Of avoidable or removable causes of disease we have those conditions around or within our dwellings or places of business or resort, errors in our mode of living, etc., which vitiate health, or rather tend to diseases, and yet which can be removed or changed by human agency. For example, a country residence may be most favorably located for health, and yet decaying vegetable matter in the cellar, or a cesspool so situated as to allow the gaseous emanations to be diffused through the house, will expose all the inmates to fevers, diarrhoea and dysentery. These would be preventable diseases, and all the deaths therefrom would be preventable, and hence unnecessary deaths. In like manner in cities, all diseases and deaths due to causes which human agencies can remove are preventable. And it is a melancholy fact that fifty per cent of the mortality of cities is estimated to be due to such causes, and is hence unnecessary. In reviewing the result of this inspection, I shall call your attention only to the more patent causes of disease found existing, and to the preventable diseases discovered, and their relation to these causes. In this evidence you will find ample proof that radical reforms are required in the health organizations of New York. [Sidenote: Filthy Streets] I will first notice the causes of disease which exist external to our dwellings, and which are the most readily susceptible of remedy. The first that attracts attention in New York is the condition of the streets. No one can doubt that if the streets in a thickly populated part of a town are made the common receptacle of the refuse of families, that in its rapid decomposition a vast amount of poisonous gases must escape, which will impregnate the entire district, penetrate the dwellings, and render the atmosphere in the neighborhood in a high degree injurious to the public health. In confirmation of this statement, I will quote the City Inspector, who, in a former communication to the Common Council, says: “As an evidence of the effect of this state of things upon the health of the community, I would state that the mortality of the city, from the first of March, has been largely on the increase, until it has now reached a point of fearful magnitude. For the week ending April 27th, there were reported to this department one hundred and forty more deaths than occurred during the same week of the previous year. Were this increase of mortality the result of an existing pestilence or epidemic among us, the public would become justly alarmed as to the future; but although no actual pestilence, as such, exists, it is by no means certain that we are not preparing the way for some fatal scourge by the no longer to be endured filthy condition of our city.”