in the country three kinds of sanitariums for consumptives, according to the climate classification that experience has recently demonstrated, to wit: Highland, Lowland, and Maritime Sanitariums.

A fact that is worthy of note is that the Chilean Indians cannot bear the benefit of civilization.

The religious order of the Saletians established in Puinta Arenas, gathered during the last years of the past century four hundred Patagonian Indians, who belong to a robust and well developed race, for the purpose of civilizing them; but at the end of seven years only thirty of them were left, all the others were victims of consumption. A short while after they entered the Institution most of them were attacked with galloping consumption. Those that escaped from the disease owed their lives to the fact that they were allowed to return to the life to which they had been accustomed, to walk barefooted and to cast away all other hindrances that they had been compelled to wear in accordance with the requirements of civilization.

At the present time consumptives take refuge in certain points which have a quiet reputation for the treatment of their ailment, but which have really become foci of infection for tuberculosis.

The municipal authorities at those points have been alarmed by such conditions and in one of them, Quilque, they have anticipated their measures to those of the Central Government by compelling physicians to report all cases of consumption to the local authorities, in order to disinfect the houses where consumptives have died or from which they have been removed.

The Superior Council of Hygiene in its session of April 3, 1902, resolved, on motion of Doctor Carvallo, to request the Minister of the Interior to suggest to Congress the amendment of the law of February 7, 1899, to the end of including pulmonary tuberculosis among the diseases that physicians are compelled to report.

By virtue of Section 1 of the Municipal Ordinance of Santiago of July 12, 1899, disinfection is compulsory under penalty of forty pesos in all cases of smallpox, scarlet fever, diphtheria and typhoid fever, and, besides, in cases of tuberculosis when the patient is in public or private institutions, such as colleges, hotels, boarding houses, houses of prostitution, etc. (Annex F. 4).

In some branches of the Government the prophylaxis of tuberculosis is more or less well attended, as, for instance, in the Government Railroad where the service is in charge of the distinguished physician, Sr. Eduardo Garcia Collao. Annex shows that the disinfection division of the Santiago station composed of a majordomo and twelve disinfectors, attend to the daily disinfection of the baggage of all passengers arriving at the capitol, which is done by the Morrison apparatus with a solution of formalin at 5 per cent in the interior of the freight cars after having been hermetically closed. When it is known that a passenger suffering from an infectious disease has travelled in the Government lines, especially if there be traces of his presence, such as sputum, blood, etc., the cars are disinfected in the manner above stated and besides thoroughly scrubbed and washed with a solution of corrosive sublimate. We will soon have in operation machinery for the disinfection by steam of sleeping cars, and also for live stock cars.

On the other hand, prophylaxis of tuberculosis is neglected in some institutions, the public schools, for instance. It occurs frequently that school teachers suffer from consumption. These unfortunate persons whose salaries are very limited, depriving themselves of many necessities of life, and the majority of whom have to work excessively in order to make both ends meet, are compulsory victims of tuberculosis. It is in these cases that the affection of the larynx is observed. These consumptive teachers, who in order to make themselves audible to their pupils, have to get close to them, constitute a real danger for the children who become infected by respiration. In order to overcome this great danger to the country the condition of those consumptive teachers should be ameliorated, either exempting them from service with full pay during the time of their sickness or discharging them definitely.

Annex K. 2 shows the statistics of mortality by tuberculosis compared with the other causes of death in the principal cities of the Republic, and which gave an average of 15.7 per cent for 1899 and 14.4 per cent for 1905.

It is true that the tuberculosis mortality shown in that table is lower, but it should be borne in mind that consumptives are not admitted in our hospitals, and in many cases the families of those dying from the disease give other causes of

death in order to deceive the authorities. Santiago has an asylum for consumptives, and the San Jose Hospital to which are removed such consumptives as are found in other hospitals and also those which apply for admission therein, the latter ones are few, however, for the reason that the people are prejudiced against it, and only recur to it in the more advanced stages of the disease..

PRACTICAL MEASURES TO PREVENT the Infection from Consumptives Travelling TOGETHER WITH WELL PERSONS EITHER BY RAIL OR WATER.

Compared with other diseases, tuberculosis is not easily transmitted; while a transmitory connection is needed for the transmission of syphilis and gonorrhea, a persistent infection is necessary for that of tuberculosis. We all know the experiments that Grancher and Potian used to make with the nasal mucus of their alumni after their lectures in the hospital, finding in many cases the presence of Koch bacillus, which before the lectures were absent.

Generally, the presence of a person in the railroad cars is too short to enable him to contract the disease, for which reason we are of the opinion that it would be sufficient to follow the same practice in force in many countries of Europe and of the United States, and that has been established in our Republic with satisfactory results by the director of the service, which is the daily disinfection of the passengers' baggage, as well as of the berths that have been used; it would also be advisable to do away, as far as possible, with rugs and curtains. The cars should be provided with numerous cuspidors properly distributed.

If the above measures are prescribed for railroads they are more necessary for steamers. The latter should be provided with a Geneste-Herschell apparatus for the disinfection of berths by steam, and all cabins should be washed with antiseptic solutions. In the dining rooms the same methods followed in sanitariums for consumptives should be observed, to wit: Sterilization of forks, knives, plates, etc., after having been used; napkins used by consumptives should be adequately wrapped so as to prevent them from coming into contact with the others. There should be cuspidors in the rooms, passageways, etc., of the

steamer.

Finally, a fine should be imposed, as is done in Sydney, Australia, upon those who expectorate in public places.

WATER SUPPLY.

The State supports especially the Water Services of the Republic. The office of Water Inspection and Sanitation, studies and orders the execution of all the technical works required by the need of the people.

The Fiscal Administrations of the Water Enterprises or the Municipalities, supported by the State, are in charge of these public services. In the city of Santiago the sources of water supply are the water-falls of Ramón and Vitacura, located east of the city, the former having its origin in the chain of mountains and the latter from filtrations of the Mapocho River, located at a distance of 4 and 8 kilometers, respectively, of the city of Santiago. From these sources are drawn an average annual supply of 72,040 m3 daily, with a maximum of 118,910 m3, and a minimum of 37,280 m3. Additional works and water conduits now in construction, shall increase within two years the water supply of Vitacura to 91,928 m3 daily.

The Ramón Creek has a variable supply, for the average annual production has been of 11,722 m3 daily; its monthly maximum being of 180,300 m3, and a daily supply of 251,860 m3, and a monthly minimum of 56,683 m3, and a daily supply of 54,800 m3.

The average consumption of drinking water in Santiago, in 1905, was of 40,300 m3, corresponding to a monthly maximum of 46,930 m3, and daily of 51,120 m3, and to a monthly minimum of 33,900 m3, and a daily of 30,448 m3, or, that is to say, in the neighborhood of 100 liters a day per capita.

In view of the further needs of drinking water, required by the progress of the capital, and by future requirements of the sewer system, the Supreme Government appointed three university professors to report in regard to the future needs of the capital, which, according to the opinion of the Department of the Interior, should be at the rate of 300 liters a day of drinking water per capita. This Commission, in a brilliant report that we have the honor to submit, as it contains valuable and interesting information regarding these services,

agreed, after having examined the works of Freeman, on drinking water in New York, those of Beechman on Paris, and those of the engineers that directed the works in Boston, Philadelphia and Cincinnati, that the distribution of water for a city like Santiago should have a minimum of 500 liters a day per capita, which would give a supply of 200,000 m3 for a population estimated at 400,000 inhabitants. This amount of water could easily be drawn from the hydrographic basins that surround Santiago, and still better, from the Laguna Negra or Vicuña Mackenna, located in the heart of the Andes range of mountains, for it is an immense and deep body of water, having a surface of 16 kilometers, and being at an altitude of 2,772 meters above the sea level. The Laguna Encañada, formed from filtrations of the first mentioned, is located at an altitude of 2,572 meters, and could also be exploited for the capital's use.

The quality of the drinking water of Santiago is always satisfactory; its temperature in the distributing reservoirs is not higher than 15 degrees or 16 degrees centigrade. Chemical analysis show that its salts are in a normal proportion to be drinking water; chlorine and ammoniac leave infinitesimal traces. Its classification is "very good."

The Hygienic Institute of Santiago has been making fortnightly, since 1894, six years before that of Paris, some bacteriological and chemical analysis of the waters on various samples taken from the reservoirs and from the spigots of this service at the aforesaid Hygienic Institute.

The number of colonies of bacteria has been, on an average, of 46 per cubic centimeter; in the analysis of former years, maxima of 204 have been observed in the summer and a maximum of 5, in winter, for the waters of Vitacura. Those of Ramón have had a maximum of 134 and a minimum of 8 colonies. The coli bacillus is found three or four times during the year in the various fortnightly samples. The waters in Paris, in all its samples, show the presence of the coli bacillus.

The Eberth bacillus has not been found in the waters of Santiago.

In Valparaíso the Peñuelas Lake is the source of supply, and the consumption for a population estimated at 150,000 inhabitants, was only of 22,221 m3 of filtered water a day and 16,200 m3 of unfiltered water, used by the Electric Traction Company.

Iquique, Antofagasta and Pisagua have private sources of water supply, deficient for the present needs of their inhabitants.

The Supreme Government has sent a message to Congress, asking the authorization to spend three million dollars to supply the city of Iquique with splendid water which it abundantly possesses in the falls of Chintaquay and at the rate of 160 liters a day per capita. To-day the cubic meter of water costs $10. In the annexes relative to the sewer systems is found a description of the cities which will be benefited with new services or improvement of those now existing, according to the project of the Executive, that disposes of £1,500,000 for Sanitation and water works.

In Annex V we publish a note of the Sanitary Inspection to the Hygienic Council, in which all the cities that possess drinking water are enumerated; those that require improvements, the works now under construction, and those under consideration. We also enclose a chart showing the distribution of conduits of drinking water in the city of Santiago.

Annex VI shows in a table the general supply of water, its origin, system of purification, and ration per day and per capita, in liters.

Annex VII is a memorandum of the Water Enterprise of Santiago, which reviews the history, antecedents and present condition of the water service.

SANITARY ORGANIZATION IN CHILE.

SANITARY ORGANIZATION.

It is pleasing to state that during the period that has elapsed since the last Sanitary Congress, public sanitation in Chile has been the subject of special attention on the part of our Government, assisted by the Superior Council of Health.

The exotic epidemic of bubonic plague, the recrudescence of an epidemic of small-pox, demographic statistics showing high figures for the victims of tuberculosis, typhoid fever, etc., have impelled the authorities and the people of the country to unite their efforts for the purpose of attaining a high degree

of sanitation in our cities and to protect ourselves against diseases entirely foreign to our country. Unfortunately, an earthquake that, on the 16th of August, 1906, caused the loss of over two thousand lives, destroyed several towns, and occasioned a national loss of over 300,000,000 pesos, diverted the attention of the Government from public health, but now that the country has recovered to a certain extent from so great a calamity, the authorities have resumed their activity in prosecuting the work of sanitation with greater energy.

As stated by our colleague, Dr. Moore, before the First Sanitary Convention, we lack in Chile an executive board of public health charged with the_control of the sanitary affairs of the country. As constituted at present, the Superior Council of Health is only an advisory board, and is not vested with the executive powers which high corporate bodies of this character should have.

But a reactionary movement has already been initiated. In 1906, the Government appointed a committee, on motion of the Superior Council presented by my colleague, Dr. Soza, composed of two hygienists, Doctors Lucio Córdova and Mariano Guerrero, Secretary and Counsel, respectively, of said board. This committee is entrusted with the preparation of a bill, organizing in the most perfect form and in accordance with the most modern methods of hygiene, the sanitary legislation of the country.

The committee referred to visited during the past year the principal nations of Europe and the United States of America in order to make a careful study of their sanitary laws, and it is now preparing its report and the proposed law that will be submitted to the consideration of the National Congress.

Another step originated by this reactionary movement was the Decree of January 25th, of the current year, whereby a Bureau of Public Health and Beneficence, under the Department of the Interior, was created. On the 29th of the same month, the Executive appointed Dr. Luis Astaburuaga, Director of said Bureau. (Annex VIII.)

Later on, the sub-department of health wanted by the medical institutions of the country, and for the creation of which a petition has already been made to the Government, will be organized. In the meanwhile, efforts are being made for the establishment of a Department of Public Health, which would be the most advanced and commendable step that a nation could take toward the cause of sanitation.

Judging from the interest shown by the Executive, and from public opinion, it may be assured that Chile will have within a short time a Sanitary Code which will be as complete as those of the nations most advanced in public health. Complying, therefore, with the provisions of the program, we will state in this report what has been done during the past two years in regard to sanitary legislation and methods, adding a few brief details on the present condition of the health service of the country.

The Political Constitution of the Republic, in its provisions relating to sanitation, prescribes, in Section 73, that all public establishments shall be under the supreme supervision of the President of the Republic, in accordance with the special ordinances governing them.

Pursuant to Section 119, of the same Constitution, the municipal governments are charged with the sanitation, comfort, embellishment, and recreation of their respective cities, as well as with the care of hospitals, orphans and foundling asylums, penitentiaries, houses of correction, and other charitable institutions under the provisions of law.

A synopsis of the sanitary functions and duties of the Central and the Municipal Governments has been presented by the Superior Council of Health under the following paragraphs:

"In Chile the affairs relating to public health are entrusted to

"(a) The Department of the Interior, and

(b) The Municipal Governments of the Republic.

(a) The Department of the Interior issues the sanitary ordinances and regulations relating to the sanitation of the country. In this respect, the Central Government has under its supervision all measures for the eradication of infectious diseases, and the land and maritime international sanitary police.

"For the adoption of such public health measures, as well as for the enforcement thereof, the Department is advised by the Superior Council of Health and the Institutes of Hygiene, both operating in the city of Santiago.

"For the execution of these measures in provinces and departments, the

Intendentes and Governors, officers representing the Chief Executive in their respective territories, receive orders and instructions from the Minister of the Interior. They are advised by the Departmental Councils of Health. For the enforcement of the provisions of Maritime Sanitary Regulations, the Intendentes and Governors in maritime districts are advised by boards of health, of which are also members the senior customs officers, and the physicians of the port.

(b) The municipalities, represented by the First Alcalde (Mayor), are entrusted with all matters referring to the public health and sanitary condition of towns. In this respect the local authorities have under their supervision the sanitation of streets, squares, parks, and other public places; the construction and maintenance of sewers; the protection of canals and aqueducts; the supply and distribution of water; the establishment and management of free public bath houses; the establishment and management of public slaughter houses; the regulation of bars, saloons, grocery stores, etc.; the regulation of unhealthful factories and industries, workshops, stables, and poultry yards; the encouragement of the construction of cheap hygienic dwellings; the adoption of measures for the prevention or eradication of epidemics; the organization of services of disinfection, etc.

"For the adoption of these public measures, the Alcalde is advised (1) by the Superior Council of Health, upon which all municipalities of the Republic may call for advice; (2) by the Departmental Councils of Health, presided over by the Intendente or Governor of the province or department.

"Some municipalities have established within their respective territories health bureaus, or chemical laboratories."

The Government, besides the general supervision which it exercises over all sanitary matters, has, in case of an epidemic, the right to enforce for a definite period, and the consent of Congress previously obtained, the Law of Sanitary Police, passed on the 30th of December, 1896. By virtue of this law, the President is empowered to close the maritime and land ports; to prescribe quarantine measures, compulsory disinfection of passengers and cargoes, and to adopt such other measures which he may deem necessary for the eradication of any of the epidemics specified in the regulations. The General Health Ordinance of January 10, 1887, specifies the sanitary measures that may be adopted by the authorities.

The General Board of Sanitation, which was created to advise the Government in sanitary matters, and to study and submit health and prophylactic measures, and the departmental boards of sanitation, were abolished on May 23, 1900, and the Superior Council of Health was organized instead thereof. The provincial councils of hygiene, established by decree of January 19, 1889, were also reorganized and subdivided into the present Departmental Councils which have been operating since the 10th of December, 1892.

The Law of Navigation, in force since June 24, 1878, and the Maritime Health Regulations of February 18, 1895, prescribe the measures of a permanent character that should be taken against epidemics; the inspection of vessels; the issuance of bills of health; the adoption of prophylactic measures that should be observed before, during and after the voyage; quarantine and examinations; sanitary stations, sanitary tariff, and the duties pertaining to sanitary authorities. (The Law of Sanitary Police and the Maritime Health Regulations referred to are contained in the report of Dr. Moore, published in the Transactions of the First Sanitary Convention of 1902, Annexes C and K.)

SANITARY STATIONS.

The Sanitary Station of Arica was established in April, 1905, on account of epidemic of plague that invaded the provinces of the coast of Peru. Its personnel consists of: I chief physician, I assistant, I bacteriologist, I mechanic, I disinfector, I clerk, 2 first class sailors, and 2 second class sailors; this personnel may be increased when necessary. The lazaretto is provided with a steam launch whereon is mounted a Clayton apparatus for the disinfection of vessels. It is proposed to have a land lazaretto built in the Port of Arica, for the hulk serving as lazaretto has been condemned recently The regulations governing the station have been approved by the Superior Council of Health. but have not yet been promulgated as law by the Government. In the meanwhile it is governed by the Maritime Health Regulations, the instructions from the Su