think, to the fact that parents, when there is a case of diphtheria in the family, will not strictly confine their other children to their own premises. We have had quite a run of malarial fever, and the laying of our new sewer is, by many, thought to be the cause. This, however, cannot be the fact. There is no reason why the digging up of our streets, when the soil is mostly sand, should generate or liberate malarial germs. WOBURN. With the advent of the sewers there is a decided improvement in the drainage of the city. The number of cases of diphtheria for the past year was eighty-six, two of which were fatal. During the year the board undertook and carried out the work of cleaning out Horn Pond, a large pond of about one hundred acres, into which the drainage of tanneries had been discharged for many years, and which had become offensive in consequence of the growth of large quantities of foul-smelling algæ. WORCESTER. Public baths have been repeatedly recommended in our annual reports, and it is a matter of gratification to this department that the establishment of the same is apparently near realization. Regatta Point, if it can be procured, is probably the best spot for location, but if it cannot be had there should be no difficulty in obtaining permission from the parks commission to locate on a part of the Lake Park. Bacteriological Department. - The work of this department during the year has been satisfactory, and continues to justify its establishment. In several cases where death has been sudden, and suspicions of diphtheria aroused, we have been able, through its aid, by cultures made after death, to fix the disease positively, and thus fortified have taken the necessary precautions to prevent its further spread. Nine hundred and forty-seven cultures in all were examined during the year. All the known bakeries of the city have been inspected and a copy of the act posted in each. Orders have been issued to make the alterations found necessary. In August last a report was received of three cases upon the route of a milkman who lived in a neighboring town, and a visit was paid to his house, where he was found sick in bed suffering with what was said to be "malarial fever." A call by telephone the next morning upon the physician in attendance disclosed the fact that it was typhoid. It was also found that there was a case of it in the family of the man from whom the milk peddler received more than half his whole supply. He kept no cows himself, buying all of the milk from neighboring farmers. Prompt measures were taken to prevent any further spread of the disease from this source. In all, eight cases were reported, with two deaths, among families All of these cases had their who received their milk from this peddler. beginning about the same time. No new cases were reported whose symptoms began subsequent to the precautions taken by this department, as was mentioned above. The Isolation Hospital, for the treatment of patients suffering with diphtheria and scarlet-fever, was completed during the year. It was opened for the reception of patients November 25. The cottage or separate pavilion plan was the one selected by the board of health, and consists of four separate buildings, arranged somewhat in the form of a hollow square. The following rules have been adopted by the board for the regulation of the hospital: 1. Patients may be admitted to the privileges of the hospital by the board of health, at such rates of board as it may from time to time determine. 2. In all cases where, in the opinion of the board, the circumstances of the patient will warrant it, the whole or a part of the board shall be paid. 3. Patients admitted to the Isolation Hospital cannot receive visits from friends, unless such patients are dangerously ill. 4. Inquiries concerning such patients may be made at the office of the board of health, or by telephone at the hospital. 5. If a patient should become dangerously ill, the nearest relative or friend will be notified, with an intimation that he may be visited. Except in very urgent cases only one visitor will be allowed. 6. Visitors are advised: a. Not to enter any of the wards when in a weak state of health or in an exhausted condition. b. To partake of food before entering the hospital. C. To avoid touching the patient or exposing themselves to his breath or to the emanations from his skin. d. To sit on a chair at the bed-side at some little distance from the patient, and not to handle the bed-clothes. 7. Visitors will be required to wear a gown, which will be provided at the hospital, to cover their dress when in the wards, and to wash their hands and face with a disinfecting solution. 8. Each visit must be limited in time, and friends must leave when requested by the resident physician or the nurse in charge. 9. No visitor shall be allowed to give any article of food or drink to a patient unless by permission of the nurse. 10. No visitor will be allowed to take any meal in the hospital, or to pass the night therein, without permission from the board of health or the resident physician. 11. When the patient ceases to be dangerously ill friends cannot be admitted. 12. Religious services for the dead may be held in the chapel. The attendance is strictly limited to the officiating clergyman and the adult members of the immediate family. 13. Visitors are strongly urged not to enter any street car or other public conveyance immediately after leaving the hospital. NOTE. The following information should have been inserted on page 682, at the close of the two years' summary of the use of antitoxin, but was received too late for insertion at that point: Use of Antitoxin for Immunisation. Antitoxin, furnished by the State Board of Health, was employed at the Children's Hospital, for the purpose of immunisation, as follows: No record was kept with reference to complications or sequelæ in these cases, but a note from the superintendent states that " urticaria occurred in only a small number of cases and these were not particularly noteworthy." In three cases only did diphtheria develop after injection of antitoxin for immunisation, in one case in 36 days and in two cases in 23 days. There was occasionally some tenderness for twenty-four hours at the seat of injection, but it soon passed off," INDEX. Abbott, Samuel W., M.D., vital statistics of Massachusetts (1856-95) Water supply of, examination of Accord Pond, Hingham, examination of water of Adams Fire District, Adams, water supply of, examination of Advice of the Board to cities, towns, corporations, etc., upon water supply and sew- Agawam, sewage disposal of, advice of Board Air, aid received from current of, in rapid filtration of sewage Water supply of, examination of Andover, water supply of, examination of Antitoxin in diphtheria, report upon the production and use of Aqua Rex Spring, Millis, examination of water of. Water supply of, examination of Ashburnham, Upper Naukeag Pond, examination of water of Reservoir No. 6, Boston Water Works Sudbury River at head of Reservoir No. 2, Boston Water Works Examination of water of tubular wells with reference to Ashley Brook Reservoir, Pittsfield, examination of water of. Water supply of, examination of Attleborough, consumption of water in PAGE 713 411 83 170 9 84 251 869 84 7 49 476, 477 632 464 869 85 87 675 240 869 88 89 484 102 103, 105 98, 100 107 10 89 284 176 333 870 90 411 870 49 92 137 328 411 93 411 94 |