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HEALTH OF TOWNS.

Under this title are presented abstracts of such reports of the local boards of health as have been received at the office of the State Board. A general review of these reports shows that a constantly increasing interest in all matters pertaining to public hygiene is manifest throughout the State. The public health would undoubtedly be promoted very much if the harmonious relations which already exist between the State and local boards were made more effective by the requirement that all local boards, or at least those of the cities and large towns, should send copies of their annual reports to the State Board of Health as well as to their own citizens.

Among the sanitary matters which appear to have been foremost was the increased attention paid to public water supplies and sewerage systems. The experimental and advisory work of the Board upon these important questions occupies the principal part of this volume.

The question of the disposal of garbage, street sweepings and house refuse has attracted more than usual interest, and several of the larger cities are considering the question, with the intention of erecting establishments for such disposal. There is great need of some better methods than those largely practised in the State. None of the older modes of disposal are entirely satisfactory. The dumping of garbage in enormous heaps, to putrefy and cause a constant nuisance ; the feeding of decomposed material to cattle and swine; the depositing at sea, where it occasionally floats upon the shore of some crowded summer resort, all of these modes bave objections of greater or less weight, according to the degree of injury thus created. Hence more perfect systems of disposal are demanded, like those in use in British cities and in some municipalities of our own country.

Another question which has been prominent in the cities is the need of separate hospitals in which persons becoming sick with infectious diseases can be isolated.

By the provisions of two statutes, which have existed for many years, it is incumbent, both upon the householder and the attending physician, to report each case of disease dangerous to the public health to the selectmen or local board of health. The statute relative to the householder was enacted in 1792, a century ago, and that relating to the physician in 1827. Originally the only specified disease to which this statute applied was small-pox. The statute was amended in 1884 by specifying also diphtheria and scarlet-fever. Other amendments required the disinfection of infected houses, and still further the keeping of records of cases which have been duly notified to the local boards of health. These record books of infectious diseases have proved very valuable for the purpose of tracing the course and origin of epidemics in towns and cities, and each succeeding year finds a better compliance with the laws relating to the recording of reported cases of infectious disease. It would be an improvement if the statute required the notices of the more dangerous infectious diseases to be sent to the State Board of Health as well as to the local board.

From the annual reports of the local boards of health for 1891 the following table has been compiled, in which are presented the total number of cases of infectious disease which have been reported to the local boards of health, so far as they are published in the reports sent to the office of the State Board of Health, together with the number of deaths from the same causes.

From this table it appears that the number of reported cases and deaths and the percentages of deaths to reported cases was as follows:

Reported cases of diphtheria,
Reported deaths from diphtheria,

Percentage of deaths to reported cases,

2,444

575 23.5

Reported cases of scarlet-fever, .
Reported deaths from scarlet-fever,

Percentage of deaths to reported cases,

4,517

151 3.34

.

Reported cases of typhoid fever,.
Reported deaths from typhoid fever, .

Percentage of deaths to reported cases,

2,414

460 19.05

Reported cases of measles, .
Reported deaths from measles,

Percentage of deaths to reported cases,

5,861

84 1.4

The foregoing percentages may be considered as somewhat larger than the actual percentages of fatalities from these diseases during the year, for the reason that the number of deaths is known, while the number of reported cases is probably somewhat less than the actual number.

The two diseases, scarlet-fever and measles, undoubtedly prevailed in an unusually benign form, since the percentage of fatality from these diseases (3.3 and 1.4) is considerably less than the average fatality in a long period of years.

Certain Infectious Diseases reported to Local Boards of Health.

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Amesbury,
Attleborough,
Ayer,
Belmont,
Beverly,
Blackstone,
Boston,
Bradford,
Bridgewater,
Brookline,
CAMBRIDGE,
Canton,
CHELSEA,
CHICOPEE,
Clinton,
Easthampton,
Everett,
FALL RIVER,
FITCHBURG,
Franklin,
Gardner,
GLOUCESTER,
Great Barrington,
Greenfield, .

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Certain Infectious Diseases reported to Local Boards of Health Concluded.

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HAVERHILL,
Hingham,
Hudson,
Hull,
Hyde Park, .
Lexington,
LOWELL,
LYNN,
MARLBOROUGH,
Marshfield,
Medford,
Melrose,
Millbury,
Natick, .
Needham,
New BEDFORD,
NEWBURYPORT,
NORTHAMPTON,
North Andover,
Norwood,
Palmer,
PITTSFIELD,
Plymouth,
Provincetown,
Quincy,
Reading,
Revere,
Rockland,
Salem,
Saugus,
Sharon,
SOMERVILLE,
Southbridge,
SPRINGFIELD,
Stoneham,
Swampscott, 3
TAUNTON,
WALTHAM,
Ware,
WOBURN,
WORCESTER,
Watertown,
Winchester,
Westfield"
Winthrop,

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1 Including membranous croup. 2 One case of small-pox. & Cases not specified. * Including twenty-five cases at Massachusetts School for the Feeble-minded. 5 Four cases of small.pox.

• Twenty cases not specified.

AMESBURY.

The dead porgies or menhaden fish have been a great annoyance the past year, and their removal has been quite a bill of expense, but it was done without exceeding the appropriation for the use of the Board of Health. It seems that the way to avoid such expense, year after year, is to devise some plan to prevent fishermen, far down the Merrimack, from dumping menhaden, which they do not want for bait, into the river, for the incoming tide to float up stream and deposit along our river front.

A case of glanders or farcy in a horse was reported. The animal was at once ordered to be isolated, and the cattle commissioners were notified, as required by law. The commissioners came, thoroughly examined the horse, and, becoming satisfied that it was a case of glanders, ordered the horse to be killed.

ATTLEBOROUGH.

Like many towns in the State, Attleborough was visited by that dreadful scourge, diphtheria, and, but for the prompt action of the school committee, acting in consultation with the Board of Health, the disease might easily have beconie epidemic. The first case reported was on October 11; from that time until the 2d of November five cases among children who attended school in the old Academy building on Sandford Street were recorded. The school was discontinued November 2, and the building was examined for a possible source of the contagion. It is not believed that the cases originated there. The building itself, situated upon a high, gravelly elevation, has been in its present location about three years; no water pipes enter it, and no sewer pipes lead from it; the cellar is large, light and dry. Two sinks connected with a cask buried in the ground are in the building, and it was suggested that these be trapped and the receptacle ventilated, although no dirty water or filth of any kind is ever poured down the siuks; and there was no more odor about them than there was the day they were put in. It is probable, as so often happens, that the cases arose from one of so mild a type that it was not recognized, and perhaps never treated by a physician. The school building was closed for two weeks, the rooms thoroughly disinfected, and the books and other articles belonging to the sick children were destroyed. This action put a stop to further spread of the disease among children attending that school, but isolated cases in various parts of the town were continually reported. These cases were carefully looked after, but in nearly every instance it was impossible to decide upon the source of the contagion ; fortunately, how

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