to vitiate the mortality figures. The whole thing is
an absurdity; as absurd as the illiterate and fallacious three-page
leaflet which constitutes this community's total attempt at an annual
health report.

[Illustration: DR. J. MERCIER GREEN

HEALTH OFFICER OF CHARLESTON, SOUTH CAROLINA, WHO STAMPED OUT A SMALLPOX
EPIDEMIC AND REFORMED THE CITY'S WATER SUPPLY]

St. Joseph, Missouri, claimed, one year, a rate of 6.5 deaths out of
every 1,000 inhabitants. Were this figure authentic, the thriving
Missouri city, by the law of probability, should be full of
centenarians. It isn't. I essayed to study the local reports, hoping to
discover some explanation of the phenomenon, but was politely and
regretfully informed that St. Joseph's health authorities issued no
annual reports. The natural explanation of the impossibly low rate is
that the city is juggling its returns. In the first place, that favorite
method of securing a low per capita death rate--estimating a population
greatly in advance of its actual numbers--is indicated; since the
community has fewer lines of sewers and a smaller area of parks than
other cities of the size it claims--two elements which, by the way,
would in themselves tend to militate against a low mortality. Perhaps,
too, the city has that ingenious way of eliminating one disturbing
feature, the deaths under one week or ten days, by regarding them as
"still-births." Chicago used to have this habit; also the trick of
counting out non-residents, who were so thoughtless as to die in the
city. At present, it is counting honestly, I believe. Buffalo used to
pad for publication purposes. One year it vaunted itself as the
healthiest large city in the country. The boast was made on the original
assumption of a population nearly 25,000 in excess of the United States
Census figures, to which 20,000 more was added arbitrarily, the given
reason being a "general belief" that the city had grown to that extent.

Perhaps as complete returns as any are obtained in Maryland, where the
health official, Dr. Price, culls the death notices from 60 papers,
checks up the returns from the official registrars, and if any are
missing, demands an explanation by mail. It behooves the registrar to
present a good excuse. Otherwise he is haled to court and fined. The
Board has thus far never failed to secure a conviction.

Now, if the most concrete and easily ascertainable fact in public health
statistics, the total of deaths, i