CHOLERA, YELLOW FEVER, PLAGUE, AND SMALLPOX-Continued. Reports Received from July 1 to Dec. 1, 1911.

MORTALITY-Continued.

Weekly mortality table, foreign and insular cities—Continued.

BRITISH BURMA-Rangoon.—Month of August, 1911. Population, 289,432. Total number of deaths from all causes 864, including plague 125, scarlet fever 61, smallpox 4, tuberculosis 49, typhoid fever 4.

GREAT BRITAIN.-Week ended October 28, 1911.

England and Wales.--The deaths registered in 77 great towns correspond to an annual rate of 13.3 per 1,000 of the population, which is estimated at 16,157,797.

Ireland. The deaths registered in 21 principal town districts correspond to an annual rate of 17.1 per 1,000 of the population, which is estimated at 1,149,495. The lowest rate was recorded at Drogheda, viz, 4.2, and the highest at Tralee, viz, 37.

Scotland. The deaths registered in 8 principal towns correspond to an annual rate of 16.7 per 1,000 of the population, which is estimated at 1,710,291. The lowest rate was recorded at Greenock, viz, 8.3, and the highest at Leith, viz, 19.4 per 1,000. The total number of deaths from all causes was 548, including diphtheria 8, measles 12, scarlet fever 7, typhoid fever 2.

Week ended November 4, 1911.

England and Wales.-The deaths registered in 77 great towns correspond to an annual rate of 13.5 per 1,000 of the population, which is estimated at 16 157,797.

Ireland. The deaths registered in 21 principal town districts correspond to an annual rate of 17.1 per 1,000 of the population, which is estimated at 1,149,495. The lowest rate was recorded at Lurgan, viz, 4.3, and the highest at Wexford, viz, 31,9 per 1,000.

Scotland. The deaths registered in 8 principal towns correspond to an annual rate of 16.4 per 1,000 of the population, which is estimated at 1,710,291. The lowest rate was recorded at Paisley, viz, 9.3, and the highest at Glasgow, viz, 18.3 per 1,000. The total number of deaths from all causes was 538, including diphtheria 11, measles 15, scarlet fever 4.

NEW ZEALAND.-Month of July, 1911.

Auckland.-Population, 102,676. Total number of deaths 85, including diphtheria 3, tuberculosis 6, typhoid fever 1.

Christchurch.-Population, 80,193. Total number of deaths 67, including tuberculosis 7.

Dunedin.-Population, 64,237. Total number of deaths 66, including diphtheria 1, tuberculosis 6.

Wellington. Population, 70,729. Total number of deaths 69, including diphtheria 2, measles 5, tuberculosis 7, typhoid fever 1.

SOUTH AFRICA-Bloemfontein.—Month of September, 1911. Population, 11,200. Total number of deaths from all causes 8, including diphtheria 1, tuberculosis 2.

SPAIN-Almeria.-Month of October, 1911. Population, 50,910. Total number of deaths from all causes 115, including measles 1, tuberculosis 10, typhoid fever 2.

Huelva.-Month of September, 1911. Population, 29,982. Total number of deaths from all causes 56, including diphtheria 1, tuberculosis 5, typhoid fever 3.

TURKEY IN ASIA-Jaffa.-Month of September, 1911. Population, 50,000. Total number of deaths from all causes 23, including tuberculosis 3, typhoid fever 4.

TURKS ISLANDS.-Four weeks ended September 30, 1911. Population, 1,681. Total number of deaths from all causes 3. No contagious diseases..

VENEZUELA.-Two weeks ended September 30, 1911. Population, 10,000. Total number of deaths from all causes 13, including tuberculosis 2, typhoid fever 2.

By authority of the Secretary of the Treasury:

A. H. GLENNAN,
Acting Surgeon General,

United States Public Health and Marine-Hospital Service.

PUBLIC HEALTH REPORTS.

VOL. XXVI.

DECEMBER 15, 1911.

THE CHOLERA SITUATION.

No. 50.

The number of cases of cholera being reported in Italy and Russia continues to decrease. According to last advices a few cases were still being reported in Austria-Hungary. From October 15 to November 11, 22 cases of cholera were reported on the island of Malta, where the infection is supposed to have been carried by refugees from Tripoli. Nine cases of cholera have been reported at Antivari, the seaport of Montenegro. In Tunis the cities of Tunis and Beja were declared by the authorities to be free from cholera on November 3, and the city of Bizerte was so declared November 4. Outside of these cities, however, the disease continues present.

PELLAGRA AS OBSERVED IN BARBADOS.

By P. G. SMITH, Acting Assistant Surgeon, Public Health and Marine-Hospital Service.

Upon visiting the out-patient department of the Barbados General Hospital, at Bridgetown, one is impressed with the large number of patients who come in for treatment, almost invariably giving the same history and presenting a most remarkable chain of symptoms.

These patients give a history of failure in appetite, falling off in weight, lassitude, slight vertigo, a burning sensation in the stomach, and in most instances diarrhea. This class of patients rarely improves under treatment, and within a few weeks or months they can be found in the hospital wards at the St. Michael's Almshouse. Later, when serious mental symptoms develop, it becomes necessary to admit them to the asylum for the insane, where they can be properly

restrained.

Physical examination shows marked anemia, pulse increased and weak, and the temperature normal or slightly subnormal. The skin feels hard and dry and symmetrical pigmented patches are found scattered over the knuckles, backs of the hands, wrists, elbows, ankles, and on the fronts of the legs. These pigmented patches have a scaly, branlike appearance and sometimes can be brushed off, leaving an apparently healthy under skin, which rapidly becomes again pigmented. The lips are red and the gums somewhat spongy. The tongue is red and swollen, and along its edges may be seen a few pigmented spots, varying in size from a pin's head to a small pea, and in some places the tongue appears to be denuded of its epithelium. There may also be seen on the tongue and buccal mucous membrane, and on the roof of the mouth, numerous small vesicles filled with a clear serum which break and leave small, regular-shaped ulcers, giving the parts a peculiar appearance.