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occurred in other parts of the village where I could not detect any malarial influence. The symptoms seemed somewhat rheumatic in character in most cases, though some were peculiar to that disease.
“The chief apparent cause mnight have been remedied by a little more energetic action of our board of health, a month earlier, so far as the stagnant pool was concerned.
“Cholera infantum always prevails here during July and August. More children die with some form of morbid discharge from the prima viæ, than from anything else during summer and early autumn. The causes seem to me to be mainly these : hot, impure air, sympathetic irritation from teething, and improper diet. A very large majority of the cases occur among our foreign population, and the causes can only be removed by a development of higher intelligence among the mothers, and the enforcement of stricter sanitary measures by our corporations and health officers.
“Scarlatina, whooping-cough and measles have each had their turn among the children ; but neither was extensively prevalent or fatal.
“Typhoid fever has disturbed us less than usual, and much less than it has adjoining towns. This disease occurs much oftener near certain streets here than in other localities, and I have little doubt that badly arranged privyvaults, imperfect sewerage, damp cellars and too heavily shaded streets, are responsible for almost all these cases. In passing near the large corporation blocks, along the rear alleys, one cannot help receiving emphatic, sensible evidence of the foul odors of decomposing organic and excrementitious matters, during any of the warm months. It cannot be easily helped, with our present amonnt of sewerage, except by using a large quantity of disinfecting material, and by putting up high ventilating pipes connecting with every vault, and keeping the vault tight.
“Our local health authorities are the 'selectmen,' fair business-men, of average intelligence, none of them physicians, druggists or chemists, I think. I do not think that they are as vigilant to detect, or energetic to remove, causes detrimental to public health, as would be highly desirable in so crowded a villago; but tax-payers are generally ready to cry out against any but the most obvious and pressing needs of reform, and without more liberal public sympathy to back them, I suppose they could effect but little more than thoy do, without great personal sacrifice."
Clinton.—“ A catarrhal fever was very prevalent in February, March and April. It seemed to follow the ‘horse-disease,' of the previous autumn, and many of the sick said, 'I have got the horse-disease.”
Dedham.—"Typhoid fever was specially prevalent, caused by overwork. The health authorities are intelligent, vigilant and efficient.”
Dorchester.—“Typhoid fever was specially prevalent this autumn. It is only during two or three years past that any but imported cases were frequent in Dorchester. Turning over the earth for water-pipes, and the use of Cochituate water, for the disposal of which there is no drainage, are possible causes."
Easthampton.-"Only a mild epidemic of scarlatina prevailed. No cause for the epidemic, preventable or otherwise, was apparent. The health authorities are active, intelligent and efficient."
Esser.—"Scarlatina of a mild type has prevailed here during the spring and summer, and a few cases still exist (November 7th). In some thirtyfive cases under my own care, one death has occurred. These cases have all been confined, thus far, to one part of our village and town, extending over the area of about three-fourths of a mile. I am not able to assign a reason why it should be confined to this particular part, as it is apparently as high, dry and healthy as the section which has been exempt.
"As to our health authorities, in my opinion, they are not as vigilant and efficient as the interests of the public require."
Ererett.—"Although there are no specially prevalent diseases, yet we have one sort of nuisance which has not been fully abated. John P. Squire transports his offal through the streets of this town, always in the daytime, and through the principal street (Broadway), and I often wonder we are not afflicted with typhoid more than we are.
The stench is sufficient to generate typhoid dysentery. “The rankest compound of villanous smell that ever offended nostril,' you would say.
"The selectment of the town are its board of health, and I think they are prompt in abating nuisances. When I had a seat upon the board of health, we effectually suppressed the opening of sink-drains upon the surface of the land. The case of the hotel at Mount Desert is a strong point for health officers to consider."
Fairharen._"Influenza prevailed from December, 1872, to June, 1873. Then cholera morbus and other affections of the bowels. From September to December influenza again prevailed. It was caused by some peculiar condition of the atmosphere during cold and sudden changes in temperature. Improved drairage would operate for the prevention of cholera morbus.
“The health authorities are not intelligent, vigilant, and efficient. The whole system is a sham.”
Fall Rirer.—“Early in the year, cerebro-spinal meningitis prevailed to a limited degree, and this autumn scarlet fever was quite generally prevalent. No cause for these was discovered.
"Our board of health is composed of the mayor and aldermen, who are intelligent men. I believe it is usual for the city marshal to represent them.”
Fitchburg.—“The year 1873 has thus far been remarkably exempt from epidemic or other prevalent forms of disease in this city. Influenza and bronchial affections in moderate degree, a small amount of dysentery and cholera infantum, and a very trifling amount of typhoid fever. I have known of two families where enteric fever prevailed, evidently of local poisonous origin, from sink and privy-soil contamination. One case was fatal. It is a matter of surprise that many cases of the same character have not occurred in this city from the same causes among the tenements of the poor and filthy, where bad drainage and no sewerage exists.
"We have no board of health, except the ex officio board of aldermen, who have not thus far, to my knowledge, taken any official action of a hygienic or sanitive character as a board of health. Last winter, there having been three or four cases of varioloid in a remote part of the city, a spasmodic attempt was made by the city council to secure general vaccination, which failed of complete success, by reason of some disagreement between committees and those employed to do the work; a disastrous result, which would have been avoided if a proper board of health had existed and taken the work in charge."
Forborongh.—“During the whole of the winter of 1872 and 1873, there was an unsual number of cases of mumps. Many cases occurred which were undoubted second and third attacks. I know of no cause which will explain the prevalence of the disease.
"The local authorities have been equal to all occasions that have called for the exercise of their powers."
Groveland.—“I am not aware that any form of disease has prevailed in this locality the last year. We have had, in past years, visitations of typhus, scarlatina and dysentery, but I have never referred them to local causes. The local authorities in this healthy country village have never interfered, unless in small-pox.
“ That my answers may not be entirely useless, I add a few words as to the health and locality, though not exactly relevant to your inquiries. I was born about four miles from here, in Georgetown, and have lived eightysix years, the eighth of December. I have lived as a physician on this spot fifty-six years last June; on the south bank of the Merrimack, about twenty rods from the water and thirty feet above high tide. The tide flows four to six feet, running both ways, unless in freshets from above.
“We have about a hundred families along Water Street, with some variety of elevation. A small stream comes into the river near a number of houses, from a peat meadow whose ditches ought to be better drained. This whole locality bas been rather remarkable for health and longevity. In it myself and wife have lived to 85 and 87 years; Mrs. 8. Parke, 87; N. Gould, 87; B. Parker, 84; 1. Tenney, 80; N. Hopkinson, 83;fA. Greenough, 83; Mr. Hawley, 83; I. Lyford, 84; S. Tuttle, 92,—now living. I might add, besides, the names of 50 who have died in 50 years aged from 80 to 97.
“The vicinity of a large river, streams of running water, or even green meadows, have not appeared to be injurious to health. I cannot see that fevers or consumption have prevailed at the river-side or in the valley more than on our hills. One house, so situated that a cemetery, on sandy soil, may filtrate, on a clay bed, to its cellar and well at thirty rods distance, has been unhealthy, as it must be. I think the banks of the Merrimack must compare well with any part of the country, in the health and long life of its inhabitants."
Hadley.—“We have had a little more of typhoid fever than usual, but not a great many cases and they have not been especially severe. There have been rather more fogs than usual this fall, and the weather has been very changeable. These may have had some influence. They are not directly preventable causes of disease; but with increased attention to sanitary conditions and personal care, they would be less potent for evil.
“The local health authorities perform no sanitary duties."
Haverhill.—" Cerebro-spinal meningitis and small-pox have prevailed. The former was perhaps caused by a damp, clayey soil, and damp cellars. A better system of drainage would remedy this; and a better system of isolation would be desirable in small-pox.
“ The health authorities are moderately intelligent, vigilant and efficient. No “regular' physician is on the board of health."
Hingham.—" Taking the year through, the public health has been good. Typhoid fever, which prevails to some extent every autumn, we have been unusually free from.
" The selectmen act as a board of health, and they appear to be fully alive to the interests of the town in this respect."
Hinsdale.-" Typhoid fever has prevailed; principally among the Irish population, operatives in mills, who live in crowded tenements and do not observe to any great extent the hygienic rules of health. No other cause for the disease has been observed.
“ The health authorities are moderately intelligent, vigilant aid efficient.”
Hopkinton.—"No forms of disease have been specially prevalent, except, recently, a severe form of bronchitis ('influenza'). The peculiar state of the weather, and want of preparation for the early winter, may have had something to do with this prevalence. Of course the people may be more careful about their clothing and exposure.
“ The local authorities are as intelligent, vigilant and efficient in matters of health as boards of selectmen in country towns usually are.”
Hyde Park.—“No forms of disease have been specially prevalent in the year that has passed. Scarlatina, pneumonia and typhoid have occurred in sufficient number of cases to justify the term frequent, but I cannot say that they have been specially prevalent.
" The cases that have fallen under my observation, have not appeared to follow any law by which their appearance could be systematized or in any way accounted for. Scarlatina has appeared almost entirely in sporadic cases where contagion did not appear possible, and, when so occurring, has seemed to exhibit no special tendency to extend itself by contagion, and has been of a mild type. Malignant cases have been very few.
“ Pneumonia has presented nothing unusual, occurring after sudden and extreme changes of temperature, and after unusual exposure. But it has presented no indications of special interest in the investigation of sanitary conditions.
"Typhoid has occurred in locations and in conditions as favorable to health to any in our vicinity, while neighborhoods where less attention has been paid to proper sanitary precautions, have not been visited with any extraordinary frequency or fatality.
“Other forms of disease have presented no marked features; and the year has been rather better than the average in respect to the health of this commanity. Consumption probably stands at the head of the list of fatal diseases, but it occurs in all classes and conditions, the only cause apparently operating in all cases being the very changeable climate to which we are all subject.
**Are the causes of prevalent diseases in any degree removable?' I do not know by what means. A considerable portion of our territory is low and wet, and many cellars are very damp. If proper drainage could be effected, as much might be expected from it as from any other means.
“The general opinion is, that the local health authorities are intelligent, vigilant and efficient."
Lawrence.—"In reply to your inquiry, whether any forms of disease have been specially prevalent in this city during the past year, I have to report
the occurrence of a number of cases of cerebro-spinal meningitis. Some of them were typical cases of the gravest forms of the disease, and terminated fatally in a number of instances; while many were of a milder character, having little or no tendency towards a fatal result, recovering spontaneously, or with little aid from medicine. I am unable to give any satisfactory information concerning the causes of the prevalence of cerebro-spinal meningitis. It did not usually appear to derive either its remote or its exciting causes from any influence arising from locality, although a few cases appeared amid surroundings which more than suggested the opinion, that the vitiated air of ill-ventilated rooms was instrumental in developing the disease.
“During the midsummer months, dysentery of a severe type prevailed quite extensively in one portion of the city. The mortality from this cause was quite large, but I have no means of determining the ratio of the fatal cases to the whole number.
“Of the six wards of the city, only one, ward five, suffered in any notable degree. Indeed, all other parts of the city were remarkably exempt from dysentery during the past season.
“The mortuary record in the city clerk's office, shows that there were eighteen (18) deaths from this cause in the entire city, between June 1st and November 1st, 1873; of which thirteen (13), more than two-thirds, occurred in ward five. This ward contains an extensive area of low, swampy land, situated upon the left bank of the Merrimack River. From its westernmost point it extends easterly along the river for a distance of half a mile, and then, leaving the river at nearly a right angle, it runs northerly for twothirds of a mile. Its width varies from one hundred and fifty to three hun. dred yards.
“From the inner angle thus formed, and from the western line of the swamp, “Tower Hill” and other high lands rise more or less abruptly.
“The swamp is intersected by streets which have been made by 'filling in'gravel taken from the bordering highlands.
“The land intervening between these streets being for the most part ungraded and undrained, is covered alternately with still-water and decay. ing vegetation.
“The natural outlet of the water of the swamp is into the Merrimack River on the south, and the Spicket River on the north, but the descent is so slight, and the land so low, that it is never completely drained. One part of it is constantly covered with still-water, while another part is always wet and spongy, and still another part is alternately wet and dry. During high water, in the spring, all the ungraded surface of the swamp is flooded, but during the remainder the condition varies according to circumstances. That portion of the territory which becomes comparatively dry, exposes to the sun a rank growth of coarse grasses and other forms of vegetation indig. enous in wet soils, which, during the decomposition that ensues, fills the air with an odor often quite offensive, and necessarily deleterious to the health of those compelled to inhale it.
“It was among the population of this section of the city that dysentery chiefly prevailed during the past summer. Many of the deaths occurred in houses situated in streets traversing, or contiguous to, the worst portion of the swamp
“As the records do not show that dysentery has been conspicuously prevalent in this ward in former years, it is probable that the exciting cause of the disease was due to some peculiarity of the season, which aroused into fatal activity influences ordinarily dormant.