PLAN OF DRAINAGE FOR MYSTIC VALLEY.

on Saturday, January 21, 1882, at eleven A.M., at the State House, on the matter of cleansing Mystic Lower Pond, in accordance with the provisions of the Statutes of 1881, above cited:

The remedy which will finally relieve the city of Boston from its present well-founded anxiety as to the protection of the Mystic water-supply from contamination, and secure the towns bordering upon Mystic Lake and Mystic River against offensive smells, sure to come at some time from both lower lake and river, whether Boston brings a sewer here or not, — lies in a comprehensive system of drainage for the whole Mystic valley.

The legislative Committee on Public Health appended to one of its reports a bill, of which they say, that it is worthy, in their judgment, of consideration in connection with any plan to be hereafter submitted to the Legislature.

The bill provides for the creation and incorporation of a metropolitan health district, made up of nineteen cities and towns, organized for the purpose of constructing and maintaining a system of intercepting sewers, without powers of interference with the internal sewerage system of the towns composing the district. So far as the work of making a system of intercepting sewers is concerned, this district is to be regarded as a unit, with equal needs and, in proportion to the respective valuations of its parts, equal responsibilities.

The Legislature, recognizing the great importance of the subject thus presented, passed the following resolve :

[Chap. 62.]

RESOLVE FOr a Plan FOR THE DRAINAGE OF THE MYSTIC VALLEY AND THE NEIGHBORHOOD OF THE CITY OF BOSTON.

Resolved, That the governor and council are hereby authorized and requested to examine and report in print to the next legislature a plan for the drainage of the Mystic valley, with an estimate of the cost thereof and a recommendation as to the methods of apportioning said cost. And they are further authorized, within their discretion, to include the Charles River valley and the immediate neighborhood of the city of Boston in their investigation regarding drainage, and in any plan or recommendation which they think it advisable to report for the action of the legislature. For these purposes they may incur such engineering or other expenses as they may deem necessary. — Approved May 12, 1881.

RESOLVE REGARDING THE SEWAGE OF WORCESTER.

The Governor and Council have referred the matter to a committee, consisting of E. S. Chesbrough, C.E., of Chicago, H. P. Walcott, M.D., C. F. Folsom, M.D., A. W. Boardman, Esq., and Dr. Azel Ames, jun. As the consideration of this report, in connection with one to be subsequently noticed, will bring more directly to public attention than ever before the rapidly increasing pollution of streams not used as sources of water-supply for domestic uses (but which, as in the case of the Blackstone at Millbury, are becoming too foul even for manufacturing purposes, and as objectionable to residents on their banks as open sewers would be), it is time to ask whether the State must not take one step more, and protect rivers not used for domestic water-supply, in the interests of the residents upon their banks, and of the manufacturers themselves. A comparison of the chemical analyses of waters of the Blackstone River made in 1881, with a large number made by the State Board of Health in 1875, reveals a very serious increase in the percentages of polluting matter. This deterioration shown in the waters of the Blackstone is undoubtedly also true of many other streams of Eastern Massachusetts. Complaints have for some years been made of the condition of the Nashua below Fitchburg, and of one stream at least which enters the Taunton River. The attention of the Legislature is therefore called to the Act of 1878 for the protection of streams and ponds used for domestic water-supply, with the suggestion that some protection might usefully be extended to streams, ponds, and tidal waters not used as sources of domestic water-supply.

The third resolve is as follows:

[Chap. 67.]

RESOLVE REGARDING THE SEWAGE OF THE CITY OF Worcester. Resolved, That the state board of health, lunacy, and charity is hereby authorized and directed to examine and consider the question of the disposition of the sewage of the city of Worcester, especially with a view to prevent the pollution of the Blackstone River and its tributaries, and report its conclusions in print to the next legislature, with recommendations as to a definite plan for the prevention of such pollution. For this purpose the board may employ such assistants and incur such engineering or other expenses as shall be approved by the governor and council. Approved May 12, 1881.

Н

CIRCULARS OF THE STATE BOARD.

The Board at once entered upon the investigation of this question, and, after due notice given to all the parties in interest, spent parts of two days, early in July, in Worcester, when a hearing was had, at which appeared the city of Worcester and the town of Millbury, represented by city and town officers, or committees duly appointed. One result of this hearing was, that the Board voted to request the city of Worcester and the town of Millbury to submit in writing such evidence of experts, as to methods of disposal of the Worcester sewage, as each municipality should deem proper, especially with a view to prevent the pollution of the Blackstone River and its tributaries. Another was, that Dr. C. F. Folsom of the National Board of Health, J. P. Davis,* C.E., of New York, and Dr. H. P. Walcott, Health Officer of this Board, were appointed a committee to consider the matter of the disposal of Worcester sewage, and report their conclusions to this Board. They have presented their report with plans and estimates of expense, which, together with the documents furnished by the town of Millbury, will be found in the special Sanitary Appendix. Our recommendations as to a definite plan for preventing the further pollution of the Blackstone River are given in Part Fifth.

The circulars of the State Board of Health relating to the prevention of disease are often asked for, and continue to be distributed. So many changes have taken place in the requirements for house-drainage, that this circular has been revised, with the assistance of E. S. Philbrick, C.E., and is printed in the special Sanitary Appendix, pp. 107–116.

*Not Dr. R. T. Davis, as erroneously printed on p. xx.

PART SECOND. - LUNACY.

PART SECOND.

LUNACY.

THE United States Census of 1880, when completed with respect to insanity, will show a larger number of the insane in Massachusetts than has ever before been reported; but no more than this Board, from its inquiries in the past two years, has had reason to believe were resident in the State. The whole number, at any one date, cannot be exactly determined even now; but by the preliminary census tables it exceeded 5,000 in June, 1880, and must now be somewhat greater. Table XIX. in the Appendix exhibits the number that has come to the official notice of this Board, in hospitals and asylums, during the year ending Oct. 1, 1881; and also gives by estimate, in a foot-note, the additional number in the city and town almshouses and prisons during the year. The number visited in almshouses was 585; but the whole number resident there during the year was more than 650, of whom it is estimated that 40 died. In the hospitals and asylums 4,350 different persons appeared in course of the year, of whom 297 died. Adding together the almshouse and the asylum cases, and excluding those who appeared in both lists, nearly 100 in all, we find the total to be 4,900 different persons; and to these should be added, also, about 100 insane persons, supported by the public in prisons and in private families during the year. The aggregate of the insane who came under official notice, then, was about 5,000; and, of these, all but 110 had their domicile within the State. The known recoveries and deaths among these 5,000 persons did not exceed 650, although a few more than this, no doubt, recovered or died. More than 100 insane persons were re

NUMBER AND INCREASE OF THE INSANE.

moved from the State during the year, and at least 50 came into the State in a condition of insanity, besides those who presented themselves as private patients in our hospitals and asylums. The net reduction in the number of the Massachusetts insane, therefore, was not far from 700 in the whole year, while the number of insane persons appearing for the first time was more than 900. These figures indicate a net increase of our insane, amounting to at least 200 in the year; and it is probable that they will necessarily accumulate to the extent at least of 200 annually for many years to come. This, as already remarked, is not in consequence of any noticeable increase of recent insanity, but because this disease is less curable than we have been willing to believe, until careful inquiries have shown us the painful facts. Table XXI. in the Appendix shows that of 440 patients discharged, either by recovery or death, in the last reported year, and who had never before been in any hospital, 215 died, while 225 recovered. Other statistics in this Report, and in the careful reports of the Massachusetts hospitals and asylums, show that, of these first recoveries, at least ten per cent, sooner or later, relapse into insanity, which ends in death; so that, of all first admissions to our hospitals at present, more than half die insane. This reduces the percentage of possible permanent recoveries below fifty; and it is the opinion of those who have investigated the question most accurately, that the permant recoveries do not exceed 40 per cent. If this be so, and if we are to have a yearly admission of 1,000 new persons to our hospitals, 600 of them will be added to the list of the chronic insane, of whom no more than 400 will die in any ordinary year. By this calculation, which the facts seem to warrant, we reach in another way the conclusion that provision must somewhere be made in Massachusetts for a yearly addition of at least 200 to our chronic insane population, already numbering more than 4,000.

Assuming this to be so, and it does not seem possible to doubt it, unless some means shall be found to establish more recoveries of the insane, the question at once becomes important, How shall we provide for this constantly increasing multitude of the insane? The expedient of sending them