The board requires a certificate of the attending physician, stating the cause of death, without which certificate no permit is issued. It often occurs that persons die without the attendance of a physician, either from poverty or violence of the attack. The medical sanitary inspector attached to the board of health is then ordered to investigate the cause of death and report to the health officer; upon his certificate the permit is issued. If this inspector, however, should not be satisfied with the cause of death, the case is referred to the coroner of the District. In this manner, crime is prevented or discovered. Again, the causes of death alleged by the physician may be typhoid or malarious fever, diphtheria, or any disease from local cause. The medical inspector investigates the causes, reports them to the board, which at once throws protection around the neighborhood by removing them, and thus checks the spread of the disease. In other instances, in case of a contagious disease, as small-pox, scarlet fever, &c., the same service is rendered.

In this city, into which the war has suddenly thrown thirty thousand negroes, pauperism has greatly increased, and virtue among them at a discount, not having been greatly fostered on the old plantations. Hence concubinage, with all its dire consequences, is quite prevalent. It happens, therefore, that still-births are often the result of doubtful causes, requiring the vigilance of the board of health. Many die also in such a state of destitution as to need burial at public expense, in which case the medical sanitary inspector makes an investigation, and reports to the board with recommendations. This service is expensive, but indispensable to a well-regulated community. The board has often received communications from foreign governments requesting documentary evidence of the death in this city of individuals of foreign birth, and it was mortifying to our pride as a board of health and as American citizens that there was no record or reliable evidence of the death of the person named. This is corrected now, however, and the board of health is able to account for the death and burial of every person in the District of Columbia.

The sale of unwholesome food is now prevented by the daily inspection of the markets and green-grocers' stores. To prove the importance of this service, it is enough to state that in the last five years there have been condemned 122,601 pounds of meats, 8,114 chickens, birds, rabbits, squirrels, &c., 28,691 bunches of fish, 28,479 bushels of oysters, 188,000 clams, 171,390 crabs; the valuation of these articles of food condemned and destroyed amounting to about $70,000.

No animals are now allowed to run at large; and although this nuisance baffled the efforts of the police for many years, it is now entirely abated. The fierce opposition of the people who kept cows and hogs to be fed on public grounds has been conquered, and the service is now performed without molestation, to the great relief of our citizens. Eleven thousand seven hundred and forty-seven animals have been impounded in the past five years. The dogs, another source of evil and danger to the community, have received the attention of the board. During the four warm months, dogs are required, by the ordinances of the board, to be muzzled, and the pound-master to capture all the unmuzzled ones. Through this service, 7,327 worthless curs have been captured and killed.

There have been, moreover, 122,784 nuisances reported and abated, 43,348 tons of garbage and 14,000 tons of night-soil removed, 838 vacant lots containing stagnant water filled, 492 houses reported and condemned as unfit for human habitation removed.

THE SICK POOR.

The poor also have received the humane care of the board. From time immemorial it has been the custom of the city authorities to provide the indigent with medical attendance and medicines. This has been quite an item of expense, having reached beyond the sum of $20,000 per annum. The honorable Commissioners properly requested the board of health to take charge of this service, it systematized the work, employed physicians, supplied the medicines, and reduced the expense to $8,000 per annum.

Such has been the work performed by the board of health, the details of which would take more space than this report will allow. The labor is a peculiar one, requiring knowledge of sanitary science and law. No board of health can be competent unless a majority of its members have been trained in the school of sanitary science. To determine what are nuisances injurious to health, to provide for the removal of the same, to prevent the incursion of disease and provide for the abatement of its cause, the use of disinfectants and deodorizers, to analyze potable waters, to record deaths and causes of deaths with proper classifications, to decide what is wholesome and unwholesome food, to search for local causes of disease, to determine whether dwellings are in sanitary condition, require a knowledge that only those trained in sanitary science can possess.

The composition of the personnel of this board is well adapted for the purposes of its organization. It contains all the elements of success, and it is hardly to be doubted that its triumphant career has been due greatly to the united forces of men qualified not only to judge and act in a sanitary sense, but according to law, and in compliance with the judgment of an independent citizen.

The work of this board has been very laborious. In framing ordinances for the prevention of nuisances injurious to health, it created a complete code of health, under which the sanitary officers have been able to act in conformity with law. It was so well devised as to be sustained by all the courts of the District. Under this system, the officers have become experts, and their investigations, inspections, and reports demonstrate their qualifications for the work. It has become a school of sanitary science, from which not only the officers connected with it could learn, but one which spreads knowledge among the citizens. All sorts of questions of scientific and sanitary character are daily presented to the board, which treats and discusses them in public, thus diffusing that knowledge of sanitary science so necessary to the preservation of the lives and health of the people. We find now that our people are conversant with sanitary questions, to which their attention had never been called before. This is demonstrated by the many applications that the board receives from the people to treat questions of peculiar nuisances about which they are in doubt.

Citizens living in the neighborhood of a soap and candle factory where grease is rendered wish to know if the nauseous smell is deleterious to health. This opens at once the question of what smells are, what gases are; when, and under what circumstances they may be considered injurious to health. Another complains of a bone-crushing factory; another of a depot of guano; another of accumulations of manure; another of a slaughter-house, of a sewer, of drains, of damp dwellings, &c. These are questions that involve the right of property, the right of breathing pure air, the right of citizens in their avocations, the right to live unpoisoned. All these questions that arise every day in a large

community where industry, trades, and manufacturing are carried on, must be decided by the board of health in the interest of all. Their decision must be based upon a thorough knowledge of the subject both in its sanitary and legal importance. We are very glad to say that, in almost every instance where an appeal has been taken, the courts have sustained the board of health. Although the board has had almost unlimited power in declaring what are nuisances injurious to health, it has used that power with so much discretion as to create no discontent with the people. The fierce and unreasonable opposition it met in the beginning of its labors was conquered by the development of a sanitary system in which the unprejudiced and intelligent citizens could but see a praiseworthy effort to improve the condition of the city; and few are those to-day who will not acknowledge the great improvement in the healthfulness of our city, the guardianship and unremitting vigilance of the board of health for the welfare of all.

Much has been said about the expenditures of this board. No one has impeached, however, its accounts; for there never was a department in which the public moneys have been spent with so much fidelity. Although the board has a trusty and bonded treasurer, he is not allowed to pay even for a penholder the bill for which has not been presented to the board, referred to the committee on finance, and by said committee reported to the board. The board approves or disapproves; if ap proved, the treasurer is ordered to pay it. At the end of every month, this officer is required to make a financial statement, and at the end of the year his accounts are audited by a committee of the board and the proper accounting-officers of the Government. Hence, we state with pride that the accounts of the board are above suspicion. But are the expenses of the board excessive, taking into consideration the amount of work performed? That the work is a necessity in a well-governed community we have demonstrated.

Let us compare the expenses for sanitary work during the old, inefficient régime with the present successful one:

Medical attendance and medicines for the poor, 1871, 1872, and 1873, average

Office and salary per annum of a secretary to a board of health composed of many members, without money or authority whatsoever..

Sanitary squad of police, composed of ten policemen and a lieutenant, ignorant of sanitary laws and the science of hygiene, and under no advisory sanitary counsel....

Removal of dead animals...

Total.....

No inspection of food;

No inspection of marine products;

No registration of vital statistics;

No interference with contagious and infectious diseases;

No systematic inspection of streets, alleys, yards, houses, sunken lots, sewers, &c.;

No taking-up of domestic animals running at large;

No protection against rabid dogs;

No board of sanitary experts, to whom citizens could refer nuisances

of a special character and find relief;

No board of sanitary 'experts for the framing and promulgation of sanitary laws, rules, and regulations;

A system, in fact, remarkable only for its negativeness and inefficiency.

Board of health, as at present constituted, composed of 5 members

4 clerks at $1,200 each (health office and registration service).

Messenger and janitor service..

Collection of garbage..

Care of sick, poor, and medicines..

Pound service..

Transportation of offals..

Total...

Comparative expenses of boards of health.-Memorandum compiled from reports of other health boards.

Philadelphia, expenses for 1874, $337,809.44; population, 750,000; expenses per capita, 45 cents. Boston, year ending April 30, 1875, $469,031.91; population, 342,000; expenses per capita, $1.37.

Baltimore, year ending October 31, 1875, $268,855.47; population, 350,000; expenses per capita, 763 cents. New York City, year ending, 1873, salary account alone, $215,277.04.

VITAL STATISTICS.

The number of deaths registered during the year was 106 less than last year, and by reference to the tables it will be seen that this gratifying result is largely due to reduction of the death-rate from zymotic or preventable diseases; no better argument as to the value of the service of this department could possibly be presented. It appears from the records that from July 1, 1876, to date, the death-rate in the District has been on the increase. It is believed, and it is no doubt true, that such increase is almost, if not entirely, due to the large reduction in the sanitary force, rendered necessary by the meager appropriations made by Congress for expenses of the board for the current fiscal year.

NUISANCES.

During the year, 20,261 nuisances, of greater or less degree, have been reported and abated. Three hundred and seventy-one houses were condemned as unfit for human habitation, and destroyed or rebuilt by their owners; 424 others were reported as being in insanitary condition from various causes, and the cleaning and repairing of the same ordered and enforced. One hundred and sixty-six sunken lots upon which stagnant water was found have been filled, and 1,641 sewer-connections made. These results indicate the extent and value of the service.

FOOD-INSPECTIONS.

Since the commencement of the current fiscal year, the efficiency of this important branch of the service has been greatly impaired for want of funds, Congress having failed to appropriate as estimated and urged by the board. During the year, 22,217 pounds of meats, 3,940 pounds of game, 2,632 dozen eggs, and large quantities of fruits and vegetables have been condemned as unfit for food. Value of such food when of wholesome quality, $11,926.28. The inspection of marine products has

been thorough and efficient. The number of fish inspected aggregate 4,775,114; condemned as unfit for food 47,423. The condemnation of shell-fish includes 62,915 clams, 61,084 crabs, and 4,759 bushels of oysters. Value of condemnations when of wholesome quality, $6,601.70.

ANIMALS AT LARGE.

It is made the duty of the board by Congress "to make and enforce regulations to prevent domestic animals from running at large in the cities of Washington and Georgetown." Under the operations of this law, 2,668 animals have been taken up and impounded, of which number 1,917 were killed, mostly dogs, 744 were redeemed, and 5 sold.

MEDICAL SANITARY INSPECTION.

This service has been prosecuted with intelligence and vigor, and the valuable statistical information collected, concisely set forth in the tabular statement herewith presented, and to which attention is invited.

REPORT OF THE TREASURER.

From the treasurer's report it will appear that $52,235 was appropriated for the service of the board for fiscal year ending June 30, 1876, and that the same sum has been expended. The receipts and disbursements are accurately presented in detail, as certified by the auditing committee.

REPORT OF ATTORNEY TO THE BOARD.

This report shows that the number of cases referred for prosecution during the year was 138;

Number of convictions, 58;

Number of cases nolle prosequied or discontinued, 62;

Number of cases dismissed, 6;

Amount of fines imposed, $238;

Amount of collateral forfeited, $35.

In the past as in former years, the regulations of the board have been sustained by the courts of the District, and compliance with the requirements of such regulations uniformly enforced.

SECRETARY'S REPORT.

Letters received, 1,480; replied to by indorsement, 458; letters written and recorded, 439; referred to health officer, 187; other references, 271. Ninety-six meetings have been held during the year, and the proceedings had at same duly recorded.

BOARDS OF HEALTH AND LEGISLATION.

Experience teaches that municipal governments, dependant upon uni versal suffrage, do not give that support necessary for the creation and maintenance of thorough sanitary systems. It is well to study the causes of this antagonism to rules and regulations so important to our well-being. It comes from the ignorance of one class and the selfish interests of another. People indifferent to habits of cleanliness seem not to be aware that filth and dirt on their premises, even if tolerated by them. selves, is a source of constant alarm to their neighbors. They do not