. New Orleans has 155,000 white, 55,000 colored; deaths, 69 white, 33 colored. Rate per 1,000, white 23.2, colored 31.3. Shreveport has 4,500 white, 5,000 colored: deaths, 3 white, 1 colored. Rate per 1,000, white 34.7, colored 10.4. Austin has 12,000 white, 4,000 colored; deaths, 1 white, 3 colored. Rate per 1,000, white 4.3, colored 39.1. Memphis has 16,705 white, 13,954 colored; deaths, 7 white, 10 colored. Rate per 1,000, white 21.8, colored 37.4. Nashville has 26,000 white, 11,000 colored; deaths, 8 white, 5 colored. Rate per 1,000, white 16.0, colored 23.7. Chattanooga has 7,860 white, 5,020 colored; deaths, 2 white, 4 colored. Rate per 1,000, white 13.2, colored 41.5. Clarksville has 3,000 white, 3,000 colored; deaths, 6 colored. Rate in table. Louisville has 153,125 white, 21,875 colored; deaths, 38 white, 20 colored. Rate per 1,000, white 12.9, colored 47.7. Jacksonville, Ill., has 14,500 white, 500 colored; deaths 2 white, 1 colored. Rate per 1,000, white 7.2, colored 104.3. Total white population, 1,538,850; deaths, 500; annual rate per 1,000, 16.9. Total colored population, 393,007; deaths, 243; annual rate per 1,000, 32.2.

The following reports, for the week ending April 24, are from places requiring burial permits and having less than 5,000 population:

Bridgewater, Mass., 4,000; one death. Brunswick, Ga., 4,000; deaths, 4; under 5 years, 3; diarrhoea 1, pneumonia 1. Edgartown, Mass., 1,400; no deaths. Morgan City, La., 2,500; deaths, 2. Murfreesborough, Tenn., 3,500; no deaths. Saint Augustine, Fla., 2,500; one death. San Diego, Cal.; 3,000; deaths, 4; under 5 years, 1; consumption 2, lung disease 1, whooping-cough 1. Shelbyville, Tenn., 2,000; no deaths.

Total population, 22,900; deaths under 5 years, 4; total deaths, 12; annual rate per 1,000, 27.7.

deaths, 2; enteric fever 1, malarial fever 1. Ocala, Fla., 1,000: diphtheria 1, under 5 years. Oshkosh, Wis., 18,000; one death. Ox

ford, Miss., 2,000; no deaths. Painesville, Ohio, 5,000; pneumonia 1. Pontotoc, Miss., 600; consumption 1. Port Gibson, Miss., 1,100; two deaths. Port Jervis, N. Y., 10,000; deaths, 5; under 5 years, 1. scarlet fever 1. Portsmouth, Va., 14,000; one death, under 5 years. Ripley, Miss., 1,000; no deaths. Rock Island, Ill., no deaths: pop ulation not given. Rockland, Me., 7,000; deaths, 3; enteric fever 1. pneumonia 1, old age 1. Santa Cruz, Cal., 5,000; one death, under 5 years. Springfield, Ohio, 23,000; deaths, 8; under 5 years, 2: consumption 1, diarrhoea 1, scarlet feverl, pneumonia 1. Starkville. Miss., 1,163; no deaths. Tampa, Fla., 1,200; no deaths. Titusville. Pa., 9,000; two deaths. Tuscaloosa, Ala., 4,000; no deaths. Verona. Miss., 1,000; no deaths for two months. Wesson, Miss., 2,000; one death. Winchester, Va., 5,500; one death. Winona, Minn., 10,000; pneumonia 2, whooping-cough 1. Total population, 467,866; deaths one death. Youngstown, Ohio, 17,000; deaths, 6; under 5 years, 2; under 5 years, 25; total deaths, 121; annual rate per thousand, 13.5.

NOTICE. In filling the reports on the postal cards for cities and hospitals, the figures are frequently so placed between the lines as to leave the disease intended entirely uncertain, except in cases where the judgment of the compiler may enable him to determine which is meant. This may be avoided by a stroke of the pen after the disease to be recorded. The total numbers should be placed in their proper columns, and no figures placed immediately after the word total will be noted in the tables. Those who report still-births will please note them separately, as they are not included in the tables of mortality in the BULLETIN.

The following reports, for the week ending April 24, are from places in which burial permits are not required: Alexandria, Va., 13,000; deaths, 4; under 5 years, 1; consumption 1, old age 1. Allegheny, Pa., 75,000; deaths, 10; under 5 years, 2; consumption 1, croup 1, lung diseases 2. Bath, Me., 10,000; deaths, 3; under 5 years, 1; consumption 2. Belfast, Me., 5,278; one death. Boulder, Colo., 3,500; no deaths. Brattleborough, Vt., 6,500; deaths, 2; pneumonia 1. Calais, Me., 7,000; deaths, 2; under 5 years, 1; consumption 1, diphtheria 1. Cambridge, N. Y., 1,900; one death. Carrollton, Miss., 600; no deaths. Chatham, Conn., 3,000; no deaths. Chillicothe, Mo., 4,750; deaths, 2. Clinton, Mich., 1,200; no deaths. Columbus, Ga., 10,000; deaths, 2; measles 1. Corinth, Miss., 2,300; pneumonia 1, under 5 years. Dallas, Tex., 20,000; deaths, 3; under 5 years, 1; diarrhea 2, enteric fever 1. Davenport, Iowa, 27,000; deaths, 5; under 5 years, 2; scarlet fever 1, whooping-cough 1. Dunkirk, N. Y., 8,000 (for two weeks); deaths, 7; under 5 years, 1; consumption 1, pneumonia 1. East Haven, Conn., 1,200; two deaths. Fairfield, Conn., 4,000; deaths, 3; consumption 1, malarial fever 1, pneumonia 1. Fayette, Miss., 300; no deaths. Greenville, Ala., 4,500; no deaths. Gunn City, Mo., 125; no deaths. Helena, Mont., 3,500; deaths, 3; lung diseases 2. Huntingdon, Pa., 4,500; no deaths. dianola, Tex., 900; no deaths. Iuka, Miss., 1,000; whooping-cough 1. Jefferson, Tex., 3,000; puerperal 1. Kenosha, Wis., 5,000; deaths, 3; consumption 1, pneumonia 1, old age 1. Lansingburgh, N.Y., 7,150; deaths, 4; consumption 1, enteric fever 1, malarial fever 1, puerperal 1. Lebanon, Pa., 9,000; pneumonia 1, under 5 years. Little Falls, N. Y., 5,900; pneumonia 1. Louisiana, Mo., 5,200; deaths, 2; puerperal 1. Madison, Ind., 12,000; deaths, 5; diphtheria 1, pneumonia 1. Marquette, Mich., 4,000; consumption 1. Martinsburg, W. Va., 6,000; consumption 1. Meridian, Miss., 5,500; one death. Milledgeville, Ga., 4,000; deaths, 2; under 5 years, 1, consumption 1, measles NOTICE.-Extra copies of the BULLETIN will be fur 1. Monmouth, Ill., 6,000; deaths, 4; under 5 years, 3. Mount Pleasant, Iowa, 5,000; scarlet fever 1. Muscatine, Iowa, 7,500; consump-nished at this office at the rate of five cents per copy. Notice tion 1. Muskegon, Mich., 13,000; deaths, 3; under 5 years 1, con- of at least one week should be given when a large number sumption 1, diphtheria 1, pneumonia 1. Natchez, Miss., 10,000;

In

NOTICE.-The populations of cities of the United States adopted in the tables of the BULLETIN are those furnished by the city authorities to the National Board of Health. They differ in some cases from the figures given in mortuary reports.

deaths, 4; under years 1, croup 1. New Britain, Conn., 12,000; is required.

REPORTS FROM HOSPITALS IN THE UNITED STATES FOR THE WEEK ENDING APRIL 24, 1880.

REPORTS FROM HOSPITALS IN THE UNITED STATES FOR THE WEEK ENDING APRIL 24, 1880-Continued.

CORRESPONDENTS OF THE NATIONAL BOARD OF HEALTH.

PRESTON H. BAILHACHE, M. D., U. S. M. H. S., 1316 R st., N. W., Washington, D. C.
SAMUEL M. BEMISS, M. D., &c., 558 Saint Charles street, New Orleans, La.
JOHN S. BILLINGS, M. D., United States Army, 84 Gay street, Georgetown, D. C.
HENRY I. BOWDITCH, M. D., &c., 113 Boylston street, Boston, Mass.

JAMES L. CARELL, M. D., &c., University of Virginia, Va.
HOSMER A. JOHNSON, M. D., &c., 4 Sixteenth street, Chicago, Ill.
ROBERT W. MITCHELL, M. D., &c., 34 Madison street, Memphis, Tenn.
SAMUEL F. PHILLIPS, esq., Solicitor-General, 1119 K street, Washington, D. C.
STEPHEN SMITH, M. D., &c., 31 West Forty-second street, New York.
THOMAS J. TURNER. M. D., U. S. N., 1227 M street, N. W., Washington, D. C.
TULLIO S. VERDI, M. D., &c., 815 Fourteenth street, N. W., Washington, D. C.