OFFICE OF THE 
Igoanl of 
Sir: 
The Board of Health of the city is desirous of investigating the subject of 
the local causes of Diphtheria. To that end, it is proposed to make an analysis of the 
mortality of the disease during the year ending April 30th, 1876. Will you please favor 
the Board with answers to the following questions concerning the case at No..., 
Street, reported by you to have ended fatally theth 
day of187 , and return your reply at your early convenience 
to Dr. F. W. Draper, at this office, who is instructed to report upon the subject. 
Respectfully, your obedient servant, 
C. E. DAVIS, Jr., Clerk. 
1. What were the three most prominent symptoms in the case? 
2. Did you trace any connection between this case and others antecedent? 
3. What was the sanitary condition of the premises, as regards 
(a) Drainage? 
(b) Ventilation? 
(c) Light ? 
(d) Personal habits of the family? 
(e) Offensive odors ? 
4. What, in your opinion, were the causes of the infection? 
(a) Remote ? 
(b) Immediate? 
Any detailed statement relating to the case, in addition to brief answers to the 
foregoing, will be gratefully appreciated by the Board.