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DIRECTORY OF THE DEPARTMENT OF HEALTH

OFFICES

Headquarters: S. W. Corner (entre and Walker Streets, Borough of Manhattan

Telephone, 6280 Franklin Borough of The Bronx, 3731 Third Avenue,

Telephone, 197.5 Tremont Borough of Brooklyn, Flatbush Avenue and Willoughby Street.

Telephone, 4720 Main Borough of Queens, 372-371 Fulton Street, Jamaica, L. I.

Telephone, 1200 Jamaica
Borough of Richmond, 514-516 Bay Street, Stapleton, S. I.

Telephone, 410 Tompkinsville
Office Hours--9 a.m. to 5 p.m.; Saturdays, 9 *.m. to 12 m.

INFANTS' MILK STATIONS

Manhattan 1. 172 East 341 S:.

$ Vanderbilt Clinic 15. 1391 Avenue A 22. 73 Cannon St. 2. 522 East 11th St.

326 East Ilth St. 16. 200 East 97th Si. 23. 110 Suffolk St. 3. 281 Avenue A

10.

114 Thompson St. 17. 209 Stanton St. 21. 96 Monroe St. 4. 2.10 East 28th St.

11. 315 East 112th St. 18. 2297 First Ave. 25. 251 Monroe S:. 5. 225 East 107th St. 12. 21+ Mulberry St. 19. 108 Cherry St. 26. 413 West 40th St. 6. 241 East 40th St.

13. 438 West 48th St. 20. 122 Mulberry St. 27. 74 Allen St. 7. 174 Eldridge St.

14. 78 Winth Ave.

21. 207 Division St.

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TUBERCULOSIS CLINICS
Manhattan West Side Clinic, 307 West 33d Street. Telephone, 3171 Murray Hill.

East Side (linie, $1 Second Street. Telephone, 5586 Orchard.
Harlem Italian Clinic, 420 East 116th Street. Telephone, 5384 Harlem.
Southern Italian Clinic, 22 Van Dam Street. Telephone, 412 Spring.

Day (amp. Ferryboat "Middletown," foot of East 91st Street. Telephone, 29.57 Lenos.
The Bronx -- Northern Clinic, St. Pauls Place and Third Avenue. Telephone, 197.5 Tremont.

Southern Clinic, 193 East 139th Street. Telephone, 5702 Melrose.
Brooklyn - Main Clinic, Fleet and Willoughby Streets. Telephone, 1720 Main.

Germantown Clinic, 55 Sumner Avenue. Telephone, 3228 Williamsburg.
Brownsville Clinic, 362 Bradford Street. Telephone, 2732 East New York.
Eastern District Clinic, 108 South 31 Street, Williamsbury. Telephone, 710) Greenpoint.

Day ('amp, Ferryboat "Rutherford," foot of X. 24 St., Williamsburg. Tel., 795 Greenpoint
Queens - Jamaica Clinic, 10 L'nion Avenue, Jamaica. Telephone, 1386 Jamaica.
Richmond Richmond Clinic, Bay and Elizabeth Streets, Stapleton, Telephone, 110 Tompkins.

CLINICS FOR SCHOOL CHILDREN
Manhattan--Gouverneur Slip. Telephone, 2916 Orchard.

Pleasant Avenue and 18th Street. Telephone, 972 Harlem. Brooklyn - 330 Throop Avenue: , Telephone, 5319 Williamsburg..

121 Lawrence Street. Telephone, 562? Main.

1219 Herkimer Street. Telephone, 2681 East New York. The Bronx--JSo East 169th Street. Telephone, 2558 Tremont.

HOSPITALS
Manhattan - Willard Parker Hoipital, foot of East 16th Street. Telephone. 1600 Stuyvesant.
The Bronx --Riverside Hospital, North Brother Island. Telephone. 101) Melrose.
Brooklyn-Kingston Avenue Hospital, Kingston Avenue and Fenimore Street. Telephone, 4100 Flatbush.

SANATORIUM FOR TUBERCULOSIS
Otisville, Orange County, N. Y. (via Erie Railroad from Jersey City'). Telephone, 13 Otisville.

LABORATORIES
Diagnosis Laboratory, Centre and Waiker Streets. Telephore, 6280 Franklin.
Research Laboratory,

(hemical Laboratory. Vaccine Laboratory. Drug Laboratory,
Foot of East Sixteenth Street. Teiephone, 100) Stuvvesant.

TUBERCULOSIS HOSPITAL ADMISSION BUREAU
Maintained by the Department of Health, the Department of Public Charities, and Bellevue and Allied

Hospitals, 126 First Avenue. Telephone, 8667 Marison Square. Hours 9 a.m. to jp.m.

MPEWN FON NUANI RU.

4) PARKPLA , # W ARK

522-A-13 (B) 2000

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DEPARTMENT OF HEALTH

Report for Week Ending January 11, 1913

DISCONTINUANCE OF THE FREE ADMINISTRATION OF DIPHTHER'A ANTIOXIX.

The free administration of antitoxin in diphtheria and the performance of intubation by the Inspectors of the Department of Health oi The City oi New York was begun in 1895, the objects in view being not only the cure and prevention of the spread of the disease, but also the education of the medical proiession and the general public. These ends have been accomprished. The death rate of the disease in Manhattan and The Bronx has fallen inom 15.9 per 1000 oi p pulation in 1894 to 2.2 in 1912. In 1894 twenty-nine out of every one hundred cases reported died. In 1912 less than nine cases out of every hundred died. Since 1845 almost 40,000 cases have been injected with antitoxin furnished by the Department of Health, and of these less than 6 per cent. proved fatal. Fina'ls, the records show that at the present day practically every case of diphtheria receives antitoxin.

On and after February 1, 1913, therefore, the present system of free administration by Inspectors of the Department of Health of diphtheria antituxin and performance of intubation at the homes of patients, at the request of the attending physician, will be discontinued. After that date, when it becomes necessary for the Department of Health to administer antitoxin or periorm intubation in any case oi diphtheria the patient will be at once removed to one of the hospitals oi the Department for further observation and treatment. Diphtheria antitoxin may still be obtained free of charge by physicians from supply stations at drug stores for use, where payment for the same by the patient would be a hardship.

REPORTING OF VENEREAL DISEASES. The Department of Health has undertaken an extensive study of the venereal diseases in New York City and is desirous of obtaining as full information as possible as to the prevalence of these diseases. By virtue of the resolution of the Board of Health of The City of New York, dated February 20, 1912, the Superintendents of all public institutions have been required since May 1. 1912. to report promptly all cases of syphilis, chancroid or gonorrheal injection coming under observation. All physicians were requested to furnish similar information concerning their private patients (omitting name and address), but no attempt was made at that time to reach every physician in the city.

Cases reported by private physicians will be filed by case number, which will be given the physician for future identification, when his report is acknowledged.

A supply of report cards to be used for this purpose will be forwarded on request. All information is regarded as absolutely contidential and is not accessible to the public nor are the records deemed public records.

DIAGNOSIS OF VENEREAL DISEASES. The Department of Health, makes, without charge, the Wassermann test for the diagnosis of syphilis, and also provides facilities for the free bacteriological examination of discharges for the diagnosis of gonorrheal infections.

Outfits, with full directions for obtaining specimens, can be had free at any of the Department supply stations, a list of which will be mailed on application.

A diagnosis clinic for venereal diseases is held daily between 9 and 10 a. m. at the central office of the Department of Health at Centre and Walker streets, where patients may be referred by physicians for the periormance of the Wassermann reaction and for examination of fresh specimens for the presence of treponema. to patients are examined unless referred by physicians (excepting those who have no physicians), and under no circumstances are the results of examinations reported to the patients. A similar clinic is held at 307 West 33d street on Wednesday evenings, between 8 and 9 p. m., for the benefit of applicants unable to attend during the day.

For further information application should be made to the Department of Health, Division of Communicable Diseases, Centre and Walker streets, New York City.

IMMUNIZATION AGAINST TYPHOID FEVER. Immunization against typhoid fever, or the inoculation of a healthy person with sterilized typhoid cultures, in order to prevent infection with typhoid fever, has passed beyond the experimental stage and has become established as a prophylactic measure of proved efficiency.

Practically all authorities now agree that the practice confers a notable immunity against typhoid infection and reduces by three-quarters the number of cases in locali11e's where it is adopted.

Under similar conditions typhoid fever occurring in immunized persons is, approximately, only one-half as fatal as in persons not so protected.

Typhoid fever thus is less apt to occur, and when it does occur. runs a milder course among the sick who have been immunized than among those who have not.

Feeling that its wider use, under proper precautions, is called for, the Board of Health of The City of New York on December 10, 1912, authorized the performance of immunization against typhoid fever by its Inspectors, under conditions similar to those governing the free administration of diphtheria antitoxin. Beginning January 1, 1913, inoculations will be made at the homes of applicants or at the Central Office of the Department, Centre and Walker streets, Borough of Manhattan; or the culture will be furnished free to physicians for their own use. All requests for immunization must be made or approved by the attending physician.

Requests for inoculation can be made by telephone or letter to the Division of Communicable Diseases of the Department of Health.

Immunization will be offered to all other members of every family in which a case of typhoid fever occurs.

As at least 10 per cent. of the cases of typhoid fever occurring in New York City are thought to be due to contact, immediate or indirect, with a preceding case in the same locality, and not to infected water or milk, it is hoped that widespread immunization of the members of all such families will sensibly reduce the occurrence oi typhoid fever in New York City.

A circular of information regarding immunization against typhoid fever has been issued, and (together with a leaflet of information regarding the new Diagnostic Clinics for Venereal Diseases of the Department of Health) has been sent to every physician in New York City. These circulars will be supplied to any citizen upon request.

THE HEALTH OF THE CITY IN 1912. The number of deaths reported during the year ending 12 m., December 31, 1912, was 73.008 with a death rate of 14.11 per 1,000 of the population. This number is less by 2,415 deaths reported during the year 1911, and 16,857 deaths less than the average of the immediately preceding decennium, corrected to correspond to increase in population during the previous ten years. It is hardly necessary to say that this is the lowest death rate that the City of New York has ever experienced, and while the figures of the large cities of the world are not yet at hand, it is probable that this rate will compare very favorably with that of any other large city in the world, including London, Paris, Berlin, Vienna, Chicago and Philadelphia.

Mortality compared with the Decennial Average. In order to make a fair comparison the mortality from different causes for the year 1912 has been compared with the corrected decennial averages of the years 1902 to 1911, inclusive. We find that the death rate from typhoid fever has decreased 34 per cent.; smallpox, 95 per cent.; measles, 30 per cent.; scarlet fever, 38 per cent.; diphtheria and croup, 48 per cent.; tuberculosis of the lungs, 17 per cent.; other forms of tuberculosis, 11 per cent. ; pneumonia (lobar- and broncho-) showed a decrease of 2.678 deaths, compared with the decennial average.

The greatest gain in lives has resulted from the reduced mortality from diarrhoeal diseases under five years of age, the average for the decennium being 6,805, while during the year 1912 the number of deaths reported from this cause was 4,148, a diecrease of 2,657 deaths.

Cirrhosis of the liver showed a decrease of 266 deaths, Bright's disease and nephritis, 1.114 deaths; puerperal diseases, 206 deaths; accidental deaths, 687; suicide, 174. Appendicitis showed a slightly decreased mortality of 15 deaths less, cerebro-spinal meningitis, (04 deaths; bronchitis (acute and chronic), 1.042 deaths.

The only causes which showed an increased mortality were cancer, an increase of 295 deaths: homicides, an increase of 57 deaths; organic heart diseases, an increase of 1,455 deaths. This latter increase, however, is offset by a decrease of 1.449 deaths from apoplexy and diseases of the arteries, due to more accurate certitication, so that the only two causes that really showed an increased mortality during the year were those of the cancerous and homicidal deaths.

Viewed from the point of age grouping, we find that the mortality was decreased at all ages. The deaths of children under one year of age showed a decrease of 5,159

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deaths; of children under five years of age, 8.463 dea:hs; between the ages of five and sixty-five years, 7,570 deaths; sixty-five years of age and over, 824 deaths.

The decrease among the females reached 20 per cent.. whilst that of the males was about 18. The mortality among the colored population was stationary. There were 28,242 deaths reported in the various institutions of the City, a decrease of 658 compared with the decennial average. Dea:hs reported in tenement houses numbered 30,579, a tremendous decrease of 12,781 deaths being shown in comparison with the decennial average. The death rate for the previous decennium was 17.37, that of the year 1912 being 14.11, giving a decreased rate oi 3.26 per 1.000 of the population.

The infant mortality during the year was the lowest ever recorded in the City, 14.289 deaths being reported, which gives a rate of 10: 2 per cent., or, as it may be stated, 105 deaths occurred out of every 1,000 children born during the year. This is considerably lower than any of the large cities of the world, with the exception of the City of Paris; not that the credit of lowest infant mortality, however, should be given to this latter city, since the procedure there is to regard as still-born any infant who does not live longer than three days. Another factor in the low mortality of Paris infants is that a considerable number are placed in institutions and homes outside of the city limits, the deaths occurring among these infants not being included among the mortality rates of the city.

Births and Jarriages. The number of births reported during the year was 135,625, an increase of 1,083 compared with the returns for the year 1911, but while the returns show an increase in the absolute numbers, still the birth rate for the year, 26.22 per 1,000, is the lowest rate since the year 1906. On the other hand, the number of marriages reported was 52,391, with a rate of 10.13, this being the highest marriage rate in five years.

The number of still-births reported was 6,617, a decrease of 1,379 compared with the decennial averages.

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