surate therewith. It is for the purpose of obtaining an entirely candid and absolutely unbiased expression of opinion in regard to the uncertainties implied above, that the following question is submitted:

In your opinion, have the teachers in your jurisdiction given such attention to the subjects presented in the Monthly Bulletin, and derived such benefit to themselves and others from the sanitary information presented therein, as to warrant the continuance of the distribution of the publication to the said teachers under your superintendence?

To this interrogation replies were received attached to the circulars and otherwise written, from a considerable majority of the superintendents of the public schools and also from some school officers in different positions, in all of which, with three exceptions, the responses were emphatically in the affirmative. Reports in person from some not replying by mail, were to the same effect.

At the Forty-Seventh Annual Meeting of the Rhode Island Institute of Instruction in October, 1891, the following preamble and resolution was introduced by Supt. H. S. Tarbell of the Providence public schools, and the resolution was passed without dissent:

WHEREAS, The Monthly Bulletin of the Rhode Island State Board of Health has been published for the purpose of disseminating a knowledge of the fundamental principles of general sanitation and personal hygiene, and has, after a three years' issue, been discontinued by the Secretary under the impression that the publication did not accomplish its intended purpose in such measure as was hoped and desired, and therefore did not warrant its continuance, now, therefore,

Resolved, That the Rhode Island Institute of Instruction hereby gives expression of its regret at such discontinuance, and declares its opinion that the publication of the Monthly Bulletin has been of large value to the teachers of the State.

With such decided expressions of opinion from parties whose judgment was entitled, by reason of position and general intelligence, to the highest respect, it could hardly be otherwise than that the Secretary should be induced to resume the publication.

During the six months of publication the Secretary had written 41 articles, long and short; and during the year had prepared 12 summaries of deaths, with sex, parentage and ages; 24 pages of causes of deaths and number, with comments and percentages; and 24 pages of meteorological observations and summaries. Supervision was also given to printing, correcting proofs, addressing, wrapping, mailing and other methods of distribution of copies.

HEALTH IN THE STATE.

The general health of the State during 1891, so far as the prevalence of dangerous diseases may be considered, was unusually good. No wide spread epidemic occurred during the year except of the infectious influenza, and the few epidemics that did occur, were limited to restricted localities and comprised the following diseases only, namely: Measles, typhoid fever and whooping cough.

The Monthly Bulletin, for one-half of the year, presented from month to month the general conditions of the public health and the degrees of prevalence of the more important diseases, and for the remaining part of the year, the Secretary prepared monthly reports, covering the same circumstances, which were published in the daily papers. The following are abstracts of such monthly reports in relation to the public health:

January.

Compared with the previous month, the amount of sickness of all kinds, taking the towns altogether, was, according to the reports of medical correspondents, about the same.

Compared with the corresponding month in 1890, the amount of sickness was very considerably less, and compared with the average of the same month for four years previous to January, 1890, the general amount was nearly the same.

Of the respiratory diseases, bronchitis and pneumonia were reported from every section, and as occurring in considerably large numbers and with varying degrees of severity.

Typhoid fever was very largely prevalent in the vicinity of Lonsdale and Berkeley, and sporadic in one-quarter of the towns elsewhere.

Malarial fever was prevalent in unusual numbers for the season, in three towns on the Blackstone river.

Whooping cough was epidemic in South Kingstown and moderately prevalent in Hopkinton and Pawtucket.

Diphtheria, scarlet fever, croup, influenza or lá grippe, and diarrhoea, were reported as having sporadic occurrence in one-quarter of the towns and of moderate severity.

Chicken pox was epidemic in Warwick, and tonsillitis was unusually prevalent in several towns.

February.

The amount of general sickness throughout the State during the month was rather less than in the month of January preceding.

Taking the State at large, bronchitis, influenza, diphtheria, scarlatina, tonsillitis and rheumatism had slightly increased in prevalence, and pneumonia, typhoid fever, measles and whooping cough had decreased.

Scarlet fever had considerably larger prevalence in Providence and vicinity, and whooping cough in South Kingstown.

Compared with February, 1890, the amount of sickness was about 20 per cent. less in February, 1891. The difference consisting very largely in the smaller amount of pneumonia, influenza, diphtheria, scarlatina, measles, and whooping cough in 1891.

March.

Reports from correspondents showed that the amount of sickness, including all kinds, in March, was about the same as in the previous month, but was at least 20 per cent. less than in the corresponding month in 1890.

Compared with the preceding month, the influenza or la grippe had largely increased in area of prevalence, comprising about 70 per cent. of the towns, but of less severity of type than in the month of March, 1890.

The percentage of localities where diarrhoea and malarial fever were prevalent, was unusually large for the month of March. Bronchitis, pneumonia, scarlet fever, measles and whooping cough, were reported with slightly extended prevalence, and typhoid fever, croup, tonsillitis and diphtheria with a decreased prevalence.

No disease was reported as having epidemic prevalence except the influenza or la grippe.

April.

Otherwise than the influenza, the amount of general sickness had decreased from the previous month. Pneumonia and bronchitis still holding considerable prominence, partly as secondary to the influenza; and diphtheria, measles, scarlet fever and whooping cough prevailing with lessened numbers.

Malarial fevers were prevalent in some localities on the Blackstone and Woonasquatucket rivers in unusual numbers for the season.

May.

The reports of medical correspondents covering all sections of the State, indicated that for the month of May, the influenza or la grippe continued to be the most prevalent form of disease, excepting towns bordering on the lower Narragansett Bay, not only as continuations of the same disease in April, but also in the occurrence of new cases. Bronchitis was reported as the next most prominent form of disease in a large proportion of the towns, although that discase, with pneumonia and other diseases of the respiratory organs, had diminished slightly in numbers but not in general severity.

Compared with the preceding month, diphtheria, typhoid fever, and scarlatina had slightly increased in area of prevalence, but of mild form and sporadic, scarlet fever only, having increased in numbers in Providence, East Providence and vicinity.

Compared with the previous month, the amount of general sickness varied considerably in the different towns, but taking the State at large the amount would seem to be about the same.

Measles had quite large prevalence in the vicinity of Kingston and Valley Falls.

Malarial fevers were also quite prevalent along the Blackstone and Woonasquatucket rivers.

No report of an epidemic prevalence in any locality of any contagious or infectious disease, except influenza.

June.

According to the reports of the medical correspondents, the influenza or la grippe had nearly disappeared during the last weeks in June, lingering mostly in the towns on the western border of the State. Compared with the preceding month, diseases of the respiratory organs had largely diminished, bronchitis only holding any important prevalence. Compared with the preceding month, the infectious diseases, diphtheria, measles, scarlatina and whooping cough, had greatly lessened in prevalence, not only in the number of cases, bu in the number of localities. Measles was reported as having large prevalence only in Kingston and vicinity, and whooping cough in Valley Falls and vicinity.

Typhoid fever had little prevalence in the State, according to the reports, except in the vicinity of Carolina and at Valley Falls, where typhoid fever and fever from septicemia were reported as having large prevalence, occasioned by the use of polluted water.

Malarial fevers were reported only from localities on the Blackstone river, except as sporadic and imported. The diseases of the alimentary organs had assumed considerable importance during the last half of the month.

Of the 36 deaths that occurred in Lincoln during the month of June, nine, or 25 per cent., were from cholera infantum. In Woonsocket the proportion was 14 per cent., in Pawtucket 9 per cent., and in Providence city only 4 per cent.

Compared with the corresponding month in 1890, there were in the total mortality about 15 per thousand more deaths from diarrhoeal diseases of all kinds in June, 1891, but the mortality from cholera infantum was in the proportion of about 30 more in every thousand deaths in June, 1891, than from the same disease in June, 1890.

July.

From the reports of medical correspondents for the month of July, it would appear that the amount of general sickness in much the larger proportion of the towns was rather less than the average of the same month in previous years. Of special diseases, compared with the preceding month, the reports indicate a considerable decrease of bronchitis, pneumonia, diphtheria, croup, scarlet fever, whooping cough and measles. The last two were reported as having large prevalence in two sections only; the whooping cough in Scituate and Foster and measles in the vicinity of Kingston. Diarrhoeal diseases had largely increased in a number of the larger towns. In Woonsocket the mortality from cholera infantum was more than 50 per cent. of the whole number of deaths from all other diseases; in Lincoln 36 per cent.; in Warwick 32 per cent.; North Providence, 33 per cent.; Providence, 15 per cent.; all in contrast with Newport, showing 4 per cent. There was no return of the mortality in Pawtucket for July.

Sporadic cases of typhoid fever reported from nearly one-half of the towns, occurring in mild form; malarial fever along the Blackstone river and large sickness at Valley Falls from the use of polluted water. The general amount of diarrhoeal diseases, other than cholera infantum, was not unusual for the season, and scarcely half of the amount in July, 1890. Compared with the corresponding month in 1890, there was about an equal prevalence of bronchitis, cholera infantum, malarial fevers, measles and whooping cough; a larger prevalence of typhoid fever and pneumonia, and a smaller prevalence of diphtheria in July, 1891.