There are deaths by cholera, epidemic diarrhœa, and dysentery, of which during the biennial period we have had nearly 900; by fever, of which we have had 284; by erysipelas and puerperal fever, of which we have had 84; by small-pox, of which we have had 50; and cases of this sort partake of the nature of deaths by violence, not only because they are abrupt and untimely, but because they are _avoidable_. If in the instances which I have specified it were possible to make inquiry into the antecedent circumstances of the dead, you would find irrefragable evidence that life was lost in each individual instance by the operation of removable causes--by the foolhardy neglect of some familiar precaution, or by the obstinate retention of some notorious ill. The death of a child by small-pox would in most instances call for a verdict of ‘homicide by omission’ against the parent who had neglected daily opportunities of giving it immunity from that disease by the simple process of vaccination; the death of an adult by typhus would commonly justify still stronger condemnation (though with more difficulty of fixing and proportioning the particular responsibility) against those who ignore the duties of property, and who knowingly let, for the occupation of the poor, dwellings unfit even for brute tenants, dwellings absolutely incompatible with health. In addition to the diseases which I have named, there are others which owe their chief malignity and numerical largeness of fatality, though not their existence, to local and removable causes. The proportionate mortality from scarlatina, measles, and hooping-cough, is greatest when the general death-rate is greatest. Under similar circumstances, too, we find among the infant population a frequency and fatality of other diseases, not commonly accounted specific, which warrant us in considering them to be mainly of endemic and avoidable origin. Such are the hydrocephalus and convulsions, the diarrhœa, bronchitis, and pneumonia of infants; often indeed referred to the irritation of teething, but prevailing in different localities with so marked a proportion to the causes of other endemic disease that we may be sure of their partial and considerable dependence on those local and obviable causes. I dwell on this aspect of the subject, and particularly invite the attention of your Hon. Court to the table[35] which illustrates it, because it is in respect of these diseases that your exertions have already effected valuable improvements for the health of the City, and because the future registry of such cases will attest year by year the further progress of your sanitary reforms. In examining this index of preventable deaths you will notice that those from fever are fewer by 29 _per cent._ in the year just terminated than in the previous twelve months; that those from scarlatina are 75 _per cent._ fewer; those from infantile zymotic disorders nearly 40 _per cent._ fewer; those from