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GENERAL REPORT.

The following report comprises the general work of the State Board of Health for the year ending Sept. 30, 1891, together with certain papers on special topics relating to public health.

The following are the general and special subjects embraced in the report:

REPORT TO THE LEGISLATURE ON WATER SUPPLY AND SEWERAGE, IN

CLUDING THE ADVICE OF THE BOARD GIVEN UNDER THE PROVISIONS
OF CHAPTER 375 OF THE ACTS OF 1888.

REPORTS UPON FOOD AND DRUG INSPECTION.

REPORT UPON ARSENIC IN WALL-PAPERS AND FABRICS.

SUMMARY OF WEEKLY MORTALITY REPORTS.

PAPER UPON THE GEOGRAPHICAL DISTRIBUTION OF CERTAIN DISEASES

IN MASSACHUSETTS.

HEALTH OF TUWNS.

The following members comprised the Board in 1891 :

HENRY P. WALCOTT, Chairman. FRANK W. DRAPER,

JULIUS H. APPLETON, Hiram F. MILLS,

Joseph W. HASTINGS, ELIJAH U. JONES,

JOHN M. RAYMOND,

The term of office of Julius H. APPLETON expired in May, 1891, and MORRIS SCHAFF of Pittsfield was appointed a member of the Board.

At the annual meeting, held in June, 1891, the following officers were chosen :

Chairman,
Secretary,

HENRY P. Walcott.
SAMUEL W. ABBOTT.

The following officers of the Board were also chosen, under the provisions of chapter 375 of the Acts of 1888, and chapter 263 of the Acts of 1882 :

Under the Provisions of the Food and Drug Acts.

CHARLES P. WORCESTER.

Analyst,

.

Under the Provisions of the Acts to Protect the Purity of Inland Waters.
Chief Engineer,

FREDERIC P. STEARNS.
Consulting Engineer,

JOSEPH P. DAVIS.
Assistant Engineer, .

X. H. GOODNOUGH.
Chemist,

Thos. M. DROWN.
Biologist,

W. T. SEDGWICK.
Chemist in Charge of Experiment Station, ALLEN HAZEN.
Biologist at Experiment Station,

GEORGE W. FULLER.

ution;

INFECTIOUS DISEASES. With a few exceptions, there were no serious and wide-spread epidemics in the State during the year ending Sept. 30, 1891. The unusual prevalence of typhoid fever in the cities of the lower Merrimac valley during November, December and January, 1890 and 1891, was made the subject of a special paper in the annual report of 1890.

Influenza, which prevailed with unusual severity in the winter of 1889 and 1890, was made the subject of a special report in the annual report of 1889. It reappeared with much diminished intensity in the following winter, but again returned with nearly if not quite as great intensity in the winter of 1891 and 1892. (See page 746, and diagram.)

Small-po.c. During the year 1891 small-pox has produced but little disturbance in Massachusetts. The State has been comparatively free from this disease for a period of nearly ten years. The whole number of deaths from this cause for the ten years ending with 1891 was 91, or an average of 9.1 per year. If 1882 be omitted, the annual average of the succeeding nine years was but 5 deaths per year. The following record embraces the details of such cases as were reported to the State Board of Health in 1891 :

Record of Cases reported to the Board in 1891, under the Provisions

of Chapter 138 of the Acts of 1883.

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* No. 2 was employed as a rag-cutter in paper.mill. Vaccinated in infancy. Nos. 3 and 4 were the children of a shoemaker who moved from Lenox to Pittsfield after the illness of No. 3.

A case of suspected small-pox was reported from Greenfield, April 29, and was removed to the pest-house. On the further development of the eruption, it proved to be measles.

A case reported from Cohasset, an adult, proved upon examination to be chicken-pox.

The following brief account is given of the cases which occurred at Pittsfield and Lenox. A child of a French Canadian family living in Lenox, aged one and a half years, was taken ill with an eruptive disease in June, 1891, and died June 30, the certificate which was given by the attending physician stating that it was a death from “ chicken-pox and dentition.” The events which followed, however, would seem to confirm a diagnosis of small-pox. The family moved to Pittsfield, and another child, aged three and a half years, was taken ill early in July, and on the 17th was seen by the secretary of the State Board, who at once pronounced it a case of small-pox. Meantime, another person in Lenox, an adult, who had been exposed to the first case as early as June 19, was taken ill with milder symptoms (varioloid), but not until July 11. Both the latter cases, one in Lenox and the other in Pittsfield, were isolated; careful precautions as to vaccination and disinfection were taken, and no other cases ensued.

Cases of Small-pox reported from Other States. The following cases were reported from other States and provinces by the secretaries of the State and provincial boards of health, in compliance with the resolutions adopted

at Toronto in 1886 for the mutual notification of certain infectious diseases :

Pennsylvania. - January 21, one case at Scranton ; January 24, one at Erie ; February 9, six cases at Johnsonburg and Pittsburg ; February 20, two cases at Ridgeway, April 22, three at Philadelphia ; November 16 and 23, two cases at Point Pleasant.

New York. January 27, February 16, seven cases at Jamestown.

Wisconsin. — January 31, one at Prairie du Chien ; April, ten cases at same place; April 21, May 6, two cases at Wright's Ferry.

Illinois. — April 2, two at Sparta ; April 9, one at Chicago.
North Carolina. - April 5, two cases at Lexington.

Ohio. January 23, one case at Urbana ; May 18, one at Cleveland ; November 29, one at Cincinnati and one at Glendale.

Connecticut. - April 11, one at Waterbury, said to have originated in Massachusetts ; March 30, one at Greenwich.

Florida. — April 27, one at Jacksonville.

Tennessee. - May 18, one at Knoxville ; June 9, seven at Knoxville ; October 5, one at Obion ; November 26, one at Memphis.

Iowa. May 26, one at Council Bluffs.

Minnesota. - June 13, four cases at St. Paul; August 13, four more at St. Paul.

Michigan. - August 15, one at Sheboygan ; September 21, one at St. Joseph's.

Province of Quebec. March 25, one case at Sheffington ; June 1, immigrants at Grosse Isle (quarantine); June 9, one case at Montreal ; September 28 and October 6, eight cases at Carleton ; October 10, seventeen cases at Macneeder. These appear to have been followed by a general epidemic, in which many cases and deaths occurred.

While the number of cases occurring in the State in 1891 was much less than those of the preceding year, the number reported throughout the country at large was considerably greater, although no serious epidemic appears to have prevailed except in the Province of Quebec, where one hundred and fifty cases and thirty-one deaths occurred between the middle of September and the close of the year.

With the possibility of many small outbreaks occurring in different parts of the country, and also in view of the abundant facilities of communication by railway travel, it is incumbent upon all our local health authorities to see that all the possible protection that vaccination affords should be extended to the people of their respective municipalities.

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