which make the chief contribution to infant mortality; and deaths from accidents were slightly fewer (558 as compared with 594). Infant mortality — the ratio of deaths under one year of age per 1,000 births dropped from 103 in April to 98 in May; the urban rate fell from 104 to 102, while the rural rate decreased from 98 to the very low figure of 80; this in spite of the marked decrease in the number of births, which serves as the denominator of the fraction. On the whole, although March and April showed some increase in death rates, the present year so far compares favorably with 1914. For the first five months, January to May inclusive, the total number of births registered was 101,255 (rate 24.1 per 1,000) as compared with 96,064 (rate 23.3) for the corresponding five months of 1914; deaths were 66,402 (rate 15.8) in 1915, 67,011 (rate 16.2) in 1914; infant mortality 99 per 1,000 births in 1915, 103 in 1914. The following are the total deaths from certain important causes during the first five months of 1915, the corresponding figures for the preceding year being given in parentheses: typhoid fever, 202 (296); measles, 386 (589); scarlet fever 297 (475); whooping cough, 309 (373); diphtheria, 887 (1,057); tuberculosis of lungs, 6,776 (6,789); tuberculosis-other, 914 (910); cancer, 3,773 (3,685); cerebrospinal meningitis, 115 (157); diarrhea and enteritis of infants under 2 years of age, 1,166 (1,203); accidents, 2,628 (3,142); suicide, 692 (625); homicide, 188 (149). We have now reached the most healthful period of the year - June to November - and if the infant death rate can be kept down, as it seems likely to be by the aggressive infant welfare work, the rate for the year bids fair to be phenomenally low. The usual comparisons are presented for the cases of sickness reported and deaths from reportable diseases, and in the detailed table (page 224) may be found the statistics of individual cities and groups of cities. The caution has been frequently given that rates based upon small numbers of events, as are all monthly rates for cities below a certain size — say approximately fifty thousand population are subject to wide fluctuations due to the influence of only a very few cases in excess of or below the average. Thus for Johnstown, a city with a population of 10,614 as estimated for July 1, 1915, and reporting 10 births and 10 deaths for May, corresponding to a rate of 11.1 per 1,000, it is evident that an increase or diminution of a single birth or death would affect the rates by 10 per cent. In general the probability of error, or the likelihood of the monthly rates of a locality being fairly representative of average conditions, varies as the square root of the number of observations. It is not the purpose, however, of monthly rates to afford conclusive evidence of sanitary conditions. They are straws showing the momentary indications only, and must be studied in series. * Rates for all causes per 1,000 estimated midyear population; for individual diseases rates are per 100,000. In the last three columns an excess of April mortality over that of May is indicated by the minus sign (-). An asterisk in the last column, which is based on comparison of the rates, indicates that the figures are too small to afford significant percentages. Sickness from certain diseases is very imperfectly reported, hence the ratios of deaths to cases are not fully trustworthy. Percentages dependent upon small numbers are omitted, as indicated by asterisks. *Rates of deaths of infants under 1 year of age are per 1,000 living births; other rates are per 1,000 population estimated Health Departments' estimate (5,805,532), is 13.5 and the birth rate 22.5. REPORTS OF DIVISIONS Division of Sanitary Engineering-May, 1915 Examination and approval of plans for sewerage and sewage disposal: Farmingdale; Minoa; Hudson; Webb (T); Malone; Shelter Island; Auburn; Rome; Long Beach; Mt. Kisco. Investigations and reports of complaints relating to sewage disposal, stream pollution and public nuisances: Tonawanda (T); Athens; Beacon; Watervliet; Wawayanda (T). Investigations and reports of public water supplies: Fulton; Wellsburg; Saugerties; Owego; Plattsburg; Batavia; Prattsburg; Amsterdam; Poughkeepsie; Yonkers; White Plains; Nyack; Kingston; North Tarrytown (water rules enacted). Investigations and reports of sanitary conditions of state institutions: Newark, State Custodial Asylum; Gowanda State Homeopathic Hospital; Rome, State Custodial Asylum; Letchworth Village. Investigations and reports of operation and efficiency of sewage disposal plants: Auburn, Wards 1, 6 and 10; and 4, 5, 6 and 7; Penn Yan; Sharon Springs. More important letters of advice were prepared and sent out to the following places: Elmira, sewage disposal for school; Hermon, cesspools and subsurface irrigation. Division of Laboratories and Research-May, 1915 The new appropriations of the Legislature for the laboratory which were recently signed by Governor Whitman have brought new interest and encouragement to the staff which has been so greatly overtaxed with the increase in the work during the past twelve months. The serum diagnosis of the venereal diseases and other new branches of the work are now permanently established. The Director of the Laboratories visited the Hygienic Laboratory of the United States Public Health Service in Washington and also the laboratory and hospital of the Rockefeller Institute for Medical Research. The new methods of preparing smallpox vaccine which have recently been developed by Dr. Noguchi were of special interest because it is now possible to prepare an uncontaminated vaccine free from all danger of contamination by tetanus spores. The methods Dr. Cole and Dr. Dochez have used for the past three years in their studies of serum therapy of pneumonia were also of such promise in the future treatment of certain types of this disease that the attempt will be made by the laboratory at Albany to carry on similar work for physicians so situated that advantage can be taken of these new methods of diagnosis and treatment. Miss Kirkbride of the laboratory staff devoted a week at the Institute to the study of all the technical details of the work. Before the first of next year it is expected that sera for the treatment of selected cases will be ready for distribution. May Apr. May Distribution of diagnostic outfits, diphtheria, tuberculosis, typhoid fever, syphilis, and other diseases, and culture tubes. 1672 5609 3984 packages of diphtheria antitoxin, 3000 units... packages of diphtheria antitoxin, 1500 units. packages of tetanus antitoxin, 10,000 units. packages of tetanus antitoxin, 1500 units.... packages for the prophylaxis of ophthalmia neonatorum.. packages of typhoid vaccine.. 1100 1866 1198 156 574 249 49 374 197 142 659 386 474 3295 3236 418 351 Examinations for diagnosis, diphtheria. tuberculosis typhoid fever syphilis Examinations of samples of water, chemical. bacterial 745 1493 1826 268 398 363 81 90 129 669 539 |