on a condition of great depression, with slow pulse, much restlessness, sighing, respiration, etc., resembling that of epidemic cerebro-spinal meningitis, of which disease there were several cases in this vicinity at that time."

Ashland.—“Two cases reported. Cause not appreciable. Sanitary surroundings of the patients good: the soil a deep, heavy, sandy loam with a gravelly subsoil; natural drainage good; the cellars a little damp."

Andover.-Dr. Kimball reports four cases. In one case the location was dry; in two cases it was dry, but near a pond or running stream; in one it was "rather damp." Nothing definite is stated as to origin or supposed cause; two of the cases followed exposure to wet and cold after very violent exercise.

Attleborough.-Dr. Sanford reports a single case.

"Patient was robust, ac

tive and athletic. Of origin or supposed cause," he says, "nothing can be stated."

Belchertown. Three cases reported. In two, "locality low, the patients being occupants of an Irish shanty on the bank of a river so swollen at the time as almost to reach the threshold of the house; no conveniences of any kind." In one case the disease supervened upon typhoid fever. This patient was from a good family, but had been overworked, both physically and mentally,-was away from home at school when seized with the fever, and living in a very damp location."

66

Beverly. Three cases are reported by Dr. Haddock. In one instance the locality was high; in two it was low.

Boston. The records of the city registrar show that 216 deaths were attributed to this disease in 1873. Of this number, 100 were males and 104 females; in 12 the sex was not stated. The first case was recorded on the 11th day of January. I have been able, through the courtesy of Mr. Appollonio, to obtain the dates and fix upon the exact locality of 204 of these reported cases, as will appear in the following table:—

Table showing the DEATHS attributed to Cerebro-Spinal Meningitis in Boston in 1873-Taken from Books of the City Registrar.

I.

I.

XIV.

XVI.

XV.

XI.

XII.

The percentage of Deaths in each Ward may be shown by the following

It may be proper to give in this connection the general locality and extent of the wards which, according to this table, have furnished the largest ratio of deaths per thousand of inhabitants, in order, as follows, viz.: Ward XIII.--By inspecting a recent map of the city, we shall see that this ward is situated in the south-easterly part of the old city proper, spreading out along the waters of the South Bay and intersected with tidal streams. It comprises the "Swett Street District," lies low, and has for the most part no proper drainage. The raising of a considerable portion of this territory is now being mooted by the city authorities. The contemplated route for the extension of East Chester Park to Dorchester nearly bisects this ward. Ward II comprises a segment of the North End, so called, the oldest part of the city; its semi-lunar outline bordering upon the Charles River and the harbor. Many portions of this ward have a densely crowded population. Ward IV is centrally situated, occupying very nearly a circle whose centre is in Scollay Square. It includes Portland Street, with the numerous courts and alleys adjacent, which can hardly be said to revel in favorable hygienic surroundings; eastward it reaches to the harbor and includes some of the most active business parts of the city. Ward XV is included in the extensive and sparsely settled district in the south-westerly part of the city. It lies low, and is in considerable part a marsh. It is largely intersected by tidal inlets. Ward X extends from

1

.616

.604

.594

.353

.212+

the South Bay, by which it is bounded for a considerable part of its extent on the east, to Warren Avenue and the Providence Railroad on the west. Washington Street, which formerly connected Boston with Roxbury as a narrow neck, passes through it lengthwise and nearly midway with made lands on either side. Ward XIV comprises the picturesque and elevated portion of the city-Roxbury Highlands, formerly so called-and extends in a somewhat narrow strip northerly as far as Tremont Street. Ward I comprises the whole of East Boston and the islands in the harbor, and is sometimes called the "Island Ward." Ward VIII is small in extent, stretching from the Common eastward to Ward VII. It is bounded by Albany Street on the east, and is intersected by Harrison Avenue, Washington and Tremont Streets.

Beginning now with those wards which are said to have furnished the least number of victims in proportion to their population:- Ward IX is situated between the Common and Public Garden and the remotest portions of the Back Bay lands in the one direction, and between Commonwealth Avenue and Ward X in the other. It is largely bottomed on made lands, but lately reclaimed from the sea, and comprises some of the finest streets of the city. It embraces also the recently raised Church Street District. The artificially made portion of this ward was originally a dry gravelly bank in Newton. Ward V extends from the Common eastward to the harbor, and includes the greater part of the burnt district, so called. Ward VI covers the more elevated part of the city north of the Common, extending thence along the Charles River to Brookline. Ward XII comprises the greater part of the peninsular of South Boston. Ward XI is similarly situated with Ward X, adjoining it upon the south. Chester Park, and Franklin and Blackstone Squares are in this ward. Ward III is bounded by Cambridge Street on the south, and extends along the borders of the Charles River as far as Warren Bridge. Most of the northern and eastern railway freight and passenger depots are in this ward.

It is not possible to predicate upon the meagre skeleton of facts here given, any positive opinion as to the conditions