SANITARY CONDITION OF PUBLIC INSTITUTIONS.

SECT. 6. Every person selling, or offering, or exposing any article of food or drugs for sale, or delivering any article to purchasers, shall be bound to serve or supply any public analyst or other agent of the state or local board of health appointed under this act, who shall apply to him for that purpose, and on his tendering the value of the same, with a sample sufficient for the purpose of analysis of any article which is included in this act, and which is in the possession of the person selling, under a penalty not exceeding fifty dollars for a first offence, and one hundred dollars for a second and subsequent offences.

SECT. 7. Any violation of the provisions of this act shall be treated and punished as a misdemeanor, and whoever shall impede, obstruct, hinder, or otherwise prevent any analyst, inspector, or prosecuting officer in the performance of his duty, shall be guilty of a misdemeanor, and shall be liable to indictment and punishment therefor.

SECT. 8. Any act or parts of acts inconsistent with the provisions of this act are hereby repealed.

4. The Public Institutions.

Changes have been recommended in the various public institutions under the supervision of the Board, where the sanitary arrangements have not been satisfactory. The building used as a hospital at the State Primary School at Monson has been thoroughly reconstructed, and in its present shape is a much more satisfactory structure than it seemed possible a year ago to obtain from the old, badly planned, insufficiently ventilated, and entirely unfit hospital. Changes were suggested in the ventilation of the Lunatic Asylum at Northhampton, and these have been made. The water-supply of the State Workhouse at Bridgewater has been examined, and the discontinuance of the use of one of the sources of supply recommended, this source proving under chemical examination to be impure.

At the request of the Prison Commissioners, a sanitary inspection was made of the State Prison at Concord. Some serious defects in the ventilation of the cells were discovered. The drinking-water was found to be exposed directly to the influence of sewer gases. The drainage of the officers' houses was so constructed that the wells had become polluted by leakage from cesspools and privies, and in many cases had already been abandoned; and the drainage of the prison still entered a tributary of the Concord River, notwithstanding

F

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LOCAL BOARDS OF HEALTH.

the prohibition contained in chap. 10 of the Acts of 1878. In consequence of the recommendation of the Board, immediate attention was given by the Prison Commissioners to the matters above referred to; the ventilation of the prison has been improved, the drainage of the officers' houses made safe; the sewage of the prison is purified by irrigation before entering the stream. From the nearness of the irrigation field to the wells of the prison, there is, however, danger of contamination of the general water-supply for drinking pur

poses.

5. Local Boards of Health.

The absence of an officially constituted and competent sanitary authority in each of the cities and towns of the Commonwealth has proved a serious hindrance to the obtaining by the Board of prompt and trustworthy information as to the prevalence of contagious diseases, and to the gathering of necessary statistics upon the various subjects pertaining to the public health. The following bill was reported to the Legislature of the last year by the Committee upon Public Health, and was apparently regarded with some favor, though it did not become a law: :

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:—

Section one of chapter twenty-six of the General Statutes is hereby amended so as to read as follows:

"SECTION 1. In each of the several towns of this commonwealth the board of selectmen shall, in the month of January, in the year eighteen hundred and eighty-two, appoint two persons, neither of whom shall be a member of the board of selectmen, and one of whom shall be a physician (provided there be a resident physician), who, together with the chairman of the board of selectmen, shall constitute the board of health of each town.

"The board so constituted shall enter upon its duties on the first Monday of February then next succeeding. The terms of office of the two appointed members shall be so arranged at the time of their appointment that the term of one shall expire on the first Monday in February in each year after the year eighteen hundred and eighty-two.

"In each of said towns said boards of health shall, annually, in the month of January, present to the state board of health, lunacy, and charity, a report made up to and including the thirty-first day of the preceding December, upon the sanitary condition of the town during the year.

SANITARY IMPROVEMENTS.

PREVALENT DISEASES.

It will be noticed that provision is made for an annual report from the local boards to this Board; and in this provision lies one of the greatest advantages offered by the bill. The Board would secure a correspondent of unquestioned authority in every town, and the health authorities of the town would be brought into more immediate relations with the State Board, and could more readily obtain that advice and assistance so often desired in the abatement of nuisances, oftentimes supported by local influences too powerful for a local board.

A Board of Health has been formed in Brockton, and, in the short term of its service, has much improved the sanitary condition of the city. As this town has recently completed a system of public water-supply, and is as yet not provided with sewers, there will probably arise in the near future some troublesome questions as to the most harmless method of disposing of the sewage. One of the plans suggested is, drainage into the Salisbury River, one of the streams emptying into the Taunton River. The portion of the river selected for the out-fall is more than twenty miles distant from Taunton, and therefore is not within the limit established by the Act of 1878.

Chap. 133 of the Acts of the year 1877 was so amended by the Legislature of 1881, that local boards of health have now the power to make satisfactory rules for regulating the construction of house-drainage, and its connection with the public sewers. Orders for this purpose have been prepared in a number of cities and towns, and are now in successful operation.

6. Prevalent Diseases and Causes of Disease.

While the past year has not been marked by the widespread prevalence of any one of the more destructive diseases, it has still been of less than the average good health. Measles, almost universally prevalent during the winter and spring, was not of a severe type; but the fatal epidemic of diphtheria has continued, and with apparent increase above the preceding two years. The so-called infection diseases have generally caused a larger amount of sickness than usual.

PREVALENT DISEASES IN NAHANT AND LYNN.

Typhoid fever has prevailed more extensively throughout the whole State than for a number of years, but has been of an unusually mild type. The towns with public and well-regulated water-supplies present the smallest number of reported cases. One of the marked outbreaks of this disease was on the peninsula of Nahant during the summer and fall. So far as can be at present ascertained, there have been about sixty cases of the disease occurring either at Nahant, or shortly after the return home of those who had been summer residents there. As the deaths thus far known do not exceed four, most of the cases were light.

The great natural advantages for health of this small and wealthy town have been lost by a neglect of many of the simpler sanitary precautions. The water for domestic uses was obtained either from wells or rain-water cisterns, not sufficiently distant from cesspools and privies. In the case of some of these wells and cisterns, chemical analysis has demonstrated such contamination as comes from direct pollution by human excreta. The town authorities have entered upon a thorough and well-directed investigation into the sanitary condition of the place, In marked contrast to the condition of Nahant, so far as this disease is concerned, is Lynn, where comparatively few cases of typhoid fever have been up to this time reported; and yet the general conditions affecting health in Lynn are far from favorable. It has, however, a Board of Health and a voluntary sanitary association, which has educated public opinion in many ways; and a public water-supply, which, though not always satisfactory, has during the past year been the subject of less complaint than in the preceding year. A comparison of these two neighboring towns shows what has been so often observed before, that, if typhoid fever originates in filth, the filth is very often so concealed that only an expert can recognize it.

Intermittent fever has appeared in many of the towns upon the eastern water-shed of the State, where in the previous year it was unknown. As a general rule, there have been some constant local peculiarities which it is customary to associate with the first manifestation of this disease and its subsequent spread. In a few instances, though, the first

THE SMALL-POX IN MASSACHUSETTS.

cases have not appeared in those districts where marsh influences have been most prominent. The largest number of cases in the eastern portion of the State have been upon streams emptying into Narragansett Bay. These cases are of great interest, as the first recorded in this part of the State. They have not, however, been of any serious concern, so far as treatment goes, to which they have readily yielded, and have not presented the aggravated forms that have made this disease so justly feared in other sections of the United States. Early in the year it became evident, from the mortality returns of the cities of Philadelphia and New York, that small-pox was rapidly increasing in those two cities, more especially in the former. A copy of the following paper was therefore sent to the chairman of the board of health of every town in the State:

"DEAR SIR, The State Board of Health, Lunacy, and Charity voted at its regular monthly meeting, Feb. 5, 1881, that a communication be sent to the towns of the Commonwealth, urging the importance of a protection of the people before small-pox appears in this State. That it may be more or less prevalent in this State during the coming year seems probable for the following reasons:

"The deaths from small-pox in the city of Philadelphia for the week ending Feb. 5, 1881, number sixty-one. They have steadily increased in number since October, 1880. Cases or deaths from the same disease have been reported during the last few weeks in the cities of New York, Brooklyn, Pittsburg, and Chicago.

"In several cities and towns of this Commonwealth, during the year last past, there have been outbreaks of the disease, which, by prompt isolation of individuals attacked and vaccination of those exposed, have been happily checked.

"It is, however, certain that even in this State large numbers are still without protection by reason of their neglect to be vaccinated, or because vaccination has not been properly performed.

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It has been sufficiently demonstrated that thorough vaccination with suitable lymph affords a practical protection against the fatality of smallpox or its worst symptoms.

"It is not to be asserted that it furnishes absolute protection against the attacks of this disease, which does occasionally occur in the individual who has been vaccinated successfully and repeatedly, or who has had a previous attack or attacks of small-pox.

"But it has been established by a vast amount of evidence, that vaccination renders the individual, in first place, much less liable to an attack of small-pox; in second place, the disease, if it does occur, is deprived of its most dangerous characteristics.