properly if their energies are daily drained to the very last drop in the performance of routine duties.

The public is entitled, it is believed, to this frank statement of the situation. The shortcomings of the health department are better known to the health officer than they are to any other individual in the entire population, and these shortcomings have undoubtedly been to him a matter of graver concern than to anyone else. But without generous support the future has in it but little hope for a broad and effective development of the health department.

Respectfully,

WM. C. WOODWARD, M. D.

Health Officer.

APPENDIXES

TO THE

REPORT OF THE HEALTH OFFICER

OF THE

DISTRICT OF COLUMBIA.

The publication of these reports as appendixes to the report of the health officer is not to be construed to mean that the opinions and recommendations set forth in them have been adopted by the health department.

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APPENDIX A.

REPORT OF THE INSPECTOR IN CHARGE OF THE CONTAGIOUS DISEASE SERVICE.

WASHINGTON, September 9, 1908. SIR: I respectfully submit the following report of the work done in the contagious disease service for the fiscal year ending June 30, 1908:

DIPHTHERIA.

From January 1 to December 31, 1907, 411 cases of diphtheria were reported to the health department; 377 of this number occurred among the white and 34 among the colored population. These figures show a decrease of 9 when compared with those of the preceding year. The white population, as in the several preceding years, furnished most of the cases. Of the 411 cases reported 28 died, 21 being white and 7 colored. The percentage of deaths to cases for the white was 5.6 and for the colored 20.6, the total for all being 6.8. The total percentage in 1906 was 8.6. A comparison of these figures with those of last year show that while the white mortality was reduced from 7.3 to 5.6, the colored rose from 17.6 to 20.6. The total mortality, however, for the entire population was reduced from 8.6 in 1906 to 6.8 for the year just closed. The prevalence of the disease among the whites was in proportion of 161.1 and among the colored 35.3 per 100,000 of population, the total for the whole population being 124.7 per 100,000. The white population furnished 91.73 and the colored 8.27 of the cases reported.

There was a slight increase in the number of cases of diphtheria reported between January 1 and June 30, 1908, over the corresponding period of last year. During the first six months of 1907 142 cases were reported as against 167 during the same period of 1908. This increase was mostly in the colored population. Of the 167 cases reported, 11 resulted fatally, 7 white and 4 colored. The percentage of deaths to cases being 4.9 for the white, 16.0 for the colored, and 6.5 for all.

During the calendar year ending December 31, 1907, 2,370 cultures from the throats of patients suffering from diphtheria, or who were suspected to be suffering from that disease, were submitted to the health department for examination; 1,201 of these were primary cultures, and 299 or 24.9 per cent contained the diphtheria bacillus.

SCARLET FEVER.

This disease has shown quite a marked reduction in the number of cases reported. During the year 1906 231 cases were reported, while during the year ending December 31, 1907, 168 cases were reported.

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