PLAGUE.

Plague has continued to be present to some extent in most of the maritime countries. There have been no striking or unusual outbreaks. It has persisted most frequently in seaports. In numerous instances the infection has been found in rats, but has not affected man, so far as known.

SOUTH AMERICA.

In South America the disease has been reported in Brazil at Bahia, Pernambuco, and Rio de Janeiro; in Ecuador at Duran, Guayaquil, Milagro, and Sanborondon. The greatest prevalence of the disease was reported at Guayaquil, where there were 366 cases reported between November 1, 1913, and March 31, 1915. In Peru the disease was reported in the Provinces of Ancachs, Arequipa, Cajamarca, Callao, La Libertad, Lambayeque, Lima, and Piura. The disease was present in many localities, although the number of cases reported was not great in any one place.

CUBA.

Between March 5 and September 17 there were 43 reported cases of plague in Cuba. Twelve of these cases were reported at Santiago, and 4 at El Aceite. Between February 9 and June 14, 1915, there were 17 cases reported at Habana. Plague infection has been found among the rats in Habana. On April 9, 1915, two cases were reported at Pinar del Rio, and May 13 one case at Guanabacoa.

ASIA.

In Ceylon 241 cases of plague were reported at Colombo between May 19, 1914, and April 24, 1915. The disease was present in various parts of China during the year. Among the more important cities at which it was reported were Amoy, Canton, Chinchew, Fatshan, Hongkong, Pakhoi, and Shanghai.

The disease continued to prevail throughout India, where there were 270,242 reported cases between January 4 and October 17, 1914. In most of the provinces the disease has continued without intermission. Among the principal cities harboring the disease were Bassein, Bombay, Calcutta, and Rangoon.

In Indo-China the disease has been present in several provinces and numerous localities.

In Japan the disease was reported at Hodogaya, on the island of Taiwan, at Tokyo, and at Yakohama, as well as in other localities.

The disease was also reported in various places in Persia, Siam, and the Straits Settlements. In Turkey in Asia the disease was reported at Adalia, Bagdad, Basra, Beirut, Jaffa, Mitylene, Samos, and Smyrna.

In the Dutch East Indies a considerable prevalence of the disease was reported in the province of Kediri, Madioen, Pasoeroean, and Surabaya.

EUROPE.

In Great Britain nine cases of plague were reported at Liverpool between August 8 and 12, 1914. The disease was reported in various localities in Greece, chiefly at Chios, Piræus, and Saloniki. In Italy 17 cases of plague were officially reported during the period beginning September 1, 1914. Eight cases were reported in Portugal at Lisbon, October 8, 1914. In Russia plague was reported in the Astrakhan government in various localities, and 9 cases at Moscow between December 6, 1914, and February 13, 1915.

AFRICA.

Plague was reported in British East Africa at Mombasa during June and July, 1914. In Egypt the disease was reported at Alexandria and at Port Said, and also at various localities throughout the provinces. Fourteen cases were reported in German East Africa. Cases were reported in Derna and Marsa-Susa in Libya. Twelve cases were reported at Dakar in Senegal.

In the Union of South Africa pneumonic plague was reported at Queenstown and Tarka between September 24 and October 5, 1914. Between February 5 and April 10, 1915, the disease was reported present in Cape Province in the districts of Cradock, Maraisburg, Molteno, and Queenstown. Between July 1 and October 31, 1914, 30 cases of plague were reported at Zanzibar.

MAURITIUS.

Plague was reported on the island of Mauritius between April, 1914, and April 5, 1915.

YELLOW FEVER.

As usual, the principal localities in which the occurrence of yellow fever was reported were in South America. In Brazil 24 cases were reported at Bahia between May 10, 1914, and February 20, 1915, 2 cases at Rio de Janeiro, and 1 at Pernambuco. In Ecuador 16 cases were reported at Guayaquil between May 1, 1914, and April 30, 1915. In French Guiana 15 cases were reported at St. Jean du Maroni in September and October, 1914. In Venezuela 1 case was reported in June and 2 cases in December, 1914, 1 case at La Guayra in August, and 1 at Maracaibo in June, 1914.

In Mexico the disease was reported in Yucatan in Merida and Progreso.

A case of yellow fever was reported at Curacao December 9, 1914.

TYPHUS FEVER.

Typhus fever has continued to be reported in foreign countries, and during the year it appeared in the reports of European countries much more frequently than usual.

EUROPE.

Austria-Hungary.-In Austria-Hungary from August to December, 1914, there were 279 cases of typhus fever reported. From

January 1 to April 24, 1915, there were 5,310 cases reported. The disease has continued since that time, but apparently in a diminishing extent. Cases were reported at Budapest, Fiume, and Vienna, also in localities in Bosnia-Herzegovina and Croatia-Slavonia.

Germany.-In Germany 240 cases of typhus fever were reported between February 14 and May 8, 1915. The cases were principally among the German soldiers and prisoners of war. Ĉases were

reported at Frankfort on the Main, Konigsberg, and Lubeck.

Great Britain and Ireland.-In Dublin cases of typhus fever were reported in February, March, and June, 1915; in Dundee during May; in Glasgow in March and May.

Greece.-In Greece typhus fever was reported present at Athens during April and May, 1915, and at Saloniki from December, 1914, to May, 1915.

Italy. Typhus fever was reported present in Florence from November 1, 1914, to the end of April, 1915. In Venice it was reported present during January, 1915. In Turin one case was reported during May, 1915.

Netherlands.-A case of typhus fever was reported at Rotterdam in October, 1914, and another case at Flushing in May, 1915.

Russia. During the period December, 1914, to April, 1915, typhus fever was reported present in Russia at Moscow, Odessa, and Petrograd. During the latter part of 1914 the disease was present in Warsaw. A case was reported at Batum in August, 1914. At Riga there were 15 reported cases between June 1 and October 17, 1914. The greatest prevalence of the disease in Russia was reported at Moscow.

Serbia. There has been some typhus fever in Serbia and the Balkan region for a number of years. In January, 1915, the disease became epidemic in Serbia, and for the next few weeks the number of cases increased rapidly. At one time there were estimated to be at least 500 deaths daily from the disease. It was unusually virulent and attacked a great many physicians and nurses in attendance upon the sick. To such an extent was this so and so great were the fatalities that it was difficult at times to maintain an adequate medical and nursing service. By May the disease seemed to be diminishing, both in virulence and in number of cases, and by June it seemed to be well under control.

Spain. In Spain typhus fever was reported at Madrid and Tarragon, there being five reported deaths at Madrid during March and three during April, 1915.

Switzerland. One case of typhus fever was reported at St. Gallen in May and one in April; and two cases were reported in June at Zurich.

ASIA.

Siberia. Typhus fever was reported present at Vladivostok from December, 1914, to March, 1915.

China-Cases of typhus fever were reported in China at Antung, Hankow, Harbin, Manchuria Station, and Tientsin.

Japan. In Japan typhus fever was present at Hakodate, Tokyo, and Yokohama.

Turkey in Asia.-Typhus fever was reported from many points in Turkey in Asia. The disease seemed to be pretty well distributed throughout the country. The reported cases were principally at military centers, camps, and hospitals.

MISCELLANEOUS.

Egypt. A considerable number of cases of typhus fever were reported during the year at Alexandria, Cairo, and Port Said. At Alexandria there were 232 reported cases from February 12 to May 20, 1915, and at Cairo 170 deaths between January 21 and April 29. Guatemala.-Typhus fever was reported present at Guatemala City during March, 1915.

Mexico.-Typhus fever was present in Mexico, as it has been for a number of years, especially at the higher altitudes.

Islands. Typhus fever was reported present in the Azores at Terceira in February, 1915, and in Bermuda at Warwick Camp. There was a case reported in the Canary Islands, and a death was reported at Santa Cruz de Teneriffe in May, 1915. The disease was reported present in the Dutch East Indies at Batavia and in the surrounding country.

MARINE HOSPITALS AND RELIEF.

RELIEF STATIONS.

During the fiscal year ended June 30, 1915, the service operated 23 marine hospitals, all of which are owned by the Government, and maintained 121 other relief stations where hospital and dispensary relief was furnished patients. In order to furnish medical relief to seamen in districts not heretofore provided for, relief stations were established during the year at Port Angeles, Wash., and Newport, Oreg. Owing to the limited amount of treatment furnished sick and disabled seamen, the relief stations at Crisfield, Md., and Beaufort, N. C., were reduced during the year from stations of the third class to stations of the fourth class and placed in charge of the local customs officers.

In lieu of the then existing Revenue-Cutter Service and LifeSaving Service, to be composed of those two organizations with the incumbent officers and men, the United States Coast Guard was established by act of Congress approved January 28, 1915. In accordance with the provisions of this act, officers and enlisted men of the Coast Guard are entitled to the same medical relief as is provided by the regulations of the service for officers and enlisted men of the former Revenue-Cutter Service. It is apparent that this provision, as affecting surfmen in particular, will greatly increase the expenditure for the maintenance of the service.

Section 3 of the above-mentioned act of Congress provides in part as follows:

That all existing laws affecting rank, pay, and allowances in the present LifeSaving Service and the present Revenue-Cutter Service shall apply to the corresponding positions in the Coast Guard and the officers and men transferred thereto and their successors. This shall include all laws and regulations which now give to the enlisted men of the existing Revenue-Cutter Service increased pay of $1 per month for each year's service, allowances for uniforms, and all other allowances or gratuities due to enlisted men, which are hereby made applicable to the enlisted men of the Coast Guard who were formerly surfmen in the Life-Saving Service. The provisions of sections 3, 4, 5, 7, 8, and 9 of the act of April 12, 1902, in so far as they provide for the retirement of officers of the Revenue-Cutter Service, are hereby extended to include commissioned officers, warrant officers, and enlisted men of the Coast Guard.

In view of the provision made for the retirement of officers and enlisted men of the Coast Guard, said service requires that all its officers and men be subjected to rigid physical examinations for enlistment and reenlistment. As these physical examinations are made by medical officers of the service, the effect of said provision is, so far as it concerns the service, to require medical officers in charge of relief stations to make a far greater number of, and much more complete, physical examinations of such applicants than formerly.

In accordance with provisions contained in paragraph 459, regulations of the service, officers and crews of the several vessels belong