among patients applying for treatment, and although many who applied subsequently found their way to the smallpox hospital, so carefully did those in charge of the various dispensaries and general hospitals manage such cases that in no instance could the spread of the disease be traced to exposure at such an institution. Cases did, however, find their way into the male workhouse, and into the Central Union Mission, which necessitated the quarantining of all of the inmates of the former, and some of those of the latter, for the statutory period, sixteen days. The advantage of having a smallpox hospital more or less suitable for the work for which it was intended was repeatedly demonstrated during the outbreak. The only real defect in the hospital accommodations which have been established proved to be the insufficiency of the heating apparatus, which rendered it necessary to rely on gas-heating stoves as auxiliaries to a certain extent, and at times altogether. It is important that this defect be corrected as soon as possible.

While the hospital accommodations proved sufficient for all cases, the health department was embarrassed for a time by the absence of a place to which inmates of infected houses could be moved when their own premises were being disinfected and where they could stay during the quarantine period if they so desired. The want was met at a later period in the outbreak by renting certain buildings in the vicinity of the smallpox hospital for such purposes.

In any case, treating a large number of persons suffering from smallpox and quarantining those who have been exposed to the disease involve very great expense, and the present instance was no exception to the rule. At one time it looked as if available funds might be exhausted by the unusual drain upon them, and such would have been the case had Congress not been in session and had it not met the emergency with an appropriation of $50,000. The approximate cost of the outbreak up to June 30 was $25,785.70.

House to house inspections were made only as special circumstances seemed to indicate. No search of the city as a whole was ever undertaken. General vaccination was, however, effected, partly through the agency of the dispensaries, which willingly lent their assistance, and partly through physicians appointed for the purpose, and who went from house to house offering their services. Although the power conferred under the law to enforce vaccination in a general way was never exercised, approximately 22,000 were vaccinated through Government agencies. When to this number is added the number of those who were vaccinated by physicians acting in a private capacity, some idea can be formed as to the extent to which the community as a whole has been protected. The following statement shows the amount of work done by the vaccine physicians in the employ of the health department, and the results: The entire number of vaccinations effected was 16,175, of which 6,377 were primary, and 9,798 were secondary. Of the primary vaccinations it was not possible to inspect more than 5,691, because the persons vaccinated could not be found; of the number inspected 5,313 were successful and 378 unsuccessful, the corresponding percentages being 93.34 and 6.64. Of the secondary vaccinations 8,672 were examined, and 7,358 found to have been successful and 1,314 unsuccessful; the corresponding percentages were 84.84 and 15.16.

The uncertainty of legislation was demonstrated in an effort to institute proceedings against a physician who had visited a case which he suspected of being smallpox, and so informed the family, but who then failed to visit the patient for seven days, to take any steps to confirm or to disprove his suspicion until his second visit, or to establish any efficient quarantine. The second visit, however, convinced him that he

had a genuine case of smallpox to deal with, and he reported the case to the health department by mail. The idea of such delay on the part of a physician when the community had so much at stake had, apparently, never entered the minds of those who drafted the current law relative to major contagious diseases, and the attorney had to report, therefore, that there was no provision which would compel a physician to use diligence in arriving at his diagnosis. While such neglect on the part of physicians is rare, as has been demonstrated by the experience of the health department in the previous outbreaks of contagious diseases of this character, there should be legislation whereby anyone who may offend can be punished.

In this connection, the faithful performance of duty by those engaged in the smallpox service during the time of the great storm, February 14, and several days following, is worthy of mention. While the public was sympathizing with the police in their suffering in the discharge of their duty, and wondering what would happen if the services of the fire department were suddenly needed. the watchmen in the smallpox service were patiently doing service at their posts of duty, and the physicians and others engaged in the examination of suspects, in the removal of patients to the hospital, in the disinfection of houses, and in supplying food and fuel to those in quarantine were doing their work in spite of cold, snow, and wind, of broken harness, wrecked vehicles, and exhausted horses. And all was done so quietly that people did not stop to think what would be the result if the smallpox service were to be interrupted by the storm.

CONTAGIOUS DISEASES AMONG ANIMALS.

The number of cases of contagious diseases among animals, which is reported to the Health Department, is never large. Probably it never represents any considerable part of the cases which occur, because in many instances the sickness and death of such creatures is not under the observation of those familiar with the maladies from which they suffer. On the other hand, many of the conditions which the laity believe to represent contagious diseases among animals are by no means diagnostic, and suspicions are aroused when there is no good reason why they should be.

Rabies. The number of cases of hydrophobia reported to the health office during the past year was 13. In each instance the remains of the animal supposed to have suffered from the disease were taken to the Bureau of Animal Industry, where, through the courtesy of Dr. D. E. Salmon, the chief of that bureau, such tests were made as were necessary to determine the real nature of the sickness. In eight cases the diagnosis was confirmed and in five cases the results were negative.

Glanders.-There were only three cases of glanders reported during the year. On account of rumors which reached the health department of the existence of this disease among the horses belonging to the United States Army which were in the corral at St. Asaph's Junction, Virginia, and about to be sold at public auction, and in view of the likelihood of a large number of such horses, if sold, finding their way into the District of Columbia, an investigation was made and the existence of the disease demonstrated. Acting in conjunction with the Federal Bureau of Animal Industry and the State veterinarian of Virginia, the attention of the Quartermaster's Department of the Army was called to the spread of glanders likely to result if the proposed sale should be consummated, and as a result it was postponed, and afterwards all animals in the corral were tested with mallein before being sold.

Texas or splenic fever.-Two carloads of southern cattle infested with the Texas fever tick, Boophilus bovis, found their way to the stock yards at Bennings. They were, however, not allowed to leave the premises except for slaughter, and were killed at the abattoir adjoining, so that no harm resulted from their importation. An outbreak of this disease occurred at Silverhill, Md., near the District of Columbia, and from which certain of the milk supply of this city is derived. It resulted in the loss of the entire herd of dairy cows through the entrance of one Southern cow into it.

Actinomycosis.-Three cattle suffering from actinomycosis were killed under supervision at various slaughter houses. Three milch cows suffering from the same disease were found on dairy farms and were condemned. The diagnoses in these cases were proved by microscopical examination.

Tuberculosis.-So far as can be determined by physical examination, tuberculosis among dairy herds in the District of Columbia and such adjacent territory as has been covered by the inspection of the health department seems to be decreasing. This decrease is probably due to the inspection, and to the general enlightenment of dairy farmers on this subject. The tuberculin test would, however, probably show a large percentage of dairy cows to be suffering from tuberculosis. Such examinations as have been made in this vicinity at the request of dairymen have given results varying from the complete absence of the disease from the herd in one instance, to its presence in 50 per cent of the cattle in another.

Hog cholera and swine plague.-A few cases of these diseases occurred in the District in the fall of 1898, but the outbreak was not at all general.

PERMITS TO OBSTUCT TRAVEL.

There were issued during the year 61 permits to obstruct travel so as to secure quiet for persons seriously ill. This is an increase of 17, or 39 per cent since last year. The number remains, however, lower than during any other year since 1892-93. The average length of time covered by each permit has, however, increased from 7.8 days to 8 days, which has been exceeded only once during the past seven years. The number of physicians responsible for such permits increased from 40 to 48. The judgment of the health department remains the same as heretofore, viz: That the practice of issuing permits for the obstruction of travel on account of illness should be discontinued until such time, if ever, as it may be authorized and regulated by positive legislation.

TABLE I.-Permits issued to rope off streets and alleys to cause temporary suspension of travel in consequence of serious illness, etc., during seven years ended June 30, 1899.

CHEMICAL LABORATORY.

The work done in the chemical laboratory during the past year has been quite as varied in character, and even greater in amount than heretofore. While the greatest number of analyses which have been made have had reference to foods, drugs, or beverages, the proper field for the work of the health department, some have referred to articles submitted by the police department for the purpose of assisting in the detection of crime The total number of specimens examined was 707. Of these 213 were water, 273 milk, 53 cream, 76 foods, 80 drugs, and 12 miscellaneous articles submitted by the police department.

Of the samples of water analyzed, 149 came from public wells. In 16 cases it was found to be unfit for drinking purposes, and in 6 instances the results showed it to be of doubtful potability. Of 46 samples of water from private wells, 12 gave results warranting the condemnation of the wells, and in 2 instances justifying the classification of the water as suspicious.

Among the more important results accomplished by the analysis of foods may be mentioned the discovery of four instances in which adulterated lard was sold for the genuine article. On the basis of the analyses in these cases 3 dealers were fined, and in one case the personal bonds of the offending party were taken. For the sale of adulterated cream of tartar, 6 prosecutions were instituted, which resulted in 1 dealer being fined and 5 being put under personal bonds. Of the 8 samples of cider which were analyzed not one was genuine and 2 contained salicylic acid. Four samples of bread examined to ascertain whether or not alum had been used in its preparation yielded negative results. Eleven samples of so-called butter were found to be oleomargerine, and in one instance the dealer was fined for its sale.

More attention was paid to the examination of milk than to any other article of food. Two hundred and seventy-three analyses were made. In 19 instances the analyses had reference to samples submitted by citizens, in 69 to samples collected at the Baltimore and Ohio depot, and in 185 to samples collected at random throughout the city. The average percentage of fat contained in the samples collected at the Baltimore and Ohio depot was 4.02, and in those collected in the city, 4.20. One hundred and forty-six of the latter samples were examined as to acidity. Five showed an acidity calculated as lactic acid, varying from 1.08 per cent to 3.25 per cent-so excessive that it has been deemed best to omit them in calculating the average acidity of the samples collected. The average of the remaining 141 samples was 0.52 per cent, the figures varying from 0.27 per cent to 0.96 per cent. Of the entire number, 79 were above and 62 were below the average. This aspect of the milk question will receive further consideration from time to time, and an effort will be made to correct existing conditions. Three samples of cream were collected at the Baltimore and Ohio depot and 50 came from various parts of the city. Eleven samples were found to have been colored, and the result was the imposition of fines on 7 dealers and the forfeiting of collateral by 1. Seven samples of cream did not contain the required amount of butter fat, and for this 6 dealers were fined and 1 forfeited collateral.

Bacteriological examinations of milk have been made by the inspector of dairy farms in 146 instances. In these samples the number of organisms varied from 2,592 to 6,400,000 per cubic centimeter. Most of the specimens were taken from the wagons of milk dealers who produced the milk which they sold, on their own farms, and the results corresponded closely with what might have been anticipated from a

knowledge of the more or less cleanly condition of the premises and the more or less ignorant and careless methods of handling the milk. The value of the electric centrifuge as an aid in the examination of milk was demonstrated in the work of this office during the year by the readiness with which the pus corpuscles were discovered in samples centrifugalized.

The examination of 45 specimens of spirits of nitrous ether, commonly called sweet spirits of niter, collected from various drug stores throughout the city, showed that in only two instances did it conform to the recognized standard. In view of the liability of this preparation to rapid deterioration, no prosecutions were brought, but the druggists responsible for its sale were notified of its condition. The analysis of 15 samples of Hoffmann's anodyne, otherwise known as compound spirits of ether, showed that 7 contained no ethereal oil and 2 contained only a trace of it. Prosecutions are pending against most of the parties responsible for the sale of these samples.

The apparent failure of the health department to institute prosecutions in a large number of cases, against dealers who were found to have sold adulterated foods and drugs is due to the fact that one of the necessary witnesses was directed by the judge of the police court, before whom such cases would necessarily have been tried, not to appear in court so long as he had any connection with the smallpox service. His connection with such service continued so long that it was not deemed advisable to institute proceedings after it had ceased. The nature of his duties was such, however, that there was at no time any good reason why he could not have appeared as a witness without danger to either the judge or any of the officers of the court.

A more detailed statement relative to the work of the chemical laboratory appears in the report of the chemist, and data and suggestions relative to the inspection of milk in the report of the inspector of live stock and dairy farms in the appendix to this volume, to which attention is respectfully invited.

INSPECTION SERVICE.

NUISANCES.

A statement of the number and character of the nuisances which have been abated at the instance of this department appears below. The total number was 11,915, a decrease of 2,774 since last year. The most frequent source of complaint has been the condition of yards connected with dwellings and stores; 2,662 nuisances of this character have been discovered and abated or referred to the attorney to enforce abatement by legal process. Next in order follow nuisances connected with privies; in 2,546 cases action has been necessary in order to secure the removal of the contents of such places; in 807 they were found to be filthy; in 102 they were found to be unlawfully located; and in 104 to be provided with leaky receptacles. Privy vaults have required action in 27 cases, and 40 notices have been necessitated by the entire absence of privy accommodations for inhabited dwellings and stores. The condition of water closets was the occasion of the service of 872 notices; leaky or obstructed sewers, of 781; negligent care of garbage, of 855; and defective surface drainage of an equal number. The largest number of nuisances occurs in the summer months. The number dealt with in the month of February was diminished by the occurrence of the great storm, which kept insanitary conditions of all sorts