The prevalence of venereal diseases at the training stations for the year is shown by the admissions per thousand in the following table:

General infective diseases (nonvenereal) show a decrease in the number of admissions, but the number of sick days shown by this group is increased by 2,325.

Only 3 cases of diphtheria were found during the year at the training stations-these occurred at Newport.

During the year there were 1,051 cases of mumps; of this number, 828 cases occurred at the three training stations Newport, Norfolk, and San Francisco-while the remainder, 223 cases, are credited to the service at large. The admission rate for mumps at the training stations was 150.27, while for the service at large it was only 4.35 per thousand.

At the training stations the admission rate for pneumonia was 16.33 (Newport furnishing more admissions than the total from the other stations), while the rate for the service, exclusive of the training stations, was 3.43 per thousand.

Excepting malaria, the greatest decrease in the admission rate of any disease occurred in tonsillitis-falling from 61.71 in 1909 to 55.02 per thousand in 1910. Only 3 cases of scarlet fever occurred at the training stations during the year, and the remainder of the service gave 29, making a total of 32.

An outbreak of cerebrospinal fever occurred at the San Francisco training station. There were 5 cases, with 1 death. One case occurred at Newport, making a total of 6 cases in the service during the year.

A careful survey of the returns continues to indicate that the naval training station at San Francisco is unfortunately situated, from a climatic viewpoint. Twenty-five cases of tuberculosis developed at the training stations during 1910.

3. Affections depending upon ship life show little variation from the rates of admission for last year; the most marked difference being the reduction in number of admissions for tonsillitis, due, in part, to the substitution of the bubbling-spring drinking device for the common drinking cup. The admissions for typhoid fever show a reduction. The number of drownings in 1910 was 109, as compared with 51 in 1909.

The returns show 15 cases of variola in the force afloat during 1910, as against 7 in the preceding year. The outbreak on the U. S. S. Washington resulted in 10 of the 15 cases. Owing to the frequent intimate contact of the naval auxiliary service with the force of the Navy, it is recommended that compulsory vaccination of these men be performed.

Diphtheria shows a slight decrease among the force afloat. In this connection, it may be added that the Bureau, in accordance with

the opinions held by the foremost practitioners to-day, has discontinued the administration of general prophylactic dosage with antitoxin, at the same time the Bureau urges the early and bold administration of antitoxin to persons who have developed the disease.

Heat exhaustion and thermic fever both show reduction in admission rates.

4. Affections depending upon exotic exposure. The rate of admission for malaria shows a decrease from 18.85 in 1909 to 11.79 in 1910. There is a marked reduction in the incidence of dengue. There is a markedly increased rate for admission for ankylostomiasis, 0.16 per thousand in 1909, and 0.97 per thousand in 1910. This is probably due to systematic examination for this disease.

Influenza shows an increase in the admission rate per thousand from 22.15 in 1909 to 26.74 in 1910. Dysentery shows a decrease in the admission rate from 2.19 in 1909 to 1.37 in 1910.

5. Affections depending upon special conditions of service.-The admission rate for appendicitis shows a reduction from 6.77 to 6.43 per thousand. Operative treatment was given to 231 cases of appendicitis, with 3 deaths.

Mental diseases appear to show slight increase during the past year. The statistical report of the insane from the Navy at the Government Hospital for the Insane is on page 95.

Suicides have been frequent, 20 having occurred during the year. The manner of suicide and number of deaths from each method is shown in the statistical table on page 76.

UNITED STATES NAVAL DISPENSARY.

The increasing work which falls upon the naval dispensary in Washington, D. C., has necessitated the detail of an additional medical officer to meet the urgent needs of this duty.

After a practical trial of several years the present location of the dispensary at the naval hospital is regarded as unsatisfactory. Its inaccessibility is believed to deter many ambulant cases from appearing for office treatment, thus materially and unnecessarily increasing the number of visits required of the medical officers in attendance upon sick officers and their families.

Further, officers on active duty can not afford the time consumed in visiting this remotely situated dispensary, consequently, it has been necessary to maintain a second dispensary and to devote to dispensary purposes several rooms of the much-needed space of the bureau, in the Mills Building.

It is believed that a centrally located dispensary, easily accessible to the department and to the resident families of officers could be efficiently maintained with a personnel reduced in number below that now required for dispensary purposes, and at no inconsiderable saving in cost of equipment.

The Bureau recommends the establishment of a centrally located dispensary in Washington.

THE NAVAL MEDICAL SUPPLY DEPOTS.

Naval medical supply depots are maintained at New York, Mare Island, Cal., and at Cavite, P. I. The activities of these depots embrace the purchase of medical and surgical supplies, instruments,

furniture, etc., their delivery to ships, stations, and hospitals and the acquisition of information concerning the condition of the market and the sources of supply available in event of national emergency. The following table gives an idea of the amount of work done at these depots during the year:

NAVAL PRISONS AND PRISON SHIPS.

So far as possible the circumstances and surroundings of the prisoners are made as comfortable as may be, consistent with their confinement.

A reasonable and proper amount of work is required of prisoners, and the physical exercise thus enforced serves to keep them in better health than if they were permitted to follow their personal inclina

tions.

The prisons are all reported to be in excellent sanitary condition. A laundry and drying room are needed at the prison at Mare Island, Cal., and attention has been invited to the need of providing facilities for the care and treatment of prisoners who may develop infectious diseases while in confinement at the naval prison, Portsmouth, N. H.

TRAINING STATIONS.

Norfolk. The health of this station has been satisfactory. No epidemic other than mumps has occurred. Not a case of true measles appeared. There were 19 cases of German measles (rubella). All cases of contagious and infectious disease, except mumps, have been contracted outside the station.

The following special diseases occurred during the year: Mumps, 178 cases; rubella, 19 cases; chicken pox, 2 cases; typhoid fever, 17 cases; pneumonia, 14 cases; syphilis, 43 cases; chancroid, 122 cases; gonorrhea, 389 cases; and malaria, 4 cases.

The total number of sick days was 3,259, and the percentage of sick was 0.46.

The unit system of barracks would tend to lessen the spread of contagious disease. Screening and mosquito extermination would prevent malarial infection. Rigid enforcement of venereal prophylaxis would help reduce the amount of venereal disease.

Typhoid fever has been more or less prevalent at this station for some years at times reaching epidemic proportions. Strict sanitation at the station and the compulsory use of typhoid prophylaxis to all the personnel will tend to reduce the incidence of this disease. So long as typhoid fever is present to any degree in the city of Norfolk men from the station on liberty will be in danger of contracting the disease.

Newport. The prevalence of catarrhal and respiratory diseases and the large number of cases of pneumonia at this training station indicate that climatic conditions are not ideal.

During the year there occurred 46 cases of pneumonia, 39 cases of influenza, 10 cases of tuberculosis, 3 cases of diphtheria, 54 cases of tonsillitis, 270 cases of mumps, 68 cases of measles, 114 cases of German measles (rubella), 1 case of cerebrospinal fever, and 2 cases of typhoid fever. The total number of sick days was 3,013, and the percentage of sick was 0.32.

Some of the diseases have been practically perennial in their prevalence since the establishment of the station, and there appears to be no practicable way to prevent contraction of these diseases by susceptible persons during their period of service at this station.

Every effort has been made to prevent occurrence of these diseases. Even a routine quarterly fumigation of the living spaces and clothing has been tried, but it appears that no known and practicable method of prophylaxis will prevent development of measles and mumps among large bodies of closely herded young and susceptible recruits who are granted liberty in communities where the diseases are endemic.

The senior medical officer of the station at Newport comments upon conditions as follows:

Though from an individual or professional point of view this condition of things is not ideal, yet serious complications are almost unknown in these diseases, the illness incident to the average case of mumps or rubella is no more serious than that incident to vaccina, and a corresponding immunity is acquired for the man's future aboard ship, which may be regarded as a compensating advantage.

The new receiving building, when completed, will prove a most valuable adjunct to the station. This building includes an emergency ward for the treatment of mild cases of illness, which may develop among the recruits who are segregated for observation before their admission to the barracks where they come in contact with the large body of men who are under training.

A weekly inspection is made of all persons under training with view to discover and prevent the spread of skin diseases.

San Francisco. This training station is unfavorably situated because of climatic conditions, and has been the subject of previous adverse report. The health of this station has not been satisfactory. During the year there were 18,710 sick days. The percentage of sick was 4.28.

Some of the contagious or infectious diseases noted. were: Pneumonia, 30 cases; influenza, 149 cases; cerebro-spinal fever, 5 cases; typhoid fever, 2 cases; mumps, 380 cases; measles and German measles, 149 cases; tuberculosis, 3 cases; tonsillitis, 114 cases; and venereal diseases, 204 cases.

The annual report of the medical officer at this station says of the receiving building:

The building is at times overcrowded; the entire air space when all bunks are filled is 166 cubic feet per man, which is far too small and should not be tolerated for a moment on a shore station.

Contamination of the water of the bay with refuse is said to result in polluting the water of the swimming tank. This should be remedied by filtration if necessary.

The present method of dumping the garbage from the station into the bay should be abandoned and an incinerator should be installed for garbage disposal.

The Great Lakes Training Station has just been formally opened. It seems probable that the morbidity and mortality statistics of this station will closely parallel those of the naval training station at Newport, especially in so far as catarrhal and respiratory diseases may be concerned.

RECEIVING SHIPS.

Whether in large barracks or in receiving ships, the outbreak of infectious disease is always a matter of great moment, because of the number of persons who may have been exposed before the disease is discovered. This is peculiarly true of the old and, from a a sanitary viewpoint, unsatisfactory receiving ships which are at times overcrowded.

In the last annual report of this bureau the desirability of the use of unit barracks instead of the receiving ships now in use was expressed. Experience has proved the higher disease rate for the receiving ships, and it seems that only by the employment of unit barracks in lieu of the receiving ships can the best hygienic surroundings be given to the officers and men who must serve at receiving and training stations.

In this connection the medical officer of the U. S. S. Franklin says: I am of the opinion that two years spent on the Franklin in the close, poorly ventilated offices of the ship, and the additional requirement of being obliged to live in the wardroom for that period, materially lowers the vital resistance of those officers quartered on board.

The U. S. S. Independence is the subject of unstinted criticism in the annual sanitary report of the medical officer serving on board that ship.

The U. S. S. Hancock is reported to be in good sanitary condition, but her present position (Jan. 1, 1911) is insanitary, as she lies alongside the caved-in portion of the Cob Dock, and accumulation of refuse occurs on the shelving shore. The decomposition of this material, expecially in warm weather, produces a far from ideal sanitary environment.

The U. S. S. Lancaster, U. S. S. Philadelphia, and U. S. S. Wabash are reported to be in good sanitary condition, except as to certain minor features.

NAVY YARDS.

The sanitary conditions of the navy yards have, generally speaking, been excellent. A consideration of the large mass of work which falls upon the medical officers of the yards illustrates the important functions performed by these officers, not alone in the rendering of aid to the injured and treatment of the sick, but also in the prevention of communicable disease or of its spread.

It is the Bureau's duty again to recommend the provision of unit barracks for the accommodation of the crews of ships which are undergoing extensive repairs or annual overhauling at the navy yards. The discomfort and insanitary conditions prevailing aboard ships in dry docks and undergoing extensive rapairs call urgently for remedy. It is believed that the health of the personnel would be conserved by the evacuation of ships undergoing general repairs, especially in winter, and the berthing of the crews in sanitary and comfortable