No. 118. April 9, 1917: Executive order of the President of the United States placing matters pertaining to Porto Rico under the jurisdiction of the War Department.

No. 119. April 9, 1917: War proclamation of the President of the United States. No. 120. March 10, 1917: Promulgating amendment to sanitary rules and regulations concerning transmissible diseases.

No. 121. April 25, 1917: Proclamation of the President of the United States regarding agencies in the United States of German insurance companies.

No. 122. April 30, 1917: Treason proclamation.

No. 123. May 4, 1917: Mothers' Day proclamation.

No. 124. May 10, 1917: Promulgating sanitary rules and regulations concerning embalmers and disinfectors.

No. 125. May 10, 1917: Promulgating sanitary rules and regulations concerning the storage and sale of foods and drugs.

No. 126. May 11, 1917: French Day proclamation.

No. 127. June 5, 1917: Promulgating sanitary rules and regulations concerning the health of operatives and the conditions which should prevail in buildings or places devoted to the manufacture of cigars, cigarettes, etc.

No. 128. June 28, 1917: Military registration proclamation.

No. 129. June 28, 1917: Designating officers and places for the purpose of carrying out the military registration.

PARDONS AND PAROLES.

During the fiscal year 1916-17, the governor received 322 petitions for clemency.

The following statement shows the number of petitions received and the action taken thereon:

The sanitation service, as it has heretofore been called, was converted by the new organic act into the department of health on March 2. The director of sanitation was appointed commissioner of health and took his seat in the executive council; but in accordance with the new law part of the work of the old department of labor, charities and correction, namely, the two asylums, was assigned to the department of health. This made a considerable addition to the work to be performed by the sanitation service. During the year, in order to lay a foundation for improvement of the medical charity work performed by the municipalities, a thorough survey was made of the actual conditions existing in this department of municipal administration. These conditions were found to be very unsatisfactory in most of the municipalities, and the difficulties in the way of improvement are very great; but it is hoped that some method may be found of overcoming them.

REPORT OF THE GOVERNOR OF PORTO RICO.

During the year also the department had to contend with an unusually persistent and virulent epidemic of measles which originated in San Juan but appeared also in various other municipalities throughout the island and caused trouble throughout the whole of the year. This epidemic attracted fresh attention to the deplorable housing conditions in the congested district of that part of San Juan known as Puerta de Tierra and an effort was made to secure legislation that would enable the government to establish a system of government tenement houses for the improvement of this dangerous and degrading situation. The bill authorizing this reform failed of passage, but the effort will be renewed in the next legislature and it is hoped with better success. After a beginning in this direction has been made in the congested region of San Juan it is expected that better housing for laborers will be gradually developed in the other cities throughout the island.

During the year there was an alarming increase in the general mortality from 21.9 last year to 28.5 per thousand this year. The number of births was again reduced during the year by 3,331. This shows a total decrease in the number of births in the island for the year 1916-17 of 4,688 under the figures for the year 1914-15.

Full information regarding health and sanitation will be found in the report of the commissioner of health in Appendix III.

PUBLIC ASYLUMS.

Immediately after the passage of the Jones bill the department of labor, charities, and correction ceased to exist and all the institutions attached thereto by the laws of Porto Rico were assigned to other departments. The insane asylum and the blind asylum were given to the department of health, while the charity schools were placed under supervision of the commissioner of education.

Insane asylum.-As stated in previous reports, the present building of the insane asylum is entirely inadequate and unfitted for the treatment of patients. Fortunately, the Legislature of Porto Rico in its last session enacted a law, following my recommendations, which authorizes the governor to transfer the present building to the Federal Government, sets aside the sum of $300,000 for the construction of a modern asylum, and appoints a commission to select the proper site for the new construction. No steps have yet been taken to carry out this project due to pressure of the war, but preparations are under way and it is expected that this matter will be undertaken at an early date.

The first efforts of the commissioner of health when appointed and intrusted with this new work were directed toward making more space for the admission of new patients. He was able to do this by reducing the amount of space set aside for the officers' quarters. These reforms were submitted to the consideration of the legislature and $2,000 for changes in the building were obtained, as well as the sums necessary for the subsistence of 50 additional patients to June 30 and of 125 additional from July 1.

When the institution was transferred to the health department there were outside of the institution about 115 cases of dangerous insane whose admission had been ordered by the courts and between 300 and 350 insane whose admission had been requested by their families.

An inspection of the insane confined in the municipal jails and hospitals shows that there were 225 insane requiring treatment, and orders have been given for their admission as soon as the requirements of law have been complied with.

Proper blanks and instructions have been also prepared for the careful study of each case.

Many chronic harmless insane have been found and it is the intention of the medical officers of the institution to turn them over to their relatives or to the municipality from which they came in order to make space for other more urgent cases. This plan if carried out will greatly relieve the difficulties involved in the care of the insane and diminish the expense of maintenance.

The number of patients on June 30, 1917, was 421. During the year 164 were admitted, 30 were discharged as cured, 23 left the asylum uncured at the request of their guardians, and 46 died during the year.

During the year no epidemics have been reported. The health of the inmates has been good and the mortality was 11 per cent.

Blind asylum.—The number of patients in this institution on June 30, 1916, was 76. One hundred and sixty-three were admitted during the fiscal year. One hundred and five left cured, 46 left improved, and 8 died of various diseases. There were 118 operations performed during the year. The number of inmates remaining in the asylum on June 30, 1917, was 48 men and 25 women, making a total of 73.

INSULAR BOARD OF HEALTH.

During the year under review this board has prepared various rules and regulations which have in turn been approved by the executive council and the governor and now have the force of law.

These rules and regulations cover vaccination; transmissible diseases, the removal of corpses; cemeteries, burials, disinterments and cremations; transmissible diseases of animals; the prohibition. of the sale of fowls suffering from certain transmissible diseases; the organization and regulation of the profession of embalmers and disinfectors; the storage and sale of foods and drugs; and the health of operatives and the conditions which shall prevail in the buildings and places devoted to the manufacture of cigars, cigarettes, etc.

Rules and regulations governing the practice of pharmacy; the supply and sale of water; the manufacture of sausages, fritters and other cooked foods; and amendments to the regulations and rules governing dairies, milk depots, and the sale of milk, and governing the keeping of dogs, the suppression of stray animals, and prevention of rabies, have also been drafted and are now pending approval.

The regulation governing vaccination was drafted in accordance with the sanitary law which provides for the compulsory vaccination of all the inhabitants of the island, and the board has recommended the creation of an insular vaccine institute for the purpose of facilitating vaccination at all times.

In order to prevent as far as possible the introduction into the island of epidemic poliomyelitis (infantile paralysis) an amendment was made to the existing sanitary rules so as to place this in the list of diseases notifiable within 24 hours; and one of the members of this board visited the United States, especially the city of New York, for the purpose of making a study of this disease, and as a result

of his investigations the board has suggested a series of prophylactic measures for the consideration and adoption by the sanitation authorities of the island.

The regulation governing the manufacture of cigars and cigarettes was amended so as to permit the establishment of departments for the stripping of tobacco within the urban zone. Inasmuch as this work is usually performed by women living in the towns and who, under the original regulation, would be obliged to give up this means of livelihood, and inasmuch as the inconveniences caused by stripping the tobacco in the manner actually practiced outside the urban zone would be offset by efficient and positive sanitary improvements in the factories, it was agreed to authorize the stripping of tobacco within the urban zone, but subject to such regulations as would prevent its being a menace to public health.

This board has also recommended that a beginning be promptly made to improve the sanitary conditions in Puerta de Tierra which has frequently been the source of epidemics and seriously threatened the health of the city of San Juan during the present year by an outbreak of scores of cases of measles.

INSTITUTE OF TROPICAL MEDICINE AND HYGIENE.

The investigations of the institute have continued along the same lines as in former years and the examinations made, by reason of the interest awakened in the medical profession of the island, have been larger than in previous years.

On account of the present abnormal conditions and the lack of sufficient funds the hospitalization of patients and the annual expedition to other points of the island could not be made.

More attention than ever before has been given to the study of the cause of sprue and now the bases for its specific treatment have been found. In connection with this work the services of Dr. Carl Michel, assistant surgeon, United States Public Health Service, were of great value.

Owing to the present state of war between the United States and Germany the institute regrets the loss of Dr. Bailey K. Ashford, who was detailed to duty with the Army in France. We feel also the loss of Dr. W. W. King's services, who has been assigned to sanitary work in the Virgin Islands.

A few scientific articles have been written by the members of the institute embracing their respective investigations. Some have already been published and the others will be given to the public in the near future.

INSULAR POLICE.

The only change of importance made in the organization was the separation of the detective force into a distinct body of 25 men, classified into three grades and called bureau of information. The entire number of the whole force, including the bureau of information and officers of all ranks, is 718. The work of the force was considerably increased by strikes among the longshoremen, agricultural and other laborers which were widely scattered throughout the island and continued in a desultory manner throughout the whole year. A good record for efficiency was made by the whole force during the year. Public order was maintained and much valuable assistance was afforded to all the various departments of the Government by

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the police force as a whole, due to its excellent organization widely distributed over the entire island. This was especially true with regard to the military registration, recruiting of volunteers for the Porto Rico regiment, and other military work made necessary by the state of war.

Out of 50,233 arrests made during the year, 84 per cent of convictions were secured, with 1,324 cases still pending. The removal of the Porto Rican regiment from the island increases somewhat the responsibilities and potential importance of the police, and it is recommended that its personnel be slightly increased.

Complete statistics with reference to the work of the insular police force will be found in Exhibit C of Appendix I.

CIVIL SERVICE COMMISSION.

Applications for examinations were received during the fiscal year from 1,156 persons, which is 270 fewer than in the preceding year. Nine hundred and fifty-four persons were examined and 453, or 47.48 per cent, passed. The commission also examined 242 persons for the United States Civil Service Commission. Of these, 206 took. examinations for appointment in Porto Rico and 140, or 67.42 per cent, passed.

One hundred and seventy-three appointments were made as a result of examinations as against 98 for the previous year, this increase being due to the larger number of positions in the classified service provided for in the budget.

There has been no difficulty in securing sufficient eligibles for clerical positions, but it has been almost impossible to secure competent stenographers and typewriters. During the year only 31 applications were received for this examination; of these, 27 reported for examination and only 9 passed. In the examination for typewriters there were 90 competitors of whom only 31 passed.

Of the 5,441 positions in the government, 1,284 are in the classified service and 4,157 are in the unclassified service. Only 327 of the total number of positions in the service, both classified and unclassified, are filled by nonnatives of the island, and most of these are teachers. Statistics concerning the work of the commission will be found in Exhibit E of Appendix I.

BOARD OF MEDICAL EXAMINERS.

During the year just ended, 41 applicants for licenses as general practitioners, 18 as minor surgeons, 21 as nurses, and 1 as optometrist were examined by this board. Of these, 29 physicians, 9 minor surgeons, 20 nurses, and 1 optometrist passed and were duly licensed upon payment of the requisite fees. A license was also issued to a doctor of the United States Army without examination upon presentation of satisfactory documents and certificates.

After a careful study of the matter by one of its members, a list of schools for optometrists the diplomas of which are acceptable to the board was prepared and approved, and in consonance with its usual practice, the board has devoted a considerable part of its time to investigations for the purpose of reporting to the proper authorities persons practicing the medical profession unlawfully.

The recommendation made last year for a clerk exclusively for the examining boards is urged again, with a view to securing prompter attention to the various matters that come up for their consideration.