far in excess of other years, the work of disinfecting material taken from private houses has, at times, been considerably delayed. There is no want of capacity in the disinfecting apparatus; the defect lies in the insufficient number of wagons and horses and drivers to compass the City and clear up the work each day. An effort has been made to increase the force, but it has been only in part successful. As promptness is very necessary in this branch of the public servcie, both for the object of destroying infection, and for relieving the families where sickness has occurred, it is not only recommended but urged that every facility be afforded for doing this work with the least possible delay. There were 16,015 articles received at the disinfecting station for disposal in one way or another. This is an excess of 7,902 over the number of articles received during the year 1895, which is nearly double the number. Most of these articles had to be placed in the steam disinfecting chamber for treatment. There were 2,101 calls made by the disinfecting wagons for infected articles, and 1,282 calls made by the delivery wagons. Many of the articles brought to the hospital are unfit for preservation and are burned at the request of the owners in the cremating furnace constructed for the purpose. By reference to tables contained in the appendix it will be seen that the work of the station has increased steadily from the beginning to the end of the year, the largest amount of work being done in December.

The apparatus for outside disinfection, that is, upon the streets, gutters, alleys, yards, privy wells and offensive places, constructed in the basement of the City Hall, for the manufacture of the hypochlorite of sodium, has been in active operation most of the year. In the cold months it is impracticable to distribute this material, and for a brief period the manufacture of it is dispensed with. Tests

were made of this material as manufactured by the Bureau, both in the bacteriological and chemical laboratories. The chemical test for available chlorine, made by Mr. William C. Robinson, Jr., Chemist of the Board of Health, shows the strength of chlorine as hypochlorites in the solution obtained from the tank to average 35 grains to the gallon, which equals a solution of between 0.05 and 0.06 per cent. of strength. The bacteriological test investigations were made by Dr. William J. Gillespie, Assistant Bacteriologist, which indicate its germicidal value. A detailed report will be found in the appendix.

The preparation of antitoxin under the supervision of the Bacteriological Laboratory has been continued throughout the year. More than sufficient antitoxin has been produced to supply the needs of the Municipal Hospital, and it was deemed advisable to offer the excess to physicians for use in the treatment of the indigent sick. Accordingly, notices were sent to all the physicians of the City. In addition to this plan early in the year an officer was appointed for the administration of antitoxin and for the practice of intubation in those cases where the family was too poor to pay for the use of this remedy or to have the advantages of intubation. The report of Dr. Royal W. Bemis, the Medical Officer appointed for this purpose, is of interest and will be found in the appendix.

The number of cases injected with antitoxin, gratuitously, was 100. The number of deaths was 28. There were 28 cases injected twice or more, with 5 deaths. Intubation was performed in 30 serious cases, of whom 11 recovered.

Antitoxin was injected and intubation practiced in 19 cases with 6 recoveries. There were 11 cases in which intubation was performed, but the antitoxin was not in

jected, with the result of 5 recoveries. All of these cases might be classed as desperate cases. Among the 20 cases injected within the first two days there was only 1 death. There were 7 deaths among the 30 cases injected on the third day, and 3 deaths among the 15 injected on the fourth day. Of the 32 cases injected upon the fifth, sixth, seventh and eighth days there were 17 deaths. It will be observed that the very early injections were followed almost invariably by recovery. A number of these cases were sent to the hospital after intubation and injection. If it were possible to have a prompt notification of the existence of disease, the advantage would be the saving of life of many persons who are victims of delay.

Small-pox which prevailed to a considerable extent in the first and second quarters of 1895, particularly the former, disappeared from the City about the 1st of October of that year, since which date there has not been a case of this disease in the City. In 1895 there were 30,284 vaccinations performed and about the same number in 1894, both years in which small-pox was somewhat prevalent in the City, and on this account the number of operations performed was much larger than usual. In 1896, the year just closed, the number of vaccinations. performed by the public vaccinators was 18,364. It is always the case that after the disappearance of small-pox the number of vaccinations diminish in a very marked degree. Most of the operations were performed in the last quarter of the year, namely, 7,018. There were 1,941 vaccinations in the first quarter, 5,326 in the second quarter, and 4,079 in the third quarter.

The following table shows the number of vaccinations performed in each year from 1860 to 1896, both inclusive;

also the average number per year :

On June 18, 1895, the Legislature of the State of Pennsylvania passed "An Act to provide for the more effectual protection of the public health in the several municipalities of this Commonwealth." Section 12, of this Act, provides All principals cr other persons in charge of schools, as aforesaid, are hereby required to refuse the admission of any child to the schools under their charge or supervision except upon a certificate signed by a physican setting forth that such child has been successfully vaccinated, or that it has previously had small-pox." The enforcement of this provision of the law will have the effect of thoroughly protecting the citizens of Philadelphia against the inroads of small-pox, as it applies to all schools -public, parochial and private. If faithfully enforced, in