Reports were made to the Board upon their sanitary condition, and letters were then issued to the proprietors of those resorts where existing conditions were unsatisfactory, describing the nature of the conditions which needed improvement, and in such instances as were necessary the aid of the Board was offered in examining and approving such plans as might be devised for the remedy of unsanitary conditions. In most instances the proprietors cheerfully complied with such suggestions as were made.

The distribution of these resorts by counties was as follows:

1

6

11

4

11

WATER SUPPLY AND SEWerage.

When the State Board of Health was reorganized in 1886, upon a similar plan to that of the original board of 1869, a new law was enacted which gave to the Board enlarged powers and new duties of the highest importance, having special reference to the water supplies and systems of sewerage which constitute so large a share of the public sanitary works throughout the State. This law, entitled the "act to protect the purity of inland waters," often alluded to in these reports, has proved one of the most useful and comprehensive enactments of recent years. Under its provisions an engineering department was established, which has carried out all the important work of this character which has been accomplished by the Board during the succeeding years.

Among the transactions of this department of work, already noticed in the reports of the Board, may be enumerated the establishment of the experiment station at Lawrence, with the many important additions to science which have been made there; the maintenance of a laboratory in Boston for constant use in the examination of the waters of the State, with equally important discoveries and demonstrations of new principles in this department of work (e. g., the chlorine determinations of the waters of different localities. at variable distances from the sea and their practical usefulness); the constant general supervision of water supplies and systems of

sewerage; the continuous examinations of these waters by means of chemical and bacterial analyses, as well as personal inspection of the sources of supply, especially of those of doubtful quality; the work of giving advice to cities, towns, corporations and individuals as to the selection of new sources of supply, the improvement and enlargement of old ones, the introduction of systems of sewerage and sewage disposal.

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In addition to all these duties, the establishment of this department has made it possible for the Board to carry out the wishes of the Legislature in regard to the following matters, some of which be reckoned among the most important public undertakings in the State the devising of the metropolitan sewerage system, now being completed, started in 1889; the investigation of the sources of ice supply of the State (1890) and of manufactured ice (1893); the metropolitan water supply (1895), now in process of construction; the improvement of the Charles River, two reports (1894 and 1896); the improvement of the Concord and Sudbury rivers (the work of making these improvements was intrusted to the Board); improvement of the Neponset River; the sewerage of Salem and Peabody; and the investigation of the Green Harbor dike and marshes.

In the present report the details of the work performed by this department in carrying out its routine duties will be found under the head of "Advice to Towns;" "Examination of Water Supplies and Rivers; ""Summary of Water Supply Statistics; " "Work at the Lawrence Experiment Station in 1896;" and "Sewage Purification of Cities and Towns in Massachusetts.'

BACTERIOLOGICAL DEPARTMENT FOR INVESTIGATIONS RELATIVE TO THE PREVALENCE OF INFECTIOUS DISEASES.

This department of the work of the Board was established at the Bussey Institute, near the Forest Hills station of the New York, New Haven & Hartford Railroad, in 1894, and at once became a most important adjunct to the work of the Board. Dr. Theobald Smith, Fabyan Professor of Comparative Pathology at Harvard University, has charge of the work of the laboratory, which now consists mainly of the diagnostic examination of suspected diphtheria cultures, of material forwarded to the Board to be examined for the presence of tubercle bacilli, of specimens from the blood of persons suffering with malarial symptoms, the preparation of diphtheria

antitoxin, and such investigations of an experimental character as are from time to time deemed necessary. In addition to the supply of diphtheria serum, a supply of tetanus antitoxin is also now prepared for such use as may be demanded.

Very much of this work is conducted under the difficulties incident to constant transmission of material by express and messenger service, and of daily correspondence with local boards and physicians by means of the mails, telegraphs and telephones.

Cities and towns in all parts of the State, including several in Berkshire County, at a distance of one hundred and fifty miles from the laboratory, have availed themselves of the advantages of this department.

This useful work has grown rapidly, and at the present time several of the local boards of health of large cities have organized departments of their own for the purpose of bacteriological examination. In one instance (in the city of Boston) the local board also maintains a plant for the production of antitoxin.

Some of the important operations of this department of the Board's work may be found detailed in this volume under the head of reports upon Toxin Production," "Antitoxin" and "Malaria."

VITAL STATISTICS OF THE STATE.

It has been customary in recent years to publish in the annual report of the Board a condensed statement of the vital statistics of the State, since all correct deductions relating to the sanitary progress of a community must depend for their accuracy upon the records to be found in the returns of the vital statistics of cities and towns. In the present report special attention has been given to this subject by the presentation of a summary embracing the statistics of forty years, and including the period from 1856 to 1895, inclusive.

IMPROVEMENT OF THE CHARLES RIVER.

By the provisions of chapter 475 of the Acts of 1893 the Board together with the Metropolitan Park Commissioners were made a joint board to investigate the "sanitary condition and prepare plans for the improvement of the beds, shores and waters of the Charles River, between Charles River bridge and the Waltham line on Charles River, and for the removal of any nuisances therefrom."

The report of this joint board was made to the Legislature in April, 1894, and was also published in the twenty-sixth annual report of the Board (page cxxxiii).

An act was passed in that year (1894) by which the joint board was continued and instructed to investigate the condition of the river from the point at which the previous investigation terminated as far as Mother Brook in Dedham, and to "report plans for its improvement and for the removal of nuisances therefrom."

This report was completed and submitted to the Legislature in May, 1896, and the general report of the joint board is published in this volume. The original report also contains a summary of the prevalence of intermittent fever in the region embraced in the report, by Dr. J. J. Thomas, who collected information relative to the occurrence of nearly five thousand cases of malarial disease in this region in the period 1890-94.

THE SEWERAGE OF SALEM AND PEABODY.

The city of Salem and the town of Peabody are two municipalities, the former lying upon Salem harbor and the latter adjoining Salem, but further inland. They have a combined population of nearly 45,000, and are without an adequate system of sewerage. The sewage of the city is discharged without system, along the shores, while that of Peabody, consisting largely of the drainage of tanneries, empties into the North River, which flows into Salem harbor at the northern boundary of the city and also receives sewage from Salem.

By the provisions of chapter 112 of the Resolves of 1895 the State Board of Health was "authorized and directed to consider and report a general system of drainage and sewerage" for Salem and Peabody, or "for such parts of said city and town, not all of which shall be wholly within either of said municipalities, as may, in the opinion of said Board, be best drained by said system."

By the terms of this resolve this report was to have been made in January, 1896, but the time was insufficient for the required survey, and was therefore extended by the provisions of chapter 69 of the Resolves of 1896 to January, 1897.

The general report of the Board upon this subject will be found in the present volume.

THE NEPONSET MEADOWS.

In the last annual report of the Board (1895) reference was made to the action of the General Court directing the State Board of Health to investigate the sanitary condition of the meadows of the

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Neponset River, and the bed, shores and waters of said river in the towns of Canton, Sharon, Norwood, Dedham, Milton and Hyde Park, and report whether their condition is dangerous or injurious to the public health by reason of stagnant water, or refuse from manufactories, or other causes" (chapter 83, Resolves of 1895).

The investigations required by this resolve were completed and the report was made to the Legislature in May, 1897.

The general report is also published in this volume. The recommendations of the Board were as follows:

1. Legislation to prevent the pollution of the river.

2. Removal of the flash boards at the dam at Mattapan, enlargement of cross-section of the river at certain points, and deepening and reconstruction of the channel wherever it is necessary to prevent flooding of the meadows.

GREEN HARBOR RIVER.

In the report of the Board for 1894 reference is made to a petition of those inhabitants of Marshfield living at Green Harbor, a settlement upon the seashore in the easterly part of that town. By the provisions of chapter 303 of the Acts of 1871 a dike was built across the outlet of this river about a half mile above its mouth, by which some two or three miles of salt marsh were converted into a fresh-water region.

Application was made to the Legislature for the removal of the dike. The question was referred to the State Board of Health and the Harbor and Land Commissioners in 1896, acting as a joint board, to investigate and report upon the matter. This investigation is now in progress.

LOCAL BOARDS OF HEALTH.

As towns increase in population, and consequently in the density with which the principal villages are settled, the need of efficient sanitary supervision becomes more apparent every year. Boards of health are organized in towns where no separate board has previously existed. Legislation is also being enacted every year, giving additional powers to boards of health and increasing their duties.

Among the duties imposed upon local boards in more recent years are those which relate to cattle diseases, the inspection of plumbing, the licensing of stables, the inspection of bakeries, the reporting of cases of infectious diseases and of annual mortality returns to the State Board of Health.