i879-] 
Its Present and its Future . 
5i 
had been performed. The causes of insalubrity affecting 
infant mortality were not yet within control. In the year 
1868 the work of registration was extended and specialised 
in such a way that comparisons could be made in the death- 
rate between portions of the city occupied by a degraded and 
overcrowded population and those more favourably situated, 
whether in point of natural advantages or in the character 
of inhabitants. This specialisation enabled the sanitary 
inspectors to judge of the value of their labours in the matter 
of cleansing and disinfection. In faCt they had lowered the 
death-rate in certain of the most wretched wards below that 
in some of the best, sanitation in these latter having been 
omitted. The registration extended also to the effeCt of 
modes of living upon the death-rate, and in this manner 
pointed out the necessity of controlling the excessive mor- 
tality in tenement houses. That health reports, when 
promptly and intelligently used, might be effectively employed 
in the prevention of disease, was shown by the returns made 
during the last two weeks in July, 1878. The Registrar, 
apprehending that the infective quality of Asiatic cholera 
might prove to be present in the rapidly fatal diarrhoeas 
then prevalent, sent warning to the Surgeon-General of the 
United States army, in consequence of which the General 
in charge of the recruiting and transportation of troops 
ordered the immediate suspension of that branch of the 
army service in New York. Valuable illustrations of the 
relation existing between damp houses and pulmonary con- 
sumption were obtained by selecting certain wards of the 
city and forming maps in which every death from phthisis 
for a number of years was marked on the chart opposite the 
locality of its occurrence. The evidence so obtained pointed 
to an excess of consumption at the lowest levels, and in two 
of the wards to a crowding of fatal cases of this disease in 
localities unusually damp and in rainy seasons flooded, 
although these dwellings differed in no other respeCt from 
the average of the ward. The results obtained in this man- 
ner were deemed so valuable that the registration was 
applied to each house in the city. In this way excessive 
mortality in any locality or from any special class of diseases 
became known at once to the sanitary inspectors. 
With regard to the registration of marriages, improve- 
ment was more difficult. The system of registration, 
expecting a voluntary support from clergymen and civic 
officers concerned, could secure very partial returns, and it 
was only by diffusing information through the press and the 
lavish distribution of circulars that the accuracy and com- 
E 2 
