In the city of New York the epidemic first appeared September 18. Up to and including December 27 there were reported to the Department of Health 136,061 cases of influenza and 21,388 cases of pneumonia. The number of deaths since September 18 was 11,725 attributed to influenza in the death certificates filed in the Health Department and 11,601 attributed to pneumonia. The epidemic reached its peak during the week of October 19, slowly subsided and was practically at an end on November 9. While the epidemic is reported as ending on this date, the mortality rate from influenza and pneumonia is still very much above normal. No particular features concerning the meteorological conditions were noted, except that in this city the weather was clear and delightful during the months of September and October when the epidemic was rampant. In the city of Philadelphia on July 22 the Health Department issued its first health bulletin on so-called Spanish influenza, announcing the possible spread of this disease into the United States. On September 18 a warning was issued against an epidemic, the department starting a public campaign against coughing, sneezing and spitting. On September 21 the Bureau of Health made influenza a reportable disease. At this time the authorities stated an epidemic of influenza was recognized as existing among the civil population of similar type to that found in the naval stations and cantonments; that a large percentage of cases was accompanied by pneumonia; that patients should be isolated and attendants wear masks; that isolation be practiced for a period of ten days after recovery to prevent carriers; that patients be guarded against relapse and that the public be cautioned against large assemblages and crowded places, as well as to avoid coughing, sneezing and spitting. On October 3 the churches, saloons and theatres were closed, funerals were made private and food handlers were required to protect their wares. The number of cases reported from September 23 to November 8 was 48,131, but the Bureau states, from a rough estimate, the number of cases was probably 150,000. The total number of deaths reported was 7,915 from influenza and 4,772 from pneumonia in all its forms, the presumption being that the deaths during this period were due to influenzal pneumonia. The weather condition during this time is recorded as mild and fair. The influenza cases began to be reported in Cleveland on October 5, and up to December 20, 22,703 cases had been recorded. Certificates recording deaths due to influenza alone numbered 2,497, while pneumonia amounted to 833. The epidemic was at its height in the latter half of October and the weather was spoken of as pleasant fall weather. During the week of October 26 the epidemic reached its greatest height, abated in the week ending November 23, increased later, but showed a drop for the week ending December 21.