USA > Massachusetts > Middlesex County > Somerville > Report of the city of Somerville 1879 > Part 12
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A large number of petitions for sewers are now before the Board of Aldermen, and we hope that in their consideration proper regard will be paid to the urgent requests of owners of houses, notwith- standing the owners of vacant lands may object because of assess- ments.
The result of the use of cesspools in porous soil was forcibly illustrated last season during the excavation for the sewer in Park Street. The stench emitted from the earth as it was removed from the trench proved conclusively that the filth from cesspools not only saturates the soil in close proximity to them, but is liable . to render the whole neighborhood unfit for the location of dwell- ings.
During the past year the construction of sewers in Joy Street and Line Street has enabled the owners of property to abate in- tolerable nuisances.
211
A good sanitary improvement was also made by the construction of a system of sewers in Clarendon Hill.
A sewer has also been placed in Hamlet Street, the need of which was noted in our last report.
HOUSE DRAINAGE.
The house drainage in nearly all the dwellings in this city is defective ; reports being received from the inspector, almost every day, of broken and leaking drains, drains without traps, defective joints, etc.
We are convinced that these defects, which are wholly inside the dwellings, cause many cases of zymotic diseases.
Poor workmanship is responsible for much of the trouble, as evidences of gross ignorance and carelessness on the part of me- chanics are frequently brought to our notice.
Many new arrangements have been proposed and invented, but the following are admitted by all sanitary experts to be absolutely necessary in a proper system of house drainage : -
All pipes in or under the dwelling to be of iron or lead, with tight joints.
House sewer to be trapped just before leaving the house or in manhole outside.
Soil pipe to be extended through the roof, at its full size.
Each pipe to be trapped close to its connection with water-closet, bath, bowl, sink, or other fixture.
. We think it necessary that all house draining and plumbing be done in accordance with regulations made by this board, and that an inspector be appointed to superintend the work.
212
MORTALITY IN SOMERVILLE IN 1879.
January.
February.
March.
April.
May.
June.
July.
August.
September.
October.
November.
December.
Total.
Zymotic Diseases.
MIASMATIC.
Scarlet Fever
4
1
1
1 HN
1 1
2
+.
2
5
2
4
29
Croup .
2
2
2
1
1
'Typhoid Fever
1
3
Erysipelas
1
1
2
2
2
1
20
Cholera Morbus
1
1
Puerperal Fever
1
1
Puerperal Peritonitis
1
1
Septicemia
2
.
1
2
DIETIC.
Delirium Tremens .
Constitutional Diseases.
DIATHETIC.
Dropsy and Anæmia
2
1
1
·
·
·
H.
1
6
Cancer of liver
1
1
Mortification .
1
TUBERCULAR.
Phthisis Pulmonalis
4
5
4
6
8
3
6
7
7
18
3
6
67
Tubercular Meningitis
1
1
1
1
Tubercular Enteritis
Hydrocephalus
1
1
.
1
·
·
·
6
Local Diseases.
NERVOUS SYSTEM.
Apoplexy
Paralysis
1
2
2
1
1
1
1
2
7
Epilepsy
Convulsions
1
1
1
1
1
2
Q
11
Laryngismus Stridulus
1
.
1
.
.
.
. .
1
.
2
Phlebitis
Heart Diseases .
2
4
3
3
3
·
N.
3
2
1
.
2
25
RESPIRATORY ORGANS.
Laryngitis
1
1
2
1
1
6
Pneumonia
3
4
3
7
3
2
2
1
2
1
28
Congestion of Lungs
1
Pleur sy .
1
1
2
Lung Diseases
1
.
.
.
1
.
2
·
1 3
2
2
8
Insanity
1
1
.
1
1
1
5
.
.
4
1
1
1
·
8
ORGANS OF CIRCULATION.
Pericarditis
1
.
1
.
. ·
·
·
.
. ·
.
1
Bronchitis
1
1
·
·
2
Marasmus
.
.
1
. .
1
.
.
·
.
.
.
1
. .
.
.
·
.
.
·
.
·
.
.
.
.
1
7
Cancer .
1
1
1
·
·
.
·
3
2
16
Diphtheria
6
4
6
Whooping Cough
1
Dysentery
2
2
2
6
Diarrhea
Cholera Infantum
1
1
2
13
2
1
1
Cerebro-Spinal Meningitis
1
3
Rheumatism
-
-
--
.
.
.
2
.
2
1
.
1
1
11
1
2
1
Brain Diseases
1
Cerebral Meningitis
1
1
1
.
·
1
6
1
H. 1
1
7
1
1
-
. ·
1
213
MORTALITY IN SOMERVILLE IN 1879, continued.
January.
February.
March.
April.
May.
June.
July.
August.
September.
October.
November.
December.
Total.
DIGESTIVE ORGANS.
Gastritis .
2
.
1
1
2
2
Abscess in Stomach
Indigestion
1
2
.
1
1
Abdominal Tumor
1
Jaundice
1
1
Liver Disease
URINARY ORGANS.
Nephritis
2
1
H. H.
1 1
1
Bright's Disease
1
.
2
GENERATIVE ORGANS.
Ovarian Disease . .
. .
. .
· .
. .
.
.
.
. .
. .
.
1
Developmental Diseases
OF CHILDREN.
Premature Birth and Infantile
Debility .
2
.
1.
H. 1
3
1
2
14
Imperforate Anus
OF WOMEN.
Childbirth .
OF OLD PEOPLE.
Old Age . .
1
.
. .
1
1
·
2
1
1
1
9
DISEASES OF NUTRITION. Atrophy and Debility . .
2
2
1
1
Violent Deaths.
Railroad .
1
1
Scalding .
1
1
1
1
Exhaustion following injury
Accident not specified
1
1
SUICIDE.
Drowning
1
Unknown
.
. .
1
1
·
· ·
. .
. ·
. .
·
3
Total
37
40
27
34
38
22
37
46
27
35
27
28
398
Still-born
2
2
6
4
. .
2
1
. .
1
5
1
1
25
.
· .
.
. .
1
·
· .
1
1
Suffocation
2
Fracture of Skull
1
1
.
.
2
.
Death rate per thousand, based on an estimated population of 23,562
16.9
Enteritis .
1
1
2
Peritonitis
1
Ulceration of Intestines Hemorrhage from Bowels
Hernia
1
·
.
1
1
1
.
1
1
2
1
.
1
3
Diabetes
Disease of Kidneys
Cyanosis
1
5
1
1
6
1
.
1
1
1
21
2
6
214
DISTRICTS.
The comparison of the rates of mortality, the prevalence of diseases dangerous to the public health, and the number of nui- sances abated in the ten sanitary districts of the city, which was begun in 1878, has been continued during the past year.
In estimating the population, we have taken that of 1878, as stated in our last report, as a basis ; and having ascertained from the assessors' books the increase of polls in 1879 over the number in 1878 to be 4-7% per cent, we assume that the increase in popu- lation has been in the same ratio, and has been uniform throughout the city.
The number of dwellings in the city was about the same May 1, 1879, as in 1878.
The accompanying map shows the location of each district, the boundaries being indicated by red lines and the numbers by roman numerals. It also shows the location of each case of scarlet fever, diphtheria, and typhoid fever reported, and each fatal case (the characters used being explained in the lower right-hand corner), and the locations of sewers, which are represented by dotted lines.
The characteristics of each district may be briefly stated as follows : -
DISTRICT I. Includes the McLean Asylum, the filled basins of Miller's River, the filled clay pits near Oliver Street, the territory known as " Brick Bottom," and the thickly populated section near the Union Glass Works ; also all the pork-packing and rendering establishments in the city. Area, about 337 acres. Soil, mostly clay. About three eighths vacant uplands and one eighth marsh. Population almost entirely foreign, living in small houses most of which are connected with sewers. The land is generally low, the greater part being not more than 13 feet above mean low tide. Number of dwellings, 1,006. Estimated population, 4,293 ; aver- age to each dwelling, 4738.
DISTRICT II. Embraces nearly all of East Somerville east of Cross Street, including Mt. Benedict. Area, about 107 acres. Soil, clayey gravel. General elevation, about 40 feet above mean low tide. Thickly populated almost entirely by native-born people, living in good houses nearly all of which are connected with sewers. Number of dwellings, 678. Estimated population, 4,189 ; average to each dwelling, 51%.
DISTRICT III. Bounded by Washington Street, the Fitchburg
215
Railroad, Prospect Street, and the Cambridge line. Area, about 93 acres. Soil, chiefly clay. Land generally low and damp. Ele- vation, about 16 feet above mean low tide. About one half vacant land. Population principally native-born, living in good houses. Sewers are in most of the thickly settled streets. Number of dwellings, 285. Estimated population, 1,623 ; average to each dwelling, 5778.
DISTRICT IV. Embraces all of the valley south of Somerville Avenue, and west of Mystic and Merriam Streets, except those parts in Districts I. and III .; and includes the American Tube Works and the Middlesex Bleachery. Area, about 171 acres. Soil, sandy. Land low and damp. Elevation, about 20 feet above mean low tide. About one eighth vacant land. Population more than one half foreign-born, living in small houses, the native-born people living in good houses. Most of the streets are provided with sewers, of which several were built in 1879. Number of dwellings, 499. Estimated population, 2,880 ; average to each dwelling. 518%.
DISTRICT V. Includes Prospect Hill, Spring Hill, and the southerly slope of Central Hill, and extends from Medford Street to Willow Avenue, between Highland Avenue and Somerville Avenue. Area, about 361 acres. Soil, clayey gravel. Elevation, from 20 to 140 feet above mean low tide. About one third vacant land. Population almost entirely native-born, living in good houses. The thickly settled portions are generally provided with sewers. Number of dwellings, 814. Estimated population, 4,503 ; average to each dwelling, 550.
DISTRICT VI. Bounded by Highland Avenue, Willow Avenue, the Medford line, and Medford Street. Includes the city land and city buildings on Central Hill, the city farm, the Tufts brick- yard, the "Birch Pasture," "Polly Swamp," and the "Patch." The thickly settled parts are populated by foreign-born people, living in small houses with no sewers ; the native-born people as a general rule live in good houses, with large lots of land. There are but three common sewers, accommodating but a very few houses. Area, about 285 acres. Soil in settled parts, clayey gravel. Elevation, from 35 to 115 feet above mean low tide. About three fourths vacant land. Number of dwellings, 255. Estimated population, 995 ; average to each dwelling, 37%.
DISTRICT VII. Bounded by Medford Street, Broadway, and Cross Street, including a part of Winter Hill. Area, about 194 acres. Soil, clayey gravel. Elevation, from 35 to 140 feet above
216
mean low tide. About one third vacant land. The greater part is thickly populated by native-born people, in good houses. Most of the streets have sewers, several of which were built in 1879. Number of dwellings, 447. Estimated population, 2,461 ; average to each dwelling, 5-55.
DISTRICT VIII. Bounded by Broadway, the Medford line, Mystic River, the Boston line, Mystic Avenue, and the rear of lots on the west side of Austin Street. Includes " Convent Hill," Broadway Park, and " Ten Hills Farm." Area, about 482 acres. About one third is water and flats, one fifth marsh and one fourth vacant upland. In the settled parts the soil is clayey gravel, and the elevation from 10 to 145 feet above mean low tide. About one half of the people are native-born and live in good houses, those of foreign birth living in ordinary houses. The only sewers are in Mystic Avenue near the Boston line, and in portions of Broadway. Number of dwellings, 160. Estimated population, 733 ; average to each dwelling, 476% .
DISTRICT IX. Includes the most thickly settled part of West Somerville, and extends from Willow Avenue to the rear of lots on the west side of Irving Street, including the " Powder House Farm." Area, about 174 acres. Soil, in parts sand and in other parts clay and clayey gravel. Elevation, about 40 feet above mean low tide. Population almost entirely native-born, in good houses. Sewers are in most of the streets. Number of dwellings, 273. Estimated population, 1,309 ; average to each dwelling, 41%.
DISTRICT X. Includes College Hill and all of West Somerville, west of Irving and Meacham Streets ; the greater part being a farming territory. Area, about 456 acres. Soil, chiefly clayey gravel. Elevation, from 10 to 122 feet above mean low tide ; the settled part being high. Population, nearly all native-born, living in good houses. Sewers are in six streets, and they were all built in the fall and winter of 1879. Number of dwellings, 136. Esti- mated population, 576 ; average to each dwelling, 4123.
Number of dwellings in the city, 4,553. Estimated population, 23,562 ; average to each dwelling, 5125.
The following statistics are given in the four accompanying tables : -
First. Number of deaths in each district and in the entire city, with the rate per thousand of population, during the last six years, exclusive of deaths in the McLean Asylum for the insane.
Second. The five principal causes of death in Somerville in
la
217
1879, with the number of deaths from these causes and rate per thousand of population, in each district.
Third. Number of cases of scarlet fever, diphtheria, and typhoid fever in each district reported in 1879, with the number of these cases that have up to this date proved fatal, and the number per thousand of population.
Fourth. Nuisances abated in each district in 1879.
TABLE OF DEATHS IN EACH DISTRICT DURING THE LAST SIX YEARS, EXCLUSIVE OF DEATHS IN THE MCLEAN ASYLUM.
Districts Population i. 1879.
I.
II. 4,189
III.
IV.
V.
VI. 995
VII. 2,461
VIII. 733
IX. 1,309
X. 576
Entire City. 23,562
No. per 1,000 of population.
1874
147
37
53
14
24
16
86
33
67
16
34
37
26
11
17
25
18
15
3
8
475
22
1875
149
37
84
22
26
17
56
21
75
18
29
32
32
14
13
19
15
12
7
15
486
22
1876
113
30
62
17
17
12
62
24
78
20
23
26
25
12
11
17
25
22
10
20
426
21
1877
126
32
57
15
18
12
57
22
61
15
31
34
29
13
12
18
32
27
5
10
428
20
1878
92
22
50
12
32
21
53
19
53
12
24
25
32
14
15
21
17
14
7
13
375
17
1879
92
21
50
12
29
18
62
22
77 .
17
14
14
22
9
14
19
16
12
16
385
16
6 years
719
31
356
15
146
16
376
24
411
16
155
28
166
12
82
20
123
17
41
14
2,575
20
1,623
2,880
4,503
No. per 1,000
No. of deaths.
No. of deaths.
No. of deaths.
of population. No. per 1,000
No. of deaths.
No. of deaths.
No. per 1,000 of population.
No. of deaths.
No. of deaths.
No. of deaths.
No. per 1,000
of population.
No. per 1,000
of population.
of population. No. per 1,000
No. of deaths.
of population.
No. per 1,000
of population.
of population. No. per 1,000
4,293
No. per 1,000
of population.
No. of deaths.
No. of deaths.
of population. No. per 1,000
218
219
TABLE SHOWING THE FIVE PRINCIPAL CAUSES OF DEATH IN SOMERVILLE IN 1879, WITH THE NUMBER AND RATE IN EACH DISTRICT.
CONSUMPTION.
DIPHTHERIA.
PNEUMONIA.
HEART DISEASE.
C OLKRA INFANTUM.
DISTRICTS.
No. of Deatha
No per 1,000 of pop.
No. of Deaths
No. per
1,000 of pop.
No. of Deaths.
No. per
1,000 of pop.
No. of Deaths.
No per 1,000 of pop.
No. of Deaths.
No. per
1,000 of pop.
I. .
18
4.19
4
0.98
9
2.10
8
1.86
0.47
II.
7
1.67
.
· .
3
0.72
5
1.19
4
0.95
III.
3
1 85
2
1.28
3
1.85
1
0.62
3
1.85
IV.
9
3.13
2
0.69
5
1.74
5
1.74
3
1.04
V. .
13
2.89
10
2.22
4
0.89
4
0.89
4
0 89
VI.
3
3.02
.
.
. . .
1
1.01
.
..
3
3.02
VII.
4
1.63
2
0.81
.
1
0.40
1
0.40
VIII.
5
6.86
3
4.09
. .
· .
1
1.36
IX
3
2.29
4
3.06
2
1.52
x.
2
3.47
2
3.47
1
1.74
Total
67
2.84
29
1.23
28
1.19
25
1.06
20
0.85
TABLE OF SCARLET FEVER, DIPHTHERIA, AND TYPHOID FEVER IN EACH DISTRICT IN 1879.
SCARLET FEVER.
DIPHTHERIA.
TYPHOID FEVER.
DISTRICT.
Casea
reported.
Proved
fatal.
Cases per
1,00 1 of pop.
Deaths per
1,000 of pop.
Cases
reported.
Proved
fatal.
Cases per
1,000 of pop.
Deaths per
1,000 of pop.
report: d.
Proved
fatal.
Cases per
1,000 of pop.
Deaths per
1,000 of pop.
I. . . .
34
6
7.92
1.40
10
4
2.33
0.93
5
1
1.16
0.23
II.
37
.
8.83
. . .
13
3.10
. . .
2
.
0.41
III.
14
1
8.63
0.62
8
2
4 98
1.23
1
·
0.61
IV. . . .
22
2
7.99
0.69
5
2
1.77
0.69
2
1
0.69
0.35
v. . . .
31
a
6.88
0.67
33
8
7.33
2 00
VI. .
5
5 03
· .
.
.
3.02
. . .
VII.
16
22
6.09
0.81
22
2
8.94
0.81
1
1
0.41
0.41
VIII. .
6
· .
·
. . .
8
3
10.91
4.09
3
4.09
IX.
6
.
.
·
.
.
0
3
6 87
2.29
1
. .
0.76
xx. . . .
1
1
1.74
1.74
2
2
3.48
3.48
Total . . .
171
15
7.26
0.64
113
27
4.79
1.15
15
3
0.64
0.13
.
.
.
a
8 19
4.58
·
Cases
220
NUISANCES ABATED IN EACH DISTRICT IN 1879.
District
I.
II.
III.
IV.
V.
VI.
VII.
VIII.
1X.
x.
Total
Population
4293 4189 1623 2880, 4503
995
2461
733
1309
576
23562
Cellar damp .
8
6
5
10
1
Cesspool defective
offensive .
overflowing
2
1
4
14
66 under stable offensive .
1
Connections of waste with drain- pipes defective
7
10
8
2
7
3
2
1
4
44
Drainage defective
23
4
5
5
6
2
2
1
7
1
56
66
emptying in cellar . emptying on surface .
30
4
14
11
9
9
9
1
1
88
Drain pipe broken and leaking
6
9
4
10
3
2
4
1
1
40
4
1
·
1
1
4
1
9
Dwelling rooms in basement low and damp .
1
1
Filth in cellar
2
2
1
1
1
20
Garbage in street
1
Hennery offensive
3
.
.
.
.
3
3
1
1
1
31
Offal on land
1
3
·
.
1
3
1
1
10
Offensive materials carted through streets
1 1
13
2
2
3
18
3
3
.
44
Pig-pen offensive
1
1
Privy not properly constructed
2
1
2
3
3
3
1
16
Soil-pipe not ventilated
2
2
1
1
6
1
3
6
9
2
1
3
17
105
8
11
16
41
11
8
9
14
4
7
3
1
2
. .
1
1
6
38
not properly ventilated offensive
9
4
4
12
3
2
2
6
43
Waste-pipes defective .
4
2
3
1
4
1
17
7
14
5
209
stopped up
2
1
9
1
1
13
1
1
1
28
insufficiently supplied
1
3
with water Water-closet not supplied with water .
1
6
7
Water-closet offensive . stopped up
9
1
4
1
15
Water-course obstructed
polluted
1
1
Wooden waste-pipes and drains
18
5
1
2
3
29
391
141
68
79
217
89
66
49
73
24
1197
.
6
1
.
1
6
2
.
4
3
1
1
1
11
6
on premises
12
.
4
1
1
1
.
1
1
5
Manure-pit not properly constructed
2
.
.
.
·
3
1
.
23 227 15
6. not properly constructed
11
4
Q
8
5
1
5
1 21
17
not trapped
55
30
11
8
38
24
·
·
2
1
3
.
·
.
.
1
1
2
20
.
1
·
4
Vault full . .
leaking .
2
12
Rendering, method of, defective
1
1
Slops thrown on surface
5
1
2
Hens kept in cellar
1
1
Manure exposed
17
3
1
1
4
.
2
1
1
5
‹ 6
under house offensive
2
2
1
.
·
2
4
2
15
in cellar defective
not trapped stopped up
2
2
1
1
1
Stable filthy
offensive
6
Stagnant water in house cellar
in stable cellar on surface
2
.
.
1
5
5
·
3
1
6
Water-closet defective .
.
1
2
.
2
1
Offensive odor in and around dwell- ings
1
Horse kept in house
2
5
3
2
2
15
30
3
3
.
MAP OF-
MIDDLESEX
R. A.
VIII
AVE.
AVE.
MYSTIC
MILL POND,
1879.
SCALE.
SHOWING HEALTH DISTRICTS.
THE MONY
D
WILLS ST.
MAIN
FLINT
IVE
D
E
M
-
BOSTON & LOWELL
COLLEGE AVE.
CEDAR
WARWICK ST.
VI
OXFORD
INDAN
O Lowder Ena
CITY
LAST
-BASIN
IX
MOTTMM
RAILFORD
HAWKINSY
ET
57
37
29
FROST AV
AVE.
SUMMER
O
57
O
Sewers shown thus:
IM MICK
Sewer Outlets,.
Boundaries of Health Dists.
REPORTED CASES, 1979.
Scarlet Fever ... . O
Fatal cases, ..
C
Typhoid
...
L
Diphtheria.
M
B
R
I
D
G
E
MALDEN BRIDGE
RIVER
S
4
EASTCAN
SOMERVILLE,
GRANT
WHEATLAND
47240YM2
PARK,
BROADWAY"
BROADWAY.'
BOSTON & MAINE
D
LEN
ENSTERN
HEATH 10000
CENTRAL
TensTen
GAL MAN
TENNYS
LOWELL ST.
CARTRIDGE ALL
JENNY LIND
MYSTIC
RESERVÉMAI
ATURDOCK AT
00
COLUMBUS
MYSTIC
GEMKLEY
ANDON ST
SUMMEN
FILLED
EAST
MORRISON
ARLINGTON
BELMONT
C
IDE CH
AVE.
HUTTER
BLAND
PORTER
CRAIGIE
CLARE
NEWAURY
MERDE
CAMERON
DAWE
G
MEAGHAN
BEACON
ITCHDUNG
LING."
0
C
AVE
DOO
57
AVE
LINWOOD
-
HINCKLEY ST.
MEDFORD
ADAMS ST.
SYCAMDRO
THURSTON
SCHOOL
WALNUT
FOUNTAIN
.ASYLUM
MYSTIC RIVER BR. R.R ..
Tufts College,
HIGHLAND
SCHOOL
PRESCOTT
& STEIN PUMP
CUATTE
MYSTIC
LLENS
G.J.
APPLETONST
GRANITE
HIGHLAND
S
RAILROAD.
INGHE
BROOK.
HOLLAND
ARLIN.
ALEWIEL
BROADWAY.
RAILROAD.
D
BADADINAY
00
WINTHROP
AUSYIN ST.
AFT
DERBY ST.
JAQUES
PINCK
AV
MILLERS RIVEN
OF
CAMBRIDGE
ELN
CITY LINE.
. .
JUNKER HIT
NAIN
BOST
.
مـ
-
.
221
STATEMENT OF THE APPROPRIATION AND EXPENDITURES FOR HEALTH DEPARTMENT, 1879.
Appropriation,
$2,700 00
Expended :
For collecting offal,
$980 00
ashes,
977 19
burying animals,
24 00
66 abating nuisances,
38 75
" repairing culvert for water-course,
17 36
66 fumigating,
57 00
" disinfectants,
5 95
66
oil of peppermint,
36 00
66 serving notices,
9 64
carriage-hire,
22 00
66
expenses at Woburn,
7 39
" books, stationery, and printing,
43 87
" advertising,
9 50
66
postage stamps,
6 00
66
map and plates for report of 1878,
50 22
" vials,
1 75
66 salary of clerk,
100 00
66 salary of inspector,
500 00
$2,886 62
Excess of expenditures over appropriation,
$186 62
In closing this report we wish to express our appreciation of the cordial aid and encouragement received from physicians of Som- erville and vicinity ; the assistance rendered us in many ways by the chief of police and his officers ; and the faithfulness of the officers in our employ.
CHARLES W. SAWYER, Chairman. GEO. A. KIMBALL, C. E. JOHN F. COUCII, M. D.
PREVENTION OF DISEASE.
BY JOHN F. COUCH, CITY PHYSICIAN.
THE study of this subject involves a consideration of all of man's surroundings : the air he breathes, the water he drinks, the food he eats, the soil on which his house is built, the character and social condition of his neighbors, his occupation, hereditary influences, etc. For ages these subjects have received the atten- tion of physicians, who have labored in the cause of sanitary reform with a zeal untainted by selfishness.
Until a comparatively recent period but little interest was shown in these subjects by the public; but at present the signs are encouraging. We find that reports of boards of health are sought for and read with interest. National, State, and city boards of health have been organized, and through them much valuable information has been given to the people. When the public shall have recognized the fact that some diseases are preventable, and that many others can by taking certain precautions be restricted in their spread, we can reasonably hope that great results will follow. But it must not be forgotten that with this knowledge there comes a corresponding obligation. The man who, with a knowledge of the result, exposes himself to the influence of any cause that eventuates in his death, is a suicide ; and he who per- mits his neighbor's child to visit his house in which there is a contagious disease, is morally, if not legally, guilty of a great crime. If the child should contract the disease and die, he should be held responsible for its death. Each one of us is entitled to pure air and pure water; and it is absolutely essential to health that, in addition to these, the soil on which we live should be clean. It is the province of those who are engaged in the noble work of sanitary reform to point out to the people some of the many ways in which health may be impaired and disease engen- dered. Disease was once supposed to be inevitable, and was regarded as an evidence of divine displeasure. It is now well
223
known that man is himself responsible for many of the diseases with which he is afflicted, and that they are the result of a viola- tion of laws established in the beginning. It matters not what position he holds in society, whoever violates these laws must pay the penalty.
That there is a great deal of unnecessary sickness in our city is susceptible of proof; and that by thoroughly carrying out the measures suggested in this paper, our death-rate will be materially reduced, is my earnest hope. By reference to the mortality table for 1879, it will be seen that there were 398 deaths in this city during the past 12 months. Of these 98 were due to " zymotic " diseases, and 67 to consumption. Of the principal " zymotics," diphtheria was the cause of 29 deaths, cholera infantum 20, scarlet fever 16, croup 6, and typhoid fever 3. The prevalence of these diseases in a city is considered by sanitarians as an evidence of the existence in that city of removable causes of disease. In the con- sideration of these diseases in the following pages, only such points will be alluded to as may have a practical bearing on prevention and restriction. *
SCARLET FEVER. - Medical writers of the present day are unan- imous in the belief that this is a contagious disease. Of this there cannot be a reasonable doubt, - my own experience confirms it; and until the public realize the truth of this fact, we cannot hope to do much towards stamping it out. Recognizing the fact that this is a contagious disease, each individual in the community will feel that he is morally obliged to do all that he can to keep the disease from spreading. He will promptly notify the author- ities of its existence in his own family, and will cheerfully carry out their suggestions. "Scarlet fever is the very type of what has always been, and still is regarded as a contagious and infectious malady." - Murchison, " London Lancet," October, 1864.
Mr. John Simon says, "Of this subtle and destructive con- tagion, we know of no other birthplace than the human body." Dr. Thomas, in Ziemssen's Cyclopædia, says, "In the large majority of cases, the poison can be proved to have emanated from sick persons; or we can at least trace its course with more or less certainty from these to the newly affected persons." And again, " It is indisputable that the cause of scarlatina is a peculiar substance which is transferable from the patient to the unaffected individual." Hillier writes, "The only known cause of the dis- ease is contagion."
224
In the Fourth Annual Report of the State Board of Health of Michigan there is a paper by Dr. O. Marshall, of Lansing, on an epidemic of scarlet fever in Lansing, Mich., in 1875-76, from which I quote : " The centres of the disease were nearest to the centre of business, where the possibility of contact was greatest. The disease commenced on both sides of the river nearest to the public schools, and its extension outside of the city eastwardly was on the main travelled road. The evidence is strong in favor of con- tagion as being the first cause of the disease as it prevailed here. Eighty-three persons had scarlet fever following other cases in the same houses. Eighteen had the disease after visiting those sick, or where persons passed frequently from the sick to those who were well, in other houses. In two instances physicians had the disease in their own families after visiting many cases of scarlet fever. In three other instances there was a strong probability that the family physician had carried the disease in his clothes, hair, or breath, because of the remoteness of the cases from others who had scarlet fever, and no precautions having been taken to change his clothing immediately after visiting those who were sick with the disease. Seventeen persons had first symptoms in school, where it can be proven there were persons in attendance who had not fully recovered from scarlet fever. In the remaining thirty- seven cases the evidence of contagion is not so clear ; but in a large proportion of them, on careful inquiry, the source can be traced with considerable certainty. Further evidence of the contagious- ness of the disease might be found in the fact that where com- plete separation of the well from the sick was rigidly enforced, and every possibility of its being conveyed in clothing was prevented, none took the disease " Anything that has come in contact with an infected person may be the means of transporting the contagion of the disease, - air, food, clothing, sheets, blankets, furniture, toys, whiskers, hair, domestic animals, etc. Richardson believes that the poison is " thrown off by the lungs or skin, probably with epithelium." Thomas says there is " little doubt that the poison is present somewhere in the skin of the patient. It is probably also present in the pulmonary exhalations. Other secretions may also be the carriers of the contagion ; as, for instance, the nasal and pharyngeal secretions, perhaps also the urine."
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