USA > Massachusetts > Essex County > Newburyport > City Officers and the Annual Reports to the City Council of Newburyport 1888 > Part 12
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Drains should be put in perfect order. These precautions are especially important, as diphtheria and typhoid fever are liable to dangerous relapse under unwholesome surroundings.
Thorough cleanliness and abundant fresh air are the only efficient disin- fectants in the sick room, while it is occupied.
On the recovery or death of the patient, the room should be most thor- oughly disinfected, and then exposed to free currents of air.
The best method of disinfection is fumigation, followed by a thorough washing of the floor, walls ceiling and all furniture with the bichloride of mercury solution.
Effective fumigation requires two pounds of sulphur to every 1000 cubic feet of space. The sulphur should be broken into small pieces, moistened with alcohol for ready ignition, and burned in a proper vessel over a tub of water, to avoid danger from fire. The room must be tightly closed for twelve hours. Most articles may be disinfected by being hung loosely in the room during this time.
When a death occurs from diphtheria or scarlet fever the body should be wrapped in a sheet saturated with the solution of bichloride of mercury, placed at once in the coffin, and tightly and finally closed. No public fun eral should ever take place at the house where the patient died, nor else- where unless the coffin remains hermetically sealed.
On recovery from scarlet fever the patient should not mingle with others until the skin is entirely smooth and healthy. From four to six weeks from the beginning of the disease is the average period.
Children in the family where measles, diphtheria or scarlet fever has been present, must not be allowed to attend school or mingle with other children
38
298
REPORT OF THE BOARD OF HEALTH.
until after all infected articles have been disinfected, and a certificate of safety nas been signed by the physicians or by the Board of Health.
By order of the Board of Health,
H. F. ADAMS, M. D., Chairman.
Attention is called to the following statute, enacted in 1884 :
[CHAP. 98.] An Act concerning Contagious Diseases.
Be it enacted as follows :
SEOT. 1. When a householder knows that a person within his family is sick of small-pox, diphtheria, scarlet fever, or any other disease dangerous to the public health, he shall immediately give notice thereof to the select- men or board of health of the town in which he dwells, and upon the death, recovery or removal of such person, the rooms occupied and the ar- ticles used by him shall be disinfected by sbch holder in a manner approved by the board of health. Any person neglecting or refusing to comply with either of the above provisions shall forfeit a sum not exceeding one hun- dred dollars.
The Board also voted to placard all houses where small pox, diphtheria, or scarlet fever should appear, and to require a certifi- cate of proper disinfection after each case.
The following regulation was added to those already in force :
No public funeral shall be allowed over the the remains of any person who has died of small-pox, diphtheria or scarlet fever, without the written permission of the Board of Health, and under such regulations as may pre- vent the spread of such disease.
During the year the following cases of contagious diseases were reported :
Diph- theria.
Scarlet Fever.
Measles.
Typhoid Fever.
January .
1
. .
February
1
. .
. .
March.
1
.
2
1
May
2
130
. .
June
1
139
. .
July
1
1
23
. .
August
5
1
September
. .
1
6
October
. .
. .
2
November
.
. .
. .
1
December
6
1
1
·
Total
10
5
301
13
2
April
.
299
REPORT OF THE BOARD OF HEALTH.
Deaths reported-Diphtheria and Croup, 5; Scarlet Fever, 1; Measles, 3 ; Typhoid Fever, 2.
The epidemic of measles during summer disclosed a popular error which merits our attention. There is a belief that measles is a trivial disease, needing no restrictions or regulations ; and too commonly children are advised to have the disease while young. This false belief is responsible for much sorrowing. The truth is that the disease should be regarded very seriously. It certainly is no advantage to a child to contract it. In the first place the mor- tality frrom measles is, beyond all comparison, greatest in the sec- ond year of life. In the second place, all educated physicians know that very grave after-effects often follow the disease, in chil- dren who are not perfectly healthy. Catarrhs of various kinds, deafness, bronchial and lung troubles, so-called scrofulous disorders and other complications often date their origin from an apparently trifling attack of measles, and are frequently the real cause of death later on.
Among the 301 cases reported during the year there were 3 deaths. In Boston where the same health regulations are carried out as here, there were, for the same period, 2,273 cases reported, and 119 deaths. The record of the past epidemic is complicated by the prevalence at the same time of Rætheln, an entirely distinct dis- ease, which is often confounded with measles, and which is com- monly called "German measles." This disease is comparatively trivial, and is not included among those sufficiently "dangerous to public health" to require stringent regulations.
From mistaken diagnoses of physicians, or of parents, (for these cases are so light that often no physician is called,) many of these cases were undoubtedly reported as cases of measles. Aside from the serious annoyance thus caused a serious misfortune results from this mistake. It tends to strengthen the mischievous idea, that, after all, measles is a disease of little danger.
The small epidemic of diphtheria in the lower ward in December, also disclosed views which demand a word from us.
Two fatal cases of membranous croup were reported. The family and neighbors had been told that it was not diphtheria, and
300
REPORT OF THE BOARD OF HEALTH.
was not contagious. The Board, thinking differently, placarded the house with a diphtheria notice, and required proper disinfec- tion afterwards. To guard against such danger to health in future, the Board voted to require notification from physician and parent in every case of so-called membranous croup.
It may be well to state here that a large and increasing number of the most competent physicians believe that all cases of mem- branous croup are true diphtheria. The latest standard medical books say this, and other boards of health are now grouping croup and diphtheria in the same table of statistics. At any rate it is certain that no educated physician would attempt to say positively that any given case of membranous croup was surely not diphtheria . It well understood that many cases of fatal diphtheria have no mem- brane visible in the upper air passages.
With reference to the origin of these December cases, another word. No medical authority now questions the fact that diphtheria is contagious. Since nearly all of these children attended the Hancock street school there naturally arose a suspicion that the first cause was there. This Board was called upon to inspect tlie premises which was done, with negative results. Since then, how- ever, more light has been thrown upon the probable connection of this school with these cases. Two children of one family, attend- ing this school, were sick during the last of November with an affection called by the physician "diphtheritic sore throat." After a few weeks these children returned to school in December, with no precautions to prevent the spread of the disease. Educated phy- sicians, familiar with the fact that patients often have diphtheria so lightly as to be upon the street, will not be inclined to doubt that these children, seriously sick with ' diphtheritic throats," were the reasonable cause of the other cases of diphtheria and so-called "membranous croup."
Too much emphasis cannot be put upon the following statement : Any case of sore throat which is properly called "diphtheritic" is true diphtheria and should be reported as such to the Board of Health. In other words there is no such thing as a "diphtheritic sore throat" except the sore throat of diphtheria.
301
REPORT OF THE BOARD OF HEALTH.
DANGER FROM WELL WATER.
Since the introduction of aqueduct water there has been an in- creasing disuse of well water for drinking and food purposes. Be- yond question much disease arises from the use of water from pol- luted wells ; and of the wells in the thickly settled parts of this city very few can be considered free, or safe from pollution.
Nearly all have vaults or cess pools in the immediate neighborhood , and the soil, now for over two centuries, receiving filth and poison, has been recently rendered much more dangerous to health by the introduction into many houses of aqueduct water without at the same time making provision for sewerage. It is a pity that all cannot enjoy a supply of our pure and most excellent aqueduct water. To such households as are prevented by poverty and the present exorbitant water rates, we would recommend the collection of rain-water for food and drinking purposes. Sufficient care in the collection and keeping of rain-water makes it a satis- factory supply. If not so palatable as well-water its disadvantages are far more than balanced by its freedom from the germs of ty- phoid fever and other diseases, which find their way into our wells.
In our opinion an ordinance prohibiting the use of most wells in the city would not only be a justifiable but a desirable measure. One most important need we urge upon the city government. Aque- duct water should be supplied to the public schools of the city. for the protection of the health of the children.
SEWERAGE.
We congratulate the city upon the progress of the past year in this most important and pressing matter. Complete and perfected plans for the construction of sewers throughout the entire city have been furnished by a civil engineer of unquestioned authority in the field of sanitary drainage. It remains only for us to awaken to the urgent necessity for their immediate construction. Sure to come sooner or later, it is only a question whether the wisdom and enterprise of the community will endure a dangerous delay. For many reasons of importance to the health of the city, this system should be built by the city and not by a private company, and at one time and not piecemeal. The dangers from sewers, so pop-
302
REPORT OF THE BOARD OF HEALTH.
ularly dwelt upon, are chiefly dangers from defective construction and from lack of proper inspection and supervision in the making of connections. All difficulties of this kind will be minimized by completing the work as one piece of engineering under municipal control. The abundant writings extant concerning the dangers from sewer gas have probably misled many people. done much to prejudice against sewers, and to delay their construction here. It is true that old fashioned sewers, which in many cities are no better than cess-pools elongated to reach through the streets to the water front, are a source of disease and death. But the modern sewer, as it will be built in Newburyport, is a small, smooth, me- chanically true, practically tight water-way, so devised that no filth may remain in it to decompose, no water to stagnate. A smooth- running stream of inoffensive sewage will discharge itself from each outlet while yet only a few hours old, and while still whole- some food for fishes. No offensive gases arise from such sewage, and the only danger of "sewer-gas poisoning" in our houses will practically be from our fixtures, plumbing and house-drains inside the houses themselves.
The natural advantages of Newburyport for surface drainage are such that many have been misled into arguing that therefore we need no sewers. It is true that storm water takes care of itself perfectly well from nearly all parts of the city and need not be considered. Therefore the engineer's plans are for a "separate system" of sewers, calculated mainly for house drainage. As to the necessity for sewers for this purpose a very short study of the facts will convince every one. We would urge upon the city gov- ernment and upon all citizens, the duty of acting without unneces- sary delay to secure the completion of this sorely needed improve- ment of our city.
HOUSE DRAINAGE.
The numerous inspections of houses made by this board during the past year have shown a very commonly bad condition of house drains. Cess-pools usually have no air-shaft for venting. Hence all gases formed by decomposition in the cess pool must be forced back through the drain into the house. Cess-pools are frequently
---
303
REPORT OF THE BOARD OF HEALTH.
so near the cellar walls as to cause dampness of the walls, and so pollution of the air which rises from the cellars into the rooms above. Drains inside the house wall are often of wood, and leaky both as to gas and water. Only metal pipes with perfectly sealed joints should ever be allowed. Traps under sinks and other fix- tures are not as universally used as they should be. While not an absolute protection against danger, they yet practically prevent the return of dangerous gases into the house, provided the cess-pools are properly vented.
CLEANING OF CESS-POOLS AND VAULTS.
The present method of emptying these receptacles is, like our cess-pools and vaults themselves, a reproach to our civilization.
The intention of this board is to allow in future only the use of the apparatus known as the "Odorless Excavator." This method, now in use in Boston and other places, seems to give satisfaction to the health officers. It is the best way now known and will not prove any more expensive to the owners of cess-pools than the barrel method, which it succeeds.
During the past year there were removed from cess-pools and vaults a total of 1,161 loads, of 12 barrels each, of 13,932 barrels.
HOUSE OFFAL
Regular house-to-house collections of swill and garbage should be systematically carried on, especially in the summer months. The board hopes to arrange for this the coming year by contract with responsible parties. This will make it possible to forbid in future, the collection by irresponsible individuals, with wheelbar- rows and hand carts,-a practice which has become a nuisance in itself. Moreover this disposal of the swill will make it practicable to refuse permits for the keeping of hogs within the city, and so prove the solution of the "swine nuisance."
BATHING HOUSES.
As a health measure we urge the building of at least one public bath. Deprived by neeessary regulations of the privilege of bath- ing along our water front our boys and men can only enjoy a cleansing and refreshing swim by going a distance too great for
304
REPORT OF THE BOARD OF HEALTH.
most working people. The case seems all the more aggravated since the entire length of the city looks upon the tempting river.
. The beneficial effects of thorough cleanliness of body upon both health and morals is emphatic. We should not hesitate before the expenditure necessary to provide the proper facilities for bathing, both to men and women. Such outlays, like money spent upon public play grounds and parks return good dividends in the im- proved health of the community and in the increased attractiveness of the city to the public, thus materially aiding to increase the bus- iness prosperity of the city.
METEOROLOGICAL OBSERVATIONS.
The importance of accurate and scientific records of the weather has been more generally recognized of late, both by physicians and others. We have added to the instruments for observation owned by the city, a barograph, or automatic continuous recorder of barometric changes, and a sunshine recorder.
We are fortunate in possessing an able and faithful observer, earnestly interested in his work. His report is appended.
MORTUARY STATISTICS.
At the close of this report will be found a table of the deaths in Newburyport for the year 1888.
Respectfully submitted.
H. F. ADAMS, M. D. JOHN F: YOUNG, M. D. C. W. DAVENPORT.
STATISTICAL ACCOUNT OF DEATHS IN NEWBURYPORT FOR THE YEAR ENDING DECEMBER 31, 1888.
CAUSE OF DEATH.
Males.
Females.
Total.
January.
February.
April.
May.
June.
July.
August.
September.
November.
December.
Under 1 year.
| 1 to 2 years.
|2 to 5 years.
| 5 to 10 years.
10 to 15 years.
15 to 20 years.
|20 to 30 years.
30 to 40 years.
40 to 50 years.
| 50 to 60 years.
60 to 70 years.
| 70 to 80 years.
| 80 to 90 years.
| 90 to 100 years|
CLASS I .- Zymotic Diseases:
Croup
2
1
3
1
1
2
1
1
1
Measles
1
2
3
3
2
Scarlet Fever.
1
1
1
1
Typhoid Fever.
...
CLASS II .- Constitutional:
Anaemia
Consumption
14
34
48
5
5
6
4
4 6
1
5 4611
1
1 11 16 3
3
78 2 1
Cancer .
2
9
1
1
1
3
1
1
1
...
1
3
..
1
...
...
1
1
3
...
CLASS III .- Local Diseases:
Apoplexy.
5
8 13
2
3
1
2 3
1
1
3
1
2
2 5
Asthina ..
1
1
1
2
1
3
1 3
1
1
1
1
1
2
1
2
1.
Bright's Disease
3
6
9
1
1
1
2
1
2
1
2
2
1
1
Cholera Infantum ..
8
10
18
110
6
1
13 3
1
1
1
Convulsions
2
2
1
1
1
1
2
1
Congestion' of brain ..
3
1
1
1
1
2
Congestion of Lungs.
1
2
3
1
1
1
1
1
1
Cirrhosis Hepatis
3
1
1
1
1
1
1
Cystitis
1
1
1
1
...
...
1
1
1
1
2
1
4
2
1
1
2
Gastric Ulcers
1
1
1
1
1
1
1
Heart Disease
11
12
23 4 4
1 1
2
1 3
1
1
1
3 4 10 2
Indigestion
1
1
1
1
1
1
1
1
1
Meningitis Basilar.
1
1
1
1
Meningitis Tuberculous
1
1
1
1
Meningitis
1
1
1
1
1
1
1
1
1
1
..
...
9
1
1
3
1
1
10
2
1
8
4
4
1
1
1 1
2
6
4
1
2 1
2
2
2
4
1
1
1
1
1
1
Rlienmatism
1
1
1
1
1
1
1
1
1
2
1
1
1
1
5
1
2
2
1
1
1
1
1
3
1
1
1
1
1
...
CLASS IV .- Developmental:
Adyuemia.
2
1
1
1
:
Cyanosis.
1
1
2
1
1
1
2
Puerperal Fever
....
...
...
3
6
1
1
1
1
1
6
16
19
1
1
1
3
1
1
3
1
1
Still born
6
3
9
1
1
2
1
1
1
1
9
Teething
2
1
3
2
1
Congenital Debility
2
5
7
1
3
1
2
1
7
CLASS V .- Accidental:
Drowning .
1
1
1
Burns ....
1
1
Injuries in factory.
1
1
1
1
1
...
Fall (neck broke).
1
1
1
1
Miscarriage
Unknown
1
1
...
...
...
...
.. .
..
... .. .
...
...
. .
.
...
6 14 25 14 16,33 28 44 29 5
TOTALS
128 176 304 29 25,27 20 26 25 20 38 26 28 15,25 58 16
...
.
1
1
1
...
...
...
.. .
1
2020
1
Diplitberia
Erysipelas
2
2
1
1
1
1
1
1
3
3
...
1 ..
Bronchitis ..
1
1
1
Brain Disease.
7
3
Carcinoma
...
Catarrlı Iutestiual
1
1
1
1
Cholic Hespatic ..
1
1
1
1
Cholera Morbus
1
...
2
2
1
1
1
Emphysema Pulmonam ..
1
1
1
1
1
.
Gastritis
2
2
Gaugrene Seuile ..
1
1
1
Inflammation of Lungs Jaundice
1
1
1
1
Locomoto Atoxica.
...
Nephiritis.
2
2
1
1
1
Paralysis .
3
G
Pueumonia
17
Pleurisy
Plilebitis.
1
1
Stomach, Inflammation of
1
1
Spinal Disease.
2
3
1
2
1
. .
Scrofula ..
1
1
1
Septiceima ..
1
...
Tuberculosis
3
1
1
1
...
1
Premature birtlı ..
3
4
Old age.
3
...
...
...
1
...
1
...
1
Protracted labor.
1
1
1
..
.. .
1
2
Hydrocephalus
2
1
...
...
..
...
1
1
1
3 1
2
Marasmus
1
...
..
1
1
4
3
..
1
Dropsy.
Enteretis
2
1
Angina Pectoris
1
3
1
Pericarditis
Peretonitis
3
2 1
27
...
Stoppage ..
1
Softening of Brain
1
1
1
1
...
...
...
11
1
2
1
1
1
2
1
3
10
61
1
...
1
..
1
...
....
1
8 8
.
March.
1
October.
..
REPORT OF METEOROLOGICAL OBSERVATIONS.
To the Board of Health :
GENTLEMEN :- I beg leave to present the following as the ninth annual report on the meteorological observations taken in this city under the supervision of your department.
The station of observation last year was the same as for the past three and a half years, and the same instruments are still in use, with one or two additions, which will be noted.
The instruments belonging to the city, in use at the present time, are as follows :- One mercurial barometer, two mercurial thermometers (dry and wet bulb), one mercurial self-registering maximum thermometer, one spirit self-registering minimum ther- mometer, one copper rain-gauge, one (reserve) galvanized iron rain-gauge, one anemometer, with electric self-recording anemo- graph, battery, wire, etc., one self-recording aneroid barometer, and one pair of sunshine recorders. In addition to these instru- ments the observer has had the use, through the courtesy of the New England Meteorological Society, of a valuable self-recording aneroid thermometer. These instruments are all in good condition. The self-recording aneroid barometer and pair of sunshine recorders, mentioned above, were purchased dur- ing the past year. The self-recording barometer, or barograph, as it is properly called, may be described as follows : A series of
39
306
METEOROLOGICAL REPORT.
thin metallic boxes, eight in number, screwed together and ex- hausted of air, form the chamber of the barometer. By the ex- pansion and contraction of this chamber, caused by the varying pressure of the atmosphere thereon, a compound lever is moved, transmitting the motion of the chamber to a marking pen which describes a curve on the recording paper, or chart, bound. on a constantly revolving cylinder run by clock-work. The chart is ruled horizontally, at spaces 0.05 inch apart, and in vertical curves, at spaces to represent periods of two hours in time. The instru- ment is compensated for temperature, and can be easily turned and adjusted within small limits so as to keep both the time and pressure scales correct.
This instrument has proven of great value in recording the minor changes of pressure, as well as the sudden changes be- tween the hours of observation, and will be of constantly in- creasing value in affording a constant and unbroken record of barometric variations, which will be always available for the pur- pose of studying the laws governing not only storms, but also the ordinary conditions of the weather.
Some difficulty has been met in finding a suitable exposure for the sunshine recorders, and hence these valuable instruments have not yet been put to full and successful use.
All the "normals" used in the following tables and elsewhere in this report, have been obtained from the observations of the past nine years, except those of the movement of the wind, which cover only six years.
ATMOSPHERIC PRESSURE.
All readings under this head are expressed in inches and frac- tions thereof, and are obtained from observations of the standard mercurial barometer, at an altitude of 72.7 feet above mean sea level. These readings are corrected for temperature, elevation and instrumental error, but not for standard gravity, the reduc- tion for which would probably be -. 007 inch.
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METEOROLOGICAL REPORT.
TABLE I.
1888.
Month.
Normal.
Mean.
Dep. from Normal.
Maximum.
Minimum.
Range
January.
30.067
30.086
+.019
30.866
29.064
1.802
February
30.068
30.067
-. 001
30.428
29.509
0.919
March.
29.918
29.976
+.058
30.619
29.166
1.453
April
29.956
30.076
+.120
30.531
29.518
1.013
May
29.988
30.018
+.030
30.301
29.745
0.556
June
29.942
29.904
-. 038
30.248
29.567
0.681
July
29.920
29.967
+.47
30.301
29.274
1.027
August.
29.985
29.940
-. 045
30.337
29.390
0.947
September.
30.060
30.067
+.007
30.679
29.279
1.400
October.
30.063
29.921
-. 142
30.533
29.269
1.264
November
30.049
30.110
+.061
30.847
29.404
1.443
December
30.026
29.957
-. 069
30.571
28.905
1.666
Mean
30.004
30.007
+.004
30.522
29.341
1.181
The mean pressure for the year was 30.007 inches. or .004 inch above normal. Highest annual mean in nine years, 30.024 inches, in 1880 ; lowest, 29.963 inches, in 1885.
The highest pressure recorded during the year was 30.866 inches on the 12th of January, and the lowest was 28.905 inches, on the 18th of December ; annual range, 1.961 inch. Highest pressure recorded in nine years, 31.016 inches in 1887 ; lowest, 28.772 inches in 1886 ; extreme range 2.244 inches.
The means of the different months were very near normal, except two,-those of April and October, which were .12 inch above and .14 inch below normal, respectively. The mean of October was by far the lowest mean for that month in nine years. The mean of July was the same as that of July 1887. the highest for that month in the same period.
Great fluctuations of pressure occurred in January, in connec- tion with the many severe storms of that month, one fall of 1.473 inch in 30 hours being noted, on the 25th and 26th. February was unusually quiet for a winter month, and the whole range of pres- sure was less than one inch. March presented its usually stormy characteristics, while April furnished only one marked depression, May was noted for the smallest barometric range (with two excep-
308
METEOROLOGICAL REPORT.
tions) of any month in nine years, and June was wholly free from marked fluctuations. July, August and September were each characterized by generally equable pressure, but each month was visited by one severe storm, that of July coming upon us from the Canadian border, those of August and September being well- defined tropical cyclones. The changes of pressure in October were about normal, as were those of November, the latter month, however, being noted for the violent and disastrous northeast snow and rain storm of the 25th-27th. In December a lower pressure was reached than had previously been recorded since February, 1886.
The following figures show the means at the time of the several daily observations :
Annual mean at 7 a. m. 30.025
2 p. m 29.984
66
9 p. m 30.014
Mean of all observations. 30.007
Decrease of pressure from 7 a. m. to 2 p. m., .041 inch; rise from 2 p. m. to 9 p m., .030 inch. This is about the usual diurnal oscillation.
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