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Case VII. Chestnut Street, off Water Street.-House on a declivity, perhaps forty feet above the river, and twenty rods. from its northern bank; surroundings good; the water, however, from the higher ground flows into the cellar, making it wet and foul, and often necessary to "put down boards"; had been very wet and damp just before patient was attacked; there was a disused well in the cellar, and an offensive odor in the sitting-room immediately over it; the drainage from the sink is carried into the garden a few feet from the house.
Case VIII. Adult female, Green Street.-House appeared all right; cellar a trifle damp, but not wet; the flowage from the sink of the next house above is seen upon the surface about ten or twelve feet distant, and has been "complained of."
Case IX. Adult female, Auburn Street.-House small; soil clayey and damp; no drainage; cellar very damp; two or three inches of water stands there, the exit of which has become stopped up; an offensive smell comes up the cellar stairway into the sitting-room immediately above; sink empties into a hogshead set in the ground.
Case X. A child, in " Portland Extension."-House stands high; cellar in fair condition; the locality of this house is good; the sink-drainage stands where it is poured out, quite near the house; but on the whole the hygienic conditions are favorable.
Lynn.-In company with Dr. Webster, I visited and examined the localities and habitations where a majority of the well-authenticated cases of the disease had occurred.
Case I. Oxford Street, between Willow and Almont, right side.-Land low; surroundings poor.
Case II, A child, Willow Street, between Oxford and Liberty, left side. The family occupied the upper story of an old house; shop underneath; land low; surroundings bad; the surface bestrewed with manure and garbage; a pool of stagnant water near.
Case III. Central Street, north side, near City Hall.House surroundings fair.
Case IV. A child, C Street, water side, in near vicinity of lumber yards-This street skirts the harbor, is muddy, almost impassable in spring; soil saturated with moisture.
Case V. Adult male, Pleasant Street, foot of Harbor Street. -Soil low and damp; surroundings bad; cellar always wet. The tide-water backs up through the drain, standing sometimes a foot or more in depth; sink empties into back yard direct; a pool of stagnant water near. There has been much sickness in this house during the past year, typhoid fever or rheumatism being almost constantly present.
Case VI. A child, on the same street, and near the above.— House similarly situated; cellar damp and uncleanly; apparently no drainage; bad smells.
Case VII. A child, Tyrrell's Block, on Pleasant Street.— This block consists of several rows of wooden houses, all of the same build. The street, in this part, is "very muddy, and difficult to drive through in spring." Land low; surfacewater runs readily into the cellar. It has water supplied from the water-works, and each tenement is furnished with a watercloset in the cellar. I learn that a fatal case of the disease occurred in this block six months previously.
Case VIII. A child, Bond Street, west side.-General situation and construction of tenement similar to that in precedLand low, but the soil drier; cellar damp; surface-water sometimes flows into it.
Case IX. A child, Church Street, south side, quite near Lynn common.-Land somewhat low, but not damp; surroundings good; aspect of house and street cheerful and pleasant; no sanitary defects.
Case X. A child, Emerson Street, west side.-Land low and flat; it is, however, dry and pleasant. Sanitary surroundings good; cellar in fair condition.
Case XI. North Common Street, north side.—Surroundings good; premises not examined.
Case XII. A child, Water-Hill Street.-Irish settlement; poor class of dwellings; very near the mill-pond, formed by a sluggish stream which connects Flax Pond, or Wyoma Lake, with Saugus River.
Case XIII. A child, Boston Street, north side, near Raddin Court and near the Saugus River.-Ground marshy in near vicinity; surroundings generally poor.
Case XIV. Raddin Court, north side, near the last case.Position higher; soil apparently dry.
Case XV. Winter Street, south side, midway between Stony and Strawberry Brooks.-House small and poor; land wet; drainage bad.
Case XVI. Washington Street, near Main, north side.— Land low; house better than ordinary; apparently no drain
Case XVII. A child, Laighton Street, south side.-House of one story, with cellar and attic; stands comparatively high ; cellar damp, and water backs in from drain.
Case XVIII. Off Jenness Street.-North side of Wyoma Lake, and within three or four rods of its margin; behind is a rocky and fairly wooded hill; surroundings apparently good.
Case XIX. On the same side of the pond and just upon its border; surroundings good.
Case XX. Near Browne's Pond, east side.-Surroundings good.
Case XXI. A child, Browne's Block (Wyoma).—East side of Main Street and close to the westerly point of Flax Pond.
Locality bad; marshy grounds, saturated with stagnant water, in rear; close by is a water-course connecting Wyoma and Wenuchus lakes.
Case XXII. Boston Street, east side, near the lakes.— House small, of two stories; in the lower is a barber's shop; ground in rear of house marshy and low. Two cases occurred in this house.
Case XXIII. Adult male, Lake Street (Glenmere).—This was an old man who lived alone in a small tenement, with a wood-house or lumber-room beneath, twenty rods or so from Flax Pond; surroundings poor; no drainage.
Case XXIV. Adult female, Lake Street, east side.-About the same distance from Flax Pond as the preceding case. Sanitary surroundings good; cellar in fair condition; drinkingwater obtained from a pump near by; drains apparently all right; vegetables stored in the cellar.
Case XXV. A child, Maple Street, east side.-Distant one or two rods from Flax Pond. Premises not examined.
Case XXVI. A child, Fayette Place, north side.-Small tenement; no drainage; stagnant water after a rain. A few rods north of this house is a small pond.
Case XXVII. A child, Essex Street.-House has two stories and an attic; in fair sanitary locality, airy and pleasant; but there is a hollow in the near vicinity, on the west side and across the road, where the soil is wet and heavy and water stands after a rain. In other respects, surroundings good.
Case XXVIII. Amity Street, lower part.-The locality is low, near the margin of salt water, with marshy grounds around.
Four other localities were visited, but the premises were not examined. They all had apparently good hygienic surroundings.
Salem.-But comparatively few cases have occurred in this city. Early in the season, I examined, with Dr. Johnson, the following localities, where he had heard of the existence of the disease :
Case I. Daniels Street, off Derby Street.-Now a dilapidated portion of the town; near the harbor; sanitary surroundings fair.
Case II. A child, Pratt Street, off High Street.-Surroundings generally poor. This is a sort of court, near the millpond.
Case III. A child, Webb Street.-This street skirts Collins Cove; land is low; hygienic conditions poor.
Case IV. Adult female, South Prospect Street―This locality is almost on a point of land, having water on three sides. Sanitary surroundings fair.
We now present, in briefest form, an analysis or résumé of the principal facts and circumstances received in answer to the series of questions before stated.
The details, more or less complete, of five hundred and seventeen cases, are given. All ages, occupations and nationalities were alike amenable to the disease. The age of the youngest patient on the record is five weeks, that of the oldest seventy years. Two hundred and thirty-one were males, and two hundred and eight were females; in seventy-eight the sex was not stated. The character of the attack in the large majority of instances was sudden, without premonition or previous noticeable illness.
The earlier and later symptoms correspond very nearly with those I have named as belonging to the disease in a former part of this paper,-violent, often excruciating, pain, referred to the back part of the head and neck, with muscular stiffness and a tendency to retraction of the head, great sensitiveness of the surface, restlessness and jactitation, with irregular panting respiration and delirium, mostly of a superficial character, were the prominent symptoms.