(navigation image)
Home American Libraries | Canadian Libraries | Universal Library | Community Texts | Project Gutenberg | Children's Library | Biodiversity Heritage Library | Additional Collections
Search: Advanced Search
Anonymous User (login or join us)
Upload
See other formats

Full text of "Annual report of the Department of Public Health for the year ending ..."

►t-x^^>x>-^;»>>^»x^^>>^»^»:«»:«»i-:«»;>*;»;-i«»! «-^ 



BOSTON UNIVERSITY 
LIBRARIES 




University Library 



>.«.^^^^^.j..j.^^.j..r..j.^^^^ 



Public Document 



No. 34 



C!)e Commontoealtl) of Qia$$aci)u$etts! 



ANNUAL REPORT 



Department oe Public Health 



FOR THE 



Year ending November 30, 1920 




BOSTON 

WRIGHT & POTTER PRINTING CO., STATE PRINTERS 

32 DERNE STREET 



Publication of this Document 

approved by the 
Supervisor of Administration. 



CONTENTS. 



Report of the Public Health Council 

Report of the Commissioner of Public Health 

Infant and Child Hygiene ..... 

Personnel Problems ...... 

The Plague Problems ...... 

Tuberculosis and Leprosy . . 

Special Water Supply Investigation 

Disease Prevalence ...... 

Venereal Disease .....•• 

Public Health Nursing ...... 

The Continuing Laboratory Problem of the Department 

The Plumbing Report ...... 

Legislative Recommendations .... 

Division of Administration ..... 

Division of Sanitary Engineering .... 

Division of Water and Sewage Laboratories 

Division of Communicable Diseases 

Division of Tuberculosis ..... 

Division of Hygiene . . . . • • 

Division of Biologic Laboratories .... 
Wassermann Laboratory . . . . ■ 

Division of Food and Drugs ..... 

Appropriations and Expenditures for the Year ended Nov 
Division of Administration .... 

Division of Hygiene ...... 

Division of Communicable Diseases 
Subdivision of Venereal Diseases 
Division of Biologic Laboratories 
Division of Food and Drugs .... 

Manufacture and Distribution of Arsphenamine . 

Division of Sanitary Engineering 

Division of Water and Sewage Laboratories . 

Division of Tuberculosis (Sanatoria) 

State Examiners of Plumbers .... 

Penikese Hospital ...... 

Recapitulation .....•• 

Expenditures of Tuberculosis Sanatoria for the Year en^ 

Special Appropriations — Tuberculosis Sanatoria . 

Supplement ......-• 

Report of Division of Sanitary Engineering 

Private Wells ....... 

Water Supplies of Camps . . . . • 

Difficulties of providing Water and Sewerage Facilities 
Rainfall and Flow of Streams .... 

Sanitary Protection of Public Water Supplies . , 

Examination of Water Supplies .... 

Analyses of the Water of PubHc Water Supplies 



30, 1920 



ded Nov. 30 



in Certain Districts 



1920 



PAGE 

3 

4 
5 
7 
8 
10 
12 
13 
15 
16 
17 
18 
19 
19 
20 
21 
22 
28 
30 
32 
34 
34 
36 
36 
37 
37 
38 
39 
39 
40 
41 
41 
42 
42 
43 
44 
45 
46 
47 
51 
52 
53 
53 
54 
55 
55 
56 



BOSTON UNIVERSITY LIBRARIES^ 



IV 



CONTENTS. 



Supplement — Continued. 

Report of Division of Sanitary Engineering — Concluded. 

Comparison of Water Supplies of the State by Chemical Analysis 

Surface Water Sources 

Ground Water Sources 

Water Supply Statistics 

Consumption of Water 

Rainfall 

Flow of Streams 

Sudbury River 

Nashua River 

Merrimack River 

Sudbury, Nashua and Merrimack Rivers 
Sewerage and Sewage Disposal . 
Examination of Rivers 

Assabet River 
. Blackstone River . 

Charles River 

Chicopee River 

Concord and Sudbury Rivers . 

Connecticut River . 

Deerfield River 

French River 

Hoosick River 

Housatonic River . 

Merrimack River . 

Millers River 

Nashua River 

Neponset River 

North River in Peabody and Salem 

Taunton River 

Other Rivers .... 

Report of Division of Water and Sewage Laboratories 
Investigations in Regard to Corrosion of Pipes 
Bacillus Coli and Bacillus Aerogenes 
Studies of Shellfish ...... 

Purification of a Gas Company's Wastes 
B. Coli in the Water of Swimming Pools 
Operation of Trickling Filters .... 

Intermittent Sand Filters in Operation Thirty-three Years 

Removal of Color from Water 

The Effect of Low Temperature upon Sterilization of Water by Means of 

Liquid Chlorine or Bleach 
Bacterial Measurement of the Degree of Pollution of Water 
Report of Division of Food and Drugs 
Report of Division of Communicable Diseases 
Report of the State District Health Officers . 

Nursing Assistants ..... 

Educational Work ...... 

Diseases Dangerous to the Public Health . 

District Changes ...... 

Health Districts and State District Health Officials 

Work of the Engineering Division 
Report of the Work of the Bacteriological Laboratory 

Diphtheria ....... 

Typhoid Fever ...... 

Pneumococcus Type Determination . 



CONTENTS. 



Supplement — Continued. 

Report of Division of Communicable Diseases — Concluded, 
Report of the Subdivision of Venereal Diseases 
Statistics 
Clinics . 
Social Service 
Lapsed Cases 
Arsphenamine 
Advertising . 
Educational . 
Industrial 

Meeting of Clinic Directors 
Police Departments .... 

Inspection of Jails and Houses of Correction 
Sources of Infection . . . • 

Courts ....... 

Keeping Fit Campaign .... 

Penikese Hospital ..... 

Report of the Epidemiologist 

Epidemiological Significance of Age Distribution in Certain Communicable 
Diseases . . . . • 

Sex Distribution of Communicable Diseases 
Outbreaks of Communicable Diseases in 1920 
Anterior Poliomyelitis 
Influenza 
Measles 

Whooping Cough 
Diphtheria 
Scarlet Fever 
Septic Sore Throat 
Typhoid Fever . 
Progress made in Past Five-year Period 
Cases and Deaths from Diseases Dangerous to the Public Health, 1920 
Cases and Deaths, with Case and Death Rates, per 100,000 Population for 

All Reportable Diseases during the Year 1920 
Incidence of Communicable Diseases by Months, 1920 
Report of Division of Biologic Laboratories 
Antitoxin and Vaccine Laboratory 
Personnel 
Production 
Economics 
Improvements 
Educational . 
Needs . 
Wassermann Laboratory 
Routine Tests 

Complement Fixation Tests in Tuberculosis 
Complement Fixation Tests in Gonococcal Infections 
Costs ..... 

Report of Division of Hygiene 
Changes in Personnel 
Lines of Work .... 

Investigations 

Food and its Relationship to Health 

Mouth Hygiene 

Clinics for the Child in the Rural Community 

Cancer Control ..... 



PAGE 

211 
211 
212 
214 
214 
214 
215 
215 
215 
216 
216 
216 
217 
217 
217 
219 
221 

221 
228 
229 
229 
230 
232 
233 
233 
233 
234 
234 
235 
245 

262 
263 
267 
267 
267 
267 
269 
269 
269 
270 
271 
271 
271 
272 
272 
275 
275 
275 
276 
277 
278 
279 
280 



VI 



CONTENTS. 



Supplement — Continued. 

Report of Division of Hygiene — Concluded. 
Lines of Work — Concluded, 

Educational Work .... 

Special Work .... 

Report of Division of Tuberculosis (Sanatoria) 

An Act to establish the Massachusetts Hospital for Consumptives 

cular Patients . 
Consultation Clinics . 
Examination Clinics . 
Observation Hospital 
Subsidy . 

Examination of Prisoners 
Public Health Nurses 
Consultants 
Follow-up Work 

North Reading State Sanatorium 
Report of the Superintendent 
Medical Report . 
Clinics 

Recommendations 
Improvements 
Medical Staff 
Acknowledgments 
Treasurer's Report 
Valuation 
Special Report 
Statistical Tables . 
Westfield State Sanatorium 
Report of the Superintendent 
Days of Treatment 
Num*ber treated and Classification 
Length of Residence 
Support of Patients 
Gain in Weight . 
Dentistry . 
Conditions of Discharge 
Sanatorium School 
Out-patient Department 
Improvements 

Additional Improvements requested 
Acknowledgments 
Treasurer's Report 
Valuation 
Special Report 
Statistical Tables . 
Lakeville State Sanatorium 
Report of the Superintendent 
Medical Report . 
Work performed 
Improvements 
Farm 

Recommendations 
Changes in Personnel 
Acknowledgments 
Treasurer's Report 
Valuation 



and Tuber- 



PAGE 

281 
285 
289 

289 
294 
295 
296 
296 
296 
296 
297 
297 
298 
298 
299 
300 
300 
300 
300 
300 
301 
306 
307 
308 
314 
314 
314 
314 
314 
315 
315 
315 
316 
316 
316 
317 
317 
318 
318 
323 
324 
325 
330 
331 
332 
332 
333 
333 
333 
334 
334 
334 
340 



CONTENTS. 



Vll 



Supplement — Concluded. 

Report of Division of Tuberculosis (Sanatoria) — Concluded 
Lakeville State Sanatorium — Concluded. 
Special Report 
Statistical Tables . 
Rutland State Sanatorium . 
Report of the Superintendent 
Medical 
Farm 

Recommendations 
Treasurer's Report 
Valuation 
Special Report 
Statistical Tables . 
Report of the State Examiners of Plumbers ..... 
Papers written in 1920 and Pamphlets issued ..... 

Papers written by Members of the State Department of Public Health during 

the Year 1920 

Pamphlets issued by the State Department of Public Health 
Index .......••• 



PAGE 

340 
341 
350 
350 
351 
353 
353 
354 
359 
360 
361 
369 
375 

375 
377 
379 



C&e Commontoealtf) of a^a00ac|)U0ett0 



Department op Public Health, 
Boston, Jan. 19, 1921. 

To the General Court of Massachusetts. 

In accordance with the provisions of section 32 of chapter 30 of 

the General Laws I have the honor to submit herewith the annual 

report of the Department of Public Health for the year ending Nov. 

30, 1920. 

Respectfully, 

EUGENE R. KELLEY, 

Commissioner of Public Health. 



SIXTH ANNUAL REPORT 



Department of Public Health of Massachusetts. 



For the fiscal year ending Nov. 30, 1920, the Department of Public 
Health was constituted as follows: — 

Commissioner of Public Health, .... Eugene R. Kelley, M.D. 

Public Health Council. 

Eugene R. Kelley, M.D., Chairman. 
David L. Edsall, M.D., 1921. Sylvester E. Ryan, M.D., 1922. 

J. E. Lamoureux, M.D., 1921. George C. Whipple, S.B., 1923. 

Warren C. Jewett, 1922. Wm. T. Sedgwick, Ph.D., 1923. 

During the j-ear 12 formal meetings of the Council were held, as 
well as many meetings of the standing and special committees of 
the Department. The standing committees of the Council for the 
year were as follows: — 

Sanitary Engineering (including Housing and Rural Hygiene). 
Professors Whipple and Sedgwick, Dr. Kelley and Mr. Jewett. 

Preventive Medicine and Hygiene. 
Drs. Edsall, Kelley, Lamoureux and Ryan. 

Food and Drugs. ' 

Professor Sedgwick, Drs. Lamoureux and Ryan and Mr. Jewett, 

Finance, Law and Demography. 
Professor Whipple, Dr. Ryan and Mr. Jewett. 

In accordance with section 2 of chapter 792 of the Acts of 1914, 
at a meeting of the Public Health Council held on Dec. 21, 1920, 
the Commissioner of Public Health submitted to the Council a report 
of the Department for the fiscal year 1920, and it was voted that 
this report be approved and adopted as the report of the Depart- 
ment of Public Health for the fiscal year 1920. 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



SIXTH ANNUAL REPORT OF THE COMMISSIONER OF PUBLIC 

HEALTH. 

To the Public Health Council. 

Gentlemen: — In accordance with chapter 792 of the Acts of 
1914, I have the honor to present herewith a report of the activities 
of this Department for the past year, the sixth since the creation of 
the present Department and the first under the reorganization of the 
State government, with the change of title from State Department 
of Health to State Department of Public Health, and with the im- 
portant added function of administering five institutions, — the 
four State tuberculosis sanatoria and the Penikese Leper Hospital. 
Unlike nearly all other departments of the State government, the 
general reorganization did not affect the form of organization, per- 
sonnel, functions or fundamental statutes pertaining to the work 
of the Department save in the matter of the transfer of these in- 
stitutions. 

The activities of the Department have followed the same general 
lines as in previous years, but the impetus towards the newer fields 
of health work has been greatly accentuated. Under the term "newer 
fields of health work" I include such matters as nutrition, oral hy- 
giene, personal hygiene, and public health nursing. In a sense these 
subjects may be contrasted with the old-established factors in depart- 
mental health work, such as sanitary engineering, pure food work, 
and communicable disease control. These newer branches of sanitary 
science are in many ways highly specialized, but have one thing in 
common to a striking degree — they all center upon the individual 
to a much greater extent than do the older branches of sanitary 
science. To be effective they must reach the individual and evoke 
a conscious response. To be most effective they must reach the 
individual very early in life, by proxy through the parents up to 
school age and thereafter by directly enlisting the child's active in- 
terest and co-operation. 

This does not mean that the adult has nothing to learn or to apply 
for his own benefit from the teaching, for example, of modern nu- 
tritional methods — he can learn much. It does mean that unless 
an intelligent foundation is laid during childhood the resources of 
preventive medicine must work against a tremendous and in many 
respects a hopeless handicap when brought to bear upon the problem 
of the adult. One who has suffered from faulty nutrition as an infant 
and young child can never quite remove the resulting physical handi- 
caps even by following the most judicious program of diet and phys- 
ical training in later life. 



No. 34.] ANNUAL REPORT. 5 

Unfortunately the day has not yet arrived when the general public 
or our agencies of government can get a true perspective upon the 
relation of these newer phases to the whole subject of public health. 
However, public enlightenment in these matters is rapidly becoming 
more general, and it is daily becoming more difficult to find quali- 
fied expert workers in these fields than it is to find opportunities for 
them to follow their calling. 

In the past decade the conviction has grown upon those who seek 
to control the ravages of communicable disease that in many instances 
a sound nutritional and physical developmental foundation in early 
life is necessarv for success in combating infection in later life. 



Infant and Child Hygiene. 

For several years this Department has called attention in every 
possible way to the problem of infant and child hygiene. It has 
encouraged the extension and multiplication of such activities by 
both public and private agencies. It was responsible for a State- 
wide survey of infant and child hygiene needs early in the period 
of the war, made possible by the far-sighted generosity of the Metro- 
politan Chapter of the Red Cross. Since then it has consistently 
urged cities and towns to supply the workers needed in each com- 
munity as shown by the survey. 

The Department has gradually increased its own staft' of investi- 
gators in this field and has conducted educational programs and 
demonstration clinics to point out to communities their needs in 
these matters. This last method has been used during the past year, 
particularly in the western portion of the Commonwealth, and the 
local response has been most surprising. Every community, large 
or small, which our workers have visited has been astonished at 
the amount of malnutrition and correctable defects among its infants 
and children as revealed by these examination clinics, and many 
have set in motion some machinery for the perpetuation of such 
work and for providing facilities to correct the defects uncovered 
in clinic examinations. 

The most far-reaching and ambitious proposals in this direction, 
however, are those embodied in the various so-called "Maternity 
Benefit" measures introduced in the Legislature during the past 
session. The Great and General Court, finding itself unable to arrive 
at a definite conclusion upon this important subject, referred all 
such proposed legislation to a special recess commission for study, 
and provided a sum of money sufficient to carry out fundamental 
field investigations for the purpose of collecting accurate data upon 



6 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

the subject for this State. This commission consisted of the Com- 
missioner of Public Health and the Commissioner of Public Welfare, 
ex officio, and three members appointed by the Governor. The per- 
sonnel of the commission was as follows: Dr. Alfred Worcester, chair- 
man, Dr. Eugene R. Kelley, Mr. Robert W. Kelso, Mr. Edward E. 
Whiting and Mrs. Helen A. MacDonald. For months the commis- 
sion met regularly each week under the able leadership of its chair- 
man, Dr. Alfred Worcester of Waltham, who devoted a great deal 
of time to the investigation. A first-hand study was made of the 
causes of maternal and infant deaths in this State in the months 
just preceding the appointment of the commission, together with 
statistical studies for more remote periods. All data bearing on 
this problem in other parts of the country and abroad were sought 
and considered. 

As a result of its deliberations the commission reached the con- 
clusion that a system of State-wide extension of public health nursing 
service offered the most promising results with the least expenditure 
of public funds, and legislation designed to extend rapidly such serv- 
ice was submitted with a unanimous recommendation from the com- 
mission for its adoption. 

It is felt that the present loss of maternal and infant life is obviously 
so much greater than need be, and the life-saving results of such 
nursing service have been so promptly and uniformly realized where- 
ever they have hitherto been given fair trial, that the people of the 
Commonwealth through their representatives will authorize this 
Department to enter upon this phase of public health service on a 
broad scale in co-operation with the private nursing agencies already 
in the field. 

Mouth hygiene and nutrition problems are closely allied with child 
hygiene, although these subjects have vast and important applica- 
tions to later age periods as well. The activities of the Department 
in these fields have been the subject cf most careful thought on my 
part during the entire year. I wish emphatically to express my con- 
viction that we are falling far short of what we should do in these 
subjects, but for several years past recommendations looking towards 
expansion in these fields to an extent more nearly approximating what 
the Department should be doing have been greatly revised down- 
wards by the authorities controlling finances. This experience has 
been the more striking because these same authorities have been 
sympathetic with nearly all other phases of our work. They have 
said that they could not perceive any widespread popular demand 
for expansion in these fields, and, while willing to continue the slender 
staff already employed, have declined to appropriate funds for an 



No. 34.] ANNUAL REPORT. 7 

extension of the force. Personally I feel that these subjects are so 
vital to the well-being of the present and future citizens of the State 
that an immediate expansion at least threefold is imperatively needed, 
with every regard for public economy, and I do not see that any one 
can set limits as to the possible future extension that may be indi- 
cated. But, until public opinion on this point is aroused, no one can 
justly criticize either the executive or legislative branches of the 
State government for declining to approve this Department's recom- 
mendations in this respect. The first and most obvious duty of the 
Department is to better inform the public of the facts. Once this 
is done public opinion will shape itself on these subjects, and I know 
of no subject upon which public opinion is more universally of one 
mind when once informed. In the summary of the Division of Hygiene 
the present small activities of the Department in nutrition and mouth 
hygiene are very briefly sketched. 

Peksonnel Problems. 

I wish to refer briefly here to one handicap under which all of 
our divisions have labored to an even greater extent than last year. 
I refer to the constant losses among our professional and skilled per- 
sonnel on account of better remuneration available outside the State 
service. 

A substantial salary increase, averaging from 15 to 20 per cent, 
was granted to nearly all our staff by action of the legislative and 
executive departments during the year just closed. This all too 
long delayed and in many instances still inadequate recognition of 
faithful service alone saved the work of the Department from utter 
demoralization and breakdown. Doubtless the same condition held 
true in many other State departments, but the Department of Public 
Health is peculiarly a department of technically trained executives 
and employees, and here is felt and will continue to be felt to an 
unusual degree the pressure of outside competition. Five professions 
make up the bulk of our technical staff, — medicine, chemistry, en- 
gineering, bacteriology and nursing. The outside pressure of economic 
competition for trained service in these professions has been so great 
that I marvel that the Department has been able to retain any of 
its staffs. I do not think that the facts in this matter are at all known 
or understood, but if salaries alone had been the determining factor 
the Department would have lost practically 100 per cent of its staff 
of physicians, chemists, engineers, bacteriologists and nurses during 
the past year. As it was, the percentage of turnover was very great, 
ranging from 33 to 50 per cent in all divisions. Practically all the 



8 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

members of the staff who have resigned did so to take new positions 
paying at least 50 per cent more and in several instances the new 
salary has been double that received in the Department. I refer to 
this critical situation in some detail because I am not at all satisfied 
that it is all a matter of the past. 

It is true that we have entered upon a period of industrial depres- 
sion and the demand for unskilled and certain technical services is 
much slackened. On the other hand, the cost of living and the pur- 
chasing power of the dollar generallj^ have not yet materially changed. 
Furthermore, because of a combination of lessened output of graduates 
from the technical schools during the war, or, as in the case of phy- 
sicians, for a long period before the war, and the great increase in the 
opportunities for such graduates in industry and other outside public 
service there exists to-day a partial vacuum, so to speak, in regard to 
these professions. This manifests itself in a constant economic pressure 
operating in the form of a higher wage opportunity to draw these 
classes of trained specialists out of State and municipal service. 

The Plague Problems. 

The plague has been a scourge of mankind from remotest ages. 
Originally the term was used in a loose sense to designate any severe 
epidemic, but for several centuries now it has been confined in a 
medical sense to the bubonic plague. This disease has had a curious 
and as yet unexplained tendency to sweep over all the world where 
commercial intercommunication exists at irregular periods, generally 
some centuries apart. In the intervals plague persists in certain fairly 
well-defined spots in Asia and from time to time breaks forth from 
these foci in epidemics of great severity. 

In the fourteenth century a terrible outbreak of plague occurred 
in Europe for over the period of a generation and according to the 
estimates resulted in the death of at least one-quarter of the popula- 
tion. Minor epidemics followed this great outburst. The best known 
of these, though really representing a diminishing phase of the out- 
break, was the great plague of London, immortalized by Defoe in 
his noted work. From this time on plague tended to recede from 
Europe of its own accord. It never was a factor in the Western 
Hemisphere until the present pandemic. Commencing in one of 
the well-known permanent homes of the disease in China near the 
borders of Thibet in 1894, plague again began a world-wide sweep. 
That the disease under conditions favorable to it has lost none of 
its ancient malignancy may be judged from the fact that for over 



No. 34.] ANNUAL REPORT. 9 

ten years, consecutively from 1904 to 1914, deaths from plague in 
India alone averaged nearly a million each year. 

Meanwhile modern sanitar}^ science has discovered the method 
of transmission and has found that plague is essentially a disease 
of rats and only spreads to man where man lives in close association 
with rats. Moreover, it has been demonstrated that it is possible 
by definite measures directed against the rat to minimize the prob- 
ability of the spread of infection and to eradicate it if found in sea- 
ports before it becomes sufficiently extensive in rats to be a serious 
human menace. 

Plague first manifested itself in this country in San Francisco nearly 
twenty years ago. After a period extending over several years in 
which the local commercial interests, medical authorities, political 
agencies and press all joined in a remarkable campaign of denial, 
cases of this disease, following the great disaster of 1906, assumed 
a degree of frequency and deadliness where evasion or denial were 
no longer possible. Then, by a remarkable campaign conducted by 
Federal, State and city health authorities, with all the civic bodies 
of State and city actively co-operating, the disease was completely 
eradicated from San Francisco within three years. 

In 1914 the port of New Orleans became infected. After an appar- 
ently successful campaign of eradication plague again appeared in 
that city in November, 1919. This resulted in a much more thorough 
rat eradication program being put into force with apparently prompt 
success. But this summer numerous human cases appeared suddenly 
in three other seaports, — Galveston and Beaumont, Texas, and 
Pensacola, Fla. Systematic rat catching and laboratory examination 
of rat corpses revealed extensive rat plague in all these cities. The 
control methods promptly put into effect have resulted in apparent 
control of the situation in each city. 

At the same time alarming though obscure reports have come of 
plague being present and more or less concealed in many places in 
Europe. 

As a result, it seems only the part of common prudence to make 
a careful investigation into the condition of the rat population of 
all the seaports of this State. This is already being done on a more 
or less thorough scale in practically all ports south of and including 
New York City. New England has not so large a total tonnage as 
other sections of the country, but in the aggregate number of ports, 
any one of which may serve as a point of infection, this section has 
an astonishingly large percentage of the ports of the entire country, 
and Massachusetts itself has by far the largest number of ports in 



10 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

New England. The city of Boston has already taken steps to examine 
into the condition of its rat population. 

The port of Boston is a complex affair. Ten or more separate 
cities and towns border upon it. Several other ports are in close 
proximity to Boston. In all of these places a careful survey should 
be made of water-front conditions and of the rat population. For 
instance, if a smaller city bordering or near-by Boston becomes in- 
fected, the efforts of the Boston authorities will be largely neutralized. 
For this reason and because of the obvious saving in "overhead" 
in having a scientific inquiry of this sort done in one or two labora- 
tories rather than expecting each small municipality to do its own 
investigation independently, I have considered it the plain duty of 
the Department, as a protection both to the public health and our 
commercial interests, to recommend to the General Court to appro- 
priate during the special session a sum of money sufficient for the De- 
partment to take the lead, and, supplemented by the efforts of the 
municipalities and towns directly threatened with the possibility of 
the invasion of plague, to carry through a general rat survey and 
rodent laboratory examination in all seaports carrying on interstate 
and foreign commerce. The organization that can best give the 
definite direction and concentration of laboratory material required 
for this work and at the same time guarantee an adequate type of 
laboratory work is the Department of Public Health. A unified 
State-wide effort, applied to all ports, regardless of size, presents the 
only effective method of attacking this question. 



Tuberculosis and Leprosy. 

The activities of the new Division of Tuberculosis are summarized 
later in this report, and the detailed account of the entire work of 
the Division, including that of the sanatoria, is printed in the general 
report of the Department. 

The subject is so important that I wish to refer briefly to it here 
largely by way of emphasis. 

Last year I touched upon the proposed new organization. This 
■ has been attained by the transfer to the Division of Tuberculosis of 
all tuberculosis activities formerly carried as a part of the work of 
the Division of Communicable Diseases. 

The year has been signalized by a veritable new access of enthusiasm 
and interest in the tuberculosis problem. I feel it is no reflection upon 
the splendid work of the voluntary tuberculosis societies in the past 
to state that never have the relations between such bodies and this 
Department and local boards and departments of health been as 



No. 34.] ANNUAL REPORT. 11 

mutually helpful as during the past year. All that I predicted in 
my last report has been realized and more. The establishment of 
consultation clinics for large cities and special examination clinics for 
the smaller cities and towns is in my judgment the most promising 
development in years in pointing the way towards the long-held ideal 
of having in the sanatoria only early and favorable cases of the dis- 
ease. There should be collected enough men, women and children 
in the early stage of tuberculosis to keep the four State sanatoria 
filled and still furnish a large group of this type for the county and 
municipal institutions. 

To properly develop the consultation plan will probably require 
a considerable enlargement of the sanatoria medical staff. I do not 
recommend such an enlargement this year because the experiment 
is still in its incipiency. But if the response of the medical profession, 
local health departments, school and tuberculosis workers to the 
generous offer of the sanatoria staffs to take the time, in spite of 
the already crowded routine, to examine suspicious cases in their 
own localities in consultation with patients' own physicians continues 
as it has begun, some addition to the staffs of the sanatoria will be- 
come a necessity. And if the extension of such consultation service 
brings about only a 10 to 15 per cent increase in the number of per- 
sons showing truly "incipient" or "favorable early" types of con- 
sumption seeking admission to our sanatoria, the resulting economic 
saving in the reduction of average period of treatment will be suffi- 
ciently large to many times outweigh the additional expense of an 
increased medical staff. 

The management of the sanatoria during the past year has been 
extremely difficult because of labor scarcity, failure in deliveries of 
coal and other necessities, and particularly because of the inability 
of the sanatoria to compete with industrial establishments and with 
other institutions having a more elastic wage scale. So paralyzing 
has been the effect of this labor shortage that it has been necessary 
on occasions for a superintendent of a sanatorium to "fill in" in all 
sorts of domestic service positions, even to waiting on table. That 
such a situation has meant straining the mechanism of the institu- 
tions to the point of absolute breakdown is self-evident. That, on 
the whole, a high grade of medical and nursing care and dietary and 
domestic service have been maintained throughout the year speaks 
volumes for the loyalty and patience of the superintendents and the 
group of loyal officers and employees who refused to leave their posts 
under the constant pressure of offers of higher pay from outside 
sources. 

These institutional conditions all hold true to even a greater degree 



12 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

in the problem of the administration of the leper hospital at Penikese. 
Seldom has a State received the benefit of unselfish devotion to duty 
under such peculiarly trying circumstances as these which have char- 
acterized the services rendered by the Superintendent of this insti- 
tution and his wife over a long period of years and particularly during 
the hard year just passed. 

Isolated on a small barren island, cut off from professional and 
social associations alike, ministering to the needs of those most to 
be pitied of mankind, for years he has given the benefit of a highly 
trained scientific mind and real human sympathy to his charges. 
It is only fitting that as a climax he should have succeeded in pro- 
ducing the first practical arrests in the United States of the formerly 
hopeless disease of leprosy. 

Five years ago the Federal government passed legislation providing 
for a national hospital for lepers and relieving States, counties and 
cities of further burdens in the care of such cases. During the period 
of the war it seemed to be impossible to settle the question of a site 
and suitable buildings. At present the United States Public Health 
Service has consummated a bargain with the State of Louisiana 
whereby the State has turned over to the Federal government its 
leper hospital. Certain enlargements and alterations are planned and 
in the near future the entire problem of provision for the care of the 
relatively few lepers in Massachusetts will be assumed by the Federal 
authorities. 



Special Water Supply Investigation. 

In accordance with the direction of the Legislature this Depart- 
ment and the Metropolitan District Commission have maintained 
a considerable engineering force in the field, carried out extensive 
office compilations and studies, and extensive geological and meteoro- 
logical field studies. A certain amount of laboratory experimental 
work has been done bearing upon the pressing problem of the ex- 
tension in the near future of the water supplies of Massachusetts, 
particularly in the eastern part of the State. 

The continuance of the period of excess rainfall now running over 
nearly a decade has been most fortunate for Massachusetts. It is 
this circumstance alone that has prevented an actual failure of the 
water supplies of many of our cities and towns. 

The always great difficulties of conducting an engineering investi- 
gation of such magnitude have been greatly increased by the un- 
precedented weather conditions of the past winter, which put a 
complete stop to all engineering work in the field for months, and 



No. 34.] ANNUAL REPORT. 13 

because of the universal shortage of technical services. Nevertheless, 
the investigation is making satisfactory progress, and by the end of 
another year, if not sooner, the Joint Board will complete its studies 
and submit to the Legislature plans for the solution of this problem, 
which though at present little appreciated by the general public is 
one of the most serious questions of public concern that this genera- 
tion of Massachusetts citizens must solve. 



Disease Prevalence. 

In the matter of disease prevalence the past year has been note- 
worthy in two respects: (1) a recurrence of influenza in epidemic 
form and (2) a very considerable epidemic of infantile paralysis. 
Fortunately, both of these were much less severe than the last pre- 
ceding epidemics of these diseases. 

Influenza began to exhibit epidemic proportions in January and 
continued until late in March, when it subsided rather rapidly to 
normal proportions. The epidemic was mild only in a relative sense. 
If the terrific influenza fatality of 1918 had never occurred, this epi- 
demic would have been considered by health officers and the general 
public alike as an almost unprecedented disaster. In all, 1,660 deaths 
and about 35,000 cases were reported. 

Poliomyelitis began to be reported to an unusual degree in July, 
became most serious about October 1, and then steadily declined 
until it practically reached normal frequency about December 1. 
In contradistinction to the great outbreak of 1916 this outbreak was 
quite sharply localized. At that time practically all sections of the 
State were affected, while this year nearly all the cases were in the 
eastern half of the State, the great majority being in the immediate 
vicinity of Boston with the exception of a distinct additional zone of 
relatively heavy infection extending down the Merrimack River 
valley. Although this was one of the heaviest visitations of the 
disease on record, there being almost exactly one-third as many cases 
and deaths as during the great epidemic of the disease in 1916 (689 
in 1920, 1,920 in 1916), and although this Department gave out the 
facts of prevalence as cases were reported day by day, the outbreak 
produced no public alarm whatever. 

It is difficult to state just why such a complete reversal of senti- 
ment occurred. The war and the influenza epidemic have perhaps 
accustomed our people to death in the mass to such an extent that 
the public poise is not shaken by occurrences that a few years ago 
would have produced almost a public hysteria. 

Aside from poliomyelitis and influenza the Commonwealth has 



14 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

again been free from serious epidemics. Scarlet fever has been more 
prevalent than has been the case for several years, but the relative 
mortality has been low and the total of deaths, though more than 
the yearly record of the three immediate preceding years of remark- 
ably low mortality, is not above the average for the past ten years 
and is far below the average of a generation ago. 

Diphtheria shows about the same mortality as for the past two 
years. There have been no extensive outbreaks of this disease, but 
its non-epidemic occurrence has been above the average. The means 
for the prevention and cure of diphtheria are now so well-known that 
I feel very keenly the continuance of this unnecessary mortality in 
children, and I believe the Department must make an extraordinary 
effort during the next few years to reduce the residual diphtheria 
mortality to negligible proportions. 

In my last report I dwelt in some detail upon the steadily declining 
typhoid rate. This fortunate condition has continued and our record 
for this year is a little better than ever before. For the first time in 
the history of the Commonwealth, at least since dependable statistics 
have been available, the total typhoid deaths for the year are less than 
100, and this with a steadily increasing population. This sustained 
record of less deaths practically every year for the past eight con- 
secutive years, culminating in a new low death rate record for typhoid, 
is something to which every citizen of the State can point with pride. 
This achievement represents the fruits of the intelligent application 
on a wide scale of the accumulated public health science and expe- 
rience of the past fifty years, and points the way to the possibilities for 
a more complete control of other communicable diseases. 

Even more impressive and satisfactory to every health worker is 
the continuance of the decline in mortality from tuberculosis. The 
surprising drop in mortality for this disease which I commented on 
in 1919 has continued throughout the present year. In all, approx- 
imately 500 less deaths have been recorded during 1920 than during 
1919. This establishes a new low death rate for tuberculosis for this 
Commonwealth, — the rate being approximately 100 deaths per 100,- 
000 population, — last year's rate being 105.8, and both years being 
substantially below the previous low record of 1913, which was 113 
deaths per 100,000. These figures are particularly remarkable when 
it is considered that Massachusetts has one of the most difficult 
types of population with which to show satisfactory results in tuber- 
culosis work that could well be imagined. 

As I observed last year, there is no justification for assuming that 
anti-tuberculosis activities, State, county or city, public or private, 



No. 34.] ANNUAL REPORT. 15 

are responsible for all or even the greatest portion of this showing. 
Experience teaches that fluctuations must be expected in the mor- 
tality from this disease in the future. Nevertheless, I can see no logic 
in the captious criticisms of a pessimistic school of writers who have 
come to the front of recent years, and, often approaching the subject 
from a background of theory with little or no first-hand knowledge 
of the disease, have charged that all declines in tuberculosis mortality 
have been purely accidental and especially that institutional treat- 
ment of the disease has produced no results. 

Massachusetts has put into effect one of the finest and most com- 
plete institutional programs for consumption in existence. This 
State is also developing better facilities for early diagnosis and ex- 
tending the machinery for better informing and convincing the public 
of the wisdom of early examination in suspected cases of tuberculosis 
and early treatment. All of these things are being done and coin- 
cidentally we are obtaining some of the best results in tuberculosis 
work that can be found the world over. As long as such results can 
be shown I believe it is the wisest as well as the most humane policy 
to continue steadily along the present lines while constantly on the 
alert to discover and adopt other better means of combating this dread 
disease, but not to be stampeded under any circumstances into aban- 
doning any of the methods that have been thoroughly tried out for 
tuberculosis control and which have stood the test by the only stand- 
ard for proving values — results. 



Venereal Disease. 

The present program against venereal disease has now had nearly 
three years of trial. It has been supported by a combination of State 
and Federal funds. Federal funds have been voted for the last three 
years by Congress for the furtherance of such work and these funds 
have been allotted equitably to all States whose individual appro- 
priations for venereal disease work equalled or exceeded the Federal 
allotment. In turn, States have generally passed on funds to indi- 
vidual communities to assist them in the establishing of clinics for 
the treatment of these diseases and in other ways. This Common- 
wealth led the way for venereal disease control measures by pre- 
paring and distributing freely to qualified institutions and physicians 
arsphenamine, so essential in the treatment of syphilis. Twenty such 
clinics have been assisted, and in all but five instances these clinics 
have been originated directly as a result of this program. 

Like all new movements it is only fair to say that our venereal 



16 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

disease program has had its ups and downs. We have tried out 
thoroughly and carefully proposals for better education of the public 
along these lines. 

The policy of the Department has always been distinctly conserva- 
tive on the educational side of this question and therefore has received 
criticism from certain sources representing the impatient radical 
element in venereal disease and social hygiene work who of late years 
have been urging a universal campaign of publicity without stint 
to reach the entire population in the mass. This Department 
has steadily disapproved lectures on these subjects to mixed age 
groups, and cleverly exploited moving-picture productions touching upon 
subjects of sex and the dangers of venereal infection. I believe time 
has increasingly justified this conservative stand. Experience has 
shown that a large element of morbid curiosity enters into the draw- 
ing power of the public lecture on sex topics, that a hope of viewing 
the salacious rather than of absorbing useful hygienic and moral 
lessons fills the "movie" when the sex motif is presented on the screen, 
and that some of the points so forcibly driven home by a sane lecturer 
may have precisely the opposite of the intended result upon the im- 
mature minds of their auditors. But within what the Department 
considers suitable channels an educational campaign in these matters, 
which cannot fail to be productive of good results, has been quietly 
and persistently carried on. 

Our handling of the subject as a public health problem has proved 
thoroughly sound and practical in its development. A co-operative 
project carried out with the State Probation Commission, perhaps 
unique in this country, has been the special work to thoroughly inform 
court and probation officers of the applications of the venereal dis- 
ease treatment and diagnosis facilities to their routine work. 



Public Health Nursing. 

It is a matter of deep personal regret that I cannot report better 
progress in this most important field of public health activity. In 
the Commonwealth, as a whole, public health nursing has progressed 
during the past year in splendid fashion. But in our own organization 
we have been forced to lose the services of many of our staff of public 
health nurses because of the much more attractive and adequate 
salaries offered on the outside from all manner of sources for their 
services in work of most important public health nursing character. 

I am thoroughly convinced that the Department must have a fully 
organized division of public health nursing with adequate supervising 
staff working under an efficient director before we can measure up to 



No. 34.] ANNUAL REPORT. 17 

our possibilities of leadership in this great field that is urgently de- 
sired by every one in the State interested in or engaged in public health 
nursing. Nor can the full possibilities of life saving and health pro- 
moting by the adequate development of public health nursing service 
be realized until the proper correlation of public health nursing activi- 
ties throughout the Commonwealth, as such a division can best fur- 
nish, is an accomplished fact. 

The Public Health Council of the Department realizing the great 
importance of this matter voted some months ago to establish such 
a Division and to take advantage of the nation-wide co-operative 
policy of the American Red Cross to make the Department's director 
of the Division of Public Health Nursing, when established, also the 
State supervisor of all nurses employed by the Red Cross. This 
policy was decided upon in order to avoid any duplication or friction 
between the public health nursing policies and personnel of the cities 
and towns and those directly put into the field by the Red Cross. 

Unfortunately under the present scheme of administrative organ- 
ization of the State government, it is not possible to make a proposed 
new division a reality until maintenance for it is provided in the 
annual budget. 

The budget authorities declined to approve the admission of such 
a proposal until the question of maternity benefits shall have been 
passed upon by the Legislature, and hence the problem of creating 
a separate Division of Public Health Nursing must remain in a state 
of suspended animation for the present, while the subdivision of pub- 
lic health nursing of the Division of Hygiene has been reduced to 
practically a paper organization for the reasons just explained. 

The Continuing Laboratory Problem of the Department. 

This subject was dealt with in last year's report and it was pointed 
out then how serious this matter has become. An estimate for the 
erection of a laboratory plant was submitted, but on account of 
excessive construction costs, the State Supervisor of Administration 
declined to recommend to the General Court that the erection of 
such a new building be authorized. The Department has continued 
to occupy on sufferance its old quarters for the Biologic Laboratories 
at Forest Hills and for the Wassermann Laboratory in the Harvard 
Medical School buildings and under protest from Harvard University, 
which owns the property and desires its use for university purposes. 
The Department has of necessity negotiated a short-term lease for a 
small building well adapted for the purpose for the use of the labora- 
tory unit manufacturing the remedy for syphilis, — arsphenamine. 



18 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

The pressing question of laboratory facilities for this Department 
is yet to be settled. 

In this connection I wish to call to your particular attention the 
summary submitted by the new director of the Division of Biologic 
Laboratories in reviewing the work of the first nine months of his 
administration. Never has the policy of obtaining full-time service 
at the head of each important branch of the Department's activities 
been more strikingly confirmed than by the public health and finan- 
cial results of his short administration. Of even greater importance 
for the future is the fact that this Division is beginning to bring its 
true life-saving significance and possibilities adequately before the 
medical profession, health authorities and institutional and school 
authorities of the Commonwealth generally. 

The Plumbing Report. 

Last year the Legislature took cognizance of the practical and scientific 
value of the report of the Special Plumbing Board, which had been ap- 
pointed on the initiative of the Department to study the possibilities of 
simplification of plumbing regulations and the resulting economies in 
plumbing installations and better protection of the public against fraud or 
incompetence by authorizing by special resolve the publication of the re- 
port as a legislative document. The Legislature further directed the De- 
partment to continue such studies and to submit legislation designed to 
make plumbing procedure more uniform and less burdensome financially. 

In spite of the fact that no funds were provided to carry on neces- 
sary public hearings on this matter in different sections of the Com- 
monwealth, as I recommended last year, the Board has continued 
its work, has held four hearings at the State House, and has tried to 
gain a comprehensive grasp of the problem as it affects the entire 
State by correspondence and by conferences in Boston with repre- 
sentatives of a number of organizations and official agencies interested 
in the subject. As a result, the Board has drafted legislation, which 
has been approved by the Public Health Council and which, I believe, 
will, if enacted, operate greatly to the benefit of the public and help 
in a minor way to solve the housing problem. Incidentally, by in- 
creasing the volume of business it will, I believe, be of benefit to 
persons connected with the plumbing business. I hope that the Gen- 
eral Court will enact legislation which will make it possible to in- 
corporate the fundamental principles embodied in the published report 
of the Special Plumbing Board in a new plumbing code, which, while 
providing minimum requirements State-wide in their application, 
leaves their enforcement, as well as the adoption of regulations beyond 
the minimum requirements, to the local authorities. 



No. 34.] ANNUAL REPORT. 19 

Legislative Recommendations. 

The following recommendations for legislation have been submitted 
to the General Court: — 

1. A resolve authorizing the Department of Public Health to provide for the 
prevention and control of bubonic plague. (Submitted to the special session 
of the Legislature.) 

2. An act authorizing the exchange or sale of surplus stock of biologic products 
manufactured by the Division of Biologic Laboratories. 

3. An act to provide for clean, sanitary and healthful food estabhshments. 

4. An act exempting certain employees of the Department of Public Health 
from civil service law and the rules and regulations made thereunder. 

5. An act to regulate the manufacture of certain carbonated beverages and 
soft drinks. 

Division of Administration. 

There have been but few changes in the Division of Administra- 
tion during the past year. Li accordance with the terms of chapter 
350 of the Acts of 1920 all purchases of office equipment, supplies 
and furniture by individual departments must be made through the 
Superintendent of Buildings. As might have been expected such a 
radical change as this was the cause of some delay and dissatisfaction, 
but a system has now been devised and is working smoothly between 
this Department and the office of the Superintendent of Buildings. 

The transfer of the four State sanatoria and their administration 
unit to this Department has meant a slight increase in the work of 
this Division. However, as all of the detail bookkeeping for each in- 
stitution is handled by the institution itself this increased work is 
materially less than would otherwise be the case. 

All personnel matters are now handled through the office of the 
Supervisor of Administration via the Division of Administration of 
this Department. This is true in all cases except for certain classes 
of employees at the State sanatoria, where the employment of a 
certain quota of employees of various groups is allowed, and as long 
as this quota is not exceeded individual requisitions upon the Super- 
visor's office are not required. 

"With the coming of the new year it is planned to transfer the 
library and the librarian from this Division to the Division of Hy- 
giene. The latter Division has charge of all publications and other 
printed matter issued by the Department and therefore the Division 
of Hygiene would seem a more logical place for the library than the 
Division of Administration. 



20 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Division of Sanitary Engineering. 

The total number of formal applications received from municipali- 
ties and others for advice wjth reference to water supply, drainage, 
sewerage and other subjects presented for the consideration of this 
Division during the year ending Nov. 30, 1920, was 141, or about the 
same as in the year 1919. 

The abnormally high prices of both material and labor, together 
with unfavorable financial conditions which have especially marked 
the larger part of the year 1920, have caused a further postponement 
of much necessary municipal work, including the construction, exten- 
sion or enlargement of many water supply and sewerage systems 
already too long postponed on account of the recent World War. 
The fact that this postponement of the construction of necessary 
works has been followed as yet by no very serious consequences is 
to be attributed to the high rainfall which has prevailed for a period 
of several years. The flow of streams in the fall of 1919 was un- 
usually large and the rainfall for the first six months of 1920 was 
probably the greatest that has occurred in the State in that period 
since 1870. This high rainfall, completely filling the reservoirs and 
thoroughly saturating the ground, has resulted in the highest average 
flow of rivers, judging from that of the Nashua River, in a period of 
twenty-four years. While there was a considerable deficiency in rain- 
fall in parts of the State during some of the months from July to 
October, inclusive, the flow of streams, judging from the flow of the 
Nashua River, was above the normal in all but two months through- 
out the drier part of t|ie year. These conditions have contributed 
considerably to the length of water supplies in many of the cities and 
towns where the consumption of water has increased greatly, in some 
cases nearly 50 per cent, since the last very dry year nine years ago, 
and the use of water in some of the cities and towns is in excess of the 
safe capacity of their sources of water supply. Furthermore, the 
excessive rainfall and flow of streams has had a tendency to keep them 
cleaner than usual, supplying an unusual amount of clean water for 
the dilution of sewage and other objectionable matters which they 
receive. There is no question that the use, or rather abuse, of the 
rivers of the State if continued — using them for the removal of 
quantities of foul matter in excess of their capacities for effective 
dilution — will result when the next series of dry years occurs in 
great nuisances in a number of streams. Relief from such nuisances 
cannot be afforded promptly, two years or more often being required, 
including the necessary preliminary steps, for the construction of 



No. 34.] ANNUAL REPORT. 21 

proper sanitary works, and the only practicable method of guarding 
against the evil effects of such nuisances is to provide the necessary 
works in sufficient season to make them available when required. 

In addition to the regular work of the Division, certain special 
duties were referred to it as the result of legislative proceedings during 
1920. These are — 

To make reasonable orders limiting and regulating the entrance or discharge 
into the Charles River of polluting matter injurious to the public health. (Chap- 
ter 541, Acts of 1920.) 

Report relative to the sanitary condition of the Acushnet River and certain 
streams tributary and adjacent thereto. (Chapter 32, Resolves of 1920.) 

Much work has been done by this Division in the investigation of 
special benefits accruing to land in the neighborhood of the Neponset 
River, effected by improvement in the channel of that stream, in 
order to facilitate a decision of the questions involved by the com- 
mittee of the Department having this matter in charge. While this 
work has not been very extensive, it has required considerable thought 
and much planning. 

The special investigation of the water supply needs and resources 
of the Commonwealth, authorized by the Legislature of 1919, by the 
Joint Board consisting of the Public Health Council and the Metro- 
politan District Commission has been prosecuted as rapidly as prac- 
ticable during the year. 

One of the notable accomplishments of the year, made possible by 
the return of men called away by the war and the consequent increase 
in the office force, has been the compilation and classification of the 
data which this Division collects regularly from year to year as a part 
of its routine work as required by law. This work, which for the 
past few years has been necessarily postponed to as great an extent 
as possible, is now being brought up to date. These activities are 
fundamental and essential as a basis of sound conclusions and ade- 
quate advice concerning the major problems of water supply, sewerage 
and sanitation submitted for the advice of the Department. 



Division of Water and Sewage Laboratories. 

The Division of Water and Sewage Laboratories has been engaged 
during 1920 in carrying out its usual activities. These are divided 
between analytical work and research. During the year 6,343 chemi- 
cal, 1,887 bacterial and 1,920 microscopical examinations were made. 
These analyses were made to ascertain the condition during the year 
of the rivers, wells, public water supplies and ice supplies of the State; 



22 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

of the efficiency of sewage filtration areas; for determining the char- 
acter of trade wastes and for the furtherance of studies regarding 
their disposal; and for determining the condition as regards bacterial 
pollution of shellfish from different sources. Besides this a large 
amount of analytical work has been done for the new Commission 
upon Water Supply Needs and Resources of the State. Research 
has been carried on in regard to the corrosion of pipes in many cities 
and towns of the State and at the experiment station; many studies 
have been made upon methods for the disposal of trade wastes; upon 
important modifications of the activated sludge tank process of sewage 
disposal; upon seasonal and other variations in the bacterial quality 
of shellfish from different areas of the State; of the relative signifi- 
cance of B. coli and B. aerogenes in bacterial water examinations and 
methods for the differentiation of these two species; in regard to the 
efficiency in water treatment of liquid chlorine at low temperatures; 
and of the effect of certain wastes upon municipal filtration areas. 
Many experimental water and sewage filters, septic tanks, etc., are 
in operation at the various stations for various purposes. 

One of the interesting and exceedingly important and promising 
lines of research carried on there during the past three years has been 
in regard to the removal of color from water by the precipitation of 
the usual color removing chemicals in the sand of filters instead of 
by the direct application of such chemicals to the water undergoing 
filtration as is universal in the so-called mechanical filtration of water. 
By this method of color removal the chemicals are used over and 
over again, thus reducing the cost of such water treatment very 
materially. In fact, the longer such filters continue in operation 
the smaller grows the cost per million gallons of water treated owing 
to the continual reuse of the chemicals. Among other advantages 
of the method are the absence of carbonic acid in the filter effluents, 
thus lessening the danger of corrosion common with mechanical filter 
effluents and the absolute prevention of acid effluents due to the 
passage through the filters of undecomposed aluminum sulphate. 

Division of Communicable Diseases. 

With the exception of an outbreak of influenza in January, February 
and March and of anterior poliomyelitis during the late summer 
months there have been no outbreaks of any great magnitude. 

During the influenza outbreak from January 1 to March 31 there 
were 35,633 cases and 1,660 deaths, giving an apparent fatality rate 
of 4.65 per cent. There have been roughly 1,000 additional cases 
for the remainder of this year, with 9 deaths. 



No. 34.] 



ANNUAL REPORT. 



23 



The total number of cases of all reportable diseases for the year 
was 135,242. 

The diseases showing a noticeable increase over 1919 are chicken 
pox, measles, lobar pneumonia, scarlet fever and whooping cough. 
These five diseases give an excess of approximately 31,000 reported 
cases with reports of measles markedly predominating. 

Anterior poliomyelitis showed an undue incidence about the 1st 
of July. This continued to increase up to about the week ending 
October 2 when the peak was reached, and since that date the casea 
have decreased. That the preparalytic diagnosis of anterior polio- 
myelitis through, lumbar puncture and immediate determination of 
cellular content of the spinal fluids might be available to the phy- 
sicians of the State, the Department, co-operating with the Harvard 
Infantile Paralysis Commission, appointed two physicians especially 
trained in this work. Fifty-seven cases were visited and classified 
by them as follows: — 



Late paralytic, 
Early paralytic, 
Preparalytic, . 
Not poliomyelitis. 
Not diagnosed. 




Puncture. 



8 

10 

& 

2 



The number of cases is of course too limited to draw conclusions. 
However, of the 10 cases diagnosed by this method before paralysis 
was apparent, 7 have been reported on and 3 were found to have 
subsequently developed paralysis. 

Typhoid fever has closely followed in cases and deaths the low 
figure obtained in 1919. In but six communities has there appeared 
an undue incidence: — 




Period. 



Chelsea, 
Ipswich, 
Fall River, . 
Taunton, 
Northampton, 
New Bedford, 
Total, . 



July. 

September and Octo- 
ber. 
September. 

July and August. 

January and Febru- 
ary. 
January to November. 



24 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

The necessity of revaccinating inmates of institutions against typhoid 
fever is shown by the fact that in Taunton, Northampton and Fox- 
borough State hospitals cases of typhoid fever have occurred during 
the year. 

Intensive work in diphtheria has been carried on throughout the 
year, emphasizing the necessity of taking school and neighborhood 
cultures of contacts of clinical cases. In one community — West- 
field — we have demonstrated that endemic diphtheria can be con- 
trolled by proper culturing and immunizing. 

One institution, the Lyman School for Boys, has been completely 
Schicked and immunized with toxin-antitoxin mixture. Similar work 
in other State and municipal institutions which care for children will 
be done during the ensuing year. 

Ten outbreak notices have been sent to communities showing an 
undue incidence of diphtheria. In nearly every instance this inci- 
dence has been due to the missed case and to direct contact. In 
Williamstown two outbreaks were investigated and the source of 
infection found to be an infected finger of a milker. It is interesting 
to note in connection with this outbreak that one cow developed a 
sore on the udder from which virulent organisms of diphtheria were 
obtained. 

An outbreak of septic sore throat in Winchester, involving 43 cases, 
was traced to one milk route. It was found by culturing all per- 
sons handling the milk supply that a milker had a hemolytic strepto- 
coccus in his throat, and was evidently the source of infection in these 
cases. 

Scarlet fever has had an unusual prevalence during the year. It 
is believed that because of the mild type of the infection many cases 
were not reported, no physician being called in attendance. The 
number of deaths reported will exceed that of the past few years. 
There were but eight outbreak notices sent out, these outbreaks being 
mainly due to school or community contact with the unrecognized case. 

An undue incidence of measles during the year has occurred, most 
cases being of an extremely mild type with a low fatality rate. It 
is believed that the apparent increase in the total number of cases 
of communicable disease reported represent to a considerable degree 
better reporting by physicians generally rather than an actual increase 
in the amount of disease in the State. Early in the year arrange- 
ments were made with the Board of Registration in Medicine for 
closer co-operation with this Department in obtaining reports from 
physicians who have been persistently remiss in this respect. We 
have had but one instance in which it became necessary to ask their 
assistance during the past year. 



No. 34.] ANNUAL REPORT. 25 

From Dec. 1, 1919, to Nov. 30, 1920, the Diagnostic Laboratory 
has examined 28,637 specimens, an increase of 2,783 over the corre- 
sponding period last year. The total cost will approximate S9,000. 
The cost per examination is about 31 cents, which has been the average 
for the past five years. The increase in amount of work each year 
offsets the increased cost. 

There has been an increase in all lines of work except the Widal 
test for typhoid fever and smears for gonococci. The slight decrease 
in Widal tests is probably due to the fact that there is less typhoid 
fever reported in the State. The typhoid culture work, however, 
has increased 65 per cent over the previous year, giving a total of 
approximately 900 examinations. Three typhoid carriers have been 
discovered. 

To November 30, 545 specimens of sputum were examined for 
pneumococcus type. This is an increase of 50 over last year's total. 

The subdivision of venereal diseases has continued its campaign 
for the prevention and control of venereal diseases along the same 
lines as in former years. A notable achievement has been the work 
with the courts and probation officers. Every court in the Com- 
monwealth has been visited, our campaign outlined and the co-oper- 
ation of the judge and probation officers secured. 

The incidence of venereal diseases from our reports shoM^s a de- 
crease. We have visited several communities, interviewing the phy- 
sicians, and they are unanimous in the report that they are treating 
fewer cases of venereal disease than in previous years. 

The study groups formed last year for the discussion of venereal 
disease problems have been continued and much interest has been 
displayed. During the year 62 meetings were held with 18 groups. 

More and more does it become evident that the clinic treatment 
is the keystone of all venereal disease control, and attendance at 
nearly all of the clinics is increasing. During the year three new 
clinics have been established. All large centers of the State are now 
adequately cared for by this clinic service. 

All jails have been visited during the year and have been found to 
be complying with the law requiring the physical examination of all 
inmates committed for thirty days or more. 

The conferences held quarterly for clinic chiefs have continued to 
be a marked success. The programs arranged by the subdivision have 
been of real merit and the attendance of the clinic chiefs has been 
constant. 

The reorganization act of 1919 placed the Penikese Hospital for 
lepers under the charge of this Department. There has been little 
or no change in the administration of this work from that of pre- 



26 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

ceding years. There are at present fifteen patients at the hospital, 
two of whom are soldiers cared for by the War Risk Insurance Bureau. 

The labor situation has been acute all the year and only by per- 
sistent effort on the part of the superintendent has there been suffi- 
cient personnel to keep the institution up to its standards. The per 
capita cost is unavoidably high owing to the location of the hospital. 
Nothing may be purchased without a substantial addition to the 
first cost, due to transportation charges. 

The care given by the superintendent to these unfortunate people 
is of the best and is reflected in an air of satisfaction and content- 
ment in the institution. 

The personnel of the Division has undergone many changes. Owing 
to our inability to secure properly qualified persons for District Health 
Officers it has appeared wise to redistrict the State into seven districts 
rather than eight as formerly. It is yet too soon to form an opinion, 
as to whether or not this plan may be worked out advantageously 
and without too great a burden upon the District Health Officers 
affected by the change. 

That the tuberculosis work formerly done by this Division might 
be more completely co-ordinated with the work done by the sanatoria 
it was recommended that all tuberculosis work be transferred to the 
Division of Tuberculosis. This has been done and will, I believe, 
in the very near future give evidence of the wisdom of such a move- 
ment. 

The attention of this Division was called early in July to the intro- 
duction of plague in new foci in the Southern ports. Representatives 
of the Department were sent to these ports to study plague preventive 
measures and a definite plan for rodent surveys has been outlined 
by which it is hoped the introduction of plague into the Common- 
wealth will be prevented. The surgeon general of the United States 
Public Health Service has detailed to this Department as well as to 
the health departments of the other New England States an officer 
who shall act in an advisory capacity on plague control methods. 
Preliminary surveys of all seaport cities and towns of Massachusetts 
have been made, together with a definite plan for a rodent survey 
for each, and ordinances prepared for each community to adopt. 
All that is needed is the necessary appropriation to put these plans 
into effect. 

The Public Health Service early in the year delegated to this De- 
partment an epidemiological aide who has been instrumental in carry- 
ing out several mosquito surveys and who has also done special work 
on diphtheria in the Connecticut valley. 

This Division has also lent its aid and assistance in formulating a 



No. 34.] ANNUAL REPORT. 27 

plan for lectures to nurses in hospital training schools. This com- 
prises a course of nine lectures on the fundamental principles of public 
health, with the object of interesting this group of people in public 
health matters. 

The multiplicity of detail which the District Health Officer handles 
in his district is increasing each year. During the past twelve months 
his assistance has been solicited in special investigations, such as the 
maternity investigation, in lecturing to nurses and other groups of 
people interested in public health, with considerable time expended 
in co-operative effort with the Massachusetts Tuberculosis League. 
Much of the success of the consultation service for the diagnosis of 
tuberculosis must be credited to the efforts of the field force. 

With the assistance of the United States Public Health Service, 
an attempt has been made to establish in Barnstable County a com- 
munity health organization with a full-time executive officer, trained 
in public health, and the necessary assistance. Great interest has 
been aroused and it is hoped that the local communities will appro- 
priate, at their coming town meetings, sufficient money to make such 
a combination possible. 

One of the difficult features of public health administration is the 
evaluation of the results of the efforts of those engaged in this par- 
ticular endeavor. 

We see, however, that here and there appears an additional public 
health nurse, a new nutritional or child welfare clinic, a full-time 
health officer replacing perhaps an untrained agent of the board, 
more efficient school inspection, the local board placing special em- 
phasis upon the control of an outbreak, a survey as to the tuber- 
culosis situation in a community, or increased consultations with the 
physicians in obscure cases or in helping to establish a differential 
diagnosis. These achievements give answer to the query so often 
heard, "W'hat does the District Health Officer accomplish?" — for 
these are the tangible results of the persistent effort of the conscien- 
tious public health worker. 

Side by side goes the nursing assistant advocating and teaching 
public health to the community itself. The year's work is replete 
with evidence of her devotion to her work. No new activity for 
increasing the community's public health is without her honest effort 
and participation. More than ever is it apparent that with these 
field workers must rest the task of educating the local community to 
its full responsibility. 



28 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Division of Tubekculosis. 

The Division of Tuberculosis was organized Jan. 1, 1920, pursuant 
to chapter 350 of the General Acts of 1919. This act, which is known 
as the consolidation of departments act, abolished the Board of Trus- 
tees of Hospitals for Consumptives and transferred to the Department 
of Public Health all the rights, powers, duties and obligations of said 
board. By this act the Commissioner of Public Health was directed 
to establish within the Department of Public Health a Division of 
Sanatoria which shall include the institutions formerly under the 
Board of Trustees of Hospitals for Consumptives. 

Previous to the passage of this act the tuberculosis work of the 
Department of Public Health was confined to the Division of Com- 
municable Diseases. An important step taken by this Division was 
the compilation of all known cases of tuberculosis from Jan. 1, 1915, 
to Jan. 1, 1920. This work has been transferred to the Division of 
Tuberculosis. So the Division of Tuberculosis has the administrative 
supervision of the four State sanatoria, the compilation of all known 
cases of tuberculosis in the State, and the general supervision of all 
tuberculosis activity in the Commonwealth. 

The policy of the former trustees was to admit to the State sana- 
toria only cases of pulmonary tuberculosis. Of this class only in- 
cipient cases were admitted to Rutland; advanced types of pulmonary 
tuberculosis were admitted to the other State sanatoria. Admission 
to the sanatoria was limited to persons over fifteen years of age, ex- 
cept at Westfield, where children between the ages of five and fifteen 
were admitted. 

When it is remembered that formerly the State sanatoria were 
the only hospitals in the Commonwealth where consumptives were 
admitted, the wisdom of this policy is apparent. 

The county hospital act, which provided that all cities of 50,000 
population or over should maintain a tuberculosis hospital, and that 
cities under 50,000 should combine and maintain a county tubercu- 
losis hospital, has given increased facilities for hospital care for tuber- 
culous patients. 

And so the Division of Tuberculosis has had under advisement 
the proposition of placing the four State sanatoria on an even basis. 
This plan proposes to admit to the sanatoria only cases favorable 
for arrest. It also proposes to limit the residence of patients at the 
sanatoria. The presence of patients at the sanatoria for five years 
or more is entirely incompatible with the theory of sanatorium treat- 
ment of tuberculosis. It is believed by the best minds in tuberculosis 
work that intensive sanatorium treatment of early, favorable cases 



No. 34.] ANNUAL REPORT. 29 

of pulmonary tuberculosis will arrest the disease inside of one year 
and turn the patient back to society capable of self-support. The 
old policies of restricting admission to the sanatoria to cases of pul- 
monary tuberculosis and of admitting children between the ages of 
five and fifteen years to the Westfield State Sanatorium seem sound 
and worthy of continuation. 

For the year ending Nov. 30, 1920, there were admitted to the 
sanatoria 1,472 patients; discharged, 1,363; died, 251. 

An important piece of work done during the past year was the 
examination of inmates of the prisons in the State with reference to 
the presence of tuberculosis. This examination was made by the 
staffs of the sanatoria. The following is the result of this examina- 
tion: number of prisoners examined, 1,500; active cases, 7; should 
be under observation, 43. 

The tuberculosis associations of the State are very active in securing 
physical examination of all contacts. At various times they have 
sought the aid of this Division in securing the services of the sana- 
toria staff for this purpose. The demands became so frequent that 
it was found necessary to adopt a definite policy in regard to this 
work, and so a series of examination clinics was inaugurated. These 
clinics are held in cities and towns which are not provided with a 
tuberculosis dispensary, in accordance with chapter 537 of the Acts 
of 1911. The patients for these clinics are furnished by the tubercu- 
losis societies, and the examination is done by the sanatoria staff. 

The need of assistance to physicians throughout the State in the 
early diagnosis of pulmonary tuberculosis has long been apparent. 
In order that these physicians might keep their patients as private 
patients and still avail themselves of consultation service, in cases 
where patients were unable to meet a consultant's fee, consultation 
clinics were inaugurated in September of this year. These clinics are 
held in sixteen cities. The results of three months' experience are as 
follows: number of cases, 170; positive diagnosis, 85; negative diag- 
nosis, 85. 

The co-operation of the public health nurse of local boards of health 
has been stimulated by the formation of associations of public health 
nurses. In every health district such an association has been formed 
and semi-annual meetings are held at the various State sanatoria, 
where tuberculosis problems are discussed. 

The payment of subsidy for non-bacillary types of pulmonary 
tuberculosis which are receiving hospital care will materially increase 
the appropriation formerly made for subsidy purposes. 



30 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Division of Hygiene. 

The major activities of the Division of Hygiene during the past 
year have been these: study of the maternity benefit problem; ex- 
tension of efforts along the line of improving the nutrition of the 
child and of awakening in the public an appreciation of the need of 
mouth hygiene; extension of rural clinics; and, lastly, the prose- 
cution of two investigations, namely, of the midwife situation and of 
the open-air school. 

The beginning of the legislative year saw the introduction of various 
bills providing for better care of maternity and infancy. The Divi- 
sion of Hygiene studied these bills carefully and made estimates for 
the information of the Legislature as to the cost of administration of 
one form or another, were such a law to be enacted. Many requests 
came in from women's clubs and others for a critical estimate of the 
value of such legislation. 

The facts upon which suggested legislation was predicated are un- 
deniable. The loss of over 700 mothers annually from causes related 
to childbirth, many of these from causes clearly preventable, the loss 
of nearly 4,000 infants under one month of age, and the loss of 2,500 
babies stillborn; these, and the additional facts of maternal and 
infant ill-health and disability are sufficient to render it imperative 
to attempt some remedy. 

The creation by the Legislature of a recess commission to study 
the problems involved in maternity benefits gave an additional oppor- 
tunity to the Director and staff of the Division of Hygiene to study 
this subject so bound up with the most vital part of the Division's 
work. This study, begun under the auspices of the Maternity Benefit 
Commission, ought to be carried on by the Division of Hygiene 
through a series of years, regardless of the passage of specific legis- 
lation regarding maternity protection. This would have been done 
previously but for the lack of an adequate force and funds. Profiting 
by the experiences gained during the summer, such an investigation 
could be carried along with much greater ease than would heretofore 
have been the case. 

An investigation into the midwife situation in this State has re- 
<?ently been made. Massachusetts has been criticized because of its 
illogical method of handling the midwife. Obliged by law to report 
births, the midwife is liable to prosecution for practicing medicine 
illegally if she does report them. Attempts have been made to abolish 
the midwife but without avail, as figures will show. 

The investigation undertaken this year by the Division of Hygiene 
furnished information upon which could be based some estimate as 



No. 34.] ANNUAL REPORT. 31 

to the number of midwives practicing and as to the type of work 
done by them. A series of nine representative cities and towns was 
chosen for careful study. In these towns two keen investigators 
found 117 midwives practicing and obtained information which would 
point to still others. Certain of these midwives are graduates of 
training schools abroad; others have had little or no training of any 
kind. Some apparently have a fair idea as to cleanliness and an 
appreciation of their limitations; others have neither the one nor 
the other. There is reason to believe that repressive measures have 
done more to discourage the practice of the better grade midwives 
than of the poorer ones who are willing to take a greater chance with 
the law. A proper solution of the midwife problem is yet to be made 
and this is a subject which must be considered very carefully again 
during the coming year. 

A further investigation of the open-air schools of the State has 
been made this year in the course of which practically all the open- 
air schools or classes in Massachusetts were visited. Answers to 
questionnaires were obtained as to the practice in respect to such 
schools in other States. It was hoped that possibly sufficient light 
"would be thrown on this problem so that tentative uniform standards 
might be suggested. However, it does not appear that this can 
safely be done at present, and study and experience along these lines 
in the near future seem to be indicated. 

Several years have elapsed since educational effort directed towards 
the practical application of the facts of nutrition to personal hygiene 
and the public health was begun in the Division of Hygiene. With 
printed material and lectures as a beginning, the work has developed 
until vital contact is now had with practically all the agencies of the 
State interested in this type of work. Contact with public groups 
through the medium of illustrated lectures has reached the point 
where one worker can no longer meet the demand. The great object 
of the Division now is to be of assistance in the gradual process of 
bringing the dietitian or nutritionist — the heir of the " cooking teacher" 
— from a position of isolated specialist into the fellowship of public 
health workers in general. 

Hand in hand with the development of an interest in nutrition is 
going interest in mouth hygiene. The latter field is newer in point 
of time but bids fair to be tilled with equal rapidity owing to the 
tremendous appeal which oral hygiene seems to be making at the 
present time to the general public. As in the case of the nutrition 
work, the first step in mouth hygiene activity in this Division was 
through public lectures and the printed word. The work has grown 
to the same point referred to under the head of nutritional activities. 



32 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

One field worker is no longer sufficient to meet the demands. Re- 
quests for advice on new problems involving the establishment of 
new centers in municipalities for mouth hygiene work and the co-ordi- 
nation of the newer with the older public health activities are becoming 
more pressing every day. The exponent of mouth hygiene, like the 
nutritionist, must be helped to find a secure and logical place within 
the ranks of public health workers. 

The newest activity of the Division of Hygiene bids fair to be one 
of great importance. Starting in a modest way a year ago at the 
agricultural fairs, the rural clinic service has developed into a whole- 
time piece of work which has won for itself a definite place in the 
Division's activities. The aim of the rural clinics is to demonstrate 
by the examination of children the need of greater attention being 
paid to their normal development. The ultimate aim of this work 
is to so demonstrate the need for such preventive and corrective 
facilities for children that communities will institute and provide such 
facilities as a permanent thing. 

Division of Biologic Laboratories. 

Certain changes have been made in the organization of this Divi- 
sion during the past year, the principal one being the appointment 
of a full-time director, an arrangement which has proved most suc- 
cessful. The volume of work of both branches of the Division of 
Biologic Laboratories — the Antitoxin and Vaccine Laboratory and 
the Wassermann Laboratory — show a noteworthy increase over the 
previous year. During the coming year it will be absolutely necessary 
to somewhat increase the present small force in order to properly 
handle the increased work; as has been stated previously the present 
quarters afford altogether too little space for the number of workers 
and the amount of work being done. The problem of providing for 
the expansion of the laboratories and their permanent housing is still 
to be settled. 

A considerable saving has been effected by purchasing supplies on 
bids and in quantity, and by standardizing the various apparatus and 

supplies used. 

The accompanying table shows the production, distribution and 
stock on hand of all products of the Antitoxin and Vaccine Laboratory 
for the past two years and is a very interesting exhibit of the work 
of the Laboratory for this period (see next page). With reference 
to production it is interesting to note that the amount of blood taken 
from immune horses at each semimonthly bleeding has been increased 
by approximately 30 per cent. The horses have borne the increased 
bleedings with no ill effects and production has been increased by the 



No. 34.] 



ANNUAL REPORT. 



33 



above figures. The methods formerly used in the vaccination of 
calves for the production of smallpox vaccine have been changed, 
with the result that the yield of vaccine from each calf has been 
increased approximately 75 per cent. 

On Feb. 1, 1920, the average potency of diphtheria antitoxin pro- 
duced was 230, whereas the serum will average approximately 450 
units at the present time. The 100 per cent increase in the average 
potency of all diphtheria antitoxin produced during the year has been 
made possible by the stronger toxin available and by the change in 
the method of immunizing diphtheria horses. 



Product. 



1 . Diphtheria antitoxin : 

Produced 

Distributed, .... 
On hand, .... 

2. Diphtheria plasma: 

Produced, . . . 

Used in concentration, 

On hand, .... 

3. Concentrated diphtheria antitoxin: 

Produced, .... 
Distributed, .... 
On hand, .... 



1919. 



Liters. 



602.26 

646.067 

72.3 



165.95 

109.05 

60. 



Total 

1,000 Unit 

Doses. 



143,101 



16,028 



Units 
per c.c. 



221 



147 



Liters. 



769.1 
482.0 
232.4 



1,126.6 

725. 
369.1 



158.6 

100.73 

55.2 



1920. 



Total 

1,000 Unit 

Doses. 



Units 
per c.c. 



179,756 



38,471 
60,720 



372 



381 
1,100 



Product. 


1919. 


1920. 


Liters. 


Total Doses. 


Liters. 


Total Doses. 


4. Antimeningococcic serum: 

Produced, 

Distributed, 

On hand, 

5. Antipneumococcic serum, Type I: 

Produced 

Distributed 

On hand, 

6. Smallpox vaccine: 

Produced 

Distributed, 

On hand, 

7. Typhoid paratyphoid vaccine: 

Produced 

Distributed 

On hand 


86.5 

67.365 

31. 

23.800 
42.200 
36.925 

2.349 
3.247 

112.3 
74.123 


5,766 
4,565 

238 
422 
369.25 

140,940 
194,807 

112,300 
74,123 


317.665 
48.310 
47.2 

147.700 

44.4 

100.700 

4.844 
3.151 
1.624 

73.5 

49.191 

16.6 


21,177 
3,585 

1,477 

444 

1,007 

290,610 

189,064 

97,440 

73,500 
49,191 
16,600 




Outfits. 


Total Doses. 


Outfits. 


Total Doses. 


8. Schick outfits: 

Produced 

Distributed, 

On hand, 


96. 
96. 


9,600 
9,600 


91. 
63. 
30. 


9,100 
6,300 
3,000 



34 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 





1919. 


1920. 


Product. 


Liters. 


Total Doses. 


Liters. 


Total Doses. 


9. Diphtheria toxin-antitoxin: 

Produced, 

Distributed 

. On hand, 


1.108 


1,108 


6.443 
3.614 
2.829 


6,443 
3,614 

2,829 




Liters. 


Potency. 


Liters. 


Potency. 


10. Diphtheria toxin: 

Produced, 

Used, 

On hand, 


533. 

583. 

20. 


.006 
.006 
.006 


539. 

456. 

83. 


.0025 
.0025 
.0025 



Wassermann Laboratory. 

During the past year the activities of the Wassermann Laboratory 
have been confined to the execution of tests established during previous 
years. Its personnel has not changed in number but the volume of 
its work shows a noteworthy increase over that of 1919 as indicated 
in the following table: — 



1919. 



1920. 



Increase 
(Per Cent). 



Wassermann tests, 

Gonococcus fixation tests 

Diagnostic examinations for Department of Animal Industry: 
(o) Complement fixation test for glanders, 

(b) Examination for rabies, 

(c) Pathologic and bacteriological examinations, 

Totals 



31,485 
222 

122 

84 
79 



31,S92 



37,277 
1,758 

237 

161 

65 



39,498 



18 
609 

94 



23.5 



1 Decrease. 



In addition to these activities, investigations carried on by this 
laboratory on the utility of complement fixation as a clinical aid in 
the diagnosis of tuberculosis have shown that the test at present is 
not sufficiently dependable for the purpose. 



Division of Food and Drugs. 

During the year just passed, 10,847 samples were examined and 
311 cases were prosecuted. This figure represents a slight increase 
in prosecutions over last year's figures, but a decrease in the number 
of samples collected, due largely to weather conditions in the early 
part of the year when transportation was practically stopped. 



No. 34.] ANNUAL REPORT. 35 

There has been rather more special co-operative work with local 
boards of health than heretofore. Analyses have been furnished to 
the milk inspectors or health officers of Barnstable, Lawrence, Newton, 
North Adams, Fitchburg, Weymouth, Arlington, New Bedford and 
Woburn, and the milk inspectors or agents of the boards of health of 
Springfield, Fitchburg, Fall River, Newton and Somerville have fur- 
nished this Department information resulting in the collection of 
evidence relative to violations of the law. 

The liquor samples are nearly as numerous as those submitted last 
year, but all the samples submitted were intended for prosecution in 
the Massachusetts courts, a marked contrast to the large numbers 
submitted and examined last year for prosecution in the United States 
courts. Fifty cities and towns submitted samples during the year. 
The character of the samples 'submitted has changed materially from 
those submitted in former years. Most of the samples formerly sub- 
mitted consisted of beer, cider and wine. More than half the samples 
now submitted consist of distilled liquors. 

Special investigations outside of the usual work upon milk and 
eggs have been made of sausages, dried fruits, salad dressing, sugar, 
clams and soft drinks. It was found that many of the soft drink 
manufacturers were using saccharine. Most of these persons ceased 
this practice after being given a hearing. Those who did not were 
prosecuted, and in all cases convictions have been obtained. 

The usual investigations of the cold-storage warehouses and cold- 
storage food have been made during the year as well as the usual 
investigations of slaughtering under Massachusetts inspection. Rela- 
tive to the latter, a number of violations were found in Berkshire 
County, such as selling unwholesome meat and selling meat obtained 
from diseased animals. Convictions were secured in these instances. 
In general, however, the local slaughtering inspection is carried out 
in a satisfactory manner. 

During the year a new bakery law has been enacted, to be enforced 
jointly by this Department and local health authorities. Regulations 
have been adopted after a series of conferences with local boards of 
health and certain bakeries. One inspector has been assigned to work 
under this law. The bakeries of certain cities have already been in- 
spected, and it is proposed to inspect all the bakeries in the State in 
this manner during the coming year. 

In connection with the co-operative purchasing plan of the State 
institutions, a number of analyses have been made for the Depart- 
ment of Public Welfare, these analyses being confined to soap chips, 
soap bars and milk powders. The soap chips are being purchased 
upon specifications and each barrel is examined to see whether or 



36 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

not the chips conform with the specifications. It was intended to 
purchase coal in this manner, and the apparatus has been purchased, 
but owing to the fact that no competitive bids could be obtained, 
no analyses of coal have been made as yet. 

Since January 1 the arsphenamine production has been suffi- 
cient to supply all the needs of the Department. A new method for 
the recovery of toxic batches has been developed by the staff of the 
department of pharmacology of the Harvard Medical School, the 
head of which department. Dr. Reid Hunt, has served as pharma- 
cologist to test the toxicity of arsphenamine ever since this Depart- 
ment commenced its manufacture. This method has been applied 
to several toxic batches and the resulting purified product has been 
used successfully in the clinics. The process seems to produce a 
purer product than the process usually employed, and steps are now 
being taken to manufacture all our arsphenamine by this process. 

Appropkiations and Expenditures for the Year ended Nov. 30, 

1920. 

Division of Administration. 

Appropriation for personal services, . . . . . . . $21,100 00 

Expended for personal services, 20,343 62 

Balance, $756 38 

Appropriation for expenses, $11,500 00 

Brought forward from 1919 to cover sundry charges, ... 66 50 
Credit by refund, 12^00 

$11,578 50 

Traveling, $503 13 

Express, 145 12 

Printing and binding, 5,288 15 

Books and subscriptions, 377 25 

Advertising, 15 28 

Stationery, maps and blue prints, 811 26 

Postage and postal orders, 1,673 82 

Telephone and telegraph messages, 966 84 

Typewriter supplies and repairs, 144 39 

Sundry office supplies, 101 35 

Messenger, 274 90 

Miscellaneous, "0 S2 

Total, S10,3S1 31 

Unexpended balance, 1>197 19 

$11,578 50 



No. 34.] ANNUAL REPORT. 37 



Division of Hygiene. 

Appropriation for personal services, 118,645 00 

Expended for personal services, 16,690 26 

Balance, $1,954 74 

Appropriation for expenses, S20,500 00 

Brought forward from 1919 on account of cancer investigation, . 1,801 54 

Transfers from Administration appropriation, 292 39 



S22,593 93 

Traveling, $5,029 22 

Express, . 268 05 

Printing and binding, 6,977 57 

Books and subscriptions, 53 36 

Advertising and educational work, 2,159 20 

Stationery, maps and blue prints, 412 25 

Postage, 849 94 

Telephone and telegraph, 99 20 

Typewriting supplies and repairs, 136 73 

Mo\ing-picture expenses, 92 58 

Automobile truck expenses, 1,101 95 

Office supplies, 328 62 

Laboratory supplies, 31 69 

Special investigations, 3,173 62 

Miscellaneous, 76 12 

Total, $20,790 10 

Unexpended balance, 1,803 83 

$22,593 93 
Division of Communicable Diseases. 

Appropriation for personal services, . $55,500 00 

Expended for personal services, 54,969 03 



Balance, $530 97 

Appropriation for expenses, $22,500 00 

Brought forward from 1919, 168 60 

Credit account of cash returned to treasury, 4 50 

$22,673 10 



38 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Traveling, $11,933 26 

Express, 37 19 

Printing and binding, 1,223 90 

Books and maps, 164 85 

Postage, 1,500 85 

Typewriter supplies, 35 50 

Extra services (field), 274 33 

Telephone and telegraph, 889 13 

Office supplies and stationery, 946 00 

Laboratory and experimental work, 3,069 46 

Furniture, "53 08 

Animals, 174 25 

Food for animals, 19 29 

Labor, 62 05 

Office rent and Hght, 1,187 13 

Miscellaneous, 55 80 

■ Total, $22,326 07 

Unexpended balance, 347 03 

$22,673 10 
Subdivision of Venereal Diseases. 

Appropriation for personal services, ^ $5,200 00 

Expended for personal services, 8,949 83 

Balance withdrawn from Federal fund, ..... $3,749 83 

Appropriation for expenses, ^$11,342 50 

Travehng, $2,269 99 

Printing and binding, 151 95 

Reprints, books and maps (educational), 1,641 33 

Typewriter supplies, 4 00 

Extra services (field), 50 00 

Telephone and telegraph, 28 65 

Office suppUes and stationery, 98 19 

Clinics, 9,458 34 

Furniture, 9 00 

Miscellaneous, 1 75 

Total, $13,713 20 

Balance withdrawn from Federal fund, ...... 2,370 70 

$11,342 50 

1 An equal amount received from the United States government for venereal disease control activities 
in accordance with the provisions of the Chamberlain- Kahn act does not appear as State appropriation. 



No. 34.] ANNUAL REPORT. 39 



Division of Biologic Laboratories. 

Appropriation for personal services, 1 $29 740 00 

Expended for personal services, 29 120 94 

Balance, $619 06 

Appropriation for expenses, 1 $26 500 00 

Credit account of refunds to treasury, 438 15 

126,938 15 

Apparatus, chemicals and laboratory supplies, $8,489 23 

Traveling, 222 94 

Express, 136 18 

Books, stationery, office supplies and furniture, 961 50 

Printing, 618 84 

Purchase of animals, 3,057 75 

Shipping, 1^135 19 

Services of veterinary surgeon and saddlery, 9 30 

Food for animals, 7,601 20 

Rental of telephone, messages and postage, . . . . . 515 17 

Rent, 2,058 32 

Water, gas, electric lighting and heating, 1,251 96 

Labor and materials, 1,215 17 

Ice, 647 20 

Miscellaneous, 656 02 

Total, $28,575 97 

Balance withdra^vn from Federal fund, 1,637 82 

$26,938 15 

Division of Food and Drugs. 

Appropriation for personal services, $28,750 00 

Expended for personal services, 28,359 65 

Balance, $390 35 

Appropriation for expenses, $11,000 00 

Brought forward from 1919, 7 80 

$11,007 80 

Apparatus and chemicals, $1,688 46 

Traveling, 6,524 98 

Purchase of samples, 516 04 

Express, 20 75 

> An additional amount equal to one-half of expenditures of Wassermann Laboratory received from 
the United State? government for venereal disease control activities in accordance with the provisions 
of the Chamberlain-Kahn act does not appear as State appropriation (approximately S5,000). 



40 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Printing, $498 69 

Books, maps and stationery, 441 64 

Telephone, telegraph messages and postage, 186 15 

Sundry laboratory supplies, 499 27 

Typewriter supplies and repairs, 115 78 

Branding outfits, 78 74 

Labor, . 10 80 

Professional services, 225 00 

Miscellaneous, 3 04 

• ,1. 

Total, $10,809 34 

Unexpended balance, 198 46 



$11,007 80 



Manufacture and Distribution of Arsphenamine. 



Appropriation for personal services, ^ $5,250 00 

Expended for personal services, 8,156 77 

Balance withdrawn from Federal fund, $2,906 77 

Appropriation for expenses, ^ $3,775 00 

Brought forward from 1919, 5 77 

Credit account of refund, 25 00 

$3,805 77 

Apparatus, chemicals and laboratory supplies, $2,512 68 

Professional services, i 733 33 

Animals, 510 40 

Travel, 115 20 

Express, 81 18 

Rent, 900 00 

Labor, 69 96 

Purchase of arsphenamine, 1,660 96 

Heat and light, 414 57 

Ice, 45 63 

Telephone, 35 04 

Water, . 21 00 

Shipping, 1,158 23 

Printing and binding, 19 40 

Miscellaneous, 78 84 

Total, $8,356 42 

Balance withdrawn from Federal fund, 4,550 65 

$3,805 77 

' An equal amount received from the United States government for venereal disease control activities 
in accordance with the provisions of the Chamberlain-Kahn act does not appear as State appropriation. 



No. 34.1 ANNUAL REPORT. 41 



Division of Sanitary Engineering. 

Appropriation for personal services, S33,500 00 

Expended for personal services, 28,882 14 

Balance, $4,617 86 

Appropriation for expenses, $11,200 00 

Brought forward from 1919, 7 15 

$11,207 15 

Apparatus and materials, $1,650 53 

Traveling, ' 4,096 08 

Express, 1 96 

Printing and binding, 239 71 

Maps, blue prints and books, 259 25 

Stationery, drawing materials and office supplies, .... 1,077 06 

Telephone, telegraph messages and postage, 235 14 

Services, collecting samples and reading gauges, . . . . 351 95 

Furniture and equipment, 1,132 44 

Miscellaneous, 74 94 

Total, $9,119 06 

Unexpended balance, 2,088 09 

$11,207 15 
Division of Water and Sewage Laboratories. 

Appropriation for personal services, $28,500 00 

Expended for personal services, 26,470 27 

Balance, $2,029 73 

Appropriation for expenses, $5,000 00 

Credit by refunds to treasury, 148 43 

$5,148 43 

Apparatus and materials, $2,878 03 

Traveling, 386 97 

Express, 1,275 67 

Printing and binding, 158 40 

Maps, blue prints and books, 17 75 



42 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Stationery, drawing materials and office supplies, .... S130 67 

Telephone, telegraph messages and postage, 53 82 

Labor, 40 80 

Rent, 150 00 

Miscellaneous, 32 30 

Total, S5,124 41 

Unexpended balance, 24 02 

$5,148 43 

Division of Tubekculosis (Sanatoria). 

Appropriation for personal services, $12,170 00 

Expended for personal services, 11,850 83 

Balance, S319 17 

Appropriation for expenses, $2,700 00 

Credit by cash returned to treasury, 48 89 

$2,748 89 

Traveling, $1,343 46 

Printing, 491 34 

Telephone and telegraph, 66 10 

Books and subscriptions, 60 19 

Stationery, 219 94 

Postage, 230 10 

Office equipment, 13 00 

Miscellaneous, 79 50 

Total, S2,503 63 

Unexpended balance, 245 26 

$2,748 89 
Appropriation to cover payment of subsidies to which certain 
cities and towns are entitled under the provisions of chap- 
ter 597, Acts of 1911, as amended by chapter 290, General 
Acts of 1917, $173,596 12 



State Examiners of Plumbers. 

Appropriation for the year ended Nov. 30, 1920, .... $4,620 00 
Brought forward from 1919, 219 86 

$4,839 86 



No. 34.] ANNUAL REPORT. 43 

Salaries and examiners' wages, $3,478 06 

Traveling, 510 94 

Express, 34 97 

Printing, 349 56 

Postage, 79 44 

Books and stationery, 42 32 

Plumbers' materials, 30 25 

Extra services, 105 15 

Cleaning, 17 00 

Office supplies, 19 77 

Telephone and lighting, 106 16 

Miscellaneous, 8 25 

Total, $4,781 87 

Unexpended balance, 57 99 



$4,839 86 
Penikese Hospital. 

Appropriation for the year ended Nov. 30, 1920, .... $34,820 00 

Salaries, $13,742 12 

Traveling, transportation and office expenses, 1,887 88 

Food, 6,173 32 

Clothing and materials, 723 12 

Furnishings and household supplies, 1,354 84 

Medical and general care, 2,076 44 

Heat, hght and power, 4,358 47 

Farm and stable, 3,857 21 

Grounds, 54 52 

Repairs, ordinary, 1,464 75 

Total, $35,692 67 

Deficit, 872 67 



44 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Recapitulation. 



Appro- 
priation plus 
Credits. 



Total Appro- 
priation. 



Expended. 



For the Division of Administration, 



For the Division of Hygiene, 



i 



For the Division of Communicable Diseases, . . \ 

[ 

For the Subdivision of Venereal Diseases, 
For the Division of Biologic Laboratories, . . . \ 



For the Division of Food and Drugs, . 



. i 



For the manufacture and distribution of arsphenamine, { 



For the Division of Sanitary Engineering, . 

For the Division of Water and Sewage Laboratories, 

For the Division of Tuberculosis (Sanatoria), 

For subsidies to cities and towns, 

For the State Examiners of Plumbers, 

For the maintenance of Penikese Hospital, . 

Totals 



. I 



$32,600 00 

78 50 

39,145 00 

2,593 S3 

78,000 00 

173 10 



56,240 00 
438 15 
39,750 00 
7 80 
9,025 00 
30 77 
44,700 00 1 
7 15 J 
33,500 00 1 
148 43 J 
14,870 001 
48 89 J 

4,620 00 
219 86 



$32,678 50 

41,738 93 

78,173 10 

16,542 50' 

56,678 15- 

39,757 80 

9,055 77' 

44,707 15 

33,648 43 

14,918 89 

173,596 12 

4,839 86 

34,820 00 



$30,724 93 

37,480 36 

77,295 10 
22,663 03 
57,696 91 

39,168 99 

16,513 19 

38,001 20 

31,594 68 

14,354 46 
173,596 12 

4,781 87 
35,692 67 



$581,155 20 



$579,663 51 



1 An equal amount received from the United States government for venereal disease control activities. 

2 Approximately $5,000 additional received from the United States government for venereal disease 
control activities in accordance with thp provisions of the Chamberlain-Kahn act. These sums of money 
do not appear as State appropriation. 



No. 34.] 



ANNUAL REPORT. 



45 



ExPE^^DITUKES OF Tuberculosis Sanatoria for the Year ended 

Nov. 30, 1920. 





Rutland. 


Lakeville. 


Westfield. 


North 
Reading. 


Totals. 


Appropriation for maintenance, 


$304,280 00 


$201,810 48 


$196,503 00 


$163,355 00 


$865,948 48 


Balance brought forward from pre- 


3,722 33 


- 


- 


789 48 


4,511 81 




$308,002 33 


$201,810 48 


$196,503 00 


$164,144 48 


$870,460 29 


Personal services, .... 


$115,107 90 


$86,245 11 


$82,998 08 


$57,876 35 


$342,227 44 


Religious instruction, 


1,800 00 


1,131 44 


1,189 60 


1,600 00 


5,721 04 


Travel, transportation and office 


3,184 34 


1,947 37 


1,841 38 


2,036 06 


9,009 15 


Food, 


93,199 34 


31,771 18 


39,968 30 


56,699 78 


221,638 60 


Clothing and materials, . 


239 64 


14 95 


979 89 


936 63 


2,171 11 


Furnishings and household supplies, 


10,455 68 


5,946 08 


10,034 44 


6,285 84 


32,722 04 


Medical and general care. 


8,787 89 


3,866 35 


3,365 87 


3,308 26 


19,328 37 


Heat, light and power, . 


30,734 22 


12,827 04 


14,859 63 


12,514 78 


70,935 67 


Farm, 


20,419 85 


39,236 88 


16,889 89 


8,400 25 


84,946 87 


Garage, stable and grounds, . 


7.181 58 


7,867 16 


5,082 98 


2,724 75 


22,856 47 


Repairs, ordinary, .... 


9,129 09 


7,233 25 


9,950 06 


3,412 98 


29,725 38 


Repairs and renewals. 


1,090 48 


654 06 


9,325 54 


3,735 72 


14,805 80 


Total expenditures, . 


$301,330 01 


$198,740 87 


$196,485 66 


$159,531 40 


$856,087 94 


Unexpended balance, 


$6,672 32 


$3,069 61 


$17 34 


$4,613 08 


$14,372 35 


Average number of inmates, . 


345 


231 


265 


188 


1,029 


Weekly per capita cost, . 


$16 78 


$16 50 


$14 24 


$16 29 


$16 00 


Receipts for board of inmates. 


$48,712 23 


$34,574 10 


$42,187 19 


$29,322 30 


$154,795 82 


Receipts from sales, 


830 87 


1,070 16 


1,541 96 


796 13 


4,239 12 


Total receipts 


$49,543 10 


$35,644 26 


$43,729 15 


$30,118 43 


$159,034 94 



46 



DEPARTMENT OF PUBLIC HEALTH. [P. D. No. 34. 



Special Appropriations — Tuberculosis Sanatoria. 

Rutland. 



Appropriation fob — 


Act or Resolve. 


Amount. 


Total ex- 
pended to 
Nov. 30, 
1920. 


Balance 
carried to 
Next Year. 


Kitchen, service and storehouse buildings, . 


Chap. 55, 1918 


$55,000 00 


353,905 74 


$1,094 26 



Lakeville. 



Shelter for young stock, .... 


Chap. 629, 1920 


$2,500 00 


$1,696 52 


$803 48 


Generator unit 


Chap. 629, 1920 


9,005 00 


153 30 


8,851 70 


Purchase of land, 


Chap. 153, 1919 


2,500 00 


- 


2,500 00 




$14,005 00 


$1,849 82 


$12,155 18 





Westfield. 








Purchase of land, 


1920 


$1,890 00 


- 


$1,890 00 


Remodeling barn, 


1920 


5,700 00 


$5,662 76 


37 24 


Remodeling farmhouse and dormitory, 


1920 


10,000 00 


9,988 23 


11 77 


Installing engine and generator, . 


1920 


6,500 00 


1,311 90 


5,188 10 




$24,090 00 


$16,962 89 


$7,127 11 



North Reading. 



Nurses' hall and chapel. 
Cottage for engineer and steward. 



Chap. 211, 1919 

Chap. 629, 1920 
Chap. 225, 1920 



$48,150 00 



16,500 00 



$64,650 00 



$48,144 42 
9,611 29 



$57,755 71 



$5 58' 
6,888 71 



$6,894 29 



1 Reverting to treasury of Commonwealth. 



( 



SUPPLEMENT 



[471 



Division of Sanitaey Engineering 



X. H. GooDNOUGH, Director 



149] 



I 



EEPORT OF DIVISION OF SANITARY ENGINEERING. 



During 1920, as in the years which immediately preceded, the 
conditions brought about by the war — scarcity and excessive prices 
of labor and material — have continued to prevent the construction 
of necessary public works, especially water supplies and sewerage 
systems. Furthermore, the remarkably high rainfall — the greatest 
in thirty years — following the high rainfall of preceding years has 
furnished an abundant supply of water from nearly all sources of 
water supply in use in the State, including many which are noAv being 
used in excess of their safe capacity. At the same time, the high 
rainfall has maintained a high flow in the streams, and thus has caused 
a greater dilution of polluting substances than has been the case in 
any previous year for more than a quarter of a century. 

The Department received during the year 141 applications in 
relation to water supply, drainage, sewerage, the pollution of streams 
and similar matters, the number being about the same as for several 
years. Of these, 40 were in relation to public water supplies, 55 in 
relation to wells and springs used mainly as sources of water supply 
for factories, camps and summer colonies, 7 to sources of ice supply, 
17 to sewerage, drainage and sewage disposal, 5 to pollution of streams, 
and 17 to miscellaneous matters. One new water supply was introduced 
during the year, the works being constructed by a water company for 
the supply of the town of Auburn, and a very few additions were made 
to existing water supplies. 

The total population of the State by the Census of 1920 was 
3,852,356, of which 3,702,549 were included in cities and towns 
having public water supplies in the whole or in part of their territory. 
The towns not yet provided with water supplies number 138, the 
aggregate population of which in 1920 was 149,807. There still 
remain 13 towns, having in 1920 a population in excess of 2,500, which 
are not provided with public water supplies. These towns are the 
following: — 



52 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Town. 


Population. 


Town. 


Population. 


Tewksbury, 

Templeton 

Somerset, 

Warren, 

Westport, 

Seekonk, 


4,450 

4,019 
3,520 
3,467 
3,115 
2,898 
2,780 


Wilmington, 

Sutton, ...... 

Hanover 

Dighton 

Harvard 

Bourne, 


2,581 
2,578 
2,575 
2,574 
2,546 
2,530 


Wilbraham, 


39,633 



In most of these towns and in many others of smaller size, public 
water supplies are very badly needed, not only for public comfort 
and convenience and for protection from fire, but principally for the 
protection of health, since the well waters, which are the main 
sources of supply in most of the villages of the State not yet pro^'ided 
with public works, are usually more or less polluted and in many 
cases wholly unfit for use. In many of these long-settled communities 
sewage has been disposed of by discharging it into vaults and cess- 
pools for many years, and seepage from these sources of contamination, 
which tends to flow to a lower level, pollutes the ground water and 
commonly finds its way to the nearest w^ell or perhaps to several wells 
where the ground water is lowered on account of the draft for domestic 
use. The results of the continuous discharge of sewage into the ground 
about the dwelling houses in villages are to a considerable extent 
cumulative, and the w^ater of wells in such communities usually grows 
worse from year to year. 

Private Wells. 

In consequence of the pollution of wells in the thickly populated 
villages not yet provided with public water supplies and of the 
general spread of the knowledge of the fact that a pure water supply 
is the most valuable agent in the maintenance of health, the Depart- 
ment is receiving an increased number of applications for the examina- 
tion of private or semi-public sources of water supply, that is, supplies 
used for farms and village dwellings often used by two or more 
families. The results of the tests of a limited number of these sources 
which have been examined during the past year have showm that the 
majority of the wells brought to the attention of the Department 
were very badly polluted and unsafe for domestic use. The amount 
of this work is constantly growing, and properly attended to is no 
doubt a great aid in the protection of the public health from the 
dangers following the use of impure water. This work requires 



No. 34.] DIVISION OF SANITARY ENGINEERING. 53 

expert care to avoid the condemnation of sources which may safely 
be used and subjecting the owner or occupant of such premises to a 
serious expense for a new well or other source of water supply, and 
to avoid at the same time the approval of sources which may be the 
cause of great injury to health. The danger from the use of polluted 
wells needs no emphasis, and is now becoming so well understood 
that the requests for examinations of such sources are increasing, and 
further provision for this work will have to be made if it is to be 
continued and properly carried out. 



Water Supplies of Camps. 

A most notable increase in the work of this Division has been 
brought about by the multiplication of the number of camps for 
associations of all sorts since the close of the war. Most of these 
camps are located along the banks of the rivers or near the shores of 
lakes or ponds usually remote from any source of public water supply. 
A supply of drinking water is obtained in these cases usually from 
some neighboring spring or well, or by sinking a well at the most con- 
venient point on the premises. The danger to the public health of the 
use of an improper or infected water supply in such places is obvious, 
and this Division has sought to meet the demands for sanitary exam- 
inations of such communities as promptly and effectively as possible, a 
work that has been difficult under the existing circumstances and one 
which if it is to be continued will require a larger organization. 

Difficulties of providing Water and Sewerage Facilities in 

Certain Districts. 

Attention has been called to the problem in water supply and 
sewerage brought about by the development of lands for occupation 
by summer cottages and camps, which have been increasing very 
rapidly not only on the seashore but also along the banks of rivers 
and the shores of lakes and ponds. A similar important problem is 
that of water supply and sewerage in connection with real estate 
developments adjacent to or in the neighborhood of cities and larger 
towns. In some places lands are built upon which are so located or 
are of such a character that it is impracticable to provide them with 
a public water supply or an effective system of sewerage or drainage 
unless at excessive cost. 

The attention of the Department has been called to a number of 
such districts where houses, sometimes in large numbers, have been 



54 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

constructed on rocky hills, mostly in outlying territory, where the 
ledge has little or no earth covering and where it is impracticable or 
exceedingly difficult and expensive to construct water and sewer 
mains and service pipes. The purchaser of lands in such cases often 
fails to realize or gives little heed to the difficulties he is likely to 
meet in maintaining satisfactory sanitary conditions in and about 
his premises, and the municipality hesitates to extend proper water sup- 
ply and sewerage service to such a district. In other cases, areas of low, 
wet land have been built upon where proper drainage is impracticable 
except at an expense which may be far in excess of the value of the 
property involved. Such conditions have been overcome and made 
satisfactory in a few municipalities by taking advantage of the laws 
providing for a board of survey, or a planning board if the powers 
and duties of the board of survey are placed in its hands. The 
board of survey, under existing laws, is empowered to examine, hold 
hearings, and pass upon all schemes for new development of real 
estate at the outset and before any construction work is undertaken. 
The public is thus given an opportunity to learn the dangers of 
building in a locality deemed objectionable by the board of survey. 
Such publicity, if placed in the hands of properly trained officials, 
would not only secure better development of the new districts in 
cities and towns but would aid greatly in preventing the development 
of undesirable areas for residential purposes, and prevent the danger 
to the public health which such settlements entail. 

Many of the difficulties arising from objectionable real estate de- 
velopments could be prevented if cities and towns generally would 
accept and put in force the board of survey laws already provided by 
the Legislature. 

Rainfall and Flow of Streams. 

The rainfall for the year 1920 was greatly in excess of the normal, 
and during the first six months of the year was probably the greatest 
that has occurred in a period of fifty years. On the Wachusett 
watershed near the middle of the State the excess of rainfall over 
the normal amounted to 10.34 inches and an excess occurred in every 
month of the year, with the exception of January, August and October. 
The flow of the Nashua River during 1920, as measured by the 
Metropolitan Water Board at Clinton, exceeded that of any year 
since the observations of the flow of that stream were established 
twenty-four years ago. The flow of the stream was much less than 
the normal in the months of January and February, a condition due 
largely to an exceptionally cold winter, since the precipitation in 



No. 34.] DIVISION OF SANITARY ENGINEERING. 55 

those months was chiefly in the form of snow. Slight deficiencies also 
occurred in August and October, but in the other months the flow 
was in excess of the normal, that of March being the greatest that 
has occurred in that month in any year since measurements of the 
flow of this river were begun. 

Sanitary Protection of Public Water Supplies. 

The importance of efficient sanitary protection of public water 
supplies has been emphasized again by the occurrence of a great 
epidemic of typhoid fever in a middle western State. In this case 
the water supply of a town of 10,305 inhabitants became contaminated, 
a condition which was followed by the occurrence of about 882 cases 
of typhoid fever and 25 deaths, a rate of about 24 per 100,000 of 
population. This epidemic calls attention once more to the calamitous 
results which may follow the pollution of a public water supply, and 
emphasizes again the need of giving to public water supplies all the 
protection possible against danger of infection from whatever cause. 
The death rate from typhoid fever in Massachusetts in 1887, the first 
year after the establishment of supervision of the water supplies by 
the State, was 45 per 100,000 of population, while in the year 1920 
the death rate was 2.5 per 100,000, in all probability the lowest of any 
State in the Union. In a large degree this decrease is a measure of 
the improvement in water supplies and in the efficiency of their protec- 
tion during that period. 



Examination of Water Supplies. 

The usual examinations of water supplies have been carried on 
during the year and many of the sources have been inspected by the 
engineers of this Division. The waters of the various sources have 
been analyzed chemically and microscopically, the latter in the case 
of surface w^aters, and bacterial tests have been made where such 
tests appeared to be necessary or desirable. In very few cases have 
emergency water supplies been found necessary, the high rainfall 
insuring an adequate supply in practically all cases from existing 
works. 

Following are average results of chemical analyses of the sources of 
public water supply examined in 1920. 



56 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Analyses of the Watek of Public Water Supplies. 
Averages of Chemical Analyses of Surface-water Sources for the Year 



1920. 





[Parts in 100,000.] 
















Source. 


o 

a 


a 

> 

a 
o 

S fi 


Ammoni.v. 



1 








6 


ALBUMINOID. 




City or Town. 


■3 


a 

1 
02 


i 

a 


Metropolitan Water 
District. 


Wachusett Reservoir, upper end, 
Wachusett Reservoir, lower end. 


.27 
.15 


3.78 
3.52 


.0026 
.0020 


.0157 
.0120 


.0023 
.0019 


.25 

.27 


1.1 
1.1 




Sudbury Reservoir, . 




.17 


4.12 


.0028 


.0135 


.0024 


.31 


1.4 




Framingham Reservoir No 


3, . 


.19 


4.08 


.0034 


.0161 


.0029 


.31 


1.5 




Hopkinton Reservoir, 




.60 


4.28 


.0041 


.0188 


.0033 


.32 


1.1 




Ashland Reservoir, 




.59 


4.32 


.0027 


.0180 


.0028 


.29 


1.3 




Framingham Reservoir No 


2, 


.79 


6.40 


.C067 


.0230 


.0037 


.62 


1.6 




Lake Cochituate, 




.22 


6.12 


.0027 


.0204 


.0044 


.64 


2.6 




Chestnut Hill Reservoir, 




.18 


4.07 


.0026 


.0119 


.0020 


.33 


1.5 




Weston Reservoir, 




.17 


4.04 


.0027 


.0134 


.0018 


.35 


1.5 




Spot Pond, . 




.10 


4.00 


.0014 


.0130 


.0024 


.33 


1.4 




Tap in State House, . 




.18 


4.18 


.0013 


.0112 


.0015 


.33 


1.5 




Tap in Revere, . 




.08 


3.91 


.0010 


.0113 


.0014 


.34 


1.5 




Tap in Quincy, . 




.15 


4.02 


.0006 


.0104 


.0012 


.33 


1.6 


Abington, 


Big Sandy Pond, 




.10 


4.47 


.0028 


.0127 


.0018 


.68 


1.4 


Adams (Fire Dis- 
trict). 


Dry Brook, 
Bassett Brook, . 




.18 
.00 


6.47 
3.92 


.0011 
.0010 


.0072 
.0041 


.0002 
.0003 


.14 
.11 


4.7 
2.5 


Amherst, 


Amethyst Brook large reservoir, 


.41 


3.31 


.0008 


.0132 


.0011 


.14 


0.8 




Amethyst Brook small reservoir. 


.16 


3.10 


.0007 


.0090 


.0016 


.13 


0.8 


Andover, 


Haggett'a Pond, .... 


.15 


4.53 


.0018 


.0148 


.0023 


.40 


1.9 


Ashburnham, 


Upper Naukeag Lake, 




.08 


2.39 


.0009 


.0092 


.0005 


.15 


0.5 


Ashfield, 


Bear Swamp Brook, . 




.26 


5.10 


.0009 


.0124 


.0012 


.09 


2.8 


Athol, . 


Phillipston Reservoir, 




.75 


5.10 


.0046 


.0196 


.0033 


.18 


1.2 




Buckman Brook Reservoir 




.28 


3.67 


.0072 


.0215 


.0069 


.16 


1.0 




Inlet of filter. 




.30 


3.93 


.0035 


.0178 


.0041 


.13 


1.0 




Outlet of filter, . 




.49 


3.81 


.0026 


.0171 


- 


.15 


1.1 


Barre, 


Reservoir, . 




.13 


4.25 


.0016 


.0206 


.0046 


.33 


1.4 


Blandford (Fire Dis- 
trict). 
Brockton, 


Freeland Brook, . 




.05 


4.05 


.0008 


.0040 


.0005 


.28 


1.4 


Silver Lake, 




.16 


3.80 


.0013 


.0119 


.0014 


.55 


0.7 


Cambridge, . 


Lower Hobbs Brook Reservoir, 


.27 


6.04 


.0042 


.0213 


.0026 


.45 


2.5 




Upper Hobbs Brook Reservoir, 


.51 


6.74 


.0069 


.0233 


.0034 


.47 


2.7 




Stony Brook Reservoir, 


.36 


6.25 


.0047 


.0203 


.0025 


.52 


2.7 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



5/ 



Averages of Chemical Analyses of Surface-water Sotirces, etc. — Continued. 

[Parts in 100,000.] 









a 


0) 

> 
§ . 

l-s 

§2 


Ammonia. 


6 

e 

1 
O 






Source. 


<u 

1 


ALBUMINOID. 




CiTT OR Town. 


"3 
...» 
o 
H 


c 


c 
■d 


Cambridge— Con. 


Fresh Fond 


.27 


7.25 


.0056 


.0230 


.0054 


.61 


3.1 


Cheshire, 


Thunder Brook, . 




.02 


8.22 


.0019 


.0049 


.0003 


.11 


5.3 




Kitchen Brook, . 




.01 


6.93 


.0010 


.0049 


.0005 


.09 


4.9 


Chester (Fire Dis- 
trict). 


Austin Brook Reservoir, 
Horn Pond, 




.08 
.10 


4.45 
3.75 


.0006 
.0010 


.0092 
.0148 


.0022 
.0008 


.12 
.12 


1.6 
1.6 


Chicopee, 


Morton Brook, . 




.06 


4.27 


.0024 


.0056 


.0012 


.22 


1 




Cooley Brook, 




.60 


4.33 


.0060 


.0120 


.0022 


.20 


1.3 


Clinton, . 


Tap in town, 




.11 


3.90 


.0005 


.0105 


.0025 


.20 


1.2 


Colrain (Griswold- 

ville). 
Concord, 


McClellan Reservoir, . 
Nagog Pond, 




.01 
.05 


7.38 
3.09 


.0008 
.0013 


.0048 
.0105 


.0009 
.0015 


.17 

.35 


5.1 
1.0 


Dalton (Fire Dis- 
trict). 


Egypt Brook Reservoir, 
Windsor Reservoir, 




.19 
.35 


4.85 
4.97 


.0006 
.0055 


.0087 
.0168 


.0013 
.0027 


.12 
.13 


2.3 
2.5 




Cady Brook, 




.20 


4.17 


.0013 


.0091 


.0012 


.16 


1.9 


Danvers, 


Middleton Pond, 




.53 


4.48 


.0053 


.0196 


.0036 


.38 


1.7 




Swan Pond, 




.23 


5.22 


.0018 


.0176 


.0031 


.33 


2.0 


Deerfield (South 
Deerfield Water 
Supply District). 

Egremont (South), 


Roaring Brook, . 
Goodale Brook, . 




.03 

.00 


6.97 
4.00 


.0002 
.0006 


.0053 
.0024 


.0002 
.0001 


.15 
.11 


4.1 
2.4 


Fall River, . 


North Watuppa Lake, 




.18 


4.08 


.0022 


.0162 


.0034 


.50 


1.3 


Falmouth, 


Long Pond, 




.06 


3.98 


.0008 


.0090 


.0010 


1.01 


0.7 


Fitchburg, . 


Meetinghouse Pond, . 




.07 


3.12 


.0034 


.0154 


.0015 


.18 


0.8 




Scott Reservoir, . 




.12 


2.99 


.0081 


.0120 


.0025 


.25 


0.9 




Wachusett Lake, 




.09 


2.96 


.0025 


.0117 


.0021 


.18 


0.7 




Falulah Brook, . 




.15 


3.04 


.0031 


.0123 


.0021 


.18 


0.7 




Ashby Reservoir, 




.34 


3.31 


.0069 


.0186 


.0027 


.18 


0.6 


Gardner, 


Crystal Lake, 




.07 


5.04 


.0018 


.0149 


.0015 


.34 


2.1 


Gloucester, . 


Dike's Brook Reservoir, 




.28 


3.88 


.0040 


.0106 


.0017 


.68 


0.5 




Wallace Reservoir, 




.57 


4.57 


.0037 


.0147 


.0022 


.79 


0.4 




Haskell Brook Reservoir, . 




.19 


3.75 


.0025 


.0087 


.0012 


.65 


0.5 


Great Barrington 
(Fire District). 


East Mountain Reservoir, . 
Green River, 




.10 
.00 


5.52 
9.30 


.0075 
.0011 


.0101 
.0045 


.0017 
.0002 


.11 
.10 


3.0 
6.6 


Great Barrington 
(Housatonic ) . 

Greenfield (Fire 
District No. 1). 


Long Pond, 

Glen Brook Upper Reservo 

Glen Brook Lower Reservo 


ir, . 
r, . 


.04 
.03 
.02 


7.05 
6.52 
5.77 


.0019 
.0040 
.0023 


.0169 
.0068 
.0089 


.0013 
.0011 
.0015 


.20 
.23 
.17 


5.9 
2.6 
3.6 



58 



DEPARTIMENT OF PUBLIC HEALTH. [Pub. Doc. 



Averages of Chemical Analyses of Surface-water Sources, etc. — Continued. 

[Parts in 100,000.] 









i 

o 
O 


1 
> 

§ 
Jo 

Pi 


Ammonia. 


.1 
u 

O 






Source. 


6 


albuminoid. 




City or Town. 


t 


o 

B 

§ 


% 


Hadley (Water Sup- 
ply District). 
Hatfield, 


Hart's Brook Reservoir, 
Running Gutter Brook Reservoir 


.04 

.06 


5.37 
5.60 


.0024 
.0017 


.0133 
.0057 


.0026 
.0008 


.23 
.23 


2.5 
2.5 


Haverhill, . 


Johnson's Pond, .... 


.21 


5.46 


.0022 


.0169 


.0018 


.44 


2.5 




Crystal Lake, 




.17 


3.87 


.0012 


.0146 


.0016 


.33 


1.4 




Kenoza Lake, 




.20 


5.00 


.0017 


.0155 


.0019 


.42 


2.4 




Lake Saltonstall, 




.07 


6.81 


.0028 


.0168 


.0028 


.62 


2.7 




Pentucket Lake, 




.15 


4.38 


.0011 


.0148 


.0024 


.38 


2.1 




Millvale Reservoir, 




.61 


5.45 


.0034 


.0178 


.0019 


.35 


2.0 


Hingham, 


Accord Pond, 




.19 


3.22 


.0022 


.0122 


.0013 


.45 


0.6 




Fulling Mill Pond, 




.67 


5.71 


.0091 


.0275 


.0094 


.69 


1.5 


Hinsdale (Fire Dis- 
trict). 

HOLYOKE, 


Reservoir, . 

Whiting Street Reservoir, 




.15 

.08 


2.95 
5.01 


.0007 
.0033 


.0093 
.0115 


.0014 
.0014 


.12 
.21 


0.4 
2.9 




Fomer Reservoir, 




.35 


4.19 


.0017 


.0118 


.0019 


.16 


1.4 




Wright and Ashley Pond, 




.08 


5.36 


.0045 


.0149 


.0025 


.18 


3.0 




High Service Reservoir, 




.08 


4.27 


.0038 


.0146 


.0024 


.19 


2.0 




White Reservoir, 




.26 


3.67 


.0052 


.0184 


.0062 


.17 


1.4 


Hudson, . 


Gates Pond, 




.07 


3.59 


.0034 


.0180 


.0035 


.24 


1.6 


Huntington (Fire 

District). 
Ipswich, . 


Cold Brook Reservoir, 
Dew's Brook Reservoir, 




.13 
.32 


3.22 
5.04 


.0012 
.0048 


.0061 
.0159 


.0008 
.0020 


.14 
.63 


1.3 

1.8 


Lawrence, . 


Merrimack River, filtered. 


.40 


6.24 


.0062 


.0081 


- 


.47 


1.2 


Lee, 


Codding Brook Upper Reservoir, 


.10 


4.32 


.0027 


.0090 


.0015 


.12 


2.3 




Codding Brook Lower Reservoir, 


.09 


4.31 


.0022 


.0070 


.0007 


.13 


2.1 




Basin Pond Brook, 


.59 


4.55 


.0030 


.0170 


.0014 


.12 


1.6 


Lenox, 


Reservoir, . 




.04 


7.70 


.0003 


.0068 


.0014 


.09 


6.1 




Laurel Lake, 




.10 


13.40 


.0033 


.0140 


.0032 


.18 


13.2 


Leominster, . 


Morse Reservoir, 




.16 


2.65 


.0017 


.0119 


.0019 


.17 


0.5 




Haynes Reservoir, 




.20 


2.52 


.0050 


.0205 


.0040 


.17 


0.4 




Fall Brook Reservoir, 




.11 


2.65 


.0027 


.0117 


.0016 


.20 


0.5 


Lincoln, . 


Sandy Pond, 




.09 


3.72 


.0048 


.0117 


.0015 


.36 


1.4 


Longmeadow, 


Cooley Brook, 




.05 


5.22 


.0050 


.0083 


.0015 


.23 


2.6 


Lynn, 


Birch Reservoir, 




.16 


4.76 


.0056 


.0176 


.0045 


.59 


1.6 




Breed's Reservoir, 




.33 


4.73 


.0052 


.0172 


.0024 


.56 


1.6 




Walden Reservoir, 




.39 


4.51 


.0048 


.0172 


.0029 


.50 


1.5 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



59 



Averages of Chemical Analyses of Surface-water Sources, 


etc.— 


- Continuec 


. 




[Parts in 100,000.] 














Source. 




1 

> 

c 

o . 
2 c 


Ammoni.a.. 


6 








.albuminoid. 




CiTT OR Town. 




T3 


i 








3 o 






a 




c 






o 


:2-B 


6 
2 


"3 
o 


1 


1 


-a 






O 


rt 


fe 


H 


03 


o 


K 


Lynn — Co«. . 


Hawkes Reservoir, 


.36 


5.71 


.0067 


.0214 


.0038 


.59 


2.2 


Manchestei", . 


Gravel Pond, 




.13 


4.39 


.0020 


.0129 


.0026 


.74 


1.1 


Marlborough, 


Lake Williams, . 




.18 


5.72 


.0056 


.0191 


.0026 


.47 


2.0 




Milham Brook Reservoir, . 




.35 


4.99 


.0049 


.0170 


.0024 


.41 


1.8 


Maynard, 


White Pond, 




.08 


3.14 


.0018 


.0128 


.0022 


.27 


0.7 


Milford, . 


Charles River, filtered. 




.18 


6.93 


.0015 


.0071 


- 


.31 


4.0 


Montague, i 


Lake Pleasant, . 




.06 


3.70 


.0034 


.0090 


.0013 


.17 


0.9 


Nantucket, 


Wannacomet Pond, 




.15 


6.86 


.0060 


.0203 


.0056 


2.06 


1.6 


New Bedford, 


Little Quittacas Pond, 




.49 


3.90 


.0034 


.0177 


.0017 


.49 


0.8 




Great Quittacas Pond, 




.69 


4.04 


.0045 


.0201 


.0035 


.47 


0.9 


Newburtport, 


Artichoke River, 




.36 


7.51 


.0155 


.0303 


.0052 


.62 


2.8 


North Adams, 


Notch Brook Reservoir, 




.03 


6.85 


.0009 


.0055 


.0009 


.09 


5.1 




Beaman Reservoir, 




.02 


6.68 


.0019 


.0081 


.0012 


.10 


4.8 


Northampton, 


Middle Reservoir, 




.22 


4.18 


.0026 


.0115 


.0021 


.16 


1.7 




Mountain Street Reservoir, 




.14 


4.09 


.0021 


.0073 


.0011 


.13 


1.8 


North Andover, 


Great Pond, 




.11 


4.77 


.C041 


.0139 


.0017 


.44 


1.9 


Northborough, 


Lower Reservoir, 




.58 


4.44 


.0041 


.0178 


.0022 


.24 


1.3 




Upper Reservoir, 




.69 


4.40 


.0034 


.0185 


.0027 


.25 


1.3 


Northbridge, . 


Cook Allen Reservoir, 




.02 


2.99 


.0017 


.0059 


.0013 


.21 


0.8 


North Brookfield, . 


Doane Pond, 




.40 


3.58 


.0052 


.0219 


.0044 


.17 


0.7 




North Pond, 




.41 


3.67 


.0042 


.0249 


.0059 


.19 


0.8 


Northfield, . 


Reservoir, . 




.14 


3.12 


.0005 


.0064 


.0006 


.16 


1.0 


Norwood, 


Buckmaster Pond, 




.16 


4.30 


.0074 


.0162 


.0032 


.47 


1.6 




Outlet of filter, . 




.08 


3.57 


.0012 


.0082 




.48 


1.5 


Orange, . 


Reservoir, . 




.07 


3.92 


.0006 


.0045 


.0007 


.13 


0.9 


Palmer (Fire Dis- 


Lower Reservoir, 




.28 


4.02 


.0039 


.0139 


.0021 


.25 


1.4 


trict No. 1). 




















Peabody, 


Spring Pond, . . 




.26 


6.48 


.0062 


.0158 


.0029 


.68 


2.0 




Suntaug Lake, . 




.07 


5.49 


.0049 


.0192 


.0057 


.98 


2.5 


PiTTSFlELD, 


Ashley Lake, 




.16 


4.50 


.0036 


.0142 


.0025 


.15 


1.8 




Ashley Brook, 




.20 


6.34 


.0043 


.0130 


.0017 


.14 


3.8 




Hathaway Brook, 




.01 


8.97 


.0012 


.0044 


.0004 


.13 


7.7 



> Supply for Turner's Falls Fire Bistrict, Millers Falls Water Supply District and Lake Pleasant Water 
Supply District. 



60 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Avermjes of Chemical Analyses of Surface-water Sources, etc. — Continued. 





[Parts 


in 100,000.] 
















Source. 


6 


i 

t 

W 

a 
o 
a £3 

S2 


Ammonia . 


6 
O 






^ 


albuminoid. 




City or Town. 


1 


0) 

C 

CO 


i 

a 


PiTTSFIELD— Con. . 


Mill Brook 


.29 


4.17 


.0022 


.0112 


.0011 


.08 


2.1 




Sacket Brook, 




.01 


9.54 


.0004 


.0036 


.0001 


.12 


7.8 




Farnham Reservoir, . 




.48 


4.22 


.0027 


.0177 


.0025 


.09 


1.6 


Plymouth, 


Little South Pond, . 




.00 


2.97 


.0037 


.0136 


.0023 


.59 


0.5 




Great South Pond, . 




.00 


2.78 


.0028 


.0132 


.0022 


.67 


0.4 


Randolph, 


Great Pond, 




.41 


4.68 


.0017 


.0157 


.0017 


.51 


1.3 


Rockport, 


Cape Pond, 




.29 


9.91 


.0058 


.0191 


.0033 


3.47 


1.8 


Russell, . 


Black Brook, 




.46 


4.65 


.0015 


.0152 


.0021 


.11 


1.5 


Rutland, 


Muschopauge Lake, . 




.05 


3.55 


.0006 


.0095 


.0011 


.32 


1.2 


Salem, . 


Wen ham Lake, . 




.27 


6.98 


.0088 


.0195 


.0043 


.81 


2.5 




Longham Reservoir, . 




1.24 


9.35 


.0184 


.0361 


.0076 


1.12 


2.5 


Shelburne (S h e 1- 
burne Falls Fire 
District) . 

Southbridge, . 


Ipswich River at pumping sta- 
tion. 
Fox Brook, 

Hatchet Brook Reservoir No. 3, 


.56 

.02 

.16 


11.29 
6.02 

3.37 


.0135 
.0002 

.0029 


.0243 
.0038 

.0143 


.0068 
.0001 

.0018 


.81 
.15 

.16 


5.2 
3.0 

0.8 




Hatchet Brook Reservoir No. 4, 


.16 


3.21 


.0028 


.0134 


.0026 


.16 


0.9 


South Hadley (Fire 
District No. 1). 


Leaping Well Reservoir, 
Buttery Brook Reservoir, . 


.07 
.19 


3.33 
4.96 


.0013 
.0036 


.0132 
.0094 


.0044 
.0017 


.20 
.33 


0.9 
1.4 


Spencer, . 


Shaw Pond, .... 


.05 


2.54 


.0013 


.0115 


.0012 


.18 


0.7 


Springfield, . 


Westfield Little River, filtered, . 


.16 


3.24 


.0006 


.0070 


- 


.16 


1.4 


Stockbridge, . 


Lake Averie, .... 


.09 


6.86 


.0014 


.0128 


.0014 


.14 


4.8 


Stoughton, 


Muddy Pond Brook, . 


.17 


3.67 


.0007 


.0081 


.0016 


.40 


1.0 


Taunton, 


Assawompsett Pond, . 


.39 


3.80 


.0032 


.0162 


.0023 


.41 


0.6 




Elder's Pond, .... 


.18 


3.67 


.0028 


.0148 


.0017 


.46 


0.8 


Wakefield, . 


Crystal Lake, .... 


.17 


6.06 


.0072 


.0194 


.0036 


.79 


2.3 


Wareham (Onset), . 


Jonathan Pond 


.05 


2.67 


.0011 


.0095 


.0013 


.58 


0.4 


Wayland, 


Snake Brook Reservoir, 


.74 


5.36 


.0092 


.0244 


.0037 


.37 


1.6 


Westfield, . 


Montgomery Reservoir, 


.33 


3.49 


.0018 


.0117 


.0023 


.15 


0.7 




Tillotson Brook Reservoir, 


.09 


3.16 


.0012 


.0051 


.0002 


.14 


0.8 


West Springfield, . 


Bear Hole Brook, 


.13 


7.73 


.0044 


.0092 


.0011 


.21 


4.1 




Bear Hole Brook, filtered, . 


.02 


7.18 


.0008 


.0051 


- 


.23 


4.0 


Weymouth, . 


Great Pond, .... 


1.01 


5.10 


.0073 


.0224 


.0018 


.44 


0.8 


Williamsburg, 


Reservoir, 


.12 


4.63 


.0004 


.0077 


.0015 


.15 


2.3 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



61 



Averages of Chemical Anahjses of Surface-water Sources, etc. — Concluded. 

(Parts in 100,000.] 













a 


1 

W 
a 

o . 
«o a 

l-a 
1^ 


Ammonia. 


i 

U 






Source. 


6 


ALBUMINOID. 




City or Town. 


1 


13 

a 
1 


i 

a 
1 


Williamstown, 


Reservoirs 


.03 


7.75 


.0008 


.0048 


.0005 


.11 


6.0 


Winchester, . 


North Reservoir, 








.06 


4.00 


.0034 


.0133 


.0016 


.37 


1.7 




South Reservoir, 








.06 


3.76 


.0034 


.0136 


.0021 


.36 


1.6 




Middle Reservoir, 








.16 


4.07 


.0069 


.0226 


.0042 


.35 


1.7 


Worcester, . 


Bottomly Reservoir, 








.23 


3.52 


.0025 


.0146 


.0012 


.18 


1.3 




Kent Reservoir, . 








.20 


3.52 


.0012 


.0149 


.0041 


.17 


1.4 




Leicester Reservoir, 








.34 


3.40 


.0032 


.0157 


.0029 


.19 


1.3 




Mann Reservoir, 








.22 


3.67 


.0023 


.0153 


.0028 


.16 


1.7 




Upper Holden Reservoir, 






.12 


3.71 


.0010 


.0105 


.0020 


.21 


1.0 




Lower Holden Reservoir, 






.10 


3.31 


.0017 


.0108 


.0019 


.19 


0.9 




Kendall Reservoir, 






.09 


3.10 


.0015 


.0119 


.0019 


.19 


1.1 



Averages of Chemical Analyses of Ground-water Sources for the Year 1920. 

[Parts in 100,000.] 





Source. 


6 


c 
'■♦J 

II 


Ammonia. 


d 

c 

1 

3 
o 

.65 
.18 


Nitrogen 
as — 


i 

c 

1 




City or Town. 


6 


13 

.1 

SB 

< 


1 


CO 

'B 


1 


Acton (West and 
South Water Sup- 
ply District). 

Adams (Fire Dis- 
trict). 

Amesbury, 


Tubular wells, . 
Tubular wells, . 


.00 
.00 


8.15 
13.65 


.0004 
.0003 


.0024 
.0014 


.0940 
.3320 


.0000 
.0000 


3.5 
10.6 


•008 
.006 


Tubular wells, . 


.36 


14.68 


.0047 


.0039 


.52 


.0075 


.0001 


7.2 


.295 


Ashland, . 


Tubular wells, old supply. 


.01 


6.65 


.0002 


.0019 


.64 


.0057 


.0000 


2.1 


.022 




Tubular wells, new supply. 


.00 


5.92 


.0006 


.0033 


.39 


.0054 


.0001 


2.1 


.016 


Attleboro, . 


Large well. 


.01 


4.82 


.0003 


.0048 


.48 


.0105 


.0000 


2.1 


.009 


Avon, 


Wells 


.00 


7.84 


.0010 


.0030 


.55 


.2420 


.0001 


2.9 


.010 


Ayer, 


Large well. 


.00 


6.80 


.0005 


.0021 


.60 


.0580 


.0001 


3.0 


.015 




Tubular wells, , 


.00 


6.43 


.0011 


.0043 


.33 


.0113 


.0001 


3.1 


.020 


Barnstable, 


Tubular wells, . 


.00 


4.30 


.0007 


.0017 


1.11 


.0043 


.0000 


1.0 


.023 


Bedford, . 


Large well. 


.00 


4.23 


.0005 


.0023 


.31 


.0060 


.0000 


2.1 


.015 


Billerica, . 


Old wells 


.07 


11.48 


.0014 


.0060 


.42 


.0105 


.0000 


4.5 


.176 



62 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Averages of Chemical Analyses of Ground-water Sourcet, etc. — Continued. 





[Parts in 100,000.] 


















Source. 




c 


Ammonia. 


c 


Nitrogen 

AS — 


i 




City or Town. 




■V 




(» 








6 




1 


o 
i.S 


1 

O 
.45 




■4-0 


c 
•a 

03 


c 
2 

hi 


Billerica — Co?j. 


New wells. 


.14 


6.88 


.0012 


.0060 


.0135 


.0000 


2.9 


.040 


Braintree, 


Filter-gallery, . 


.28 


6.93 


.0020 


.0117 


.74 


.1233 


.0000 


2.5 


.017 


Bridgewater, . 


Wells, 


.00 


4.72 


.0003 


.0018 


.59 


.0288 


.0000 


1.4 


.015 


Brookfield (East), . 


Tubular wells, . 


.00 


2.80 


.0000 


.0018 


.30 


.0030 


.0001 


0.2 


.005 


Brookline, 
Canton, . 


Tubular wells and filter- 
gallery, filtered. 
Springdale well. 


.11 
.02 


9.04 
4.67 


.0006 
.0003 


.0063 
.0022 


.76 
.50 


.02C6 
.0230 


.0000 
.0001 


3.9 
1.9 


.012 
.010 




Well near Henry's Spring, 


.07 


4.72 


.0005 


.0035 


.50 


,0252 


.0000 


1.8 


.017 


Chelmsford (North 
C hebnsf ord Fire 
District). 

Chelmsford (Water 
District). 

Chicopee (Fairview). 


Tubular wells, . 

Tubular wells, . 
Tubular wells, . 


.06 

.00 
.02 


6.35 

8.00 
5.49 


.0088 

.0003 
.0007 


.0064 

.0014 
.0024 


.59 

.65 

.28 


.1137 

.1263 
.0634 


.0004 

.0010 
.0000 


2.6 

3.0 

2.0 


.016 

.018 
.038 


Cohasset, . ■ . 


Tubular wells, . 


.09 


12.99 


.0008 


.0072 


1.81 


.1386 


.0000 


5.2 


.011 




Filter-gallery, . 


.33 


11.00 


.0017 


.0149 


1.34 


.0520 


.0000 


3.9 


.055 




Dug well, filtered. 


.11 


8.14 


.0026 


.0074 


1.08 


.0069 


.0001 


2.9 


.025 


Dedham, 

Deerfield (Fire Dis- 
trict). 
Douglas, . 


T,arge well and tubular 

wells. 
Wells 

Tubular wells, . 


.07 
.01 
.02 


10.43 
4.45 
6.30 


.0021 
.0004 
.0005 


.0045 
.0039 
.0022 


1.08 
.20 
.41 


.1483 
.0100 
.0505 


.0002 
.0000 
.0000 


4.2 
2.0 
2.0 


.016 
.012 
.024 


Dracut (Water Sup- 
ply District). 

Dracut (Collins- 
ville). 

Dudley, . 


Tubular wells, . 
Tubular wells, . 
Tubular wells, . 


.00 
.00 
.00 


9.00 
4.70 
3.13 


.0004 
.0005 
.0002 


.0024 
.0022 
.0014 


.70 
.30 
.23 


.1200 
.0050 
.0093 


.0001 
.0000 
.0000 


3.8 
1.6 
1.4 


.006 
.027 
.010 


Duxbury (Fire and 

Water District). 
Easthampton, . 


Tubular wells, . 
Tubular wells, . 


.00 
.00 


4.50 
8.17 


.0003 
.0002 


.0021 
.0014 


.71 
.20 


.0123 
.0173 


.0000 
.0001 


0.7 
3.7 


.020 
.012 


E a s t n (North 
Easton Village Dis- 
trict). 

Edgartown, 


Well 

Large well, 


.00 
.00 


5.03 
3.20 


.0003 
.0004 


.0023 
.0020 


. 46 
.98 


.0469 
.0045 


.0000 
.0000 


2.1 
0.7 


.008 
.010 


Fair haven. 


Tubular wells, . 


.29 


9.07 


.0022 


.0081 


.86 


.1320 


.0005 


2.8 


.037 


Foxborough (Water 

Supply District). 
Framingham, . 


Tubular wells, . 
Filter-gallery, . 


.00 
.00 


5.15 
12.53 


.0008 
.0154 


.0029 
.0069 


.53 
2.05 


.0530 
.0148 


.0000 
.0008 


1.5 
5.6 


.018 
.010 


Franklin, . 


Tubular wells, . 


.00 


5.30 


.0006 


.0028 


.61 


.0240 


.0000 


1.8 


.010 


Grafton, . 


Filter-gallery, . 


.04 


11.82 


.0004 


.0050 


1.41 


.1750 


.0001 


4.5 


.015 


Granville, 


Well 


.05 


4.18 


.0002 


.0019 


.10 


.0083 


.0001 


2.0 


.069 


Groton, . 


Large well, 


.01 


6.43 


.0004 


.0026 


.25 


.0040 


.0000 


3.0 


.013 


Groton (West Groton 
Water Supply Dis- 
trict). 

Hingham, 


Tubular wells, . 


.00 


4.90 


.0002 


.0017 


.17 


.0077 


.0000 


2.8 


.010 


Wells 


.10 


5.25 


.0026 


.0051 


.66 


.0152 


.0001 


1.8 


.020 



i 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



63 



Averages of Chemical Analyses of Ground-water Sources, etc. — Continued. 

[Parts in 100,000.] 









c 
o 


Ammonia. 




Nitrogen 

AS — 






City or Town. 


Source. 


5 


S 2 


1 


-a 
'3 

< 


1 

o 

.40 


2 




a 

1 

K 


c 

2 


Holliston, 


Large well. 


.38 


4.23 


.0078 


.0147 


- 


- 


1.7 


.031 


Hopkinton, 


Tubular wells, . 


.00 


10.75 


.0004 


.0025 


.71 


.1600 


.0000 


4.7 


.022 


Huntington (Fire 

District). 
Kingston, 


Tubular wells, . 
Tubular wells, . 


.00 
.00 


5.75 

s.'s 


.0005 
.0006 


.0020 
.0017 


.24 
.77 


.0090 


.0000 


2.4 
1.3 


.010 
.015 


Leicester (Water Sup- 
ply District). 

Leicester (Cherry 

• Valley and Roch- 
dale Water Dis- 
trict). 

Littleton, 


Wells 

Wells 

Tubular wells, . 


.08 
.19 

.00 


5.70 

4.28 

3.90 


.0003 
.0027 

.0002 


.0028 
.0123 

.0019 


.30 
.31 

.24 


.0807 
.0103 


.0000 
.0000 


2.0 
2.0 

1.8 


.012 
.013 

.008 


Lowell, . 


Boulevard wells (tubular). 


.43 


6.87 


.0447 


.0064 


.51 


.0192 


.0003 


3.0 


.356 




Boulevard wells, filtered, . 


.05 


5.73 


.0007 


.0035 


.50 


.0351 


.0000 


2.6 


.021 


Manchester, . 


Wells 


.00 


12.22 


.0005 


.0018 


1.95 


.1400 


.0000 


4.1 


.025 


Mansfield (W a t e r 

Supply District). 
Marblehead, 


Large well. 
Inlet of filter, . 


.00 
.31 


4.87 
16.03 


.0003 
.0146 


.0014 
.0105 


.35 
1.76 


.1027 
.0094 


.0006 
.0001 


1.8 
6.3 


.007 
.228 




Outlet of filter, . 


.13 


13.58 


.0004 


.0066 


1.61 


.0107 


.0000 


6.1 


.017 




Wells 


.14 


15.33 


.0014 


.0064 


2.13 


.0117 


.0001 


6.0 


.040 


Marion, . 


Tubular wells, . 


.00 


4.93 


.0003 


.0013 


.65 


.0287 


.0001 


1.5 


.013 


Marshfield, 


Wells 


.00 


12.00 


.0008 


.0022 


3.60 


.0920 


.0000 


3.1 


.010 


Mattapoisett, . 


Tubular wells, . 


.00 


5.63 


.0002 


.0017 


.80 


.0407 


.0000 


2.2 


.0C9 


Medfield, 


Spring 


.00 


3.67 


.0002 


.0021 


.32 


.0083 


.0000 


1.5 


.013 


Medway, . 


Wells 


.00 


6.79 


.0008 


.0020 


.57 


.0327 


.0001 


2.7 


.007 


Merrimac, 


Tubular wells, . 


.00 


8.08 


.0006 


.0018 


.51 


.0150 


.0001 


3.3 


.017 


Methcen, 


Tubular wells, . 


.32 


7.75 


.0023 


.0090 


.50 


.0148 


.0000 


3.1 


.073 


Middleborough (Fire 
District). 


Well 

Filtered water, . 


.28 
.12 


7.23 
5.92 


.0092 
.0006 


.0058 
.0044 


.58 
.58 


.0277 
.0283 


.0001 
.0000 


2.5 

2.2 


.335 
.043 


Millbury, 


Well 


.00 


4.50 


.0007 


.0026 


.33 


.0147 


.0000 


1.9 


.013 


Millis, 


Spring, .... 


.00 


10.50 


.0003 


.0018 


.84 


.2833 


.0001 


4.6 


.011 


Monson, . 


Large well. 


.05 


3.43 


.0003 


.0023 


.19 


.0073 


.0000 


1.5 


.011 


Nantucket, 


Welb in Wyers Valley, 


.04 


4.32 


.0043 


.0077 


1.32 


.0050 


.0000 


0.9 


.050 


Natick, . 


Large well. 


.00 


10.08 


.0006 


.0032 


.84 


.0333 


.0000 


5.0 


.010 


Needham, 


Welb 


.01 


6.10 


.0007 


.0022 


.64 


.0760 


.0004 


3.0 


.024 


. 


Hicks Spring, . 


.00 


7.72 


.0007 


.0032 


.83 


.2667 


.0000 


2.7 


.007 


Newburyport, 
Newton, 


Wells and Artichoke River, 
filtered. 

Tubular wells and filter- 
gallery. 


.16 

.04 


6.84 
6.61 


.0010 
.0011 


.0091 
.0047 


.71 
.44 


.0207 
.0268 


.0000 
.0001 


2.9 
2.6 


.044 
.016 



64 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Averages of Chemical Analyses of Ground-water Sources, etc. — Continued. 

[Parts in 100,000.] 











o 

a 


Residue on 
Evaporation. 


Ammonia. 


.s 

2 
o 

.55 


NiTBOGEN 

AS — 


c 

1 




City ob Town. 


Sotirce. 


1 


"o 

..s 

< 


GO 

1 


8 

2 


i 


No. Attleborough, . 


Wells, 




.00 


4.62 


.0005 


.0024 


.0140 


.0001 


2.1 


.013 


Norton, . 


Tubular wells, . 






.00 


4.73 


.0005 


.0021 


.42 


.0057 


.0001 


1.4 


.015 


Norwood, 


Tubular wells, . 






.15 


8.52 


.0021 


.0064 


.56 


.0400 


.0001 


3.7 


.161 


Oak Bluffs, 


Springs, 






.00 


4.30 


.0005 


.0022 


1.01 


.0060 


.0001 


0.7 


.012 


Oxford, . 


Tubular wells, . 






.00 


5.23 


.0001 


.0021 


.36 


.0353 


.0000 


1.8 


.010 


Palmer (Bondsville), 


Tubular wells, . 






.00 


5.70 


.0006 


.0015 


.27 


.0160 


.0000 


2.6 


.012 


Pepperell, 


Tubular wells, . 






.00 


4.05 


.0000 


.0014 


.20 


.0040 


.0000 


1.5 


.017 


Provincetown, 


Tubular wells, . 






.01 


16.42 


.0005 


.0017 


7.42 


.0048 


.0000 


4.4 


.025 


Reading, . 


Filter-gallery, . 






.54 


9.25 


.0147 


.0149 


1.35 


.0100 


.0000 


2.2 


.235 




Filtered water, 






.19 


16.60 


.0006 


.0050 


.99 


.0072 


.0003 


7.1 


.065 


Salisbury, 


Well, . 






.19 


9.48 


.0008 


.0034 


.61 


.0067 


.0000 


4.2 


.059 


Scituate, . 


Tubular wells. 






.00 


14.32 


.0001 


.0014 


2.99 


.1660 


.0001 


4.9 


.009 


Sharon, . 


Well, . 






.00 


13.77 


.0003 


.0020 


2.11 


.2633 


.0001 


! 6.0 


.007 




Tubular wells. 






.03 


5.00 


.0004 


.0015 


.47 


.0230 


.0001 


2.0 


.020 


Sheffield. . 


Spring, 






.00 


4.23 


.0000 


.0010 


.12 


.0093 


.0000 


1 1.7 

1 


.005 


Shirley (Shirley Vil- 
lage VVater Dis- 


Well, . 






.00 


4.27 


.0001 


.0012 


.40 


.0930 


.0000 


1.3 


.012 


trict). 
Shrewsbury, . 


Tubular wells. 






.00 


5.42 


.0002 


.0020 


.49 


.0310 


.0000 


1.9 


.010 


South Hadley (Fu-e 

District No. 2). 
Tisbury, . 


Large well, 

Well, . 






.00 
.00 


5.50 
3.90 


.0004 
.0000 


.0014 
.0016 


.19 
1.01 


.0320 
.0070 


.0002 
.0000 


1.6 

0.8 


.005 
.004 


Uxbridge, 


Tubular wells. 






.00 


5.20 


.0001 


.0020 


.55 


.0680 


.0000 


1.9 


.007 


Walpole, . 


Tubular wells. 






.00 


4.80 


.0003 


.0014 


.48 


.0233 


.0000 


1.8 


.018 


Waltham, 


Old well, . 






.15 


8.95 


.0046 


.0037 


.78 


.0154 


.0000 


4.2 


.066 




New well, . 






.00 


7.45 


.0006 


.0036 


.57 


.0142 


.0000 


i ^'^ 


.010 


Ware, 


Wells, 






.00 


7.57 


.0002 


.0015 


.56 


.1750 


.0001 


; 2.9 


.016 


Wareham (Fire Dis- 


Tubular wells. 






.00 


3.55 


.0002 


.0008 


.63 


.0030 


.0000 


0.7 


.007 


trict). 
Webster, . 


Wells, 






.00 


4.03 


.0003 


.0018 


.34 


.0133 


.0000 


2.0 


.014 


Wellesley, 


Tubular wells, 






.00 


10.38 


.0020 


.0023 


1.15 


.0883 


.0000 


4.3 


.017 




Well at Williams 


Spr 


ng, . 


.22 


17.70 


.0015 


.0029 


1.37 


.6900 


.0001 


6.0 


.014 




Filter-gallery, 






.00 


8.75 


.0017 


.0037 


.99 


.1007 


.0000 


4.3 


.009 


West borough, . 


Filter basin, 






.00 


3.30 


.0018 


.0079 


.29 


- 


- 


0.9 


.016 


West Brookfield, . 


Tubular wells. 






.00 


5.53 


.0004 


.0015 


.29 


.0713 


.0000 


1.2 


.010 


Westford, 


Tubular wells. 






.00 


4.65 


.0002 

1 


.0017 


.19 


.0075 


.0000 


2.3 


.005 

1 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



65 



Averages of Chemical Analyses of Ground-water Sources, etc. — Concluded. 

[Parts in 100,000.] 





Source. 


o 


a 
o 


Ammonia. 


6 

s 

o 


Nitrogen 

AS — 


o 

c 




City or Town. 


8 


■0 
'o 

..s 

IB 


1 


CO 


c 
o 


Weston, . 


Well 


.26 


7.05 


.0007 


.0079 


.52 


.0120 


.0000 


2.7 


.015 


Winchendon, . 


Old well 


.11 


4.20 


.0017 


.0024 


.18 


.0073 


.0000 


1.1 


.118 




New well, 


.01 


3.22 


.0009 


.0024 


.16 


.0065 


.0000 


1.1 


.007 


WOBTJRN, 


Filter-gallery, . 


.00 


11.53 


.0006 


.0047 


1.36 


.0370 


.0000 


5.3 


.008 


Worthington (Fire 

District) . 
Wrentham, 


Springs, .... 
Tubular wells, . 


.01 
.00 


2.77 
4.25 


.0004 
.0001 


.0033 
.0014 


.13 
.32 


.0080 
.0210 


.0000 
.0000 


1.5 

1.4 


.026 
.007 



Comparison of Water Supplies of the State by Chemical 

Analysis. 

A comparison of the different water supplies of the State by chemi- 
cal analysis furnishes much information of interest and value as to the 
general characteristics of the supplies now in use. In most places the 
supplies are satisfactory, and those which are least desirable have not 
yet become sufficiently unsatisfactory, at least from the consumer's 
point of view, to lead to a change. 

A comparison of the physical characteristics of the various sources 
of water supply of the State shows wide differences in the character- 
istics of w^aters which are in daily use often in adjacent communities. 
All waters, whether from lakes, ponds and streams or from springs or 
wells, have a common origin in the rainfall, yet there are such essential 
differences in character between surface waters and ground waters that 
in any attempt to compare the water supplies of the State it is im- 
portant to consider these two classes separately. The waters of 
running streams under normal conditions contain but little organic 
life. Streams which drain swamps and areas of meadow lands, in 
which much of the water is in contact for considerable periods with 
decaying vegetation, grasses, leaves, soil and other organic matter, are 
often highly colored and contain a great amount of organic matter, 
commonly, however, carried for the most part in solution, so that 
these waters, though highly colored, are often nearly or quite clear. 
In the winter, and especially in the spring, the waters of the streams 
are made up very largely of rain and melting snow, and the color and 



66 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

organic matter are less than at other seasons. In hilly or mountain- 
ous regions or in valleys where the soil is composed largely of sand 
and gravel, surface waters are often clear and colorless and especially 
in the drier part of the year contain but little organic matter and 
differ but little from ground waters of which, in fact, they largely 
consist. Ground waters, that is the waters of springs, wells and filter 
galleries, are usually clear, colorless and free from odor and contain 
little or no organic matter, though they may contain greater or less 
amounts of mineral matter, depending upon the character of the soil 
and rocks over which they pass. While most ground waters are clear, 
colorless and practically free from organic or suspended matter, some 
of them are affected by excessive quantities of iron or manganese, and, 
though they may be clear and colorless when drawn from the ground, 
quickly become turbid and colored, due to the oxidation of the mineral 
matter they contain which accumulates in the form of a sediment. 
The storage of water in ponds and reservoirs affords conditions favor- 
able to the growth of vegetable and animal organisms which, in some 
of the ponds and in reservoirs not properly prepared for the storage of 
water, at times develop to such an extent as to give the water a de- 
cided turbidity and an objectionable taste and odor. In some parts of 
the State, chiefly in Berkshire County, the waters are affected by an 
excessive amount of mineral matter due to limestone. 

In the following tables are presented the analyses of all of the sur- 
face and ground water supplies in use in the State, including possible 
auxiliaries, which were examined during the five years from 1915 to 
1919, inclusive. In the case of most of these waters the figures repre- 
sent averages of from 30 to 60 analyses made at regular intervals of 
one or two months. In a few cases the samples have been fewer and 
represent longer intervals, but in all as often as once in three months, 
and in a few other cases samples have been collected at intervals of 
two weeks or even less. The use of some of these sources was begun 
subsequent to 1915, and the examinations consequently cover a shorter 
period than the five years mentioned, but these cases are indicated by 
footnotes. 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



6; 



Surface Water Sources. 
Averages of Chemical Analyses from 1915 to 1919, inclusive. 

[Parts in 100,000.] 





Source. 




1 

a 

w 

a 
o 


Ammonia. 










ALBUMINOID. 




City or Town. 






05 






g 

§ 


2 a 
.3 2 

0) t. 


1 


i 

o 


a 
o 
0. 

§ 


6 

3 
O 




Metropolitan Water 
District. 


Wachusett Reservoir, upper end, 
Wachusett Reservoir, lower end, 


.30 
.14 


3.80 
3.30 


.0023 
.0023 


.0155 
.0128 


.0024 
.0019 


.29 
.29 


1.1 

1.0 




Sudbury Reservoir, . 


.17 


3.87 


.0028 


.0158 


.0029 


.33 


1.3 




Framingham Reservoir No. 3, . 


.17 


3.81 


.0036 


.0171 


.0034 


.34 


1.3 




Hopkinton Reservoir, 


.63 


4.37 


.0031 


.0223 


.0026 


.39 


1.2 




Ashland Reservoir, . 


.64 


4.57 


.0032 


.0248 


.0029 


.36 


1.3 




Framingham Reservoir No. 2, . 


.79 


5.30 


.0055 


.0275 


.0035 


.46 


1.4 




Lake Cochituate, 


.20 


6.44 


.0045 


.0249 


.0058 


.70 


2.5 




Chestnut Hill Reservoir, . 


.17 


3.79 


.0023 


.0149 


.0027 


.34 


1.4 




Weston Reservoir, 


.16 


3.87 


.0026 


.0155 


.0027 


.33 


1.3 




Spot Pond, 


.08 


3.78 


.0021 


.0160 


.0027 


.36 


1.4 




Tap in State House, . 


.17 


4.16 


.0015 


.0144 


.0023 


.35 


1.4 




Tap in Revere 


.09 


3.84 


.0014 


.0140 


.0019 


.35 


1.4 




Tap in Quincy 


.15 


3.89 


.0010 


.0121 


.0015 


.36 


1.4 


Abington, 


Big Sandy Pond, 


.09 


3.74 


.0032 


.0149 


.0021 


.73 


0.9 


Adams (Fire Dis- 
trict). 


Bassett Brook, .... 
Dry Brook, .... 


.02 
.22 


4.01 
6.80 


.0016 
.0021 


.0048 
.0109 


.0007 
.0016 


.11 
.13 


2.4 
4.9 


Amherst , 


Amethyst Brook small reservoir, 


.21 


3.40 


.0037 


.0128 


.0025 


.18 


0.7 




Amethyst Brook large reservoir, 


.49 


3.72 


.0026 


.0152 


.0029 


.17 


0.8 


Andover, 


Haggett's Pond 


.15 


4.25 


.0031 


.0180 


.0026 


.39 


1.5 


Ashburnham, 


Upper Naukeag Lake, 


.07 


2.52 


.0013 


.0090 


.0010 


.16 


0.5 


Ashfield, 


Bear Swamp Brook, . 


.30 


5.54 


.0025 


.0125 


.0013 


.14 


2.7 


Athol, . 


Phillipston Reservoir, 


.61 


4.32 


.0115 


.0377 


.0123 


.20 


1.0 




Buckman Brook Reservoir, 


.25 


3.56 


.0057 


.0224 


.0065 


.15 


0.8 




Inlet of filter 


.53 


4.33 


.0074 


.0273 


.0068 


.16 


1.1 




Outlet of filter 


.49 


4.42 


.0051 


.0213 


- 


.17 


1.2 


Barre, 


Reservoir, . . . . 


.16 


3.83 


.0049 


.0184 


.0033 


.22 


1.3 


Blandford (Fire Dis- 
trict). 
Brockton, 


Freeland Brook 


.07 


3.56 


.0005 


.0047 


.0005 


.21 


1.4 


Silver Lake 


.11 


3.48 


.0029 


.0140 


.0030 


.64 


0.8 


Cambridge, . 


Lower Hobbs Brook Reservoir, . 


.16 


6.39 


.0054 


.0252 


.0037 


.51 


2.5 




Stony Brook Reservoir, 


.45 


6.73 


.0049 


.0259 


.0042 


.59 


2.5 



68 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Averages of Chemical Analyses from 1915 to 1919, inclusive — Continued. 

[Parts in 100,000.] 





Source. 




i 

1 

G 
o 
a) C 


Ammonia. 


6 

a 

1 

o 








ALBUMINOID. 




City ob Town. 




-a 

<D 


i 






o 

6 


^1 

CO d 


6 


"3 

f2 




s 
■a 

u 

a 


Cambridge — Core. 


Fresh Pond, .... 


.27 


6.94 


.0092 


.0289 


.0084 


.65 


2.9 


Cheshire, 


Thunder Brook, .... 


.01 


6.87 


.0006 


.0044 


.0006 


.12 


5.8 




Kitchen Brook, .... 


.01 


6.04 


.0010 


.0041 


.0005 


.11 


4.7 


Chester (Fire Dis- 
trict). 
Chicopee, 


Austin Brook Reservoir, . 


.11 


3.78 


.0023 


.0141 


.0034 


.15 


1.71 


Cooley Brook, .... 


.66 


4.28 


.0055 


.0159 


.0037 


.17 


1.3 




Morton Brook, .... 


.07 


4.05 


.0012 


.0051 


.0008 


.17 


1.0 


Colrain (Griswold- 

ville). 
Concord, 


McClellan Reservoir, . 


.05 


7.02 


.0031 


.0078 


.0007 


.14 


4.3 


Nagog Pond, .... 


.06 


2.79 


.0021 


.0137 


.0015 


.37 


0.8 


Dalton (Fire Dis- 
trict). 


Egypt Brook Reservoir, 


.26 


3.25 


.0028 


.0126 


.0022 


.12 


1.5 


Cady Brook 


.30 


4.73 


.0014 


.0134 


.0012 


.11 


2.2 


Danvers, 


Middleton Pond, 


.53 


5.39 


.0034 


.0230 


.0030 


.44 


1.8 


Deerfield (South 
Deerfield Water 
Supply District). 

Egremont (South), 


Roaring Brook, .... 
Goodale Brook 


.10 

.02 


6.54 
4.52 


.0011 
.0003 


.0061 
.0029 


.0008 
.0002 


.17 
.12 


5.7 

2.6 


Fall Rivek, . 


North Watuppa Lake, 


.15 


4.32 


.0028 


.0193 


.0032 


.63 


1.0 


Falmouth, 


Long Pond, .... 


.01 


3.71 


.0024 


.0120 


.0015 


1.04 


0.4 


FiTCHBTJRG, . 


Meetinghouse Pond, . 


.09 


3.11 


.0050 


.0165 


.0023 


.20 


1.0 




Scott Reservoir, .... 


.14 


3.17 


.0075 


.0182 


.0046 


.23 


0.7 




Wachusett Lake, 


.10 


2.88 


.0051 


.0163 


.0025 


.19 


0.8 




Falulah Brook, .... 


.22 


3.27 


.0057 


.0168 


.0035 


.21 


0.6 




Ashby Reservoir, 


.65 


3.84 


.0165 


.0304 


.0062 


.20 


0.71 


Gardner, 


Crystal Lake, .... 


.09 


4.73 


.0026 


.0156 


.0027 


.31 


1.9 


Gloucester, . 


Dike's Brook Reservoir, 


.32 


4.12 


.0039 


.0164 


.0023 


.84 


0.4 




Wallace Reservoir, 


.52 


4.69 


.0039 


.0216 


.0049 


.97 


0.5 




Haskell Brook Reservoir, . 


.27 


4.25 


.0025 


.0142 


.0027 


.86 


0.5 


Great Barrington 

(Fire District). 


East Mountain Rejervoir, . 
Green River, .... 


.12 
.00 


5.87 
10.00 


.0061 
.0012 


.0120 
.0043 


.0027 
.0005 


.13 
.14 


3.7 

7.91 


Great Barrington 
(Housatonic). 

Greenfield Fire Dis- 
trict No. 1). 

Hadley (Water Sup- 
ply District). 

Hatfield, 


Long Pond, .... 


.07 


8.83 


.0044 


.0201 


.0027 


.14 


6.2 


Glen Brook Lower Reservoir, . 
Hart's Brook Reservoir, 
Running Gutter Brook Reservoir, 


.03 
.08 
.10 


5.52 
4.30 
4.79 


.0024 
.0015 
.0029 


.0078 
.0058 
.0071 


.0016 
.0010 
.0010 


.17 
.19 
.21 


3.2 

i.gi 

2.3 


Haverhill, . 


Johnson's Pond 


.16 


5.27 


.0025 


.0192 


.0020 


.50 


2.3 




Crystal Lake 


.19 


4.06 


.0026 


.0208 


.0033 


.38 


1.4 



1 Average of foiu- years. 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



69 



Averages of Chemical Analyses from 1915 to 1919, inclusive — Continued. 

[Parts in 100,000.] 











a. 

03 
> 

§ 


Ammonia. 


6 

1 
O 






Source. 


£ 


albuminoid. 




City or Town. 


"3 


a 

3 


c 
-a 


Haverhill— Core. . 


Kenoza Lake, .... 


.20 


5.23 


.0027 


.0207 


.0030 


.46 


2.2 




Lake Saltonstall, 




.10 


6.59 


.0048 


.0193 


0029 


.65 


3.0 




Pentucket Lake, 




.17 


5.26 


.0029 


.0205 


.0035 


.49 


2.2 




Millvale Reservoir, 




.59 


6.21 


.0042 


.0246 


.0044 


.40 


2.3 


Hingham, 


Accord Pond, 




.23 


3.93 


.0024 


.0162 


.0024 


.66 


0.7 


Hinsdale (Fire Dis- 
trict). 

HOLTOKE, 


Reservoir, . 

Whiting Street Reservoir, 




.22 
.09 


2.70 
5.02 


.0040 
.0048 


.0136 
.0161 


.0023 
.0025 


.10 
.22 


0.7 
2.6 




Fomer Reservoir, 




.33 


4.19 


.0031 


.0145 


.0024 


.16 


1.4 




Wright and Ashley Pond, 




.12 


5.33 


.0048 


.0173 


.0031 


.18 


2.6 




High Service Reservoir, 




.12 


4.26 


.0055 


.0193 


.0032 


.19 


1.7 




White Reservoir, 




.26 


3.90 


.0085 


.0203 


.0047 


.15 


1.5 


Hudson, 


Gates Pond, 




.08 


3.63 


.00.34 


.0178 


.0030 


.27 


1.5 


Huntington (Fire 

District). 
Ipswich, . 


Cold Brook Reservoir, 




.17 


3.08 


.0006 


.0073 


.0009 


.15 


1.31 


Dow's Brook Reservoir, 




.29 


5.87 


.0041 


.0197 


.0031 


.80 


2.0 


Lawrence, . 


Merrimack River, filtered. 


.34 


5.91 


.0051 


.0082 


- 


.45 


1.4 


Lee. . . . 


Codding Brook Upper Reservoir, 


.13 


4.51 


.0028 


.0087 


.0010 


.12 


2.0 




Codding Brook Lower Reservoir, 


.12 


4.52 


.0016 


.0084 


.0011 


.12 


2.6 




Basin Pond Brook, 


.59 


4.54 


.0028 


.0187 


.0028 


.11 


1.5 


Lenox, . 


Reservoir, . 




.06 


7.46 


.0016 


.0073 


.0010 


.11 


5.7 


Leomixster, . 


Morse Reservoir, 




.21 


2.99 


.0081 


.0228 


.0050 


.19 


0.4 




Haynes Reservoir, 




.29 


3.12 


.0228 


.0403 


.0141 


.18 


0.4 




Fall Brook Reservoir, 




.13 


2.69 


.0032 


.0150 


.0029 


.21 


0.6 


Lincoln, . 


Sandy Pond, 




.09 


4.21 


.0049 


.0166 


.0033 


.39 


1.5 


Longmeadow, 


Cooley Brook, 




.09 


5.31 


.0040 


.0069 


.0016 


.25 


2.4! 


Lynn, . 


Birch Reservoir, 




.22 


5.26 


.0081 


.0226 


.0036 


.73 


1.9 




Breed's Reservoir, 




.37 


5.95 


.0095 


.0269 


.0046 


.73 


2.1 




Walden Reservoir, 




.47 


6.45 


.0076 


.0240 


.0036 


.78 


2.3 




Hawkes Reservoir, 




.58 


6.95 


.0088 


.0302 


.0050 


.81 


2.7 


Manchester, . 


Gravel Pond, 




.13 


4.65 


.0050 


.0158 


.0022 


.90 


1.1 


Marlborough, 


Lake Williams, . 




.13 


5.19 


.0035 


.0193 


.0023 


.56 


1.8 




Milham Brook Reservoir, 




.52 


5.45 


.0062 


.0256 


.0045 


.44 


1.6 


Maynard, 


White Pond, 




.28 


3.55 


.0011 


.0142 


.0019 


.29 


1.0 



1 Average of three years. 



- Average of four years. 



70 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Averages of Chemical Analyses from 1915 to 1919, 


inclusive — 


Continued 


• 




[Parts in 100,000.] 












Source. 


u 

o 

a 


i 

> 

W 
a 
o 

S c 


Ammonia. 


o 

c 

1 

O 






1 


albuminoid. 




City or Town. 


"3 

e2 


•6 

a 

to 




Milford, . 


Charles River, filtered. 


.22 


5.86 


.0011 


.0074 


- 


.37 


2.5 


Montague, i . 


Lake Pleasant, . 




.05 


2.88 


.0019 


.0111 


.0028 


.16 


0.8 


Nantucket, 2 . 


Wannacomet Pond, . 




.10 


7.12 


.0037 


.0175 


.0053 


2.24 


1.5 


New Bedford, 


Little Quittacas Pond, 




.39 


4.29 


.0044 


.0222 


.0029 


.58 


1.0 




Great Quittacas Pond, 




.50 


4.30 


.0036 


.0225 


.0030 


.57 


0.9 


North Adams, 


Notch Brook Reservoir, 




.06 


7.22 


.0021 


.0060 


.0010 


.09 


5.8 




Beaman Reservoir, 




.05 


7.18 


.0030 


.0102 


.0020 


.10 


4.9 


Northampton, 


Middle Reservoir, 




.23 


4.29 


.0023 


.0139 


.0025 


.17 


1.7 




Mountain Street Reservoir, 




.09 


4.05 


.0017 


.0089 


.0016 


.14 


1.8 


North Andover, 


Great Pond, 




.16 


5.09 


.0030 


.0190 


.0020 


.48 


1.9 


Northborough, 


Lower Reservoir, 




.75 


4.61 


.0054 


.0280 


.0052 


.32 


1.2 




LTpper Reservoir, 




.86 


5.35 


.0067 


.0293 


.0060 


.34 


1 33 


Northbridge, . 


Cook Allen Reservoir, 




.10 


3.21 


.0027 


.0083 


.0014 


.23 


0.7 


North Brookfield, . 


Doane Pond, 




.43 


3.69 


.0078 


.0331 


.0082 


.19 


1.1 




North Pond, 




.48 


3.56 


.0060 


.0365 


.0120 


.19 


0.9 


Northfield, . 


Reservoir, . 




.23 


3.67 


.0007 


.0079 


.0006 


.14 


1.2 


Orange, . 


Reservoir, . 




.10 


3.22 


.0010 


.0050 


.0004 


.13 


1.0 


Palmer (Fire Dis- 
trict No. 1). 
Peabody, 


Lower Reservoir, 
Spring Pond, 




.25 
.29 


3.58 
6.32 


.0070 
.0109 


.0148 
.0225 


.0031 
.0051 


.19 
.80 


1.0 
2.4 




Suntaug Lake, . 




.06 


5.49 


.0082 


.0203 


.0032 


1.08 


2.8< 


Pittsfield, . 


Ashley Brook, 




.20 


5.92 


.0039 


.0138 


.0016 


.11 


3.8 




Hathaway Brook, 




.05 


9.09 


.0016 


.0066 


.0011 


.13 


7.3 




Sacket Brook, 




.13 


6.73 


.0017 


.0069 


.0007 


.12 


5.5 




Farnham Reservoir, . 




.58 


4.81 


.0040 


.0213 


.0030 


.12 


1.8 


Plymouth, 


Little South Pond, 




.02 


2.85 


.0030 


.0209 


.0032 


.68 


0.3 


/ 


Great South Pond, 




.01 


2.95 


.0034 


.0172 


.0024 


.69 


0.2 


Randolph, 


Great Pond, 




.41 


4.81 


.0023 


.0179 


.0021 


.66 


1.2 


Rockport, 


Cape Pond, 




.38 


11.88 


.0100 


.0299 


.0084 


4.47 


2.2 


Russell, . 


Black Brook, 




.20 


3.87 


.0008 


.0095 


.0012 


.16 


1.5 


Rutland, 


Muschopauge Lake, . 




.06 


2.86 


.0017 


.0131 


.0026 


.32 


1.0 



> Supply for Turner's Falls Fire District, Millers Falls Water Supply District and Lake Pleasant Water 
Supply District. 

2 Not including Siasconset supply. ' Average of tliree years. 



< Average of four years. 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



71 



Averages of Chemical Analyses from 1915 to 1919, inclusive — Concluded. 

[Parts in 100,000.] 









o 

6 


a 

> 

c 
o 

i-B 


Ammonia. 


d 
'u, 

o 






Source. 


6 


albuminoid. 




City or Town. 


e2 


C 
ft 


a 

a 

1 


Salem, . 


Wenham Lake, .... 


.36 


7.45 


.0115 


.0263 


.0061 


.97 


2.5 




Longham Reservoir, . 


1.31 


7.84 


.0190 


.0452 


.0114 


.96 


1.9 


Shelburne (Shel- 
burne Falls Fire 
District). 

Southbridge, . 


Fox Brook 

Hatchet Brook Reservoir No. 3, 


.05 

.22 


5.50 
3.27 


.0004 
.0039 


.0048 
.0178 


.0005 
.0032 


.11 

.20 


3.2 
0.8 




Hatchet Brook Reservoir No. 4, 


.24 


3.07 


.0053 


.0205 


.0038 


.20 


0.7 


South Hadley (Fire 
District No. 1). 


Leaping Well Reservoir, 
Buttery Brook Reservoir, . 


.08 
.12 


3.37 
4.47 


.0063 
.0070 


.0192 
.0106 


.0079 
.0023 


.20 
.33 


0.9 
1,1 


Spencer, . 


Shaw Pond, .... 


.07 


2.71 


.0017 


.0151 


.0015 


.21 


1.0 


Springfield, . 


VVestfield Little River, filtered, . 


.19 


3.79 


.0011 


.0082 


- 


.15 


1.3 


Stockbridge, . 


Lake Averic, .... 


.12 


7.52 


.0020 


.0176 


.0031 


.11 


5.2 


Stoughton, 


Muddy Pond Brook, . 


.19 


3.90 


.0007 


.0089 


.0018 


.40 


1.0 


Taunton, 


Assawompsett Pond, . 


.30 


4.15 


.0040 


.0197 


.0029 


.55 


0.8 




Elder's Pond 


.13 


3.81 


.0043 


.0188 


.0026 


.55 


0.8 


Wakefield, 


Crystal Lake 


.23 


5.98 


.0100 


.0251 


.0035 


.84 


2.0 


Wareham (Onset), . 


Jonathan Pond, .... 


.02 


2.59 


.0011 


.0096 


.0013 


.67 


0.4 


Wayland, 


Snake Brook Reservoir, 


.87 


5.48 


.0091 


.0336 


.0046 


.38 


1.6 


VVestfield, . 


Montgomery Reservoir, 


.44 


3.31 


.0048 


.0183 


.0026 


.15 


0.6 




Tillotson Brook Reservoir, 


.14 


3.23 


.0023 


.0082 


.0012 


.17 


0.7 


West Springfield, . 


Bear Hole Brook, filtered, . 


.06 


7.96 


.0018 


.0055 


- 


.21 


4.3 


Weymouth, 


Great Pond, .... 


.79 


4.15 


.0044 


.0204 


.0025 


.52 


0.8 


Williamsburg, 


Reservoir, . 




.14 


4.44 


.0013 


.0090 


.0014 


.15 


1.9 


Williamstown, 


Reservoirs, . 




.04 


8.08 


.0012 


.0108 


.0050 


.10 


6.2 


Winchester, . 


North Reservoir, 




.08 


3.93 


.0038 


.0159 


.0025 


.44 


1.5 




South Reservoir, 




.08 


3.73 


.0044 


.0158 


.0029 


.41 


1.5 




Middle Reservoir, 




.15 


3.62 


.0047 


.0235 


.0045 


.42 


1.3 


Worcester, . 


Bottomly Reservoir, 




.27 


4.64 


.0048 


.0194 


.0026 


.24 


1.6 




Kent Reservoir, . 




.23 


4.21 


.0031 


.0174 


.0031 


.27 


1.5 




Leicester Reservoir, 




.18 


3.92 


.0052 


.0172 


.0022 


.24 


1.2 




Mann Reservoir, 




.18 


4.33 


.0031 


.0163 


.0022 


.24 


1.6 




Upper Holden Reservoir, . 


.15 


3.24 


.0021 


.0114 


.0018 


.24 


0.9 




Lower Holden Reservoir, . 


.13 


3.13 


.0030 


.0131 


.0017 


.23 


0.9 




Kendall Reservoir, 


.22 


4.05 


.0037 


.0166 


.0029 


.26 


1.2 



72 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Gkound Water Sources. 
Averages of Chemical Analyses from 1915 to 1919, inclusive. 





[Parts in 


100,000.] 


















Source. 


o 

6 


o 

o S 
o 0. 


Ammonia. 


6 

a 

O 
.69 

.57 


Nitrogen 

AS — 


a 




City or Town. 


6 


Albu- 
minoid. 


01 


o 

'B 
2 


o 


Acton (West and 
South Water Sup- 
ply District). 

Amesbury, 


Tubular wells, . 
Tubular wells, . 


.00 
.23 


9.13 
16.48 


.0005 
.0027 


.0020 
.0044 


.1500 


.0001 


3.6 
9.0 


.006 
.194 


Ashland, . 


Tubular wells, old supply, 


.00 


4.51 


.0006 


.0020 


.41 


- 


- 


1.4 


.007 


Attlebobo, . 


Large well. 


.05 


5.15 


.0005 


.0053 


.58 


.0163 


.0000 


1.9 


.010 


Avon, 


Wells 


.00 


6.76 


.0008 


.0025 


.56 


.1984 


.0000 


2.3 


.007 


Ayer, 


Large well. 


.01 


6.79 


.0005 


.0028 


.64 


.0542 


.0000 


2.7 


.010 




Tubular wells, . 


.02 


5.99 


.0005 


.0021 


.28 


.0090 


.0001 


2.5 


.017 


Barnstable, 


Tubtilar wells, . 


.00 


4.41 


.0007 


.0020 


1.16 


- 


- 


0.7 


.012 


Bedford, . 


Large well. 


.05 


4.44 


.0007 


.0034 


.36 


- 


- 


1.7 


.021 


Billerica, . 


Old wells 


.19 


7.62 


.0017 


.0064 


.47 


- 


- 


2.7 


.098 




New wells 


.13 


7.80 


.0013 


.0050 


.41 


- 


- 


3.1 


.0691 


Braintree, 


Filter-gallery, . 


.27 


9.02 


.0018 


.0139 


1.13 


.1564 


.0000 


2.7 


.024 


Bridgewater, . 


Wells 


.01 


5.64 


.0007 


.0021 


.67 


.0309 


.0002 


1.7 


.029 


Brookfield (East), . 


Tubular wells, . 


.00 


3.32 


.0004 


.0016 


.23 


- 


- 


0.7 


.008 


Brookline, 
Canton, . 


Tubular wells and filter- 
gallery, filtered. 
Springdale well. 


.17 
.03 


9.25 
4.56 


.0007 
.0004 


.0079 
.0034 


.79 
.46 


.0294 
.0115 


.0000 
.0000 


4.3 
1.4 


.0141 
.008 = 




Well near Henry's Spring, 


.10 


5.17 


.0005 


.0042 


.55 


.0264 


.0000 


1.6 


.008 


Chelmsford (North 
Chelmsford Fire 
District). 

Chelmsford (Water 
District). 

Chicopee (Fairview), 


Tubular wells, . 

Tubular wells, . 
Tubular wells, . 


.11 

.00 
.04 


5.09 

8.21 
5.21 


.0121 

.0005 
.0004 


.0086 

.0015 
.0017 


.48 

.65 
.23 


.0427 

.1275 
.0562 


.0001 

.0002 
.0002 


1.9 

2.9 
1.5 


.017 

.008 
.030 


Cohasset, 


Tubular wells, . 


.10 


14.19 


.0007 


.0076 


1.96 


.1422 


.0001 


5.4 


.011 




Dug well, filtered, . 


.38 


9.00 


.0017 


.0127 


1.30 


.0060 


.0000 


2.9 


.035 


Dedham, 

Deerfield (Fire Dis- 


Large well and tubular 

wells. 
Tubular wells, . 


.06 
.00 


10.19 
5.17 


.0016 
.0004 


.0059 
.0027 


1.08 
.15 


.1178 


.0001 


4.2 
2.6 


.008 

.0102 


trict). 
Douglas, . 


Tubular wells, . 


.01 


4.88 


.0005 


.0017 


.39 


.0433 


.0000 


1.7 


.063 


Dracut (Water Sup- 


Tubular wells, . 


.00 


8.29 


.0004 


.0016 


.56 


.0857 


.0000 


3.9 


.011 


ply District). 
Dracut (Collins- 

ville). 
Dudley, . 


Tubular wells, . 
Tubular wells, . 


.05 
.00 


6.41 
3.58 


.0005 
.0003 


.0053 
.0020 


.37 
.25 


.0225 


.0000 


2.5 
1.1 


.024 
.005 


Duxbiiry (Fire and 

Water District). 
Easthampton, 


Tubular wells, . 
Tubular wells, . 


.00 
.00 


4.36 
7.21 


.0004 
.0003 


.0017 
.0013 


.86 
.16 


.0150 
.0240 


.0000 
.0000 


0.6 
3.9 


.006 
.007 



1 Average of three years. 



- Average of four years. 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



73 



Averages of Chemical Analyses from 1915 to 1919, inclusive — Continued. 





[Parts in 100,000.] 


















Source. 




c 

1%. 
It 


Ammonia. 


d 
c 
'u 
O 

o 

.60 
.96 


Nitrogen 

AS — 


i 

o 

a 
-a 




City or Town. 


1 


-d 
.1 

< 


in 
o 

s 


OQ 


1 


Easton (North 
Easton Village Dis- 
trict). 

Edgarto-vvn, 


Well, 

Large well, 


.00 
.00 


4.99 
3.19 


.0004 
.0003 


.0022 
.0015 


.0464 


.0000 


1.7 
0.3 


.008 
.005 


Fairhaven, 


Tubular wells, . 


.42 


8.09 


.0017 


.0115 


1.04 


.0726 


.0000 


2.6 


.014 


Foxborough (Water 

Supply District). 
Framingham, . 


Tubular wells, . 
North filter-gallery, . 


.00 
.02 


4.97 
11.56 


.0006 
.0117 


.0018 
.0069 


.50 
1.74 


.0408 
.0152 


.0000 
.0003 


1.7 
5.3 


.013 
.0141 




South filter-gallery, . 


.02 


12.36 


.0310 


.0077 


2.00 


.0228 


.0006 


5.3 


.006' 


Franklin, 


Tubular wells, . 


.00 


5.26 


.0005 


.0020 


.58 


.0317 


.0000 


1.8 


.008 


Grafton, . 


Filter-gallery, . 


.06 


12.61 


.0009 


.0044 


1.68 


.1802 


.0000 


4.8 


.021 


Granville, 


Well 


.02 


4.15 


.0004 


.0028 


.16 


- 


- 


1.8 


.013 


Groton, . 


Large well. 


.00 


6.41 


.0004 


.0028 


.24 


.0019 


.0000 


3.1 


.011 


Groton (West Groton 
Water Supply Dis- 
trict). 

Hingham, 


Tubular wells . 

Wells 


.00 
.36 


4.83 
6.30 


.0004 
.0064 


.0016 
.0111 


.19 

.78 


.0118 
.02C4 


.0000 
.0002 


2.8 
1.8 


.010 
.019 


HoUiston, 


Large well, 


.50 


5.12 


.0030 


.0179 


.41 


.0056 


.0000 


1.4 


.102 


Hopkinton, 


Tubular wells, . 


.00 


13.16 


.0009 


.0029 


1.15 


.2793 


.0001 


5.4 


.018 


Kingston, 


Tubular wells, . 


.00 


4.72 


.0005 


.0018 


.74 


- 


- 


1.1 


.010 


Leicester (Water 
Supply District). 

Leicester (Cherry 
Valley and Roch- 
dale Water Dis- 
trict). 

Littleton, 


Wells 

Wells, .' . 

Tubular wells, . 


.14 
.13 

.00 


6.41 
5.17 

4.39 


.0015 
.0054 

.0003 


.0062 
.0082 

.0016 


.37 
.31 

.22 


.0174 


.0000 


2.2 
2.2 

1.7 


.031 
.009 

.006 = 


Lowell, . 


Boulevard wells (tubular), 


.45 


6.96 


.0427 


.0073 


.43 


.0222 


.0001 


2.8 


.278 




Boulevard welb, filtered, . 


.08 


6.55 


.0007 


.0052 


.45 


.0398 


.0000 


2.5 


.0181 


Manchester, 


Wells 


.00 


12.15 


.0003 


.0016 


2.01 


.1523 


.0000 


4.0 


.015 


Mansfield (Water 

Supply District). 
Marion, . 


Large well. 
Tubular wells, . 


.00 
.00 


4.41 
4.52 


.0006 
.0003 


.0019 
.0017 


.45 
.73 


.0550 
.0286 


.0000 
.0000 


1.6 
1.2 


.007 
.007 


Marshfield, 


Wells 


.00 


29.42 


.0004 


.0023 


10.51 


.1030 


.0001 


6.4 


.0242 


Mattapoisett, . 


Tubular wells, . 


.00 


6.53 


.0005 


.0020 


.96 


.0464 


.0000 


2.2 


.007 


Medfield, 


Spring 


.00 


4.15 


.0005 


.0036 


.37 


.0088 


.0000 


1.4 


.009 


Medway. . 


Wells 


.01 


7.28 


.0005 


.0022 


.60 


.0445 


.0000 


2.9 


.009 


Merrimac, 


Tubular wells, . 


.00 


6.89 


.0005 


.0019 


.54 


.0152 


.0000 


2.8 


.012 


Methuen, 


Tubular wells, . 


.32 


7.73 


.0024 


.0098 


.48 


.0160 


.0000 


3.0 


.086 


Middleborough (Fire 
District). 


Well 


.39 


7.42 


.0066 


.0083 


.67 


.0336 


.0001 


2.5 


.360 



1 Average of three years. 



2 Average of four years. 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Averages of Chemical Analyses from 1915 to 1919, indvsive — Continued. 

[Parts in 100,000.] 











Ammonia. 




Nitrogen 

AS — 






City or Town. 


Source. 


'o 


o g 

o 




•6 
'o 

ii 


o 
a 

'u 

2 


CO 

o 

1 


..2 

U 


o 

•5 

03 


o 






o 


tf 


£ 


< 


.67 


z 


z 


ffi 


A 


Middleborough (Fire 


Filtered water, . 


.10 


6.41 


.0005 


.0051 


.0331 


.0000 


2.4 


.028 


District) — Con. . 


























Millbury, 


Well, . 






.02 4.53 


.0009 


.0040 


.34 


.0125 


.0000 


1.7 


.019 


Millis, 


Spring, 






.00 10.23 


.0004 


.0016 


.80 


.2285 


.0000 


4.2 


.006 


Monson, . 


Large well. 






.07 


3.57 


.0004 


.0035 


.20 


- 


- 


0.9 


.009 


Natick, . 


Large well. 






.00 


9.59 


.0006 


.0030 


.82 


.0274 


.0000 


4.6 


.006 


Needham, 


Wells, 






.01 


6.98 


.0004 


.0026 


.73 


.1004 


.0000 


2.6 


.0141 




Hicks Spring, 






.02 


7.35 


.0008 


.0035 


.79 


.1610 


.0000 


2.3 


.007 


Newburyport, 


Wells and Artichoke River, 
filtered. 


.19 


7.30 


.0036 


.0133 


.73 


.0194 


.0000 


2.9 


.044> 


Newton, 


Tubular wells and filter- 
gallery. 
Wells 


.02 


6.71 


.0006 


.0037 


.53 


.0433 


.0001 


2.7 


.008 


North Attleborough, 


.01 


6.22 


.0008 


.0025 


.53 


.0260 


.0000 


2.3 


.010 


Norton, . 


Tubular wells. 






.00 


4.38 


.0002 


.0013 


.49 


- 


- 


1.3 


.008 


Norwood, 


Tubular wells. 






.14 


9.73 


.0018 


.0061 


.61 


.0368 


.0001 


4.2 


.051 


Oak Bluffs, 


Springs, 






.00 


4.47 


.0008 


.0023 


1.02 


.0155 


.0000 


0.8 


.009 


Oxford, . 


Tubular wells. 






.00 


4.93 


.0003 


.0016 


.35 


.0463 


.0000 


1.8 


.005 


Palmer (Bondsville), 


Tubular wells. 






.00 


5.63 


.0006 


.0020 


.22 


.0197 


.0000 


2.0 


.013 


Pepperell, 


Tubular wells, 






.00 


3.48 


.0002 


.0017 


.20 


- 


- 


1.4 


.006 


Plainville, 


Tubular wells. 






.01 


4.92 


.0005 


.0016 


.37 


- 


- 


' 2.2 


.019 


Provincetown, 


Tubular wells, 






.01 


17.06 


.0002 


.0015 


8.71 


- 


- 


3.8 


.019 


Reading, . 


Filter-gallery, 






.68 


12.95 


.0231 


.0164 


2.12 


.0093 


.0002 


3.3 


.376 




Filtered water. 






.23 


19.19 


.0010 


.0093 


1.75 


.0118 


.0005 


8.8 


.038 


Salisbury, 


Well, . 






.14 


9.24 


.0005 


.0036 


.60 


- 


- 


4.2 


.0272 


Scituate, . 


Tubular wells. 






.00 


16.19 


.CC03 


.0023 


3.35 


.1982 


.0000 


5.4 


.007 


Sharon, . 


Well, . 






.01 


13.65 


.0004 


.0017 


1.82 


.2749 


.0000 


5.6 


.007 




Tubular wells, 






.00 


5.04 


.0004 


.0016 


.49 


.0326 


.0000 


1.9 


.013 


Sheffield, 


Spring, 






.00 


3.70 


.0017 


.0023 


.09 


.0046 


.0000 


1.8 


.006 


Shirley (Shirley Vil- 


WeU, . 






.00 


4.76 


.0003 


.0014 


.49 


.1282 


.0000 


1.4 


.007 


lage Water District) . 


























Shrewsbury, . 


Tubular wells, 






.00 


4.98 


.0003 


.0021 


.52 


.0459 


.0000 


1.7 


.0062 


South Hadley (Fire 


Large well. 






.01 


4.28 


.0004 


.0018 


.17 


.0331 


.0000 


1.5 


.007 


District No. 2). 


























Tisbury, . 


Well, . 






.00 


4.44 


.0002 


.0019 


.96 


.0048 


.0000 


0.6 


.008 


Uxbridge, 


Tubular wells. 






.00 


5.42 


.0004 


.0022 


.55 


.0542 


.0000 


1.8 


.007 


Walpole, . 


Tubular wells. 






.00 


4.92 


.0002 


.0018 


.46 


.0341 


.0000 


1.8 


.013 


Waltham, 


Old well, . 






.15 


8.94 


.0044 


.0042 


.83 


.0175 


.0000 


3.9 


.074 



Average of three years. 



- Average of four years. 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



75 



Averages of Chemical Analyses from 1915 to 1919, incltLsive — Concluded. 

[Parts in 100,000.] 





Source. 


6 


c 

o 


Ammonia. 


o 

a 

1 

o 


Nitrogen 

AS — 


c 
-3 

03 




City or Town. 


6 


Albu- 
minoid. 




o 

'S 


1 


Waltham — Con. 


New well, .... 


.00 


7.96 


.0013 


.0041 


.65 


.0181 


.0000 


3.7 


.007 


Ware, 


Wells 


.00 


7.04 


.0002 


.0017 


.47 


.1351 


.0000 


2.4 


.007 


Wareham (Fire Dis- 


Tubular wells, . 


.00 


3.36 


.0005 


.0018 


.59 


_ 


- 


0.6 


.008 


trict). 
Webster, . 


Wells 


.02 


4.08 


.0009 


.0044 


.36 


.0134 


.0000 


1.6 


.015 


Wellesley, 


Tubular wells, . 


.01 


9.87 


.0006 


.0023 


1.16 


.0622 


.0000 


4.2 


.012 




Well at Williams Spring, . 


.00 


15.53 


.0016 


.0027 


1.35 


.5771 


.0000 


5.6 


.008 




Filter-gallery, . 


.01 


9.43 


.0018 


.0036 


1.03 


.0882 


.0000 


4.1 


.006» 


Westborough, . 


Filter basin, 


.03 


3.27 


.0020 


.(3097 


.29 


- 


- 


1.1 


.013 


West Brookfield, . 


Tubular wells, . 


.00 


4.72 


.0003 


.0016 


.27 


.0441 


.0000 


1.3 


.007 


Westford, 


Tubular wells, . 


.00 


4.42 


.0003 


.0016 


.19 


- 


- 


1.7 


.009 


Weston, . 


Well 


.17 


7.41 


.0013 


.0078 


.61 


.0346 


.0000 


3.1 


.009 


Winchendon, . 


Old well, .... 


.12 


4.07 


.0039 


.0038 


.16 


- 


- 


1.3 


.250 




New well 


.06 


3.24 


.0004 


.0033 1 


.15 


- 


- 


0.8 


.009 


WOBURN, 


Filter gallery, 2 . 


.00 


11.99 


.0026 


.0047 


1.55 


.0287 


.0001 


5.5 


.005' 


Worthington (Fire 

District). 
Wrentham, 


Springs, .... 
Tubular wells, . 


.04 
.00 


3.02 
4.23 


.0005 
.0004 


.0038 
.0017 


.11 

.40 


.0463 


.0000 


1.4 
1.4 


.028 
.014 






1 Average of three 


years. ^ Mixture of we 


is an 


d filte 


r-galle 


ry. 


3 A^ 


rerage ( 


jf four 


yean 


3. 



AVater Supply Statistics. 

During the year 1920 but one new water works has been introduced 
in the cities and towns in Massachusetts, this one being for the town 
of Auburn. The reason that more works have not been installed has 
been previously explained as being due, in part, to the high cost of 
labor and materials, a condition which is gradually reverting back 
to normal. New works in a great many places are urgently needed, 
however. 

Works for the public distribution of water in various cities and 
towns in Massachusetts have been in use since the year 1799, and as 
a means of reference as to when the works of the various cities and 
towns were installed, the character of the w^orks, and the population 
and valuation of the town in which the WT)rks are located, the follow- 
ing table is submitted: — 



76 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



CiTT OR Town. 



Date 
of In- 
troduc- 
tion. 



Ownership. 



Ground 

or Surface 

Supply. 



Popu- 
lation in 
1920. 



Municipal 
Valua- 
tion April 1, 
1920. 



Abington, 

Acton, 

Acushnet, 

Adams, . 

Agawam, 

Alford, . 

Amesbury, 

Amherst, 

Andover, 

Arlington, 

Ashburnham, 

Ashby, . 

Ashfield, 

Ashland, 

Athol, . 

Attleboro, 

Auburn, . 

Avon, 

Ayer, 

Barnstable, 

Barre, 

Becket, . 

Bedford, 

Belchertown, 

Bellingham, 

Belmont, 

Berkley, . 

Berlin, . 

Bernardston, 

Beverly, 

Billerica, 

Blackstone, 

Blandford, 

Bolton, . 

Boston, . 

Bourne, . 

Boxborough, 

Boxford, 



1887 
1912 
1916 

1874 
1877 

1885 
1880 
1890 
1872 
1870 

1904 
1911 
1875 
1873 
1920 
1890 
1887 
1912 
1895 

1909 



1887 



1868 
1898 
1911 
1909 

1848 



Town, 



West and' South Water Supply 
District. 

Town (New Bedford Water Sup- 
ply). 

Adams Fire District, . 

Town (Springfield Water Supply), 



Town 

Amherst Water Company, 

Town 

Town (Metropolitan Water Sup- 
ply). 
Town 

Ashfield Water Company, . 

Town, 

Town 

City 

Auburn Water Company, . 

Town 

Town, 

Barnstable Water Company, 
Town 

Town 



Town (Metropolitan Water Sup- 
ply). 



City, 
Town, 



Town (Woonsocket, R. I., Water 

Supply). 
Blandford Fire District, 



City (Metropolitan Water Sup- 
ply). 



Surface, 

Ground, 

Surface, 

Surface and 

ground. 
Surface, 

Ground, 
Surface, 
Surface, 
Surface, 
Surface, 

Surface, 
Ground, 
Surface, 
Ground, 
Ground, 
Ground, 
Ground, 
Ground, 
Surface, 

Ground, 



Surface, 



Surface, 
Ground, 
Surface, 
Surface, 

Surface, 



5,787 
2,162 
3,075 
12,967 
5,023 
248 
10,036 
5,550 
8,268 
18,665 
2,012 
834 
869 
2,287 
9,792 
19,731 
3,891 
2,176 
3,052 
4,836 
3,357 
674 
1,362 
2,058 
2,102 
10,749 
935 
868 
769 
22,561 
3,646 
4,299 
479 
708 
748,060 
2,530 
298 
588 



$4,243,042 
2,414,185 
2,567,452 
10,643,007 
4,996,985 
224,072 
10,168,527 
7,180,021 
10,086,766 
24,118,118 
1,454,467 
761,338 
1,035,864 
2,084,150 
8,690,193 
22,106,770 
2,412,441 
1,396,341 
3,055,335 
10,163,250 
3,118,820 
782,366 
2,283,686 
1,173,870 
1,526,955 
15,730,691 
732,655 
867,607 
642,058 
41,903,615 
6,854,879 
2,127,465 
897,887 
842,275 
1,572,457,180 
6,244,000 
351,644 
987,807 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



77 



City or Town. 



Date 
of In- 
troduc- 
tion. 



Ownership. 



Ground 

or Surface 

Supply. 



Popu- 
lation in 
1920. 



Municipal 
Valua- 
tion April 1, 
1920. 



Boylston, 

Braintree, 

Brewster, 

Bridgewater, 

Brim field, 

Brockton, 

Brookfield, 

Brookline, 

Buckland, 

Burlington, 

Cambridge, 

Canton, . 

Carlisle, . 

Carver, . 

Charlemont, 

Charlton, 

Chatham, 

Chelmsford, 

Chelsea, 

Cheshire, 

Chester, . 

Chesterfield, 

Chicopee, 

Chilmark, 

Clarksburg, 

Clinton, . 

Cohasset, 

Colrain, . 

Concord, 
Conway, 
Cummington 
Dalton, . 
Dana, 
Dan vers, 
Dartmouth, 
Dedham, 



1887 

1888 

1880 
1889 
1875 



1856 
1889 



1907 
1914 
1867 
1876 
1893 

1845 



1882 
1886 
1901 
1902 
1873 

1916 
1884 

1876 
1915 
1881 



Town 

Bridgewater Water Company, 

City 

Town, 

Town 

City 

Town 



North Chelmsford Fire District, ] 

Chelmsford Water District, j 

City (Metropolitan Water Sup- 
ply). 
Cheshire Water Company, 

Chester Fire District, 



City. 



Town, 

Cohasset Water Company, 

Griswoldville Manufacturing ] 

Company (Griswoldville). \ 

Colrain Fire District No. 1, J 



Town, 



Town, . 

Dalton Fire District, 



Town, 



Town (New Bedford Water Sup- 
ply). 
Dedham Water Company, 



- 


794 


Surface, 


10,580 


- 


688 


Ground, 


8,438 


- 


778 


Surface, 


66,254 


Surface and 

ground. 
Ground, . 


2,216 
37,748 


- 


1,433 


- 


885 


Surface, 


109,694 


Ground, . 


5,945 


- 


463 


- 


891 


- 


808 


- 


1,995 


- 


1,737 


Ground, 


5,682 


Surface, 


43,184 


Surface, 


1,476 


Surface, 


1,302 


- 


441 


Surface and 
ground. 


36,214 
240 


- 


1,136 


Surface, 


12,979 


Ground, . 


2,639 


Surface, 


1,607 


Surface, 


6,461 


- 


961 


Ground, . 


489 


Surface, 


3,752 


- 


599 


Surface, 


11,108 


Surface, 


6,493 


Ground, 


10,792 



$649,306 

11,092,239 

1,113,360 

4,751,311 

946,250 

60,628,361 

1,768,596 

103,636,400 

2,341,876 

1,424,102 

141,704,972 

6,866,045 

582,686 

2,120,815 

765,657 

1,639,920 

2,795,650 

6,421,540 

41,364,400 

941,612 

1,016,673 

436,702 

42,718,050 

455,524 

505,669 

11,774,907 

6,647,539 

1,167,220 

7,331,008 
982,491 
390,010 

4,716,879 
537,104 

8,671,925 

7,383,875 
16,311,565 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



City or Town. 



Date 
of In- 
troduc- 
tion. 



Ownership. 



Ground 

or Surface 

Supply. 



Deerfield, 

Dennis, . 
Dighton, 
Douglas, 
Dover, . 
Dracut, . 

Dudley, . 

Dunstable, 

Duxbury, 

East Bridgewater, 

East ham, 

Easthampton, 

East Longmeadow, 

Easton, . 



Edgartovvn, 
Egremont, 
Enfield, . 
Erving, . 
Essex, 
Everett, 
Fairhaven, 
Fall River, 
Falmouth, 

FlTCHBURQ, 

Florida, . 
Foxborough, 

Framingham, 

Franklin, 

Freetown, 

Gardner, 

Gay Head, 

Georgetown, 



1903 
1911 



1910 

1900 
1906 
1910 
1918 
1914 
1888 

1870 
1913 
1887 
1915 

1916 
1906 
1913 

1896 

1867 
1894 
1874 
1899 
1872 

1891 
1912 

1885 
1884 

1882 



South Deerfield Water Supply 

District. 
Deerfield Fire District, 



Town, 



American Woolen Company, 

Collinsville. 
Dracut Water Supply District, 

Town 

Town, 

Duxbury Fire and Water Dis- 
trict. 

Town (Bridgewater Water Sup- 
ply; Brockton Water Supply). 



Town, 



Town (Springfield Water Sup- 

North Easton Village District, 

South Easton and Eastondale 
Fire and Water District 
(Brockton Water Supply). 

Unionville Fire and Water Dis- 
trict. 
Edgartown Water Company, 

South Egremont Water Com- 
pany. 



Millers Falls Water Supply Dis- 
trict. 



City (Metropolitan Water Sup- 
ply). 
Fairhaven Water Company, 

City, 

Town 

City 



Foxborough Water Supply Dis- ) 

trict. 
East Foxborough Water Supply 

District. 
Town 



Town, 



Town, . 



Surface, 
Ground, 



Ground, 



Ground, 

Ground, 

Ground, 

Ground, 

Ground and 
surface. 

Ground, 
Surface, 



Ground and 
surface. 



Ground, 
Surface, 

Surface, 

Surface, 
Ground, 
Surface, 
Surface, 
Surface, 

Ground, 

Surface and 

ground. 
Ground, 

Surface, 



Popu- 
lation in 
1920. 



Municipal 
Valua- 
tion April 1, 
1920. 



2,803 

1,536 

2,574 

2,181 

867 

5,280 

3,701 

353 

1,553 

3,486 

430 

11,261 

2,352 

5,041 

1,190 

441 

790 

1,295 

1,478 

40,120 

7,291 

120,485 

3,500 

41,029 

298 

4,136 

17,033 
6,497 
1,532 

16,971 

144 

2,004 



$4,287,051 

1,517,435 
2,973,227 
1,656,730 
2,797,267 

3,311,301 

3,146,800 
434,890 

4,231,456 

3,614,481 

591,299 

12,489,697 

1.986,590 



4,476.6S-4 

1,786,825 

715,224 

670,610 

1,836,832 

1.370,514 

40,855,050 

7,854,354 

178,728,693 

7,706,918 

48,050,360 

1,303,096 

3,163,220 

22,675,720 
6,462,986 
1,385,917 

15,374,117 

65,605 

1,497,903 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



79 



City or Town. 



Date 
of In- 
troduc- 
tion. 



Ownership. 



Ground 

or Surface 

Supply. 



Popu- 
lation in 
1920. 



Municipal 
Valua- 
tion April 1, 
1920. 



GUI, 

Gloucester, 

Goshen, . 

Gosnold, 

Grafton, . 

Granby, . 

Granville, 

Great Barrington, 

Greenfield, 

Greenwich, 
Groton, . 

Groveland, 

Hadley, . 

Halifax, . 

Hamilton, 

Hampden, 

Hancock, 

Hanover, 

Hanson, . 

Hardwick, 

Harvard, 

Harwich, 

Hatfield, 

Haverhill, 

Hawley, . 

Heath, . 

Hingham, 

Hinsdale, 

Holbrook, 

Holden, . 

Holland, 

Holliston, 

HOLYOKE, 

Hopedale, 

Hopkinton, 

Hubbardston, 



1888 
1885 



1886 

1910 
1867 
1888 
1870 

1897 
1912 

1915 
1905 



1887 



1896 
1802 



Riverside Water Company, 
City 



Grafton Water Company, 



Granville Center Water Com- 
pany. 
Great Barrington Fire District, ' 

Housatonic Water Works Com- | 

pany, Housatonic. j 

Greenfield Fire District No. 1, . 



Groton Water Company, . 1 

West Groton Water Supply Dis- 
trict. J 
Town (Haverhill Water Supply), 

Hadley Water Supply District, . 



George H. Gilbert Manufactur- 
ing Company. 



Town, 
City, 



1880 


Hingham Water Company, 


1889 


Hinsdale Fire District, 


1888 


Town 


1905 


Town 


1891 


Holliston Water Company, 


1873 


City 


1881 


Milford Water Company, . 


1884 


Town 



Ground, 

Surface, 



Ground, 

Ground, 
Surface, 



Surface and 
ground. 



Ground, 

Surface, 
Surface, 



Ground, 



Surface, 
Surface, 



Surface and 

ground. 
Surface, 

Surface, 

Surface, 



Ground, 

Surface, 

Surface and 

ground. 
Ground, 



879 
22,947 
224 
131 
6,887 
779 
655 

6,315 

15,462 

399 

2,185 

2,650 

2,784 

563 

1,631 

624 

464 

2,575 

1,910 

3,085 

2,546 

1,846 

2,651 

53,884 

390 

325 

5,604 

1,065 

3,161 

2,970 

153 

2,707 

60,203 

2,777 

2,289 

1,045 



$712,611 

29,692,552 

305,598 

1,002,223 

3,792,103 

888,824 

597,010 

8,170,305 

17,242,462 

391,095 

3,190,650 

1,610,246 
2,977,390 

941,155 
4,250,789 

487,078 

399,434 
2,335,728 
2,085,278 
3,316,752 
2,053,333 
2,186,898 
2,432,825 
64,125,571 

295,134 

325,928 
8,917,067 

810,568 
2,132,630 
2,536,319 

168,476 

2,577,881 

89,527,690 

3,397,653 

2,093,587 

885,751 



80 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



City or Town. 



Date 
of In- 
troduc- 
tion. 



Ownership. 



Ground 

or Surface 

Supply. 



Popu- 
lation in 
1920. 



Municipal 

A'alua- 

tion April 1, 

1920. 



Hudson, 


1884 


Hull, . 


1882 


Huntington, . 


1899 


Ipswich, . 


1894 


Kingston, 


1886 


Lakeville, 


- 


Lancaster, 


1885 


Lanesborough, 


- 


Lawrence, . 


1875 


Lee, 


1881 


Leicester, 


1891 




1911 


Lenox, . 


1875 


Leominster, . 


1873 


Leverett, 


- 


Lexington, 


1884 


Leyden, . 


- 


Lincoln, . 


1874 


Littleton, 


1912 


Longmeadow, 


1895 


Lowell, 


1872 


Ludlow, . 


1873 


Lunenburg, . 


- 


Ltnn, 


1871 


Lynnfield, 


- 


Malden, 


1870 


Manchester, . 


1892 


Mansfield, 


1888 


Marblehead, . 


1885 


Marion, . 


1908 


Marlborough, 


1883 


Marshfield, 


1890 




1900 


Mashpee, 


- 


Mattapoisett, . 


1913 


Maynard, 


1889 


Medfield, 


1889 



Town 

Hingham Water Company, 
Huntington Fire District, . 

Town 

Town 

Town (Clinton Water Supply), . 

City 

Berkshire Water Company, 

Leicester Water Supply District, 1 

Cherry Valley and Rochdale [ 
Water District. J 

Lenox Water Company, 

City 

Town (Metropolitan Water Sup- 
ply). 

Town : 

Town 

Town 

City 

Ludlow Manufacturing Com- 
pany (Springfield Water Sup- 
ply). 

City 

City (Metropolitan Water Sup- 
ply). 
Town, 

Mansfield Water Supply District, 

Town 

Town, 

City 

Brant Rock Water Company, 

Humarock Water Company, 

Town 

Town ; 

Medfield Water Company, 



Surface, 

Surface and 
ground. 

Surface and 
ground. 

Surface, 

Ground, 



Surface, 

Surface, 
Surface, 

Ground, 

Surface, 
Surface, 

Surface, 

Surface, 
Ground, 
Surface, 
Ground, 
Surface, 

Surface, 

Surface, 

Surface and 

ground. 
Ground, 

Surface and 

ground. 
Ground, 

Surface, 
Ground, 

Ground, . 

Surface, 

Ground, 



7,607 
1,771 
1,425 
6,201 
2,505 
1,419 
2,461 
1,054 
94,270 
4,085 

3,635 

2,691 

19,744 

695 

6,350 

330 

1,042 

1,277 

2,618 

112,759 

7,470 

1,634 

99,148 

1,165 

49,103 

2,466 

6,255 

7,324 

1,288 

15,028 

1,379 

242 
1,277 
7,086 
3,595 



S5,827,389 

13,178,150 

1,040,095 

6,052,526 

1,844,360 

1,284,210 

2,531,339 

931,196 

104,659,330 

3,662,596 

2,822,116 

7,378,422 
17,484,515 

447,114 
9,945,296 

282,843 
1,969,111 
1,630,355 
4,967,612 
123,803,827 
8,427,628 

1,864,655 
101,544,572 

1,976,018 
44,542,777 
11,539,928 

6,345,655 
11,878,027 

3,326,240 
13,293,501 

3,021,935 

501,445 
2,143,276 
5,184,220 

2,209,389 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



81 



City or Town. 



Date 
of In- 
troduc- 
tion. 



Ownership. 



Ground 

or Surface 

Supply. 



Popu- 
lation in 
1920. 



Municipal . 
Valua- 
tion April I, 
1920. 



Medford, 

Medway, 

Melrose, 

Men don, 

Merrimac, 

Methtten, 

Middleborough, 

Middlefield, 

Middleton, 

Milford, . 

MUlbury, 

MUlis, . 

MillviUe, 

Milton, . 

Monroe, . 

Monson, . 

Montague, 



Monterey, 
Montgomery, . 
Mount Washington 
Nahant, . 
Nantucket, 

Natick, . 
Need ham. 
New Ashford, 
New Bedford, 
New Braintree, 
Newbury, 
Newbuktport, 
New Marlborough 
New Salem, . 
Newton, 
Norfolk, . 
North Adams, 



1870 
1911 
1870 

1904 
1875 
1885 

1876 
1881 
1895 
1891 

1885 

1895 
1887 
1886 
1909 

1917 



1885 
1878 
1913 
1874 
1890 

1869 



1881 



1876 



1861 



City (Metropolitan Water Sup- 
ply). 
Town, 

City (Metropolitan Water Sup- 
ply). 



Town 

City, ..;... 

Middleborough Fire District, 

Town (Danvers Water Supply), 
Milford Water Company, . 
Millbury Water Company, 
Town 



Town (Metropolitan Water Sup- 
ply). 



Town, 

Turners Falls Fire District, 

Millers Falls Water Supply Dis- 
trict. 

Lake Pleasant Water Supply 
District. 

Montague Village (Edgar L. 
Bartlett). 

Monterey Water Company, 



Town (Metropolitan Water Sup- 
ply). 
Wannacomet Water Company, . 

Town (supply at Siasconset), 

Town 

Town, 

City, 

City 



Surface, 
Ground, 
Surface, 



City, 
City. 



39,038 

2,956 

18,204 

961 



Ground, 


2,173 


Ground, 


15,189 


Ground, . 


8,453 


- 


280 


Surface, 


1,195 


Surface and 


13,471 


ground. 
Ground, 


5,653 


Ground, . 


1,485 


- 


2,224 


Surface, 


9,382 


- 


173 


Ground, 


4,826 


Surfaxie, 


7,675 


Surface, 


282 


- 


229 


- 


73 


Surface, 


1,318 


Surface and 

ground. 
Ground, . 


2,797 


Ground, . 


10,907 


Ground, . 


7,012 


- 


116 


Surface, 


121,217 


- 


394 


- 


1,303 


Surface and 
ground. 


15,618 
1,010 


- 


512 


Ground, 


46,054 


- 


1,159 


Surface and 
ground. 


22,282 



S39,159,850 

2,407,055 

21,085,400 

811,820 

1,728,342 

18,712,925 

5,914,217 

291,584 

1,119,101 

12,046,230 

4,371,128 

2,047,446 

1,328,130 

21,293,325 

401,507 

2,090,308 



9,174,190 

477,102 

218,018 

166,375 

4,159,697 

5,659,990 

9,754,425 

10,945,340 

88,815 

182,889,883 

509,416 

1,623,781 

11,919,502 

1,503,567 

514,800 

86,376,380 

1,330,423 

20,639,900 



82 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



City or Town. 



Date 
of In- 
troduc- 
tion. 



Ownership. 



Ground 

or Surface 

Supply. 



Popu- 
lation in 
1920. 



Municipal 
Valua- 
tion April 1, 
1920. 



Northampton, 
North Andover, 
North Attleborough, 
Northborough, 
Northbridge, . 
North Brookfield, 
Northfield, . 



North Reading, 
Norton, . 
Nor well, 
Norwood, 
Oak Bluffs, 
Oakham, 
Orange, . 
Orleans, . 
Otis, 

Oxford, . 
Palmer, . 

Paxton, . 

Peabodt, 

Pel ham, . 

Pembroke, 

Pepperell, 

Peru, 

Petersham, 

Phillipston, 

PiTTSFIELD, 

Plainfield, 

Plainville, 

Plymouth, 

Plympton, 

Prescott, 

Princeton, 

Provincetown, 

QUINCT, . 
Randolph, 



1871 

1898 
1884 
1882 
1889 
1893 
1879 
1900 

1912 

1885 
1890 

1873 



1906 
1908 
1920 

1799 
1909 



1855 

1909 
1855 



City 

Town 

Town 

Town, 

Whitin Machine Works (Whitins- 

ville). 
Town, 

Northfield Schools, Inc., . 

Northfield Water Company, 



Norton Water Company, . 

Town 

Cottage City Water Company, 



Town, 



Oxford Water Company, . 

Boston Duck Company (Bonds- 

ville). 
Palmer Fire District No. 1 

(Palmer). 

City 

Town 

City 

Town (North Attleborough Water 

Supply). 
Town 



Surface, 

Surface, 

Ground, 

Surface, 

Ground, 

Surface, 

Surface and 

ground. 
Surface, 

Ground, 



Surface and 

ground. 
Ground, 



Surface and 
ground. 



Ground, 
Ground, 
Surface, 

Surface, 
Ground, 



Surface, 

Ground, 
Surface, 



1893 
1884 
1888 



Town, 

City (Metropolitan Water Sup- 

pl.v). 
Town, ...... 



Ground, 
Surface, 
Surface, 



21,951 
6,265 
9,238 
1,753 

10,174 
2,610 

1,775 

1,286 
2,374 
1,348 
12,627 
1,047 

477 
5,393 
1,012 

361 
3,820 

9,896 

489 

19,552 

503 

1,358 

2,468 

149 

642 

354 

41,763 

332 

1,365 

13,045 

469 

236 

682 

4,246 

47,876 

4,756 



$22,203,961 
7,296,129 
8,623,600 
2,045,808 
6,006,224 
2,173,100 

1,739,103 

1,517,842 
2,073,450 
1,341,430 
18,647,488 
2,624,580 

439.394 
4,612,575 
1,641,920 

409,363 
2,435,268 

9,683,698 

488,633 

20,623,635 

550,311 

1,449,065 

2,721,233 

288,691 

1,385,576 

348,506 

43,759,915 

260,471 

1,188,194 

20,860,000 

570,668 

265,082 

1,118,828 

3,796,555 

56,577,605 

3,008,600 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



83 



CiTT OR Town. 



Date 
of In- 
troduc- 
tion. 



Ownership. 



Ground 

or Surface 

Supply. 



Raynham, 

Reading, 

Rehoboth, 

Revere, 

Richmond, 

Rochester, 

Rockland, 

Rockport, 

Rowe, 

Rowley, . 

Royalston, 

Russell, . 

Rutland, 

Salem, . 

Salisbury, 

Sandisfield, 

Sandwich, 

Saugus, . 

Savoy, . 

Scituate, 

Seekonk, 

Sharon, . 

Sheffield, 

Shelburne, 

S her born, 

Shirley, . 

Shrewsbury, 

Shutesbury, 

Somerset, 

Somerville, 

Southampton, 

Southborough, 

Southbridge, . 

South Hadley, 

Southwick, 
Spencer, . 

Springfield, 



1891 



1884 



1887 
1895 



1911 
1896 
1868 
1915 



1878 
1901 

1885 

1897 
1912 

1903 
1915 

1867 



1880 

1872 
1911 

1883 
1874 



Town, 



City (Metropolitan Water Sup- 
ply) • 



Town, 
Town, 



Town, 

Town 

City, 

Salisbury Water Supply Com- 
pany. 



Town (Lynn Water Supply; 
Metropolitan Water Supply). 



Scituate Water Company, . 

Town 

Sheffield Water Company, 
Shelburne Falls Fire District, . 

Shirley Village Water District, . 
Town, 



City (Metropolitan Water Sup- 
ply). 



Southbridge Water Supply Com- 
pany. 
South Hadley Fire District No. 1, 

South Hadley Fire District No. 2, 



Ground, 



Surface, 



Surface, 
Surface, 



Town, 

City, 



Surface, 
Surface, 
Surface, 
Ground, 



Surface, 

Surface and 
ground. 

Ground, 
Ground, 
Surface, 

Ground, 
Ground, 



Surface, 



Surface, 
Surface, 
Ground, 

Surface, 
Surface, 



Popu- 
lation in 
1920. 



1,695 

7,439 

2,065 

28,823 

561 

1,047 

7,544 

3,878 

333 

1,249 

819 

1,237 

1,743 

42,529 

1,701 

460 

1,458 

10,874 

436 

2,534 

2,898 

2,467 

1,435 

1,436 

1,558 

2,260 

3,708 

242 

3,520 

93,091 

814 

1,838 

14,245 

5,527 

1,194 
5,930 

129,614 



Municipal 
Valua- 
tion April 1, 
1920. 



$1,365,849 

9,196,445 

1,747,213 

28,537,600 

590,847 
1,172,526 
6,629,853 
4,545,204 

278,324 
1,098,021 

998,704 

2,256,682 

1,074,503 

45,985,245 

2,334,699 

511,071 
1,590,625 
8,462,188 

245,790 
7,295,345 
2,547,588 
3,829,222 
1,189,910 
2,337,539 
1,760,870 
1,964,565 
4,585,653 

394,683 

2,884,343 

83,910,855 

764,000 

2,380,611 

11,144,369 

5,508,097 

1,099,914 

3,810,507 

231,696,735 



84 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



City ok Town. 


Date 
of In- 
troduc- 
tion. 


Ownership. 


Ground 

or Surface 

Supply. 


Popu- 
lation in 
1920. 


Municipal 
Valua- 
tion April 1, 
1920. 


Sterling, . 


- 


_ _ _ _ 


- 


1,305 


$1,459,310 


Stockbridge, . 




1862 


Stockbridge Water Company, . 


Surface, 


1,764 


5,745,797 


Stoneham, 




1883 


Town (Metropolitan Water Sup- 
ply). 
Town 


Surface, 


7,873 


7,396,820 


Stoughton, 




1886 


Surface, 


6,865 


5,867,198 


Stow, 




- 


- - - - 


- 


1,101 


1,579,593 


Sturbridge, 




- 


_ _ _ _ 


- 


1,573 


1,097,250 


Sudbury, 




- 


_ _ _ _ 


- 


1,121 


1,490,085 


Sunderland, . 




1883 


Sunderland Water Company, 


Surface, 


1,289 


921,109 


Sutton, . 




- 


_ _ _ _ 


- 


2,578 


1,693,259 


Swampscott, . 




1885 


Town (Metropolitan Water Sup- 
ply). 


Surface, 


8,101 


15,324,854 


Swansea, 




- 


- 


2,334 


2,106,786 


Taunton, 




1876 


City 


Surface, 


37,137 


34,811,725 


Templeton, 




- 


- - 


- 


4,019 


2,595,342 


Tewksbury, 




- 


- - - - 


- 


4,450 


2,889,746 


Tisbury, 




1887 


Town, 


Ground, 


1,275 


2,428,159 


Tolland, . 




- 


_ _ _ _ 


- 


192 


345,616 


Topsfield, 




- 


- , - 


- 


900 


2,361,460 


Townsend, 




- 


_ _ _ - 


- 


1,575 


2,069,544 


Truro, . 




- 


_ _ _ _ 


- 


554 


650,395 


Tyngsborough 




- 


_ _ _ _ 


- 


1,044 


940,055 


Tyringham, 




- 


- - - 


- 


267 


399,655 


Upton, . 




- 


_ _ _ _ 


- 


1,693 


1.482,953 


Uxbridge, 




1879 


Town, 


Ground, 


5,384 


6,244,860 


Wakefield, 




1883 


Town 


Surface, 


13,025 


13,550,701 


Wales, . 




- 


_ _ _ _ 


- 


419 


359,407 


Walpole, . 




1896 


Town 


Ground, 


5,446 


8,109,828 


Waltham, 




1873 


City 


Ground, 


30,915 


38,249,575 


Ware, . 




1886 


Town, 


Ground, 


8,525 


6,594,755 


Wareham, 




1894 
1908 


Onset Water Company, 
Wareham Fire District, 


Surface, 
Ground, 


4,415 


8,240,584 


Warren, . 




- 


_ _ _ - 


- 


3,467 


3,822,662 


Warwick, 




- 


- - - 


- 


327 


472,048 


Washington, 




- 


_ _ - _ 


- 


240 


311,408 


Watertown, 




1885 


Town (Metropolitan Water Sup- 
ply). 
Town, 


Surface, 


21,457 


28,892,703 


Wayland, 




1878 


Surface, 


1,935 


3,015,300 


Webster, 




1881 


Town 


Ground, 


13,258 


10,365,216 


Wellesley, 




1884 


Town, 


Ground, 


6,224 


18,234,610 


Wellfleet, 




- 


_ - _ _ 


- 


826 


879,700 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



85 



City or Town. 



Date 
of In- 
troduc- 
tion. 



Ownership. 



Ground 

or Surface 

Supply. 



Ponn- I Municipal 
lopu- Valua- 

lationin 



1920. 



tion April 1, 
1920. 



Wendell, 

Wen ham, 

West borough. 

West Boj'lston, 

West Bridgewater, 

West Brookfield, 

Westfield, . 

Westford, 

Westhampton, 

Westminster, . 

West Newbury, 

Weston, . 

Westport, 

West Springfield, 

West Stockbridge, 

West Tisbury, 

West wood, 

Weymouth, 

Whately, 

Whitman, 

Wilbraham, 

Williamsburg, 

Williamstown, 

Wilmington, 

Winchendon, 

Winchester, 

Windsor, 

Winthrop, 

WoBtTRN, 

Worcester, 
Worthington, 
Wrentham, 
Yarmouth, 



1879 

1911 
1913 
1874 
1908 



1896 

1875 
1873 

1885 

1883 

1903 
1859 

1896 
1873 

1884 
1873 
1845 
1911 
1908 



Town 

Town (Brockton Water Supply), 

Town, 

City 

Westford Water Company, . 



Weston Water Company, . 

Town, 

East Mountain Water Company, 



Town 

Town (Brockton Water Supply), 

Town 

Williamstown Water Company, . 

Town, 

Town, 

Town (Metropolitan Water Sup- 
ply). 
City 

City 

Worthington Fire District, . 

Town 



Ground, 

Surface, 
Ground, 
Surface, 
Ground, 



Ground, 

Surface, 
Ground, 

Surface, 

Surface, 

Surface, 
Ground, 

Ground, 
Surface, 

Surface, 

Ground, 

Surface, 

Surface and 

ground. 
Ground, 



346 

1,090 

5,789 

1,624 

2,908 

1,281 

18,604 

3,170 

305 

1,343 

1,492 

2,282 

3,115 

13,443 

1,058 

345 

1,358 

15,057 

1,234 

7,147 

2,780 

1,866 

3,707 

2,581 

5,904 

10,485 

403 

15,455 

16,574 

179,754 

409 

2,808 

1,229 



S666,726 

2,708,410 

3,712,997 

1,281,697 

2,077,244 

1,140,391 

14,167,407 

2,735,339 

316,210 

1,156,051 

1,082,889 

5,411,290 

4,637,925 

17,777,12] 

751,670 

600,168 

2,760,223 

14,811,209 

954,599 

6,262,978 

2,120,623 

1,192,074 

5,154,178 

2,441,419 

4,883,380 

22,322,125 

388,165 

18,229,450 

16,377,302 

232,004,780 

486,006 

1,908,254 

2,023,424 



Note. — East Brookfield not considered as a town in this report. 

Of the above cities and towns in Massachusetts, all of the 39 cities 
and 177 of the towns are provided with public water supplies. The 
following table shows the cities and towns having and not having 
pul)lic water supplies at the end of the year 1920: — 



86 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Population, 1920. 



Number of 

Places of Given 

Population 

having 

Public Water 

Supplies. 



Total 
Population of 

Places 

in Preceding 

Column. 



Number of 

Places of Given 

Population 

not having 

Public Water 

Supplies. 



Under 500, . 
500-999, 

1,000-1,499, . 

1,500-1,999, . 

2,000-2,499, . 

2,500-2,999, . 

3,000-3,499, . 

3,500-3,999, . 
4,000 and over, 

Totals, . 



6 

3 

24 

10 

17 

17 

7 

11 

121 



216 



2,453 
2,403 
30,799 
17,468 
38,811 
46,408 
22,386 
40,833 
3,500,988 



3,702,549 



Total 
Population of 

Places 

in Preceding 

Column. 



44 

32 

28 

15 

6 

8 

2 

1 

2 



138 



13,667 

23,872 

34,471 

25,377 

12,787 

21,062 

6,582 

3,520 

8,469 



149,807 



The following table indicates when a fairly complete system of 
water supply was introduced in each city and town : — 



Yeabs. 


Number of 

Public Water 

Supplies 

introduced. 


Yeabs. 


Number of 

Public Water 

Supplies 

introduced. 


Previous to 1850 

1850-1859, inclusive, 
1860-1869, inclusive, 
1870-1879, inclusive, 


5 

4 

9 

45 

70 


1890-1899, inclusive, 
1900-1909, inclusive, 
1910-1919, inclusive, 

1920 

Total 


34 
21 

27 

1 


1880-1889, inclusive. 


216 



At the end of the year 1920 the water supplies in all of the cities 

in Massachusetts and in 134 of the towns were owned either by the 

city or town or by a water supply or fire district. In 43 towns the 
works were owned by private companies. 

The following table gives the classification by population of the 

cities and towns which own their water works, and those which are 
supplied by private water companies: — 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



87 



Population, 1920. 



Number of 

Places of Given 

Population 

owning 

Water Works. 



Total 
Population of 

Places 

in Preceding 

Column. 



Number of 
Places of Given 

Population 
supplied with 

Water by 
Private Com- 
panies. 



Total 
Population of 

Places 

in Preceding 

Column. 



Under 1,000, 
1,000-1,999, . 
2,000-2,999, . 
3.000-3,999. . 
4,000-4,999. . 
5,000-5,999, . 
6,000-6,999, . 
7,000-7,999, . 
8,000 and over, 
Totals. . 



4 
23 
26 
12 

6 
13 
10 

9 
70 



1,730 
32,382 
64,418 
41,951 
26,678 
72,131 
63,926 
66,707 
3,167,050 



173 



3,536,973 



5 
11 
8 
6 
2 
3 
1 
2 
5 



43 



3,126 
15,885 
20,801 
21,268 

8,921 
16,807 

6,887 
14,761 
57,120 



165,576 



The following table shows, for the census years since 1890, the total 
population of all cities and towns supplied with water, and the total 
population of those supplied by private companies, with the percentage 
of the total population so supplied: — 



Year. 


Total 

Population 

of All Places 

supplied 
with Water. 


Population 

of Places 

supplied 

by Private 

Companies. 


Per Cent of 

Total 
Population. 


1S90 


1,924,812 


318,319 


16.5 


1895, 


2,237,017 


212,579 


9.5 


1900, 


2,565,301 


236,869 


9.2 


1905 


2,792,490 


193,290 


6.9 


1910 


3,171,055 


159,730 


5.0 


1915, 


3,528,769 


174,760 


5.0 


1920 


3,536,973 


165,576 


4.7 



The foregoing table shows that the total population of the places 
supplied with water by private companies is only 4.7 per cent of the 
total population of all the places supplied with water. Of the towns 
supplied by private water companies, only 11 have a population in 
excess of 5,000. These towns are as follows: — 



88 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Town. 


Population, 
1920. 


Town. 


Population, 
1920. 


Southbridge 

Milford • . 

Dedham, 

Northbridge 

Bridgewater, 

Ludlow, 


14,245 
13,471 
10,792 
10,174 
8,438 
7,470 


Fairhaven, 

Grafton 

Millbury, 

Hingham, 

Amherst, 


7,291 
6,887 
5.653 
5,604 
5,550 



Consumption of Water. 

The consumption of water in 1920 in the various cities and towns in 
which records are kept is shown in the following table, and the jfigures 
represent all the public supplies in any one municipality: — 



Consumption of Water in Various Cities and Towns in 1920. 







Popula- 


Average Daily 
Consumption. 




Popula- 


Average Daily 
Consumption. 












CiTT OR Town. 


tion, 
Census 
of 1920. 


Gallons. 


Gallons 
per 

Inhabit- 
ant. 


City or Town. 


tion, 
Census 
of 1920. 


Gallons. 


Gallons 
per 

Inhabit- 
ant. 


Metropolitan Water 
District:! — 
Arlington, . 


1,206,849 
18,665 


127,265,500 
1,055,600 


106 
57 


Abington and Rock- 
land. 
Acushnet, 


13,331 
3,075 


657,000 
48,000 


49 
16 


Belmont, 




10,749 


591,400 


55 


Agawam, 


5,023 


179,000 


36 


Boston, 




748,060 


94,297,400 


126 


Amesbury, 


10,038 


564,000 


56 


Chelsea, 




43,184 


3,316,400 


77 


Andover, 


8,268 


621,000 


75 


EVEBETT, 




40,120 


3,455,200 


86 


Ashburnham, 


2,012 


142,000 


71 


Lexington, 




6,350 


424,300 


67 


Athol, . 


9,792 


798,000 


81 


Malden, 




49,103 


2,793,300 


57 


Attleboro, . 


19,731 


1,151,000 


58 


Medford, 




39,038 


1,739,700 


45 


Avon, 


2,176 


94,000 


43 


Melrose, 




18,204 


1,108,100 


61 


Barnstable, . 


4,836 


159,000 


33 


Milton, 




9,382 


430,900 


46 


Bedford, 


1,362 


41,000 


30 


Nahant, 




1,318 


192,600 


146 


Beverly, 


22,561 


1,590,000 


70 


QUINCY, 




47,876 


4,472,500 


93 


Billerica, 


3,646 


513,000 


141 


Revere, 




28,823 


1,975,900 


69 


Braintree, 


10,580 


742,000 


70 


Somerville, 


93,091 


7,177,300 


77 


Bridgewater, . 


8,438 


223,000 


26 


Stoneham, . 


7,873 


789,600 


100 


Brockton, 


66,254 


2,931,000 


44 


Swampscott, 


8,101 


657,200 


81 


Brookline, 


37,748 


3,451,000 


91 


Watertown, 


21,457 


1,911,700 


89 


Cambridge, . 


109,694 


11,435,000 


104 


Winthrop, . 


15,455 


876,400 


57 


Chelmsford, . 


5,682 


130,000 


23 



I Figures for metropolitan consumption are exclusive of Newton and are based entirely on meter read- 
ings. District result based on pumpage will vary slightly from the above. 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



89 



Consumption of Water in Various Cities and Toims in 1920 — Continued. 





Popula- 
tion, 
Census 
of 1920. 


Average Daily 
Consumption. 


City or Town. 


Popula- 
tion, 
Census 
of 1920. 


Average Daily' 
Consumption. 


City or Town. 


Gallons. 


Gallons 
per 

Inhabit- 
ant. 


Gallons. 


Gallons 

per 
In labit- 

ant. 


Clinton, . 


12,979 


758,000 


58 


Littleton, 


1,277 


44,000 


34 


Cohasset, 


2,639 


346,000 


131 


Longmeadow, 


2,618 


96,000 


37 


Concord, 


6,461 


585,000 


91 


Lowell, 


112,759 


7,144,000 


63 


Danvers and Mid- 


12,303 


1,510,000 


123 


Ludlow, . 


7,470 


202,000 


27 


dleton. 
Dedham, 


10,792 


799,000 


74 


Lynn and Saugus, 


110,022 


9,084,000 


83 


Dracut, . 


5,280 


97,000 


18 


Manchester, . 


2,466 


293,000 


119 


Dudley, . 


3,701 


106,000 


29 


Mansfield, 


6,255 


531,000 


85 


Duxbury, 


1,553 


74,000 


48 


Marblehead, . 


7,324 


635,000 


87 


Easthampton, 


11,261 


723,000 


64 


Marion, . 


1,288 


95,000 


74 


East Longmeadow, 


2,352 


32,000 


14 


Marlborough, 


15,028 


698,000 


46 


Easton, . 


5,041 


182,000 


36 


Mattapoisett, 


1,277 


55,000 


43 


Edgartown, . 


1,190 


84,000 


71 


Maynard, 


7,086 


330,000 


47 


Fairhaven, 


7,291 


353,000 


48 


Medway, 


2,956 


122,000 


41 


Fall River, . 


120,485 


6,376,000 


53 


Merrimac, 


2,173 


111,000 


51 


Falmouth, 


3,500 


383,000 


109 


Methuen, 


15.189 


762,000 


50 


FiTCHBURG, . 


41,029 


4,406,000 


107 


Middleborough, 


8,453 


405,000 


48 


Foxborough, . 


4,136 


322,000 


78 


Milford and Hope- 
dale. 
Millbury, 


16,248 


987,000 


61 


Framingham, 


17,033 


1,111,000 


65 


5,653 


334,000 


59 


Franklin, 


6,497 


513,000 


79 


Millis, . 


1,485 


61,000 


41 


Gardner, 


16,971 


862,000 


51 


Nantucket, > . 


2,797 


271,000 


97 


Gloucester, 


22,947 


1,567,000 


68 


Natick, . 


10,907 


669,000 


61 


Grafton, 


6,887 


226,000 


33 


Needham, 


7,012 


450,000 


64 


Greenfield, 


15,462 


1,614,000 


104 


New Bedford, 


121,217 


10,085,000 


83 


Groton, . 


2,185 


120,000 


55 


Newburyport, 


15,618 


1,339,000 


86 


Groveland, 


2,650 


33,000 


13 


Newton, 


46,054 


3,687,000 


80 


Haverhill, . 


53,884 


6,031,000 


112 


North Andover, 


6,265 


371,000 


59 


Holliston, 


2,707 


119,000 


44 


North Attleborough, 


9,238 


503,000 


54 


HOLYOKE, 


60,203 


7,154,000 


119 


North Brookfield, . 


2,610 


268,000 


103 


Hudson, 


7,607 


366,000 


48 


Norton, . 


2,374 


189,000 


80 


Ipswich, 


6,201 


383,000 


62 


Norwood, 


12,627 


1,191,000 


94 


Lancaster, 


2,461 


81,000 


33 


Oak Bluffs, . 


1,047 


189,000 


181 


Lawrence, . 


94,270 


4,624,000 


49 


Orange, . 


5,393 


150,000 


28 


Lenox, . 


2,691 


303,000 


113 


Peabody, 


19,552 


3,967,000 


203 


Lincoln, . 


1,042 


221,000 


212 


Pepperell, 


2,408 


164,000 


66 



' Does not include supply at Siasconset. 



90 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Consumption of Water in Various Cities and Towns in 1920 — Concluded. 





Popula- 


Average Daily 
Consumption. 




Popula- 


Average Daily 
Consumption. 












City or Town. 


tion, 
Census 
of 1920. 


Gallons. 


Gallons 
per 

Inhabit- 
ant. 


City or Town. 


tion, 
Census 
of 1920. 


Gallons. 


Gallons 
per 

Inhabit- 
ant. 


PiTTSFIELD, . 


41,763 


5,926,000 


142 


Tisbury, 


1,275 


130,000 


107 


Plainville, 


1,365 


26,000 


19 


Uxbridge, 


5,384 


279,000 


52 


Plymouth, 


13,045 


1,419,000 


109 


Wakefield, 


13,025 


620,000 


48 


Province town, 


4,246 


310,000 


73 


Walpole, 


5,446 


893,000 


164 


Randolph and Hol- 

brook. 
Reading, 


7,917 


531,000 


67 


Waltham, 


30,915 


1,960,000 


63 


7,439 


287,000 


39 


Ware, . 


8,525 


514,000 


60 


Roekport, 


3,878 


312,000 


80 


Wareham, 


4,415 


186,000 


42 


S.iLEM, . 


42,529 


5,700,000 


134 


Webster, 


13,258 


708,000 


53 


Salisbury, 


1,701 


100,000 


59 


Wellesley, 


6,224 


536,000 


86 


Scituate, 


2,534 


349,000 


138 


West Brookfield, . 


1,281 


23,000 


18 


Sharon, . 


2,467 


207,000 


84 


Westfxeld, . 


18,604 


2,254,000 


121 


Shirley, . 


2,260 


93,000 


41 


Westford, 


3,170 


143,000 


45 


Shrewsbury, . 


3,708 


94,000 


25 


Weston, . 


2,282 


159,000 


70 


Southbridge, . 


14,245 


916,000 


64 


Weymouth, 


15,057 


1,464,000 


97 


Springfield, 


129,614 


12,520,000 


97 


Whitman, 


7,147 


244,000 


34 


Stockbridge, . 


1,764 


260,000 


147 


WOBURN, 


16,574 


2,104,000 


127 


Stoughton, 


6,865 


423,000 


62 


Worcester, . 


179,754 


16,517,000 


92 


Taunton, 


37,137 


3,395,000 


91 


Wrentham, 


2,808 


89,000 


32 



Rainfall. 

The normal yearly rainfall in Massachusetts as deduced from long 
continued observations in various parts of the State is 44.60 inches. 
The average rainfall for the year 1920 in these places was 49.67, an 
excess of 5.07 inches over the normal. There was an excess of pre- 
cipitation in the months of February, March, April, May, June, Sep- 
tember, November and December, and a deficiency in the other four 
months of the year. The greatest excess in any month occurred in 
June, when the average rainfall was 6.21 inches, or 2.93 inches greater 
than the normal, and the greatest deficiency occurred in October, Avhen 
the average rainfall was 1.36 inches, or 2.37 inches less than the normal. 

The following table gives the normal rainfall in the State for each 
month as deduced from observations at various places for a long 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



91 



period of years, together with the average rainfall at those places 
for each month during the year 1920, and the departure from the 
normal: — 



Month. 


Normal 
Rainfall 
(Inches). 


Rainfall 
in 1920 
(Inches). 


Excess or 

Defi- 
ciency in 

1920 
(Inches). 


Month. 


Normal 
Rainfall 
(Inches). 


Rainfall 

in 1920 

(Inches). 


Excess or 

Defi- 
ciency in 

1920 
(Inches). 


January, . 

February, 

March, 

April, 

May, 


3.74 
3.69 
3.94 
3.60 
3.66 
3.28 
3.75 


2.92 
5.72 
3.98 
5.37 
3.94 
6.21 
2.67 


-.82 
-f2.03 

+ .04 
+1.77 

+ .28 
+2.93 
—1.08 


August, . 
September, 
October, . 
November, 
December, 
Totals, 


4.21 
3.50 
3.73 
3.82 
3.68 


3.18 
4.59 
1.36 
4.96 
4.77 


—1.03 
+1.09 
—2.37 
+1.14 
+1.09 


June, 
July, 


44.60 


49.67 


+5.07 



Flow of Streams. 

Sudbury River. 

The average flow of the Sudbury River during the year 1920 was 
1,239,000 gallons per day per square mile of drainage area, or about 
24 per cent in excess of the normal flow for the past forty-six years. 
The flow was above the normal in the months of March, April, May, 
June, July and December, but less than the normal in the other six 
months of the year. The greatest excess occurred in the month of 
March, and the greatest deficiency in the month of February. The 
average flow for the driest six months, June to November, inclusive, 
was 360,000 gallons per day per square mile, or about 5 per cent below 
the normal flow for that period during the past forty-six years. 

In order to show the relation between the flow of the Sudbury 
River during each month of the year 1920 and the normal flow of that 
stream, as deduced from observations during forty-six years, from 
1875 to 1920, inclusive, the following table has been prepared. The 
drainage area of the Sudbury River above the point of measurement is 
75.2 square miles. 



92 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table showing the AveracjC Daily Flow of the Stidbvry River for Each Month in 
the Year 1920, in Cubic Feet per Second per Square Mile of Drainage Area, 
and in Million Gallons per Day per Square Mile of Drainage Area; also, 
Departure from the Normal Flow. 









Normal Flow. 


Actual Flow in 1920. 


Excess or Deficiency. 


Month. 


Cubic Feet 

per 

Second 

per Square 

Mile. 


Alillion 
Gallons per 

Day 

per Square 

Mile. 


Cubic Feet 

per 

Second 

per Square 

Mile. 


Million 
Gallons per 

Day 

per Square 

Mile. 


Cubic Feet 

per 

Second 

per Square 

Mile. 


Million 
Gallons per 

Day 

per Square 

Mile. 


January 


1.761 


1.138 


.483 


.312 


—1.278 


—.826 


February, . 






2.509 


1.622 


1.149 


.743 


-1.360 


—.879 


March, 






4.245 


2.744 


8.033 


5.192 


-f3.788 


+2.448 


April, . 






3.078 


1.990 


4.503 


2.911 


+1.425 


+ .921 


May, . 






1.680 


1.086 


2.856 


1.846 


-1-1.176 


+ .760 


June, . 






.787 


.509 


2.625 


1.696 


4-1.838 


+1.187 


July, . 






.284 


.184 


.439 


.284 


+ .155 


+ .100 


August, 






.351 


.227 


-.061 


—.039 


— .412 


— .266 


September, 






.355 


.230 


.099 


.064 


—.256 


— .166 


October, 






.614 


.397 


— .040 


—.026 


—.654 


— .423 


November, 






1.134 


.733 


1.035 


.669 


— .099 


— .064 


December, . 






1.510 


.954 


1.857 


1.200 


+ .347 


+ .246 


Average for w 


fhole 


year. 


1.518 


.981 


1.917 


1.239 


+ .399 


+ .258 



The following table gives the rainfall upon the Sudbury River 
watershed and the total yield expressed in inches in depth upon the 
watershed (inches of rainfall collected) for each of the past five 
years, from 1916 to 1920, inclusive, together with the average for a 
period of forty-six years, from 1875 to 1920: — 



Rainfall, in Inches, received and collected on the Sudbury River Drainage Area. 





1916. 


1917. 


1918. 


Month. 


Rain- 
fall. 


Rain- 
fall 
col- 
lected. 


Per 
Cent 
col- 
lected. 


Rain- 
fall. 


Rain- 
fall 
col- 
lected. 


Per 

Cent 
col- 
lected. 


Rain- 
fall. 


Rain- 
fall 
col- 
lected. 


Per 
Cent 
col- 
lected. 


January, .... 


1.53 


1.680 


109.8 


3.50 


.909 


25.9 


3.47 


.486 


14.0 


February, 


5.91 


2.262 


38.2 


2.68 


1.216 


45.5 


3.58 


2.914 


81.3 


March, .... 


• 4.16 


3.245 


78.1 


4.96 


3.940 


79.4 


2.50 


3.896 


156.2 


April, .... 


4.19 


5.243 


125.1 


2 41 


2.425 


100.5 


4.43 


2.530 


57.1 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



93 



Rainfall, in Inches, received and collected on the Sudbury River Drainage Area ■ 

Concluded. 









1916. 


1917. 




1918. 




Month. 


Rain- 
fall. 


Rain- 
fall 
col- 
lected. 


Per 
Cent 

col- 
lected. 


Rain- 
fall. 


Rain- 
fall 
col- 
lected. 


Per 
Cent 
col- 
lected. 


Rain- 
faU. 


Rain- 
fall 
col- 
lected. 


Per 

Cent 
col- 
lected. 


May, 






3.43 


2.567 


74.9 


4.93 


2.632 


53.4 


1.16 


1.141 


98.8 


June, 






4.77 


2.068 


43.4 


4.23 


1.802 


42.7 


3.65 


.319 


8.7 


July, 






5.17 


1.044 


20.2 


1.11 


.076 


6.8 


4.07 


.171 


4.2 


August, 






2.01 


.139 


6.9 


6.40 


.361 


5.6 


1.61 


—.096 


—6.0 


September, 






1.80 


.044 


2.5 


1.52 


.100 


6.6 


8.60 


1.100 


12.8 


October, . 






1.49 


— .009 


— .6 


5.65 


.860 


15.2 


1.04 


.490 


47.0 


November, 






2.28 


.189 


8.3 


1.31 


.757 


57.6 


2.75 


.843 


30.7 


December, 






3.22 


.562 


17.4 


2.81 


.678 


24.2 


3.68 


1.673 


45.5 


Totals and : 


ivera 


ges, . 


39.96 


19.034 


47.6 


41.51 


15.756 


38.0 


40.54 


15.467 


38.2 











1919. 


1920. 


1 

Mean for 

FoRTY-si.x- Ye.\rs, 

1875-1920. 


Month. 


Rain- 
fall. 


Rain- 
fall 
col- 
lected. 


Per 
Cent 
col- 
lected. 


Rain- 
fall. 


Rain- 
fall 
col- 
lected. 


Per 
Cent 
col- 
lected. 


Rain- 
fall. 


Rain- 
fall 
col- 
lected. 


Per 
Cent 
col- 
lected. 


January, . 






3.52 


2.329 


66.1 


3.26 


.556 


17.1 


4.02 


2.031 


50.5 


February, 






3.40 


1.477 


43.4 


6.49 


1.239 


19.1 


4.15 


2.635 


63.5 


March, 








4.79 


4.916 


102.7 


4.45 


9.262 


207.9 


4.33 


4.894 


112.9 


-April, 








2.93 


2.957 


101.0 


5.19 


5.017 


96.6 


3.58 


3.435 


95.9 


May, 








4.60 


2.301 


50.0 


3.45 


3.292 


95.6 


3.31 


1.936 


58.6 


June, 








1.86 


.193 


10.4 


6.67 


2.929 


43.9 


3.15 


.878 


27.8 


July, 








5.47 


.533 


9.8 


2.04 


.506 


24.9 


3.64 


.328 


9.0 


August, 








3.75 


.164 


4.4 


1.78 


— .070 


—4.0 


3.81 


.405 


10.6 


September 








5.28 


1.232 


23.3 


3.53 


.110 


3.1 


3.42 


.396 


11.6 


October, 








2.16 


.498 


23.1 


1.01 


-.046 


-^.6 


3.67 


.708 


19 3 


November 








5.90 


2.202 


37.3 


5.68 


1,154 


20.3 


3.75 


1.265 


33.8 


December, 






1.98 


1.952 


98.6 


5.11 


2.141 


41.9 


3.79 


1.702 


44.9 


Totals 


and: 


ivera 


ges, . 


45.64 


20.754 


45.5 


48.66 


26.090 


53.6 


44.62 


20.613 


46.2 



94 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



The following table gives the record of the yield of the Sudbury 
River watershed for each of the past five years and the mean for 
forty-six years, the flow being expressed in gallons per day per square 
mile of watershed: — 

Yield of the Sudbury River Drainaqe Area in Gallons per Day per Square Mile. * 















Mean for 


Month. 


1916. 


1917. 


1918. 


1919. 


1920. 


Forty-six 

Years, 
1875-1920. 


January, . . . . 


942,000 


510,000 


273,000 


1,306,000 


312,000 


1,138,000 


February, 








1,356,000 


755,000 


1,809,000 


917,000 


743,000 


1,622,000 


March, . 








1,820,000 


2,209,000 


2,187,000 


2,759,000 


5,192,000 


2,744,000 


April, . 








3,037,000 


1,405,000 


1,466,000 


1,713,000 


2,911,000 


1,990,000 


May, 








1,439,000 


1,476,000 


639,000 


1,290,000 


1,846,000 


1,086,000 


June, . 








1,198,000 


1,044,000 


185,000 


112,000 


1,696,000 


509,000 


July, . 








585,000 


43,000 


96,000 


299,000 


284,000 


184,000 


August, 








78,000 


202,000 


—54,000 


92,000 


—39,000 


227,000 


September, 








26,000 


58,000 


637,000 


713,000 


64,000 


230,000 


October, 








—5,000 


482,000 


274,000 


279,000 


—26,000 


397,000 


November, 








110,000 


438,000 


489,000 


1,275,000 


669,000 


733,000 


December, 




hole year. 


315,000 


380,000 


938,000 


1,095,000 


1,200,000 


954,000 


Average for w 


904,000 


750,000 


736,000 


988,000 


1,239,000 


981,000 


Average for driest sLx 
months. 


186,000 


267,000 


209,000 


458,000 


360,000 


378,000 



' The drainage area of the Sudbury River used in malcing up these records included water surfaces 
amounting to about 2 per cent of the whole area from 1875 to 1878, inclusive, subsequently increasing by 
the construction of storage reservoirs to about 3 per cent in 1879, to 3.5 per cent in 1885, to 4 per cent in 
1894, and to 6.5 per cent in 1898. The drainage area also contains extensive areas of swampy land, which, 
though covered with water at times, are not included in the above percentages of water surfaces. 



Nashua River. 

The average flow of the South Branch of the Nashua River at the 
outlet of the Wachusett Reservoir, Clinton, during the year 1920 was 
1,629,000 gallons per day per square mile of drainage area, or 50 
per cent in excess of the normal flow for the past twenty-four years. 
The flow was greater than the normal in the months of March, April, 
May, June, July, September, November and December, and less than 
the normal in the other four months of the year. The greatest excess 
occurred in the month of March, and the greatest deficiency in the 
month of February. The average flow for the driest six months, 
June to November, inclusive, was 870,000 gallons per day per square 
mile, or about 59 per cent in excess of the normal flow for that 
period during the past twenty-four years. 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



95 



In order to show the relation between the flow of the Nashua 
River during each month of the year 1920 and the normal flow of that 
stream as deduced from observations during twenty-four years, 1897 
to 1920, inclusive, the following table has been prepared. The drainage 
area of the Nashua River above the point of measurement was 119 
square miles from 1897 to 1907, and 118.19 square miles from 1908 
to 191-3, inclusive. Since Jan. 1, 1914, the city of Worcester has been 
diverting water from 9.35 square miles of this drainage area for the 
supply of that city, leaving the net drainage area 108.84 square miles. 
In the calculations of yield, allowance has been made for water over- 
flowing from the Worcester area. 



Table sJwxcing the Average Daily Flow of the South Branch of the Nashua River 
for Each Month in the Year 1920, in Cubic Feet per Second per Square 
Mile of Drainage Area, and in Million Gallons per Day per Square Mile 
of Drainage Area; also, Departure from the Normal Flow. 









Normal Flow. 


Actual Flow in 1920. 


Excess or Deficiency. 


Month. 


Cubic Feet 

per 

Second 

per Square 

Mile. 


Million 
Gallons per 

Day 

per Square 

Mile. 


Cubic Feet 

per 

Second 

per Square 

Mile. 


Million 
Gallons per 

Day 

per Square 

Mile. 


Cubic Feet 

per 

Second 

per Square 

Mile. 


Million 
Gallons per 

Day 

per Square 

Mile. 


January, .... 


1.798 


1.162 


1.000 


.646 


— .798 


— .516 


February, . 






2.104 


1.360 


1.122 


.725 


— .982 


— .635 


March, 






4.122 


2.664 


7.248 


4.685 


+3.126 


+2.021 


April, . 






3.334 


2.155 


5.413 


3.498 


+2.079 


+1.343 


May, . 






1.948 


1.259 


3.205 


2.071 


+1.257 


+ .812 


June, . 






1.256 


.812 


2.974 


1.922 


+1.718 


+ 1.110 


July, . 






.686 


.443 


1.252 


.809 


+ .566 


+ .366 


August, 






.628 


.406 


.506 


.327 


122 


— .079 


September, 






.571 


.369 


.835 


.540 


+ .264 


+ .171 


October, 






.742 


.480 


.634 


.409 


— .108 


— .071 


November, 






1.203 


.777 


2.013 


1.301 


+ .810 


+ .524 


December, . 






1.815 


1.173 


4.007 


2.590 


+2.192 


+ 1.417 


Average for vi 


,'hole 


year. 


1.682 


1.087 


2.521 


1.629 


+ .839 


+ .542 



The following table gives the rainfall upon the Nashua River 
watershed and the total yield expressed in inches in depth upon the 
watershed (inches of rainfall collected) for each of the past five years, 
1916 to 1920, inclusive, together with the average for the past twenty- 
four vears : — 



96 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Rainfall, in Inches, received and collected on the Nashua River Drainage Area. 









1916. 


1917. 


1918. 


Month. 


"3 
a 
"3 
Pi 




o 

II 

^8 


3 

"3 


Rainfall 
collected. 


o 
II 

Pm 


■3 



.5 8 

03 


i 


January, . 




1,60 


2.346 


146.7 


3.37 


1.224 


36.3 


2.97 


.864 


29.1 


February, 






5.98 


3.030 


50.7 


3.05 


1.476 


48.3 


4.25 


3.260 


76.6 


March, 






3.32 


3.374 


101.5 


4.21 


4.409 


104.8 


2.24 


4.614 


206.0 


April, 






3.65 


5.696 


156.0 


1.80 


2.535 


140.6 


3.47 


2.775 


80.0 


May, 






3.34 


3.028 


90.7 


3.89 


2.350 


60.5 


1.07 


1.201 


112.8 


June 






6.57 


3.546 


53.9 


4.47 


2.122 


47.4 


4.57 


.902 


19.8 


July, 






5.66 


1.937 


34.2 


1.22 


.471 


38.8 


2.80 


.499 


17.8 


August, . 






1.72 


.506 


29.5 


4.46 


.552 


12.4 


2.82 


.284 


10.1 


September, 






4.21 


.506 


12.0 


1.20 


.144 


12.0 


7.18 


1.041 


14.5 


October, . 






1.42 


.250 


17.6 


6.03 


.990 


16.4 


1.58 


.609 


38.6 


November, 






3.15 


.554 


17.6 


1.25 


.540 


43.1 


3.08 


1.004 


32.6 


December, 






2.81 


.820 


29.2 


2.31 


.694 


30.0 


3.74 


1.884 


50.4 


Totals and 


avers 


iges . 


43.43 


25.593 


58.9 


37.26 


17.507 


47.0 


39.77 


18.937 


47.6 











1919. 


1920. 


Mean 

FOUK 1 


FOR TwENTY- 

EAKs, 1897-1920. 


Month. 


3 
■3 


.5 8 


73 

II 




1 
c 

■3 



!58 


■6 


3 

"s 
■3 

Pi 


— 

•3.S 


■d 


Pi 


January, . 




3.23 


2.392 


74.1 


3.17 


1.153 


36.4 


3.59 


2.073 


57.6 


February, 






3.51 


1.279 


36.5 


6.26 


1.210 


19.3 


3.89 


2.208 


56.7 


March, 






5.27 


5.621 


106.7 


4.26 


8.356 


196.0 


4.09 


4.752 


116.1 


April, 








2.57 


2.954 


115.0 


6.13 


6.031 


98.4 


3.76 


3.721 


99.0 


May, 








6.06 


3.931 


64.9 


4.01 


3.695 


92.1 


3.43 


2.246 


65.6 


June, 








2.01 


.798 


39.6 


6.07 


3.317 


54.6 


3.78 


1.400 


37.0 


July, 








5.00 


.713 


14.3 


4.33 


1.443 


33.3 


4.09 


.791 


19.3 


August, 








4.17 


.467 


11.2 


2.91 


.584 


20.1 


4.09 


.724 


17.7 


September 








6.78 


1.887 


27.8 


6.39 


.931 


14.6 


3.84 


.638 


16.6 


October, 








2.35 


.884 


37.6 


.63 


.731 


116.1 


3.23 


.856 


26.5 


November 








6.01 


3.168 


52.7 


5.49 


2.246 


40.9 


3.47 


1.342 


38.6 


December, 






2.09 


2.305 


110.4 


6.01 


4.619 


76.9 


4.06 


2.093 


51.5 


Totals 


and ! 


ivera 


ges, . 


49.05 


26.399 


53.8 


55.66 


34.316 


61.7 


45.32 


22.844 


50.4 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



97 



The following table gives a record of the yield of the Nashua River 
for each of the past five years and the mean for the past twenty-four 
years, the flow being expressed in gallons per day per square mile of 
watershed : — 

Yield of thb Nashua River Drainage Area in Gallons per Day per Square Mile. ^ 



Month. 


1916. 


1917. 


1918. 


1919. 


1920. 


Mean for 
Twenty- 
four Years, 
1897-1920. 


January, 
February, . 
March, 
April, . 
May, . 
June, . 
July, . 
August, 
September, 
October, 
November, 
December, . 




1,315,000 

1,816,000 

1,891,000 

3,300,000 

1,697,000 

2,054,000 

1,086,000 

284,000 

294,000 

140,000 

321,000 

460,000 


686,000 

916,000 

2,472,000 

1,468,000 

1,317,000 

1,229,000 

264,000 

309,000 

84,000 

555,000 

313,000 

389,000 


484,000 

2,024,000 

2,590,000 

1,608,000 

673,000 

523,000 

280,000 

159,000 

603,000 

341,000 

582,000 

1,056,000 


1,341,000 

794,000 

3,155,000 

1,711,000 

2,204,000 

462,000 

400,000 

262,000 

1,093,000 

495,000 

1,835,000 

1,292,000 


646,000 

725,000 

4,685,000 

3,498,000 

2,071,000 

1,922,000 

809,000 

327,000 

540,000 

409,000 

1,301,000 

2,590,000 


1,162,000 

1,360,000 

2,664,000 

2,155,000 

1,259,000 

812,000 

443,000 

406,000 

369,000 

480,000 

777,000 

1,173,000 


Average for v 

year. 
Average for ( 

six months 


vhole 
Iriest 


1,215,000 
432,000 


834,000 
320,000 


902,000 
412,000 


1,257,000 
752,000 


1,629,000 
870,000 


1,087,000 
546,000 



1 The drainage area used in making up these records included water surfaces amounting to 2.2 per 
cent of the whole area from 1897 to 1902, inclusive, to 2.4 per cent in 1903, to 3.6 per cent in 1904, to 4.1 
per cent in 1905, to 5.1 per cent in 1906, to 6 per cent in 1907, to 7 per cent in 1908, 1909 and 1910, to 6.5 
per cent in 1911, to 6.8 per cent in 1912, to 7 per cent in 1913, to 7.4 per cent in 1914 and 1915, to 7.6 per 
cent in 1916, to 7.4 per cent in 1917 and 1918, and to 7.5 per cent in 1919 and 1920. 

Merrimack River. 

The flow of the Merrimack River has been measured for many 
years at Lawrence, above which place the river has a total drainage 
area of 4,663 square miles, which includes 118^ square miles on the 
South Branch of the Nashua River, 75 square miles on the Sudbury 
River, and 18 square miles tributary to Lake Cochituate, or a com- 
bined area of 211^ square miles from which water is drawn at the 
present time for the supply of the Metropolitan Water District. The 
flow as measured at Lawrence includes the water wasted from these 
three drainage areas, the aggregate quantity of which, in the wet 
months of the year, is considerable, but which becomes very small in 



* Including 9.35 square miles from which water is drawn for the supply of the city of Worcester. 



98 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



the dry months. Records of the quantity of water wasted have been 
kept by the Boston Water Board and by the Metropolitan Water and 
Sewerage Board, and these quantities have been deducted from the 
flow as measured at Lawrence. In presenting the record of the flow 
of the river, these three drainage areas have been deducted from the 
total above Lawrence, so that the net drainage area above that 
point was 4,567 square miles in 1880, 4,570 square miles in the years 
1881 to 1897, inclusive, and 4,452 square miles since the latter year. 

The average flow of the Merrimack River during the year 1920 
amounted to 1.98 cubic feet per second, or 1,280,000 gallons per 
day, per square mile of drainage area, or 35 per cent in excess of the 
normal flow for the past forty-one years for which records are avail- 
able. The flow was in excess of the normal in the months of March, 
April, May, June, July, August, September, October and December, 
and less than the normal in the other three months of the year. 

In order to show the relation between the flow of this stream 
during each month of the year 1920 and the normal flow as deduced 
from observations during forty-one years, from 1880 to 1920, inclusive, 
the following table has been prepared: — 



Table shoicing the Average Monthly Flow of the Merrimack River at Lawrence 
for the Year 1920, in Cubic Feet per Second per Square Mile of Draina{)e 
Area; also, Departure from the Normal Flow. 



Month. 



January 

February, . . . . 

March, 

April, 

May, 

June, 

July, 

August, . . . . 

September 

October, . . . . 

November 

December 

Average for whole year. 



Normal Flow, 
1880-1920. 



Actual Flow 
in 1920. 



1.267 

1.382 

2.747 

3.457 

2.218 

1.266 

.741 

.677 

.652 

.814 

1.117 

1.269 



1.467 



.570 

.618 

4.082 

6.002 

3.545 

1.607 

.746 

.678 

.680 

1.051 

.921 

3.258 



1.980 



Excess or 
Deficiency. 



— .697 
—.764 

+1.335 
+2.545 
+1.327 
f .341 
f .005 
+ .001 
+ .028 
+ .237 

— .196 
+1.989 



+ .513 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



99 



The following table gives the record of the flow of the Merrimack 
River at Lawrence for each of the past five years and the mean for 
forty-one years, the flow being expressed in cubic feet per second 
per square mile of drainage area: — 



Flow of the Merrimack River at Lawrence in Cubic Feet per Second per Square 

Mile. 



MOXTH. 


1916. 


1917. 


1918. 


1919. 


1920. 


Mean for 
Forty-one 

Years, 
1880-1920. 


January, 


1.527 


1.023 


.466 


1.314 


.570 


1.267 


February, . 




1.674 


.770 


.819 


.872 


.618 


1.382 


March, 




1.735 


2.316 


1.983 


3.383 


4.082 


2.747 


April, . 




4.323 


3.242 


3.337 


2.542 


6.002 


3.457 


May, . 




2.733 


2.124 


1.540 


2.741 


3.545 


2.218 


June, . 




3 101 


3.037 


.757 


1.007 


1.607 


1.266 


July, . 




1.531 


1.024 


.553 


.539 


.746 


.741 


August, 




.924 


.629 


.470 


.401 


.678 


.677 


September, 




.972 


.549 


.847 


.653 


.680 


.652 


October, 




.798 


.613 


.991 


.699 


1.051 


.814 


November, 




.743 


.882 


1.126 


1.648 


.921 


1.117 


December, . 




1.154 


.569 


1.492 


1.331 


3.258 


1.269 


Average for whole 


1.768 


1.398 


1.198 


1.427 


1.980 


1.467 


year. 
Average for driest 
six months. 


1.020 


.711 


.791 


.825 


.947 


.878 



Sudbury, Nashua and Merrimack Rivers. 

The following table shows the weekly fluctuations during the year 
1920 in the flow of the Sudbury River at Framingham, the South 
Branch of the Nashua River at the outlet of the Wachusett Reservoir, 
Clinton, and the Merrimack River at Lawrence. The flow of these 
streams, particularly that of the Sudbury River and of the South 
Branch of the Nashua River, serves to indicate the flow of other 
streams in eastern Massachusetts. The area of the Sudbury River 
watershed is 75.2 square miles, of the South Branch of the Nashua 
River 118.19 square miles, and of the Merrimack River 4,452 square 
miles. 



100 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table showing the Average Weekly Flow of the Sudbury, South Branch of the 
Nashua and the Merrimack Rivera for the Year 1920, in Cvhic Feet per Sec- 
ond per Square Mik of Drainage Area. 





Flow in Cubic Feet per 




Flow in Cubic Feet per 




Second 


PER Square Mile. 


Week ending 


Second 


PER Square Mile. 


Week ending 














Sunday — 




South 


Merri- 
mack 
River. 


Sunday — 




South 


Merri- 
mack 
River. 




Sudbury 


Branch, 




Sudbury 


Branch, 




River. 


Nashua 
River. 




River. 


Nashua 
River. 


Jan. 4, 


.488 


.916 


.669 


July 4, 


1.529 


1.633 


.976 


11, 


.426 


1.175 


.575 


11, 


.703 


.935 


.779 


18, 


.293 


.987 


.573 


18, 


.142 


1.318 


.701 


25, . . 


.775 


1.033 


.560 


25, 


.392 


1.740 


.741 


Feb. 1, 


.683 


.885 


.559 


Aug. 1, 


—.072 


.538 


.630 


8, 


1.425 


1.511 


.578 


8, 


—.306 


.343 


.533 


15, 


.828 


1.134 


.641 


15, 


.202 


.996 


.678 


22, 


1.260 


1.068 


.683 


22, 


.032 


.512 


.919 


29, 


.881 


.858 


.635 


29, 


.206 


.219 


.651 


Mar. 7, 


2.285 


1.813 


.777 


Sept. 5, 


.185 


.155 


.514 


14, 


6.879 


6.230 


1.667 


12, 


.248 


.703 


.523 


21, 


11.949 


9.042 


5.010 


19, 


.000 


.226 


1.032 


28, 


12.517 


11.188 


6.335 


26, . . 


.092 


.260 


.640 


Apr. 4, 


7.809 


8.368 


8.148 


Oct. 3, 


.475 


3.495 


1.653 


11, 


4.989 


5.399 


5.783 


10, 


.006 


.553 


1.412 


18, 


3.536 


4.131 


5.669 


17, 


.119 


.313 


.727 


25, 


3.523 


4.609 


5.852 


24, 


.257 


.364 


.615 










31, 


.149 


.446 


.653 


May 2, 


4.273 


5.542 


6.379 










9, 


3.001 


3.706 


3.972 


Nov. 7, 


.275 


.760 


.983 


16, 


3.116 


2.763 


3.413 


14, 


.021 


.304 


.721 


23, 


2.800 


4.318 


2.748 


21, 


1.200 


2.054 


.754 


30, 


2.511 


2.212 


3.466 


28, 


2.666 


4. 968 


1.198 


June 6, 


2.406 


3.178 


1.653 


Dec. 5, 


1.480 


4.257 


1.145 


13, 


1.857 


1.937 


1.916 


12, 


1.789 


3.723 


3.923 


20, 


3.479 


4.650 


1.440 


19, 


2.965 


6.439 


5.343 


27, . . 


3.150 


2.539 


1.663 


26, 


1.362 


2.552 


2.736 



Sewerage and Sew^age Disposal. 

Notwithstanding the difficulty and cost of construction work during 
the past year, a considerable amount of essential sewerage work has 
been carried on by a number of municipalities. 

At Andover a large extension has been made to the sewerage 
system to provide for the Shawsheen or Frye Village district, which 
is increasing very rapidly in population. 

At Billerica the sewage disposal system has been materially in- 
creased in size, and at Northbridge an additional area of filter beds 
has been provided. At Brockton new works, comprising a series of 
large settling tanks and 1^ acres of trickling filters, have been under 
construction during the year. 

At Worcester the w^ork of improving the sewerage system, required 
by the provisions of chapter 171 of the Special Acts of the year 1919, 
has been carried on during the year, and the amount of work done and 



No. 34.] DIVISION OF SANITARY ENGINEERING. 101 

the expenditure made during 1920 comply fully with the requirements 
of the act. 

The year has been a favorable one for the disposal of sewage into inland 
waters, especially running streams, on account of the excessive rainfall 
and the great quantity of water available for the dilution of the sewage. 

The flow of streams has been the highest, judging from the measure- 
ments of the flow of the Nashua River, that has occurred probably 
for more than a quarter of a century; and the flow was not only 
greater than usual in the colder and wetter months of the year, but 
also was much higher than usual in the months which are warmer 
and usually dry, with the exception of August and October. The 
amount of pollution from cities and towns is constantly increasing, 
in a general way approximating the increase in the use of water, 
while the amount of manufacturing waste, though varying from 
time to time, also has a tendency to increase from one period of 
manufacturing activity to another. When dry seasons again occur, 
the effect of these increases will inevitably result in far worse con- 
ditions than have occurred under similar circumstances in the past, 
since little has been done for a number of years towards relieving 
streams from pollution by sewage or manufacturing waste. 

These conditions, while favorable for the dilution of sewage dis- 
charged into streams, have been less favorable for the operation of 
sewage disposal works on account of the increase in the quantity of 
sewage requiring disposal. A number of the sewage disposal works 
of the State have already become inadequate, on account of the 
growth of the municipalities which they serve, for the proper care of 
all of the sewage requiring disposal. In a number of these cases, owing 
to the increased flow of sewage in the past year, considerable quan- 
tities of sewage have in many instances been discharged untreated 
into the streams. This condition has obtained at times at Pittsfield, 
Clinton, Spencer and Southbridge, among others, while, at the same 
time, municipalities which have adequate works for the treatment and 
purification of the sewage have found no difficulty in producing a 
very satisfactory effluent. This has been the case, for example, at 
Attleboro, Concord, Framingham, Hopedale, Hudson, Marlborough, 
North Attleborough, Northbridge, Norwood and Westborough. A 
new sewerage system has been introduced at Millis. This, when 
completed, will remove much of the excessive pollution from a stream 
in the valley of which is situated the well used as a source of water 
supply for the town. 

The average results of analyses of samples of sewage and effluent 
and statistics concerning the more important sewage disposal works 
in the State are presented in the following tables : — 



102 



DEPARTINIENT OF PUBLIC HEALTH. [Pub. Doc. 



"8 



<Sl> 






CO 



CO 

O 






cu 



CO . 

e 

(a ' 

C3 



=0 



CO ^ 



:i3 o 

S "to 

CO 



C3 






CO 



CO 

e 



O 

< 



•s;b^ 



•ua§oj|t|^ 



iqBpiaKj 



y-t lO 



CD O CC O ■* 
OS CO CS cc> iC 

l> M COi-i (D 






o 



•pai9;]i^ 



■paj9:jigun 



r- Oi ■'j^ fo 



OO t-^ "^ I>- I>- 

OO t-- O CO CO 



t^ CO ■— ' o 

o »— oo 



CO-^ OOs 

■^ t^ ai 00 



CO COCVJ o 
rp CO 1— " CO 



CO-* GO 

r- o t- 



CO c<» ot* 

oo o: ici CO 
t— I .-. CO O 



Tj- OOl t-^ CO 

»0 CD (M ■^ C^l 
lO OO CO I— ' CQ 



O-* CO 

CO •-< •— I 



■^ lO ■* (M 

OO lO c^ c^ 
■^ CM -^ C^ 



<* <M TjH CO 

CO'^ »0 CO 

CO '— I CO c^a 



CO oo 
CD OO 
1— ( COOi 



OS 



•paiajlij 



■paj9^igufi 



r* CO coioco 

OCOCOM-^ 


OCOOOUtlO 
'(^^ CM ^ OS CO 




CO CO OS CO O 
t^ COCM '*^- 


CM CM OS CM CO 

OS OS CD CO O 


ooooo 
,-.■^00 


CO^H lOIr* i-H 


CO CO «:> 1-1 CO 


CM -* CO^^ 


CM COCM i-t CO 


OO T-i C^l C^l CM 


CO CO CO 


■^ CO-^ Ci CS 
t^ O CO CQ t-* 


■«* CM CM Oi CO 
lO CO "* CM t- 


b- CO t— CM ^H 

CD »0 CO I— < IlO 


•^ Oi ^ CM iJO 
t^ CM coco t^ 


CMI^-CMb- CM 


^ CM 00 
^ t^ 10 



CO (M O CO C<1 CDCDO"<J<00 iC 05 O C^ C^ CO O ^ <M iO cq (M <:D t/5 N W5 C^ OO 



•aniioinQ 



oo^-C30« coeooeccc oo^cocts OT^tMccr- 03^-.^ooo rt^tr 
O5t^cv5ooc~- iftooooc^t— CO.— <<Meo.-' ^^cs-^csjc-^ cor~c^i.-;c^ c-ioo 

cot^oscoeo wseot— pot^ CO CO CO CO CO ooosoo^co 



papnadsng 



■paAiossiQ 



"I^^ox 



■88Jj^ 



t^ Ci CO OS 10 
CO'-;-^!-;^ 


CM 10 CO CO OS 
CM CM »0 CM OS 


OS 10 CO 10 CO 


OSIOCM OCM 

CO CO CM C<1 CO 


oOTt* t^ ^ 

CO T-H COCM ^ 


10-^ 

CM -^ -^ 


00-^ CO OCM 
10 CO CD 00 CM 


lOlOfMOSOO 

-^ CO -^ -^^ 

' *^ CM 


.73 

1.11 

1.23 

.21 
.22 


OS 00 W3 CM 
iO CO CM CM iC 


b- 1-" Tfi 00 

^co-^-^^ 


^SS 


10 C^ CO OS t^ 
OS *0 OiO CO 


CO CDiC b-"^ 

' *-H CO 


CM CO ■^ CD 10 
C^iC OS CO CO 


c:s -^ o»c Tf 
CO i>- »c Tt< cx) 


iciot-.-<*os 

COrf r- CD CM 


^ t^ CO 


CO CO t^ "O CO 


lO CM t^ 'Tt^ r-l 


CO CO 00*^ CM 
t^ t- .-H COCO 


CO OS •<*< t'- 10 
OHO ^COi-H 


r^ CD 10 CO -^ 

10 '<*| 00s CO 


CO OS CM 
^H iC CD 



CO (M -^ -^ r^ Tj* C4 CO CO O t^ CO CO 1— I ^H CO CO CO ^^ "* 



IM C^ Tt< M ^H 



■papuadsng 



•paA^ossiQ 



'F^OX 



t^ 00 ^ CO ^H 



lf3 05 O C5 U5 



•papnadsng 



•paA|OSSIQ 



•IB^ox 



o 
H 

K 

o 

6 



COOOiOO 
OiTiCM -^ CM 

coic 00 t^ 
iC Tft 00 »C CM 


(M oco or- 

i-HCOOSOsrjH 
CD t^ CO 00 OS 

kO wo 00 co^>- 


I>. 00 CD 1^ 

10 CM ^ OS 1— ' 

t^ CM -H r--^ 

iO t^ CM CM 


000 CO i>- 

CM lO •— ' t^ OS 

CO CD »0 CO '<»* 


in ^Tf 

r- tJO CO CD 

OS »0 -<** 
OCOU5 CO CO 


45.30 

110.80 

82.40 







- ° 2 ---a 
V S !- 
* o o 

O fi c 

«:3 o 






<;-<noo 



c 

o le ' ^ 

g D M C h 

■5 S £ eg 

to H S OS b 

cs s t. t. 5 



a. 










S 


• 


• 


• 


• 


a> 










H 


— 




















<u 


^ 


(.4 





c 


a 


a 

M 


-*-> 

M 

g 


c 



(fl 





3 




cj 


a 


T^ 


:i5 


►-; 


S 



• M • 

3 
O 

. o- 

«-3 



S3 
O 
P 

■<~ a! O O 



B 

o S 

2;^ 



QJ_Q 

ago 



j= """ 

M « « 

2 B a 

P H Eh 



o o 



dj O O 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



103 















as 
5- 



-5^ 'S 



o 



CO S 















OS C 



^ 









ISO 



6 
< 












•S^BJ 


6.42 

8.05 
10.62 


3.39 
17.65 

9.07 


2.57 
3.67 


4.38 
3.92 


4.16 
2.69 

3.28 
1.60 


6.54 




•uaSoj^T^ 

iq^ppfM 


^ Oi 00 <M CO 
C4 GO t-- Tf !>■ 


OM c^a ot^ 

rj* OS CO to o 
— H 'cm* * CO 


OOO OCO CS 

r* CO CM i>- CD 


CO CM COt^O 

O CM CM to CD 


1.06 

.87 

1.11 

1.33 

.50 






o 


•paj8:inj 


lOiO OO 

I^C3i -^ oo 
OO— ;Os J 


OOt—-* CO t- 

CD OS O CD CD 
O ^_ '^ o o 


00 Ol^CD 
O , OOO 


OS-* O^ 
OCSOS t* 
CM OO O 1 


-* coooo 

M^CDr-HQO 


oo 




•paj9:Hgua 


O C^ OOi 
CO o »o O 
f-H i-H CO CO 1 


OOOOi M* CO 
OS ■-' CM CM (M 

1-. -* CO ^ CM 


OS C^ C^l t^ 

to t^ ■* 00 


to CO -* lO 
^ -* C^l to 
-*CM^.-; , 


OCM ■* CO 
CD -* coco 
CO ^ CM CM 1 


to o 
"cd 




§1 

Kg 


•paja^^nj 


^00 cot* CO 
CD oo OOCD Tf 

M r-H »r3 »0 1-1 


3.36 
2.81 
5.18 
1.04 
3.30 


CM CM CO b-^- 

Oi O CM r-4 -* 

^ CO CO '-' ^* 


CD to OS CO to 
^. ^. (M. ^. -^ 

cm" CO* cm ^ 1-1 


CD CM CM C^ CO 

-* OS O CO o 

no 1-i CM CM C^i 


OCO 

CO CO 




■paja^Hgun 


CO CO*^ t^C5 

lO as CO CO !>■ 
-<** cct O t^ c^' 


CM t^CM i-H CO 
l>- o •* ■* l>- 

CD ■*' O ^ 00 


OOOcOCMi-H 
O r-H CD t-j to 

CO to "*' cm' cm' 


-* OS -^ -* to 
OS -* COCO CD 

CO ■* -* ^ ^' 


OS I-- to I^- Ol 

OS l>. CD O to 

CD* CM CO to CM 


1—1 CM 

.— ( 1^ 

to CM 




•auiaoiqo 


csi^o: Tt< CO 

COr>; CO t^ t>; 


OOS OS COCO 
OS -* CO CM t>. 

wi CO t^ CO t^ 


CO to O CO OS 
CO OS -H CO I-H 

|>l t^ ococc 


OOOC^I CM oo 
!>; O ■* CS -* 

t-; OS* 00 -*■ CM* 


os^ooooo 

rt^ I-^ CS --^ CM 

oo' rj* CD* -*' cm" 


-^-* 
CM O 

to-"*" 




5 
o 
s 

< 


S 
g 

s 


•papuadsng 


i>-asco o»o 

(M 1-1 Tt< (M i-H 


b- CM COI>- OS 

CO —1 to ocs 


00 r^rt* toco 

r-< COCM »-H^ 


OOO CM t^O 

CM i-" CM O 1-1 


b--* — ' Oi-i 
CO 1-1 CM CM ^ 


to rt< 
CM -* 








•paApssiQ 


CD-* COOOC^ 
Tt« CO CO -<»< (M 


OOCO CM ■* 00 
^CM O'-*'* 


CM OS ■^ ^ CM 

CO-*-*CMCM 


CM OOO-* to 
to-* CM 1-H^ 


r^ ^CM -* 00 

^H CO CO r}< l-H 


CO CO 
Tj-CD 




1—1 OQ 




'mox 


COCO':D CO t- 
I>-lCi OCO CO 


lOOO to ^ t^ 
00 CO »0 CM tP 


OCD to CO to 
to 00 CD CO CO 


CM GO O -^ to 
t- to to CM CM 


-* to CO-* OS 
to -* tO CO CM 


t^ o 




'-' 


^ CO 








'"' 




•aajj 


r^ ^ CD t^ lo 

rH CO r* ^ CO 


CD lO CO GO — < 

OCM r^ 00 ^ 


to OS to ^ CM 
to CO"-- COCD 


OOS-* OCM 

o-* ^ »o o 


CO CD CO CO-* 
CD-* COOS CO 


coos 

^lO 




Tf <M -* CO i-f 


CO CM CO T-^ O 


COCO -* 1-11-1 


-* CO CO 1-1 CM 


C<ICM COCMi-. 


CM CM 




i, 
o 

K 

cu 
■>! 

> 
H 

o 

& 

O 


f5 
O 

s 

o 


■papuadsng 


t^-* ■* CO ■* 
CS) corf CO (M 

05 CO o6 oo' lO 


OOO CO o 
CM -* CM CO O 

to CO ^ '-i CO 
^ CM CM 


CO OOO to r- 

CO COI>; ^ CO 
CO O -*' CM CM 


O OtO coi^ 
O GO 00 l'^ to 

CD CO 1-" »-* 


CO OS CD CO lO 
CO O !>■ CD t^ 

to CM o6 -*' 


9.43 
32.56 




'paA|OSSTQ 


OCOOOb- CO 
Tt* *0 »C (N CO 

-<*< ^ CO !>■' t^ 


CM CO-* t^ O 
1— 1 !>■ CM to -* 

■*' CM CM t^ O 

^r-iCM CM 


t^ O OtO to 
■* ■* O O CO 

c5 to oi Odd 


OOO CO b- CO 
cm to CO t* t^ 

to CD to t* CD 


CO CO t-^r- o 
CO 1-; 1-; CO -* 

CO -*' CO CO cm" 


14.12 
15.64 




l^^ox 


t^ h* <M Ot^ 

CD oq o CO o 
CO t-^ c^i lO CO 

C^ ^ •* CO ^ 


CM CO-* CO O 

CO •-"* OS -* 

Os' CD CO od CD 
CM t-H-* -* 


OOCO OCM 

CO r- c^ c^) CM 

-* to co' cm' ^ 

1-1 CM CM ^ 1-1 


OOO 00 O O 
CM CO -* to CO 

■^ CS t^od 00 

CM CM C^l 


CM Ol CO o to 
t^ Ol OS to —^ 

coco -^ GO CO 
CO 1—1 CM 1-1 ^- 


lO <z> 

to Ol 

CO GO 
CM ■* 




P 
O 

K 


•papuadsng 


OS r* (M — ' CO 
OS CO o ic ^^ 

O l>^ CD (m' GO 


CM OCO CO** 
COOO OO ^ to 
o6 to' CM CO c<i 
1— 1 CO CO 


oor* oooo 

CM 00 tOI>; to 

to to' CD to -* 


CM OCsOSi-H 

OS CO CO b-; 1-; 

t--^ to "* CM* CO 


0-* OCOiO 
CO-* OOCO 
OS ■* ^ !>.■ ^ 


to o 

^•* 




•paApseiQ 


OS cooo «5 t^ 
(M ^ ^ kO O 


-* CO CO Oco 

GO o^ r^ Ol 


O OcO OI>- 
O to CO C-1 CO 


CO CD-* CO CO 

CO c^i t^ -* r* 


Ob- t^ t-- to 

Oi O -* O: Ol 


CM CO 
l>- b* 

coed 

coco 




CD 00-* 00 OS 
CO CO»C lO ^ 


00 CO •— ' OS CD 

coco to ^ ■* 


^ -* 00 CM OS 
CO CO-* CM ^H 


OS ■* — . 1-H CD 
CO -* -* O) w 


O to CO -^ OS 
CD CO CO Ol CM 




■p^ox 


00 OO t* O 
C^ »C C^J o c^ 

r^ ic o ^" "^ 

-* -* 00 t^ (M 


CO CO CD CO t^ 

1— ' oo OS oo "* 
r^ 00 CO c^i OS 

to CO 00 Ol t-* 


oot--< ot- 

C-a CO CS CS ^ 
CD 0-* t^-* 
CO to to CM CM 


to CD CO r^t^ 

CM O •-' CO oo 
b-i OCD -*CS 
-* to to CM --H 


O — t^OO 
CM to -* O O 

o <::•' -*" -*' o 

t-- CO ■* CO CO 


oo 
coco 

to o 




1 














Tank, . 
None, . 
None, . 
Basins, 
None, . 


Tanks, 
Imhoff tanks 
None, . 
Tanks, 
None, . 


Tanks, 
Tanks, 
Tanks, 
Tanks, 
None, . 


Tanks, 
Tanks, 
None, . 
Tanks, 
Tanks, 


Tank, . 
None, . 
Tanks, 
None, . 
None, . 








:5 
?: 



H 


6 


... . . . 




Andover, 

Brockton, 2 , , . . 

Clinton 

Concord, ^ . , . . 


Easthampton, 3 

FiTCHBURG, 

Framingham,^ 

Franklin, 1 

Gardner (Gardner area),* 


_ 










rf • • • • 

C3 






bC K 

5 w 
2 ^ 

a) C 




Gardner (Templeton 
Hopedale, ^ 
Hudson, . 
Leicester,^ 
Marion, 


Marlborough, 
Milford, . 
Natick,2 . 
North Attleborough, 
Northbridge, 1 . 


1 a § S.I 



104 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



CO 
!3> 



O 



fc< 



5J 



60 



<i5 






^ 


■ .■ 


%^ 





ftn 





"^-^ 










CO 


fl 


g 


m 


!- 


-M 





C3 






T3 

e 

CO 

i 

tea 

8 



&Q 






CO 

6 

^^ 
P5 
<^ 



g 



a 



•aSBMag 


CO t^ '* C^J 
|>.10»0 CO CO 


CO 10 000 

COC2 ^ t^ 


(M 00 as 00 CO 

Ci M* -^ C2 »o 
t3<C^ 00 CO CD 


'aSBAiag AVB^j 


00 OcO coco 
Oi 00 10 OOM 

CO CO uD CO CO 


00— 1 O-H 
CO CO CO CX3 0S 


oor*03 ■^^-. 
c^c^ CO (M 

■^COIOCOOO 


CD 


•paAoraai 

^uaO jaj 


^0 1 ^^ 1 

■^00 -^ 


\r> 1 .-•00 1 


1 1 00 1 1 


•aS'BMag 
pa^eaix 10 pai^^ag 


6.42 

10.62 

3.39 


2.57 

3.67 
4.38 


4.16 


•aSBAiag AiB^ 


10.85 
52.03 

6.40 


5.66 

7.47 
6.06 


7.96 




s 



z; 





•paAOuiaj 

^uao aaj 


c^ 10 1 cot^ 
coio coco 


t^CO CO (M 05 


t^^H tocq t^ 

CO t^-^-^co 


•a§B.\iag 
p8:(BaiX JO pai»9g 


CO t^ (M t^ ^H 
10 COI>; 0'<a; 

^ t^ CO -^ i-t 


OCOCO'^ C5 
•— ' CO 05 rji 

COtOTpCO-^ 


■*^iO Oi to — ' 
CO CO C5 CO 00 

i-H 1-lCO coc^ 


•aSBAiag M.'By^ 


1-H Ol-^ <M Ci 
t^ CM 10 CO C^ 

COCOCOCOtJH 


r^co t^'^ OS 

CO to CO t— C^l 

to C5 OCO CD 


CM to <M N 00 

CO t* t>-co to 

CS to (M CO 00 


a 


So 

§ 


•paAOtnai 

(^nao jaj 


cor* 1 r^CM 


OS to CD 05 N 
10 -^ CO<-i CQ 


CO OCO T-'-H 

to t^ CO coI>■ 


•aSBAiag 
pa^T3ajx JO panics 


t» CO 00 COM 


OCD tCCM 00 

to 00 CO t^ to 


^ toTj* cor* 


■aSBAiag MBy; 


10 OS t-* OiO 
03 10 CO CO t* 


d cO-^Oi-^ 
C^ IOCS 00 t^ 


to •* to t* CO 
■*** 00 00 1>. OS 


a 


03 

a 

» 

g 


■paAoraai 

^nao jaj 


00^ 1 UO-^ 
cooo t^l^ 


COt--*-^Oi 
t* -^ l>- CO ■<*< 


CDb-l>.COOS 
CO t>. to "^t^ 


•aSBMag 
pa^^aix JO pai:»^ag 


CS ^H(M OCO 

OS 10 CO 00 *-^ 

0(M 00 to CO 


00 r* oO(N 

(M 00 to 0100 
to to CO l>- to 


2.79 
3.11 
9.30 
11.00 
5.21 


•aSBAiag Ai'B)j 


CO CO 00 !M CO 

ir* 00 to ^ 

t-Il^COCOM 

^-H>. ^ W fH 


19.87 
29.71 
25.36 
22.17 
11.45 


■^ r* -.** -.*H 
c^i 10 t^ c<i 

OOfO^ OtO 






i 

■3, 


Tank, 

Basins, 

Tanks, 

Imhoff tanks, . 

Tanks, 


Tanks, 
Tanks, 
Tanks, 
Tanks, 
Tanks, 


Tanks, 
Tanks, 
Tank, 
Tanks, 

Chemical prec 
tion. 




!i5 




a 



. _ _ 


Andover 

Clinton, . . . . 

FiTCHBURG 


Gardner (Templeton area), 

Hopedale, 

Hudson, 

Marlborough, 

Milford, 


North Attleborough, 
Northbridge, 
Norwood, . . . 
Southbridge, 
Worcester, . 






13 
<u 
o 



3 

o 

XI 
c3 



<u 



■3 



a 
fe 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



105 



i 

o 

fie 

o 



£ 






<a 


















•cJ 






fc. 






o> 






g^ 






"<s> 












rii 






O 






•cJ> 






i~ 






E-. 






<» 






•< . 






■" o 












O (^i;) 


















"^ 1? 






S SJ 






•S 5i 






"^ o 






fin S 






s ^ 






e ^ 






'o 42 












S O 












^ Is 






«^f^ 






o^ 




. , 


CO 




o 


<^ « 


^ 


g 


fi. ^ 


o 


o 


S cc" 


S 


o 


e -^ 


o 


r. 








s . 






.<=> -1: 










rO 



^ 



00 
51 



d 











er has an 
1 acre and 
o 6.5 feet 
one from 
s in size, 
te of oper- 
t 1,580,000 
B per day. 
nder con- 


mentation 
t one and 
s. Tank 
er week. 










i 


E =2 


^ tn^ 2 o o == 


^SS^" 










S3 

1 


bti'o 


of 5. 
hed 
3 inc 

rage 
as ab 
per a 
orks 
n. 


f se 
d ab 
f ho 
once 










be trick 
area of 
a depth 
of crus 
1.5 to 
The ave 
ation w 
gallons 
New w 
structio 


eriod o 
average 
one-hal 
cleaned 












H 




fin 












*o 


M< o "« 












•g;BJ 


o 

00 


CO p; o; 


1 t>- 






•u83oj:(t^ n^PP?H 


1-i 


s s s 


2 5 








. 




CO 


•* CO 











a 


•paja^inj 


oq 


o> t, -: 
« =o M 


' |§ 




















O 






■^ 


CO -H 








o 


•pajaiignxi 


CO 

o 


o _ ^ 
■*■ <= CO 


.-1 CO 








o 




f-H 


















O CO 








S5 

a 
o 
o 

IS 


I 


•sa:^tJ^IJS[ 


1 


53 ' § 

o o 


1 1 






n 






CO t* 








H 


-< 






CO (M 








12: 




•sa:>BJ:(i^ 


1 


OO ' oq 


1 1 












OS 


CO »o 












•anuoiqo 


CO 
OS 


CO o> '^ 
CO "^s t^ 


' ?3 












CO 


CO CI 










Q 


•papnadsng 




■ ■»< 


s s 








O 




























. 


y, 




CO 


t^ ^H 








^ 


■P 


■paAJOSSIQ 




"^ CO <M. 


1 t^ 

CO 






X 


P 






























5! 


iJ 




CO 


O CO 








S 
< 


■< 


•IB^ox 


o 

1— « 


i; (M « 

CO 


2 g 










CO 


CO lO 












•asjj 




CO o "^ 

c^ '-'' c-i 


' 5! 








^ 




■* 


e^ •* 










o 


•papnadsng 






O CD 
lO OO 








H 




*— t 












O 
i-t 
















oo 


OO ^ 








^ 


•paAjossiQ 


»q 


■* -H -«• 
^ '^ ci 


' 5; 






< 


K 






.-1 .-1 








o 


O 
















<M 


O OO 








^ 


O 


•IB^ox 


o 


°o o ■=; 

CO CO irj 


2 S 








i-l 




^ 


.-» .— t 








o 




















S2 


■* o' 








p 


•papnadsng 


CO 


""I CO 1 

r- t^ CO 


^-1 t* 






P" 


O 




<M 










P 




to 




OO 


C^l CD 








« 


•paAJOSSIQ 


f-H 


»0 c^l iO 

-H ^ CO 


' .S 






fn 


d 




»o 


CO C3 








« 




























H 




o 


CO CD 










o 


■[■B^ox 




38.6 

52 

39.6 


' g 












to 

c 

o 

i3 


ing filter, 
m trick- 


y tank, . 

by trick- 
ing tank. 












-a 


rickl 
ed. 
t frc 


edb 

ved 
sett 














*- ■* c 


> Q-a 












p. 


e 2 " 

C c ^ . 


i is 














tfrc 
tre 

effl 

Iter 












<o u 


c c -a-" 


er cen 

er cen 
ling fi 












^2 


02 o a,— ■ 












M 


W ft< M 


p., Ph 1 





106 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 






« 

n 
a 

o 

Eh 



Cm 



O 









S" g <u 


rt§ 


>i^ 


d O-TJ 














^ (U 












'"^ °-s 




■c » 


•^■^ c 














0-2 


cj cC 












J2 


t- S ° M 
















a 


c^2m 


2^ 


c3^ 










0) 


•— C<Jt^ O 


s§ 


ft-- 


.«-a a> 










« 


3^ o-w 


!D =5 


Co S 












o 0_j.-H 


0.2 


ct 


C3 .«'-3 












is c3-s,a 


c3 

13 














H 


H 




Ph 












Oi 
















•SIB^ 


CO 
CO 


I 


1 


1 


1 


1 








<M 


00 


oo 


CO 





CO 


■uaSoj;i}«j nBpiatj[ 


Oi 




-«l 






ICI 








T-t 


Oi 




"^ 








S 


•pajain^ 


oo 


c^ 


s 




'S" 


CD 

10 
















O 








00 













•paja^igafi 


o 




CO 

10 




00 


§ 










(M 




^_, 
























O 

K 


1 


■sa}u:>i]<[ 




CO 












M 











00 






H 


< 






•^ 




'^ 






« 




•sajBJiif,j 


1 


Oi 


1 


Oi 


' 


1 








en 







-* 










•auuoiqo 


CO 


CO 
CD 


CO 


CD 


1-H 


Tjl 










cn 




r^ 








p 


■papuadsng 







U5 




S3 

























CD 


■«** 




CO 






-< 


? 


■paAjossiQ 


cq 


»-4 


to 


' ' 


t^ 




"0 


o 


D 
















,j 




oo 


CO 




s 






< 


< 


"I^^OX 


CO 




s 




« 








lO 


t^ 















■aoj^ 




!>• 


CD 
CD 




1 


s 








o 


CO 




;3! 








b 


■papuadsng 


CO 


M 


CO 






Ci 


o 




















CO 


t^ 




c» 








•paAjossiQ 


t^ 





10 





05 


-* 





z 






»— 1 














CO 







CV| 






Oh 


rr 






CO 










< 


O 


I^^oX 


CD 




T-* 


C-1 


1— » 


CV| 


;> 
W 

z 

o 


►J 










r-( 










o 


00 




S 






K 
D 


•papuadsng 


oq 


-•a^ 


01 


(M 


00 
CO 



10 


O 


























!2 








■peA[osstQ 


o 




^^ 


ci 


1 











CO 


(M 










<; 



























i5 








H 


















O 


IB^ox 


oo 


'«*< 


»-H 


(M 












CO 


CO 




CO 












1 

c3 




• 


I 


to 










CO F-> 


ca 




-is £1, 


c 


i3« 








c3 O 








m 


bfi 










c 
2 






>1 










3 c 





-c 




T^ 


£ S 








E3 




S? 


■^■^ !r 





^ m 








■*j 


> 




> 


0^ 











H 



a 




a 



eg 

M 








C3 


-4-3 

c 



-4-3 

c 




0) bL 2 


c 
8 








1- 

1— ( 


E 


(-1 












K 


(-H 


M 


h-t 


Ph 



I 



I 

I 



No. 34.] DIVISION OF SANITARY ENGINEERING. 107 



Table No. 5. — Average Results of the Analyses of Monthly Samples of Effliient 

from Sand Filters. 

[Parts in 100,000.1 









Free 
Am- 
monia. 


Total 
Albu- 
minoid 

Am- 
monia. 


Chlor- 
ine. 


Nitrogen as — 




CiTT OR Town. 


Ni- 
trates. 


Ni- 
trites. 


Iron. 


Andover, 1 


1.74 


.1308 


6.45 


.3012 


.0367 


.458 


Brockton, i . 






3.40 


.1014 


8.35 


.1515 


.0015 


1.716 


Clinton, 1 .... 






1.85 


.0822 


4.66 


.3035 


.0024 


2.283 


Concord, 2 .... 






.04 


.0130 


3.65 


.7288 


.0056 


.015 


Easthampton, ^ . . . 






1.36 


.1204 


4.60 


.3300 


.0279 


1.070 


Framingham, i 






2.36 


.1292 


7.02 


.3747 


.0201 


1.365 


Franklin, ^ . . . , 






1.05 


.0514 


3.23 


.2667 


.0050 


.156 


Gardner (Gardner area), ■• 






1.34 


.4333 


5.83 


4.5410 


.0360 


.273 


Gardner (Templeton area),' 






1.82 


.3716 


8.85 


1.7768 


.0639 


.089 


Hopedale,' 






2.00 


.1710 


6.33 


2.6586 


.0169 


.082 


Hudson, 






.92 


.1227 


10.34 


1.3179 


.0218 


.202 


Leicester,^ 






.55 


.0564 


2.58 


.1983 


.0129 


.059 


Marion 






.36 


.0344 


2.72 


.6551 


.0030 


.049 


Marlborough,! , 






.78 


.0840 


6.45 


1.5182 


.0102 


.083 


Milford 






2.02 


.1002 


7.06 


.4415 


.0114 


.777 


Natick 






2.22 


.0907 


7.47 


.1833 


.0047 


.847 


North Attleborough, - . 






.06 


.0130 


3.42 


.5983 


.0055 


.016 


Northbridge,2 






.39 


.0375 


2.47 


.5797 


.0127 


.182 


Norwood, 






1.06 


.0751 


13.11 


.1759 


.0199 


.543 


PiTTSFIELD,' . 






.70 


.0753 


4.81 


.6132 


.0231 


.201 


Southbridge, ^ 






2.02 


.1191 


5.30 


.1694 


.0005 


1.642 


Spencer,' 






.16 


.0214 


3.15 


.8753 


.0005 


.180 


'Stockbridge.i 






.25 


.0387 


1.98 


.4002 


.0168 


.170 


Westborough, i 






.97 


.0892 


4.57 


.2741 


.0127 


.580 


Worcester, ^ 






1.87 


.2360 


11.12 


1.0558 


.0110 


1.400 



1 Regular samples from two or more underdrains combined in one average. * 
' Six samples. ' 

3 Five samples. 



Four samples. 
Fourteen samples. 



\ 



108 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



I 



Table No. 6. 



Efficiency of Sand Filters (Per Cent of Free and Albuminoid 
Ammonia removed). 





[Parts in 


100,000.1 














Free Ammonia. 


Total Albumi- 
noid Ammonia. 


Chlorine. 


Rate of Operation with 
Even Distribution (Gal- 
lons per Acre per Day).' 


City or Town. ' 


6 
us 

-0 

2 

1 
< 


-.J 
o 


> 
1 

a 
o 
O 


6 

CO 


+3 

13 


> 

i 

£ 

a 
o 
O 

Pi 


M 
0) 

W 

■a 
.2 
"E 

0. 

< 


a 


Andover, 


4.17 


1.74 


58 


.73 


.1308 


82 


7.39 


6.45 


68,000 


Brockton 


4.76 


3.40 


29 


1.06 


.1014 


90 


9.39 


8.35 


55,000 


Clinton 


3.17 


1.85 


42 


.68 


.0822 


88 


5.74 


4.66 


42,000 


Concord 


1.35 


.04 


97 


.37 


.0130 


96 


3.73 


3.65 


124,000 


Eaathampton, 


3.06 


1.36 


56 


.85 


.1204 


86 


5.90 


4.60 


- 


Framingham, 


3.76 


2.36 


37 


1.55 


.1292 


92 


7.89 


7.02 


60,000 


Franklin, 


1.88 


1.05 


44 


.21 


.0514 


76 


3.28 


3.23 


65,000 


Gardner (Gardner area). 


10.11 


1.34 


87 


3.47 


.4333 


88 


7.73 


5.83 


1 

!■ 80,000 


Gardner (Templeton area), 


3.55 


1.82 


49 


.50 


.3716 


26 


7.36 


8.85 


Hopedale, 


6.39 


2.00 


69 


.86 


.1710 


80 


7.95 


6.33 


23,000 


Hudson, 


4.15 


.92 


78 


.65 


.1227 


81 


10.10 


10.34 


49,000 


Leicester, 


1.31 


.55 


58 


.36 


.0564 


84 


3.33 


2.58 


- 


Marion, 


1.62 


.36 


78 


.35 


.0344 


90 


3.19 


2.72 


76,000 


Marlborough, 


4.00 


.78 


80 


.72 


.0840 


88 


7.70 


6.45 


52,000 


Milford 


3.49 


2.02 


42 


.58 


.1002 


83 


9.08 


7.06 


105,000 


Natick, 


3.14 


2.22 


29 


.50 


.0907 


82 


8.42 


7.47 


119,000 




1.50 


.06 


96 


.21 


.0130 


94 


4.92 


3.42 


111,000 


Northbridge, . . ... 


2.02 


.39 


81 


.25 


.0375 


85 


2.48 


2.47 


49,000 




2.66 


1.06 


60 


.54 


.0751 


86 


18.49 


13.11 


114,000 


PiTTSFIELD, 


2.46 


.70 


72 


.45 


.0753 


83 


4.71 


4.81 


86,000 


Southbridge, 


3.86 


2.02 


48 


.53 


.1191 


78 


6.98 


5.30 


- 


Spencer 


2.93 


.16 


95 


.64 


.0214 


97 


4.10 


3.15 


- 


Stockbridge, 


1.34 


.25 


81 


.29 


.0387 


87 


2.28 


1.98 


- 


Westborough, 


2.16 


.97 


55 


.71 


.0892 


87 


5.21 


4.57 


91,000 


Worcester, 


2.59 


1.87 


28 


1.07 


.2360 


78 


14.04 


11.12 


59,000 



1 See also Table No. 7. 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



109 



Estimated 

Rate of 
Operation 

with 
Even Dis- 
tribution 
(Gallons 
per Acre 
per Day). 


ooooo 


1 


1 ooo 


ooooo 


OOOOO 


1 1 oo 










o o o o c> 




O O C5 


ooooo 


OOiOOO 


o o 










ooo_oo_ 

GO CC »o Oj' -.1^' 




OOO 

o»o'o 


ooooo 
CO crco"c^i"io 


OOOOO 

Ci '-TaT-^cD 


oo 










CD CO i« -^ C^J 




(O CO 00 


CM "^l>- lO o 


^^^ '-00 


a lO 














































CJ d)'-^ 


»0 OOP5 00 


o 


w^o 


cio»o oo 


OOO-^iC 


OOOO 










et Ar 

of 
terBi 
Acres 


cc >o r^ CD -^ 


CM 
CM 


i-H CC CM 


r* or^cs CO 

coos oo> 


CD0010-; 
CM !>. C^l O t-i 


»0 COOC CD 

oocsioc-i 










.-* eo cq 




CM .-H 


CM 


^ i-Hi-l^ 


t^ 






























^ £- 






















Estimated 

Average 

Quantity 

of Sewage 

per 

Connection 

(Gallons 

per Day). 


1 OOOO 


1 


1 OOO 


I OOOO 


OO 1 OO 


i 1 O 1 




-H CM C-. N 




'Tj'Oi lO 


»0 CD O-^ 


CD O COCO 


ira 










lO -.^^ CO ^H 




OCClO 


CD eo*ot^ 


OCM Ol>- 


o 






s. 
























«:2 S 


OO 1 oo 


1 


1 O [ 1 


OO 1 oo 


OOO 1 o 


1 t O 1 






oo 




» 


oo oo 




o 


oo oo 


OOO o 










0^ 


oo OC3 




o 


oo oo 

OOO CO ^ 


ooo o 
odco^od »o 


o 








oo IM O 




u:) 


lO Ci CO ^ 


1^ CD CD CS 


00 








— ixti o^ 




00 


CM CDOO 


■^CD-^ O 


CM 








r « 










CO 








o 
o 
o 




§s 




















>o 






































<M 




(h — 




O 1 1 1 o 


1 


I O I 1 


oo 1 oo 


oo I I 1 


1 1 O 1 






1^ 


if 




o o 




o 


oo O CZ) 


oo 


o 






.4.3 


o o 

00 M^ 




o 


oo oo 

OC^f cT CM 


o^o 

oo o 


o 






1 


■i 


"*< CM 




»— ( 


iO CO 1— ' 1— 1 


'-* ir> 


oo 






.n 


Ut 


< "^ 


CO t- 




»— « 


—•CD oo O 


Oi 00 


oo 






03 


o 


&0 






cT 


i-Tt-J" 


CO 








o 


a 


<2 »^ 


















a 






















bD 

.S 


o tl 


ooooo 


1 


OOO C) 


OOOOO 


ooooo 


U3 

1 1 oo 


o 


M c3 


ooooo 




OCiOO 


ooooo 


ooooo 


oo 






a 


M 

o 
o 

o 


o o o^ o 

r^ CD CD >c c^j" 




OOOO 
■i^c^o O 


ooooo^ 


ooooo^ 
rd^CM"o»i:3" 


oo 

cTo 






o 


-* CO CD CTi CO 




OO— 'O 


oo CO lO h- t^ 


ai t^oo OCM 


CI C5 






c3 


5n H 


C^ iO t^ OiO 




0<M (N O 


■^it^ oo 


-^l^-iOCM »0 


IOC-1 






W 


<o 


eM"rt 




cvfi-T ^" 




^ -4"co 


•^ 




© 


o 

o 




















-..J 


u 


CO 




















© 
"a 


© 


Tjj* 
















M 


Approxi- 
mate 
Number 
of House 

Con- 
nections. 
















£ 


<B 


& 


1 CQiO OcD 


1 


1 COtJ* ■^ 


I r^ o lO CO 


CD CD I ^ 1-H 


1 1 00 I 




o 


M 


5 


lOOOOt- 




C^l CO CO 


t^ or- CM 


OtJ< CO c^j 


«ra 




© 


C 


^ q- 


.-- »0 iO ^J* 
r-^CO ^ 




COiOCO 


CD — ^CO 
CMi-H 


■^ o ^^oo 


l« 


c 


-.J 
o 
a 


3 

u 

-.J 


2 „ 

© 03 

to H 


















o 


© 

J3 


•T3 
















3 .2 


Approxi- 
mate 
Length of 
Sanitary 
Sewers 
(Miles). 


CD OCD O 




lOOOO 


'■^ CM CM CD 


O -^b^ 


oco 


CO 

c 


s 

3 




00 CD »0 Oi 

or^ -- 00 


1 


■o coco 


CO O OOC3S 

oco o t^ 


CO OOCM 
CD" t^ ^ 


1 1^-^ 

Oi to 




o _ 
© 'B 

o g 


CO 00 CM 




CM — t (M 


—1 CMtI 


1— 1 ^H CD 


CO 


o 
© 

© 


1 


© 

© 
















-a 
c 


"o 


-..3 


© >. 






























;3 


>. 


n: .^ 


i -1 . 


oo— •■* CI— 1 


.— 1 


Oient^'^ 


h-b^OO 00 •-» 


t^QO-^t^CO 


iCOO-rt* 


C3 


CO 




S-d 


CD CO lO t^ CD 


CO CM CO Cit^ 


t^ o oo CT r- 


O CO t^ CM CO 


Tj< CO00»Ci 


© 


"S 

o 

E 

(-• 

o 


a 
3 


— 1 .2 


U$i 


CMIr^C<l C^ -^ 


CM 00"rt* C5 


t^ CO CI O -^ 


OlCM ^^CDt'- 


CM o: t^b' 


OS 




odcTco cJco 


—7 


^ I^-cO CD 


CM t^T-^irTco 


C^OrOC^i'i-r 


•^irfio oT 


o +3 c ^ 


— CO ■-' 




-^1-1 ,-1 


1— 1 1—1 


rH i-Ht-H-*^ 


1-H t-- 


"3 

_0 


© 


CD ^ 

II 
















"■+J 

"3 




-a 

_2 




1 




























TJ 


c3 


*© 




















a 
1— 1 




■* A 


o 
H 

K 

o 




















rd 












u 






.... 




.l... 
















> a w o o 


■le o c c t^ 


as" 
. . . o , 



o 

o 3 53 <::: 


-.J t- fc- fc- c^ 
oJ o o o S 













no ' 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



o 

2; 








^ 


^s 


JS 


^ 


■w 


•S 


Ui 




-3 


fe. 


3 


r^O 


ri 


c 


o 


s~ 




<l^ 


^ 


K 


H 


iW 




<^ 


PQ 



00 



J2; ;S 



p 
H 



01 

-a 






05 



o 











neces.sary. 

en necessary. 

one in winter. 

others v/hen 


03 


i 


. >, 


. t; .b 


en 

aj 

■ t3 
>1 >>« 












^ CO 


>>b >>03 

t- ^ U CO 

03 ^ 03 CO 


1 id 

CO CO S 




o 






0) CO o o 
O Ol o 

o o a >> 
do S t. 

d« fi ^ 


g 

d 


CI QJ 

<U d 


CO aS M 4) 
CO 5 CO o 

o fl^ o a; 

^ 5s ^ G 
a) d <u -^ 


0) OJ^ 

0) aj S 

d do 




^ 




c-^ 






C d 


^ e « g 


d d £ 








u S 


<u d o w 




d «d.S 

OJ -'-' O t- 


a) a) o 




n 

O 




J3 <u 




^2 -^ 


o 


J3 J3"^ 








o S o g 


en o 

11 


.d 5.d ^ 

&g, Sjo 

2 2 2.S 
o-d ui; 
-fi o-d o 


0) II)—' 

° . °-S 

Qj aJ dj fl 






d 


<D aT 


:3 t^ 

2 .• i^" ?^ ° 


o <» » o .— • 


o 


O .. 
ffi 


O O .- 




.1 


B 


2§ 




ee ss c >. 


.§ 


■^a 




a a a-2 




''■+2 


■+3 -3 


•^•^•43-^.2^ 


'■+3 


^- 


.^ .^ .« (T) 




C 


.s 




l:!^s^ 


O » ffl 0) c . 


.s 


>,.s 


>'^>'l^ 


Qj Q O '*^ 

-d .d j=s 




.2 

a 


-M 






..J -^ .fj ..^ -^ t-t 


-fj 


> . — 1 


>S >-;S d 


^ "^ ;!!^ 




"3 


<^ O 03 s ■" 


s d d d C^ d 


l1 

S =3 


ffl o3 

d d 


O 03 » "3 O 

d d d C d 


c3 03 o3 aj 
d d d a 




< 


o3 


« c3 03 g 2 


a C3 03 03 c3 -S 03 

gsssa'-rs 

2 a) 0) 0) <D S' a) 


03 03 


c3 03 c3 2 03 


03 c3 03_ 




a 


&a 


aa 


aaa«a 


a a ag^ 

a> o a) g c3 
n d d g CO 
O O Om 






V 


ffl s 


o o ffl £ o 


d "u 


CD ffl 


aj oj a> 1^ oj 






c 


C o 


^ c c-a c 


C d d d d S d 


- d 


d d 


d d d ^ d 






O 


Ofe 


hOOHO 


OOOOO 


O 


OO 


OOOHO 






"cS 










■_d 


■ ■ ■ ■■B 


•'-'-- • • 






• ' • • • 03 

a 










i 

• c8 . • • 


g 




. d 

o3 


•3 

O • • • B 


. . d" 
aT .2 <B 






S 




•— 0. • • 
0...3 

>:2 > > > 

d c3 d c3 o3 

H-r ^- t^ ^- 

M g U) tO] M 


-a 




CO 


« 03 




3 

S 


'-.^ 
o 

1 

O 

>. 

+j 
C 
03 
3 

cr 


C 03 
3—. 

2 > 

;3 c3^- 


c 

. .^- . . =* 

c -a 

- d' o S ,- M 

S.2 dj g 0, 
dgSg-a^ 

d 03 o d S M 

IS " g, 03 g ™ 

» o ^" >> 

g =« a s !3 s 


ii 

o . 

r?d 


. d a . . >, 

; £-2 - 1 

'^ :3 (li "^ d S 

S C^ d dTJ e bt 


ft • -ga 

d to d 
d — 

d " d 

3 d d 

^"o"^ .2 _>. 
"aj S o3"3'a3 

bC S CO c hD 

fS a) =3 is 
..•-« .... 

- 03 a'j^ 03 03 

5t3 o -x!-a 






E 

CO 


d c c c c 

03 3 d 03 C3 


as 

is CD 




g c3 c3 d C.^, 

o-a-a =^ .-d 


(-• C3 . (_ C3 C3 

d^E*-a-a 






> 


- "J-u 


TJ-aTS-^Tj 


^ d 


c; O^ C C'^T! c3 






■a i;-.^ a 


c rt e c d 


cd 


tS bD 


.. 03 03 d d-a 


o d i^ d d c 






a 


:s c c3 


03 (3 c3 o3 ce 




. 


M to CO 03 03 c 


*" o3i; O cS 03 








m m « CO « 


■a-d 




O <B 0) ■» «= 03 
S CO ^^^ ^ 


CO cd "^ CO CO 

a-a^ S,-a-a 
o o g.Mg o 






tH 


S S o 


o o o o o 


c +^ 


Km 


o 03 03 O O.b 
ft O O O O c« 






'3 


^ « o 


o o o o o 


— 03 


IK o S t- o o 
OwAOO 






WO 


OOOOO 


rt 


ooooS 






o 


lO o 


O 1 ooto 


OOOOOO 1 


o 


Oeo 


»CiC OW5 O 


1 CO OO o 
C^ CO*? »o 


c 


c^ 


coco 


t^ ■»•* M 


CM CO CO O 


>o 


■*oo 


*C t^'* CO -^ 


• r-l 

Q 






i ii 


J. 1 '"^ 
OiO 1 


1 

o 




o 


OiO 






to cqoo 


(N CO O 

lO 


CO 




lO 


coco 




















^ 


.d 


i «^ 


■* 


ir^iO 


C» 0) iOiO »o 


lO -^ CO =o-^ »o 


CO 


i/3 CO 


lO -^ O TJH Tt* 


I lO iCiO CO 


75 a) e -iJ 
S* O S 03 « 




4*40 


d ^ 


1 1 
CO lO 


•»JI 




CO ^ 


CO CO 


Q 


ts-SS 
















^^ 




2 §.2-2 




CO ic CJ 05 


OS O 


00 Oi 


Ol^ lO 


^H 


t4-l 




2S = 


-t 05 


O ^H 


o- 

2s 




^H o -^ 


»— ( p^ 


o 


oo 


S2Soiooo»o 


-SoS'X'O 


5r^ CO 


22a2co 


fe ■== 2oO 


tx 


^jt*-i ,jj o 


as 




Qi O OS ^H 


C35 O oo 




-.005 


O Ci 


Os Oi OS 


C3 


§°^^ 


00 




- * oo Oi oo OS 


c»_^ai -00 Oi 


-moioo 


^^— r^ _^^ 


GO CO -OO 


O 




(MroOOOO..H^Hi-l^ 








o:> to ,— 1 •— • 1— . 


^ ^ (>J ^H 


>^ 


5.p2 




— iSoos 


Oi C32 


§i" 


OO o 


Oi 
OO 














»— 1 




> 








.'5 

03 is 

HI 


. 


• • 


J3 


.... 




> 
o 












^ 






o 

6 


o 


o p 

<;pq 


. .g'a . 

1 ill? 


11 

9^ - 

"^^ CD ^ (J" 

o Si's d" « _- 
d d'O o to S 

"E-s a| g-g 

03 03 O 3-S oj 


S 


O 
K 
O 

n 
.J 

< 


0.2 

:=; c3 


s 

c5 a> • . (u 


- IH O H 
fc- t- b c« 

d 3 ■£" 
a ° >> 



No. 34.] DIVISION OF SANITARY ENGINEERING. Ill 



Examination of Rivers. 

The condition of the polluted rivers of the State has been less 
objectionable than for many years. This has been due to two causes: 
(1) the excessive rainfall and flow of streams throughout the year; 
and (2) a great reduction in the polluting matter discharged from 
factories and mills, many of which have been closed or operated only 
on part time during the latter part of the year. 



Assabd River. 

The Assabet River in the upper part of its course has been in 
rather better condition than usual, but below Hudson the quantity of 
organic matter in the river water, notwithstanding the high flow of 
the river, was greater than usual. Below Maynard the river was 
offensive during the latter part of the summer, but, on the whole, 
not as objectionable as usual. 



Blackstonc River. 

The Blackstone River below Cherry Valley has shown less pollution 
than at any time in the last four years, but at the outlet of Curtis 
Pond the pollution was slightly greater than last year, and this is 
true, also, of the stream above the Worcester sewage disposal works. 
Below the disposal works the condition of the river appears to have 
been much the same, as last year. At Uxbridge and Millville its 
condition has shown little change in the last few years. 



Charles River. 

The condition of the Charles River has shown marked improve- 
ment throughout its course as compared with last year, a result due 
very largely to the reduced quantity of polluting matter discharged 
into the stream from factories and mills, since this river receives 
comparatively little sewage. Many of the factories in the upper part 
of the drainage area were either closed or operated only on part time 
during the latter half of the year. One of the largest mills in the lower 
portion of the watershed reduced its output for the year to about 
one-eighth of that of 1919. Under such conditions the effect of the 
discharge of manufacturing waste into the stream naturally has been 
much less noticeable than formerly. 



112 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Chicopee River. 

The condition of the Chicopee River and its tributaries has been 
better than for many years. The flow of the river has been unusually 
great, and its pollution by manufacturing waste less than usual. 

Concord and Sudbury Rivers. 

The Sudbury River has been in better condition than usual, and 
the same is true of the Concord River, as far as the city of Lowell. 
Its condition in the city of Lowell continues to be objectionable, and 
no action appears to have been taken by the city or other parties 
interested as advised by the Department at various times, notably in 
a communication to the municipal council of Dec. 10, 1912. 

Connecticut River. 

The Connecticut River and its tributaries show little change as 
compared with previous years. While this river receives large quanti- 
ties of polluting matter from the cities and towns along its course, 
its flow" is so great in proportion to the population that practically 
no evidence of this pollution is noticeable, except by chemical analysis. 
Local pollutions along the banks, due to the discharge of sewage or 
other refuse too close to shore, have been objectionable at certain 
points for many years, and some of the tributaries, notably the Mill 
River below Northampton and the Manhan below Easthampton, are 
very badly polluted and objectionable in years of less than average 
rainfall. 

Deerfield River. 

The Deerfield River receives but little pollution at any point ex- 
cepting near its mouth, where the sewage of the town of Greenfield 
enters the stream. Its condition has not been objectionable during the 
past year. 

French River. 

The French River, which is badly polluted at several points, 
especially by sewage and manufacturing waste at Webster, was less 
offensive than usual during the year. 



No. 34.] DIVISION OF SANITARY ENGINEERING. 113 



Hoosich River. 

There has been a marked increase in the pollution of the Hoosick 
River below Adams, but below North Adams and at Williamstown its 
condition was somewhat less objectionable than usual. 



Ilousatonic River. 

The Housatonic River has been polluted during the year by the 
discharge of untreated sewage from the city of Pittsfield, but the 
effect of this pollution has been diminished by the unusually high flow 
of the river. 

Merrimack River. 

The Merrimack River, like most of the other streams, has shown 
less evidence of pollution during the past year than usual. The 
reduction in the quantity of manufacturing waste discharged into the 
river at Lawrence had a marked effect in reducing the pollution of the 
river at that point during the latter part of the year. 



Millers River. 

The Millers River watershed contains few large towns, and the 

stream has never been very seriously polluted by sewage. It receives 

the sewage of the towns of Athol and Orange and small amounts of 

sewage at other points. 

• 

Nashua River. 

The Nashua River below Fitchburg, but above the outlet of the 
city sewage disposal works, has shown more evidence of pollution than 
in any year for several years. At North Leominster its condition 
has been much the same as usual. The condition of Monoosnock 
Brook, a tributary which receives the sewage of Leominster, was 
worse than in the previous year, and the same is true of the main 
stream below Monoosnock Brook. In this portion of its course the 
stream was very offensive during the drier part of the year. Farther 
down the river the unusual dilution reduced considerably the effect 
of this pollution, and the condition of the river, on the whole, was 
about the same as in the previous year. 



I 



114 DEPARTMENT OF PUBLIC HEALTH. [P. D. No. 34. 



Neponset River. 

The results of chemical analyses of the water of the Neponset 
River and its tributaries at a number of points show that the river 
has been less polluted than usual during the past year, a condition 
due no doubt to a reduction in manufacturing activity in this water- 
shed. Additional disposal works for the treatment of manufacturing 
wastes have been built in this valley during the past year, which have 
no doubt contributed to the improvement in the condition of the 
river. One of these works treats the waste of a tannery in Walpole 
and another the wastes from a finishing works at Canton. 

North River in Peahody and Sahvi. 

The North River, one of the most polluted rivers in the State, 
has shown no improvement during the past year. Much of the 
sewage of Peabody has overflowed into the river, and the stream has 
been very offensive during the past year. Certain minor changes 
have been made at the Salem pumping station, but the main im- 
provements needed to insure efficient operation of the trunk sewer and 
outfall works have been postponed, in common with other necessary 
public works. 

Taunton River. 

The Taunton River below Brockton has been more noticeably 
polluted than usual, notwithstanding the high flow of the river. The 
condition of the river has been less objectionable than usual in other 
parts of its course, due to its unusual flow. 

Other Rivers. 

The remaining rivers of the State are less affected by pollution 
than those mentioned, and no change in their condition worthy of 
note has occurred during the past year. 



Division of Watee and Sewage 
Laboeatoeies 



H. W. Clark, Director 



[1151 



i 
1 



Keport of Division of Water and Sewage 

Laboratories. 



The activities of this Division are divided between analytical 
work and research. During the year 1920, in the State House labora- 
tories of this Division and at the Lawrence Experiment Station, 
13,413 chemical, microscopical and bacterial analyses were made, as 
shown by the following summary. A large percentage of these 
analj'ses was made to ascertain the condition during the year of 
public water supplies, ice supplies, rivers and domestic wells, the 
efficiency of municipal water filters and the safety of their effluents 
for domestic use, the quality of the sewage applied to and of the 
effluents from sewage filters, the character of trade wastes for the 
furtherance of studies regarding their disposal, and the condition, as 
regards bacterial pollution, of shellfish from different sources, etc. 
Besides this a large amount of analytical work was done for the new 
Commission upon Water Supply Needs and Resources of the State. 

Most of the analyses made in the State House laboratories are 
summarized in the tables presented in the annual reports of the 
Division of Sanitary Engineering. 

Research was carried on during the year in regard to the corrosion 
of pipes in many cities and towns of the State, and at the experiment 
station many studies were made upon methods for the disposal of 
trade wastes; upon important modifications of the activated sludge 
tank process of sewage disposal; upon seasonal and other variations 
in the bacterial quality of shellfish from different areas of the State; 
of the relative significance of B. coli and B. aerogenes in bacterial 
water examinations and methods for the differentiation of these two 
bacteria; in regard to the efficiency in water treatment of liquid 
chlorine at low temperatures; of the effect of certain wastes upon 
municipal filtration areas, etc. Many experimental water and sewage 
filters, septic tanks, etc., are in operation at the station for various 
purposes. 

One of the interesting and exceedingly important and promising 
lines of research carried on at the station during the past three years 
has been in regard to the removal of color from water by the precip- 
itation of the usual color removing chemicals in the sand of filters 



118 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

instead of by the direct application of such chemicals to the water 
undergoing filtration, as is universal in the so-called mechanical 
filtration of water. By this method of color removal the chemicals 
are used over and over again, thus reducing the cost of such water 
treatment very materially. In fact, the longer such filters continue 
in operation the smaller grows the cost per million gallons of water 
treated, owing to the continual re-use of the chemicals. Among other 
advantages of the method is the absence of carbonic acid in the 
filter effluents, thus lessening the danger of corrosion common with 
mechanical filter effluents and the absolute prevention of acid effluents 
due to the passage through the filters of undecomposed aluminum 
sulphate. 

The analytical work can be classified as follows: — 

State House Laboratories. 

Samples from public water supplies: — 

Surface waters, 2,440 

Ground waters, 1,030 

Samples from rivers, 768 

Samples from sewage disposal works : — 

Sewages, 380 

Filter effluents, 570 

Samples of wastes and effluents from factories, 173 

Samples of sea water from various locations, 22 

Miscellaneous samples (color, hardness, chlorine, etc.), .... 212 

5,595 

Special examinations of water for manganese, lead, etc., .... 556 

Determinations of fats, alkalinity, etc., 406 

Microscopical examinations, 1,983 

Determinations of dissolved oxygen, carbonic acid, etc. (field work), . 240 

3,185 

Lawrence Experiment Station. 

Chemical examinations on account of investigations concerning the 
disposal of domestic sewage and factory wastes, filtration and other 
treatment of water supplies and suammmg pools, 1,072 

Mechanical and chemical examinations of sand, 56 

Bacterial examinations of water from pubHc water supplies, rivers, 

sewage effluents, ice, etc., 807 

Bacterial examinations in connection with methods of purification of 

sewage and water, 2,358 

Bacterial examinations of sheUfish, 342 

4,635 



No. 34.] WATER AND SEWAGE LABORATORIES. 119 



Investigations in Regard to Corrosion of Pipes. 

In the condensed reports of the work of this Division as now written, 
it is impossible to describe very fully all the investigations made, but 
the following pages give information in regard to some of them. 

Owing to the occurrence twenty-five years ago of many cases of lead 
poisoning in the State, an investigation was then made in regard to 
the cause of this poisoning and the corrosion of service pipes. At 
that time a large amount of research work was done and the results 
of all that work were incorporated in two articles concerning the 
action of water upon metals, — one published in the report for 1898 
and the other in the report of this Department for the year 1900.^ 
The summary of this latter article was as follows : — 

The results of the investigation up to the time of writing the report given in 
1898 seemed to show that the cause of the taking of lead from the service pipes 
by the water of certain towns and cities was the presence of a considerable 
volume of free carbonic acid in the ground waters, which actively attacked 
lead, and further investigation has confirmed this conclusion. . . . Wliile pure 
soft water, especially when containing some dissolved oxygen, attacks lead, 
and while the presence of coloring matter, free ammonia, nitrates and nitrites 
in soft water also causes considerable solvent action, . . . j^et, taking into 
consideration the results of our entire investigation we find that in actual prac- 
tice, with the conditions prevailing in the service pipes of a distribution system, 
a potable water in Massachusetts to have any dangerous lead-dissolving action 
must contain considerable free carbonic acid. 

It was shown, also, that the greater the hardness of a water, as 
compared with its free carbonic acid, the less effect did this carbonic 
acid have upon lead. At that time much work was done, as described 
in these two articles, in regard to the action of waters upon tin, 
zinc, brass, etc., as well as lead. 

In modern chemistry the reason that some waters corrode metals 
while others do not is explained by stating that the two essential 
factors in corrosion are the hydrogen ion and dissolved oxygen. The 
hydrogen ion is the active principle of acidity and this is the present 
way of stating that the more acid a water is the more corrosive it is. 
The old statement holds true, however, that the greater the acidity 
shown by the carbonic acid present and the purer the water, that is, 
the freer from mineral and other matters, the more corrosive is its 
action upon metals. 

I Action of Water upon Metallic or Metal-lined Pipes, etc., by H. W. Clark and Fred B. Forbes, pages 
487 to 506, inclusive. Report of State Board of Health for 1800. 



120 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Early in 1920 further investigations were begun upon this subject 
of corrosion, due to troubles experienced in some of the cities and 
towns of the State by the destruction, apparently by water, of certain 
parts of iron, copper and brass piping, this trouble occurring invariably 
in cities and towns having ground water supplies. 

In the course of this investigation twenty-three municipalities have 
been visited and many determinations of alkalinity, free and half- 
bound carbonic acid and dissolved oxygen have been made, these 
determinations being made on the supplies at the source, and also 
considerable work has been done to determine the quality in these 
three particulars of private wells adjacent to the public supplies. 

As a result of this work, it has been found, as was determined more 
than twenty years ago, that the active factor in corrosion is the acidity 
of the water, and this acidity is best ascertained by the determination 
of the carbonic acid present. Ground water supplies containing free 
carbonic acid in amounts greater than 1.70 parts in 100,000 have, 
according to this new investigation, caused corrosion, while those 
containing carbonic acid in quantities less than this do not apparently 
cause trouble with brass, copper and iron pipes. 

The following table shows cities and towns where corrosion occurs, 
together with the amount of carbonic acid present in parts in 100,000, 
and cities and towns where examinations have been made and found 
to be comparatively free from corrosion, together with the carbonic 
acid figures of the water supplies in these municipalities. 



List of Cities and Towns having and not having Corrosion Trouble. 



City or Town having 
Corrosion. 



Ayer, . 

Lowell, 

Billerica, 

Brookline, 

Dedham, 

Weston, 

Acton, . 

Walt HAM, 

Wellesley, 

Tewksbury, 

Newton, 

Norwood, 



Carbonic Acid 

(Parts 

in 100,000). 



3.78 

3.67 

3.52 

3.26 

2.90 

2.86 

2.51 

.46 

.20 

.06 

.02 

.80 



City or Town not having 
Corrosion. 



Medway, 

Hopkinton, 

Needham, 

Dracut, 

Chelmsford 

Littleton, 

Walpole, 

Natick, 

Bedford, 

Groton, 

Westford, 



Carbonic Acid 

(Parts 

in 100,000). 



1.69 

1.63 

1.58 

1.28 

1.14 

1.06 

1.01 

1.01 

.84 

.70 

.44 



In the course of this work it has been found that the presence of 
cemeteries upon the watersheds apparently had a direct effect upon 
the amount of carbonic acid present in the water supplies. For 
instance, in one of the cities of the State using ground water entirely 
and having a large area covered with driven wells, it was found that 



No. 34.] WATER AND SEWAGE LABORATORIES. 121 

while carbonic acid was comparatively high in the water of all these 
wells, the higher amounts found were from the side of the driven 
well field on the edge of the watershed bordered by a continuous line 
of cemeteries laid out on sandy soil and extending for about half a 
mile in a line parallel with the well field. 

Bacillus Coli and Bacillus Aerogenes. 

B. coli has long been used as an index of the bacterial pollution of 
water, but by the usual methods of determination the results recorded 
include two general groups, — B. coli proper, which gives a positive 
methyl red test and negative Voges-Proskauer test, and B. aerogenes, 
which gives a negative methyl red and a positive Voges-Proskauer 
test. The aerogenes group so differentiated is further divided by 
liquefaction or non-liquefaction of the gelatin into B. cloacae and B. 
aerogenes proper. The standard methods of bacterial analysis in 
general use in water laboratories further differentiate B. aerogenes as 
to its origin, whether fecal or non-fecal, by its ability to ferment 
adonite. As bacterial work along this line continued, the belief grew 
that aerogenes was not necessarily of fecal origin and that its presence 
in water did not have the same significance as did B. coli proper, 
consequently much work has been done by various investigators on 
the coli-aerogenes group. 

In studying this problem in the laboratories of this Division during 
the present year 1,560 coli-like cultures from many sources have been 
isolated and differentiated into B. coli, B. aerogenes and B. cloacae. 
The cultures isolated were from human and animal faeces, sewage and 
the effluents from sewage and water filters, ground water, surface 
water and sea water, ice, soils, grains and shellfish, and a following 
table summarizes the results of this work. 

The notable things shown in the table are that 98 per cent of the 
coli-like cultures isolated from human faeces proved to be coli proper 
and only 2 per cent aerogenes, and of the colonies isolated from the 
animal faeces, 96 per cent were coli proper and 4 per cent aerogenes; 
on the other hand, 20 per cent of the cultures isolated from sewage 
proved to be aerogenes and 3 per cent cloacae; and from rivers, 
filtered water, ground water and surface water, 33, 34, 40 and 42 
per cent, respectively, of the isolated cultures were aerogenes. 

From this work and from the work of others it appears that 
aerogenes is not common in faeces and that there is evidence that they 
are normal inhabitants of the soil or at least the surface of the ground, 
and their presence in water is due to this fact. The only feature of 
this belief not entirely satisfactory is that one would expect to find 



I 



122 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



them, if this is true, in comparatively large numbers in surface waters. 
Such is not the case, however, especially with unpolluted waters. 
Another hypothesis is that aerogenes found in water is a degenerate 
or modified form of coli, that is, one that can uniformly lose certain 
properties of coli proper when existing for a considerable period under 
adverse conditions. 

Various experiments were made during the year in the laboratory 
to transform coli to aerogenes by subjecting them to different con- 
ditions of growth. So far this attempt has not been successful al- 
though great modification of the coli cultures has been accomplished. 
In further work along this line as many coli-like cultures as possible 
have been isolated from samples of well and spring waters examined in 
our routine work. These coli-like cultures have been further dif- 
ferentiated into coli proper and aerogenes and the results compared 
with the surroundings of the wells examined and the chemical analysis 
of these waters. 

While not enough work has been done as yet on this particular 
question to give conclusive data, it can be said that the majority of 
samples of B. coli proper came from wells with poor surroundings or 
which showed pollution by the chemical analysis, while aerogenes 
were found generally in well waters good chemically and with satis- 
factory surroundings. 



Source. 



Number of Cultures isolated. 



B. Coli. 



B. Aero- 
genes. 



B. 

Cloaca? . 



Human faeces, . 

Animal fteces, . 

Sewage, .... 

Effluents from sewage filters, 

Soils 

Grains, .... 
Bath water, 

Ice, ..... 
Rivers, .... 
Filtered river waters, 
Ground waters. 
Surface waters, . 

Shellfish 

Sea water. 
Miscellaneous, . 



57 
26 
50 

87 

6 

18 
21 
68 
62 

109 
18 

141 
54 

113 



1 
1 

14 

28 

7 

26 
14 
7 
34 
34 
126 
26 
69 
25 



_i 
-I 
2 
21 

_i 

16 
_i 
-1 
4 

92 

17 

52 

57 

33 



Total. 



58 

27 

64 

136 

7 

32 

48 

28 

102 

100 

327 

61 

262 

136 

148 



Per Cent of Cultures 
isolated. 



B. Coli. 



B. Aero- 
genes. 



98 
96 
77 
64 

19 
39 
75 
67 
62 
33 
30 
54 
40 



2 
4 
20 
21 
100 
81 
28 
25 
33 
34 
40 
42 
26 
18 



B. 

CloaciB. 



-1 
-1 
3 
15 

_i 

33 
-1 

-1 
4 

27 
28 
20 
42 



> No differentiation made between B. aerogenes and B. cloacfe. 



No. 34.] WATER AND SEWAGE LABORATORIES. 123 



Studies of Shellfish. 

During the past two years a very extensive investigation has been 
made by this Division in regard to the determination of the suitability 
for consumption of clams from different sources based upon the 
bacterial contents of their shell water. When the pollution of clam 
flats is evident by inspection, bacterial examinations are probably 
more or less unnecessary, but many cases are brought to the attention 
of the Department yearly where inspection of the areas does not 
give positive information. 

For purposes of this study three areas were selected, namely, (1) 
Newburyport, (2) Ipswich River and (3) Treadwell Island Creek. 
The Joppa flats at Newburyport were selected as typical of a badly 
polluted area. These flats are extensive and on their upper portion 
the main sewer of the city of Newburyport empties. Besides this 
they are polluted by the Merrimack River water which receives all 
the sewage of the cities and towns along its course and which empties 
into the sea at Newburyport. 

The Ipswich River flat was selected as one of probably slight 
pollution but one from which clams might be used. The flats from 
which the clams were taken are about 500 feet below the town boat 
landing at Ipswich and the river is moderately polluted, although the 
town, with a population of 6,201, is unsewered. 

The flats at Treadwell Island Creek are as free from pollution as 
could be found on the shore of the northerly part of Massachusetts. 
Owing to the large area of the Newburyport flats, clams were col- 
lected invariably from five stations, the nearest station to the sewer 
outlet being 3,000 feet below this outlet and near low-water mark; 
Station No. 2 was in shore at right angles to the river and 935 feet 
from Station No. 1 ; Station No. 3 was 4,375 feet below the sewer 
outlet near low-water mark; Station No. 4 was 1,025 feet in shore 
from Station No. 3, and Station No. 5 was 5,800 feet from the sewer 
outlet. 

The average B. coli score of a series of samples of clams collected 
from each of these stations during this period of study is given in a 
following table and includes samples collected each month through 
two seasons. The volume of sewage reaching the Newburyport flats 
is fairly constant and the only things influencing the amount of 
pollution reaching the various stations from which clams were collected 
were the tide and the height of the river. 

The following table gives the B. coli score and the maximum and 
minimum scores obtained at each area: - — 



124 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Numerical Value of B. Coli in the Shell Water of Clams by the Scoring Method. 



Place of Colt.ection. 


Average. 


Maximum. 


Minimum. 


Newburyport : — 

Station No. 1 

Station No. 2, 

Station No. 3 . 

Station No. 4 

Station No. 5 

Ipswich River 

Treadwell Island Creek, 


3,000 
910 

1,100 

340 

570 

230 

7 


23,000 
4,100 
5,000 
2,300 
4,000 
500 
32 


30 
23 
4 
4 
3 
4 




It will be seen that while the average B. coli score of the Newbury- 
port clams was high and the maximum very high, yet at times samples 
were collected from every station having a very low score, clams at 
these times being in a bacterial condition which would have allowed 
them to have passed the American Public Health standard. Such 
results might be very misleading if only one or two sets of samples 
had been taken. The average maximum and minimum score of the 
clams from the Ipswich River flats show that these clams were only 
slightly polluted compared with the Newburyport clams, while the 
results of many series of samples taken at Treadwell Island Creek 
show the clams from this source to be practically free from pollution, 
the average score being but 7, the maximum 32 and the minimum 0. 
There appeared from our examinations to be no regular seasonal 
variation in the B. coli scores as has been stated by various workers. 

A second table is given showing the average number of bacteria in 
the shell water of the clams at different stations, and also in the sea 
water covering the flats at different times. 



Kuviber of Bacteria per Cubic Centimeter in Shell Water and Sea or River Water. 





Average. 


Maximum. 


Minimum. 


Pl.\ce of Collectiox. 


20° C. 


37" 


C. 


20° C. 


37° 


C. 


20° C. 


37° 


C. 




















Total. 


Red. 




Total. 


Red. 




Total. 


Red. 


Newburyport : — 




















Shell water of clams: — 




















Station No. 1, . 


32,300 


4,100 


2,700 


150,000 


21,000 


17,500 


1,000 


420 


270 


Station No. 2, . 


26,000 


5,800 


3,700 


60,000 


30,000 


25,000 


800 


75 


60 


Station No. 3, . 


21,500 


2,7C0 


2,400 


75,000 


23,000 


20,000 


600 


30 


10 


Station No. 4, . 


16,200 


1,100 


470 


57,000 


6,000 


2,000 


800 


38 


20 


Station No. 5, . 


24,000 


2,200 


430 


81,500 


19,000 


2,500 


900 


70 





Sea water: — 




















Station No. 1, . 


37,300 


4,000 


920 


100,000 


22,000 


5,000 


2,500 


70 


18 


Station No. 3, . 


2,600 


45 


14 


4,800 


80 


20 


1,100 


11 


1 


Station No. 5, . 


7,900 


100 


20 


25,000 


330 


90 


600 


6 





Ipswich River: — 




















Shell water of clams, . 


7,000 


2,170 


760 


16,000 


6,600 


3,300 


1,000 


60 


40 


River water. 


9,900 


3,600 


650 


25,000 


19,500 


2,300 


1,300 


43 


9 


Treadwell Island Creek: — 




















Shell water of clams, . 


5,100 


520 


81 


21,000 


2,500 


700 


700 


60 





Sea water, .... 


1,100 


48 


4 


2,800 


240 


25 


160 


3 






No. 34.] WATER AND SEWAGE LABORATORIES; 125 



Purification of a Gas Company's Wastes. 

During the year an interesting experiment was made in regard to 
the purification of wastes from the plant of a gas company by filtration 
through a deep filter of shavings at a rate of 1,000,000 gallons per 
day, — the process and rate proposed by this company. The wastes 
as received were very turbid brown liquors containing a large amount 
of matters in suspension and 111 parts tar in 100,000. By filtration 
through the filter of shavings the tar was reduced in amount to 27 
parts and the matters in suspension from 131 to 40 parts. The 
effluent, however, was still an exceedingly polluted, foul-looking 
liquid, and the filter of course became very rapidly clogged. Treat- 
ment of the waste as received with lime at the rate of 10,000 pounds 
per 1,000,000 gallons of waste effected a good precipitation, producing 
a clear, straw-colored liquor, having only .2 parts tar in 100,000. 
These results were similar to those obtained through previous years 
when investigating wastes of this kind. The volume of waste which it 
was proposed to treat varied from 5,000 to 10,000 gallons a day. 



B. CoLi IN THE Water of Swimming Pools. 

In the study of swimming pools used by a large number of bathers 
it has seemed more or less surprising that more B. coli were not 
found in the water examined, and during the year a special study 
was made in regard to the coli pollution of water per bather per 
given volume of water used. It was found by this study that when 
an average cleanly person bathed in a certain measured volume of 
water, having a temperature of not over 98" F., this water would, 
when soap was not used, contain 4 B. coli per cubic centimeter, and 
the number was, with the use of soap, increased to 7 per cubic centi- 
meter. Bacterial determinations by the four-day count averaged 
857,000 and 1,610,000 per cubic centimeter under the conditions 
mentioned, that is, with or without the use of soap in bathing. 
Applying these results to swimming pools, the following facts can be 
deduced, namely, if 100 bathers per day use, without previous shower 
baths, a swimming pool of 60,000 gallons' capacity and full of clean 
water, the water on examination should show approximately 11,000 
bacteria per cubic centimeter determined by the four-day counts and 
one colon bacillus in 20 cubic centimeters in addition to the number 
primarily present before use. These figures are, of course, approxi- 
mate only, but are of considerable interest taken in connection with 
the bacterial results obtained in swimming pool examinations. 



126 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Operation of Trickling Filters. 

During the year ten trickling filters receiving sewage clarified by 
sedimentation have been in operation at the station. One of these, 
No. 135, has now been in operation for twenty-one years and is 
probably the oldest trickHng filter in America, and hence is of par- 
ticular interest in giving data upon the permanence of such filters 
and the care or expense necessary to keep them in operation year 
after year. This filter is constructed 10 feet in depth of fine broken 
stone, all of which passes a 1-inch screen but is retained by a f-inch 
screen. During the twenty-one years of operation it has been neces- 
sary to dig over the surface of the filter to a depth of from 3 to 8 
inches only eight times. Besides this the upper 18 inches of stone 
was removed, washed and replaced in April, 1918. 

The eight filters used in studies of the economy and efficiency of 
different depths have been continued in operation. Four of these, 
Nos. 452 to 455, inclusive, were started in 1913, and four, Nos. 472 
to 475, inclusive, in 1915. The first series, 4, 6, 8 and 10 feet in 
depth, respectively, is constructed of broken stone, all of which passes 
a 1^-inch screen and is retained by a f-inch screen. The second 
series, Nos. 472 to 475, inclusive, while of the same depth, that is, 
4, 6, 8 and 10 feet, is constructed of broken stone of a larger grade, 
the average volume of pieces ranging from 25.2 to 29.4 cubic centi- 
meters. With this coarser material each filter has only about one-half 
as much filtering surface per foot in depth of filter as given by the 
finer material in Filters Nos. 452 to 455, inclusive. 

A following table gives the average rate of operation for each of 
these filters per foot of filter depth, and the per cent of samples of 
effluent which were stable. It has been intended to operate the first 
series of filters at the same rate per foot of depth, or approximately 
170,000 gallons per foot a day per acre. Various experiments made with 
the second series of filters, namely, Nos. 472 to 475, inclusive, have pre- 
vented comparative studies of efficiency and economy of deep and shal- 
low filters, except Nos. 472 and 474, 4 and 8 feet in depth, respectively. 

Filter No. 474 has been operated at an average rate of 2,050,000 
gallons per acre daily, while Filter No. 472 has been operated at a rate 
of 578,000 gallons per acre daily, or, expressed in foot per depth per 
day, 256,600 and 144,000 gallons, respectively; that is, the deep 
filter has been operated at a rate of 112,000 gallons greater per foot, 
this giving a rate per acre three and one-half times as great as the 
shallow filter. Notwithstanding this, it has produced an effluent of 
practically the same character as that obtained from Filter No. 472. 



No. 34.] WATER AND SEWAGE LABORATORIES. 



127 



The two following tables give the results of operation of these 
filters during the year: — 

Average Rates and Results. — Trickling Filters. 



Filter Number. 



Depth (Feet). 



Gallons filtered 

per Acre 
daily per Foot 

of Filter 

Depth during 

1920. 



Per Cent of 

Samples Stable 

during 1920. 



452, 
453, 
454, 
455, 

472, 
473, 
474, 
475, 



4 

6 

8 

10 

4 

6 

8 

10 



171,500 
161,200 
169,600 
175,100 

144,000 
516,500 
256,600 
177,900 



85 

90 

95 

100 

65 

5 

60 



Average Analyses. 

Effluents from Trickling Filters Nos. 135, /t52, 453, 454, 455, 472, 473, 474, 475 and 502. 

[Parts in 100,000.) 





Quantity 
applied. 



Gallons 

per Acre 

Daily. 


Ammonia. 


Kjel- 
dahl 
Nitro- 
gen. 


Chlo- 
rine. 


Nitrogen 

AS — 


Oxygen 

con- 
sumed. 


Bacteria 
per 
Cubic 
Cen- 
timeter. 


Filter 


Free. 


ALfiUMINOID. 


Number. 


Total. 


In So- 
lution. 


Ni- 
trates. 


Ni- 
trites. 


135, 


1,337,000 


3.50 


.55 


.32 


.99 


7.8 


1.79 


.0180 


3.63 


854,000 


452, 


686,000 


3.71 


.73 


.44 


1.33 


8.0 


1.26 


.0237 


4.03 


1,323,000 


453, 


967,000 


3.21 


.58 


.34 


1.04 


7.9 


2.10 


.0256 


3.24 


637,000 


454, 


1.357,000 


3.00 


.58 


.32 


.99 


7.8 


1.83 


.0298 


3.43 


532,000 


455, 


1,751,000 


2.77 


.52 


.28 


1.00 


7.7 


2.05 


.0313 


3.38 


553,000 


472, 


578,000 


3.62 


.64 


.38 


1.18 


7.8 


.92 


.0282 


3.84 


812,000 


473, 


3,099,000 


4,07 


.88 


.45 


1.65 


7.8 


.63 


.0655 


4.81 


1,733,000 


474, 


2,050,000 


3.68 


.66 


.37 


1.17 


7.7 


.94 


.0367 


3.64 


1,943,000 


475, 


1,779,000 


3.32 


.63 


.36 


1.15 


7.7 


1.76 


.0330 


3.80 


1,332,000 


502, 


3,396,000 


2.95 


.38 


.25 


.68 


7.9 


1.64 


.0436 


1.95 


2,204,000 



During the year careful records have been made of the solids in 
suspension in the effluents from all the trickling filters at the station, 
this being along the line of studies of recovery of valuable fertilizing 



k 



128 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



material just as so many studies are being made at the present time 
in regard to the retention and utilization of sludge from the activated 
sludge tank process of purification. 

The following table presents the results of this work in pounds per 
1,000,000 gallons of suspended matter in these effluents. During the 
year, moreover, as during previous years, an experiment was made 
in regard to settling these solids and it was found that two hours' 
sedimentation was sufficient to settle out about 90 per cent of the 
suspended matters. This settled effluent was applied to trickling 
Filter No. 502, 6 feet in depth and operated at a rate of 6,000,000 
gallons per acre daily. The results of operation of this filter, as shown 
by analytical work, are given in the tables. 

Average Suspended Solids in Trickling Filter Effluents, etc. 



Effluent from Filters. 



No. 135 

No. 452 

No. 453, 

No. 454 

No. 455 

No. 472 

No. 473 

No. 474, 

No. 475, 

No. 502,J 

Settled sewage applied to trickling filters, 



Suspended Solids 

(Pounds per 
Million Gallons). 



1,291 



,642 
,249 
,424 
940 

,441 
,275 
,708 
,615 

589 

,524 



1 Receives settled effluent from Filter No. 473. 



Average Solids. 

Effluents from Trickling Filters Nos. 135, 452, 453, 454, 455, 472, 473, 474, 475 and 502. 

[Parts in 100,000.] 





Unfiltebed. 


Filtered. 


In Suspension. 


FiLTEB Number. 


Total. 


Loss 
on Ig- 
nition. 


Fixed. 


Total. 


Loss 
on Ig- 
nition. 


Fixed. 


Total. 


Loss 
on Ig- 
nition. 


Fixed. 


135 

452, 

453 

454 

455 

472 

473 

474 

475 

502, 


61.3 

66.3 
62.5 
63.8 
58.2 

60.7 
72.4 
67.9 
67.4 

48.1 


24.4 

30.1 
26.4 
26.8 
28.5 

25.0 
28.9 
26.1 
27.4 

16.6 


36.9 

36.2 
.36.1 
37.0 
29.7 

35.7 
43.5 
41.8 
40.0 

31.5 


45.7 

46.6 
47.5 
46.7 
46.9 

43.4 
45.1 
47.4 
48.0 

41.0 


17.1 

17.3 
18.3 
18.7 
20.4 

17.3 
17.0 
19.1 
17.0 

13.8 


28.6 

29.3 
29.2 
28.0 
26.5 

26.1 
28.1 
28.3 
31.0 

27.2 


15.6 

19.7 
15.0 
17.1 
11.3 

17.3 
27.3 
20.5 
19.4 

7.1 


7.3 

12.8 
8.1 
8.1 
8.1 

7.7 
11.9 

7.0 
10.4 

2.8 


8.3 

6.9 
6.9 
9.0 
3.2 

9.6 
15.4 
13.5 

9.0 

4.3 



No. 34.] WATER AND SEWAGE LABORATORIES. 



129 



Intermittent Sand Filters in Operation Thirty-three Years. 

Filters Nos. 1, 4 (md 9 A. 

At the end of 1920 Filters Nos. 1 and 4 had been in operation for 
nearly thirty-three years and Filter No. 9A for thirty years. Each 
filter is ^/l>oo of an acre in area and approximately 5 feet in depth. 
During practically all this period regular station sewage without 
preliminary clarification has been applied to them. For many years, 
moreover, it has been the custom to apply only as much sewage to 
each filter as can be received by them without materially increasing 
the amount of stored organic matter. 

The following table shows the construction, period of operation, 
etc., of each filter. 



FiLTFR Number. 


Depth 

(Feet). 


Effective 

Size of 

Sand 

(Millimeter). 


Date 6rst 
operated. 


Actual 

Volume of 

Sewage 

applied since 

Start 

(Gallons). 


Volume of 

Sewage 

applied daily 

during 1920 

(Gallons per 

Acre). 


No. 1 

No. 4 

No. 9A 


5 
5 
5 


.48 
.04 
.17 


Dec. 10, 1888 
Dec. 19, 1887 
Nov. 18, 1890 


3,150,100 
1,113,000 
2,636,200 


35,200 
18,600 
33,700 



These are undoubtedly the oldest sand filters in point of operation 
in the country, and it is notable that each has been operated without 
sand removal since 1893, — a period of twenty-seven years. There 
has been, however, a gradual increase in the amount of stored organic 
matter in the upper foot of each filter as shown by yearly examina- 
tions, although the amount fluctuates from time to time. During 
the past few years this stored matter has increased more rapidly than 
usual owing to the increasing strength of the sewage applied, and 
because of this the rate of application of sewage to Filters Nos. 1 and 
9A was reduced on January 23 from 50,000 to 40,000 gallons daily. 

The effluents from these filters are practically always slightly acid, 
this being partly due to lack of sufficient base in the sewage to com- 
bine with the nitric acid formed during the process of purification. 
As it is possible that this acid condition may interfere with the best 
working condition of these filters, an experiment was made on October 
9 whereby 100 pounds of hydrated land hme were scattered over the 
surface of Filter No. 9A. The application of this lime, however, has 
not been effective so far in changing the character of the effluent. 
At the end of the year it was decided to remove temp.orarily the upper 



\ 



130 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



foot of sand loaded with organic matter from Filter No. 9A, and on 
November 26 this was done. This removal of 12 inches in depth is 
equal to less than one-half inch per year of operation since the last re- 
moval. Moreover, this removal was not at all necessary, but, as stated, 
was simply to ascertain certain facts. At one of the municipal sewage 
areas of the state much washing of dirty sand, at an expense of $1.75 
per cubic yard, has been done during recent years, and it is probable 
that the removed sand in this instance will be washed before replace- 
ment. The surfaces of Filters Nos. 1 and 9A are always trenched and 
ridged late in the fall and leveled in the spring. During the winter 
these trenches are covered with boards to imitate as nearly as possible 
the ice coverings formed in cold weather over the municipal filtration 
areas. Analyses of sands and effluents are shown in the following 
tables: — 

Sand Analyses. 

Albuminoid Ammonia in First Foot of Sand in Filters Nos. 1 and 9 A. 

[Parts in 100,000.] 




Average Analyses. 

Effluent from Filter No. 1. 
[Parts in 100,000.] 



Temper.^tuke 
(Degrees F.). 


Ammonia. 


Chlo- 
rine. 


Nitrogen 

AS — 


Oxygen 

con- 
sumed. 


Alka- 
linity. 


Bacteria 

per 

Cubic 


Ap- 
plied. 


Efflu- 
ent. 


Free. 


Total 
Albumi- 
noid. 


Ni- 
trates. 


Ni- 
trites. 


Cen- 
timeter. 


59 


51 


.7774 


.0624 


7.6 


3.90 


.0017 


.56 


—2.1 


7,650 • 



Effluent from Filter No. 4- 



59 



53 



.0885 .0230 



7.2 



2.82 



.0017 



.35 



—3.2 



Effluent from Filter No. 9A. 



59 



53 



.7067 I .0598 



7.6 



.87 



.0014 



.63 



—2.1 



1,020 



9,655 



No. 34.] WATER AND SEWAGE LABORATORIES. 131 



Removal of Color from Water. 

One of the most important Investigations carried on at the experi- 
ment station during the past three years has been in regard to the 
removal of color from water by filtration through sand filters im- 
pregnated with aluminum or ferric hydroxide. In ordinary sand filtra- 
tion it is seldom that more than from 30 to 40 per cent of the color 
of the applied water is removed, and, while all coloring matter can be 
removed by the ordinary mechanical filters, so called, there are, in 
certain parts of the country at least, some objections to the use of 
these filters. This is due to the application of chemicals to water 
undergoing filtration, the additional corrosive properties given to the 
water by such treatment, etc. 

By the method of color removal previously described, namely, by 
sand filtration through filters impregnated with ferric or aluminum 
hydroxide, the corrosive properties of the water treated are not in- 
creased, little or no carbonic acid is present in their effluents, and the 
cost of operation is small when compared with mechanical filtration 
and the direct application of chemicals to the water undergoing 
treatment. 

During the year three filters, each containing 4 feet in depth of sand 
with an effective size of 0.25 millimeter, were operated at a rate of 
5,000,000 gallons per acre daily. The results, as a whole, have been 
better than obtained during previous years, and it is probable that 
with a greater precipitation of chemicals within the filters a much 
greater color removal can be obtained. Filter No. 488, put into 
operation in May, 1917, has had applied to it 58.5 tons per acre of 
ferric sulphate which has been precipitated throughout the body of 
the filter as ferric hydroxide; Filter No. 494, put into operation in 
January, 1918, has had applied to it 66.5 tons per acre of commercial 
aluminum sulphate precipitated within the filter as aluminum hy- 
droxide; Filter No. 496, put into operation in September, 1918, has 
had applied to it 27 tons per acre of ferric sulphate precipitated 
within the filter as hydroxide. In the case of each filter practically 
the entire amount of chemical has been precipitated in the sand at 
the time of filter construction. Merrimack River water was applied 
to Filters Nos. 488 and 494 during the year, while Filter No. 496 
received the effluents from these two filters. Trial was made of a 
fourth filter containing 4 feet in depth of pea-size coke and 135 tons 
per acre of ferric sulphate precipitated as hydroxide, but this filter 
was more or less of a failure, however. 

Such filters when first put into operation remove practically all the 



132 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

color of the water applied. Eventually, when the color removal falls 
to about 50 per cent, it is our custom to treat them with caustic soda 
at the rate of 5 or 10 tons an acre. Generally the volume of solution 
used has been equal to about one-fifth the water capacity of the sand 
of the filter and the solution has been passed through four or five 
times, this method apparently giving better renewal results than when 
the open space of the sand has been filled with a more dilute solution 
and this solution allowed to remain within the filter for a matter of 
twelve hours or more. After such treatment it requires about three 
days' operation of the filter to remove the excess soda applied. The 
volume of water used during this period as wash water is about 7.5 
per cent the total volume of the amount filtered between such treat- 
ments. This treatment with caustic is very efficient in removing the 
organic coloring matter, the organic matter determined as albuminoid 
ammonia and that determined as oxygen consumed, which accumu- 
lates in the filter during each period of operation, the percentage 
removals of each averaging about 74, 45 and 50, respectively. The 
period between these necessary treatments has averaged forty-seven 
days in the case of Filter No. 488, forty-five days in the case of 
Filter No. 494 and one hundred and sixteen days in the case of 
Filter No. 496. The amount of chemicals per gallon of water filtered 
through each of these filters has been as follows: Filter No. 488, .15 
grain of ferric sulphate and .50 grain of caustic soda; Filter No. 494, 
.34 grain and .55 grain, respectively; Filter No. 496, .12 grain and 
.23 grain, respectively. These amounts are exceedingly small com- 
pared with the amounts necessary when treating Merrimack River 
water by the usual mechanical filter methods. Comparing amounts 
and costs shows that by the new method the cost for chemicals up 
to the present time has been less than one-third of mechanical filter 
costs and the cost per 1,000,000 gallons treated by this method is 
continually growing less owing to the fact that the treatment with 
caustic renews the efficiency of the aluminum or ferric hydroxides in 
these filters and hence these chemicals are used over and over again. 
Owing to the treatment with caustic, moreover, little surface scraping is 
necessary. Filters Nos. 488 and 494 being scraped but once during 1920. 

The increase in mineral matter in the effluents from these filters 
during the year has been .26, .24 and .69 parts in 100,000, respectively. 
The filters are not efficient in the removal ol bacteria, this undoubtedly 
being due to the removal of the sticky organic matter on the sand 
grains by the caustic soda applied from time to time to remove the 
color and other organic matters accumulated within the filter. 

Average analyses of the water applied to and of the effluent from 
these filters follow: — 



No. 34.] WATER AND SEWAGE LABORATORIES. 



133 



Average Analyses. 

Canal Water applied to Filters Nos. 488 and 494. 
[Parts in 100,000.] 





Ammonia. 


NiTH 


naw.TC 


Oxygen 

con- 
sumed. 


Iron. 


Alka- 
linity. 




Color. 


Free. 


ALBUMINOID. 


AS — 


Soap 
Hard- 
ness. 


Total. 


In So- 
lution. 


Ni- 
trates. 


Ni- 
trites. 


.40 


.0175 


.0181 


.0133 


.023 


.0004 


.62 


.0570 


1.0 


1.1 



Effluent from Filter No. 488. 



.13 



.0091 



.0076 



.027 



.0007 



.25 



.0229 



1.3 



1.3 



Effluent from Filter No. 494. 



.15 



.0093 



.0087 



.024 



.0005 



.25 .0220 



1.3 



1.3 



Effluent from Filter No. 496. 



.07 



.0046 



.0050 



.028 



.0003 



.14 



.0136 



1.3 1.3 



The Effect of Low Temperatures upon Sterilization of Water 
BY Means of Liquid Chlorine or Bleach. 

It is becoming well recognized that liquid chlorine, or bleach, is 
less efficient in cold than in warm weather, and during the year 
certain laboratory experiments were made at the experiment station 
to study this difference. The few tests given in the following table 
are characteristic of results along this line. A solution of Hquid 
chlorine of known strength was added to portions of Merrimack 
River water having temperatures of 78° F. and 46° F., samples being 
taken and platings made thirty minutes after treatment. Similar 
tests were made with bleach at temperatures of 69° F. and 41° F., the 
available chlorine being .4, .6 and .8 part per milHon. The results 
are shown here: — 



h 



134 



DEPARTMENT OF PUBLIC HEALTH. [P. D. No. 34. 



Average Bacterial Anahjses before and after Chlorination at Different Tem-peratures. 



Tem- 
perature 
(Degrees 
F.). 



Control, 

Liquid chlorine: — 
.4 part per million, 
.6 part per million, 
.8 part per million, 

.4 part per million, 
.6 part per million, 
.8 part per million, 

Control, 

Chlorine from bleach: 
.4 part per million, 
.6 part per million, 
.8 part per million, 

.4 part per million, 
.6 part per million, 
.8 part per million, 



78 

78 

78 
78 

46 
46 
46 

69 

69 
69 
69 

41 
41 

41 



Bacteria per Cubic 
Centimeter. 


20° C. 


37° C. 


Total. 


Red. 


4,600 


270 


36 


305 


23 


1 


154 


15 





58 


11 


C 


700 


39 


5 


180 


16 


1 


250 


13 


1 


2,900 


140 


28 


2,500 


15 


2 


490 


11 


1 


330 


5 





790 


19 


3 


1,640 


12 


3 


640 


13 


1 



B. Coli 
in 100 
Cubic 
Centi- 
meters. 



6,C00 

442 

62 
4 

640 

244 

44 

5,5C0 

550 

100 

55 

550 
550 
100 



Bacterial Measurement of the Degree of Pollution of Water. 

In considering the pollution of surface waters as shown by bacterial 
examinations, it is often of interest to know what this pollution would 
be if expressed in added gallons of sewage per 1,000,000 gallons of 
water, and in considering this question many samples of Lawrence sew- 
age examined for B. coli according to the standard methods showed an 
average of 60,000 coli per cubic centimeter or 227,000,000 per gallon. 
Hence, if B. coli are regularly found in 1 cubic centimeter of water 
tested, it indicates by bacterial measurement a pollution equivalent to 
approximately 17 gallons of such sewage as we have examined in 
1,000,000 gallons of water otherwise unpolluted. These figures are, of 
course, only approximate and neither allow for unequal distribution or 
other modifying factors. 



1 



Division of Food and Deugs 



Hermann C. Lythgoe, S.B., Director 



[135] 



I 



i 



i 



Eeport of Division of Food and Drugs. 



During the year 1920 the Food and Drug Division of the Massa- 
chusetts Department of Public Health has been engaged in the usual 
routine work relative to the enforcement of the milk, food, drug, cold 
storage, slaughtering and bakery laws, and in the examination of 
samples submitted by the police authorities and by the Department 
of Public Welfare, and also in the manufacture of arsphenamine. 

There have been a few changes in the scientific portion of the per- 
sonnel. Two of the chemists, Mr. Williams and Mr. Wells, left the 
Department to accept positions offering greater remuneration. They 
were replaced by the transfer of Mr. John J. May from the Division 
of Standards, Department of Labor, and by the employment of Mr. 
Harry J. Fisher. There were no changes in the personnel of the in- 
spectors nor of the clerical force, except that one additional clerk was 
employed on account of additional work due to the bakery law. 

In the work connected with the manufacture of arsphenamine, one 
male laboratory assistant left and was not replaced because of improve- 
ments made in the processes which reduced the amount of work. 
Two female laboratory helpers left and were replaced by the transfer 
of one from the Antitoxin Laboratory. A change in the method of 
ampouling the drug has reduced the amount of work. 

The following table gives a comparison of the work done during the 
past five years : — 



i 1916. 


1917. 


1918. 


1919. 


1920. 


Milk samples, 


7,958 


7,060 


7,738 


9,576 


8,960 


Food samples, . 










2,330 


1,704 


2,142 


1,382 


1,720 


Drug samples, 










874 


794 


396 


262 


220 


Police samples, 










232 


360 


210 


1,511 


1,644 


Public welfare samp 


es, 








- 


- 


- 


12 


45 


Total samples, 










11,394 


9,918 


10,486 


12,743 


12,589 


Prosecutions, . 










250 


307 


337 


262 


311 


Fines imposed, 










$8,021.80 


S5,560 60 


$8,143.10 


$7,880.00 


$10,068.18 


Confiscations, 










325 


124 


87 


97 


86 


Weight of confiscated articles (pounds), . 


128,710 


305,000 


157,557 


250,462 


39,529 1 



And 226 cans of apricots. 



L 



138 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



This table does not include any record of the cold-storage inspec- 
tions, slaughtering inspections, bakery inspections or arsphenamine pro- 
duction. It should be noted that during the past year 45 analyses 
were made for the Department of Public Welfare. This was in con- 
nection with purchases made by that Department for the State 
institutions, the price to be paid for the articles being governed by 
the composition of the articles actually delivered. 

The total number of samples collected was nearly as large as that 
collected last year. It should be borne in mind, however, that during 
the present fiscal year the railroad traffic was blocked for a consider- 
able length of time, thereby rendering travel and collecting of samples 
difficult, and in some cases impossible; otherwise, the amount of work 
done would have been greater than that reported last year. 

The number of court cases in 1920 was greater than in any year 
of the five-year period, and the fines were the heaviest. This is due, 
to some extent, to the violations of the cold-storage law, growing out 
of the fish cases tried last year by the Attorney-General, upon which 
cases sentences were not imposed until the present fiscal year. 

The number of confiscations and amount of confiscated food is 
much less than in former years. 

The following table gives a summary of the court cases disposed of 
during the year: — 



Convic- 
tion. 



Not 
Guilty. 



Nol- 
prossed. 



Filed 

without 

Plea. 



Milk: — 

Low standard, 

Cream removed 

Watered, 

Cream: — 

Low standard, ....... 

Adulterated food, 

Misbranded food, 

Decomposed food, 

Violation of food regulations, 

False advertising of food, ...... 

Cold-storage eggs not so labeled, in many instances 

sold as fresh eggs. 
Other cold-storage violations, . . . . . 

Slaughtering violations, ...... 

Obstruction of inspector, 

Totals 



23 
6 

77 

1 

33 

13 

12 

3 

5 

71 

26 

23 

1 



294 



13 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



139 



The police authorities have submitted 215 samples which were 
examined for poisons. Of these samples, 107 were morphine, 1 was 
codeine, 1 was heroin, 1 was a morphine derivative obtained in in- 
sufficient quantity for complete identification, and 2 were opium, 
making 112 samples of opium and its derivatives. There were 66 
samples of cocaine, 1 of strychnine, 1 sample of aloes and ferrous 
carbonate pills, 1 sample of griddle cakes which contained arsenic and 
34 samples which were examined for poisons, with negative results. 
A sworn certificate of the analysis is delivered to the officer leaving 




/O 20 30 i-0 SO 60 70 

PeRC£:A/r Alcohol. 



80 90 /CO 



the sample, which certificate, in most instances, is accepted in court, 
but in a few instances the analyst is summoned to appear as a witness 
at the trial. 

The amount of liquor submitted by the police has been unusually 
large. In fact, the number of samples has been greater than that 
submitted last year. This Department has been doing this work 
since 1902. Between 1902 and 1918, the maximum number of samples 
submitted was 238 in 1904, and the minimum was 51 in 1916. In 
1919 there were 1,411 samples submitted, nearly all of which were re- 



140 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

ceived after July 1. It was explained in the report for 1919 that this 
was due to samples submitted by the Internal Revenue Department 
to the police officers of the cities and towns in Massachusetts. This 
was stopped during the present year because of a change in the law 
which permitted the Department to refuse to examine any sample of 
liquor submitted by the police authorities unless the Department was 
satisfied that the analysis was to be used in the enforcement of 
criminal law in the Massachusetts courts. All the samples examined 
this year have been samples which the Department could legitimately 
analyze. 

Cities sending more than 100 samples each were Boston, Lynn and 
Cambridge. Localities submitting more than 24 samples each were 
Gloucester, Lawrence, Fall River, Chelsea and Lowell. Boston and 
Lynn submitted samples each month during the year. Cambridge 
submitted samples each month in the year except two. 

There were in all 50 cities and towns submitting samples. Of the 
samples submitted, 108 were classified as beer, 47 as cider, 165 as 
wine, 248 as whiskey, 207 as Jamaica ginger and 454 as miscellaneous. 
Most of these miscellaneous samples were distilled liquors of some 
sort. Of these samples, 256 contained less than 1 per cent of alcohol. 

A chart has been prepared showing the variation in alcohol content 
of the samples received during 1920 in comparison with the variation 
in alcohol content of the first 1,000 samples of liquor received. It will 
be noted that there has been a marked change in the character of the 
samples submitted. In former years nearly half the samples con- 
tained between 1 and 5 per cent of alcohol. During the present year 
less than 28 per cent of the samples were of such nature. Note the 
fact that the distilled beverages have more than doubled in com- 
parison with those submitted in former years, and the heavy alcoholic 
preparations, such as ginger extracts and pure alcohol, are now nearly 
four times as much in quantity as were formerly submitted. 

In this work the analyst or assistant analyst has always made a 
certificate as prescribed in the statutes. There was, however, an error 
made when the work was transferred from the Assayer of Liquors to 
the State Board of Health in not prescribing that the certificate of the 
assistant analyst or the analyst, as the case may be, should be prima 
facie evidence in court. This was discovered after the close of the 
fiscal year, and it will be necessary to request certain changes in our 
legislation to correct this defect, or there will be unusual demands 
upon the chemists of this Division to testify in court upon liquor cases. 

Considerable co-operative work has been done during the past year. 
Analyses have been made for the milk inspectors or health officers of 
Barnstable, Lawrence, Newton, North Adams, Fitchburg, Weymouth, 



No. 34.] DIVISION OF FOOD AND DRUGS. 141 

Arlington, New Bedford and Woburn, and in many of these instances 
the chemists of this Department have testified in court for these milk 
inspectors or board of health agents. 

The milk inspector of Springfield has notified the Department of 
violations of the milk law, which resulted in the prosecution of a 
farmer living outside the jurisdiction of Springfield and sending 
watered milk to the city of Springfield. The Fitchburg and the Fall 
River inspectors have furnished information of violations of the milk 
law where the persons involved were outside of their own jurisdiction. 

The milk inspector of Somerville furnished the Department upon 
several occasions with complete evidence of the collection and ex- 
amination of adulterated milk intended for sale in Somerville but 
produced in other cities and towns, and this Department has success- 
fully prosecuted upon the evidence submitted. 

The agents of the board of health of Newton submitted evidence of 
violation of the cold-storage law, and assisted the inspector of this 
Department in collecting evidence for prosecution. Owing to the 
death of Mr. Berg, the milk inspector of Worcester, the Department 
was requested by the agent of the Worcester Board of Health to make 
rather more examinations of milk sold in Worcester than were usually 
made. This request was complied with, resulting in the prosecution 
and conviction of a farmer living in Auburn, who was selling watered 
milk to a retail milk dealer in Worcester. 

Rather more co-operative work than usual has been carried on be- 
tween this Department and the United States Department of Agri- 
culture. Several interstate shipments of adulterated olive oil have 
been found, the evidence collected, and turned over to the United 
States Department of Agriculture for prosecution. A shipment of 
wormy and decomposed cocoa beans was sent from Brooklyn, N. Y,, 
to a cocoa factory in Massachusetts, and this Department was notified 
by the New York Health Department. A sample was taken by an 
inspector of* this Department, which sample was submitted to the 
United States Department of Agriculture for examination, the goods 
being held under seizure by our inspector. Since a part of the ship- 
ment had been opened, samples for interstate work could be taken 
only from unbroken packages. The United States Department of 
Agriculture declined to proceed in this case to the United States 
courts since the ultimate disposition would be identical to the dis- 
position ultimately carried out by this Department, namely, sorting 
the beans under supervision and destroying all those which were unfit 
for food. Samples were collected for the United States authorities in 
the town of Westfield. 

There were 8,960 samples of milk examined, of which 8,614 were 



142 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



collected by the inspectors. Of these samples, 6,159 were above the 
legal standard; 20 were skimmed milk sold in accordance with the 
law; 145 were samples from which a portion of the cream had been 
removed; and 582 contained added water. There was an unusually 
large percentage containing added water. This does not mean, how- 
ever, that the quality of milk which has been sold in the State is lower 
than has been sold in the past. By following up the producers sup- 
plying milk dealers selling low standard milk, we have found a num- 
ber of farmers selling milk containing added water, which milk when 
mixed with the milk of the other producers furnishing legal milk was 
not watered sufficiently to be detected in the mixture. Many of the 
dealers have been particularly helpful to the Department in assisting 
in this work. 

Tables Nos. 1 and 2 give the summary of the milk statistics by 
months during the past year. 

The average composition of milk not declared adulterated was rather 
better than during the past three years. These figures for the past 
twelve years are given in the following table : — 



Average Composition of Milk not declared Adidteraled. 



Year. 



Number 

of 
Samples. 



Solids 
(Per Cent). 



Fat (Per 
Cent). 



1909, 
1910, 
1911, 
1912, 
1913, 
1914, 
1915, 
1916, 
1917, 
1918, 
1919, 
1920, 



4,242 
5,032 
4,341 
4,516 
6,154 
5,502 
6,765 
7,458 
6,317 
6,995 
8,890 
7,852 



12.78 
12.85 
12.83 
12.66 
12.69 
12.70 
12.68 
12.66 
12.53 
12.47 
12.40 
12.49 



4.10 
4.02 
4.00 
3.89 
3.84 
3.82 
3.82 
3.72 
3.73 
3.76 
3.73 
3.78 



Solids not 

Fat 
(Per Cent). 



8.68 
8.83 
8.83 
8.77 
8.85 
8.88 
8.86 
8.94 
8.80 
8.71 
8.67 
8.71 



It will be noted that there has been a steady decrease in the com- 
position of milk sold upon the market, but since the average is con- 
siderably above the legal standard, there seems to be no great need 
at present of any reduction in the standard, although it may be 



No. 34.J 



DIVISION OF FOOD AND DRUGS. 



143 



possible that if the present slow decrease in the composition of milk 
keeps on, eventually some change may be desirable. 

This Department has the most extensive and complete set of milk 
statistics of any similar Department in the country. A study of the 
figures for a number of years shows a gradual increase in the number 
of samples between 11 and 11.9 per cent total solids; a steady in- 
crease in the number of samples between 12 and 12.9 per cent solids, 
and a decrease in the samples between 13 and 15 per cent total 
solids. These figures have been plotted and are shown in the ac- 
companying chart. Bj extrapolation upon this chart, it appears 
probable that in 1924 about 25 per cent of the Massachusetts market 



70 


ii 


ull iH 

lilt l|l; 


ijts 
m 






'7MMpk 


IP 

ii 




60 


p. !i!; 


ilu !ti'' 

1 


g 


rJIitr 

•TT TV" 


.'11''!^^ 


i 


m 


,. 1 . 


-"'1 ' 












11 


% 

'•y- 


i 


^ 


"".\:':\\ 


Ipp^ 


Jo 




i 




^50 


■^ 


Ss 


- 




^ 




■ 1 


r\. 




i- 




:-:7Tt:T: 






:;.;!.- 


— -- 




■■Ii 


\ 


M 


iiij 


t5>.., 






^^0 


HT" n^ 




If 




'r~r'" 


V 


-,,i«,-. 






. .. 




':-^r- 




— - 


----it:. 


ii 










\ 


--■- 


■— 


\30 

\ 




ill 


' -■■;::« 


r^' 



















\ 




S/. 


f^A 


^^ 


V- 


y 




:::-::"■ 




ii 


^ZO 


iiiiii 






-- - 


U- 


^4, 


5^' : '. 


■«i. 


^ 


^ 


*^ 


y 


----- 




^ 


^ 


-' 


>*' 


Iii 








liii 


JlTrf^ 


/o 


m 


^ 

W^ 


fisii 


iiiins 


'w\''" 


:^'' 


'.i:\f 


^i?i 


ifc 


i-^ifi 


^:ip^ 


iiii (iii 


a^ii 


uiiir-"^ 


mill 


•iite 




■■:!|n;: 




iii 




SttHtT 
K f rft- 
rndtr 
sti II': 


.& 


:!:;ii:!i 

\ :ii". 




FTT^-r 


jiiif 


m 


=^ 


Hi4 ffii 




:"It-;l: 


% 


V}2 




I9i 


js- 




/a 


08 




/s 




//P.5- 


'B 


/^ 




/£ 


»/7 




19 


iO 





milk will have solids between 11 and 11.9 per cent; about 63 per cent 
of the milk will have solids between 12 and 12.9 per cent; and only 
about 8 per cent of the milk will have solids above 13 per cent. The 
increase in the milk between 11 and 11.9 per cent is due to the in- 
crease in the number of Holstein cows, which give the greatest quan- 
tity of milk with the lowest quality of any breed of cattle. The 
decrease in the milk above 13 per cent solids is due to a decrease in 
that type of cattle giving milk of high quality, and it is also due to 
the disappearance of the small dealer handling milk from but few 
producers. The increase of the samples between 12 and 12.9 per cent 
solids is due to the decrease in the small dealers and corresponding 



144 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

increase in quantity of milk sold by large dealers; the milk sold by 
the large dealers being mixtures of milk of varying quality is in- 
variably between 12.2 and 12.8 per cent solids, while the milk sold by 
small dealers is liable to vary between 11.8 and 13.5 per cent. 

This consolidation of the milk business in the hands of large dealers 
probably will have a tendency to cause a decrease in the sale of milk 
between 11 and 11.9 per cent solids, as well as a decrease in the sale 
of milk above 13 per cent solids. 

In the Journal of Industrial and Engineering Chemistry for 1914 
(page 899) the Director of the Division pubHshed an article upon the 
composition of milk. The article resulted from the compilation of 
the analyses of about 500 samples of milk of known purity, of which 
63 represented herds and the balance represented milk from individual 
cows. A summary of this work will be found in the report of the 
State Board of Health for 1913. 

The conclusions recorded in the article were based upon the best 
judgment of the results obtained and were not intended to represent 
the last word upon milk analysis and milk composition, neither were 
they intended to give milk handlers the right to adulterate the prod- 
uct they sold until it conformed with the worst milk that could be 
produced by a cow or a small herd of cows and to use the conclusions 
of the article as evidence in court that the adulterated milk was pure. 

The adulteration of milk with water is risky, and will eventually be 
detected, although the profits are high and the detection of small 
quantities of added water is difficult, and in many instances impossible. 

Adulteration by the removal of cream or, in other words, by the 
addition of skimmed milk is highly profitable, is difficult of detection 
and probably is not uncommon. Owing to the demand for cream 
there is a large surplus of skimmed milk left upon the dealers' hands, 
and it is much more profitable to pass this on to the consumer as 
whole milk at 19 cents per quart than as skimmed milk at 5 cents 
per quart, particularly since the public has not shown any desire to 
purchase this skimmed milk at the prices at which the dealers desire 
to sell, and this skimmed milk therefore is practically a waste product. 

In the conclusions of the article referred to, the following state- 
ments occur: "The protein-fat ratio in all cases has been less than 1. 
If this figure exceeds 1, skimming is indicated, the amount being 
greatest in samples possessing the highest ratio." "If the protein-fat 
ratio is less than 0.7 or the percentage of fat in the solids is above 
35.0, samples may be declared watered by a low refraction of the 
serum, not necessarily below the minimum for all samples of known 
purity. This is particularly true when dealing with herd milk." 



No. 34.] DIVISION OF FOOD AND DRUGS. 145 

The legal mind has attempted to misconstrue the first statement by 
claiming that it is capable of converse construction, and means that 
If the protein-fat ratio is less than one the milk is pure. The falseness 
of this contention can be easily understood by any one of average 
mentality, particularly so when one realizes that the average market 
milk has a protein-fat ratio of 0.82 and the mixed milk of the Guernsey 
and Jersey type of cows has a protein-fat ratio as low as 0.6. Con- 
siderable skimmed milk therefore can be added to such milk before 
the ratio of proteins to fat reaches one. Milk with a fat content of 
4 per cent and a protein-fat ratio of 0.82 can be adulterated with 15 
per cent of skimmed milk and still possess a protein-fat ratio less 
than one. It is evident, therefore, that the use of a protein-fat ratio 
less than one as a criterion that milk is not skimmed is faulty, and, 
therefore, when dealing with the composite milk of a number of herds 
it is reasonable to use a lower figure for the detection of skimming, 
particularly so if other figures point to the fact that the sample 
before being tampered with naturally had a low or average protein-fat 
ratio. 

The second quotation reported here is of interest in this respect: 
that if milk of a low protein-fat ratio naturally possesses a high re- 
fracting serum, milk with a high refracting serum naturally possesses 
a low protein-fat ratio. In other words, it is not usual for milk to 
possess both a high refraction of the serum and a high protein-fat 
ratio. 

In the samples referred to the copper serum refraction and the pro- 
tein-fat ratio was determined upon 362 samples. The average pro- 
tein-fat ratio has been computed for each 0.1 variation in the serum 
refraction, each computation representing from 1 to 24, averaging 10.4 
samples, and the results were plotted, from which a resultant of the 
averages was computed to show this relation if more samples had been 
available. 

From this computation the following deductions were drawn: — 

In all cases when the average protein-fat ratio was above 0.85 the 
average refraction was below 37. In all cases when the average re- 
fraction was above 38 the average protein-fat ratio was below 0.81. 
Deductions from the computed averages indicate that mixtures of 
milk from many dairies with a copper serum refraction above 38 
would have a protein-fat ratio less than 0.80, and it therefore may be 
assumed that milk representing a composite sample from many 
dairies, with a protein-fat ratio of 0.90 or above, has in some manner 
been diluted with skimmed milk, particularly so if the refractive index 
of the copper serum is 38 or above. 



146 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

The above statements are from an article prepared in 1919 and 
withheld from publication in order that a more detailed study be 
given to the protein-fat ratio of milk and its relations to various other 
milk ingredients. As first shown by Van Slyke^ the protein-fat ratio 
is a characteristic of the breed, and in all natural milk less than one; 
if it exceeds one, skimming is indicated. This has been confirmed by 
work of the Massachusetts Department of Public Health. Other 
variations of the protein-fat ratio possibly of minor character, but, 
nevertheless, of significance, are variations with changes in solids, fat 
and serum refraction, as well as variations in herd milk compared with 
that from individual cows. All these variations have a bearing upon 
the interpretation of analyses when the possibility of skimming is to 
be considered and the protein-fat ratio is less than one. 

In order to properly compile and study these variations the arith- 
metic probability paper of Hazen & Whipple was employed. For a 
complete description of this paper and of the mathematical principles 
upon which it is constructed see "The Element of Chance in Sanita- 
tion," by George C. Whipple.^ The ordinates of this paper may be 
either arithmetic or logarithmic, but the abscissae constitute a prob- 
ability scale of such nature that if " the items of a serious observation 
plotted on this paper fall in a straight line it indicates that they form 
a probability series. That is, they occur according to the laws of 

chance." 

In all statistical work a large series of observations are desirable for 
satisfactory work, but by the use of this paper in the case of a rela- 
tively small number of observations, it is possible to ascertain whether 
or not the observations are of such a nature that conclusions can be 
drawn from them. In other words, this paper eliminates the freaks 
from a series of observations. 

In carrying out this study I had at my disposal the analyses of the 
milk of over 1,000 individual cows and of 116 herds, the samples 
being milked in the presence of an inspector or a chemist of the Massa- 
chusetts Department of Public Health. The cows were representations 
of all the usual dairy breeds and cross-breeds; they were of various 
ages; represented all periods of lactation; and the samples were col- 
lected at all seasons of the year. 

A study made in 1919 of the herd milk figures gave the surprising 
information that, although the average protein-fat ratio is about 0.83, 
11 per cent had a protein-fat ratio of above 0.90, and, except for the 
maximum value 0.96 and the 3 minimum values 0.55, 0.56 and 0,60, 

• Journal American Chemical Society, 30, 1166. 

2 Journal Franklin Institute, July and August, 1916. 



No. 34.] DIVISION OF FOOD AND DRUGS. 147 

the data plotted approximately upon a straight line on the probability 
paper. A subdivision of these figures into milk below 12 per cent in 
solids and above 13 per cent in solids showed a much larger percentage 
of milk with high protein-fat ratio in the case of those samples below 
12 per cent than in the case of the entire number. For example, 3 
per cent of the samples above 13 per cent in solids had a protein-fat 
ratio above 0.90, and 13 per cent of those below 12 per cent in solids 
were above 0.90, and of those between 12 and 12.9 per cent solids 
20 per cent were above 0.90. This compilation of samples below 12 
per cent in solids, representing but 13 samples, does not plot in a 
straight line, and, therefore, definite conclusions cannot be drawn 
from these figures; but from the similarity between the different plots 
with the same general direction in all cases, it is evident that the per 
cent of samples with high protein-fat ratio in herd milk with solids 
less than 12 per cent must necessarily greatly exceed that in herd milk 
above 12 per cent in solids. It appears from the figures in Chart I 
that it is impracticable to call commercial milk skimmed if relying 
entirely upon a protein-fat ratio between 0.90 and 0.98. 

A more complete study of the protein-fat ratio was made specifically 
in relation to its variation with breed, solids, fat and copper serum 
refraction; and the comparison between milk from individual cows and 
from herds. Chart II gives the comparison of milk from 746 in- 
dividual cows with that from 116 herds. It will be noticed that 
while a large number of low protein-fat ratios found in individual 
cows disappear in herd milk, a much less number of the high ratios 
disappear in the herd milk. This is in marked contradistinction to 
other figures, such as solids and fat taken from analyses of the same 
samples, in which cases about equal quantity of high and low figures 
in milk from individual cows are not to be found in herd milk. This 
is further emphasized by the fact that the median, which in these 
figures closely approximates the average, is about 0.80, while the 
arithmetic mean of the maximum and the minimum is about 0.70, 
showing a far greater preponderance of milk with a high protein-fat 
ratio than with a low protein-fat ratio. It is possible that the un- 
derlying cause for this condition is due to the preponderance of cer- 
tain breeds of cattle. 

The 746 samples from individual cows were obtained according to 
breeds, as follows: — 

From pure-bred Holsteins, 167 

From pure-bred Ayrshires and a few grades, 126 

From pure-bred and grades of the Jersey and Guernsey types, . . . 180 

From grade cows of the Holstein type, 273 



148 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



A study of the variation in protein-fat ratio in relation to the breed 
showed that in the Holstein breed 25 per cent, in the Ayrshire breed 
13 per cent and in the Jersey and Guernsey breeds 5 per cent of the 
cows gave milk with a protein-fat ratio above 0.90. 

It is evident that the question of breeds must be eliminated if 







ff/^y^ ■d-y^-'^^^-^^i^a!: 



No. 34.] 



DIVISIOx\ OF FOOD AND DRUGS. 



149 



figures below 0.99 are to be used in detecting skimming, and, there- 
fore, the protein-fat ratio was studied in respect to its variations with 
variations in other milk constituents, and it was found that the protein- 
fat ratio was to some extent a function of the fat, of the copper serum 
refraction, and to a less extent of the solids. 




§o 



O/jL 



^ uy^ . 4//^j. o^/ 



k 



150 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



The samples were grouped as above and below 12 per cent solids, 
as per varying fat content, as per varying copper refraction of the 
milk serum, and the variation in protein-fat ratio was plotted. The 
relative variation of the copper serum refraction with, different fat 
percentages was also plotted. These studies all illustrated the pre- 




o/-ci^^ J-iTj^ -y^^^u-Ohfc^ 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



151 



ponderance of high protein-fat ratios in contradistinction of those of 
low protein-fat ratios, and also showed that more low and less high 
protein-fat ratios disappeared in herd milk. Thirteen per cent of the 
samples with copper serum refraction from 37.5 to 38.3 were above 
0.90 in protein-fat ratio, thus showing the fallacy of the conclusions 
in the preliminary discussion of this question. 







C5N 






6^ 






P/ufri^ -^k^ -A'^S'^Ch'c^ 



6^- Qo' 



S^<5 



152 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



It is manifest that conclusive opinions relative to the removal of 
cream cannot be given in the cases referred to unless they occur so 
extensively that the probability of their natural occurrence has been 
eliminated by an overwhelming number of samples of unusual com- 
position. For comparative purposes and for ease of study that por- 
tion of the variation of the protein-fat ratio between 0.85 and 0.99, 
as compared with variation of serum refraction, fat and solids, together 
with the variation of the serum refraction between 37 and 39, as 
compared with the variation in fat, will be found in Chart IV. The 
plots being prepared, largely from analyses of individual cow's milk, 
should give sufficient margin of safety for conclusive opinions. 

The figures presented are the analyses of three samples of milk of 
known purity and the computed analyses resulting from assumed 
skimming. 

From Table III, in the publication previously referred to, showing 
the expected relation between the fats and solids, samples B, E and 
F are highly suspicious of being skimmed. The protein-fat ratio 
alone indicates nothing except suspicion in the cases of examples B, 
D and F. The figures on page 153 are computed from Chart IV, and 
show the probability expressed in per cent of these figures occurring. 

In the cases of examples E and F the very low frequency of these 
copper refraction and fat figures occurring at the same time, taken 
with the other data, is sufficient evidence to call the samples skimmed. 
In the cases of A and B, notwithstanding the high frequency of the 
occurrence of the observed protein-fat ratio compared wuth the fat, 
such samples maj' be declared skimmed if obtained from one dealer 
in sufficient quantities to overcome the probabilities of the copper, 
refraction-fat comparison and the copper refraction comparison with 
the protein-fat ratio being natural. In the case of example C the 
sale of such milk should be almost a continual performance before 
skimming could be proved, and in the case of example D at least 15 
per cent of the samples obtained from the dealer should be like the 
example. 



Solids. 


Fat. 


Proteins. 


Protein-Fat. 


Copper 
Refraction. 


Cream 

removed 

(Per Cent). 


Fat corre- 
sponding to 

Solids not 
less than — 


12.07 
11.42 
11.22 

12.40 
12.10 
11.90 

13.30 
12.50 
12.30 


3.55 
3.00 
2.80 

3.60 
3.30 
3.10 

4.00 
3.20 
3.00 


2.68 
2.68 
2.68 

2.99 
2.99 
2.99 

2.86 
2.86 
2.86 


.76 
.89 
.96 

.83 
.91 
.96 

.72 
.89 
.96 


38.3 
38.3 
38.3 

38.0 
38.0 
38.0 

39.5 
39.5 
39.5 


None 
15 — A 
21 — B 

None 

8-C 

14— D 

None 
20 — E 
25 — F 


3.30 
2.90 
2.80 

3.60 
3.40 
3.20 

4.10 
3.60 
3.50 



No. 34.] 

Probability o: 
Probability o 
Probability o: 
Probability o 

Probability o: 
Probability o: 
Probability o: 
Probability o 

Probability o: 
Probability o: 
Probability o 
Probability o 

Probability o 
Probability o 
Probability o: 
Probability o: 

Probability o: 
Probability o: 
Probability o 
Probability o: 

Probability o: 
Probability o; 
Probability o: 
Probability o: 



DIVISION OF FOOD AND DRUGS. 



protein-fat .89 occurring with copper refraction of 38.30, 

protein-fat .89 occxirring with solids of 

protein-fat .89 occurring with fat of 



11.42, 
3.00, 
3.00, 

protein-fat .96 occurring with copper refraction of 38.30, 

protein-fat .96 occurring with solids of 11.22, 

protein-fat .96 occurring with fat of 2.80, 



copper refraction 38.30 occurring with fat of 



copper refraction 38.30 occurring with fat of 

protein-fat .91 occurring with copper refraction of 

protein-fat .91 occurring with solids of 

protein-fat .91 occurring with fat of 

copper refraction 38.00 occurring with fat of 

protein-fat .96 occurring with copper refraction of 38.00, 

protein-fat .96 occurring with solids of 11.90, 

protein-fat .96 occurring with fat of 3.10, 

3.10, 



2.80, 

38.00, 

12.10, 

3..30, 

3.30, 



.96 occurring with copper refraction of 
.96 occurring with solids of 
.96 occurring with fat of 
copper refraction 38.00 occurring with fat of 

protein-fat .89 occurring with copper refraction of 39.50, 

protein-fat .89 occurring with solids of 12.50, 

protein-fat .89 occurring with fat of 3.20, 

copper refraction 39.50 occurring with fat of 3.20, 

protein-fat .96 occurring with copper refraction of 39.50, 

protein-fat .96 occurring with solids of 12.30, 

protein-fat .96 occurring with fat of 3.00, 

copper refraction 39.50 occurring with fat of 3.00, . 



16% 
30% 

55% 
6% 

5% 
11% 
20% 

6% 

15% 
19% 
25% 
26% J 

6% ] 

8% 
12% 
14% 

10% 
24% 
34% 
.6% 

4% 

8% 
22% 
•07% J 



153 



A — 15% skimmed. 



B— 21% skimmed. 



C — 8% skimmed. 



D — 14% skimmed. 



E — 20% skimmed. 



F— 25% skimmed. 



Protein-fat ratio less than one is no criterion that milk is not 
adulterated. 

The protein-fat ratio is a function of the solids, fat and serum 
refraction, as well as of the breed; and when less than one, if used in 
the interpretation of analyses, should be studied in relation to such 
figures of which it is a function. 

Milk representing the mixed milk of many dairies can be declared 
skimmed when the protein-fat ratio is less than one; provided, how- 
ever, that other analytical data is obtained to substantiate the con- 
clusion, and provided, further, that a sufficient number of samples 
have been obtained to exclude the probability of the natural occurrence 
of such milk. 

Owing to the greater prevalence of high protein-fat ratios compared 
with low protein-fat ratios in milk from the average dairy herds, it is 
inaccurate to assume that the mixed milk of a number of herds would 
not greatly exceed in protein-fat that of the average protein-fat ratio 
of the analvses on record. 



154 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

In comparing the composition of milk from individual cows with 
milk from herds both the maximum and minimum figures obtained 
from individual cows, as a rule, are not found in herd milk; the pro- 
tein-fat ratio, however, is an exception, for but few of the highest 
figures so disappear because of greater frequency of protein-fat ratios 
above the average. 

There were 1,720 samples of food collected for examination, of which 
502 were adulterated. The list of foods examined is given in Table 
No. 3. Of 36 samples of butter examined, 6 were found to be either 
rancid or to be of high moisture content. Some of the rancid samples 
were submitted by the public. A hotel keeper was convicted for serv- 
ing butter which was one-half milk. One of the guests at the hotel made 
a complaint and an inspector of this Department went to the hotel, 
obtaining the necessary evidence. 

There were a number of samples of clams collected, many of which 
were found to contain added water. Some of these clams were shipped 
from New Hampshire, and in those instances arrangements were 
made whereby this Department assisted the United States Depart- 
ment of Agriculture in collecting evidence for reference to the United 
States courts. A number of cases were tried, some of which were 
acquitted. The justice of the Chelsea Police Court found the de- 
fendants not guilty on the ground that the addition of water to clams 
was a good thing. The justice of the Newburyport Court stated that 
assuming the truth of the contention of the defendants that it was 
necessary to add water to clams in order to keep them from spoiling, it 
would in no way affect their criminal liability for selling adulterated food. 

One of the clam dealers at the hearing given by the Division director 
stated that it was necessary to put a cake of ice in the clams in order 
to keep them from spoiling. When he was asked if the same procedure 
was necessary in the case of milk, he said it would take too much ice 
to put around the cans in order to keep the clams. The analogy is 
apparent. When a cake of ice is placed in some fresh opened clams, 
the ice will eventually melt and will be absorbed by the clams. When 
a cake of ice is placed in a can of milk the ice will eventually melt 
and will be absorbed by the milk. Clams under this treatment will 
absorb nearly an equal quantity of water; therefore, a citizen buying 
a quart of soaked clams gets a pint of water and a pint of clams. 

A number of samples of dried fruits were obtained from retail 
stores and were found to contain sulphur dioxide, the dried fruits 
being sold without the necessary label. Hearings were given to the 
dealers, and the subject was then taken up with the Retail Grocers' 
Association, and a representative of the dried fruit interests. This 



No. 34.] DIVISION OF FOOD AND DRUGS. 155 

resulted in a letter being sent to the grocers by the secretary of the 
association, calling attention to the necessity of stamping the packages 
in which such articles were sold. Subsequent collections indicated 
that the grocers were complying with the law. 

There were 288 samples of eggs collected, of which 193 were found 
to be in violation of the law. This does not mean that this ratio of 
good to poor eggs exists in the markets, since the inspectors of the 
Department have reason to suspect violations, and wherever their 
experience leads them to the belief that the dealer is complying with 
the law no samples are taken. This matter of poor eggs is difficult 
of control since it is confined only to the winter months of the year. 
In the spring and summer all the eggs sold are fresh eggs. They are 
delivered within a week or so of the time they are laid because they 
are produced in such quantities. In the winter months, however, the 
price of fresh eggs is very high because hens are not laying and in 
many instances the temptation of the small dealer to sell cold-storage 
eggs with a fresh egg label on them is too much. 

A number of samples of adulterated olive oil were obtained during 
the latter part of the year. Complaints were received from certain 
dealers to the effect that there was a large amount of adulterated 
olive oil on the market. This Department investigated violations, 
which were traced back to a few wholesale dealers. These dealers 
have been prosecuted, but the cases were not completed during the 
fiscal year. There has been considerable difficulty in tracing ship- 
ments in barrels, which difficulty, however, has not been encountered 
in the case of shipments in cans. There were one or two cases where 
evidence of interstate shipment was secured, and this evidence was 
referred to the United States Department of Agriculture. The adul- 
terants used were soy bean oil, corn oil and cottonseed oil. 

A complaint was received from a citizen relative to a sample of 
salad dressing which he purchased, to the effect that it caused terrific 
physiological action to which he did not object, but he was curious 
to know what was the nature of the salad dressing because of difficulty 
involved in washing the clothing, there being grease spots which 
apparently could not be taken out by soap and water. The nature 
of the adulterant was at once evident and an inspector dispatched to 
the factory found that the proprietor was using white mineral oil 
instead of an edible oil in the manufacture of his salad dressing. 
Samples of all the salad dressings sold in the State were collected and 
the factories where they were made were inspected, and only in two small 
factories was this practice carried on. Both of these persons withdrew 
the article from sale, took back their old stock and destroyed it. 



156 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

In the early part of the present fiscal year there was a strike in the 
packing houses in this State under United States inspection. This 
curtailed the number of sausages upon the market, and an investiga- 
tion was made of sausages sold by those dealers not under United 
States inspection. It was found that most of them were taking ad- 
vantage of market conditions and were using excessive amounts of 
starch or flour in their sausages. After they were all prosecuted, this 
practice ceased. Examinations of sausages made in the fall of this 
year showed that these persons were complying with the law. 

A number of soft drinks were examined and many of them were 
found to contain saccharine. An attempt had been made to take up 
a test case on the validity of the regulations prohibiting the use of 
saccharine. These attempts were futile, and this year the Depart- 
ment began a systematic investigation of all the soft drinks sold or 
manufactured in this State. After the samples were taken hearings 
were held, and the manufacturers were notified of the fact that they 
were violating the law, and then second samples were taken. Wherever 
the second samples were found to be bad, prosecutions were in- 
stituted. 

There were 220 samples of drugs examined, of which 20 were 
found to be adulterated. Of these samples, 10 were solution of mag- 
nesium citrate, 6 were spirit of nitrous ether, 2 were turpentine, 1 
was denatured alcohol, and 1 was spirit of camphor. A few of these 
have not yet been disposed of, but all the other violations were taken 
care of by means of warnings or through hearings. 

The various cold-storage warehouses located in the State have been 
inspected a number of times during the year, and have, in general, 
been found to be complying with the law. The depositors of cold- 
storage food have also been found to be, in general, complying with 
the law. A summary of the violations has already been given. It 
should be again noted, however, that many of the cases involved 
were sentences imposed on cases instituted during the previous year. 

The warehouses first made quarterly reports of the amounts of food 
placed in cold storage, together with the amounts of butter and eggs 
on hand on the first day of the month in which the report was filed. 
A study of these statistics was printed in the 1916 report of the 
Department. Since April, 1917, the warehouses have reported 
monthly instead of quarterly the amounts of food placed in storage, 
and the amounts of butter and eggs on hand in storage the first day 
of each month. Since August, 1920, additional reports of holdings 
have been made upon all foods in storage. These latter statistics will 
be of greater value as time goes on, but their significance at present 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



157 



is problematical because they cannot be compared with statistics of 
similar data for' a period of years. 

Massachusetts is engaged to a considerable extent in foreign com- 
merce, in consequence of which a great deal of meat is stored here 
pending shipment to foreign countries. Meat intended for foreign 
shipment is shipped from Chicago to Albany, and stored there pending 
shipping facilities. It is then shipped to either Boston or New York, 
according to the availability of vessels for foreign shipment. This 



Colo Storage: of F/sh /n Massachusetts. 



100 




% ^ ^ 

•^ :i <j 

^ -:» O 

^3/7 



/3/& 



■vi k: ^' Qt: -.4 k ^ Q: -vi k ^ Q: ^■ 
/9/3 J3Z0 /92/ 



business, of course, has greatly increased since 1914, in which year, 
for the twelve months ending September 30, only 26,053,586 pounds 
of meat were placed in storage in Massachusetts. The volume of this 
business had increased so that during the twelve months ending 
Feb. 28, 1919, 142,056,249 pounds of meat were so stored. This has 
been reduced one-half since that time, the decrease during the present 
year being about 25 per cent. 

Massachusetts is a fish-producing State; the larger part of the 
fish stored here Jan. 1, 1921, consisted of whiting, all of which is 



158 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



exported to other States. Considerable herring and squid for bait 
purposes, as well as for food purposes, constitute much of the balance 
of the fish so stored. 

Three charts show statistics of storage of fish, meat and poultry in 
Massachusetts. They are prepared upon logarithmic scales rather 
than arithmetic scales, so that the annual as well as the monthly 
storage can be given upon the same chart; and so that comparison 
can be made of the rate of increase and decrease of storage. Since 
May 1 the Department of Public Health has received monthly reports 



Cold Stor/^gf of A/e/it /a/ Afytss^c/^usFrrs. 




"^ 5, C 
/3/7 



/3/3 



sj k: ^" £>: ^' K 5! S^ M K 
/*/5 JSgO 



A: ^- K^ 
'^r '^^ ^ ,i^ 

-s ^ -^ Q 



of storage of food in this State, and since Aug. 1, 1920, has in addi- 
tion received reports of amounts of food on hand in storage. The 
variation in annual storage is shown by the upper line of each chart, 
each point giving the total annual storage for twelve months ending 
in the month designated. The dotted line is one-twelfth of the heavy 
line, and each point represents the average monthly storage for the 
twelve months ending in the month upon which it is plotted. This 
facilitates comparison of the actual storage each month with the aver- 
age storage of the previous year. The fish chart shows a 50 per cent 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



159 



reduction in the fish storage between 1918 and 1920. The highest 
annual storage was 61,480,656 pounds for the year ending Aug. 30, 
1918, and the lowest storage was 30,806,150 pounds for the year end- 
ing June 30, 1920. The fish on hand in storage was apparently at its 
height this past year on November 1 when 66 per cent of the previous 
twelve months' storage was available. In all probability this will drop 
very rapidly and will reach a minimum about March 1. The meat 
chart, in a manner similar to the fish chart, shows a decrease in meat 



foe. 



Cold Storage oFPoutr/^r /AfAfy4SSyicHusETrs. 




e./}-T 



^ ^" h" ^' ^ ^" h-' ^' 8^' -•■•-■ ^" S^ :J' *^ ^ ^ -«■ 
/3/7 /3/e J9/9 I3Z0 /92t 



storage. In this case, the maximum annual storage was 142,485,920 
pounds for the year ending Feb. 28, 1919, and the minimum annual 
storage was 77,387 110 pounds for the year ending June 30, 1920, and 
represented 54 per cent of the maximum annual storage. Although 
the amount of meat placed in storage appears at present to be slightly 
increasing, the amount on hand is considerably less than the annual 
storage; the highest figure so reported being that of August 1, rep- 
resenting 40 per cent of the previous twelve months' storage. It will 
be noticed that the maximum annual fish storage occurred shortly 



160 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



before, and the maximum annual meat storage occurred shortly after, 
the armistice. If these two plots are superposed so that the maximum 
figures coincide, and the horizontal dimensions are parallel, it will be 
seen that the descending parts of the two curves very nearly coincide, 
showing the same percentage of reduction in storage in the case of both 
meat and fish. The poidtry chart, similar to the meat and fish 

ToTyiL /^MO UA/r FlACED /N StO R/i G£, 

AA/D^AfOU/vr 0A////1AfD rA^ Stor/i(?£. 



^;^l [ 1 I 1 1 1 1 1 1 I 1 1 1 1 1 1 1 


BUTTSR. 




59 


.. ___ 




36 ^-^Z^ 


"7 


^t\ - - 


S3 l- 

VJ rt,. 


J. .:. . 




Vl"~"T"' y 


1 i" 


/ 


5^ f 


:::t:::::?.::::::- 


T 


Ci^2^ / - -V- 




/ 


^ ,fl _L' ^* J- J 


,j\ 


^X--i-'^ --" 


\iQ—]-^"\ \-1 


\".__.-^..X— - 


_ j_ _j — 


,^___ .._- - 


L__ ,.._ 


7 ' \ 


\'^—-r—^-—\]- 


■""j I -_.L._ 


y^ T-- 


, 


-—\—\\ s 


::::_._.> .__. 


a _Ll Li. 


"~\_ll c 


_ ; 


. .A Ai-.. 


± 2 





^ >< <j <t ii >; <*: X. vi 1' ^" i! *f i?- ^' <!• ^ * tK ^ ij V ^ >" S if- -i V ^' * *f 
/S/S. /9I9. ISio- /92/ 'SZ2 



/3/7. 



a- 

ai ■ 

'6/8 
Q 10- 



^ ^ - '' Eg^<^s. _ _ , 


/' '*'''* 


:::;:^!:::::::::^::::::::7"::::::::::::;:==::: :::::::::: 


_ _ -*_ __ i-~» __ _ / =* - _ ^ - - -- 


-_i^_ \ _ 4-U--\ 4-t._ X-- _- H,:*- 


11 ^ I * I » ll • 


~7"r \ - --j-- --■'- - iH -- t-- - -fr- T 

_ / L-. _v 12 L IJ .__ X J - 


1, J n _ ' ._ fl \._..1 ' ._.\ 




_ j_.It ._Tr -.-I -— ^ 


It uJ] \-n .-[_.___ L 


]j J I' // . _\ T _.__: 


U :^[L .Ll iR > 






/*// 



/S/S. 



/9/9. 



ISZO. 



l9Zt- 



I 



charts, tells a different story. The high points of monthly storage all 
occur in the months of November, December and January, when the 
roasters, fowl, turkeys, ducks and geese are stored. The low storage 
is in the spring month of April when the birds are laying eggs and 
raising their young. About June and July there is another increase 
in storage, slight, however, in this case, when the storage of broilers 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



161 





^ "^ ^ ^ ^ 



i X <-; ^ ^ Q 






24. 



f 







Pc 


UL 


rn 


Y. 








- 












/ 














/ 




w 


9^ 


^ 


y^ 


y 


^ 


^ 




i 


/ 




ee 


C! 




'te 


^ 








/ 




/ 


















1/ 


r 

























# 



4-2 
3G 
SO 
U 

/e 
/z 

6 



t 


^u. 


TZ 


7? 








( 


^ 


r^ 


y^ 












A 




^ 


^ 


t— ( 


r^ 










^^^ 


1317 


•18 
■/J 








n 


) 


o- 


o- 


-o 






I 


d 






19/9 

I9ZI> 


ZO 
■21 


A 




^ 


y— 


X- 


-> 






1 




















i 


< 


















A 


: 





















1 






Food Pi/icfd /n Cold Sto^/ige 

/A/ A//iSS/}CHUS£TTS /A/ fouR YifJim. 
CUMUl/IT/V£ VyIT/i 

Foul mr:- /jf^/i/^fA/Dz/yG Dsc. 3/, /d/9 -- S'-^ Pounds. 

dUTT£R-- " »' /^/?. 5/, 13/9 :- Q^ ^•> 
M£/IT:- « *♦ f£3. 28, J9I$.: Sli 



9f 



162 



DEPARTINIENT OF PUBLIC HEALTH. [Pub. Doc. 



and superannuated male birds takes place. The holdings of storage 
poultry are probably at the lowest in October, and should be at the 
highest in January, February or March. It is not improbable that 
the poultry statistics may somewhat parallel those of the butter and 
egg statistics when sufficient data are available. For practical purposes 
it may be stated that all the poultry, butter and eggs stored here are 
consumed locally, the term "locally" being used to represent New 
England. The chart giving the holdings and cumulative storage of 
butter and eggs is based on the fact that the season for such storage 
begins in the spring. Note how the dotted lines showing the hold- 
ings on the first day of each month closely parallel the heavy lines 
showing the cumulative storage inclusive of the storage of the pre- 
vious month. 

In the case of eggs this condition continues for four months, and in 
the case of butter, for three months; but in the case of butter, the 
cumulative storage after the goods begin going out is much greater 
than in the case of eggs. Another chart shows the annual cumulative 
storage of meat, fish, poultry and butter during four years, and the 
total maximum annual storage per person. Note the variance in the 
storage of meat, fish and poultry in the different years, and note the 
comparative unity of this storage in the case of butter. The reasons 
for this variance have been previously given. The figures showing 
the maximum yearly storage per person indicate how little is the 
effect of this business upon each of us. Nine and three-quarters pounds 
of butter, and five and one-quarter pounds of poultry is not an un- 
usual year's reserve supply for one person. The actual holdings per 
capita give a still more remarkable demonstration of the smallness of 
our reserve supply of perishable foods, and for the seven months are 
as follows : — 

In Cold Storage Per Capita in Massachusetts. 



Date. 



1920. 



August 1, 
September 1, 
October 1, 
November 1, 
December 1, 

January 1, 
February 1, 



1921. 



Individual 
Eggs. 



48 
301/4 

mi 



4?i 



Butter 
(Pounds). 



4M 

5 

5%o 

4»io 

3^ 



2H 



Poultry 
(Pounds). 



% 



1% 



Fish 
(Pounds). 



4 
4M 

5H 

4J4 

3K 
2H 



Meat 
(Pounds). 



8H 



8»Ao 



No. 34.] DIVISION OF FOOD AND DRUGS. 163 

These figures seem unusually small when viewed individually, but 
if an average of the six months' holdings is taken and is multiplied 
by the number of persons in your family, you will see that it con- 
stitutes about one month's supply of the food in question. 

There were 215 extensions of time in storage granted, 139 of which 
related to meat. This was mostly pork, namely, a special cut used 
only in the foreign markets. Under ordinary circumstances this 
would have gone abroad earlier, but owing to war conditions and 
possible difficulties in exchange, the British Ministry of Food de- 
clined to have the pork shipped until some time after the close of 
the year's storage. 

A study of the storage extensions shows that each year the majority 
of extensions are applied to one article of food. In some years it is 
poultry, in other years butter, in other years fish, and in the present 
year it wao meat. 

There were 30 instances where extensions were not granted; 3 in- 
stances where permission was granted to remove goods from storage; 
and in 85 instances lots were ordered out of storage after they had 
been in storage for twelve calendar months. A summary of this part 
of the cold-storage work is as follows: — 

Requests for extension granted, 215 

Broken-out eggs, 6 

Butter, 4 

Game, 2 

Meat, 139 

Fish, 64 

Requests for extension not granted, 30 

Broken-out eggs, 5 

Meat, 4 

Fish, 19 

Condensed milk, 2 

Requests for removal granted, ........... 3 

Butter, 2 

Meat, 1 

Ordered out of storage at the end of twelve months, 84 

Broken-out eggs. 2 

Butter, 4 

Oleomargarine, 5 

Poultry, 12 

Game, 3 

Meat, 35 

Fish, 23 



164 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Very few violations of the cold-storage law were found in retail 
stores, except those already noted in connection with the sale of cold- 
storage eggs. It is unfortunate that such eggs are not sold during the 
entire year. Under the present condition where such goods are sold 
for only about five months of the year, the dealers have seven months 
in which to forget the law. 

The veterinary inspectors have been following out their usual work 
of examining the qualifications of local inspectors of slaughtering; act- 
ing as instructors to such inspectors; and investigating the conditions 
under which the local inspection is carried out. During the present 
year a number of violations were found in Berkshire County, and a 
number of cases were prosecuted, all of which resulted in conviction. 

A case tried by the board of health of Orange showed the lax pro- 
cedure which has been carried out by certain local' boards of health 
regarding the appointment of inspectors. The inspector was called 
to a farm to inspect an animal about to be slaughtered. The animal 
was slaughtered in the presence of the inspector and condemned by 
him. As he was pouring kerosene upon the carcass, the owner of the 
carcass approached the inspector with a pitchfork and assaulted and 
battered him. The local authorities prosecuted the farmer for assault 
and battery and for obstruction of the inspector. This Department 
was represented both in the lower and Superior Court in connection 
with the case, and in the latter court was called upon to show that 
the inspector was a duly appointed inspector. The records of the 
Department showed that the inspector was nominated and was duly 
approved, but the records of the local board of health showed that he 
had been appointed two days before he was approved. Mr. Justice 
Callahan of the Superior Court then ordered the jury to bring in a 
verdict of not guilty in one of the cases since the inspector was not 
an inspector, he having been appointed before the State Department 
of Public Health confirmed the nomination. Incidentally, it might be 
stated that the jury convicted for assault and battery upon the in- 
spector as a citizen. 

As the result of this case, each local board of health was sent a 
form, which, when filled out, stated the name of the inspector, the 
date of his nomination, the date of his approval by this Department, 
the date of his appointment by the local board of health, and the date 
on which he was sworn into office by the local authorities. Judging 
from the many replies received to this circular, it was rather unusual 
for the local inspector to be properly qualified for the position. 

During the past year the Legislature passed a new bakery law and 
repealed most of the old bakery laws. This law was introduced by 
one of the bakers' organizations, and had the unanimous support of 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



165 



the other bakers. It introduces a new feature in health legislation, — 
that of supervision by the State Department of Health over the ac- 
tivities of local boards of health as far as bakeries are concerned. It 
also introduces a new feature of medical examination of workers in 
bakeries, such examination to be made upon the order of the boards of 
health. It further provides that regulations should be made by the 
Department of Public Health. 

After this law was signed by the Governor, a number of confer- 
ences were held by representatives of this Department with various 
local boards of health and with various representatives of the baking 
industry, at which conferences all were requested to submit proposed 
regulations and to discuss the regulations thus submitted. Confer- 
ences were held in Springfield, Worcester and Boston, there being in 
all five such conferences. 

A special committee of 15 was appointed to draft the regulations, 
and after these regulations were submitted they were put in final shape 
by Dr. Simpson, District Health Officer, and Mr. Lythgoe, Director 
of the Food and Drug Division. These regulations were then care- 
fully considered by a committee of 5, — 2 members from this Depart- 
ment, 2 from the baking industry, and 1 representative from a local 
board of health. After a careful discussion, the regulations that were 
satisfactory were presented to the Massachusetts Association of Boards 
of Health and were then presented to the Pubhc Health Council and 
adopted with only a few minor changes. It was decided to put one 
inspector upon the bakery work and to go through all the bakeries in 
the State, working in one locality until all the bakeries in that locality 
had been inspected. 

Before doing this work, however, an inspection form was devised by 
a conference of local board of health officials with this Department. 
This form was tried out, found to be defective, and was revised in 
this Department. Using the new form, all of the bakeries in four 
cities have been examined. The results of these examinations will be 
reported to the local boards of health with the request that they call 
the bakers in to their office for hearings, at which hearings this De- 
partment may be represented. 

The bakeries inspected are as follows : — 



Boston, . 
Brockton, 

Cambridge, . 
Chelsea, . 
Framingham, 
Lawrence, 
Lowell, . 



8 1 Maiden, 



4] 
5 

10 
4 

57 

83 



Springfield, 
Watertown, 
Worcester, 



7 
14 
16 

6 

251 



166 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

In the manufacture of arsphenamine the Department has been 
unusually successful. At the beginning of the fiscal year work in the 
new laboratory had hardly begun. About the middle of December 
actual production was started and has been kept up during the entire 
year. A change in the process has been put into practical effect 
which has cut down the labor in the factory end to such an extent 
that when one of the laboratory assistants left he was not replaced. 
A change in the method of ampouling resulted in reducing the amount 
of labor to such an extent that when two of the female laboratory 
helpers left, only one additional one was employed. 

Mr. Christianson, assistant to Dr. Reid Hunt, has developed a unique 
change in the process of manufacturing arsphenamine, which process 
is also advantageous in recovering toxic batches. This process was 
tried out several times before Mr. Christianson's work was pre- 
sented for publication, and the results carried out by this Department 
and tested by Dr. Hunt confirmed the character of the reports sub- 
mitted to him by his assistant. 

We have recovered a number of toxic batches and have sent the 
product so recovered to certain selected clinics, requesting special 
reports. These reports indicate that the product is decidedly superior 
to that made by the old process. The clinical reports in these in- 
stances confirm the pharmacological reports. This work was com- 
pleted at the end of the fiscal year, and it is proposed to change our 
process of manufacture next year by adopting this new process, which 
will represent a saving in heat, labor and, to some extent, in the cost 
of chemicals. 

The largest item of expense in the manufacture of arsphenamine is 
the bottling. In making intermediates and in making the end product, 
the work can be carried out in large quantities, but the bottling is of 
necessity applied to individual doses, which must be very carefully 
weighed, carefully packed in ampoules, and sealed after exhausting 
the air. It is probable that this cost cannot be reduced below 15 
cents per ampoule. At present, however, we are making this article 
at less than the cost of the commercial article, notwithstanding the 
relatively small demand for the drug. Many of the commercial 
houses have a capacity per day equal to our demand per month, 
which of course would necessarily reduce the cost. It seems feasible, 
however, that the State should keep on making this article even were 
the commercial cost to be less than the cost to us, first, because there 
probably is a trade war being carried on between the commercial 
houses, and, second, because of the condition of our dye stuff industry. 
Because of probable German competition, unless appropriate legis- 



No. 34.] DIVISION OF FOOD AND DRUGS. 167 

lation practically prohibiting the importation of German made dye- 
stuffs and medicinals is not passed by Congress before the passage of 
a peace resolution, the future of the United States dyestuff industry 
will be subjected to such a severe setback that American dyes and 
synthetic medicinals will disappear from the market. 



168 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



•♦■a 

Si 

o 






e 

•i«^ 

^ 
rii 







1 




1 c^ 


1 C-1 


1 


^ 


1 


o « 


1 


■^ 1 




^ fe-^ 
















--' 








Sit c 




















1 




nooU 
































•* 


00 


o 


CO — . 


Cd 


oa 




"^ in-^ 






















1 


§f2g 






















% 


QOOsU 






































































T3 fe.^ 

o20 


cc 


CO 


1— < *— 1 


CO OO 

1— 1 I— 1 


'-' 


00 


1/3 


CO CO 


-* 


00 

CD 


o 
















































-0 t< ■ 

§^g 










in 


Oi 


o 


^^ .M 


o 


o 






1-1 <M 


CO »fl 


CO 


•o 


T}< 


CO ^H 




CO 


> 


2;:o 






















Q 












































J 


-d t- • 

§^g 




00 


OO i— ' 


r^ Oi 


,_rt 


OO 


CD 


o <^ 


r~ CO II 












OO 


U3 






s 


ZC 








C-^ CA 


(M 


'"' 






'— ' 




X 


— ^o 














































t3 t- • 




o 


Oi CD 


i-H cq 


Oi 


00 


CO 


CO Oi 


•^ 


-■* 












cn 


o 


lO 




o 






C<1 




,-. O 


Tt W5 


-<J< 


CO 


CO 






-* 


220 






















IS 
























T3 t. ■ 

§^g 










00 


CO 


CO 


Oi o 


_ 


M 




s 






o oi 






>ra 

















*"■ 


'"' 


'^ 




" 


" 


^ 


« 


tO^Q 






















s 


























t^ 


00 


CO t^ 


'* -<t< 


<35 


CO 


Oi 


C<t CO 


CO 


o 




SSU 






















g ij 


r* 


CO 


-t}" CO 


CO '«*' 


t^ 


- 


00 


CO OO 


■* 


OO 




;2o1^ 
























t. ciSi 
























a (g 
























Ph 


















II 










CO t^ 


■* 


CO 


CO 


E; S? 


(N 


s? 


2-S 




CO 


Tt^ 


kO 00 


■^ 


00 


-*l 






to 


a P< 






















•ss 












































^■■S g £ > 




lO 


f- OS 


CM (M 


OO 


■* 


^ 


-* CO 


c^ 


lo 










.— 1 




(M 


^^ 


























2 S " " o 






















Istj 


,-. 


(M 


1 CO 


1 (N 


■* 


O) 


(M 


rt 1 


CO 


§ 
























w=» £ 






















Cfi 




lO 


<M »0 


C^ 1—1 


■^ 


(M 


r^ 


CT la 


Oa 


■^ 


Total 

am pi 

col- 

ected 






















CO 


CO 


CO O 


OO OS 


a> 


t>" 


^^ 


OS CO 










^ 














OO 


- M - 






















Number 
below 
Stand- 
ard. 










, 


^ 


^^ 


c^ -^ 


CO 


o 


Tf 


as 


t^ o 
c^ 


CD OO 




t^ 

c^ 


c^ 

CO 


CO — 




C^^ 






















umber 
bove 
tand- 
ard. 












00 


CO 


o — 


o 


OS 






CO O 




■<j^ 


•* 










CO 


(N 


M OO 


CO CO 


CO 


■^ 








CD 






















■^«x 






















a: 


• 


• 


• 


• 




• 


• 




. 1 


f- 




O 
















z 


^ 


W 



















9> 
1-4 


s 
















S 


tT 




. 










0) 


i ^ 




<u 




>1 










ja 


jQ a 




^ 

a 


>1 

c3 


^ ^- 


^ 


• 




3 
3 


i 1 








P 


"-3 


u 




a 

1-3 


1-5 


■u O 

eg O 


> 
O 





! 



I 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



169 









Table No 


2. — Milk Statistics by Months. 








Average of 


All Samples. 


Average of All Samples not 
declared skimmed or watered. 


Month. 


Num- 
ber. 


Solids 

(Per 

Cent). 


Fat (Per 
Cent). 


Solids 
not Fat 

(Per 
Cent). 


Num- 
ber. 


Solids 
(Per 

Cent). 


Fat (Per 
Cent). 


Solids 
not Fat 

(Per 
Cent). 


1919. 


















December, 


370 


12.62 


3.82 


8.80 


352 


12.70 


3.87 


8.83 


1920. 


















January, .... 


315 


12.30 


3.71 


8.60 


261 


12.80 


3.94 


8.86 


February, 








312 


12.18 


3.62 


8.56 


265 


12.58 


3.72 


8.86 


March, 








1,015 


12.38 


3.70 


8.68 


955 


12.51 


3.75 


8.76 


April, . 








872 


12.26 


3.66 


8.20 


804 


12.40 


3.71 


8.69 


May, . 








901 


12.17 


3.64 


8.53 


810 


12.37 


3.70 


8.67 


June, . 








914 


12.29 


3.66 


8.63 


848 


12.45 


3.74 


8.71 


July, . 








722 


12,18 


3.73 


8.45 


620 


12.49 


3.87 


8.62 


August, 








747 


12.06 


3.64 


8.42 


681 


12.22 


3.73 


8.49 


September, 






912 


12.15 


3.70 


8.45 


810 


12.53 


3.82 


8.71 


October. . 






685 


12.54 


3.87 


8.67 


657 


12.63 


3.90 


8.73 


November, 






849 


12.40 


3.76 


8.64 


762 


12.60 


3.86 


8.74 


Totals, 




8,614 


12.29 


3.71 


8.58 


7,825 


12.49 


3.78 


8.71 



Table No. 3. — Summary of Statistics of Food exclusive of Milk. 



Character of Sample. 



Genuine. 



Adulterated. 



Total. 



Butter, . 
Buttermilk, . 
Cheese, . 
Clams, . 
Cocoa, . 

Condensed milk, . 
Confectionery, 
Cream, . 
Dried fruit, . 
Evaporated milk. 
Eggs, . 

Flavoring extracts, 
Flour, . 
Honey, . 



30 
3 
1 

52 
1 



53 

21 

1 

95 

15 

6 

1 



37 
2 
1 
1 
2 

24 

193 
2 



36 
3 
1 

89 
3 
1 
1 

55 

45 

1 

288 

17 
6 
1 



170 



DEPARTINIENT OF PUBLIC HEALTH. [Pub. Doc. 



Table No. 3. — Summary of Statistics of Food exdusivc of Milk — Concluded. 



Characteb of Sample. 



Genuine. 



Adulterated. 



Total. 



Ice cream, 

Maple sugar, 

Miscellaneous, 

Molasses, 

Nuts, . 

Olive oil, 

Salad dressing. 

Sausage, 

Shrimp, 

Soda water syrup. 

Soft drinks, . 

Spices, . 

Sugar, . 

Vinegar, 

Totals, . 



29 
2 

16 

1 

2 

95 

23 

571 

4 

1 

115 

8 

11 

61 



1,218 



33 
4 

87 



97 

2 
10 



502 



29 

3 

16 

1 

2 

128 

27 

658 

4 

1 

212 

8 

13 

71 



1,720 



Table No. 4. — Sximmary of Drug Statistics. 



Chahacteb of Sample. 



Genuine. 



Adulterated. 



Total. 



Almond oil, .... 
Alcohol, .... 

Camphorated oil, 
Citrate magnesium, 
Denatured alcohol, 
Dobell's solution, 
Hamamelis water, 
Magnesium sulphate, . 
Miscellaneous, 
Proprietary medicine, . 
Solution of magnesium citrate, 
Spirits of camphor, 
Spirits of nitrous ether. 

Turpentine 

Totals 



1 
1 

27 

9 

52 

13 

1 

1 

5 

1 

24 

14 

9 

42 



200 



20 



1 

1 

27 

12 

53 

13 

1 

1 

5 

1 

31 

15 

15 

44 



220 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



171 



Table No. 5. — Summary. 

Requests for extension of time granted, . . . . ' . . . . 215 

Eges, 6 

Butter, 4 

Game, 2 

Meat, 139 

Fish, 64 

Requests for extension of time not granted, 30 

Eggs, 5 

Meat, 4 

Fish, 19 

Condensed milk, 2 

Requests for permission to remove granted, 3 

Butter, 2 

Meat, 1 

Articles ordered removed from storage (no requests made"), . . . .84 

Eggs, 2 

Butter 4 

Oleomargarine, 5 

Poultry, 12 

Game, 3 

Meat, 35 

Fish, 23 



Requests for Extension of Time granted on Goods in Cold Storage from Dec. 1 , 

1919, to Dec. 1, 1920. 

[Reason for such extension being that goods were in proper condition for further storage] 



Article. 



Weight 
(Pounds). 



Placed in 
Storage. 



Extension 
granted to — 



Name. 



Eggs, canned, 
Eggs, canned, 
Eggs, canned. 
Eggs, canned. 
Egg whites. 
Eggs, mixed, 
Butter, 
Butter, 
Butter, 
Butter, 
Ducks, 
Moose, 



120 

120 

240 

1,260 

4,740 

18,360 

1,900 

2,160 

1,920 

1,140 

742 

150 



Aug. 

Aug. 

Aug. 

May 

Apr. 

Apr. 

Aug. 

Sept. 

Sept. 

June 

Aug. 

Oct. 



6, 1919 

6, 1919 

6, 1919 

23, 1919 

18, 1919 

18, 1919 

29, 1919 

4, 1919 

11, 1919 

16, 1919 

6, 1919 

10, 1919 



Oct. 

Oct. 

Oct. 

June 

June 

May 

Oct. 

Dec. 

Jan. 

Oct. 

Oct. 

Apr. 



1, 1920 

1, 1920 

1, 1920 

30, 1920 

28, 1920 
18, 1920 

29, 1920 
29, 1920 
29, 1921 

1, 1920 
24, 1920 
15, 1921 



Armour & Co. 
Armour & Co. 
Armour & Co. 

Goldsmith-Wall-Stockwell Com- 
pany. 

Goldsmith-Wall-Stockwell Com- 
pany. 

Goldsmith-Wall-Stockwell Com- 
pany. 

Lipsky, Jacob. 

Lipsky, Jacob. 

Lipsky, Jacob. 

Massachusetts Department of 

Education. 
LawTence, H. L., Company. 

Brundage, Lawrence F. 



172 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Requests for Extension of Time granted on Goods in Cold Storage from Dec. /, 

1919, to Dec. 1, ^9^0 — Continued. 



Abticle. 



Beef, 

Beef, 

Beef, 

Beef, 

Beef, 

Beef, 

Beef, 

Beef, 

Beef, 

Beef briskets. 

Beef briskets. 

Beef chucks. 

Beef loins. 

Beef shoulders 

Beef shoulders 

Beef strips. 

Beef tongues. 

Beef trimmings 

Beef trimmings 

Pork, 

Pork, 

Pork, 

Pork, 

Pork, 

Pork, 

Pork, 

Pork, 

Pork, 

Pork, 

Pork, 

Pork, 

Pork, 

Pork, 

Pork, 

Pork, 



Weight 
(Pounds) 



Placed in 
Storage. 



Extension 
granted to — 



Name. 



16,324 

15,693 

14,769 

15,280 

4,769 

11,666 

4,638 

33,278 

32,813 

2,300 

4,698 

4,683 

417 

23,842 

8,847 

4,560 

5,647 

1,908 

10,547 

51,579 

52,049 

61,162 

41,751 

43,345 

53,181 

54,423 

59,283 

50,075 

50,215 

50,290 

52,792 

55,266 

55,671 

35,501 

51,694 



Dec. 

Dec. 

Dec. 

May 

Aug. 

Aug. 

Nov. 

Oct. 

Oct. 

Dec. 

Dec. 

Dec. 

Dec. 

Dec. 

Dec. 

Nov. 

Aug. 

Nov. 

July 

Feb. 

Feb. 

Feb. 

Feb. 

Feb. 

Feb. 

Feb. 

Feb. 

Feb. 

Feb. 

Feb. 

Feb. 

Feb. 

Feb. 

Mar. 

Mar. 



13, 1918 

14, 1918 
18, 1918 

3, 1919 

9, 1919 

12, 1919 

26, 1919 

10, 1919 

11, 1919 

2, 1918 
16, 1918 

16, 1918 
18, 1918 

12, 1918 
18, 1918 
26, 1919 

13, 1919 
21, 1919 
24, 1919 

17, 1919 
17, 1919 

17, 1919 

18, 1919 
18, 1919 
18, 1919 
18, 1919 
18, 1919 
20, 1919 
20, 1919 
20, 1919 

20, 1919 

21, 1919 
21, 1919 

3, 1919 
3, 1919 



Feb. 12, 1920 

Feb. 14, 1920 

Feb. 12, 1920 

June 15, 1920 

Nov. 9, 1920 

Nov. 12, 1920 

Mar. 26, 1921 

Dec. 10, 1920 

Dec. 10, 1920 

Feb. 2, 1920 

Feb. 16, 1920 

Feb. 16, 1920 

Feb. 12, 1920 

Feb. 1, 1920 

Feb. 18, 1920 

Mar. 26, 1921 

Nov. 13, 1920 

Dec. 21, 1920 

Aug. 24, 1920 

Apr. 17, 1920 

Apr. 17, 1920 

Apr. 17, 1920 

Apr. 18, 1920 

Apr. 18, 1920 

Apr. 18, 1920 

Apr. 18, 1920 

Apr. 18, 1920 

Apr. 2C, 1920 

Apr. 20, 1920 

Apr. 20, 1920 

Apr. 20, 1920 

Apr. 21, 1920 

Apr. 21, 1920 

May 3, 1920 

May 3, 1920 



Dorr, Arthur E., & Co., Inc. 
Dorr, Arthur E., & Co., Inc. 
Dorr, Arthur E., & Co., Inc. 
Horrigan & Doe. 
Libby & Libby Company. 
Libby & Libby Company. 
Strong, Marson Company. 
Swift, E. C, & Co. 
Swift, E. C, & Co. 
Dorr, Arthur E., & Co., Inc. 
Dorr, Arthur E., & Co., Inc. 
Dorr, Arthur E., & Co., Inc. 
Dorr, Arthur E., & Co., Inc. 
Handy, H. L., Company. 
Dorr, Arthur E., & Co., Inc. 
Skinner, George E., Company. 
Libby & Libby Company. 
Fickett, Oscar A., Company. 
Libby & Libby Company. 

North Packing and Provision 

Company. 
North Packing and Provision 

Company. 
North Packing and Provision 

Company. 
North Packing and Provision 

Company. 
North Packing and Provision 

Company. 
North Packing and Prov-ision 

Company. 
North Packing and Provision 

Company. 
North Packing and Provision 

Company. 
North Packing and Provision 

Company. 
North Packing and Provision- 
Company. 
North Packing and Provision 

Company. 
North Packing and Provision 

Company. 
North Packing and Provision 

Company. 
North Packing and Provision 

Company. 
North Packing and Provision 

Company. 
North Packing and Provision 

Company. 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



173 



Requests for Extension of Time granted on Goods in Cold Storage from Dec. 1, 

1919, to Dec. 1, i 5^') — Continued. 



Article. 



Weight 
(Pounds). 



Placed in 
Storage. 



Extension 
granted to — 



Name. 



55,041 


Mar. 


3 


1919 


May 


3 


1920 


53,604 


Mar. 


5 


1919 


May 


5 


1920 


47,388 


Mar. 


6 


1919 


May 


6, 


1920 


54,661 


Mar. 


6, 


1919 


May 


6, 


1920 


55,475 


Mar. 


7, 


1919 


May 


7, 


1920 


51,384 


Mar. 


8, 


1919 


May 


8. 


1920 


22,981 


Feb. 


1, 


1919 


May 


1, 


1920 


23,335 


Feb. 


4, 


1919 


May 


4, 


1920 


25,133 


Feb. 


5, 


1919 


May 


5, 


1920 


25,209 


Feb. 


6, 


1919 


May 


c. 


1920 


25,704 


Feb. 


7, 


1919 


May 


7, 


1920 


12,999 


Feb. 


8, 


1919 


May 


8, 


1920 


21,891 


Feb. 


10, 


1919 


May 


10. 


1920 


15,494 


Feb. 


12, 


1919 


May 


12, 


1920 


13,933 


Feb. 


13, 


1919 


May 


13, 


1920 


16,881 


Feb. 


14, 


1919 


May 


14, 


1920 


14,8.30 


Feb. 


15, 


1919 


May 


15, 


1920 


15,364 


Feb. 


19, 


1919 


May 


19, 


1920 


19,959 


Feb. 


20, 


1919 


May 


20, 


1920 


16,505 


Feb. 


21, 


1919 


May 


21, 


1920 


14,645 


Feb. 


24, 


1919 


May 


24, 


1920 


21,876 


Feb. 


25, 


1919 


May 


25, 


1920 


8,803 


Feb. 


26, 


1919 


May 


26, 


1920 


46,320 


Jan. 


18, 


1919 


Mar. 


18, 


1920 


46,372 


Jan. 


18, 


1919 


Mar. 


18, 


1920 


52,600 


Jan. 


20, 


1919 


Mar. 


20, 


1920 


45,910 


Jan. 


21, 


1919 


Mar. 


21, 


1920 


52,438 


Jan. 


21, 


1919 


Mar. 


21, 


1920 


52,771 


Jan. 


21, 


1919 


Mar. 


21, 


1920 


59,400 


Jan. 


21, 


1919 


Mar. 


21, 


1920 


42,622 


Jan. 


22, 


1919 


Mar. 


22, 


1920 


42,630 


Jan. 


23, 


1919 


Mar. 


23, 


1920 


56,098 


Jan. 


23, 


1919 


Mar. 


23, 


i920 


45,584 


Jan. 


24, 


1919 


Mar. 


24, 


1920 


55,620 


Jan. 


24, 


1919 


Mar. 


24, 


1920 


59,980 


Jan. 


24, 


1919 


Mar. 


24, 


1920 



North Packing and Provision 

Company. 
North Packing and Provision 

Company. 
North Packing and Provision 

Company. 
North Packing and Provision 

Company. 
North Packing and Provision 

Company. 
North Packing and Provision 

Company. 
Springfield Provision Company. 

Springfield Provision Company. 

Springfield Provision Company. 

Springfield Provision Company. 

Springfield Provision Company. 

Springfield Provision Company. 

Springfield Provision Company. 

Springfield Provision Company. 

Springfield Provision Company. 

Springfield Provision Company. 

Springfield Provision Company. 

Springfield Provision Company. 

Springfield Provision Company. 

Springfield Provision Company. 

Springfield Provision Company. 

Springfield Provision Company. 

Springfield Provision Company. 

Squire, John P., & Co. 

Squire, John P., & Co. 

Squire, John P., & Co. 

Squire, John P., & Co. 

Squire, John P., & Co. 

Squire, John P., & Co. 

Squire, John P., & Co. 

Squire, John P., & Co. 

Squire, John P., & Co. 

Squire, John P., & Co. 

Squire, John P., & Co. 

Squire, John P., & Co. 

Squire, John P., & Co. 



174 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Requests for Extension of Time granted on Goods in Cold Storage from Dec. 1, 

1919, to Dec. 1, iS^O — Continued. 



Article. 



Weight 
(Pounds) 



Placed in 
Storage. 



Extension 
granted to — 



Name. 



Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 
Pork, 



48,186 
54,722 
55,453 
61.900 
45,150 
47,088 
51,605 
52,062 
53,103 
54,865 
55,210 
40,060 
47,329 
48,720 
53,573 
38,880 
49,909 
51,910 
53,608 
58,610 
45,840 
45,889 
52,739 
52,912 
48,787 
53,236 
53,579 
45,337 
47,000 
52,638 
54,604 
58,165 
43,184 
65,423 
52,452 
55,160 



Jan. 
Jan. 
Jan. 
Jan. 
Jan. 
Jan. 
Jan. 
Jan. 
Jan. 
Jan. 
Jan. 
Jan. 
Jan. 
Jan. 
Jan. 
Feb. 
Feb. 
Feb. 
Feb. 
Feb. 
Feb. 
Feb. 
Feb. 
Feb. 
Feb. 
Feb. 
Feb. 
Feb. 
Feb. 
Feb. 
Feb. 
Feb. 
Feb. 
Feb. 
Feb. 
Feb. 



25 


, 1919 


Mar. 


25, 1920 


25 


, 1919 


Mar. 


25, 1920 


27 


, 1919 


Mar. 


27, 1920 


28 


1919 


Mar. 


28, 1920 


29 


1919 


Mar. 


29, 1920 


29 


, 1919 


Mar. 


29, 1920 


29 


1919 


Mar. 


29, 1920 


29 


1919 


Mar. 


29, 1920 


29 


1919 


Mar. 


29, 1920 


30 


, 1919 


Mar. 


30, 1920 


30 


, 1919 


Mar. 


30, 1920 


31 


1919 


Mar. 


31, 1920 


31 


1919 


Mar. 


31, 1920 


31 


1919 


Mar. 


31, 1920 


31 


1919 


Mar. 


31, 1920 


1 


1919 


Apr. 


1, 1920 


1 


1919 


Apr. 


1, 1920 


1 


1919 


Apr. 


1, 1920 


1 


1919 


Apr. 


1, 1920 


1 


1919 


Apr. 


1, 1920 


3 


1919 


Apr. 


1, 1920 


3 


1919 


Apr. 


3, 1920 


3 


1919 


Apr. 


3, 1920 


3 


1919 


Apr. 


3, 1920 


4 


1919 


Apr. 


4, 1920 


4 


1919 


Apr. 


4, 1920 


4 


1919 


Apr. 


4, 1920 


6 


1919 


Apr. 


6, 1920 


6 


1919 


Apr. 


6, 1920 


6 


1919 


Apr. 


6, 1920 


6 


1919 


Apr. 


6, 1920 


6 


1919 


Apr. 


6, 1920 


7 


1919 


Apr. 


7, 1920 


7 


1919 


Apr. 


7, 1920 


8 


1919 


Apr. 


8, 1920 


10 


1919 


Apr. 


10, 1920 



Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire. John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 
Squire, John P., & Co. 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



175 



Requests for Extension of Time granted on Goods in Cold Storage from Dec. 1, 

1919, to Dec. 1, i5^(9 — Continued. 



Article. 


Weight 
(Pounds). 


Placed in 
Storage. 


Extension 
granted to — 


Name. 


Pork 


40,470 


Feb. 11, 1919 


Apr. 11, 1920 


Squire, John P., & Co. 


Pork, 








54,295 


Feb. 11, 1919 


Apr. 11, 1920 


Squire, John P., & Co. 


Pork, 








58,800 


Feb. 11, 1919 


Apr. 11, 1920 


Squire, John P., & Co. 


Pork, 








59,623 


Feb. 11, 1919 


Apr. 11, 1920 


Squire, John P., & Co. 


Pork, 








49,500 


Feb. 14, 1919 


Apr. 14, 1920 


Squire, John P., & Co. 


Pork, 








47,118 


Feb. 15, 1919 


Apr. 15, 1920 


Squire, John P., & Co. 


Pork, 








48,824 


Feb. 15, 191G 


Apr. 15, 192C 


Squire, John P., & Co. 


Pork, 








44,981 


Feb. 17, 1919 


Apr. 17, 192C 


Squire, John P., & Co. 


Pork, 








51,579 


Feb. 17, 1919 


Apr. 17, 1920 


Squire, John P., & Co. 


Pork, 








52,800 


Feb. 17, 1919 


Apr. 17, 1920 


Squire, John P., & Co. 


Pork, 








37,556 


Feb. 2J, 1919 


Apr. 21, 1920 


Squire, John P., & Co. 


Pork, 








52,382 


Feb. 21, 1919 


Apr. 21, 1920 


Squire, John P., & Co. 


Pork, 








54,078 


Feb. 21, 1919 


Apr. 21, 1920 


Squire, John P., & Co. 


Pork, 








45,270 


Mar. 14, 1919 


May 14, 1920 


Squire, John P., & Co. 


Pork, 








41,608 


Mar. 15, 1919 


May 15, 1920 


Squire, John P., & Co. 


Pork, 








46,410 


Mar. 18, 1919 


May 18, 1920 


Squire, John P., & Co. 


Pork, 








51,050 


Mar. 18, 1919 


May 18, 1920 


Squire, John P., & Co. 


Pork, 








42,812 


Mar. 19, 1919 


May 19, 1920 


Squire, John P., & Co. 


Pork, 








47,310 


Mar. 19, 1919 


May 19, 1920 


Squire, John P., & Co. 


Pork, 








48,085 


Mar. 21, 1919 


May 21, 1920 


Squire, John P., & Co. 


Pork, 








48,970 


Mar. 21, 1919 


May 21, 1920 


Squire, John P., & Co. 


Pork, 








55,639 


Mar. 22, 1919 


May 22, 1920 


Squire, John P., & Co. 


Pork, 








45,340 


Mar. 25, 1919 


May 25, 1920 


Squire, John P., & Co. 


Pork, 








46,959 


Mar. 25, 1919 


May 25, 1920 


Squire, John P., & Co. 


Pork, 








50,400 


Mar. 29, 1919 


May 29, 1920 


Squire, John P., & Co. 


Pork, 








51,600 


Mar. 31, 1919 


May 31, 1920 


Squire, John P., & Co. 


Pork, 








51,170 


Apr. 1, 1919 


June 1, 1920 


Squire, John P., & Co. 


Pork, 








52,345 


Apr. 1, 1919 


June 1, 1920 


Squire, John P., & Co. 


Pork, 








52,510 


Apr. 3, 1919 


June 3, 1920 


Squire, John P., & Co. 


Pork. 








54,015 


Apr. 7, 1919 


June 7, 1920 


Squire, John P., & Co. 


Pork, 








30,350 


Apr. 10, 1919 


June 10. 1920 


Squire, John P., & Co. 


Pork, 








33,170 


Apr. 10, 1919 


June 10, 1920 


Squire, John P., & Co. 


Bonita, 








1,050 


Oct. 8, 1919 


Dec. 8, 1920 


Tocco, Joseph. 


Cod. 








2,420 


Nov. 24, 1919 


Jan. 24, 1921 


O'Brien, R., & Co. 


Eels, sane 








- 


Aug. 5, 1919 


Dec. 5, 1920 


Busalacchi Brothers. 


Eels, sane 








455 


Oct. 10, 1919 


Dec. 10, 1920 


Tocco, Joseph. 



176 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Requests for Extension of Time granted on Goods in Cold Storage from Dec. J , 

1919, to Dec. 1, ^5:^0— Continued. 



Article. 


Weight 
(Pounds). 


Placed in 

Storage. 


Extension 
granted to — 


Name. 


Flounders, 


1,500 


Aug. 10 


1919 


May 20 


, 1920 


Newburyport Fisheries Com- 


Haddock, 






1,330 


Sept. 30 


1919 


Oct. 30 


, 1920 


pany. 
Atlantic & Pacific Fish Com- 


Haddock scrod 






5,000 


Aug. 15 


1919 


Dec. 31 


1920 


pany. 
Whitman, Ward & Lee Com- 


Herring, . 






21,290 


Apr. 10 


1919 


Oct. 9 


1920 


pany. 
Atwood & Co. 


Herring, . 






28,700 


Apr. 10 


1919 


Oct. 10 


, 1920 


Atwood & Co. 


Herring, i 






21,600 


Jan. 9 


1919 


Apr. 1 


1920 


Bay State Fishing Company. 


Herring, ^ 






4,300 


Jan. 24 


1919 


Apr. 1 


1920 


Bay State Fishing Company. 


Herring, * 






9,000 


Feb. 17 


1919 


May 1 


1920 


Bay State Fishing Company. 


Herring, i 






2,000 


May 3 


1918 


Apr. 1 


1920 


Bay State Fishing Company. 


Herring, i 






1,800 


June 10 


1918 


Apr. 1 


1920 


Bay State Fishing Company. 


Herring, . 






8,400 


June 4 


1919 


Oct. 1 


1920 


Bay State Fishing Company. 


Herring, . 






5,425 


Sept. 23 


1919 


Nov. 23 


1920 


Bay State Fishing Company. 


Herring, . 






3,700 


Sept. 24 


1919 


Nov. 24 


1920 


Bay State Fishing Company. 


Herring, . 






6,8C0 


Oct. 11 


1919 


Feb. 11 


1921 


Busalacchi Brothers. 


Herring, . 






2,600 


Oct. 23 


1919 


Feb. 11 


1921 


Busalacchi Brothers. 


Herring, . 






3,200 


Oct. 23 


1919 


Feb. 11 


1921 


Busalacchi Brothers. 


Herring, . 






2,500 


Nov. 14 


1919 


Feb. 11 


1921 


Busalacchi Brothers. 


Herring, . 






1,140 


Sept. 25 


1919 


Jan. 30 


1921 


Cefalu, Joseph. 


Herring, . 






],380 


Sept. 30 


1919 


Jan. 30 


1921 


Cefalu, Joseph. 


Herring, . 






2,940 


Oct. 16 


1919 


Jan. 30 


1921 


Cefalu, Joseph. 


Herring, . 






5,600 


- 


- 


July 5 


1920 


Chatham Freezer Company. 


Herring, • 






1,800 


Nov. 3 


1919 


Dec. 26 


1920 


Chatham Freezer Company. 


Herring, ' 






37,600 


Nov. 23 


1919 


Dec. 26 


1920 


Chatham Freezer Company. 


Herring, > 






24,300 


Mar. 6 


1919 


May 6, 


1920 


Nagle, John, Company. 


Herring, > . 






40,000 


Mar. 6 


1919 


May 6 


1920 


Nagle, John, Company. 


Herring, . 






4,000 


Aug., 


1919 


May 20 


1920 


Newburyport Fisheries Com- 


Herring, . 






3,000 


Oct. 20 


1919 


Mar. 1 


1921 


pany. 
Phillips, B. F., & Co. 


Herring, . 






925 


Nov. 18 


1919 


Mar. 1 


1921 


Phillips, B. F., & Co. 


Herring, . 






770 


Sept. 29 


1919 


Dec. 29 


1920 


Tocco, Joseph. 


Herring, sardine, 




1,750 


Sept. 24 


1919 


Jan. 30 


1921 


Cefalu, Joseph. 


Herring, sardine. 




175 


Sept. 30 


1919 


Jan. 30 


1921 


Cefalu, Joseph. 


Herring, sardine. 




560 


Oct. 17 


1919 


Jan. 30 


1921 


Cefalu, Joseph. 


Herring, sardine. 




630 


Oct. 24 


1919 


Jan. 30 


1921 


Cefalu, Joseph. 


Herring, sardine, 




245 


Oct. 20 


1919 


Jan. 30 


1921 


Cefalu, Joseph. 


Herring, sardine. 




780 


Oct. 29 


1919 


Jan. 30 


1921 


Cefalu, Joseph. 


Herring, sardine. 




2,200 


Oct. 22 


1919 


Dec. 22 


1920 


Mantia, John, Sons. 



1 Bait. 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



177 



Requests for Extension of Time granted on Goods in Cold Storage from Dec. 1, 

1919, to Dec. 1, iP^O — Concluded. 



Afticle. 


Weight 
(Pounds). 


Placed in 
Storage. 


Extension 
granted to — 


Name. 


Herring, sardine. 


5,000 


Nov. 25, 1919 


Jan. 


25, 1921 


Russo & Sons. 


Herring, sardine, 




1,155 


Oct. 2, 1919 


Dec. 


2, 1920 


Tocco, Joseph. 


Herring, sardine, 




3,150 


Oct. 31, 1919 


Dec. 


31, 1920 


Tocco, Joseph. 


Pollock, . 




6,414 


Dec. 9, 1919 


Feb. 


9, 1921 


Dahlman, John A. 


Salmon, . 






400 


Nov. 3, 1919 


Feb. 


3, 1921 


Busalacchi Brothers. 


Shark, . 






640 


July 15, 1919 


Nov. 


15, 1920 


Globe Fish Company. 


Skatefish, 






1,750 


Nov. 13, 1919 


Jan. 


13, 1921 


Russo & Sons. 


Skate wings, . 






175 


Aug. 13, 1919 


Dec. 


13, 1920 


Globe Fish Company. 


Skate wings, . 






1,155 


Oct. 28, 1919 


Dec. 


28, 1920 


Tocco, Joseph. 


Whiting, . 






140 


Oct. 4, 1919 


Jan. 


30, 1921 


Cefalu, Joseph. 


Whiting, . 






7,500 


Nov., 1919 


Feb. 


1, 1921 


Consolidated Weir Company. 


Whiting, . 






42,500 


Nov., 1919 


Feb. 


1, 1921 


Consolidated Weir Company. 


Whiting, . 






1,500 


Nov. 3, 1919 


Feb. 


3, 1921 


Consolidated Weir Company. 


Whiting, . 






805 


Aug. 13, 1919 


Dec. 


13, 1920 


Globe Fish Company. 


Whiting, . 






630 


Aug. 18, 1919 


Dec. 


18, 1920 


Globe Fish Company. 


Whiting, . 






6,640 


July 2, 1919 


Dec. 


31, 1920 


Mantia, Salvatore. 


Whiting, . 






2,880 


July 18, 1919 


Dec. 


31, 1920 


Mantia, Salvatore. 


Whiting, . 






175 


Sept. 4, 1919 


Dec. 


4, 1920 


Tocco, Joseph. 


Whiting, . 






560 


Sept. 11, 1919 


Dec. 


11, 1920 


Tocco, Joseph. 


Whiting, . 






1,120 


Sept. 12, 1919 


Dec. 


12, 1920 


Tocco, Joseph. 


Whiting, . 






350 


Sept. 25, 1919 


Dec. 


25, 1920 


Tocco, Joseph. 


Whiting, . 






280 


Oct. 3, 1919 


Dec. 


3, 1920 


Tocco, Joseph. 


Whiting, . 






455 


Oct. 10, 1919 


Dec. 


10, 1920 


Tocco, Joseph. 


Whiting, . 






140 


Oct. 25, 1919 


Dec. 


25, 1920 


Tocco, Joseph. 



Requests for Extension of Time not granted on Goods in Cold Storage from Dec. 

1, 1919, to Dec. 1, 1920. 



Article. 



Eggs, canned. 
Eggs, canned. 
Eggs, canned. 
Eggs, canned. 
Egg whites. 



C 



Weight 
(Pounds). 



1,020 
1,340 
1,220 
1,460 
180 



Placed in 
Storage. 



May 6, 1919 

May 8, 1919 

May 10, 1919 

May 13, 1919 

Mar. 4, 1919^ 



Name. 



Goldsmith-Wall-Stockwell Company. 
Goldsmith-Wall-Stockwell Company. 
Goldsmith-Wall-Stockwell Company. 
Goldsmith-Wall-Stockwell Company. 
Rausch, Robert, & Son. 



' Previously stored in the West. 



178 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Requests for Extensio7i of Time not granted on Goods in Cold Storage from Dec. 

1, 1919, to Dec. 1, iP^O — Concluded. 



Abticle. 


Weight 
(Pounds). 


Placed in 
Storage. 


Name. 


Beef 


4,689 


Jan. 4, 1919 


Boston Beef Company. 




Beef, .... 






8,402 


Jan. 31, 1919 


Boston Beef Company. 




Beef rumps and rounds, 






3,700 


Jan. 24, 1919 


Demary. A. C. 




Ox joints. 






810 


Sept. 2, 1918 


Wentworth Lunch Company. 




Halibut, 






3,750 


Jan. 4, 1919 


Boston Fish Pier Company. 




Halibut, 






4,431 


Jan. 14, 1919 


Boston Fish Pier Company. 




Halibut, 






375 


Jan. 15, 1919 


Boston Fish Pier Company. 




Halibut, 
Halibut, 






5,018 
5,094 


Jan. 15, 1919 
Jan. 17, 1919 


Boston Fish Pier Company. 
Boston Fish Pier Company. 




Halibut, 






7,620 


Jan. 17, 1919 


Boston Fish Pier Company. 




Halibut, 






55,011 


Jan. 20, 1919 


Boston Fish Pier Company. 




Halibut, 






5,122 


Jan. 20, 1919 


Boston Fish Pier Company. 




Halibut, 






5,220 


Jan. 20, 1919 


Boston Fish Pier Company. 




Halibut, 






7,118 


Jan. 20, 1919 


Boston Fish Pier Company. 




Halibut, 






4,099 


Jan. 22, 1919 


Boston Fish Pier Company. 




Halibut, 






7,620 


Jan. 22, 1919 


Boston Fish Pier Company. 




Halibut. 






1,074 


Dec. 11, 1918 


Fulham & Herbert. 




Halibut, 






5,165 


Dec. 27, 1918 


New England Fish Company. 




Herring, . 






2,200 


Jan. 21, 1919 


O'Brien, R., & Co. 




Salmon, . 






7,760 


Jan. 15, 1919 


Boston Fish Pier Company. 




Shad, 






10,598 


Jan. 22, 1919 


New England Fish Company. 




Shad, 






6,262 


Jan. 25, 1919 


New England Fish Company. 




Shad, 






12,616 


Jan. 25. 1919 


New England Fish Company. 




Condensed milk, . 






56 » 


July 2, 1919 


Hood, H. P.. & Sons. 




Condensed milk, . 






291 


July 19. 1919 


Hood. H. P.. & Sons. 





2 Cans. 



Bequests granted for Permission to remove Articles which had been in Cold Storage 
longer than Ttcelve Months, from Dec. i, 1919, to Dec. 1, 1920. 



Article. 


Weight 
(Pounds). 


Placed in 
Storage. 


Name. 


Butter 

Butter 

Beef 


1,200 
50 


May 20, 1919 
June 16, 1919 


Lewis, Mears Company. 

Lowney, The Walter M., Company. 

Souza, John. 

1 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



179 



Articles which had been in Cold Storage longer than Twelve Months, and on which 
No Requests for Extension had been made, ordered removed, from Dec. 1, 
1919, to Dec. 1, 1920. 



Article. 


Weight 
(Pounds). 


Placed in 
Storage. 


Name. 


Eggs, canned. 




. • 


641 


Pec. 27, 1918 


Layton, John, Company. 


Egg yolks, canned. 






30 


Apr. 18, 1919 


Goldsmith-Wall-Stockwell Company. 


Butter, . 








- 


July 3, 1919 


Apollo Lunch. 


Butter, . 








5,200 


Sept. 30, 1919 


Armour & Co. 


Butter, . 








305 


June 18, 1919 


Dube Brothers. 


Butter, . 








1,575 


July 10, 1919 


Security Trust Company. 


Oleomargarine, 








1,505 


Oct. 22. 1919 


Cushman, H. G. 


Oleomargarine, 








506 


May 19. 1919 


Kellogg Products Inc. 


Oleomargarine, 








450 


July 18, 1919 


Kellogg Products Inc. 


Oleomargarine, 








720 


Sept. 22, 1919 


Kellogg Products Inc. 


Oleomargarine, 








380 


Nov. 6, 1919 


Kellogg Products Inc. 


Chickens, 








217 


Dec. 27, 1919 


Levin, A. P. 


Chickens, 








579 


Oct. 21, 1919 


Porter, C. H. 


Fowl, 








408 


Dec. 27, 1918 


Levin, A. P. 


Poultry, . 








- 


Dec. 16, 1918 


Brigham's Restaurant. 


Poultry, . 








- 


Nov. 29, 1919 


Cohen, Samuel. 


Poultry, . 








160 


Feb. 1, 1919 


Pratt, F. B., Company. 


Poultry, . 








- 


Oct. 22, 1918 


Shearer, C. T., Company. 


Poultry, . 








- 


Feb. 12, 1919 


Shearer, C. T., Company. 


Poultry, . 








- 


Oct. 22, 1918 


Warren Hotel. 


Turkeys, 








230 


Dec. 23, 1918 


Blackstone Supply Company. 


Turkeys, 








247 


Dec. 27, 1918 


Levin, A. P. 


Turkeys, 








230 


Jan. 2, 1919 


Robbing. Nathan, Company. 


Rabbits, 








360 


Feb. 4, 1919 


McCabe, M. J., Company. 


Venison, 








15 


Nov. 14, 1918 


Finnegan, R. E. 


Game, m 


scellaneou 


s, 






15 


Feb. 8, 1919 


Mixter, Dr. S. J. 


Beef. 










23,957 


Nov. 7. 1919 


Handy, H. L., Company. 


Beef. 










5,195 


May 29. 1919 


Libby & Libby Company. 


Beef. 










434 


June 10, 1919 


Libby & Libby Company. 


Beef. 










17,949 


June 13, 1919 


Libby & Libby Company. 


Beef, 










876 


June 24, 1919 


Libby & Libby Company. 


Beef, 










1,276 


June 25, 1919 


Libby & Libby Company. 


Beef, 










2,323 


Dec. 11, 1918 


Lipsky, Samuel. 


Beef. 










2,602 


Dec. 18, 1919 


Lipsky, Samuel. 


Beef, 










- 


- 


Shearer, C. T., Company. 

_, 



' Cans. 



180 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Articles which had been in Cold Storage longer than Twelve Months, and on which 
No Requests for Extension had been made, ordered removed, from Dec. 1, 
1919, to Dec. 1, 1920 — Conthmed. 



Article. 


Weight 
(Pounds). 


Placed in 
Storage. 


Name. 


Beef briskets, .... 


5,739 


May 20, 1919 


Libby & Libby Company. 


Beef briskets, 








6,359 


May 22, 1919 


Libby & Libby Company. 


Beef briskets, 








7,025 


May 23, 1919 


Libby & Libby Company. 


Beef briskets, 








4,617 


June 2, 1919 


Libby & Libby Company. 


Beef flanks, ' . 








758 


May 29, 1919 


Libby & Libby Company. 


Beef flanks, . 








2,803 


June 20, 1919 


Libby & Libby Company. 


Beef flanks, . 








697 


June 27, 1919 


Libby & Libby Company. 


Beef flanks, . 








469 


July 1, 1919 


Libby & Libby Company. 


Beef cheek meat, . 








400 


Jan. 21, 1919 


Mindick, M. 


Beef fores. 








4,295 


Sept. 17, 1919 


Swift & Co. 


Beef kidneys, 








80 


Apr. 26, 1919 


Portsmouth Market. 


Beef kidneys. 








450 


Apr. 26, 1919 


Portsmouth Market. 


Beef livers, 








777 


Dec. 30, 1918 


Cohen, Nathan. 


Beef rounds, . 








6,461 


June 6, 1919 


Libby & Libby Company. 


Beef rounds, . 








1,538 


Jan. 6, 1919 


Lipsky, Samuel. 


Beef rumps and rou 


nds, 






2,726 


Apr. 24, 1919 


Libby & Libby Company. 


Beef stickers, . 








2,565 


Nov. 14, 1918 


Lipsky, Samuel. 


Beef stickers, . 








2,948 


Nov. 19, 1918 


Lipsky, Samuel. 


Calves' livers. 








300 


1918-1919 


Royal Market Company. 


Hogs' kidneys. 








700 


Mar. 14, 1919 


Moore, Alexander. 


Lamb, 








716 


Sept. 19, 1919 


Goulakis, A. 


Ox joints, 








625 


Sept. 2, 1918 


Boylston Caf6. 


Ox joints. 








625 


Sept. 2, 1918 


Dorr, Arthur E., & Co., Inc. 


Pork kidneys. 








249 


Sept. 18, 1919 


Goulakis, A. 


Sweetbreads, . 








90 


June 6, 1919 


Batchelder & Snyder Company. 


Veal kidneys, 








118 


Nov. 30, 1918 


Standard Beef Company. 


Eels, sand. 








35 


Oct. 15, 1919 


Busalacchi, Tony, & Co. 


Haddock, 








500 


July 3, 1919 


Foilb, M. 


Herring, . 








400 


Oct. 2, 1919 


Busalacchi Brothers. 


Herring, sardine. 








175 


Oct. 9, 1919 


Globe Fish Company. 


Herring, sardine. 








175 


Aug. 11, 1919 


Mantia, S., & Co. 


Lobster meat, 








20 


Apr. 22, 1919 


Grilli, L 


Mackerel, 








1,750 


Dec. 21, 1918 


Globe Fish Company. 


Mackerel, 








140 


Apr. 24, 1919 


Hellenic Fish Market. 


Mackerel, 








2,650 


June 11, 1919 


Masheeco, M. 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



181 



Articles which had been in Cold Storage longer than Tioelve Months, and on which 
No Requests for Extension had been made, ordered removed, from Dec. 1, 
1919, to Dec. 1, i 9^0 — Concluded. 



Article. 


Weight 
(Pounds\ 


Placed in 
Storage. 


Name. 


Monkey fish, 


280 


Aug. 23, 1919 


Mantia, S., & Co. 


Salmon, . 










200 


July 5, 1919 


Coleman Sons Company. 


Shark, . 










460 


July 3. 1919 


Globe Fish Company. 


Shark, . 










640 


July 15, 1919 


Globe Fish Company. 


Shark, . 










85 


Oct. 11, 1919 


Reynolds' Market. 


Shark, . 










192 


Aug. 30, 1919 


Russo & Sons. 


Skates, . 










- 


July 23, 1919 


Globe Fish Company. 


Skates, . 










- 


July 17, 1919 


Mantia, S., & Co. 


Skate wings. 










1,505 


Oct. 22, 1919 


Russo & Sons. 


Whiting, 










- 


July 17, 1919 


Corso & Cannizzo. 


Whiting, 










100 


June 27, 1919 


Globe Fish Company. 


Whiting, 










1,295 


Aug. 11, 1919 


Mantia, S., & Co. 


Whiting, 










3,710 


Sept. 8, 1919 


Mantia, S., & Co. 


Whiting, 










1,805 


Sept. 12, 1919 


Mantia, S., & Co. 





182 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



C5 






o 

S 

o 






CO 








::?; 


i?^ 








W5 (M 1— 1 -cj- 1^ 


Ci CO 


lO 




to 


lO C^ Tj- -r to 


»C Ci 


OO 




oo o ^ r^ GO 


CO iC 


lO 




"3 
-*^ 

o 










ec 05 ci »o c^ 


»— CM 


-<*' 




O CC Ci C^l iO 


Tf — 






cc C^CO o- 


t^ C-l 


r^ 












i-^'c^i'wf o 


t-T^ 


•^ 






C^ CCi-H 


00 CO 


o 




1 o 


O^iOOiO 1 


no TP 


1— 1 




cc-^ O t^ 


COCi 


CM 




•^t>^CC C^l^ 


t^ca 


lo 




> - 


T-TCC'^M 


00 »o 


CO 




^ 


Ci Ci^ Oi 


CO '^ 


CO 




^-lOi(X>'^^ 


OO t^ 


TP 






coco 


o 




c 

So 


o toic OO 1 


— OS 


g 




r^t^-^^ 


00 »- 




Cii-tr- 1 OO 

CD oo irf M 


CM CO 

uo od 


Cs 

CO 
OO 
CO 




■* cocr. t^ 


^ CO 




c; 


■^ ^^ "^ 


CO Ci 




o 


C^*H 


ci"CM 


CO 




iS 


OlO'-'-H 1 


iC CM 


:?; 






IC CCJ- oo 


CMC3 


CO 




Cit^^-H M 


COM- 


^ 




-.^ _ 


CDCSwi" o 


odod 


OS 




a - 


iCCD-^CJO 


CO W5 


00 




O I- 


iocc-*^o 


Ci 00 




w^ 


CO 


iOCm" 


CO 




-_ 


OOOOOU5 1 


CM lO 


OO 




-*^ 


oo^r- 


00 CO 


OO 
CM 




3-^ 




CO CM_ 

—- cf 




CC CC** lO 


CO t^ 


CO 




CO u? Ci <:o 


ot^ 




< 


»/5 


W5 ws" 


od 






ooo-* ^ 1 


O^ 


''J^ 






ou:) •-H CM 


■^ 1—1 


^ 




is 




C-J^iO 

OO od 


Ci 




'<*' CC^ <M 


CM OO 


s 




i-s'^ 




OCO 


CO 






^ o^ 


odiO 


CD 
C3 






iC-" CiiC '^ 


m lO 


^ 






r*^H cOio o 


■^ OO 


^^l 




2o 


t^OiOOCOrH 


00 CM 






§i 


UD-^jTo O 


CO ^- 


CO 




OCM t- CO 


CO ^ 






1-5 ^H 


loeo cDcs 


CM lO 


CO 






Tf i>r 


co-^jT 


CO 






S c^ '**' <^^'^ 


co-^ 


o 






O cico lO Ci 


OOif5 






S2 


^. CO O 1^5 Ci 


CO o 


o 




SS"5 CiO 

f^. CM coo 


OO CM 
OC ^^ 


CO 






2 ^ 


tC^ 


^H 






*-H 




CO 






oeocoooco 


o^ 


■^ 






O CiiOiC t^ 


Ci — 


00 




•r" o 


CO CO CO ooo 


OO 


W5 






OCO CO o 


o'-^" 


CO 




t^-^ t^iO 


»0 CD 


lO 




CO»-i COtJ* 


t- CO 


CO 






CM 


-*" 


Ci 




. 


OCO o«oco 


•^-^ 


o 




j£ • 


oo t^ coco C^i 


CD CM 


CO 




uo 


eOiO-^ 00 CO 


co_^_ 


r* 




Elc-j 


C^i" CM CO ^ 


CM tJh" 


i>r 




OTfiC^ 


CiuO 


m 




S" 


CO c^ oot^ 


OiO 


m 














^ 


Ci ^^ 


•^ 




1 o 


o»« t^ca o 


OS CM 


g 




ic<i 


to t— c; cOf-t 


c -^ 




J^2 


CO 00 00 OO CO 


Ci ■<!-__ 


OO 




iCCM ^c{cO 


OCO 


od 

OO 

CO 






CO ^H CO ITS 


OCM 




CM ■^ CO CO 


url>» 




C3 




o 


^1 






^ 


:s 






So 


O COCO CO CO 


-r*- O 


Ci 




CO CD CO r^ OO 


in t~* 


t^ 




OC 00 OO CC Oi 


1—. —I 


C^l 






Cicooci"-^" 


iC ^ 


^ 




'^ s <^2 '=^- --^ 


O CO 


CSl 




^ '^ 


^c^coco 


Ci CO 


o 




^ 


CO 


00^ 


CO 




1 ci 


Ot^cvj-*** O 


-HCO 


^ 




is 


C^l b- CO CO ^H 


CI CO 


s 




OC ■^ CO' iC CO 


CO ^^ 


co_ 




g- 


CO lO Ci -J ci 


C^'^J^ 


CS 




O t- 


^ O CO CM -^ 


1-1 !>. 


§ 






»— « r-l t>- lO 


»-" CO 




-<1<" 


od-^ 


ud 








1 ■ • 








^^ 


o 






g 


.-3 . . . 


s..^ 






Q a 


c 
:3 


-1^^ ^ 






63 O 


. o 


gjs 2 






o < 


--: c . 


X ^ o 






< K 


in--; 










!fi 


w 
















ci Si-^ 








tt btS c « 


O 2 M 








hks;phO 


^ p^ 









-o 




c 




d 




o 




a 




rn 




a 




T) 




a> 




■a 




13 


■o 


a 




2 

03 


o. 


m 




bn 


t. 


hll 


-fj 


o 


n 


u~* 


c 


o 


.2 


s 


o 


i 


rt 


T3 


M 


o 


i> 




J3 


-4J 


-M 




n 


•a 








3 






? 


a 


c 


1—1 


o 




■s 


«1 


(1) 


n1 




h« 


> 

o 


> 

OS 


c 


hf) 


o 


hll 






^ 


C3 






a 


N 


J3 


o 


-1^ 


•73 


o 
a 

r> 


c 
o 


^ 




c 


o 


tn 


ffl 




-«-> 


t4 


rl 


o 


fl) 






f 





-A 


o 






o 


(11 



o 






3 


^ 


Fi 


c 


s 




a 


<J 


KH 






to 



o 



CJi 



S 

e 
^ 



o 



to 
o 

o 

to 
00 

to 





oocot^ r-.»o 


CI 






r^ CO CM iO t^ r^ 


CO 




'"' o 


O O -^^ CD CM t^ 


CM 










^;^ 


Oodo^" Cicf 


CM 




O CJs 


CO u^ iC lO ur 1— " 


Ci 




& -^ 


C0»0 O t^ t^ CO 


o 




c 








»0 -^ CO Tf CO 


'* 






^ co^ 


CO 




_ 


0«0 Ci O CO^O 


o 






CO''*' t^ CO "0 -t" 






-"d 


Ot^ t>--t** OO ^ 


cs 










>s 


COCO-^ CO iC t^ 


o 




OO'— t^'tf CD t^ 


CO 




O-H 


I>^CO^OO OCO 


o 




z 








Ci Os-^ -^'o 


CO 






^^ CM CI 


r* 






o O't r- 'Tf ic 


o 






CO r^ic o CO Ci 


o 




— d 


■^_ CM_ lO CS t>; '-' 


b- 




.<M 


Co" CO cJ OT ud CD 


o 




..J OS 


■^ Ci '^r Ci o CI 


CO 




Ort 


OOOOt^i-t OCi 


iO 




o 








1-1 O^ «-it^ 


CM 






r~i ^ CM^ 


^* 




^ 


O t^ Ci O CO lO 


l^ 






CO O lO CO m^o 


CO 




. d 


OOi-'CO'* CiOO 


"^ 










-W!N1 


lid-^wdci" odod 


in 




Q,05 


'Tf M- i« Ci ^ Ci 


utt 




ar-i 


-rt" 00 CD <* O 00 


CO 










03 


in ci-H -^00 


l>^ 






1-1 1-1 CO f-" 


OO 






OuO O OO o o 


*-l 






CO b- CO -'S* CM O 






'" d 


00 o r^- o o CO 


OO 










^■.c^ 


O "ti — 00 CI '■!*' 


CO 




Men 


CD CO iC CO IlC CO 


CO 




3-^ 


t'-ic c CM *r:t CO 


t^ 




<J 








CO coco ■^ W5 


CM 






-H ^ COl-l 


OO 






UOIOO 1 1 1 


o 






o-* ^ 


CO 






I>- O -H 


00 




o 








>1S 


■^O CM 


to 




^- 05 


t^ 1—1 CO 






3« 


00 iC ^H 


lO 




►Ti 


CO r^ 


"^ 






1— < 


C^l 






ocor- I 1 1 


Q 






■* ^ -* 






„d 


co-^t-^ 


uO 




0(M 


tCodo 


CD 




C 05 


UO CD CO 


'Tf 




3-H 


occoco 


OO 




>-5 


c^ 


CO 






■^ 


1— ( 






O CI CI 1 II 


■^ 






lO liO ^H 


»-< 




^ o 


CO t^ Ci 


Oi 




>iC<» 


ird'^O 


o 




C3=n 


•<^ Cir^ 


1— < 




S" 


CO CO CM 


CO 

CO 






Ot^-^ 1 I 1 


.^ 




^H 


^^m 


00 




^ o 


coco t^ 


CO 










•r* CM 


odo -^j*" 


CO 




aS 


CO 00-^ 


Ci 




CO uo 


Os_ 




<; 








. 


ooco 1 1 1 


c^ 




^H 


ca -^ CO 


o 




^o 


O CM_^H 


■^ 




oco 


ododcd" 


cT 




tio 


CM^ CO 


o 




C2^ 


■^o 


in 




s 


CM 


CO 






C-1 '^ CS 1 II 


m 






Ci CO UO 


OO 




. d 


I^CO CO 


t^ 




-g- 


1-^CO -^J*" 


OS 




O COUO 


o 




o^ 


CO-^iO 


co^ 




fe 


i-T ud 


rC 






O'^ -^ I II 


OO 






oocoo 


CO 




"d 


oo^r-- 


00 




• C3 


cdcD o 


■^ 




C OS 


'* 'Tj- '^ 


C) 




o3rt 


r^-ij. t-^ 


OS 




•-9 


'^ od 


CO 






' ' ' " in ' ' 








■*J 








o 








3 








. - • .-^ . • 


• 






'm' O - 








.1..- ^ 








* 






3 tJ -C 








O o 3 








^3 " o 








2 ^" .3 






















3g5g_-5-2 


c< 




1 




03 

■3 













K-^rii:S^-? „- 


^ 






M t[-^ 3 " C-r 








fee fc£ 3 c ^ *^ .i2 








KHKP^S fe 







■a 

o 
a 
<» 



•a 


, 


r, 


tn 


rt 


•0 


.a 


B 




-1 


a 








a 


ID 


3 





•n 




■§ 




■a 






CS 









'"• 


cs 


-4^ 
09 

3 




<; 





u 


to 





B 


-4-> 




■S 


S 


■a 


•a 


s 





C3 


J3 




-4^ 









•a 





B 
3 



J3 


C 


& 


»H 




§ 
S? 


3 


L. 






-a 


> 


^ 


c3 






>■ 




OJ 




T) 


fl> 


OT 


n 


OS 





# 


n 


-iJ 


•n 






O 





C 


B 


<u 





>-• 


<*-« 








tJ) 


T 




•« 


t^ 


r* 


^ 


s 

a 


■!-! 


n 










n 














G 


0! 


i< 


■ C, 




r^ 




3 


S 


R 


c 


S^ 


-*; 


B 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



183 



Table No. 6. — List of Prosecutions. 
For Sale of Milk not of Good Staridard Quality. 



Name. 


Address. 


Court. 


Date. 


Result. 


Baracos, Charles, . 


Winthrop, 


East Boston, 


Aug. 17, 1920 


Conviction. 


Braun, Joseph, 


Springfield, 


Springfield, 


Dec. 16, 1919 


Conviction. 


Caevallu, Joseph A., 


Fall River, . 


Fall River, 


Oct. 5, 1920 


Conviction. 


Caro, Samuel, 


Springfield, . 


Springfield, 


Nov. 16. 1920 


Conviction. 


Cohen, Jacob, 


Winthrop, 


East Boston, 


Aug. 9, 1920 


Conviction. 


Creamer, Oscar, . 


Springfield, . 


Springfield, 


Nov. 24, 1920 


Conviction. 


Donovan, James, . 


Salisbury, 


Newburyport, . 


Sept. 1, 1920 


Conviction. 


Economidy, Anthony, . 


Springfield, . 


Springfield, 


Nov. 16, 1920 


Conviction. 


Gordon, James D., 


Salem, 


Salem, 


Aug. 6, 1920 


Conviction. 


Johnson, Charles, . 


Hull, . 


Hingham, . 


Sept. 3, 1920 


Conviction. 


Karelis, Dennis, . 


Hingham, 


Hingham, . 


Aug. 10, 1920 


Conviction. 


Karelis, Dennis, . 


Hingham, 


Hingham, . 


Aug. 10, 1920 


Conviction. 


Koury, Maroun, . 


Hull, . 


Hingham, . 


Sept. 3, 1920 


Conviction. 


Lampros, Samuel, 


Springfield, 


Springfield, 


Nov. 16, 1920 


Conviction. 


Litchfield, Wm. F., 


Edgartown, . 


Oak Bluffs, 


Oct. 21, 1920 


Conviction. 


Mahamad, Kaya, . 


Hingham, 


Hingham, . 


Aug. 10, 1920 


Discharged. 


McCarthy, Samuel J., • 


Springfield, . 


Springfield, 


Dec. 16, 1919 


Conviction. 


Jilellar, Stephen, . 


Springfield, . 


Springfield, 


Nov. 16, 1920 


Conviction. 


Norton, Clement, . 


Edgartown, . 


Oak Bluffs, 


Oct. 21, 1920 


Conviction. 


Peterson, Robert, . 


Hingham, 


Hingham, . 


Aug. 10, 1920 


Conviction. 


Sing, Mah, .... 


Salem, . 


Salem, 


Aug. 6, 1920 


Conviction. 


Union News Co., . 


Fall River, . 


Fall River, 


Mar. 30, 1920 


Conviction. 


Ying, Moy 


Springfield, 


Springfield, 


Jan. 6, 1920 


Conviction. 


Young, Constantine, 


Hingham, 


Hingham, . 


Aug. 10. 1920 


Conviction. 



For Sale of Milk from irhich a Portion of the Cream had been removed. 



Buckley, Charles V., 
Graustein, Wm. A., 
Johnson, Bradford S., 
Kicopoulos, Nicholas, 
Moregeau, William, 
Nobut, Peter, 



Monson, . 
Cambridge, 
Gardner, 
Monson, . 
Attleboro, 
West Medway, 



Palmer, 

Waltham, 

Gardner, 

Palmer, 

Attleboro, 

Franklin, 



Sept. 


30, 


1920 


Jan. 


7. 


1920 


Nov. 


12, 


1920 


Sept. 


30, 


1920 


July 


23, 


1920 


Oct. 


9, 


1920 



Conviction.' 

Conviction.' 

Conviction. 

Conviction.' 

Conviction. 

Conviction. 



' Continued to Dec. 30, 1920, for sentence. 



2 Appealed 



nol-prossed in Superior Court. 



184 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



For Sale of Milk containing Added Water. 



Name. 



Address. 



Court. 



Date. 



Result. 



Almedia, Joseph, . 
Arruda, Joseph J., 
Asadoorian, Hagop, 
Asoian, Nishan, 
Bacon, William H., 
Baker, D. Frank, . 
Baker, Henry A., . 
Barberian, Dan, . 
Barbieri, Andrew, . 
Bennett, Matthew J., 
Billings, Lawson H., 
Billings, Lewis E., 
Boissoneau, Alfred, 
Bonnette, Theodore J., 
Bookless, Samuel, . 
Bouchard, William, 
Bury, Charles, 
Cassidy, Frank, 
Charonitch, Alexander, 
Collins, John L., . 
Corbin, John, 
Correia, Manuel, . 
Dumas, Joseph, 
Fousica, Frank C, 
Glass, Anton, 
Goldstein, Samuel, 
Gould, Leroy F., . 
Grigolonok, John, . 
Gurl, Joseph, 
Haber, Andrew, 
Hanscom, William, 
Harrison, Rose, 
Haskell, George C, 
Houghton, Allan W., 
Huntley, Wm. H., 



Westport, 

Fall River, 

North Andover, 

Andover, 

Lexington, 

Swansea, 

Rockland, 

Andover, 

Great Barrington, . 

Burlington, 

Plympton, 

Plympton, 

Tiverton, R. I., 

Southbridge, . 

Pittsfield, 

Westport, 

Taunton, 

Med way, 

Medway, 

Woburn, 

Millbury, 

South Somerset, 

Dudley, . 

Fall River, 

North Dartmouth, 

Medway, 

Sherborn, 

Concord, 

North Dartmouth, 

South Hadley, 

Bolton, . 

Barnstable, 

Orange, . 

Amherst, 

Marblehead, 



Fall River, 
Fall River, 
Andover, . 
Andover, . 
Concord, . 
Fall River, 
Abington, . 
LawTence, . 
Great Barrington 
Woburn, 
Plymouth, 
Plymouth, 
Fall River, 
Southbridge, 
Pittsfield, . 
Fall River, 
Taunton, . 
Franklin, . 
Franklin, . 
Woburn, 
Worcester, . 

Fall River, 

Webster, 

Fall River, 

New Bedford, 

Franklin, . 

Framingham, 

Concord, . 

New Bedford, 

Northampton, 

Hudson, 

Barnstable, 

Orange, 

Northampton, 

Marblehead, 



May 21, 1920 
Oct. 5, 1920 
Nov. 16, 1920 
Nov. 16, 1920 
Oct. 11, 1920 
Aug. 31, 1920 
Apr. 21, 1920 
Apr. 12, 1920 
Dec. 16, 1919 
Nov. 8, 1920 
May 11, 1920 
May 11, 1920 
Nov. 9, 1920 
Apr. 23, 1920 
Dec. 17, 1919 
Aug. 10, 1920 
June 10, 1920 
Aug. 28, 1920 
May 18, 1920 
Nov. 5, 1920 
June 28, 1920 
Oct. 5, 1920 
June 15, 1920 
June 25, 1920 
June 22, 1920 
May 18, 1920 
Oct. 30, 1920 
Oct. 11, 1920 
Aug. 11, 1920 
June 2, 1920 
Aug. 3, 1920 
Sept. 24, 1920 
June 24, 1920 
June 2, 1920 
Aug. 5, 1920 



Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. ' 

Dismissed. 

Conviction. 

Conviction. ' 

Conviction. 

Conviction. 

Conviction. 

Conviction.' 

Nol-prossed.2 

Conviction. 

Convection. 

Conviction. ' 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction.! 

Conviction. 

Conviction. 

Conviction. 

Dismissed. 

Conviction. ' 

Conviction. 

Conviction. 

Conviction. 

Conviction. * 

Conviction. 

Conviction. 

Conviction. 



1 Appealed. 

- Responsibility assumed by Fanny Tucker. 

3 Case prosecuted in co-operation with Mr. H. E. Bowman, milk inspector, Somerville. 

* Case prosecuted in co-operation with Mr. George T. Mecarta, milk inspector, Barnstable. 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



185 



For Sale of Milk containing Added Water — Continued. 



Name. 



Address. 



Court. 



Date. 



Result. 



Jackson, Wm. O., 

Jarman, David, 

Jordan, Annie V., 

Joyce, James, 

Karam, Sheehan, 

• Katilin, Salome, 

Koziel, John, 

Larrabee, Harry A 

Machado, John, 

Mailloux, Lorenzo, 

Maringo, Frank, 

Marquis, Horace, 

May, Charles P., 

Maynard, George E 

Mello, Angelo, 

Mello, Joseph Costa 

Mello, Joseph C, 

Mingos, Charles, 

Palmer, William, 

Palmer, William H 

Perry, Frank S., 

Perry, Frank S., 

Perry, John, . 

Proctor, Warren, 

Reposa, Manuel, 

Reynolds, Sr., Frank, 

Rezendes, John, 

Rich, John H., 

Sampson, Leon A 

Silva, Alexander, 

Silva, Paul, 

Spaulding, James R., 

Steele, Joseph, 

Stockton, James 

Stone, John, . 

Sullivan, John, 

Sykes, Louis, 



Hardwick, 

Dracut, . 

Pittsfield, 

Salem, 

Agawam, 

West Medway, 

Palmer, . 

Nantucket, 

Westport, 

Berkley, . 

Fall River, 

Fall River, 

Winchendon, 

Marlborough, 

Fairhaven, 

Fall River, 

North Westport, 

Salem, 

Pittsfield, 

Pittsfield, 

Attleboro, 

Attleboro, 

Dartmouth, 

Lunenburg, 

Somerset, 

Lexington, 

Somerset, 

Truro, 

Westborough, 



Danvers, 

Middleboroug 

Salisbury, 

Provincetown 

Bellingham, 

Sudbury, 

Lexington, 

Norwood, 



h, 



East Brookfield, 
Lowell, 
Pittsfield, . 
Salem, 
Springfield, 
Franklin, . 
Palmer, 
Nantucket, 
Fall River, 
Taunton, . 
Fall River, 
Fall River, 
Winchendon, 
Marlborough, 
New Bedford, 
Fall River, 
Fall River. 
Salem, 
Pittsfield, . 
Pittsfield, . 
Attleboro, . 
Attleboro, . 
New Bedford, . 
Leominster, 
Fall River, 
Concord, . 
Fall River, 
Provincetown, . 
Westborough, . 
Salem, 

Middleborough, 
Newburyport, 
Provincetown, 
Franklin, . 
Framingham, 
Concord, . 
Stoughton, 



Feb. 5, 1920 
Nov. 4, 1920 
Dec. 17, 1919 
Mar. 16, 1920 
Dec. 1, 1919 
Oct. 9, 1920 
Oct. 27, 1920 
Aug. 19, 1920 
Aug. 10, 1920 
Oct. 19, 1920 
Apr. 21, 1920 
Oct. 13, 1920 
May 5, 1920 
Oct. 23, 1920 
Jan. 5, 1920 
Feb. 19, 1920 
Oct. 26, 1920 
Aug. 6, 1920 
Dec. 17, 1919 
June 11, 1920 
July 16. 1920 
July 16, 1920 
Sept. 21, 1920 
Aug. 13, 1920 
May 4, 1920 
Aug. 6, 1920 
Oct. 5, 1920 
Sept. 8, 1920 
June 30, 1920 
Mar. 16, 1920 
Nov. 13, 1920 
Sept. 10, 1920 
Sept. 15, 1920 
Aug. 28, 1920 
June 9, 1920 
Aug. 6, 1920 
Apr. 9, 1920 



Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. ' 

Conviction.' 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. ' 

Conviction. 

Discharged. 

Conviction. 

Conviction. 



1 Appealed. 



186 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



For Sale of Milk containing 


Added Water — 


- Concluded. 




Name. 


Address. 


Court. 


Date. 


Result. 


Sykes, Louis, 
Sykes, Louis, 
Sykes, Louis, 
Tatro, Joseph, 
Tilden, Frank P., . 
Tucker, Fanny, 
Twitchell, Lillian I., 
Wiley, John H., . 
Wolcoski, Russell, . 
Yeziersky, Martin, 




Norwood, 
Norwood, 
Norwood, 
South Hadley, 
North Scituate, 
Southbridge, . 
HolHston, 
Mansfield, 
South Billerica, 
Agawam, 


Stoughton, 
Stoughton, 
Stoughton, 
Northampton, . 
Hingham, . 
Southbridge, 
Framingham, . 
Attleboro, . 
Lowell, 
Springfield, 


Apr. 9, 1920 
Apr. 9, 1920 
Apr. 9, 1920 
June 2, 1920 
Nov. 30, 1920 
Apr. 23, 1920 
Oct. 16, 1920 
June 4, 1920 
Nov. 4, 1920 
Dec. 2, 1919 


Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Discharged. 

Conviction. 

Conviction. » 

Conviction. 



For Sale of Cream helow Legal Standard. 



Graustein, Wm. A., 
Graustein, Wm. A., 



Cambridge, 
Cambridge, 



Walt ham, 
Waltham, 



Jan. 7, 1920 
Jan. 7, 1920 



Discharged. 
Conviction.' 



Ferguson, Hugh R., 



For Sale of Adulterated Butter. 

[Contained excess moisture.] 



Hyannis, 



Barnstable, 



Aug. 12, 1920 ! Conviction. 



For Sale of Adulterated Foods Other than Milk and Milk Products. 



Clams. 
[Contained added water.] 



Anthony, George M., . 


Chelsea, . 


Chelsea, 


May 17, 1920 


Discharged. 


Brown, Rufus S., . 


Newburyport, 


Newburyport, . 


Sept. 10, 1920 


Conviction. 2 


Fowler, Wm. L., . 


Salisbury, 


Newburyport, . 


Sept. 10, 1920 


Conviction. 


Pierce, Henry A., . 


Boston, . 


Boston, 


May 23, 1920 


Conviction.' 


Smart, Phillip A., 


Lynn, 


Lynn, 


Oct. 14, 1920 


Discharged. 


Wilcox, William J.. 


Chelsea, . 


Chelsea, 


May 17, 1920 


Discharged. 



Olive Oil. 
[Adulterated with foreign oil.] 



Alexion, Markos, . 



New Bedford, 



New Bedford, . Mar. 5, 1920 1 Conviction. 



1 Case prosecuted in co-operation with Mr. H. E. Bowman, milk inspector, Somerville. - Appealed. 



\ 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



187 



For Sale of Adulterated Foods Other than Milk and Milk Products — Continued. 



Olive Oil — Concluded. 
[Misbranded.] 



Name. 


Address. 


Court. 


Date. 


Result. 


Caresi, Guiseppi, . 

Geas, Folios, .... 

Leonardi, Santi, . 


Boston, . 

Fitchburg, 

Lawrence, 


Boston, 

Fitchburg, 

Boston, 


Apr. 30, 1920 
Mar. 23, 1920 
Apr. 30, 1920 


Conviction. 
Conviction. 
Conviction. 



Sausage. 
[Contained starch in excess of 2 per cent.] 



Balkus, Andrew, . 


Lynn, 


Lynn, 


Dec. 


9, 1919 


Conviction. 


Beauchamp, Ovilla, 


Holyoke, 


Springfield, 


Feb. 


10, 1920 


Conviction. 


Briggs, John W., . 


Methuen, 


Lawrence, . 


Mar. 


25, 1920 


Conviction. 


Caton, Wm. E 


Lowell, . 


Lowell, . 


Dec. 


31, 1919 


Conviction. 


Cudahy Packing Company, 


Boston, . 


Boston, 


Mar. 


10, 1920 


Conviction. 


Cudahy Packing Company, 


Boston, . 


Boston, 


Mar. 


10, 1920 


Conviction. 


Cudahy Packing Company, 


Boston, . 


Boston, 


Mar. 


10, 1920 


Conviction. 


Eberwein, John, . 


Pittsfield, 


Pittsfield, . 


Jan. 


23, 1920 


Conviction. 


Furneaux, Henry J., . 


Lawrence, 


Lawrence, . 


Jan. 


30, 1920 


Conviction. 


Gavriluk, Alex, 


Lawrence, 


Lawrence, . 


Jan. 


21, 1920 


Conviction. 


Holt, John, .... 


LawTence, 


LawTence, . 


Jan. 


30, 1920 


Discharged. 


Holt, John, .... 


Lawrence, 


Lawrence, . 


Jan. 


30, 1920 


Conviction. 


Johnston, Robert W., . 


Lowell, . 


Lowell, 


Jan. 


22, 1920 


Conviction. 


Johnston, Robert W., . 


Lowell, . 


Lowell, 


Jan. 


22, 1920 


Conviction. 


Kirschner, Frank, 


Haverhill, 


Haverhill, . 


Jan. 


30, 1920 


Conviction. 


Mohawk Packing Company, 


Boston, . 


Boston, 


Jaq. 


16, 1920 


Conviction. 


Massachusetts Mohican Com- 


Pittsfield, 


Pittsfield, . 


Jan. 


23, 1920 


Conviction. 


pany. 
National Packing Company, 


Boston, . 


Boston, 


Mar. 


11, 1920 


Conviction. 


National Packing Company, 


Boston, . 


Boston, 


Mar. 


11, 1920 


Conviction. 


Park Sausage and Provision 

Company. 
Park Sausage and Provision 

Company. 
Park Sausage and Provision 

Company. 
Sayisck, John, 


Boston, . 
Boston, . 
Boston, . 


Boston, 
Boston, 
Boston, 


Feb. 
Feb. 
Feb. 


4, 1920 
4, 1920 
4, 1920 


Conviction. 
Conviction. 
Conviction. 


Lawrence, 


Lawrence, . 


Jan. 


30, 1920 


Conviction. 


Shedd, Harold H.. 


Haverhill, 


Haverhill, . 


Jan. 


17, 1920 


Conviction. 


Thomas, Arthur, . 


Waltham, 


Waltham, . 


Feb. 


18, 1920 


Conviction. 


Wilner, Paul, 


Haverhill, 


Haverhill, . 


Apr. 


2, 1920 


Conviction.! 


Wisniowski, Frank, 


New Bedford, 


New Bedford, . 


Jan. 


20. 1920 


Conviction. 



1 Appealed. 



188 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



For Sale of Adulterated Foods Other than Milk or Milk Products — Continued. 

Sausage — Concluded. 
[Contained coloring matter.] 



Name. 


Address. 


Court. 


Date. 


Result. 


Massachusetts Mohican Com- 
pany. 


Pittsfield, 


Pittsfield, . 


Jan. 23, 1920 


Conviction. 



Soft Drinks. 
[Contained saccharine.] 



Brazen, Joseph, 


Lawrence, 


LawTence, . 


Oct. 


1, 1920 


Dismissed, i 


Puzine, Jacob, 


Lawrence, 


Lawrence, . 


Oct. 


1, 1920 


Conviction. 


Yuz, John, .... 


Lawrence, 


Haverhill, . 


Oct. 


4, 1920 


Conviction. 



Thomas, Mishan,* 
Thomas, Misrah,' . 



Vinegar. 
[Low in acid. 



Lawrence, 
Lawrence, 



Lawrence, 
Lawrence, 



Nov. 19, 1920 
Nov. 19, 1920 



Conviction. 
Conviction.' 



Eggs. 
[Decomposed; unfit for food 



Cohen, Louis, 

Economy Grocery 

Company. 
Flood, Nathan B., 

Flood, Nathan B., 

Roosov, Abraham, 

Singer, Morris, 



Stores 



Boston, . 
Maiden, . 
North Adams, 
North Adams, 
Stoneham, 
Boston, . 



Boston, 

Maiden, 

Pittsfield, 

Pittsfield, 

Woburn, 

Boston, 



Jan. 


14, 


1920 


Dec. 


11, 


1919 


Jan. 


23, 


1920 


Jan. 


23, 


1920 


Dec. 


19, 


1919 


Mar. 


19, 


1920 



Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. * 

Conviction. 



False Advertising — Sale of Stale Eggs as Fresh Eggs. 



Bay State Market Company, 


New Bedford, 


New Bedford, . 


Jan. 20, 1920 


Conviction. 


Blay, Philip F 


Waltham, 


Waltham, . 


Mar. 3, 1920 


Conviction. 


Janes, Charles W., 


Waltham, 


Waltham, . 


Feb. 18, 1920 


Conviction. 


New Bedford Public Market, 


New Bedford, 


New Bedford, . 


Jan. 20, 1920 


Conviction. 


Newton Public Market, 


Newton, 


Newton, . 


Nov. 1, 1920 


Conviction.* 



1 Left State before summons was served. Partner convicted. 

* Case prosecuted in co-operation with the Lawrence Board of Health; analysis made by this De- 
partment. 

^ Continued for sentence. 

* Appealed. 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



189 



For Sale of Adulterated Foods Other than Milk or Milk Products — Continued. 

Eggs — Continued. 

Mishrandcd. 



Name. 


Address. 


Court. 


Date. 


Result. 


Armour & Co 


Boston, . 


Boston, 


Mar. 


11, 1920 


Conviction.' 


Flood, Nathan B., 


North Adams, 


Pittsfield, . 


Dec. 


30, 1919 


Conviction. 


Flood, Nathan B., 


North Adams, 


Pittsfield, . 


Jan. 


23, 1920 


Conviction. 


Flood, Nathan B., 


North Adams, 


Pittsfield, . 


Jan. 


23, 1920 


Conviction. 


Mills Tea and Butter Cor- 


Pittsfield, 


Pittsfield, . 


Jan. 


9, 1920 


Conviction. 


poration. 
Rosen, Morris L., • 


Boston, . 


Boston, 


Jan. 


23, 1920 


Conviction.' 


Simpson Brothers Company, 


Boston, . 


Boston, 


Jan. 


23, 1920 


Conviction. 


Usave Stores, Inc., 


Waltham, 


Waltham, . 


Mar. 


3, 1920 


Conviction. 


Walsh, Fred J., . 


Lowell, . 


Lowell, 


Dec. 


24, 1919 


Conviction. 


Young, Solomon N., 


Boston, . 


Boston, 


Jan. 


14, 1920 


Conviction. 



Selling Cold-storage Eggs without marking the Container. 



Alpert, Morris, 
Angelo, Louis, 
Barthel, Eugene E. 
Berube, George, 
Biband, J. Omer, 
Bikis, James, 
Blotner, Benjamin, 
Borges, Joauum J., 
Brown, Charles N., 
Brown, Joseph, 
Carr, Hugh, . 
Chesses, Barney, . 
Cohen, Louis, 
Cohen, Max, . 
Coutalonis, Thomas, 
Curtis, William N., 
Danas, James, 
David, Moses, 
Desisto, Patrick, . 
Direnski, Daniel, . 
Donovan, Frank D., 
Duffy, James, 



East Boston, 
Lawrence, 
Gardner, 
Lawrence, 
Amesbury, 
Springfield, 
Haverhill, 
New Bedford, 
Medford, 
Boston, . 
Medford, 
Everett, . 
Boston, . 
Waltham, 
Woburn, 
Medford, 
Lowell, . 
East Boston, 
Boston, . 
Lowell, . 
Lowell, . 
Lowell, . 



East Boston, 

Lawrence, . 

Gardner, . 

Lawrence, . 

Amesbury, 

Springfield, 

Haverhill, . 

New Bedford, . 

Maiden, 

West Roxbury, . 

Maiden, 

Maiden, 

Boston, 

Waltham, . 

Woburn, 

Maiden, 

Lowell, 

East Boston, 

Boston, 

Lowell, 

Lowell, 

Lowell, 



Feb. 6, 1920 
Jan. 21, 1920 
Nov. 26, 1920 
Mar. 25, 1920 
Jan. 12, 1920 
Nov. 16, 1920 
Jan. 17, 1920 
Jan.. 20, 1920 
Feb. 10, 1920 
Jan. 27, 1920 
Feb. 10, 1920 
Feb. 17, 1920 
Jan. 14, 1920 
Mar. 8, 1920 
Nov. 5, 1920 
Feb. 10, 1920 
Nov. 29, 1920 
Feb. 17, 1920 
Mar. 26, 1920 
Nov. 29, 1920 
Nov. 22, 1920 
Nov. 22, 1920 



Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 



Appealed. 



190 



DEPARTIMENT OF PUBLIC HEALTH. [Pub. Doc. 



For Sale of Adulterated Foods Other than Milk or Milk Products — Continued. 

Eggs — Continued. 
Selling Cold-storage Eggs without marking the Container — -Continued. 



Name. 


Address. 


Court. 


Date. 


Result. 


Eastwood, Albert, . 


New Bedford, 


New Bedford, 


Jan. 20, 1920 


Conviction. 


Finkelstein, Morris, 


West Roxbury, 


West Roxbury, . 


Feb. 3, 1920 


Conviction. 


Frentoz, Peter, 


Springfield, . 


Springfield, 


Nov. 17, 1920 


Con\'iction. 


Garber, Harry, 


Boston, . 


Boston, 


Jan. 14, 1920 


Conviction. 


Goldstein, Benjamin, . 


West Roxbury, 


West Roxbury, . 


Feb. 3, 1920 


Conviction. 


Gordon, Milton, 


Waltham, 


Waltham, . 


Feb. 18, 1920 


Conviction. 


Gotohean, John, . 


Springfield, . 


Springfield, 


Nov. 16, 1920 


Conviction. 


Green, Samuel, 


Jamaica Plain, 


West Roxbury, . 


Jan. 27, 1920 


Conviction. 


Guillet, J. Arthur, 


New Bedford, 


New Bedford, . 


Jan. 20, 1920 


Conviction. 


Handy Company, H. L., 


Springfield, . 


Pittsfield, . 


Jan. 23, 1920 


Conviction. 


Harkins, Wm. A 


Woburn, . 


Woburn, . 


Nov. 5, 1920 


Conviction. 


Harring. Herbert, . 


East Boston, . 


East Boston, 


Feb. 6, 1920 


Conviction. 


Hoxie, Charles E., 


Brockton, 


Brockton, . 


Feb. 4, 1920 


Conviction. 


Jewell, Fred M 


Amesbury, 


Amesbury, 


Jan. 12, 1920 


Conviction. 


Juk, Max, .... 


Boston, . 


Boston, 


Mar. 26, 1920 


Conviction.' 


Kapner, Hyman, . 


New Bedford, 


New Bedford, . 


Jan. 20, 1920 


Conviction 


Katz, Philip, 


Chelsea, . 


Chelsea, 


Jan. 2, 1920 


Conviction. 


Kirshner, Nathan, 


Boston, . 


Boston, 


Jan. 14, 1920 


Conviction. 


Kramer, Ernest, . 


Jamaica Plain, 


West Roxbury, . 


Jan. 27, 1920 


Conviction. 


Manninen, Herman, 


Gardner, 


Gardner, . 


Nov. 26. 1920 


Conviction. 


Melinski, Frank, . 


Lawrence, 


Lawrence, . 


Jan. 21, 1920 


Conviction. 


Morris & Co., 


New Bedford, 


New Bedford, . 


Jan. 20, 1920 


Conviction. 


Nadler, Abraham, 


Springfield, 


Springfield, 


Nov. 16, 1920 


Conviction. 


Newton Public Market, 


Newton, 


Newton, . 


Nov. 1, 1920 


Conviction. ' 


Nowak, Joseph, 


Amesbury, 


Amesbury, 


Jan. 12, 1920 


Conviction. 


Perham, George L., 


Lowell, . 


Lowell, 


Nov. 29, 1920 


Conviction. 


Poulin, Joseph, 


Amesbury, 


Amesbury, 


Jan. 12, 1920 


Conviction. 


Rayman, Harry, . 


Medford, 


Maiden, 


Jan. 28, 1920 


Conviction. ' 


Reid, Greenleaf W., 


Brockton, 


Brockton, . 


Feb. 4, 1920 


Discharged. 


Reid Company, G. W., 


Brockton, 


Brockton, . 


Mar. 1, 1920 


Conviction. ' 


Renkert, George, . 


Maiden, . 


Maiden, 


Feb. 24, 1920 


Conviction. 


Rosenberg, Abraham, . 


Boston, . 


Boston, 


Jan. 14, 1920 


Conviction. 


Ruttenberg, Abraham, . 


Newton, . 


Newton, 


Nov. 1, 1920 


Conviction. ^ 


Sawink, Eliaa, 


Pittsfield, 


Pittsfield, . 


Jan. 23, 1920 


Conviction. 


Scaltrito. John, 


Boston, . 


Boston, 


Jan. 14, 1920 


Conviction. 



Appealed. 



* Fined $25; sentence suspended. 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



191 



For Sale of Adulterated Foods Other than Milk and Milk Products — Concluded. 

Eggs — Concluded. 
Selling Cold-storage Eggs without marking the Container — Concluded. 



Name. 



Seaman, John H., 
Sevitch, Morris, 
Silvia, Frank S., . 
Simonello, Rocco, . 
Smith, Abraham, . 
Sorakes, Efine, 
Specter, David, 
Spellman, Louis, . 
Stepnowski, Louis, 
Terzepacz, Paul, . 
Tillman, Samuel, . 
Tobis, Angelo, 
Whittemore, Ichabod, 
Winer, Israel, 
Zajac, Michael, 



Address. 



New Bedford, 
New Bedford, 
New Bedford, 
Haverhill, 
Everett, . 
Springfield, 
New Bedford, 
New Bedford, 
Pittsfield, 
Pittsfield, 
Springfield, 
Springfield, 
Lawrence, 
Chelsea, . 
New Bedford, 



Court. 



Date. 



Result. 



New Bedford, . 
New Bedford, . 
New Bedford, . 
Haverhill, . 
Maiden, 
Springfield, 
New Bedford, . 
New Bedford, . 
Pittsfield, . 
Pittsfield, . 
Springfield, 
Springfield, 
Lawrence, . 
Chelsea, 
New Bedford, . 



Jan. 

Jan. 

Jan. 

Jan. 

Feb. 

Nov. 

Jan. 

Jan. 

Jan. 

Jan. 

Nov. 

Nov. 

Jan. 

Jan. 

Jan. 



20, 1920 
20, 1920 
20, 1920 
17, 1920 
10, 1920 
17, 1920 
20, 1920 

20, 1920 
23, 1920 
23, 1920 
16, 1920 
16, 1920 

21, 1920 
8. 1920 

20, 1920 



Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 



Knight & Co., Inc., 



For Sale of Decomposed Food. 
Delivering Decomposed Meat. 



Boston, . 



Charlestown, 



Mar. 24, 1920 



Conviction. 



Raisins. 



Kehayas, James C. (2 counts). 


Boston, . 


Boston, 


July 6, 1920 


Conviction. 


Segal, Jacob N. (2 counts), . 


Boston, . 


Boston, 


July 6, 1920 


Conviction. 


Zidros, John (2 counts). 


Boston, . 


Boston, 


July 6, 1920 


Conviction. 



David, Moses, 
Goldberg, Wolfe L., 



Sausage. 



East Boston, . 
Fall River, . 



East Boston, 
Fall River, 



Feb. 17. 1920 
Feb. 19, 1920 



Conviction. 
Conviction. 



Perry, Frank S., 



Obstruction of an Inspector. 



. Attleboro, 



Attleboro, . 



July 16, 1920 



Conviction. ' 



I Appealed. 



192 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



For Violation of the Laws relative to Cold Storage. 

Returning to Cold-storage Articles of Food once removed therefrom for the 
Purpose of Placing on the Market for Sale. 



Name. 


Address. 


Court. 


Date. 


Result. 


Gushing Beef Company, 


Boston, . 


Boston, 


Sept. 27, 1920 


Conviction. 



Holding Articles of Food in Cold Storage for a Period Longer than Twelve 
Months without the Consent of the Department of Public Health. 



Batchelder & Snyder, . 

Bay State Fishing Company 

(10 counts). 
Burns Company, Inc., John 

(7 counts). 
Cann's Sea Grill, Inc., . 

Cefalu, Joseph, 

Chatham Freezer Company 

Ginter Company (2 counts) 

Libby, Samuel (8 counts), 

Libby, Samuel (8 counts), 

McKeon, Wm. F. {2 counts) 

Prevoir, Frank, 

Rodman, Benjamin W., 

Security Trust Company, 

Shattuck & Jones, 

Story & Simmons Company 
(2 counts). 



Boston, . 
South Boston 
South Boston 
Boston, . 
Boston, . 
Boston, . 
South Boston 
Boston, . 
Boston, . 
Watertown, 
Boston, . 
Boston, . 
Lynn, 
Boston, . 
South Boston, 



Boston, 

Boston, 

Boston, 

Boston, 

Boston, 

Boston, 

Boston, 

Boston, 

Boston, 

Boston, 

South Boston, 

Boston, 

Boston, 

Boston, 

Boston, 



Jan. 

Feb. 

Feb. 

Mar. 

Mar. 

Jan. 

Feb. 

Oct. 

Oct. 

Feb. 

May 

Jan. 

Sept. 

Feb. 

Feb. 



14, 


1920 


9, 


1920 


9, 


1920 


10, 


1920 


24, 


1920 


19, 


1920 


9, 


1920 


27, 


1920 


27, 


1920 


9, 


1920 


25, 


1920 


14, 


1920 


16, 


1920 


20, 


1920 


9, 


1920 



Nol-prossed. 

Conviction.' 

Conviction. • 

Conviction. • 

Conviction. 

Conviction.* 

Conviction.' 

Conviction. 

Conviction. 

-2 

Conviction. 

Conviction. 

Conviction. 

Conviction.* 

Conviction.' 



Retaining Food in Cold Storage after it had been declared Unwholesome 

BY THE Department of Public Health. 



Brockton Public Market, Inc., 
Libby, Samuel, 



Brockton, 
Boston , . 



Boston, 
Boston, 



Sept. 23, 1920 
Oct. 27, 1920 



Conviction.' 
Conviction. 



Removing Articles of Food from Storage without Inspection by the Depart- 
ment OF Public Health after Such Food had been stored for More than 
Twelve Calendar Months. 



Bay State Fishing Company 

(8 counts). 
Burns Company, Inc., John 

(4 counts). 
McKeon, William F. (2 

counts). 
Story & Simmons Company 

(2 counts). 


South Boston, 
South Boston, 


Boston, 
Boston, 


Feb. 
Feb. 


9, 1920 
9, 1920 


Conviction.' 
Conviction.' 


Watertown, 


Boston, 


Feb. 


9, 1920 


-2 


South Boston, 


Boston, 


Feb. 


9, 1920 


Conviction.' 



' Defaulted ; charges taken to be true. 



2 On file, without plea. 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



193 



For Violation of the Lmvs relative to Cold Storage — Concluded, 

Retailing Cold-storage Goods without displaying a Sign marked "Cold Storage 

Goods Sold Here." 



Name. 


Address. 


Court. 


Date. 


Result. 


Goldberg, Wolfe L., 


Fall River, . 


Fall River, 


Feb. 13, 1920 


Conviction. 


Green, Isaac, 


Jamaica Plain, 


West Roxbury, . 


Jan. 27, 1920 


Conviction. 


Lipson, Morris, 


Boston, . 


Boston, 


Jan. 14, 1920 


Conviction. 


Scaltrito, John, 


Boston, . 


Boston, 


Jan. 14, 1920 


Conviction. 


Vartan, George M., 


Jamaica Plain, 


West Roxbury, . 


Jan. 27, 1920 


Conviction, 



Displaying Cold-storage Eggs without the Necessary Sign. 



Gaouette, Napoleon J., 


New Bedford, 


New Bedford, . Jan. 20, 1920 


Conviction. 


Representing Cold-storage Food as Fresh Food. 


Bay State Market, 


New Bedford, 


New Bedford, . Jan. 20, 1920 


Conviction. 



Operating a Refrigerating Warehouse without a License issued by the De- 
partment OF Public Health. 



Whittemore, Ichabod, 



Lawrence, 



Lawrence, . 



Jan. 21, 1920 



Conviction. 



For Violation of the Laws relative to Slaughtering. 
Illegal Use of Stamp. 



Pederson, Iner (2 counts), 



Acton, 



Concord, 



Apr. 14, 1920 Conviction. 



Slaughtering or authorizing Slaughtering in the Absence of Inspector, 



Gold, Samuel, 


Pittsfield, 


Pittsfield, . 


Feb. 2, 1920 


Conviction. 


Mclntire, Ralph W. (2 counts). 


Fitchburg, 


Fitchburg, 


June 19, 1920 


Conviction.' 


Shenkman, Oscar, 


New Marlborough, . 


Great Barrington, 


Aug. 25, 1920 


Conviction. 


Slomitsky, Max, . 


Great Barrington, . 


Great Barrington, 


Aug. 18, 1920 


Conviction. 


Weaver, George, 


West Acton, . 


Concord, . 


Apr. 14, 1920 


Conviction. 


Winkler, Conrad R., . 


Adams, . 


Adams, 


May 5, 1920 


Conviction, 



Appealed. 



194 



DEPARTMENT OF PUBLIC HEALTH. [P. D. No. 34. 



For Violation of the Laws relative to Slaicghtering — Concluded. 

Selling, offering for Sale, or having in Possession with Intent to sell, 

Unstamped Meat. 



Name. 


Address. 


Court. 


Date. 


Result. 


Brodsky, Barney, . 


Fitchburg, 


Fitchburg, 


June 15, 1920 


Conviction. 


Corey, Frank R 


Newport, R. I., 


Fall River, 


Jan. 30, 1920 


Conviction. 


Dumaine, Wilfred, 


Westport, 


Fall River, 


Aug. 3, 1920 


Conviction. 


Rutman, Jacob, 


Fitchburg, 


Fitchburg, 


June 15, 1920 


Conviction. 


Shenkman, Oscar, 


New Marlborough, . 


Great Harrington, 


Aug. 25, 1920 


Conviction. 


Winkler, Conrad R, . 


Adams, . 


Adams, 


May 5, 1920 


Conviction. 



Selling or delivering Carcasses of an Animal which had come to its Death 
Otherwise than by Slaughter while in a Healthy Condition. 



Cunningham, Phillip, . 


Boxborough, . 


Concord, . 


May 11, 1920 


Conviction. 


Slomitsky, Max, . 


Great Harrington, . 


Lee, . 


Aug. 24, 1920 


Conviction. 


Stoskin, Morris, 


Great Harrington, . 


Lee, . 


Aug. 24, 1920 


Conviction. 



Having Unwholesome Meat in his Possession with Intent to sell the Same. 



Friedman, Samuel, 
Mirman, Barney, . 



Fitchburg, 
Monterey, 



Fitchburg, 
Great Harrington, 



June 15, 1920 
Aug. 18, 1920 



Conviction. ' 
Conviction. 



Selling or offering for Sale Immature Veal. 



Kirby, Perry, 

Sousini, James, 



East Chatham, 

N. Y. 
Pittsfield, 



Pittsfield, 
Pittsfield, 



Feb. 13, 1920 
June 4, 1920 



Conviction. 
Conviction. 



As Inspector op Slaughtering violated the Rules and Regulations of the 

Department of Public Health. 



Farnum, Walter F., 


Lanesborough, 


Pittsfield, . 


Feb. 13, 1920 


Conviction. 


Fobes, Edwards., 


Acton, . 


Concord, . 


Apr. 14, 1920 


Conviction. 


Powers, Wm. P 


Lee, 


Lee, . 


June 3, 1920 


Conviction. 



' Appealed. 



Division of Communicable Diseases 



Bernard^W. Carey, M.D., Director 



[195] 



Report of Division of Communicable Diseases. 



The activities of the Division of Communicable Diseases have con- 
tinued along the same general lines as in past years. Much time and 
effort have been expended in making our morbidity reports more com- 
plete, and it is believed some measure of success has been attained. 

The co-operative arrangement with the Division of Registration in 
Medicine made in the early part of the year has proved most beneficial 
and far preferable to court action for violators of the law of reporting 
those diseases declared dangerous to public health. 

Critical analysis of our mortahty rates shows an appreciable decline 
in most of the diseases over that for the year 1915 and for the median 
year of the period 1906-1915. A glance at the rates for previous years 
proves beyond question that a saving of life has resulted from our 
efforts, and the economic gain to the State far exceeds the cost of this 
work. 

The following tabulation shows for the seven most prevalent diseases 
not only our gains but also our losses, forcibly pointing out the need 
for further work in whooping cough and measles: — 



Disease. 



Diphtheria 

Scarlet fever, 

Typhoid fever 

Measles, 

Epidemic cerebrospinal meningitis; 
Whooping cough, .... 
Tuberculosis 



Median, 
1906-1915. 



20.1 
7.8 
11.8 
6.7 
4.3 
7.6 
132.7 



1915. 



19.4 
4.9 
6.7 
4.0 
3.4 
7.6 
113.2 



1920. 



15.4 
5.5 
2.4 
9.0 
3.3 
14.0 
97.2 



The personnel of the Division has undergone many changes. Owing 
to our inabihty to secure properly quaUfied persons for District Health 
Officers it has appeared wise to redistrict the State into seven districts 
rather than eight as formerly. It is yet too soon to form an opinion 
as to whether or not this plan may be worked out advantageously and 
without too great a burden upon the District Health Officers affected 
by the change. 



198 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

The following persons have resigned from the Department: — 

Clark, Charles. Publicity agent in the Subdivision of Venereal Diseases. Serv- 
ices terminated Sept. 15, 1920. 

Keenan, James A., M.D. District Health Officer, Berkshire Health District. 
Services terminated Feb. 10, 1920. 

Lovell, Bertha C. Supervising investigator, Subdivision of Venereal Diseases. 
Services terminated Sept. 30, 1920. 

Osborn, Stanley H., M.D. Epidemiologist. Sen^ices terminated April 30, 1920. 

Roberts, Bertrand E., M.D, District Health Officer, Connecticut Valley Health 
District. Services terminated July 31, 1920. 

Rogers, Emily M. Nursing assistant. Northeastern Health District. Services 
terminated June 30, 1920. 

The following appointments were made : — 

Chace, Mrs. Sara W. Nursing assistant. Southeastern Health District. Ap- 
pointed Sept. 7, 1920. 

Henry, Jonathan E., M.D. Epidemiologist. Appointed June 1, 1920. 

Miner, Harold E., M.D. District Health Officer, Connecticut Valley Health 
District. Appointed Nov. 22, 1920. 

Pfeiffer, Albert, M.D. Epidemiologist, Subdivision of Venereal Diseases. Ap- 
pointed Jan. 1, 1920. 

Routine inspections of hospitals and jails, lock-ups and houses of 
correction were carried on as in previous years, with no marked change 
noted in the conditions present. 

Sixty-seven dispensaries, under the dispensary licensing law, sub- 
mitted applications for licenses to the Department. In each instance 
the dispensary submitting application was found to be operating for 
public benefit, and the license was therefore granted. 

The reported incidence of communicable diseases for the year 1920 
has reached a total of 135,242, with the rather remarkable fact that 
there has been no localized outbreak of alarming proportions at any 
one time. Influenza, with 36.312 cases, measles, with 32,141 cases, 
scarlet fever, with 10,260 cases, and whooping cough, with 9,994 cases, 
have been of State-wide prevalence. 

The reported incidence of measles and whooping cough is larger 
than has ever been recorded in Massachusetts. It has been impossible 
to determine accurately what factors are responsible for these increases. 
Epidemiological investigation shows conclusively that increased effort 
to limit the spread of these two conditions must be directed at the pre- 
school age group because it is here that both morbidity and mortaUty 
rates reach their peak. 

The morbidity and mortality of whooping cough occurring as they 
do in the years of early childhood should clearly place it in the fore- 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 199 

ground of our endeavors. The history' of so many needless exposures 
with their dire result calls for special activity on our part. We must 
overcome by persistent educational attacks the mistaken impression 
that children are bound to have this or that disease and that they 
"may as well have it and get over with it." If our people are insistent 
in this belief, they should at least choose that period of life which 
gives the least fatality and not that which gives the greatest. 

In spite of the fact that many public health officials feel there is 
nothing to be done about measles because of its extreme contagiousness 
in the pre-eruptive stage, it is believed that persistent effort in the 
beginning of an outbreak will do much to limit its spread and to effect 
a diminution of cases. A school nurse, with a thermometer, sending 
home from school children showing the slightest rise of temperature 
and the careful instruction of mothers as to the isolation of the first 
case and subsequent isolation of other children of her household show- 
ing symptoms of illness of any sort will do much to limit the incidence 
of this condition. Our experience during the past year in a few iso- 
lated instances has definitely proved the efficacy of these precautions. 

The reported incidence of diphtheria is still too high to warrant any 
degree of satisfaction over its control. Much time, thought and energy 
have been given to the control of this condition, and it is gratifying 
to see an increase in the culturing for diagnosis and more attention 
being paid to the carrier state. More and more is it evident that 
endemic diphtheria will never be controlled by antitoxin and quaran- 
tine measures alone. Our efforts must be extended to a search for all 
possible contacts with a known case, their culturing, and with im- 
mediate immunization by antitoxin of those showing positive cultures. 
Schick tests, to determine the non-immune group of the community 
with their subsequent immunization by the toxin-antitoxin mixture, 
should be persistently applied. There are several indications that in 
the near future the efforts of the Department and the local boards of 
health to control diphtheria will bear fruit. As shown by our records, 
physicians are utilizing the laboratory for diagnoses with increasing 
frequency, which must of course result in the earlier diagnosis of 
diphtheria and the earlier administration of the antitoxin. Demonstra- 
tions by Dr. White, Director of the Division of Biologic Laboratories, 
and the District Health Officers to physicians and local boards of 
health of the method of performing the Schick test, together with the 
reading of the findings, will make the future control of diphtheria more 
satisfactory. There can be no doubt that diphtheria pi'evention and 
control call for the widespread dissemination of the knowledge that all 
agencies for its control are available to the people of the Commonwealth. 

For the first time in the history of the Department the deaths from 



200 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

typhoid fever are less than 100. This yearly decrease in the death rate 
from typhoid fever is most gratifying and by its consistency points 
out that intensive investigation of the individual case for sources of 
infection, with proper preventive measures applied thereto, is the 
proper and logical procedure for typhoid control. Massachusetts, be- 
cause of its carefully guarded water supplies, its adequate sewage dis- 
posal and the relatively large amount of pasteurization of its milk, 
finds future control limited to a large extent to contact with individual 
cases and the typhoid carrier. There can be no doubt that the immuni- 
zation of our male group between the ages of twenty and forty who 
served in the Army and Navy during the late war has had an appre- 
ciable effect upon our rate. Prior to this year statistics have shown in 
both morbidity and mortality an excess of males over females. This 
year it is noted that conditions are reversed and that females are pre- 
dominating in this age group. This is, of course, additional evidence 
pointing out the wisdom of vaccinating our citizens against typhoid 
and particularly of including our female population as well as the male. 
It is recorded that 34 of our cases occurred in institutions among 
patients where typhoid prevention may be so well carried out. It is 
also regrettable that 10 cases were reported among nurses or attendants 
in our hospitals where, because of the intimate association with typhoid 
cases, infection is so likely to occur. There is need of reiterating our 
warning of 1919 and to assist as far as we may in the immunization of 
all inmates of institutions and of all who, because of their work, may 
be unduly exposed. 

We now have under supervision 55 typhoid carriers, of whom 7 were 
discovered this year, — 4 through examinations made in the Bacteri- 
ological Laboratory of this Department and 3 through local labora- 
tories. Two of these carriers who presented positive faeces or urine 
gave negative or atypical Widal reactions. This points out the neces- 
sity of not placing too much reliance upon the Widal when other evi- 
dence points to the possibility of an individual being responsible for a 
given case or outbreak. 

The reported incidence of lobar 'pneumonia does not present a true 
picture of the actual incidence and it is questionable whether or not 
we will ever be able to differentiate between broncho-pneumonia, in- 
fluenza pneumonia and the secondary pneumonias with sufficient 
accuracy from the reports to feel with any degree of certainty that 
we have the correct index of the incidence of lobar pneumonia. 

Searlct fever showed the same widespread distribution with undue 
incidence as in measles and whooping cough. Investigation shows that 
much of the infection was transmitted from the mild and often times 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 201 

unrecognized case. It was a frequent history that a given child was 
taken out of a school peeling and that he had been in constant attend- 
ance with the exception perhaps of one day, frequently being absent 
from school the Friday before and appearing Monday with evidence 
of a slight unaccounted-for rash. Until more thorough school inspec- 
tion is available, conditions similar to this must go on and will cause 
much waste of school time and money of our citizens. 

The mortality rates of pulmonary tuberculosis have shown a gratify- 
ing decrease for the year 1920. The reported incidence is approxi- 
mately that of the preceding year. An increase in the reported 
incidence is looked for, however, because of the special activities of the 
local boards of health through their follow-up work with contacts and 
the Department of Public Health with its consultation clinics. Never 
before has there been such a concerted effort by all interested in the 
control of tuberculosis towards early diagnosis through State, county 
and municipal chnics with special attention paid by nutritional and 
public health workers in the field of the school-age group. It appears 
that it is in this group our future efforts must be actively centered, 
and marked results may be expected if the present day theory of the 
early infection of tuberculosis is tenable. 

The public health aspect of tuberculosis of other forms is rapidly 
receiving more attention in the minds of health officials. There is no 
doubt that the forms of non-pulmonary tuberculosis which need 
surgical attention should be placed in hospitals where competent sur- 
geons and orthopedists are in attendance. With a death rate approxi- 
mating 20 per 100,000 over a period of the last ten years other forms 
of tuberculosis should receive the immediate and serious attention of 
this Department. 

A gradual decrease in the reporting of ophthalmia neonatorum is to 
be seen, and the cities and towns now taking care of their own cases 
have reached 42. There were but three instances where impaired 
vision occurred. Of the total 1,638 cases, 1,205 were under fifteen 
days, 307 between fifteen days and three months, and 126 were three 
months and over. It is interesting to note that many of the cases 
reported as ophthalmia neonatorum were in reality eyes red, swollen 
and showing an unnatural discharge due to the use of silver nitrate 
unneutralized by the addition of salt solution. 

There have been 67 dog-bite cases reported during the year, an in- 
crease over any preceding year. It is interesting to note that by far 
the greatest majority of these cases are limited to the southeastern 
section of the State. It is our belief that the time has come when 
■efforts should be made to lessen the incidence of dog bites in Massa- 



202 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

chusetts by at least restraining dogs on leashes while on the street and 
by a systematic campaign against the stray or ownerless dog. Fifty- 
two cases of dog bite received antirabic treatment. 

Anterior yolioviyelitis is treated in another section of this report and 
will receive only passing notice here. Our investigations have proved 
nothing which was not shown by the investigations of the outbreak 
of 1916. Multiple cases in a given household were extremely rare. 
There was no change in the age incidence and no new light shown on 
its mode of transmission. The only outstanding feature was the com- 
parative freedom from infection in the western part of the State. A 
triangle with its apex at Worcester and base drawn along the water- 
front would include practically all of the incidence. This alone differs 
from 1916 when the State, as a whole, was infected. Of what epi- 
demiological significance this may be is unknown, but may possibly 
be explained by the early infection of the eastern part of the State 
and the colder weather preventing its advance westward. 

The special work done in conjunction with the Harvard Infantile 
Paralysis Commission was too hmited to allow any definite conclusions 
to be drawn. It does appear, however, that lumbar puncture with the 
bedside determination of cellular content is a practical procedure and 
one which should become a part of our service to the physicians of the 
State. Herein lies a golden opportunity for the differentiation of the 
various meningeal conditions with the subsequent administration of 
antimeningococcic serum in the event that it is indicated. 

There was a decrease in the number of cases of anthrax reported 
during the year. There were 17 cases, of which 7 were in Peabody, 3 
in Lowell, and the rest scattered, with 1 each in Stoneham, Chelsea, 
Lawrence, Hudson, Newton, Winchester and Worcester. The infection 
was traced to hides in 11 cases, wool in 1 case and hair in 1 case. 
Source of infection in 4 cases was unknown. 

Mumps, with 5,962 cases reported, an increase of about 2,500 over 
the preceding year, is worthy of comment. Here, as in the case of 
the other frequently reported diseases, incidence has been scattered 
throughout the State. The mortality was almost neghgible. 

A lessened incidence of epidemic cerebrospinal meningitis for the year 
was noted, 182 cases being reported. Three attempts were made to 
detect possible carriers where the patient gave the history of recently 
being admitted to this country. Over 100 nasopharyngeal cultures 
were taken at the immigration station, all of which proved negative. 
There was but one outbreak of septic sore throat reported during the 
year which was milk-borne, and cultures taken from a milk handler 
proved to be of the hemolytic type. There has been some question in 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 203 

the minds of physicians as to what exactly might constitute septic sore 
throat and it has been repeatedly stated by the members of this De- 
partment that in our opinion a septic sore throat is one which exhibits 
a virulent hemolytic streptococcus. It is believed that if all public 
health officials accept this definition our reports of septic sore throat 
will be diminished in number and a more complete picture of the true 
incidence will be obtained. 

There were 37 cases of dysentery which, with the exception of 9 cases 
which occurred in August at the Medfield State Hospital, were in 
various sections of the State. The question has been raised whether 
institutional dysentery may not properly be of paratyphoid origin, 
rather than due to other causes. The attention of the Department and 
local boards of health should be directed to the possibility of dysentery 
being imported into this country through immigration, and careful 
investigation of the individual case should be carried out. 

There were 29 cases of smallpox reported during the year, with two 
distinct outbreaks, — one in May in Boston with 8 cases and 1 in 
Braintree connected with this outbreak, and one in December in 
Methuen wath 14 cases reported during the month, 9 of Avhich were 
in one family. The source of infection in these outbreaks as well as in 
the other cases was outside of Massachusetts. The majority Avere 
directly traceable to the mild outbreak that occurred in Canada. 

There were 25 cases of tetanus reported during the year. This does 
not represent the total number of cases, however, of tetanus occurring 
in the State because of the fact that 21 deaths have been recorded. 

Pellagra was reported in 16 instances, 9 cases of which were found 
in State institutions. 

There were 3 cases of actinomycosis and 3 cases of leprosy reported. 

REPORT OF THE STATE DISTRICT HEALTH OFFICERS. 

The duties enjoined upon the State District Health Officers are 
numerous and varied. They are the field agents of the Department 
and are the representatives of the Commissioner of Public Health in 
their respective districts. They are in frequent contact with boards of 
health, local health officers and workers, advising with them regarding 
the many problems incident to daily routine health administration; 
they are constantly in touch with the occurrence of cases of disease 
dangerous to the public health as reported each day to local boards of 
health, alert to inquire into or be of assistance in any instance where 
such diseases are found to be newly occurring or showing increasing 
prevalence. 



204 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

In this connection they are often called upon to aid in establishing a 
diagnosis in doubtful cases, e.g., in distinguishing between chicken pox 
and smallpox, in deciding whether a given case is scarlet fever, or in 
determining the nature of the trouble in a suspected case of infantile 
paralysis. 

The State District Health Officers annually inspect all jails, houses 
of correction, station houses, lock-ups, places of detention, all hospitals 
and dispensaries, public or private, as required by law. 

In addition they are subject to the performance of any special work 
assigned by the Department; such tasks include unusual investiga- 
tions in the field, e.g., an inquiry into the circumstances of maternal 
mortality, studies relating to infant mortality rates, surveys in given 
communities to determine the extent and prevalence of tuberculosis, 
promoting the formation of a voluntary health district with the em- 
ployment of a full-time health officer; under this is included also 
service on committees for various purposes, — the preparation of sug- 
gested minimum rules for the control of communicable diseases, to con- 
sider new possibilities of educational work, etc. 

Nursing Assistants. 

The work of the nursing assistants is concerned to a considerable 
extent with tuberculosis, — visiting the tuberculosis dispensaries and 
individual cases in communities where there is no nursing service, and 
in attempting to raise the standard of tuberculosis work, and in co- 
ordinating such work on the part of the public and various private 
agencies. 

They are also called upon to assist in other phases of the work of 
the Department, especially in connection with educational measures as 
carried out through lectures and health exhibits, and in investigating 
the occurrence of cases of communicable disease. 



Educational Work. 

Though the consideration of the educational work of the Depart- 
ment will be found in the report of the Division of Hygiene, a brief 
statement of the share of the District Health Officers and nursing 
assistants in such work is properly included here. 

During the year 199 lectures were given in 88 cities and towns 
before audiences aggregating approximately 14,000. The subjects dis- 
cussed had to do with various phases of health work, — the preven- 
tion of disease, the promotion of health, the need for trained health 
Avorkers, etc. 



No. 34.] DIVISION OF C0:M]MUNICABLE DISEASES. 205 

Many talks were sought or arranged to aid in the sohition of some 
particular problem or to assist in the creation of a public opinion 
which should eventually bring about appropriations for specific pur- 
poses, such as the employment of a public health or school nurse, the 
estabHshment of a dental clinic, etc. 

Reahzing from experience that most graduate nurses, though ex- 
cellently qualified through their training for their professional duties, 
lacked adequate knowledge of public health and pubHc health work, a 
course of eight lectures on health administration and work was pre- 
pared by the District Health Officers and other members of the De- 
partment. Through the co-operation of the Association of Training 
School Superintendents this course was given in some 20 or more 
hospitals before groups aggregating about 700 nurses in training. 
Much interest was manifested. This work will be repeated the en- 
suing year under the management of the Division of Hygiene. 

In this connection it may be emphasized that much, if not most of 
the work of the District Health Officers and nursing assistants is dis- 
tinctly, though indirectly, educational. For in the field there is con- 
stant opportunity for the quiet and unobtrusive spreading of health 
knowledge and propaganda. In retrospect it is clearly manifest that 
such continued effort has represented no small part in bringing about 
in this Commonwealth the increased interest of the present day in all 
matters pertaining to health. 



Diseases dangerous to the Public Health. 

The unusual prevalence of some of the communicable diseases, 
notably scarlet fever and diphtheria, has been due, in great degree, as 
determined by field experience, to contact infection, favored by a 
quarantine too short or poorly observed, and to "missed" or mild, un- 
recognized cases. Cases of nasal diphtheria were frequent, and in 
many instances served as a source of infection. It was also observed 
that in many instances the earUer cases in a household received no 
medical attention until a later case showed more pronounced or alarm- 
ing symptoms. It was noted further, also, that many times second and 
multiple cases occurred in the same household at intervals which indi- 
cate that household immunization was not carried out. 

Details regarding the communicable disease work will be found in 
the report of the epidemiologist. 



206 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



District Changes. 

During the year, following the passage of legislation, the number of 
State District Health Officers was reduced from 8 to 7. This necessi- 
tated a corresponding change in district boundaries. 

To District No. 2 have been added Ashland, Framingham, Holliston, 
Hopkinton, Marlborough, Natick and Sherborn. 

Ashby, Aver, Groton, Hudson, Pepperell, Shirley and Townsend 
have been added to District No. 4. 

The towns in Worcester County formerly in Districts Nos. 5 and 6 
have been consolidated into the "Worcester County District," known 
as District No. 5. 

There have been added to District No. 7 the towns of New Salem, 
Orange and Warwick. 

A list of the districts as now constituted, together with the names 
of the District Health Officers and nursing assistants, follows: — 



Health Districts and State District Health Officials. 



Acushnet. 

Attleboro. 

Barnstable. 

Berkle3^ 

Bourne. 

Brewster. 

Carver. 

Chatham. 

Chilmark. 

Dartmouth. 

Dennis. 

Dighton. 

Duxbury. 

Eastham. 

Edgartown. 

Fairhaven. 

Fall River. 

Falmouth. 



The Southeastern District — No. 1. 

Freetown. 

Gay Head. 

Gosnold. 

Harwich. 

Kingston. 

Lakeville. 

Mansfield. 

Marion. 

Mashpee. 

Mattapoisett. 

Middleborough. 

Nantucket. 

New Bedford. 

Norton. 

Oak Bluffs. 

Orleans. 

Plvmouth. 



Plympton. 

Provincetown. 

Raynham. 

Rehoboth. 

Rochester. 

Sandwich. 

Seekonk. 

Somerset. 

Swansea. 

Taunton. 

Tisburj'. 

Truro. 

Wareham. 

Wellfleet. 

West Tisbury. 

Westport. 

Yarmouth — 52. 



Dr. Charles W. Milliken, 411 Book Store Building, New Bedford, State Dis- 
trict Health Officer. 
Mrs. Sara W. Chace, Nursing Assistant. 



:N'o. 34.] DIVISION OF COMMUNICABLE DISEASES. 



207 



Abington. 

Ashland. 

Avon. 

Bellinghani. 

Boston. 

Bra in tree. 

Bridgewater. 

Brockton. 

Brookline. 

Cambridge. 

Canton. 

Cohasset. 

Dedham. 

Dover. 

East Bridgewater. 

Easton. 

Foxborough. 

Framingbam. 

Franklin. 



The Eastern District — No. 2. 

Halifax. 

Hanover. 

Hanson. 

Hingham. 

Holbrook. 

Holliston. 

Hopkinton. 

Hull. 

Marlborough. 

Marshfield. 

Medfield. 

Medway. 

Millis. 

Milton. 

Natick. 

Needham. 

Newton. 

Norfolk. 

North Attleborough. 



Norwell. 
Norwood. 
Pembroke. 
Plain\alle. 

QUINCY. 

Randolph . 

Rockland. 

Scituate. 

Sharon. 

Sherborn. 

Stoughton, 

Walpole. 

Wellesley. 

West Bridgewater. 

Westwood. 

Weymouth . 

Whitman. 

Wrentham — 56. 



Dr. George T. O'Donnell, 546 State House, Boston, State District Health 

Officer. 
Miss Cecilia A. Lemner, N^lrsing Assistant. 



The Northeaster!! District — No. 3. 



Amesburj'. 


Ljmnfield. 


Revere. 


Be\^rly. 


Malden. 


Rockport. 


Boxford. 


Manchester. 


Rowley. 


Chelsea. 


Marblehead. 


Salem. 


Dan vers. 


Melrose. 


Salisbury. 


Essex. 


Merrimac. 


Saugus. 


Everett. 


Middleton. 


Stoneham. 


Geo^geto^vn. 


Nahant. 


Swampscott. 


Gloucester. 


Newbur}^ 


Topsfield. 


Groveland. 


Newburyport. 


Wakefield. 


Hamilton. 


North Reading. 


Wenham. 


Ha\i;rhill, 


Peabody, 


West Newbury. 


Ipswich. 


Reading. 


Winthrop — 40 


Lynn. 







Dr. Lyman A. Jones, Willey House, Swampscott, State District Health Officer. 
Miss M. Gertrude Martin, Nursing Assistant. 



208 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



The North Midland District — No. 4- 


Acton. 


Dunstable. 


Somerville. 


Andover. 


Groton. 


Stow. 


Arlington. 


Hudson. 


Sudbury. 


Ash by. 


LA-WKENCE. 


Tewksbury. 


Ayer. 


Lexington. 


Townsend. 


Bedford. 


Lincoln. 


Tjmgsborough. 


Belmont. 


Littleton. 


Waltham. 


Billerica. 


LOAVELL. 


Watertow-n. 


Boxborough. 


Maynard. 


Way land. 


Burlington. 


Medford. 


Westford. 


Carlisle. 


Methuen. 


Weston. 


Chelmsford. 


North Andover. 


Wilmington. 


Concord. 


Pepperell. 


Winchester. 


Dracut. 


Shirley. 


WOBURN — 42 



Dr. Charles E. Simpson, 100 Hotyrood Avenue, Lowell, State District Health 

Officer. 
Miss Mildred F. Ashley, Niirsing Assistaiit. 





The Worcester County District — 


No. 5. 


Ashburnham . 




Hopedale. 


Royalston. 


Athol. 




Hubbard ston. 


Rutland. 


Auburn. 




Lancaster. 


Shrewsburj'. 


Barre. 




Leicester. 


Southborough. 


Berlin. 




Leominster. 


Southbridge. 


Blackstone. 




Lunenburg. 


Spencer. 


Bolton. 




Mendon. 


Sterling. 


Boylston. 




Milford. 


Sturbridge. 


Brookfield. 




Millburk'. 


Sutton. 


Charlton. 




Millville. 


Templeton. 


Clinton. 




New Braintree. 


Upton. 


Dana. 




Northborough. 


Uxbridge. 


Douglas. 




Northbridge. 


Warren. 


Dudley. 




North Brookfield. 


Webster. 


East Brookfield. 


Oakham. 


West Boylston. 


FiTCHBURG. 




Oxford. 


AVest Brookfield. 


Gardner. 




Paxton. 


Westborough. 


Grafton. 




Petersham. 


Westminster. 


Hard wick. 




Phillipston. 


Winchendon. 


Har\'ard. 




Princeton. 


Worcester — 60 


Holden. 









Dr. Francis A. Finnegan, 614 Park Building, Worcester, State District Health 

Officer. 
Mrs. Anna Hartnett, Nursing Assistant. 
Miss Katherine B. O'Connor, Nursing Assistant. 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



209 



The 

Agawam . 

Amherst. 

Belchertown. 

Blandford . 

Brim field. 

Chesterfield. 

Chicopee. 

Conway. 

Deerfield. 

Easthampton. 

East Longmeadow 

Enfield. 

Goshen. 

Granby. 

Granville. 

Greenwich. 



Connecticut Valley District 

Hadley. 
Hampden. 
Hatfield. 
Holland. 

HOLYOKE. 

Huntington. 

Leverett. 

Longmeadow. 

Ludlow. 

Monson. 

Montgomery. 

Northampton. 

Palmer. 

Pelham. 

Prescott. 

Russell. 



No. 6. 



Shutesbury. 

Southampton . 

South Hadley. 

►Southwick. 

Springfield. 

Sunderland. 

Tolland. 

Wales. 

Ware. 

West Springfield. 

Westfield. 

Westhampton. 

Whately. 

Wilbraham. 

Williamsburg — 47. 



Dr. H.VROLD E. Miner, 289 Main Street, Springfield, State District Health 

Officer. 
Miss Mary E. Ayer, Nursing Assistant. 



Adams. 

Alford. 

Ash field. 

Becket. 

Bernardston. 

Buckland. 

Charlemont. 

Cheshire. 

Chester. 

Clarksburg. 

Colrain. 

Cummington. 

Dal ton. 

Egremont. 

Erving. 

Florida. 

Gill. 

Great Barrington. 

Greenfield. 



The Berkshire District — No 
Hancock. 
Hawley. 
Heath. 
Hinsdale. 
Lanesborough . 
Lee. 
Lenox. 
Leyden. 
Middlefield. 
Monroe. 
Montague. 
Monterey. 
Mount Washington. 
New Ashford. 
New Marlborough. 
New Salem. 
North Adams. 
Northfield. 
Orange. 



Otis. 
Peru. 

PiTTSFIELD. 

Plain field. 

Richmond. 

Rowe. 

Sandisfield. 

Savoy. 

Sheffield. 

Shelburne. 

Stockbridge. 

Tyringham. 

Warwick. 

Washington. 

Wendell. 

West Stockbridge. 

Williamstown, 

Windsor. 

Worthington — 57. 



Dr. Oscar A. Dudley, Box 1036, Pittsfield, State District Health Officer. 
Miss Katharine M. Turner, Nursing Assistant. 



210 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Work of Engineering Division. 

Work coming under this head has consisted largely in taking samples 
of water from springs and wells, and submitting a report of the sur- 
roundings, at the request of the Division of Sanitary Engineering, 
more especially at points distant from the State House, where the 
doing of the work resulted in a substantial saving of time and expense. 

BEPORT OF THE WORK OF THE BACTERIOLOGICAL 

LABORATORY. 

During the year ended Nov. 30, 1920, the Bacteriological Laboratory 
iias examined 28,637 specimens. Table 1 shows the number and kinds 
of examinations. A comparison is made between the years 1915 and 

1920. 

Table 1. 



Diphtheria, 
Tuberculosis, . 
Widal test. 
Typhoid culture, 
Gonorrhea, 
Malaria, . 
Miscellaneous, 



C 




1920. 



18,046 

4,341 

1,533 

908 

2,775 

82 

9521 



28,637 



I Including 545 pneumococcus type determinations; 34 diphtheria virulence tests; 49 animal inocula- 
tions for tubercle bacilli; 78 paratyphoid A and B; 15 anthrax (animal tests). 



Table 2 shows the results of examinations: 



Table 2. 



Diphtheria (primary). 
Diphtheria (release), . 
Tuberculosis, 

•Typhoid fever (Widal test), 
Typhoid fever (culture test), 
Gonorrhea, .... 
Malaria, .... 
Miscellaneous, 

Total 



Positive. 



Negative. 



*AtJT)ical. 



1,477 

1,770 

1,013 

363 

51 

292 

1 



10,418 
4,381 
3,328 
1,087 
857 
2,483 
81 



83 



Total. 



11,895 

6,151 

4,341 

1,533 

908 

2,775 

82 

952 



28,637 



Diphtheria. 

The culturing of school children in infected schools has been carried 
.on throughout the year to a limited extent, 5,053 cultures being 
examined. Twenty-four carriers were found among this number. This 



No. 34.1 DIVISION OF COMMUNICABLE DISEASES. 



211 



work might be increased without overburdening the laboratory. 
Careful investigation of the carriers would add greatly to the value of 
the work. 

Typhoid Fever. 

Although the number of Widal tests made was less than usual, 
examinations of specimens of fajces and urine for typhoid bacilli were 
greatly increased, totaling 908. Four carriers were discovered. None 
of these handled food for sale but were apparently responsible for cases 
in their households. 

Pneumococcus Type Determination. 

There were 545 specimens of sputum examined for pneumococcus 
type. The results follow: — 



Type I, . 
Type II, . 
Type III. 
Group IV, 




Per Cent. 



11.4 
16.0 
20.9 
51.7 



No pneumococci, 195. 



Many of the specimens received were saliva rather than sputum, 
which probably accounts for the high percentage of Group IV pneumo- 



cocci. 



REPORT OF THE SUBDIVISION OF VENEREAL DISEASES. 

The campaign for the control of venereal diseases has made steady 
progress during the past year. 



Statistics. 

It does not appear wise to draw any statistical deductions from re- 
ports of cases filed since venereal diseases have been reported. Avail- 
able figures do not appear to support extravagant claims made by 
some investigators. 

The number of cases reported and consequently the reported rate 
per 100,000 population are decHning. The rate per 100,000 for the 



212 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

year July 1, 1918, to June 30, 1919, was 463; from July 1, 1919, to 
June 30, 1920, was 316; the yearly rate from July 1, 1920, based on 
four months' reports, is 283. These figures include only infectious 
cases, and even for infectious cases are probably distinctly incomplete. 

From Jan. 1, 1920, to Dec. 31, 1920, 10,212 cases were reported from 
184 cities and towns having a combined population of 3,791,726, thus 
leaving 170 towns with a combined population of 271,216 from which 
there were no reports. Granted that a uniform rate of infection ob- 
tains throughout the State, and this is a safe assumption, these re- 
porting towns should have returned 730 cases. If all physicians in 
some towns fail to make proper returns, it is fair to assume that some 
physicians in every city and town are lax in observing certain legal 
requirements. 

Even allowing for incomplete returns, these figures appear to indi- 
cate a lessened rate of infection, and this assumption is supported by 
statements of physicians in different sections of the State. 

Examinations of prisoners confined in Massachusetts penal institu- 
tions do not reveal the rate of venereal infections among the prison 
population indicated in statistics published by observers elsewhere. It 
is hoped that more accurate figures may be available next year. 

t 

Clinics. 

The work of the State-approved clinics has increased in numbers of 
patients treated, and has also improved in other respects not demon- 
strable by figures: the number of patients has increased; quarterly 
conferences of clinic directors and clinicians have tended to standardize 
methods of treatment and procedure in the several clinics; all clinics 
are apparently providing adequate clinical facilities for their several 
areas; and changes in hours and personnel have been necessary in 
some instances to meet the demand for increased service. 

In July the clinic at the Salem Hospital was formally approved; in 
November a chnic organized and equipped by the board of health of 
Haverhill was approved. In North Adams a civic committee, repre- 
senting professional, social, mercantile and manufacturing interests, is 
considering the advisability of establishing and equipping a clinic in 
that city; a method of procedure has been outlined to the committee. 

The climes at Lynn and Brockton have been reorganized, apparently 
with benefit to both clinics. 

It is difficult to establish any standard as to the amount of work 
which should be accomplished in any cHnic, and equally difficult justly 
to compare one clinic with another. Attendance at clinics in this State 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



213 



will be influenced apparently by customs and ideals obtaining in the 
city under consideration, by the character of the population, whether 
the people have been educated to seek treatment at out-patient de- 
partments, and by the fees demanded by physicians for private treat- 
ment. A clinic which apparently may treat few patients in propor- 
tion to the population may be rendering to that community valuable 
service. 

Consultation clinics conducted by neurologists for examination of 
known and suspected cases of neurosyphilis will probably be a reality 
within a few months. It is intended to refer patients from the State- 
approved clinics to these consultation clinics, and also to provide like 
service for the private cases of physicians. 

The following figures cover work of the clinics from Dec. 1, 1919, 
to Dec. 1, 1920: — 





Total New 
Patients. 


Monthly 
Average of 

Total 
Patients. 


Total Treat-! 
ments given. 


Attleboro, 


32 


13.0 


306 


Boston City, 


498 


358.0 


11,427 


Boston Dispensary 


2,421 


2,382.9 


60,395 


Massachusetts General 


2,498 


1,706.0 


39,350 


Massachusetts Homoeopathic, 


347 


285.9 


6,881 


Brockton 


98 


29.7 


906 


Fall River 


102 


80.5 


3,914 


Fitchburg 


45 


11.0 


471 


Haverhill,' 


4 


- 


13 


Holyoke, - . . . 


31 


- 


100 


LawTence, 


118 


76.4 


1.583 


Lowell, 


260 


106.4 


2,737 


Lynn 


126 


82.5 


2,728 


New Bedford 


316 


208.2 


3,043 


Pittsfield 


17 


5.6 


250 


Salem 


69 


25.6 


700 


Springfield, 


356 


171.8 


3,032 


Worcester, 


122 


126.6 


2,690 




7,460 


- 


140,526 



I Clinic opened Nov. 1, 1920. 



2 Clinic opened April, 1920. 



214 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Social Service. 

Careful studies of the social service needs of the State were made, 
and a plan for providing such service outlined. Illness necessitated 
the postponement of these plans. 

Through co-operation with the department of penal institutions a 
follow-up service for reaching families of infected prisoners has been 
inaugurated. This has not been in operation a sufficient length of time 
to warrant any statement. A prisoner paroled before the expiration of 
his sentence must, if infected, present himself regularly at a State 
clinic for treatment; this condition is written in the parole. 

Lapsed Cases. 

From Dec. tL, 1919, to Dec. 1, 1920, 1,342 cases were reported by 
name because they failed to return for treatment, or because other 
reasons indicated that summary action was advisable. These cases 
were in turn reported to local boards of health for investigation and 
necessary action. The majority of these cases were returned for treat- 
ment. In a few instances local boards of health reported that aid from 
police officials was necessary, but in no instance was court action re- 
quired. 

Early in January a new procedure was adopted in reporting lapsed 
cases to local health authorities to insure routine reporting of those 
cases only which are actively infectious. In cases of syphilis when 
three months have elapsed between the date of the numbered report 
and the report by name, and when four months have elapsed in cases 
of gonorrhea, a letter is addressed to the attending physician request- 
ing further information. This insures the possibility of giving accurate 
information to the local health authority. 

Arsphenamine. 

The number of ampoules of arsphenamine distributed during this 
year is greater than during 1919. Reports received indicate that the 
arsphenamine manufactured and distributed by the State compares 
favorably in its action with commercial products, in fact fewer reactions 
follow its use. Inquiries indicate that there is a growing demand for 
the neo-arsphenamine product, and it appears that this should be 
given careful consideration. 

A report issued some months past credited Massachusetts with the 
use of more arsphenamine per patient than any other State in the 
Union. If the figures given were correct, it indicates that physicians 
in this State are conscientiously treating their syphilitic patients. 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 215 



Advertising. 

The posting of signs advertising locations and hours of cHnics has 
been continued during the year. About 13,000 signs have been posted. 



Educational. 

As the campaign for the control of venereal disease progresses, it 
becomes increasingly evident that education in its broadest sense offers 
the most effective weapon. The educational feature to be successful 
must have the active sympathy and hearty co-operation of practically 
every individual. Since this is, for the present at least, an impossi- 
bility, plans have been devised for interesting organizations and indi- 
viduals engaged in various phases of welfare work. 

The study group feature outlined and perfected in the early fall of 
last year has been the medium through which women interested in 
various social activities and organizations engaged in welfare work for 
young women have received instruction in the problem of venereal 
disease control. It is hoped that through these study groups whole- 
some information may be given to those who may not have other 
opportunities of securing like instruction. 

As opportunity has presented, conferences have been held In various 
cities to discuss local conditions affecting prevalence of venereal disease, 
and to outline possible procedure for control of the same. These 
conferences have been attended by health officers, city executives, 
court officers, nurses, teachers, physicians, social workers, and repre- 
sentatives of social and welfare organizations. At each conference the 
State program has been carefully outlined, the chnics being especially 
emphasized. These conferences have served to give a clearer under- 
standing of the venereal disease campaign, and to establish more 
cordial relations between official and nonofficial agencies and the State 
clinics. 

Industrial. 

No great effort has been exerted to launch any comprehensive 
program through industrial companies. In answer to requests, em- 
ployers of labor have been interviewed and apprised of measures insti- 
tuted to control venereal disease. These men expressed sympathy 
with the program, but thought that active efforts on their part might 
be misinterpreted by employees. 



216 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Meeting of Clinic Directors. 

Conferences or meetings of directors and clinicians of the State- 
approved venereal disease clinics have been held quarterly in January, 
April, July and October. These meetings have been called to consider 
and discuss matters of interest relating to clinic management and to 
care and treatment of patients infected with a venereal disease. 

The meetings were as follows : — 

January — Neurosyphilis. A clinic was conducted at the Boston Psychopathic 
Hospital by Dr. H. C. Solomon. 

Papers: Dr. Henry J. Perry, Dr. J. Homer Wright, Dr. W. H. Watters, Dr. 
Townsend W. Thorndike and Hermaim C. Lythgoe. 
April — Gonorrhea in the Male. Dr. Edward J. Keyes, Jr., New York, 

Papers: Hermann C. Lythgoe and Dr. H. C. Solomon. 
July — Gonorrhea in the Female. Dr. A. K. Paine and Dr. William P. Graves. 

Paper: Dr. William A. Hinton. 
October — Congenital Syphilis. 

Papers: Dr. W. H. Watters, Dr. C. Morton Smith and Dr. M. C. Smith. 

These meetings have been interesting and instructive, and apparently 
have stimulated the clinicians to exercise their best endeavors toward 
creating a healthy atmosphere in their several clinics. 



Police Departments. 

Through co-operation with an agent of the United States Interde- 
partmental Social Hygiene Board, the animated diagrammatic film 
"Health and Disease" has been presented to many police departments 
of the State, and apparently has produced a deep impression. Many 
police departments have voluntarily promised to restrain incorrigible 
patients, and promised assistance in locating and restraining vicious 
sources of infection. 



Inspection of Jails and Houses of Correction. 

Between April 21 and July 20 every jail and house of correction in 
the State was visited for the purpose of ascertaining the methods of 
examining prisoners to determine the presence or absence of venereal 
infection and modes of treating the same. 

Eighteen institutions were visited. The combined population was 
1,902 men and 274 women, a total of 2,176, all of whom, with the 
exception of a few who had just been admitted, had been examined. 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 217 

The State institutions (Charlestown State Prison, Bridgewater, 
Concord Reformatory and Sherborn Reformatory) and four of the 
county jails (Deer Island, East Cambridge, Worcester and Springfield) 
appear to be well equipped for treating venereal diseases. 

Sources of Infection. 

Investigations of reported sources of infection during the past year, 
and facts ascertained therefrom, have proved the wisdom of having 
such investigations made by workers directly connected with the De- 
partment. Some reports appeared to be maliciously made, and others 
were apparently prompted by jealousy. All persons consulted received 
the investigator courteously. Many were examined and given treat- 
ment when necessary. 

Courts. 

Personal interviews with courts and court officials, started in Sep- 
tember, 1919, were finished late in August, 1920. During this period 
judges and probation officers of all courts of the State — superior, 
poHce and district — were interviewed. The State program for control 
of venereal diseases was carefully explained, court procedure in cases 
of actual and suspected sex offences was ascertained, methods of se- 
curing examinations in different courts were compared, and uniform 
procedure in cases suitable for probation was adopted. Thus without 
any standard legaHzed process it has been possible to secure thorough 
co-operation of courts and court officials, a uniform mode of action 
which promises all that could be secured were the exact procedure 
legally defined. 

Keeping Fit Campaign. 

A conference to outline a campaign for Massachusetts was held in 
the State House December 5. The following organizations were repre- 
sented: Y. M. C. A., Parent-Teacher Association, Massachusetts 
CathoHc Order of Foresters, State Grange, Salvation Army, Farm 
Bureau, Red Cross, Knights of Columbus, local health officers. The 
purposes of the campaign were outlined, the "Keeping Fit" posters 
were displayed, and the "Keeping Fit" pamphlet for young men was 
distributed. It was carefully explained that posters or stereopticon 
slides, or both, would be supplied free by the Massachusetts Depart- 
ment of Public Health to any organization, mercantile or manufactur- 
ing company, or to any individual who wished to assist in the cam- 
paign and who would make arrangements to have them displayed; 



218 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



that a balopticon for projecting the stereopticon slides would be loaned 
if necessary; that speakers could be supplied; that supplies of the 
"Keeping Fit" pamphlet would be provided. 

Organizations represented at this conference rendered valuable assist- 
ance during the campaign. Local conferences were held in several 
cities for the purpose of outlining campaigns for these communities, 
and in each instance appeared to give the result sought. 

Under date of January 26 a letter was addressed to the masters of 
private schools for boys in the State, asking permission to explain by 
personal interview the "Keeping Fit" campaign, and, with the per- 
mission of the masters, to provide a poster exhibit. 

All the private schools (18 in number) for boys of fifteen years and 
over requested a loan of posters and a supply of pamphlets. Some re- 
quested posters for permanent use, and in answer to these requests a 
set of posters was presented to the school. 

All the colleges of the State used the posters either in the gymnasium 
or as a part of the course in physical culture. 

By special request, a set of posters was loaned to a college for 
women, who expressed great satisfaction with the presentation. 

Exhibits were also loaned and pamphlets were supplied to Y. M. 
C. A., Y. M. H. A., Salvation Army, messenger companies, telegraph 
companies, News Boys' Union, stores, offices, and to several individuals 
interested in or having approach to boys. Many sets are in use at 
present and requests on file indicate that the demand will continue for 
many months. 

The expense of the campaign was approximately as follows: — 



Forty sets of posters, 

Pamphlets, 

Salaries, 

Traveling, 

Express, 


$330 00 

64 00 

7S0 00 

200 00 

10 00 



$1,384 00 



The results were as follows: 



Total showings of posters and slides, 192 

Total attendance (conservative estimate) , 58,507 

Pamphlets distributed, 27,383 

Cost of reaching one boy, ^ 023 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



219 



Summary, Dec. 1, 1910, to Dec. 1, 1920 

Reported by number: — 

Gonorrhea, 

Syphilis, 

Total, 

Reported by name (lapsed cases). 
Ampoules of arsphenamine distributed 
Wassermann examinations, . 
Smear examinations, ^ 
Pamphlets distributed, . 

Lectures, 

State-approved clinics, . 
New cases admitted to clinics. 
Average monthly attendance at clinics. 
Total treatments given, 



7,330 
3,180 



10,510 
1,342 

27,106 

36,910 

2,798 

53,027 

72 

18 

7,460 

5,670.1 

140,526 



PENIKESE HOSPITAL. 

The leper hospital at Penikese was transferred from the Department 
of Public Welfare to the Department of Public Health Dec. 1, 1919, 
and was then placed in the Division of Communicable Diseases for 
administrative purposes. 

The maximum number of patients treated at Penikese for the year 
was 17, two of whom were ex-soldiers and cared for under contract 
with the United States War Risk Insurance Bureau after enabling 
legislation had been secured. There were 3 deaths during the year and 
1 patient deported. 

The total appropriation granted for the year was $34,820 and $35,- 
692.67 was expended, a deficit of $872.67 resulting. This deficit was 
occasioned by the increased cost of food supplies and freight charges, 
together with labor difficulties. Never before has the institution had 
such a difficult time to procure and to keep help, and an unusual 
number of trips to Boston has been necessitated. 

The allotment and expenditure of the appropriation were as fol- 
lows : — 



1 Refers only to smear examinations made in State laboratory. Each clinic examines smears also. 



220 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Allotment, 
1920. 



Expended, 
1920. 



Personal services 

Travel, transportation and office expenses. 

Food 



Clothing, 

Furnishings and household supplies. 

Medical and general care, 

Heat, light and power, . 

Farm 

Grounds, 

Repairs, ordinary, .... 



/ $1,156 
\ 5,500 

! S136 
\ 600 



/ $408 
1. 1,800 



$13,400 00 
900 00 



6,656 00 

736 00 

1,200 00 

2,208 00 

4,000 00 

4,000 00 

50 00 

1,670 00 



$34,820 00 



$13,742 12 
1,887 88 

6,173 32 

723 12 

1,354 84 

2,076 44 

4,358 47 

3,857 21 

54 52 

1,464 75 



$35,692 67 



Two of the inmates showed such exceptional improvement under 
the Chaulmaugra oil treatment that it was thought that it might be 
possible to parole them with safety to the public. A board of exam- 
iners was appointed by the Commissioner to pass upon their condition 
and to advise the Department as to the feasibility of allowing them to 
return to community life. 

This board consisted of Dr. M. Victor Safford, Dr. Victor G. Heiser, 
Dr. Townsend Thorndike and Dr. D. Crosby Greene. 

Bacteriological examination of smears obtained from scar in the 
nose showed the presence of leprse bacilli, and the blood of both 
patients proved to be faintly positive in the Wassermann test. The 
board recommended, therefore, their return to the hospital for further 
treatment. 

The inventory submitted is as follows: — 

Land and buildings (1919 estimate), $106,201 83 

Personal, 33,515 18 

Total, $139,717 01 

The Federal government through the United States Public Health 
Service has taken definite steps to establish a national leprosarium at 
Carville, La. The patients now at Penikese will be transferred to this 
new hospital early in the year. This disposition should prove bene- 
ficial both to the patients and to the State. 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 221 

The splendid service of the superintendent and the older employees 
who have so faithfully performed their arduous duties warrants special 
mention. The State has indeed been fortunate in such service and the 
lot of these unfortunate people made lighter by the thoughtful ad- 
ministration of Dr. Parker and Mrs. Parker. 



REPORT OF EPIDEMIOLOGIST. 

Epidemiological Significance of Age Distribution in Certain 

Communicable Diseases. 

In 1918 tabulations of all reported cases of communicable disease 
by age (and by sex) was begun. At once certain important facts, long 
known to close students of these diseases, became available for use by 
boards of health and health officers in their propaganda and campaigns 
to limit the morbidity and mortality from these diseases. 

Complete tabulations of death returns by ages are not available for 
about eighteen months after the end of the year in which they occur. 
This comes about because, though the Secretary of State's office is will- 
ing to and does furnish very promptly each month a total of deaths 
from each communicable disease, which is approximately correct, it is 
not willing to sacrifice accuracy in its final tabulations and undertakes 
many time-consuming verifications which prevent an earlier publication 
of the complete tabulations of death returns. 

At first, therefore, age distributions of deaths and of cases had each 
to be studied in separate years. 

No fair fatality rates by ages could be arrived at, since the cases 
and deaths for the same year could not be compared. Therefore, it 
was not until 1920 that we were able to present complete tables on 
morbidity, mortality and fatality by ages for the same groups of cases. 
The tables presented, then, are for 1918 and not 1920, since we are 
now just getting our completed and corrected death tabulations for 
that year. 

Such tables bring out striking and valuable facts as to variations of 
morbidity, mortality and fatality at different ages. Also, they are 
valuable standards for epidemiological investigation in that much 
variation from the State average of incidence by ages would likely be 
a valuable clue in a particular outbreak. 



990 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 1. — Measles in Massachusetts, 1918, Cases and Deaths by Ages. 









• 


Morbidity. 


Mortality and Fatality. 


Age Groups (Years). 


1 -i^ 

fi fe =3 


73 ? 

-W CO Q, 

o3 hi) 
C 1- 03 


M <- 2 


o o o 
S C3.Q 3 


o-^ - 

O <s 
Pi 


j: ■ 

3 C3 


|| 
o ca 

^« 

^ Q) S) 

Pi 


III 

Ph 




1 


2 


3 


4 


5 


6 


7 


8 


9 


10 


Under 1 


736 


2.5 


789 


2.7 


- 


140 


26.4 


- 


17.8 


1. . 






1,758 


6.0 


1,928 


6.6 


2.7 


210 


39.4 


26.4 


10.9 


2. 








2,277 


7.8 


2,513 


8.6 


9.3 


69 


13.0 


65.8 


2.7 


3. 








2,337 


8.0 


2,571 


8.8 


17.9 


36 


6.8 


78.8 


1.4 


4, 








2,553 


8.7 


2,804 


9.6 


26.7 


20 


3.8 


85.6 


.7 


5. 








2,731 


9.3 


3,009 


10.3 


36.3 


\ 




89.4 




6, 








3,501 


12.0 


3,827 


13.1 


46.6 










7, 








2,579 


8.9 


2,834 


9.7 


59.7 


i 24 


4.5' 




.2 


8, 








1,718 


5.9 


1,899 


6.5 


69.4 










9. 




• • 




1,135 


3.9 


1,256 


4.3 


75.9 










10 to 14, inclusive, 




2,314 


7.9' 


2,542 


8.71 


80.2 


5 


.9 


93.9 


.2 


15 to 19, inclusive, 




935 


3.2 


1,023 


3.5 


88.9 


4 


.7 


94.8 


.4 


20 to 24, inclusive. 




816 


2.8 


906 


3.1 


92.4 






95.5 




25 to 34, inclusive. 




847 


2.9 


935 


3.2 


95.5 










35 to 44, inclusive, 




236 


.8 


263 


.9 


98.7 


i 24 


4.5 




.1 


45 to 54, inclusive. 




62 


.2 


87 


.3 


99.6 










55 and over. 




18 


.1 


29 


.1 


99.9 










Unknown, 




2,662 


9.1 


- 


- 


- 


- 


- 


- 


- 


1 


^otalE 


» 


29,215 


100.0 


29,215 


100.0 


100.0 


532 


100.0 


100.0 


1.82 



1 This figure for five years. To obtain annual average divide by 5. 

2 It is noted that the fatality rates for 1918 of 1.8 per cent for measles and 9.4 per cent for whooping 
cough are higher than the median endemic indexes for the period 1911-19 (Table 8), which were 1.3 and 
7.6 per cent, respectively. This is thought, in a measure at least, to have been due to influenza. Also, 
scarcity of physicians in 1918 in many localities probably resulted in poorer reporting than has ordinarily 
been the case. Furthermore, the classification of deaths from primary and secondary causes given on 
death certificates has been done since 1916 according to the United States census publication, "Index of 
Joint Causes of Death." This is now being done by many of the States and is an improvement in that 
it makes the statistics of the various States more comparable. It is probable that under this system 
some deaths are credited to measles and whooping cough that formerly would have been credited to 
causes that were really secondary. 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



223 



Table 


2. — W 


hooping Cough in 


Massachusetts 


1918, 


Cases 


and Deaths hy Ages. 




Morbidity. 


Mortality and Fatality. 


Age Groups (Years). 


'-' » 

Xi -^ -t^ 
B fc « 

B aw 


US 

*^ to 
c !: S 


m tH S 

S|'S§ 


CQ 0)1 

O 




las 


— .-o 

03 0) 
O C3 

^& 

PU 




>.T3 

is . 

Ill 


1 


2 


3 


4 


5 


6 


7 


8 


9 


10 


Under 1, 






772 


9.9 


831 


10.7 


- 


332 


45.6 


- 


40.0 


1, 








804 


10.4 


854 


11.0 


10.7 


212 


29.1 


45.6 


24.8 


2. 








868 


11.2 


940 


12.1 


21.7 


73 


10.0 


74.7 


7.8 


3. 








908 


11.7 


978 


12.6 


33.8 


41 


5.6 


84.7 


4.2 


4, 








810 


10.4 


870 


11.2 


46.4 


32 


4.4 


90.3 


3.7 


5. 








815 


10.5 


877 


11.3 


57.6 






94.7 




6. 








775 


10.0 


839 


10.8 


68.9 










7. 








520 


6.7 


559 


7.2 


79.7 


34 


4.71 




1.2 


8. 








297 


3.8 


318 


4.1 


86.9 










9, 








204 


2.6 


225 


2.9 


91.0 










10 to 14, inclusive, 




266 


3.41 


287 


3.7» 


93.9 


1 


.1 


99.4 


.3 


15 to 19, inclusive, 




39 


.5 


47 


.6 


97.6 


- 


- 


99.5 


- 


20 to 24, inclusive. 




27 


.4 


31 


.4 


98.2 










25 to 34, inclusive. 




52 


.7 


54 


.7 


98.6 


• 








35 to 44, inclusive. 




19 


.2 


23 


.3 


99.3 


4 


.5 




2.9 


45 to 54, inclusive. 




16 


.2 


16 


.2 


99.6 










55 and over, 




16 


.2 


16 


.2 


99.8 










Unknown, 




557 


7.2 


- 


- 


- 


- 


- 


- 


- 


T 


otals 


■ 


7,765 


100.0 


7,765 


100.0 


100.0 


729 


100.0 


100.0 


9.42 



1 This figure for five years. To obtain annual average divide by 5. 2 See similar note under measles. 

From these tables we find that — 

1. Approximately 34 per cent of the whooping cough and IS per 
cent of the measles were in children under 3. 

2. Eighty-five per cent of the deaths from whooping cough and 
79 per cent of those from measles were in children under 3 years. 

3. The apparent fatality rates for the group under 3 were 23^ per 
cent for whooping cough and 8 per cent for measles. 

4. For each thousand reported cases of measles there were 18 deaths, 
and 14 of these were under 3. 

5. In the same year each thousand cases of whooping cough repre- 
sented 92 deaths, and 77 of these were under 3. 

6. Even though there was about four times as much measles, 



224 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



whooping cough mortaUty leads with 729 deaths, compared with 532 
for measles. This is a total of 1,261 deaths from both diseases and 
1,036 of these were less than 3 years old. 

7. Measuring success by a reduction in deaths from these diseases 
it is at once apparent that the results depend very largely on how 
successfully we prevent measles and whooping cough in children under 
3, among whom 80 to 85 per cent of the deaths from the two diseases 
occurred. 

8. Propaganda and methods of control should be more specifically 
directed at this age group. 

9. In these years when so many children die of measles and whoop- 
ing cough or their complications, the most careful medical attention 
and nursing are needed to prevent dangerous complications. 



Table 3. — Diphtheria in Massachusetts, 1918, Cases and Deaths by Ages. 




Morbidity. 


MORTAXITT AND FaTALITT. 


Age Groups (Years). 


1 -M 

S a> « 
.^ -f^ -M 

fl fc « 

■z 


■:3 s 


Ota 

-if 3 a 

12; 


m (1)1 
o-gg 

all 


S a* 

H 

S cSCQ 
Pt( 


B +j 


— 13 
=3 

CJ3 
*^ . 

Si So 


■« to*; 


>.'0 

<i 

< 


1 


2 


3 


4 


5 


6 


7 


8 


9 


10 


Under 1 


195 


2.8 


215 


3.1 


- 


50 


8.2 


- 


23.2 


1, . 






281 


4.1 


311 


4.5 


3.1 


77 


12.7 


8.2 


24.7 


2, 








450 


6.5 


498 


7.2 


7.6 


77 


12.7 


20.9 


15.5 


3, 








540 


7.8 


602 


8.7 


14.8 


84 


13.8 


33.6 


14.0 


4, 








530 


7.7 


588 


8.5 


23.5 


53 


8.7 


47.4 


9.0 


5. 








502 


7.2 


554 


8.0 


32.0 






56.1 




6. 








509 


7.3 


568 


8.2 


40.0 










7. 








447 


6.5 


498 


7.2 


48.2 


178 


29.3 




7.7 


8. 








372 


5.4 


415 


6.0 


55.4 










9, 








257 


3.7 


284 


4.1 


61.4 










10 to 14, inclusive, 




850 


12.31 


935 


13.5' 


65.5 


43 


7.1' 


85.4 


4.6 


15 to 19, inclusive, 




347 


5.0 


381 


5.5 


79.0 


10 


1.6 


92.5 


2.6 


20 to 24, inclusive, 




399 


5.8 


443 


6.4 


84.5 






94.1 




25 to 34, inclusive. 




330 


4.8 


367 


5.3 


90.9 










35 to 44, inclusive, 




146 


2.1 


173 


2.5 


96.2 


i 36 


5.9 




2.4 


45 to 54, inclusive, 




65 


.9 


69 


1.0 


98.7 










55 and over, 




22 


.3 


21 


.3 


99.7 










Unknown, 




680 


9.8 


- 


- 


- 


- 


- 


- 


- 


T 


otals 


. 


6,922 


100 .0 


6,922 


100.0 


100.0 


608 


100.0 


100.0 


8.8 



1 This figure for five years. To obtain annual average divide by 5. 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



225 



Table 4. — Scarlet Fever 


in Massachusetts, 1918, Cases an 


d Deaths by Ages. 




Morbidity. 


Mortality and Fatality. 


Age Groups (Years). 


1 .^ 

q o *j 


-^ CO 

O d ■ 
® ^ 

CM 


" >- 2 


Oo o 

Ph 


C3-C 


1 on 

n o ♦i 
3 art 


..J *^ 

O 03 

Q -^ • 


^ en hn 
aj ■♦J r- 


Ill 


1 


2 


3 


4 


5 


6 


7 


8 


9 


10 


Under 1, 






31 


.7 


31 


.7 


- 


2 


2.6 


- 


6.4 


1. 








89 


2.0 


99 


2.2 


.7 


12 


15.4 


2.6 


12.1 


2. 








230 


5.1 


247 


5.5 


2.9 


8 


10.3 


18.0 


3.2 


3. 








291 


6.5 


314 


7.0 


8.4 


5 


6.4 


28.3 


1.5 


4. 








350 


7.8 


382 


8.5 


15.4 


16 


20.5 


34.7 


4.2 


5, 








384 


8.6 


418 


9.3 


23.9 






55.2 




6. 








395 


8.8 


427 


9.5 


33.2 










7, 








327 


7.3 


355 


7.9 


42.7 


17 


21.81 




1.0 


8, 








261 


5.8 


283 


6.3 


50.6 










9, 








249 


5.5 


269 


6.0 


56.9 


J 








10 to 14, inclusive, 




736 


16.41 


799 


17.81 


62.9 


3 


3.8 


77.0 


.4 


15 to 19, inclusive, 




296 


6.6 


323 


7.2 


80.7 


4 


5.1 


80.8 


1.2 


20 to 24, inclusive. 




191 


4.3 


207 


4.6 


87.9 






85.9 




25 to 34, inclusive. 




230 


5.1 


251 


5.6 


92.5 










35 to 44, inclusive. 




61 


1.3 


67 


1.5 


98.1 


1 ^^ 


14.1 




2.0 


45 to 54, inclusive. 




13 


.3 


13 


.3 


99.6 










55 and over. 




5 


.1 


5 


.1 


99.9 










Unknown, 




351 


7.8 


- 


- 


- 


- 


- 


- 


- 


T 


otals 


- 


4,490 


100.0 


4,490 


100.0 


100.0 


78 


100.0 


100.0 


1.7 



1 This figure for five years. To obtain annual average divide by 5. 



Comparing the above two tables with Tables 1 and 2 we find that — 

1. Whereas 85 per cent of the total cases of measles were under 12 
and of whooping cough under 8, for diphtheria and scarlet fever this 
percentage occurred under 20 and 18, respectively. 

2. Eighty-five per cent of the deaths from measles were in cases 
under 4 and from whooping cough under 3, whereas from diphtheria 
and scarlet fever this amount of mortality has not occurred until the 
ages of 10 and 20, respectively. 

3. In other words, in both deaths and cases diphtheria and scarlet 
fever extended over a wider range of ages. 

4. Nevertheless, the highest mortality and fatality, as in measles 
and whooping cough, came in the early years of life. 



226 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 5. — Pulmonary Tuberculosis in Massachusetts, 1918, Cases and Deaths 

by Ages. 







Morbidity. 


Mortality and Fatality. 


Age Groups (Years). 


Number of Re- 
ported Cases at 
Stated Age. 


Per Cent of Total 
Reported Cases 
at Each Age. 


Number of Cases 
at Each Age after 
redistributing the 
Unknown. 


Per Cent of Cases 
at Each Age 
based on Col- 
umn 4. 


Per Cent of Cases 
at less than 
Stated Age. 


Number of Re- 
ported Deaths 
at Stated Age. 


Per Cent of Total 
Deaths at Stated 
Age. 


Per Cent of Total 
Deaths at less 
than Stated Age. 


Apparent Fatality 
Rates at Stated 
Age. 


1 


2 


3 


4 


5 


6 


7 


8 


9 


10 


Under 1, . 














[ 54 


1.0 


- 


- 


1, . . . 














44 


.9 


1.0 


- 


2, . . . 




[ 172 


2.2 


204 


2.6 


- 


^ 14 


.3 


1.9 


66.2 


3, . . . 














19 


.4 


2.2 


- 


4, . . . 














I 4 


.1 


2.6 


- 


5 to 9, inclusive, 




188 


2.4 


219 


2.8 


2.6 


34 


.7 


2.7 


15.5 


10 to 14, inclusive, 




209 


2.7 


251 


3.2 


5.4 


80 


1.5 


3.4 


31.9 


15 to 19, inclusive. 




485 


6.2 


572 


7.3 


8.6 


366 


7.1 


4.9 


64.0 


20 to 29, inclusive, 




1,979 


25.2 


2,342 


29.9 


15.9 


1,431 


27.6 


12.0 


61.1 


30 to 39, inclusive. 




1,596 


20.4 


1,888 


24.1 


45.8 


1,280 


24.7 


39.6 


67.8 


40 to 49, inclusive. 




1,047 


13.4 


1,237 


15.8 


69.9 


895 


17.3 


64.3 


72.3 


50 to 59, inclusive. 




597 


7.6 


705 


9.0 


85.7 


559 


10.8 


81.6 


79.3 


60 to 69, inclusive. 




249 


3.2 


298 


3.8 


94.7 


275 


5.3 


92.4 


92.3 


70 and over, 




103 


1.3 


117 


1.5 


98.5 


121 


2.3 


97.7 


103.4 


Unknown, 




1,208 


15.4 


- 


- 


- 


1 


- 


- 


- 


Totals, 


7,833 


100.0 


7,833 


100.0 


100.0 


5,177 


100.0 


100.0 


66.1 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



227 



Table 6. — Tuberculosis, Other Forms, in Massachusetts, 1918, Cases and Deaths 

by Ages. 







Morbidity. 


Mortality and Fatality. 


Age Groups (Years). 


Number of Re- 
ported Cases at 
Stated Age. 


Per Cent of Total 
Reported Cases 
at Each Age. 


Number of Cases 
at Each Age after 
redistributing the 
Unknown. 


Per Cent of Cases 
at Each Age 
based on Col- 
umn 4. 


Per Cent of Cases 
at less than 
Stated Age. 


Number of Re- 
ported Deaths 
at Stated Age. 


Per Cent of Total 
Deaths at Stated 
Age. 


Per Cent of Total 
Deaths at less 
than Stated Age. 


Apparent Fatality 
Rates at Stated 
Age.i 


1 


2 


3 


4 


5 


6 


7 


8 


9 


10 


Under 1, . 




57 


7.6 


63 


8.4 


- 


98 


12.4 


- 


155.5 


1, . . . 




66 


8.8 


73 


9.7 


8.4 


100 


12.6 


12.4 


137.0 


2, . . . 




36 


4.8 


39 


5.3 


18.1 


52 


6.6 


25.0 


133.3 


3, . . . 




33 


4.4 


36 


4.8 


23.4 


54 


6.8 


31.6 


150.0 


4. . . . 




40 


5.4 


44 


5.9 


28.2 


29 


3.7 


38.4 


65.9 


5 to 9, inclusive, 




97 


13.0 


106 


14.2 


34.1 


71 


9.0 


42.1 


67.0 


10 to 14, inclusive. 




41 


5.5 


45 


6.0 


48.3 


34 


4.3 


51.1 


75.5 


15 to 19, inclusive. 




49 


6.6 


54 


7.2 


54.3 


39 


4.9 


55.4 


72.2 


20 to 29, inclusive, 




111 


14.9 


122 


16.3 


61.5 


36 


10.9 


60.3 


70.5 


30 to 39, inclusive, 




72 


9.6 


78 


10.5 


77.8 


78 


9.8 


71.2 


100.0 


40 to 49, inclusive. 




52 


7.0 


57 


7.6 


88.3 


65 


8.2 


81.0 


114.0 


50 to 59, inclusive. 




15 


2.0 


16 


2.2 


95.9 


47 


5.9 


89.2 


293.7 


60 to 69, inclusive, 




10 


1.3 


11 


1.5 


98.1 


23 


2.9 


95.1 


209.1 


70 and over, 




3 


.4 


3 


.4 


99.6 


16 


2.0 


98.0 


533.3 


Unknown, 




65 


8.7 


- 


- 


- 




- 


- 


- 


Totals, 


747 


100.0 


747 


100.0 


100.0 


792 


100.0 


100.0 


106.0 



1 Indicates poor reporting. 

These tables show that — 

1. Pulmonary tuberculosis is a disease of adult life, 54 per cent of 
the cases and 52 per cent of the deaths in 1918 being in the group 
20-39, inclusive. 

2. Pulmonary tuberculosis is not particularly a disease of childhood, 
only 8.6 per cent of the cases and 7.1 per cent of the deaths being 
under 15. 

3. Tuberculosis, other than pulmonary, is a disease of childhood, 
54 per cent of the cases and 55 per cent of the deaths being under 15. 

The fatality rate for tuberculosis, other than pulmonary, indicates 
bad reporting. H.owever, there is no reason to believe that the unre- 
ported cases are distributed by ages differently from those reported. 



k 



228 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Sex Distribution of Communicable Diseases, 

Table 7 is included so that Health Officers and others interested in 
the investigation of epidemics may have data upon which to base 
tables for normal incidence of these diseases by sex. Given a standard 
sex distribution, any marked variation therefrom would probably be 
of epidemiological significance. 

It is noted that in 1919 more females than males had diphtheria 
after twenty years of age and that for all ages more males than fe- 
males suffered from pulmonary tuberculosis. Figures for 1918 show 
the same in both cases. The total number of cases of pulmonary 
tuberculosis for 1918 was 7,833, and of these cases 4,565 were males, 
3,167 females and 101 of unknown sex. Also, in adult life in 1918, 
more cases of diphtheria occurred in females than in males. 



Table 7.- 


-Cas 


es of 


Certaii 


I Con 


imun 


icable 1 


Jisea. 


ies, 1 


919, by 


bex 


and / 


ige. 




Whooping Cough. 


Measles. 


Diphtheria. 


Pulmonary 
Tuberculosis. 


Age Groups 
(Years). 


Male. 


Fe- 
male. 


Un- 
known. 


Male. 


Fe- 
male. 


Un- 
known. 


Male. 


Fe- 
male. 


Un- 
known. 


Male. 


Fe- 
male. 


Un- 
known. 


1 


2 


3 


4 


5 


6 


7 


8 


9 


10 


11 


12 


13 


Under 1, . 


278 


263 


8 


172 


144 


15 


87 


53 


5 








1, . . . 


264 


252 


9 


315 


298 


20 


161 


106 


- 








2. . 




251 


300 


15 


374 


343 


28 


251 


203 


4 


82 


59 


1 


3, 




315 


313 


12 


417 


404 


32 


289 


284 


5 








4. 




279 


250 


8 


445 


442 


26 


305 


295 


4 








5, 




298 


297 


9 


551 


520 


30 


364 


300 


8 








6, 




327 


309 


4 


682 


652 


22 


317 


335 


2 








7, 




216 


234 


4 


506 


509 


17 


290 


303 


3 


1 ** 


107 


- 


8. 




112 


134 


3 


337 


340 


11 


244 


269 


- 








9, 




. 76 


64 


3 


201 


165 


7 


198 


223 


1 


, 






10 to 14, inclusive, 


100 


103 


1 


318 


338 


6 


531 


609 


5 


109 


161. 


3 


15tol9, inclusive, 


10 


10 


- 


80 


97 


3 


142 


169 


2 


211 


286 


4 


20 to 24, inclusive, 


15 


12 


- 


55 


68 


1 


74 


178 


- 


388 


479 


2 


25 to 34, inclusive, 


8 


19 


- 


37 


72 


2 


103 


231 


3 


883 


745 


10 


35 to 44, inclusive, 


3 


10 


- 


22 


22 


- 


48 


109 


1 


721 


483 


1 


45 to 54, inclusive 


2 


4 


- 


8 


8 


- 


25 


37 


- 


527 


224 


4 


55 and over, 


6 


6 


- 


1 


5 


- 


11 


26 


- 


371 


176 


4 


Unknown, 


165 


166 


180 


326 


239 


252 


342 


333 


41 


447 


378 


27 


1 
, 


"otals. 


2,725 


2,746 


256 


4,847 


4,666 


472 


3,782 


4,063 


84 


3,823 


3,098 


56 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



229 



Outbreaks or Communicable Diseases in 1920. 
Communicable diseases reached sufficient proportions to call 



for 



special investigation and special report to the central office by the 
District Health Officers in over fifty instances. Besides this, watch 
was kept on those diseases that were generally and widely prevalent. 

1. Anterior Poliomyelitis. 

Beginning about the middle of July and lasting until December an 
outbreak of this disease, totaling about 700 cases, took place in eastern 
and northeastern Massachusetts. Locations and dates of onsets of the 
first 23 reported cases were as follows: — 



June 30, 


Manchester 


July 


2, 


Dedham. 


July 


9, 


Rutland. 


July 


9, 


Boston. 


July 


11, 


Lawrence. 


July 


13, 


Boston. 


July 


14, 


Boston. 


July 


14, 


Lawrence. 


July 


16, 


Boston. 


July 


20, 


Maiden. 


July 


20, 


Boston. 



July 


21, 


Boston. 


July 


22, 


Boston. 


July 


22, 


Chelsea. 


July 


23, 


Boston. 


July 


25, 


Boston (two). 


July 


26, 


Somerville. 


July 


27, 


Boston. 


July 


30, 


Boston. 


July 


24, 


1 Medfield. 


July 


24, 


* East Weymouth 


August 4, 


1 Scituate. 



By the end of July, twelve foci of infection existed. One focus had 
furnished 12 of the first 23 cases and the other eleven foci furnished 
1 case each. Whether the disease had smouldered in the largest focus 
before cases were reported and had spread from unrecognized cases in 
this focus, or had originated from one of the smaller foci, is a question. 

The outbreak confined itself to eastern and northeastern Massachu- 
setts and spread slowly from the metropolitan cities into the north- 
eastern cities and towns. The incidence by months, as compared with 
1916, was as follows: — 





1920. 


1916. 


To July 1 


16 


30 


July 


16 


106 


August 


93 


252 


September, 


273 


623 


October, 


190 


701 


November 


77 


179 


December 


31 


36 


Totals 


69§ 


1,927 



1 Date of report ; date of onset not available. 



230 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

A weekly record of reports showed an incidence very closely follow- 
ing the seasonal distribution in 1916. The peak for reported cases was 
reached in both years in the week of October 2. 

Dr. Lyon and Dr. Hassman, who were supplied from the staff of the 
Harvard Infantile Paralysis Commission to do early diagnostic con- 
sultation work, saw 57 cases (Dr. Lyon, 49; Dr. Hassman, 8). Diag- 
nosis was based on study of the cell content of spinal fluid as well as 
clinical symptoms. The cases seen were classified as follows: — 



Cases. 



Punctures. 



Late paralytic 8 None 

Early paralytic 15 8 

Preparalytic, 10 10 

Not poliomyelitis, ........... 22 8 

Not diagnosed, ........... 2 2 



The early cases were those that when seen either showed very slight 
paralysis that had escaped the attention of the physician or were cases 
that had developed some paralysis in the interim since they were last 
seen. The total number of cases seen was so small that it will be 
possible to draw inferences and not conclusions from the study. Of 
the 10 cases diagnosed before there was any paralysis at all, 8 have 
been reported on and 3 were found to have subsequently developed 
paralysis. 

2. Influenza. 

(a) Chronology. — The arrival of the 1920 epidemic was noted on 
January 20, when 64 cases were reported to the Department, whereas 
the total for the previous week was only 58 cases. For comparison, 
on January 27, 482 cases were reported, and on February 2, 1,076 
cases. Because of the allied character of the diseases, lobar pneu- 
monia (the only form of pneumonia reportable in Massachusetts) 
statistics also are given. 

Following the practice of 1918, educational measures were at once 
instituted by means of moving pictures, slides, newspapers and lectures 
to warn the public, but what effect was thereby produced on the 
progress of the disease it is impossible to say. 

Cases were first reported in and around Boston, and rapidly in- 
creased, the height of the epidemic being reached sixteen days later 
on February 4, 5 and 6. Although the peak as shown by case reports 
was on February 9, 10 and 11, this false peak was caused by the 
delay in mails due to the heavy snowstorm of February 5, 6 and 7, 
and does not represent the true peak of the disease. 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



231 



The epidemic ran a ten-week course, — shorter than the 1918-19 
epidemic of six to seven months, — and was similar to that experi- 
enced elsewhere in the country. January 20 to March 31, inclusive, 
was the correct duration. 

Lobar pneumonia cases showed an immediate increase with influ- 
enza cases, and paralleled the curve of that disease. 

(b) Age Distribution. — The age distribution of the influenza cases 
of the 1920 epidemic was similar to that of the previous one, the larger 
number of cases being in the age groups of to 4 and 25 to 34 years. 
The 5 to 14 year age group suffered the least. 



Case Incidence at Different Ages. 




Ages (Years). 


Per Cent of 
Total Cases. 


Ages (Years). 


Per Cent of 
Total Cases. 


Oto 4 

5 to 14 

15 to 24 

25 to 34 


10.0 
12.0 
19.4 
27.9 


35 to 44 

45 to 54, 

55 to 64 

65 and over, 


14.7 
9.4 
3.7 
2.9 



(c) Sexes. — As in previous epidemics the incidence in males ex- 
ceeded that in females, the figures being 51 and 49 per cent, respec- 
tively. The age groups of the sexes showed that up to twenty-five 
years there were more cases among females, but after that age the 
majority of the cases were males. The mortality statistics are not yet 
complete for the age groupings. 

(d) Vir%dence. — In 1918-19 the fatality rate was 7.6 per cent, 
whereas this year there is a rate of 4.68 per cent, judging from death 
statistics. There is a great source of error in the fatality rate of in- 
fluenza because of the many mild cases that are not reported, which 
would tend to lower the fatality rate considerably. 

{e) Imviunitij. — The fact that the morbidity rate was much less 
in 1920 than 1918-19 suggests that there may be a definite immunity 
conferred by the disease or a great decrease in the virulence of the 
causative organism. Possibly both of these factors played a part. 

(/) Morbidity, Mortality and Fatality. — From Oct. 1, 1918, to April 
30, 1919, inclusive, there were 184,419 cases of influenza reported and 
13,419 deaths, giving a fatality rate of 7.3 per cent. In September, 
1918, there were 2,939 deaths, making a total of 16,358 deaths in 
Massachusetts during the epidemic from Sept. 1, 1918, to April 30, 1919. 

In the present epidemic there were 35,633 cases from Jan. 1, 1920, 
to March 31, 1920, and incomplete records give 1,660 deaths, making 
a fatality rate of 4.65 per cent. 



232 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Obviously, the fatality rates for both epidemics are much too high 
because of the non-reporting of the milder cases of influenza. A rate 
of 3 to 5 per cent for 1918 and of less than 1 per cent for 1920 would, 
perhaps, be nearer the true fatality rates of these two epidemics. 

/AfflUE'NZA m MA3JACmJErTJ' 

3r WEEKLY rOTALJ-JSl^a 



20,000 
idpoo 

^ 16^000 

§ 12p00 
^ iOfiOO 
S ^,000 

^ 4',000 
^ ^.000 




20,000 
idfiOO c^ 

i&jOOO ^ 

i4fioo ^ 
i2fioo g 

10,000 ^ 
djOOO ^ 

C,ooo fc^ 
4,000 ^4 



3 iO Jr ^4 JI 7 !4 2/ £d e £} £0 2r 3 
JANUARV FEBRUASy MARCH A 

PMIlTMOmA (103AR) 

Br WEEKLK rOTAU-iS2a 



i 

I 



7oo 

6O0 
Soo 

400 

Joo 
Boo 

loo 
o 



700 





























600 S 












/ 


^ 














soo ^ 
400 ^ 
300 ^ 












/ 




\ 




















^ 






\ 


















/' 










'\ 










200 ^ 







^ 














N 








ioo p 

^ 





























^ 10 17 24 JI 7 14 ^/ £3 C /3 £0 ^r J 



S 



3. Measles. 

A State-wide epidemic prevailed during the first seven months of 
1920. For the entire year 32,141 cases were reported, the largest num- 
ber ever known. Seventeen separate outbreaks were investigated, 
which were found to have been due to school, family and neighbor- 
hood contact before quarantine was instituted. Large numbers of 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 233 

missed mild cases and late diagnoses made control particularly diffi- 
cult. The disease became so prevalent that all individual outbreaks 
could not be investigated and resort had to be had to general advice. 

4. Whooping Cough. 

The beginning of the year saw also a widespread and well-developed 
outbreak of this disease throughout the State. It, too, with about 
10,000 reported cases, exceeded all past records of incidence. 

Health officials should acquaint themselves accurately with the 
years of greatest mortality and fatality (Tables 1 and 2) for both 
whooping cough and measles; and should preach unceasingly to par- 
ents the duty of deferring as long as possible the evil day when their 
children may contract these diseases. 

5. Diphtheria. 

In 1920 there were about 7,500 reported cases, an incidence little 
different from previous years. 

Twenty-four outbreaks that occurred were investigated. Of these, 
six, or 25 per cent, were second outbreaks in the same towns. This is 
food for thought. 

In one instance a case in the first outbreak that had been released 
from quarantine by culture became a carrier and caused the second 
outbreak. Might not released cases of diphtheria be cultured several 
times at definite intervals after release from quarantine, as a routine 
measure, to discover whether they have become intermittent carriers? 
This would protect both the immediate family and the public. The 
rule might at least apply to school children. Might not health officials 
on the occurrence of undue incidence of diphtheria at once, as a rou- 
tine, re-culture all cases that have occurred within the past six months, 
especially the ones at all likely to be associated with the current cases? 

In one instance the second outbreak came because a milker with 
diphtheria, excluded from a dairy farm on the advice of the State 
Department, had been allowed to return without release cultures. 
In the four other instances the lax quarantines practiced, the undis- 
covered mild cases, the practice of releasing from quarantine without 
cultures in some instances were still found to prevail. 

6. Scarlet Fever. 

There were sixteen outbreaks that required investigation by the 
District Health Officers. With about 10,000 cases reported, the inci- 
dence exceeded any since 1914. The total deaths also exceeded those 
of any year since 1914. 



234 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



7. Septic Sore Throat. 

But one real outbreak of this disease occurred. It was milk-borne 
and involved 43 cases on the same route. In searching for the cause 
of this outbreak several cows were found to be suffering from garget. 
Cultures were taken from the udders and from the milk of these cows 
and also from the throats of all the milk handlers. The returns from 
these first cultures showed streptococci from the garget in the cows 
but none from the milk handlers. The streptococci isolated from the 
cows were non-hemolytic, whereas all organisms that had been iso- 
lated from the cases were distinctly of the hemolytic type. A second 
trip was made to that town and all the milkers recultured, and in one 
milker's throat was found a hemolytic streptococcus. It is believed 
that he and not the cows caused the outbreak. 



8. Typhoid Fever. 
The 1920 record for typhoid excels the remarkable record made in 



1919. The following outbreaks occurred: 



Place. 


Num- 
ber of 
Cases. 


Time. 


History. 


Chelsea, . . 


18 


July 


Milk-borne epidemic. Unpasteurized supply. 
A one-dairy route. No outside help. Carrier 
not found after a number of examinations. 


Taunton, . 


8 


July and August, 


In State hospital for insane. Thought to have 
been due to a supposed carrier, who absconded 
when it began to appear that she was the 
cause of the cases. Suspected carrier, an 
attendant. 


Warner, N. H., 


9 


August, 


Vacationists, mostly teachers, at a summer 
boarding house returned to Massachusetts 
and developed typhoid shortly afterwards in 
Boston, Worcester, Waltham, Somerville and 
Stoneham. The secretary of the New Hamp- 
shire Board of Health reports that the out- 
break involved cases from Rhode Island and 
New Hampshire also, and was probably due 
to a mild case of typhoid in the kitchen help. 


Ipswich, . 


33 


September, 


Milk; three milk handlers involved. One sus- 
pected of being carrier. Suspicion not yet 
confirmed. 


Fall River, 


34 


September, 


Polluted well in one of the large mills. 


Northampton, 


15 


Dec, 1917, to Feb., 
1920. 


Two attendants who left the hospital about 
Jan. 1, 1920, suspected of being carriers. One 
had typhoid history. Suspicions were not 
confirmed. 


New Bedford, . 


29 


August and Septem- 
ber. 


No cause could be found. 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



235 



In -four of the six outbreaks tabulated, carriers were suspected but 
not proved. This is illustrative of the difficulty and large amount of 
work often necessary to detect carriers and of the disappointments 
frequently in store for us. However, as the amount of typhoid in 
Massachusetts has year by year grown less, our efforts can now be 
more intensive. Purthermore, we now begin such investigations with 
the knowledge that it will likely require great numbers of cultures to 
detect the carrier, especially if he be of the intermittent type. 

Progress made in Past Five-year Period. 

Tables 8 to 17 have been prepared for purposes of comparison with 
past years. Included in each table, except Table 13, are median rates 
for the nine-year period 1911-19, inclusive, and underneath these 
figures come the 1920 figures which are readily compared with them. 

Table 8. — Case, Death and Fatality Rates for Measles and Whooping Cough, 

1911-20, inclusive. 



Year. 



1911, . 

1912, . 

1913, . 

1914, . 

1915, . 

1916, . 

1917, . 

1918, . 

1919, . 



Popula- 
tion 
based on 
State and 

Federal 
Censuses 



3,445,416 
3,510,795 
3,576,174 
3,641,553 
3,706,931 
3,739,364 
3,771,797 
3,804,231 
3,836,664 





Measles 


1 




Cases. 


Cases 

per 

100,000. 


Deaths. 


Deaths 

per 
100,000. 


Fa- 
tality 
Rates. 


3 


4 


5 


6 


7 


16,094 


467.1 


158 


4.6 


1.0 


22,423 


638.7 


286 


8.2 


1.3 


29,192 


816.3 


315 


8.8 


1.1 


12,264 


336.8 


149 


4.1 


1.2 


22,881 


617.2 


149 


4.0 


.6 


25,460 


680.9 


392 


10.5 


1.5 


23,880 


633.1 


371 


9.8 


1.6 


29,215 


768.0 


532 


14.0 


1.8 


9,985 


260.2 


183 


4.8 


1.8 



Whooping CouqhI* 



Cases. 



Cases 

per 

100,000. 



8 

3,911 
2,112 
3,325 
3,316 
7,182 
6,447 
3,877 
7,765 
5,727 



Deaths. 



9 

113.5 

88.6 

93.0 

91.1 

193.7 

172.5 

102.8 

204.1 

149.3 



10 

292 
225 
239 
225 
283 
346 
243 
729 
319 



Deaths 

per 
100,000. 



11 

8.5 
6.4 
6.7 
6.2 
7.6 
9.2 
6.4 
19.2 
8.3 



Fa- 
tality 
Rates. 



12 

7,5 
7.2 
7.2 
6.8 
3.9 
5.4 
6.3 
9.4 
5.6 



Median Rates. 



1911-19, . 


- 


23,880 


633.1 


286 


8.2 


1.3 


3,911 


113.5 


283 


7.6 


6.8 


1920, . 


3,869,098 


32,141 


830.7 


347 


9.0 


1.1 


9,994 


258.3 


542 


14.0 


5.4 



I Made reportable in 1893. 



2 Made reportable in 1907. 



Both measles and whooping cough show greater mortality rates in 
the five-year period 1916-20 than in the period 1911-15. See 



236 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Tables 13a and h, which are based on Tables 8 to 17. As has been 
said before, most of this increase for measles and whooping cough is 
due to change in classification of deaths which occurred in 1916 (see 
the note under Table 1). This is very definitely proved in Table 136 
which is the same as Table 13a, except that it is based on the United 
States Census Mortality Reports for all years except 1920. The differ- 
ence between State and Federal figures comes through different methods 
of classifying primary and secondary causes of deaths. The same 
death certificates were used by both, the United States census data 
being taken from transcripts of original certificates. About 1916 or 
1917 the State figures began to be based on classification according to 
the United States census publication, "Index of Joint Causes of 
Death." Since that time the figures from the two sources have more 
nearly approximated and are now practically uniform for these two 
diseases. 



Table 9. — Case, Death and Fatality Rates for Diphtheria and Scarlet Fever, 

1911-20, inclusive. 





Popula- 
tion 
based on 
State and 

Federal 
Censuses. 


Diphtheria, i 


Scarlet Fever, i 


Year. 


Cases. 


Cases 

per 

100,000. 


Deaths. 


Deaths 

per 
100,000. 


Fa- 
tality 
Rates. 


Cases. 


Cases 

per 

100,000. 


Deaths. 


Deaths 

per 
100,000. 


Fa- 
tality 
Rates. 


1 


2 


3 


4 


5 


6 


7 


8 


9 


10 


11 


12 


1911, . 


3,445,416 


6,998 


203.1 


563 


16.3 


8.1 


6,173 


179.1 


184 


5.3 


3.0 


1912. . 


3,510,795 


5,433 


154.8 


473 


13.5 


8.7 


5,633 


160.4 


118 


3.4 


2.1 


1913, . 


3,576,174 


6,741 


188.5 


628 


17.6 


9.3 


8,062 


225.4 


293 


8.2 


3.6 


1914, . 


3,641,553 


8,080 


221.9 


652 


17.9 


8.1 


11,057 


303.7 


246 


6.8 


2.2 


1915, . 


3,706,931 


9,282 


250.4 


721 


19.4 


7.8 


8,613 


232.3 


182 


4.9 


2.1 


1916, . 


3,739,364 


7.282 


194.7 


629 


16.8 


8.6 


6,271 


167.7 


127 


3.4 


2.0 


1917. . 


3,771,797 


10,322 


273.7 


838 


22.2 


8.1 


5,953 


157.8 


120 


3.2 


2.0 


1918, . 


3,804,231 


6,922 


181.9 


608 


15.9 


8.8 


4,490 


118.0 


78 


2.0 


1.7 


1919, . 


3,836,664 


7,929 


206.6 


591 


15.4 


7.5 


8,018 


209.0 


130 


3.4 


1.6 



Median Rates. 



1911-19. . 


- 


6,998 


203.1 


629 


16.8 


8.1 


6,173 


179.1 


130 


3.4 


2.1 


1920. . 

r 


3,869,098 


7,513 


194.2 


595 


15.4 


7.9 


10,260 


265.2 


215 


5.5 


2.1 

=3 



I Made reportable in 1884. 



Diphtheria shows a mortality rate of 17.0 for the period 1911-15 
and of 17.1 for the period 1916-20 (see Table 13a). This is par- 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



237 



ticularly discouraging in view of the increased efforts that have been 
put forth by the State Department through educational matter and 
through the District Health Officers. However, if we consider Table 
136, based mainly on Federal figures the showing is better, viz., 17.3 
for 1911-15 and 16.9 for 1916-20. 

The epidemiologist comes into close touch with outbreaks of disease, 
and reference is again made to the 1920 outbreak of diphtheria. 

Scarlet fever has decidedly decreased in mortality in the last five 
years. 

Table 10. — Case, Death and Fatality Rates for Cerebrospinal Meningitis and 
Anterior Poliomyelitis, 1911-1920, inclusive. 





Popula- 


Cerebrospinal Meningitis, i 


Anterior Poliomtelitis 


2 




tion 

based on 

State and 

Federal 

Censuses. 






















Ye.^r. 


Cases. 


Cases 

per 

100,000. 


Deaths. 


Deaths 

per 
100,000. 


Fa- 
tality- 
Rates. 


Cases. 


Cases 

per 

100,000. 


Deaths. 


Deaths 

per 
100,000. 


Fa- 
tality 
Rates. 


1 


2 


3 


4 


S 


6 


7 


8 


9 


10 


H 


12 


1911,. 


3,445,416 


150 


4.4 


143 


4.1 


95.4 


232 


6.7 


36 


1.0 


15.5 


1912, . 


3,510,795 


202 


5.8 


138 


3.9 


68.4 


169 


4.8 


76 


2.2 


45.0 


1913, . 


3,576.174 


180 


5.0 


147 


4.1 


81.7 


361 


10.1 


69 


1.9 


19.1 


1914, . 


3,641,553 


181 


5.0 


156 


4.3 


86.3 


151 


4.1 


45 


1.2 


29.8 


1915, . 


3,706,931 


145 


3.9 


125 


3.4 


86.3 


135 


3.6 


32 


.9 


23.7 


1916, . 


3,739,364 


150 


4.0 


136 


3.6 


90.5 


1,927 


51.5 


452 


12.1 


23.4 


1917, . 


3,771,797 


196 


5.2 


168 


4.4 


85.7 


174 


4.6 


51 


1.3 


29.3 


1918. . 


3,804,231 


378 


9.9 


231 


6.1 


61.1 


99 


2.6 


37 


1.0 


37.4 


1919, . 


3,836,664 


253 


6.6 


181 


4.7 


71.5 


66 


1.7 


17 


.4 


25.8 











Median Rates. 












1911-1919, . 
1920, . 


3.869,098 


181 
182 


5.0 
4.7 


147 
129 


4.1 
3.3 


86.3 
70.8 


174 
696 


4.6 
18.0 


45 
140 


1.2 
3.6 


25.8 
20.1 



I Made reportable in 1893. 



2 Made reportable in 1909. 



Both infantile paralysis and cerebrospinal meningitis showed in- 
creased mortality in the last five-year period. In infantile paralysis 
work our lack of knowledge of the mode of spread hinders us. 

In the case of cerebrospinal meningitis there are several considera- 
tions. The disease is often rapidly fatal. A death report is frequently 
the first information that a local board has. Many deaths are so re- 
ported which may be due to other things, as tuberculous meningitis. 
Spinal punctures are often not made. Our statistics on this disease are 
not, therefore, of the best. 



i 



238 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 11. — Case, Death and Fatality Rates for All Forms of Tuberculosis, 



1911-1920, inclusive. 





Popula- 




Pulmonary. 1 






Other Forms, i 




tion 

based on 

State and 

Federal 

Censuses. 




















Year. 


Cases. 


Cases 

per 

100.000. 


Deaths. 


Deaths 

per 
100,000. 


Fa- 
tality 
Rates. 


Cases. 


Cases 

per 

100,000. 


Deaths. 


Deaths 

per 
100,000. 


Fa- 
tality 
Rates. 


1 


2 


3 


4 


5 


6 


7 


8 


9 


10 


11 


12 


1911, . 


3,445,416 


7,031 


204.1 


4,418 


128.2 


62.8 


-1 


_i 


_i 


_i 


-1 


1912, . 


3,510,795 


7,519 


214.2 


4,212 


119.9 


56.0 


447 


13.6 


855 


24.4 


179.2 


1913, . 


3,576,174 


7,424 


207.6 


4,180 


116.9 


56.4 


412 


11.5 


869 


24.6 


210.9 


1914. . 


3,641,553 


7,144 


196.2 


4,171 


114.5 


58.3 


570 


15.7 


890 


24,4 


156.1 


1915, . 


3,706,931 


8,046 


217.0 


4,194 


113.2 


52.2 


822 


22.2 


853 


23.0 


103.9 


1916, . 


3,739,364 


7,878 


210.7 


4,467 


119.4 


56.5 


657 


17.6 


955 


25.6 


145.5 


1917, . 


3,771,797 


8,365 


221.8 


4,651 


123.3 


55.5 


776 


20.6 


758 


20.1 


97.6 


1918, . 


3,804,231 


7,833 


205.9 


5,177 


136.1 


66.1 


747 


19.6 


792 


20.8 


106.0 


1919, . 


3,836,664 


6,977 


181.8 


4,200 


109.5 


60.2 


782 


20.4 


694 


18.1 


88.7 



Median Rates. 



1911-1919, 
1920, . 



C 



3,869,098 



7,424 
6,696 



207.6 
173.1 



4,467 
3,743 



119.4 

96.7 



56.5 
55.8 



747 
800 



19.6 
20.7 



855 
639 



24.4 
16.5 



145.5 

79.9 



1 All forms of tuberculosis were made reportable in 1907, but reporting of other forms than pulmonary 
was very incomplete before 1912. 



Table 13a shows some decrease in the mortaHty from all forms of 
tuberculosis. The decrease for the pulmonary form was from a rate 
of 118.4 for 1911-1915 to 117.5 for 1916-1920. Federal figures (Table 
136) are more favorable, being 116.9 and 115.8, respectively. 

Table 11 shows a decidedly decreased mortality for 1919 and 1920, 
the figures being 109.5 and 96.7, respectively. 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 239 



Table 12. — Case, Death and Fatality Rates for Typhoid Fever, ^ 1911-1920, 

inclusive. 



Year. 



Population 

based on 

State and 

Federal 

Censuses. 



Cases. 



Cases 

per 
100,000. 



Deaths. 



Deaths 

per 
100,000. 



Fatality 
Rates. 



1911. 
1912, 
1913, 
1914, 
1915, 
1916, 
1917, 
1918, 
1919, 



3,445,416 
3,510,795 
3,576,174 
3,641,553 
3,706,931 
3,739,364 
3,771,797 
3,804,231 
3,836,664 



3 

2,238 
2,088 
2,398 
2,333 
2,204 
1,515 
1,546 
1,067 
940 



4 

64.9 
59.5 
67.0 
64.1 
59.5 
40.5 
41.0 
28.0 
24.5 



5 

302 
269 
280 
268 
246 
172 
178 
160 
103 



7.7 
7.8 
7.4 
6.6 
4.6 
4.7 
4.2 
2.7 



7 

13 5 
12.9 
11.7 
11.5 
11.2 
11.3 
11.5 
15.0 
10.9 



Median Rates. 



1911-1919 


- 


2,088 


59.5 


246 


6.6 


11.5 


1920 


3,869,098 


935 


24.2 


96 


2.5 


10.3 



1 Made reportable in 1893. 

Steady progress has been made in typhoid fever work. The mortal- 
ity has been reduced from 7.6 for the period 1911-1915 to 3.7 for 
1916-1920. In 1919 and 1920 the remarkable low records of 2.7 and 
2.5 deaths per 100,000 were made. 

Being a disease involving a small number of cases as compared with 
such diseases as measles, whooping cough, diphtheria and scarlet fever, 
it has been possible for the Department to do intensive work on ty- 
phoid. For many j'ears all cases on milk farms and nearly all other 
cases have been personally investigated by the District Health Officers. 
The main factor in the decrease, perhaps, has been the increasing im- 
provement in sanitation and water supplies of towns and cities. 



240 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



CO 






Ci 



o 



I 















e I 






o 






CO 

0^ 



fe 



CO 



< 





d 


CO r* 

t>^ CO 




m o 

CO —1 
CO !>. 


t-2 

O a 

p n 




QO t^ 

1— ( i-H 
1— ( 1—1 


CO 

1 

Q 




O J 


1 


»-t CO 


00 

Q 


00 CO 
lO o 

01 l>- 


Cerebrospinal 
Meningitis. 


6 

^ 
tf 


o -^ 


CO 


Oi OO 








m CO 


OQ 

Q 


CO CO 
C^ CO 
O CO 




» 

ft 
P 


1 


C5 ^ 





co *<** 

o c^ 

CO CO 





a. o 

1" 


1 


T-i 




CO OO 




a 


1 




OQ 


O OO 




Total 
Popula- 
tions. 


CO »o 
00 1-1^ 

o ^^ 

OO (M 

OO o 


f 




kO o 
Oi Ci 

»— ( 1— 1 

OS 03 



CO 









O 

•-Si 






-h3 




a 


S 




« 


r*- 


«o 


>, 


«■) 






c 

=0 


CO 






•cil 


o 




cT 


3 
m 

a 




i,-N> 


o 


•^ 


Ci 


U 




1 


s 


!» 


<to 


CS 


CO 




...> 


Q 






^ 


'tS 


S 


fO 


s: 


a 


Ci 


es 


P 


o 






•to 




a 


s: 




o 


;s 




■n 


S 




o 

en 


o 




P3 


O 






s 






•e^ 






cs 






..o 






V- 






<» 






O 






!-. 






O 






•^ 






CO 






!M 






".o 






c 






0^ 










CO 






a . 


d 
ca 


t^ CO 


CO 

g 
p 


r^ 00 
OO O 
CO t^ 

1-H 




!h2 

O o 

S « 


1 


Oi OO 
CO lO 

1— 1 T-C 


ca 
u 

P 


CO 00 

Oi O 

c^ cq 




J 

^2 




w^ CO 


CO 

p 


(M t^ 


.4 
<J . 

« 2 

W S 
O 


d 


fcO CO 

CO "^ 


CO 

P 


CO CO 
CO (M 
CO 00 


J a 


d 


.-1 »ft 

CD CO 


GO 

P 


iO O 

Oi CD 
O CO 


a 
a 

m 

H 

B 
ft 
P 


d 


CO 05 




05 Oi 
OO ■•-I 

o c^ 

CO CO 


2m 

p. 

go 

1^ 


l-H 


t^ OO 

d ^ 


P 






tc 

a 
a 




CO o 

d d 


d 

Q 


C3S CO 


Total 
Popula- 
tions. 


Oi -^ 
CO UT> 

OO T-i_ 

o »-^ 
OO C<J 

OO o 

»— 1 1-H 


P 


i 


2 g" 

1 1 
1-1 CD 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 241 






Ci 






o 

* ^— 

e 

• »-^ 

a:; 



00 












CO 










d 


-^ 


lO 


CI 






CO 


CI 


C5 




Q . 


03 












p:^ 










00 


CO 


o 


o 




^ 






CO 






^ 


c^ 


oo 






o 


o 


t^ 






Q 




»— 1 








o 
-.-> 


OS 

oo 




CO 




1 


c^ 


CO 






« 






'-' 




O o 






















S K 


09 


t— 


»o 


M 




J H 


Ji 


'^ 


CO 


r^ 






Q 


o 


CO 

i 






s 


1 


1 


I 


1 




e £ 












O J 


^v* 










i" 


1 




















H «« 


03 


1 


1 


1 




S 2 


.c 










-4^ 

C8 










o 


Ol 










Pi 


p 










.J 












•< . 


o 


1 


1 


) 




z ss 


-*^ 










K 5 


(§ 










;» 

Ji 


1 


t 


1 




H a 














C3 










U 


p 














iM 




00 






ei 




1 








-t^ 


■^t* 




Ol 




H 


7i 










H « 


r^ 






















jj 


^ 


1 


CO 




^fe 


^ 


Tt- 




oo 




■^ 






CO 






C3 












o 


CO 




ci" 






p 














Ift 


00 


t^ 




^ 


s 


CO 


CO 


■^ 






03 










« 










X 














to 

J3 


CO 

40 


s 


U5 




-M 


•ef 


<M 


lO 






C3 

P 










Q 


C^ 


^ 


cf 






o 


-^ 


00 


lO 









o 


CO 


Ifi 




2k 










rt 










a. 












O s 






















O o 


OQ 


t^ 


oo 


•^ 




1" 


jS 


CO 


c^ 






■s 


CO 


r^ 


t>- 




o 


t-^ 


CO 


•^ 






p 




^ 










CO 


00 


Ci 






■«*« 


o 


CO 




73 


s 










a 


« 










J 












2 






















a 


03 


1/3 


CO 


CO 




x: 


■^ 


o 


cs 




S 




r* 


oo 


w 






o 


00 


CO 






P 


^^ 












"^' 


^ 


e«» 










o 


c^ 




CO j;,-^ 


o 


oo 


oo 




0. 




o 


CO 


■*?• 




r^P 


o 


oo 


*^ 




HH 


c 


»o 




irs 








t^ 


oo 


oo 










































;^ 












;h 














^ 


. 


_ 








t^ 


00 






















Cs 


Ci 


^; 








— . 


— • 


■^ 



o 

a 

C3 






CO 

o 

-.^ 

p 
u 



242 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 14. — Case, Death and Fatality Rates for Lobar Pneumonia and Influenza, 

1918-1920, inclusive. 





Popula- 

lation 

based on 

State and 

Federal 
Censuses. 


LoBAH Pneumonia. 1 


Influenza. 2 


Year. 


Cases. 


Cases 

per 

100,000. 


Deaths. 


Deaths 

per 
100,000. 


Fa- 
tality 
Rates. 


Cases. 


Cases 

per 
100,000. 


Deaths. 


Deaths 

per 
100,000. 


Fa- 
tality 
Rates. 


1 


2 


3 


4 


5 


6 


7 


8 


9 


10 


11 


12 


1918, 


3,804,231 


13,374 


351.5 


10,339 


271.7 


77.5 


145,262 


3,818.4 


13,783 


362.3 


9.5 


1919, 


3,836,664 


4,585 


119.5 


2,508 


05,5 


54.7. 


40,417 


1,053.4 


3,052 


79.5 


7.5 


1920, 


3,869,098 


5,558 


143.6 


2,781 


71.9 


50.0 


36,312 


938.5 


1,700 


43.9 


4.7 



I Made reportable in 1917. 



2 Made reportable in 1918. 



Table 15. — Case, Death and Fatality Rates for Go7iorrhea and Syphilis, 1918- 











1920 


, inclusive. 














Popula- 




Gonorrhea. 1 




Syphilis. 1 




tion 

based on 

State and 

Federal 

Censuses. 






1 








Year. 


Cases. 


Cases 

per 

100,000. 


Deaths. 


Deaths 

per 
100,000. 


Fa- 
tality 
Rates. 


Cases. 


Cases 

per 

100,000. 


Deaths. 


Deaths 

per 
100,000. 


Fa- 
tality 
Rates. 


1 


2 


1 
3 


4 


5 


6 


7 


8 


9 


10 


11 


12 


1918, . 


3,804,231 


7,681 


201.9 


6 


2 


.08 


3,284 


86.3 


280 


7.4 


8.5 


1919, . 


3,836,664 


9,435 


245.9 


8 


2 


.08 


4,127 


107.5 


281 


7.3 


6.8 


1920, . 


3,869,098 


7,225 


186.7 


4 


.1 


.05 


2,987 


77.2 


225 


5.8. 


7.5 



I Made reportable in 1918. 



No. 



34.] 



DIVISION OF COMMUNICABLE DISEASES. 



243 



■■—I 

I 






c 

CO 









to 

CO 



n 

< 





to 






























1 


o 




no 


"0 


'I' 




-.^ 




















<! 


cs 






















c- 




















< 


Q 








































< 
















oo 




C-l 


S 












Ci 


t^ 


00 


t- 




o 






















a: 






















J= 


1 










CI 




1 






-*^ 






















a 








































a< 






















M 




M 


■^ 


<N 


1— 1 


o\ 


o 


CO 


CO 


CO 


l-l 


d 






















CO 






















j= 




1 


CI 


CO 


(M 


I 


*-H 


1 


1 


tfl 






















a 
z 


Q 




















. 




















>3 

o 


6 


1— t 


( 


CJ 

CO 


CO 


CI 


1 


CI 


1 


1 




M 






















J3 








1 








00 






-*^ 




















•z. f 


« 




















S3 


5 





























































H la 


QO 


1 


1 


1 


1 


o 


.^ 


o 


o 


■* 


'^% 










o 


o 




C^l 


CO 










»o 


»o 




'^ 






o 














fcO 


a> 






di 




















>- 


















>n 


05 


-.-> 










o 


oo 


CO 


t~ 




« 


jj 




















Ed 
























Q 








































H 






















CC 


S 


1 


1 


1 


1 


OS 


oa 


o 


m 


CO 


>< 










CO 






t^ 


«M 


P 


a 










CI 












QQ 




















. 


j3 

C3 


1 


' 


1 


1 


lO 


I 


' 


' 


1 


<! a 


<a 




















w" 


Q 








































" 
























^ 






1 


1 






?o 


o 


•^« 










r* 


CI 


e-j 


C) 


•o 


a 






















c» 




















k' 




1 


1 


(N 


CO 


lO 


iO 


o 


00 


U3 


o 
















IM 






p^ 


t 






















o 










































C3 






(M 


<o 


CI 


d 


o 




5S 




I> 




OS 










■?! 


W3 


lO 


oo 


00 


»f5 




CJ 


■^ 




3 


<M 


CO 


CO 


"* 


»o 


"»f 


t^ 


■^ 


o 


o 


o 






















« 






















^ 




w 


CO 


«— 1 


■^ 


l« 


f-l 


t~ 


t-H 
























K 


0! 




















IS 


s 








































en 

o 


O 


.-» 


oo 


00 


_, 


_ 


■^ 


CO 


00 




'-' 






*-• 


CO 


U5 




'^ 




















(Q 


s 




















s 


I 


1 


CO 


<N 


■^ 


1 


CO 


1 


1 


o 


C3 




















o 


(U 




















o 


Q 










































03 


tC 


•"" 


CO 


■* 


oo 


-* 


-* 


'"' 


CO 


o 






















pi 


• 


• 


• 


' 


• 


• 


• 


• 






-«J 




• 




• 


• 


• 


. 




























K 


*-H 


ci" 


CO 


■^ 


lO 


CO 


1^ 


00 


as 




























<7> 


Ol 






ca 


Oi 


o 




o» 



oo 



"(T-i ^^ 






lO 


*n 


CI 

00 


o 




« 


CO 


(M 


CO 




•-C 1 


.-1 1 




rt 1 


.-4 






s 


CO 
CJ 


03 


CO 




1 1 


CO 


CO 




U5 


*H 


1 

V 






CO 


•S' 


1— t 


t>. 




1 -H 


■* 


CO 


05 

OS 

1 

.-1 


o 

OS 



244 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



OJ 



o 
O 















03 






o 









CO 
H 






o 

Q 



o 



1 1 .- ^ 1 1 I rt I 



I C-1 1(5 I I I IM 






C3 

Q 



O 



I M ■»> M 1 " =^ 1 I 



I O ^ »0 I •.** CO L'S M 



o 

S 






S 

M 






< 
a 



«i s 



a: <; 
? o 



•s. 

P 



o 



I I I I I I I I I 






C3 

o 

Q 



o 



t>-r^fooocc^^»ofOC'i 









(M — I I O I O I c^ 






0) 

Q 



o 



o 

Q 



o 



c^^ ^^ ^H 



a 
o 

o 



o 



C3 

Q 



U 



^-i ^- (M 



r-H C<» 1— ^H 



a 





1 


1 
1 




1 








1?) 1 




o 


in 




C<I 


r^ 




r- 


OO 




00 






c^ 


c^ 




00 


m 




CI 


TA 




» 


- 


cc 






i" 












•^ 














m 


N 


t*. 












CI 








'r^ 


o 


05 


* 








w 


OS 






o 




IM 








■<** 




(M 






OO 


o 




(M 






(N 


00 






OO 




C5 


o 










" 


^ 




>o 


e 




t^ 


C<l 




o 


•^o 




^J* 


o 










CO 


o 










05 












o 












,.^ 


o 










C5 


o 









No. 34.] DIVISION OF COMMUNICABLE DISEASES. 245 



Cases axd Deaths from Diseases Daxgerous to the Public- 
Health, 1920. 

Index to Line Numbers in the Table of Cases and Deaths from Diseases 
Dangerous to the Public Health, 1920. 



Abington, 


, 




114 


Charlemont, . 


291 


Gardner, 


45 


Acton, . 




197 


Charlton, 


189 


Gay Head, . 


. 359 


Acushnet, 






161 


Chatham, 


225 


Georgetown, . 


. 199 


Adams, 






62 


Chelmsford, . 


119 


Gill, 


. 289 


Agawam, 






115 


Chblse.^, 


19 


Gloucester, 


. 36 


Alford, . 






355 


Cheshire, 


239 


Goshen, 


. 348 


Amesbury, 






97 


Chester, 


262 


Gosnold, 


. 361 


Amherst, 






112 


Chesterfield, . 


317 


Grafton, 


. 100 


Andover, 






82 


Chicopee, 


31 


Granby, 


. 296 


Arlington, 






44 


Chilniark, 


349 


Granville, 


. 302 


Ashburnhani, 






206 


Clarksburg, . 


284 


Great Barrington, 


. 93 


Ashby, . 






290 


Clinton, 


63 


Greenfield, 


55 


Ashfield, 






283 


Cohasset, 


163 


Greenwich, 


. 335 


Ashland, 






191 


Colrain, 


211 


Groton, 


. 183 


Athol, . 






70 


Concord, 


98 


Groveland, 


. 184 


Attleboro, 






41 


Conway, 


273 






Auburn, 






136 


Cummington, 


310 


Hadley, 


. 152 


Avon, . 






193 






Halifax, 


. 306 


Ayer, 






175 


Dalton, 
Dana, . 


137 
311 


Hamilton, 
Hampden, 
Hancock, 


. 205 
. 308 
. 319 


Barastable, . .120 


Danvers, 


64 


Hanover, 


. 164 


Barre, . 






139 


Dartmouth, . 


107 


Hanson, 


. 228 


Beeket. 






287 


Dedham, 


65 


Hardwick, 


. 145 


Bedford, 






244 


Deerfield, 


154 


Harvard, 


. 276 


Belchertown, 






201 


Dennis, 


231 


Harwich, 


. 194 


Bellingham. 






195 


Dighton, 


174 


Hatfield, 


. 1.53 


Belmont , 






72 


Douglas, 


196 


H.WERHILL, . 


. IS 


Berkley, 






288 


Dover, . 


274 


Hawley, 
Heath, . 


. 332 


Berlin, . 






301 


Dracut , 


129 


. 334 


Bernardston, 






299 


Dudley, 


131 


Hingharn, 


. 116 


Beverly, 






34 


Dunstable, 


347 


Hinsrlfile 


25.5 


Billerica, 






142 


Duxbury, 


198 


Holbrook, 


. 162 


Blackstone, 






143 






Holden, 


. 167 


Blandford, 






324 


East Bridgewater, . 


1.38 , 


Holland, 


. 360 


Bolton, 






304 


East Longmeadow, 


192 


HoUiston, 


. 169 


Boston-, 






3 


Eastham, 


318 


HOLYOKE, 


17 


Bourne, 






168 


Easthampton, 


68 


Hopedale, 


. 159 


Boxborough, 






343 


Easton, 


126 


Hopkinton, . 


. 185 


Boxford, 






307 


Edgartown, . 


259 


Hubbardston, 


. 281 


Boylston, 






. 297 


Egremont, 


316 


Hudson, 


. 102 


Braintree, 






73 


Enfield, 


305 


Hull, . 


. 187 


Brewster, 






. 292 


Erving, 


275 


Huntington, . 


. 257 


Bridge water. 






69 


Essex, . 


227 






Brimfield, 






. 285 


Everett, 


26 


Ipswich, 


. 101 


Brockton, 






. 16 










Brookfield, 






. 213 


Fairhaven, 


. 92 


Kingston, 


. 176 


Brookline, 






. 28 


F.\i.L River, 


7 






Buckland, 






. 240 


Falmouth, 


. 128 


Lakevillc, 


. 220 


Burlington, . . . 295 


FiTCHBURG, . 


. 27 


Lancaster, 


. 178 




Florida, 


. 328 


Lanesborough, 


. 270 


Cambridge, ... 9 


Foxbnrough, . 


. 146 


L.\.WREXCE, . 


. 15 


Canton, . . .103 


Framingham, 


. 43 


Lee, 


. 127 


Carlisle. . . .333 


Franklin, 


. 94 


Leicester, 


. 150 


Carver, 






. 226 


Freetown, 


. 219 


Lenox, . 


. 149 



246 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Leominster, 


. 47 


Northboroug 


h, . . 216 


Shutesburj^ 






. 346 


Leverett, 


. 300 


Northbridge, 


. 77 


Somerset, 




. 140 


Lexington, 


. 109 


Northfield, 


. 210 


Somerville, . 




. 14 


Leyden, 


. 338 


Norton, 


. 180 


South Hadley, 




. 118 


Lincoln, 


. 251 


Nor well. 


. 229 


Southampton, 




. 282 


Littleton, 


. 272 


Norwood, 


. 58 


Southborough, 




. 202 


Longmeadow, 


. 215 






Southbridge, . 




51 


Lowell, 


. 11 


Oak Bluffs, 


. 245 


Southwick, 






. 230 


Ludlow, 


. 90 


Oakham, 


. 325 


Spencer, 






. 124 


Lunenburg, . 


. 223 


Orange, 


. 117 


Springfield, 






8 


Lynx, . 


. 12 


Orleans, 


. 267 


Sterling, 






. 2.52 


Lynnfield, 


. 261 


Otis, 


. 337 


Stockbridge, 






. 217 






Oxford, 


. 148 


Stoneham, 






. 85 


Malden, 


. 20 






Stoughton, 






. 89 


Manchester, . 
Mansfield, . 
iVIarblehead, . 


. 156 
. 106 
. 86 


Palmer, 
Paxton, 


. 74 
. 323 


Stow, . 

Sturbridge, 

Sudbury, 






. 278 
. 266 
. 264 


Marion, 


. 243 


Peabody, 
Pelham, 


39 
. 322 


Sunderland, 






. 242 


Marlborough, 


. 50 


Sutton, 






182 


Marshfield, . 
Mashpee, 


. 232 
. 356 


Pembroke, 

Pepperell, 

Peru, . 

Petersham, 

Phillips ton, 

Pittsfield, 

Plainfield, 

Plain\'ille, 

Plymouth, 

Plympton, 

Prescott, 

Princeton, 

Provincetown 


. 260 
. 166 
. 362 
. 309 
. 339 
. 23 
. 341 
. 253 
. 59 
. 314 
. 351 
. 303 
. 135 


Swampscott, 
Swansea, 






. S3 
. 157 


IVIattapoisett, 

IMaynard, 

Medfield, 

Medford, 

Medway, 

Melrose, 

Mendon, 

Merriinac, 

Methuen, 

Middleborough, 

Middlefield, . 


. 248 
. 96 
. 141 
. 29 
. 165 
. 46 
. 286 
. 208 
. 49 
. 80 
. 350 


Taunton, 

Templeton, 

Tewksbury, 

Tisbury, 

Tolland, 

Topsfield, 

Townsend, 

Truro, . 

TyngsborougV 

Tyringham, 


1, 




. 30 
. 132 
. 99 
. 250 
. 358 
. 277 
. 218 
. 312 
280 
. 353 


Middleton, . 


. 246 








Milford, 


. 56 


Quincy, 


. 22 




Millbury, 


. 113 






Upton 207 


Millis, . 


. 247 


Randolph, 


. 122 


Uxbridge, . . .123 


Millville, 


. 204 


Raynham, 


. 214 




Milton, 


. 79 


Reading, 


. 87 


Wakefield, ... 57 


Monroe, 


. 340 


Rehoboth, 


. 188 


Wales, . 






345 


IMonson, 


. 121 


Revere, 


. 33 


Walpole, 






111 


Montague, 


. 81 


Richmond, 


. 327 


W.^LTHAM, 






32 


Monterey, 


. 344 


Rochester, 


. 271 


Ware, . 






76 


Montgomery, 


. 357 


Rockland, 


. 95 


Wareham, 






108 


Mount Washington 


. 364 


Rockport, 


. 130 


Warren, 






133 






Rowe, . 


. 336 


Warwick, 






326 


Nahant, 


. 235 


Rowley, 


. 236 


Washington, 






352 


Nantucket, . 


. 151 


Royalston, 


. 293 


Watertown, . 






42 


Natick, 


. 67 


Russell, 


. 268 


Wayland, 






221 


Needham, 


. 84 


Rutland, 


. 203 


Webster, 






60 


New Ashford, 


. 363 






Wcllesley, 






91 


New Bedford, 


. 10 


Salem, 


. 25 


Wellfleet, 






298 


New Braintree, 


. 330 


Salisbury, 


. 224 


Wendell, 






354 


New Marlborough, 


. 294 


Sandisfield, . 


. 320 


Wenham, 






279 


New Salem, . 


. 315 


Sandwich, 


. 263 


West Boylstor 


', 




258 


Newbury, 


. 233 


Saugus, 


. 66 


West Bridgewator, 




155 


Newburyport, 


. 52 


Savoy, . 


. 321 


West Brookfield, 




269 


Newton, 


. 24 


Scituate, 


. 170 


West Newbury, 




238 


Norfolk, 


. 237 


Seekonk, 


. 158 


West Springfield, . 




61 


North Adams, 


. 38 


Sharon, 


. 179 


West Stockbridge, . 




265 


North Andover, 


. 105 


Sheffield, 


. 212 


West Tisbury, 




329 


North Attleborough 


78 


Shelburne, 


. 249 


West borough. 




104 


North Brookfield, . 


. 173 


Sherborn, 


. 209 


Westfibld, . 




40 


North Reading, 


. 241 


Shirley, 


. 190 


Westford, 




171 


Northampton, 


. 37 


Shrewsbury, . 


. 144 


Westhampton, 






331 



No. 34.] DIVISION OF COMMUNICABLE 



Westminster, 


222 


Weston, 


181 


Westport, 


147 


West wood. 


234 


Weymouth, . 


54 


Whately, 


256 


Whitman, 


88 



Wilbrahani, . 

Williamsburg, 

Williamstown, 

Wilmington, . 

Winchendon, 

Winchester, . 

Windsor, 



177 
200 
134 
172 
110 
71 
342 



DISEASES. 


247 


Winthrop, 


. 53 


WOBURX, 


. 48 


Worcester, . 


5 


Worthington, 


. 313 


Wrentham, . 


. 160 


Yarmouth, 


. 254 



24S 



DEPARTINIEXT OF PUBLIC HEALTH. [Pub. Doc. 



Cases and Deaths from Diseases Dangerovs 









63A 


19A 


9 




61A 


19B 


10 






Popu- 
lation 


An- 
terior 
Polio- 


Chicken 


Diph- 


Ep. 
Cere- 
bro- 


Ger- 
man 


In- 






esti- 
mated 
as of 


Pox. 


theria. 


.spinal 


Mea- 


fluenza. 




Cities axd Towns grouped 


mye- 
litis. 








Menin- 


sles. 






IN- Order of Population. 








gitis. 










July 1, 


























o 




1920. 




w 




cn 




m 




n 




CO 




cc 








+3 
a 






en 


c3 




.a 

cS 


i 


5* 






c 






C3 





C3 





C! 


« 


C5 


a 


C3 





M 


QJ 


3 






a 


fi 





p 





Q 





Q 





p 





P 


1 


Massachusetts, .... 


4,062,942 


696 


140 


5355 


11 


7513 


595 


182 


129 


484 


- 


36312 


1700 


2 


Cities over 500,000. 




























3 


Boston, 


823,413 


191 


48 


1052 


- 


1773 


140 


36 


33 


107 


- 


8417 


473 


4 


Cities over 150,000. 




























5 


Worcester 


180,103 


5 


- 


154 


1 


240 


14 


4 1 3 


16 


- 


1602 


83 


6 


Cities, 100,000-150,000. 


696.382 


77 


21 


1050 


2 


im 


144 


54 39 


65 


- 


5949 


254 


7 


Fall River 


1.30,515 


4 


_ 


82 


1 


284 


40 


8 10 


7 


- 


623 


33 


8 


New Bedford, 








123,022 


_ 


_ 


77 


- 


210 


32 


13 7 


2 


- 


758 


38 


9 


Springfield, 








117,601 


4 


2 


186 


- 


141 


17 


6 


6 


25 


- 


560 


60 


10 


Cambridge, 








112,973 


29 


7 


568 


1 


228 


6 


6 


4 


22 


- 


1776 


39 


11 


Lowell, 








109,7.33 


14 


6 


72 


- 


266 


21 


11 


7 


- 


- 


1236 


36 


12 


Lynn, 








102,538 


26 


6 


65 


— 


315 


28 


10 


5 


9 


— 


996 


48 


13 


Cities, 50,000-100,000. 


487,077 


88 


18 


367 


4 


960 


91 


17 


8 


63 


- 


4609 


177 


14 


Somerville, . . . . 


96,874 


19 


5 


61 


— 


121 


22 


2 


1 


10 


- 


1068 


30 


15 


Lawrence, . 








94,806 


12 


2 


65 


1 


145 


22 


6 


2 


2 


- 


354 


28 


16 


Brockton, . 








67.902 


12 


1 


73 


1 


109 


7 


3 


2 


3 


- 


149 


19 


17 


Holyoke. . 








64,030 


_ 


_ 


15 


1 


45 


6 


- 


- 


4 


- 


136 


7 


18 


Haverhill, . 








55,007 


25 


9 


67 


- 


247 


10 


3 


1 


37 


- 


1390 


43 


19 


Chelsea, 








54,858 


11 


_ 


54 


1 


117 


4 


- 


2 


6 


- 


459 


23 


20 


Maiden, 








53,600 


9 


1 


32 


— 


176 


20 


3 


~ 


1 


— 


1053 


27 


21 


Cities and Towns, 25,000- 
50,000. 


513,i53 


123 


14 


831 


- 


1190 


75 


23 


14 


49 


- 


3789 


205 


22 


Quincy 


49,039' 


12 


_ 


70 


- 


169 


4 


6 


1 


2 


- 


251 


21 


23 


Pittsfield, . 








47,404 


5 


- 


80 


- 


28 


- 


3 


2 


5 


- 


465 


28 


24 


Newton, 








46,556 


15 


2 


185 


- 


96 


6 


1 


- 


8 


- 


396 


14 


25 


Salem, 








43,502 


7 


- 


68 


- 


188 


12 


5 


5 


2 


- 


67 


14 


26 


Everett, 








42,129 


8 


1 


94 


- 


167 


10 


- 


- 


3 


- 


405 


8 


27 


Fitchburg, 








41,562 


5 


2 


36 


- 


52 


5 


- 


- 


3 


- 


321 


12 


28 


Brookline, . 








39,427 


9 


- 


126 


- 


36 


1 


1 


- 


7 


- 


227 


14 


29 


Med ford, . 








38,174 


13 


1 


25 


- 


60 


1 


- 


- 


2 


- 


223 


15 


30 


Taunton, . 








38,141 


5 


3 


5 


- 


51 


4 


2 


2 


2 


- 


227 


22 


31 


Chicopee, . 








35,071 


_ 


- 


4 


- 


137 


M 


3 


1 


10 


- 


27 


21 


32 


Waltham, . 








32,571 


28 


3 


117 


- 


89 


11 


1 


2 


4 


- 


914 


17 


33 


Revere, 








32,427 


9 


1 


- 


- 


102 


5 


2 


- 


- 


- 


94 


8 


34 


Beverly, 








27,449 


7 


1 


21 


— 


15 


1 


1 


1 


1 


~ 


172 


11 


35 


Cities and Towns, 10,000- 
25,000. 


610.1 S3 


103 


18 


861 


- 


936 


62 


28 


13 


80 


- 


4947 


236 


30 


Gloucester, . . . . 


24,561 


4 


1 


10 


- 


76 


8 


- 


1 


- 


- 


75 


8 


37 


Northampton, 








23,971 


2 


- 


14 


- 


62 


6 


- 


- 


7 


- 


129 


5 


38 


North Adams, 








22,051 


- 


- 


9 


- 


23 


2 


2 


1 


- 


- 


282 


15 


39 


Peabody, . 








21,651 


3 


- 


17 


- 


42 


3 


2 


1 


4 


- 


191 


9 


40 


VVestfield, . 








20,875 


- 


- 


43 


- 


30 


3 


1 


- 


- 


- 


158 


4 


41 


Attleboro, . 








20,839 


- 


- 


8 


- 


41 


2 


2 


2 


3 


- 


215 


11 


42 


Watertown, 








20.307 


1 


- 


114 


- 


33 


1 


2 


1 


2 


- 


119 


5 


43 


Frainingham, 








18,892 


8 


" 


36 




6 


1 


2 


_ 


" 




181 


10 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 249 



to the Public Health, 1920. 



92 



Ix)bar 
Pneu- 
monia. 



O 



Measles. 



3 

o 



5558 2781 32141 



1518 



661 



344 173 



lOSJfi 41i 



210 
79 
231 
247 
175 
142 



54 
28 
72 
78 



6450 



la; 



iio6 



507 
420 
1138 
914 
961 1360 
83 117 



664 326 

153i 69 

1081 61 

82! 57 

17i 46 

156 43 

86; 21 

52; 29 

i 

I 

633\ 362 



52 
58 
S8{ 

"'I 
62 

69 
471 
331 
35 



6 
31 



796 



8 
28 
24 
31 
35 
13 

3:; 

19 



30 
34 
44 
28 
33 
20 
18 
29 
49 
16 
28 
15 
18 



380 



17 
11 
11 
16 
17 
5 
11 
13 



19C 



Mumps, 



347 5962 6 



66 



4385 

688 
651 
697 
454 
1007 
432 
460 



5m 



154 
449 
2001 
360 
414 
549 
623 
302 
106 
77 
355 

14 



11-2 

18 
23 
11 
14 
44 
2 



n 



5439 



108 
129 
178 
79 
39 
167 
306 
215 



u 



1280 



425 



945 

13 

7 

156 
595 

24 

79 



407 

89 
30 
59 

149 
47 
33 



1032 



4 

10 
276 

67 
136 

31 
241 

62 

23 
1 

48 

110 



756 



38A 

Oph- 
thalmia 
Neona- 
torum. 



Scarlet 
Fever. 



C3 



1638 



476 



202 



524 

140 
174 
74 
44 
79 
13 



197 

28 
14 
53 
12 
21 
58 
11 



11 
4 
2 
4 
5 
6 

13 
2 
1 



95 



28-29 

Tuber- 
culosis, 
Pulmo- 
nary. 



O 



10260 



1874 



976 



1984 

138 
308 
458 
287 
227 
566 



995 

207 
244 
118 
108 
84 
104 
130 



1070 



165 
56 

143 

103 
80 
18 
81 

112 
92 
58 
63 
51 
48 



1566 



95 
35 
7 
64 
16 
71 
57 
63 



215 6696 



70 



22 



40 

4 
2 
22 
4 
2 



17 



3743 800 639 935 



2005 



328 



130', 

215 
334 
185 
208 
199 
166 



762 

142 
179 

94 

73 
109 

9' 

68 



669 



66 
89 
43 
50 
64 
62 
40 
45 



30-35 

Tuber- 
culosis, 
Other 
Forms. 



Ty- 
phoid 
Fever. 



816 



169 



626 

108 

127 

81 

133 



237 



33 



197 

31 
48 
21 
27 



85! 44 
92 26 



64 
104 
38 
66 
54 
33 
30 



368 



26 
38 
20 
40 
25 
49 
18 
20 



86 60 

36: 34 

40! 18 

23 11 
25 



879 



33 



74 



135 



39 



131 

18 
30 
22 
12 
35 
14 



67 



11 

7 
5 
6 
8 
6 
4 
4 
4 
10 
8 
1 



85 



21 



36 45! 1 



30 

31 
30 1 



33 31 

27t 7 
29! 9 



119 



21 



118 
50 
16 
18 
27 
19 



m 

16 
55 

13 

8 

14 

28 



111 



146 



Whoop- 
ing 
Cough. 



38C 



Gonor- 
rhea. 



O 



96 9994 542 7225 



11 



31 



2551 



127 



1790 

94 
70 
413 
884 
193 
136 



1238 

213 

347 

340 

38 

99 

56 

145 



1192 



122 
19 

357 
97 

131 
13 

131 
24 
43 
35 

195 

25 



1497 



30 
54 
1 

6 
121 

2 

85 
171 



155 



11 



103 

14 
13 
18 
24 
22 
12 



74 



61 



37 



Syphi- 
lis. 



03 

o 



o 



1 

4 2987 225 



3042 



366 



146: 

209 
182 
403 
195 
302 
176 



651 



139 
69 
78 

185 
66 
2, 



613 



43 
62 
30 
56 
41 
67 
24 
21 
125 
16 
30 
79 
19 



49i 



9 

16 
46 
22 
13 
20 
26 

9 



1183 



246 



67 

56 
245 

57 
130 

69 



244 

25 
95 
44 
15 
43 
12 
10 



213 



17 
13 

5 
27 

8 
27 
12 

3 
56 

6 
12 
12 
15 



304 



10 
11 

7 
20 

9 
15 

3 

4 



67 



20 



15 



32 



18 



12 



8 

9 

10 

11 

12 



13 

14 
15 
16 
17 
18 
19 
20 



21 



22 
23 
24 
25 
26 
27 
28 
29 
30 
31 
32 
33 
34 



35 



36 
37 
38 
39 
40 
41 
42 
43 



250 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Cases and Deaths from Diseases Dangerous 



o 



75 

76 
77 
78 
79 
80 
81 
82 
83 
84 
85 
86 
87 
88 
89 
90 
91 
92 
93 
94 
95 
96 
97 
98 



Cities and Towns grouped 
IN Order of Population. 



44 


Arlington, . 


45 


Gardner, . 


46 


Melrose, 


47 


Leominster, 


48 


Woburn, 


49 


Methuen, . 


50 


Marlborough, 


51 


Southbridge, 


52 


Newburyport, 


53 


Winthrop, . 


54 


Weymouth, 


55 


Greenfield, 


56 


Milford, . 


57 


Wakefield, . 


58 


Norwood, . 


59 


Plymouth, 


60 


Webster, 


61 


West Springfield 


62 


Adams, 


63 


Clinton, 


64 


Danvers, . 


65 


Dedham, . 


66 


Saugus, 


67 


Natick, 


68 


Easthampton, 


69 


Bridgewater, 


70 


Athol, 


71 


Winchester, 


72 


Belmont, . 


73 


Braintree, . 


74 


Palmer, 



100 
101 
102 
103 



Towns, 5,000-10,000. 



Ware, 

Northbridge, 

North Attleborough, 

Milton, 

Middleborough, 

Montague, . 

Andover, . 

Swampscott, 

Needham, . 

Stoneham, 

Marblehead, 

Reading, . 

Whitman, . 

Stoughton, 

Ludlow, 

Wellesley, . 

Fair haven. 

Great Barrington, 

Franklin, 

Rockland, 

Maynard, 

Amesbury, 

Concord 



99 I Tewksbury, 



Grafton, 
Ipswich, 
Hudson, 
Canton, 



Popu- 
lation 

esti- 
mated 

as of 
July 1, 

1920. 



63A 

An- 
terior 
Polio- 
mye- 
litis. 



Q 



19A 



Chicken 
Pox. 






Diph- 
theria. 



61A 

Ep. 
Cere- 
bro- 
spinal 
Menin- 
gitis. 



IS 



19B 

Ger- 
man 
Jlea- 
sles. 



10 



In- 
fluenza. 



O 



18,744 
18,121 
18,093 
17,714 
17,556 
16,673 
15,948 
15,905 
15,686 
15,493 
15,089 
14,904 
14,340 
14,214 
14,065 
13,744 
13,664 
13,542 
13,416 
13,312 
13,017 
12,876 
12,497 
12,426 
11,220 
11,146 
11,080 
10,729 
10,727 
10,672 
10,363 



3Jt2,018 

9,922 
9,718 
9,569 
9,303 
9,064 
9,029 
8,682 
8,533 
8,120 
7,905 
7,887 
7,832 
7,759 
7,675 
7,610 
7,507 
7,480 
7,356 
7,273 
7,225 
7,166 
7,137 
6.952 
6,843 
6,797 
6,788 
6,774 
6,483 



54 



H 



38 

15 

20 

36 

43 

17 

8 

6 

9 

38 

7 

91 

12 

10 

14 

8 

22 

2 

10 
15 

4 

18 

4 

2 

7 

13 
25 
70 
41 

5 



SOS 

1 

5 

27 
25 
15 
40 

1 
11 

6 



6 
44 
19 
1 
9 
3 

31 

10 

4 

3 

1 

18 



33 

7 
39 
20 
18 
59 
14 

5 
21 
18 
27 
54 

9 
33 

5 
21 
19 

7 

13 
16 
16 
23 
11 

4 
54 

5 

2 
19 
23 
12 
16 



564 

6 

2 
13 

4 

8 
25 
18 

4 
11 

7 

15 
27 

2 
32 

3 
43 
11 

72 
7 

14 
26 
18 
6 
4 
4 
7 
3 



46 // 



1 



11 



64 



272 

68 

98 

251 

181 

152 

25 

60 

183 

210 

114 

231 

23 

27 

80 

78 

88 

56 

119 

112 

80 

52 

265 

82 

50 

23 

91 
397 
101 

28 



S969 



22 

96 

1 

155 
31 
65 

122 
42 

230 

178 
14 
63 
55 

11 

133 

10 

39 

5 

10 

9 

302 

281 

3 



15 



o 



13 

11 

11 
8 

10 
2 
6 
4 
9 
8 
3 
9 
3 
2 
2 
3 
7 
6 
5 
5 
4 
4 
6 
5 
2 
3 
3 
2 
4 
2 
7 



105 



1 
5 
5 
4 
8 
2 
8 
2 
1 
4 
1 
2 
3 

6 

2 

3 
1 

3 

4 



No. 34.] DIVISION OF COMINIUNICABLE DISEASES. 251 



to the Pxihlic Health, 1920 — Continued. 



92 


6 


: 19C 38A 

1 1 1 


7 




28-29 30-35 


] 




8 


38 C 


37 




Lobar 
Pneu- 
monia. 


Measles. 


Mumps. 


Oph- 
thalmia 
Neona- 
torum. 


Scarlet 
Fever. 


Tuber- 
culosis, 
Pulmo- 
nary. 


Tuber- 
culosis, 
Other 
Forms. 


Ty- 
phoid 
Fever. 


Whoop- 
ing 
Cough. 


Gonor- 
rhea. 


Syphi- 
lis. 






Cfi 


00 




1 

QQ 




OQ 




n 




CO 


oa 




00 


CO 




n 




to 


6 

Z 

o 

c 


6 


1 i 


■Si 


03 


J3 

cm 


CO 


J3 


w 


.S 


to 




m 




CO 


O 


i 1 


ca 


at 


i 

cj 


1 


Q O 


Q 


O 


p 


O 


P 


O 


a 


U 


P 


o 


P 


O 


P 


O P 


O 


P 


o 


p 


^ 


16 


10 


229 


1 


53 




1 




109 




36 


9 


2 


8 


5 


2 


56 


1 


8 


_ 


5 


1 


44 


23 


16 


121 


2 


2 


_ 


3 


- 


34 


- 


58 


23 


8 


8 


4 


- 


1 


- 


11 


- 


4 


1 


45 


17 


9 


364 


2 


20 


- 


24 


- 


41 


- 


16 


7 


5 


5 


3 


- 


40 


1 


12 


- 


2 


- 


46 


33 


9 


32 




2 


_ 


_ 


_ 


42 


1 


55 


4 


5 


2 


3 


1 


12 


2 


44 


- 


7 


- 


47 


44 


11 


96 


_ 


12 


_ 


_ 


_ 


32 


1 


22 


14 


3 


5 


4 


- 


30 


3 


19 


- 


4 


1 


48 


20 


8 


172 


3 


26 


_ 


4 


_ 


62 


1 


20 


8 


1 


1 


2 


1 


175 


4 


4 


- 


2 


- 


49 


26 


15 


49 




80 


- 


1 


_ 


43 


1 


32 


10 


5 


6 


7 


2 


8 


- 


6 


- 


6 


- 


50 


41 


10 


12 


_ 


_ 


_ 


2 


- 


6 


- 


10 


2 


2 


1 


2 


- 


4 


1 


16 


- 


9 


- 


51 


16 


11 


161 


_ 


73 


— 


1 


- 


13 


- 


13 


12 


1 


1 


1 


1 


36 


4 


9 


- 


1 


- 


52 


36 


4 


283 


1 144 


_ 


- 


- 


78 


- 


13 


5 


- 


- 


1 


- 


100 


2 


10 


- 


4 


- 


53 


19 


12 


69 


1 1 1 


- 


1 


- 


37 


- 


14 


9 


1 


2 


1 


- 


17 


3 


10 


- 


3 


- 


54 


11 


5 


304 


1 


10 


_ 


6 


- 


96 


11 


12 


1 


- 


2 


1 


- 


60 


3 


20 


- 


13 


- 


55 


13 


14 


21 


1 


_ 


_ 


- 


- 


25 


- 


29 


18 


1 


2 


1 


- 


8 


- 


5 


- 


1 


- 


56 


11 


6 


134 


3 


_ 


— 


2 


_ 


26 


1 


24 


9 


1 


2 


2 


- 


6 


1 


8 


- 


1 


- 


57 


39 


11 


46 


_ 


6 


_ 


- 


- 


27 


- 


12 


- 





1 


6 


- 


57 


5 


18 


- 


8 


- 


58 


5 


7 


211 


7 


1 


_ 


- 


- 


24 


- 


18 


6 


3 


2 


7 


- 


17 


1 


8 




2 


- 


59 


18 


6 


39 




9 


_ 


8 


- 


10 


1 


22 


14 


5 


2 


2 


- 


30 


2 


12 


- 


2 


- 


60 


23 


9 


57 


2 


18 


_ 


- 


- 


29 


_ 


5 


8 


- 


1 


7 


- 


39 


1 


14 


- 


2 


- 


61 


11 


3 


102 






— 


1 


_ 


5 


~ 


25 


10 


1 


- 


9 


2 


5 


- 


7 


^ 


2 


- 


62 


30 11 


360 


3 


_ 


_ 


5 


- 


32 




48 


21 


5 


4 


2 


- 


6 


1 


9 


_ 


1 


- 


63 


14 


14 


2 


_ 


14 


- 


2 


- 


63 


1 


30 


18 


- 


1 


4 


1 


- 


- 


6 


- 


62 


1 


64 


10 


10 


136 


1 


4 


_ 


3 


- 


30 


1 


7 


7 


- 


1 


- 


- 


27 


2 


8 


- 


3 


- 


65 


7 


6 


17 


_ 


4 


- 


4 


- 


59 


- 


6 


5 


1 


1 


3 


1 


28 


1 


3 


- 


2 


- 


66 


22 


14 


23 


_ 


7 


_ 


1 


_ 


45 


_ 


9 6 


- 


1 


1 


1 


29 


- 


8 


- 


- 


- 


67 


32 


8 


265 


3 


_ 


- 


2 


_ 


55 


3 


19 


10 


2 


- 


1 


- 


11 


- 


6 


- 


1 


- 


68 


15 


11 


254 


2 


1 


- 


- 


- 


57 


- 


15 


17 


1 


1 


2 


- 


- 


- 


9 


- 


58 


- 


69 


6 


4 


2 


_ 


27 


_ 


3 


_ 


12 


- 


6 


2 


- 


- 


1 


- 


17 


5 


14 


- 


2 


- 


70 


13 


5 


109 


_ 


63 


_ 


3 


- 


21 


- 


9 


5 


- 


1 


2 


- 


81 


1 


5 


- 


1 


- 


71 


18 


6 


352 


_ 


49 


- 


- 


- 


20 


- 


15 


5 


- 


- 


2 


- 


13 


- 


7 


- 


2 


1 


72 


8 


4 


89 


1 


5 


_ 


_ 


- 


23 


1 


16 


38 


_ 


- 


2 


- 


75 


1 


10 


- 


2 


- 


73 


9 


10 


107 






- 


- 


- 


2 


- 


14 


4 


- 


— 


2 


— 


22 


3 


5 


- 


13 


~ 


74 


267 


ZSl 


3028 


22 


463 


1 


43 


- 


98i 


9 


344 


214 


51 


55 


101 


7 


735 


25 


273 


- 


SO 


// 


75 


1 


6 


9 




1 


_ 


2 


_ 


14 


1 


2 


2 


2 


5 


- 


- 


1 


1 


7 


- 


2 


- 


76 


8 


6 


59 


1 


18 


- 


1 


- 


8 


- 


6 


4 


- 


1 


3 


- 


4 


3 


14 


- 


1 


- 


77 


1 


4 


1 


1 


2 


- 


- 


- 


2 


- 


17 


9 


- 


1 


- 


- 


- 


- 


10 


- 


1 


- 


7S 


5 


6 


269 


_ 


10 


_ 


1 


- 


31 


- 


8 


2 


- 


- 


* 


- 


64 


1 


1 


- 


- 


- 


7S 


19 


7 


265 


2 


76 


_ 


6 


- 


10 


- 


14 


3 


1 


1 


- 


- 


16 


- 


10 


- 


1 


- 


80 


3 


4 


9 


_ 


2 


_ 


6 


_ 


5 


- 


3 


4 


- 


1 


2 


1 


6 


1 


7 


- 


3 


- 


81 


_ 


_ 


25 


_ 


17 


_ 


- 


- 


15 


- 


12 


1 


3 


1 


2 


- 


18 


1 


5 


- 


- 


- 


82 


14 


2 


40 


_ 


7 


— 


3 


_ 


40 


_ 


3 


_ 


- 


- 


3 


- 


6 


1 


6 


- 


1 


- 


83 


7 


11 


37 


_ 


15 


- 


1 


- 


19 


- 


6 


3 


- 


1 


3 


- 


12 


- 


5 


- 


4 


1 


84 


3 


8 


7 


1 


1 


_ 


_ 


_ 


8 


_ 


4 


3 


- 


1 


3 


- 


3 


- 


4 


- 


1 


- 


85 


1 


1 


4 


_ 


1 


_ 


- 


- 


24 


1 


4 


2 


- 


2 


1 


1 


4 


- 


9 


- 


- 


- 


86 


4 


3 


54 


_ 


2 


_ 


_ 


_ 


13 


_ 


7 


5 


- 


4 


- 


- 


- 


1 


6 


- 


- 


- 


87 


7 


4 


137 


_ 


_ 


_ 


- 


- 


8 


- 


5 


5 


2 


- 


- 


- 


29 


1 


4 


- 


1 


- 


88 




9 


130 


1 


_ 


_ 


_ 


_ 


8 


- 


6 


1 


2 


1 


1 


- 


11 


- 


1 


- 


- 


1 


8c 


4 


4 


61 


4 


3 


_ 


3 


_ 


17 


- 


10 


7 


- 


- 


1 


- 


- 


, - 


- 


- 


- 


- 


90 


13 


2 


84 


_ 


19 


- 


- 


- 


46 


- 


5 


3 


- 


- 


1 


- 


102 


- 


3 


- 


- 


- 


91 


2 


6 


33 


3 


19 


_ 


5 


_ 


173 


- 


12 


6 


1 


1 


4 


- 


6 


- 


- 


- 


- 


- 


92 


24 


11 


15 




5 


_ 


_ 


_ 


22 


_ 


3 


3 


- 


1 


1 


- 


24 


1 


12 


- 


- 


1 


93 


17 


7 


75 


1 


22 


_ 


_ 


_ 


27 


- 


5 


6 


- 


- 


- 


- 


- 


- 


9 


- 


1 


- 


94 


11 


8 


188 


- 


1 


- 


2 


- 


11 


- 


15 


8 


- 


1 


- 


- 


3 


- 


7 


- 


1 


- 


95 




1 


40 


1 


_ 


_ 


_ 


_ 


11 


1 


11 


8 


3 


1 


- 


- 


6 


- 


3 


- 


- 


- 


9e 


14 


4 


167 


1 


28 


_ 


2 


_ 


26 


1 


12 


5 


1 


2 


2 


- 


15 


- 


18 


- 


1 


1 


97 


10 


5 


42 


1 


12 


_ 


1 


- 


49 


- 


8 


4 


1 


- 


1 


- 


5 


- 


44 


- 


12 


1 


98 


1 


2 


3 


- 


_ 


- 


_ 


- 


13 


- 


2 


1 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


9{ 




8 


6 


_ 


— 


_ 


_ 


- 


3 


- 


9 


22 


- 


3 


1 


- 


- 


- 


1 


- 


- 


2 ]10t 


_ 


1 


3 


_ 


1 


— 


_ 


_ 


18 


1 


9 


2 


- 


1 


33 


2 


38 


1 


4 


- 


1 


- 


101 


_ 


6 


10 


_ 




_ 


_ 


_ 


4 


_ 


14 


10 


1 


1 


- 


- 


- 


2 


17 


- 


1 


- 


102 


3 


2 


269 


1 


16 


- 


- 


— 


13 


— 


11 


3 


22 


8 


1 


— 


3 


~ 


2 


" 


4 




103 



252 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Cases and Deaths from Diseases Dangerous 









63A 


19A 


9 




61A 19B 


1( 


» 






Popu- 
lation 


An- 
terior 
Polio- 


Chicken 


Diph- 


Ep. 

Cere- Ger- 
bro- 1 man 


In- 






esti- 


Pox. 


theria. 


spinal Mea- 


fluenza. 




Cities and Towns grouped 


mated 


mye- 
litis. 








Menin- 


sles. 








IN Order of Population. 


as of 
July 1, 








gitis. 




































o 

12; 




1920. 




(n 




en 




aa 




VI 




CO 




n 






rrt 


J3 


oa 


j: 


oi 


-a 


CO 


A 


M 




GO 


43 












s 




® 


.4^ 


02 




i 


■♦J 

2? 


% 


.«-> 
S 






ca 


li 


03 


<s> 


53 


s 


03 


& 


C3 


S. 


03 


O 


'^ 






O 


D 


o 


Q 


o 


Q 


o 


Q 


U 


Q 


O 


Q 


104 


Westborough, .... 


6,425 


1 




10 


_ 


8 


_ 


_ 


_ 


_ 


_ 


144 


3 


105 


North Andover, 






6,399 


1 


1 


5 


- 


11 


1 


- 


- 


3 


- 


29 


1 


106 


Mansfield, . 






6,386 


1 


- 


115 


- 


15 


1 


- 


- 


3 


- 


26 


- 


107 


Dartmouth, 






6,320 


- 


- 


2 


- 


7 


3 


- 


- 


- 


- 


49 


3 


108 


Wareham, . 






6,296 


- 


- 




- 


- 


- 


- 


- 


- 


- 


13 


2 


109 


Lexington, 






6,184 


2 


1 


11 


- 


4 


- 


- 


- 


2 


- 


196 


- 


no 


VVinchendon, 






6,148 


1 


- 


5 


- 


2 


- 


- 


- 


- 


- 


87 


3 


111 


VValpole, . 






6,115 


1 


- 


4 


- 


2 


- 


- 


- 


- 


- 


44 


1 


112 


Amherst, ' 








6,022 


1 


- 


10 


- 


6 


- 


- 


- 


17 


- 


80 


3 


113 


Millbury, 








5,873 


- 


- 


5 


1 


5 


9 


- 


- 


- 


- 


36 


- 


114 


Abington, 








5,844 


1 


- 


5 


- 


9 


2 


- 


- 


- 


- 


2 


1 


115 


Agawam, 








5,654 


- 


- 


- 


- 


4 


- 


- 


- 


- 


- 


- 


2 


116 


Hingham, 








5,576 


1 


_ 


1 


- 


3 


- 


- 


- 


2 


- 


46 


1 


117 


Orange, 








5,478 


_ 


- 


1 


- 


6 


1 


- 


- 


- 


- 


3 


1 


118 


South Hadley, . 






5,476 


- 


- 


- 


- 


5 


- 


- 


- 


2 


- 


91 


3 


119 


Chelmsford, 






5,360 


— 


_ 


_ 


- 


7 


- 


- 


- 


- 


- 


50 


- 


120 


Barnstable, 






5,328 


2 


_ 


22 


- 


2 


- 


- 


- 


1 


- 


44 


3 


121 


Monson, 






5,259 


_ 


1 


12 


- 


7 


- 


- 


- 


- 


- 


30 


1 


122 


Randolph, 






5,187 


_ 


_ 


- 


- 


- 


1 


- 


- 


- 


- 


- 


- 


123 


Uxbridge, . 






5,181 


1 


- 


2 


- 


53 


3 


- 


- 


- 


- 


24 


2 


124 


Spencer 






5,118 


- 


- 


3 


- 


16 


4 


1 


1 


— 


— 


67 


3 


125 


Towns, 2,500-5,000. 


188,563 


../rf 


4 


361 


S 


S35 


9 


4 


5 


58 


- 


11 SZ 


7o 


126 


Ea.ston 


4,986 


_ 


_ 


16 


_ 


9 


1 


_ 


_ 


- 


_ 


80 


4 


127 


Lee, . 






4,858 


_ 


_ 


3 


- 


13 


- 


- 


- 


- 


- 


9 


4 


128 


Falmouth, 






4.724 


_ 


_ 


2 


- 




- 


2 


2 


- 


- 


77 


1 


129 


Dracut, 






4,606 


- 


- 


4 


- 


4 


- 


- 


- 


- 


- 


33 


1 


130 


Rockport, . 






4,502 


- 


- 


2 


- 


8 


- 


- 


- 


- 


- 


84 


2 


131 


Dudley, . 






4,483 


1 


1 


9 


- 


2 


- 


- 


- 


- 


- 


11 


3 


132 


Templeton, 






4,420 


_ 


_ 


1 




6 


- 


- 


- 


- 


- 


69 


4 


133 


Warren, 






4,351 


- 


- 


- 


- 


1 


- 


- 


- 


17 


- 


101 


2 


134 


Williamstown, . 






4,267 


_ 


_ 


- 


_ 


36 


- 


- 


- 


- 


- 


3 


2 


135 


Provincetown, . 






4,218 


- 


- 


18 


- 


3 


1 


- 


- 


- 


- 


22 


- 


136 


Auburn, 






4,177 


_ 


_ 


3 


_ 


9 


- 


- 


- 


- 


- 


30 


2 


137 


Dalton, 






4,160 


_ 


_ 


1 


- 


1 


- 


- 


- 


- 


- 


14 


3 


138 


East Bridgewatcr, 






4,028 


— 


_ 


_ 


_ 


- 


_ 


_ 


- 


- 


- 


5 


2 


139 


Barre, 




• 


4,017 


— 


_ 


- 


_ 


1 


- 


- 


- 


2 


- 


41 


3 


140 


Somerset, . 






3,981 


_ 


_ 


- 


_ 


13 


- 


- 


- 


- 


- 


35 


1 


141 


Medfield, . 






3,836 


2 


- 


- 


- 


- 


- 


- 


- 


- 


- 


4 


- 


142 


Billerica, 






3,720 


_ 


_ 


1 


- 


11 


1 


- 


- 


- 


- 


- 


- 


143 


Blackstone, 






3,705 


_ 


_ 


1 


_ 


5 


- 


- 


- 


- 


- 


3 


1 


144 


Shrewsbury, 






3,679 


- 


- 


- 


1 


- 


- 


- 


- 


- 


- 


24 


1 


145 


Hardwick, 






3,669 


- 


- 


3 


- 


20 


3 


- 


- 


2 


- 


31 


- 


146 


Foxborough, 






3,641 


_ 


_ 


8 


- 


13 


- 


- 


- 


- 


- 


80 


4 


147 


VVestport, . 






3,610 


- 


- 


2 


- 


2 


- 


- 


- 


- 


- 


4 


1 


148 


Oxford, 






3,600 


- 


- 


19 


- 


4 


- 


- 


1 


- 


- 


40 


- 


149 


Lenox, 






3,430 


- 


- 


2 


- 


1 


- 


- 


1 


- 


- 


28 


1 


150 


Leicester, . 






3,411 


- 


- 


2 


- 


1 


- 


- 


- 


- 


- 


- 


1 


151 


Nantucket, 






3,380 


_ 


1 


- 


_ 


- 


- 


- 


1 


- 


- 


49 


1 


152 


Hadley, . 






3,359 


- 


- 


2 


- 


2 


- 


- 


- 


- 


- 


4 


- 


153 


Hatfield, . 






3,302 


- 


- 


1 


- 


1 


- 


- 


- 


13 


- 


- 


- 


154 


Deerfield, . 






3,291 


_ 


- 


5 


_ 


1 


- 


- 


- 


1 


- 


7 


- 


155 


West Bridgewater, 






3,272 


- 


- 


- 


- 


2 


- 


- 


- 


- 


- 


- 


1 


156 


Manchester, 






3,227 


4 


- 


1 


- 


2 


- 


- 


- 


- 


- 


47 


1 


157 


Swansea, . 






3,162 


_ 


- 


- 


- 


3 


- 


- 


- 


- 


- 


11 


- 


158 


Seekonk, . 






3,153 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


1 


159 


Hopedale, . 






3,140 


- 


- 


3 


- 


1 


- 


- 


- 


- 


- 


- 


- 


160 


Wrenthani, 






3,112 


- 


- 


2 


- 


3 


- 


- 


- 


- 


- 


6 


- 


161 


Acushnet, . 






3,111 


- 


- 


1 


- 


1 


- 


- 


- 


- 


- 


6 


3 


162 


Holbrook, . 






3,084 


1 


1 


- 


- 


9 


- 


- 


- 


- 


- 


5 


1 


163 


Cohasset, . . ■ 






3,024 


~ 


~ 


9 




— 


— 


— 


~ 


" 


" 


14 





No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



253 



to the Public Health, 1920 




Continued. 


























92 


6 


19C 38A i 

1 


7 




28-29 


30-35 


] 




8 


38C 


37 




I-obar 
Pneu- 
monia. 


Measles. 


Mumps. 


Oph- 
thalmia 
Neona- 
torum . 


Scarlet 
Fever. 


Tuber- 
culosis, 
Pulmo- 
nary. 


Tuber- 
culosis, 
Other 
Forms. 


Ty- 
phoid 
Fever. 


Whoop- 
ing 
Cough. 


Gonor- 
rhea. 


Syphi- 
lis. 






n 


" 1 




« 




cc 




to 




M 




CO 




OQ 




m 




« 




to 


d 

{3 


n 


J3 
c3 


1 


J3 


i 


J3 
e8 


i 


J3 
CO 


i 


OS 


S 1 


la 


CO 


J3 








J3 
C3 


K 


J3 


CO 

8 






O 


<" 03 


o 


o 


C3 


o ri 


Si 


C<3 


S 


C3 


0) 


a 


O 




o 


C3 


Q> 




O 


Q 


o 


Q Q 





o 


p 


o 


Q 


o \ 





o 


Q 


o 


Q 


O 


P 


o 


P 


O 


P 


2 


20 


22 


45 


-!l9 








19 




17 


9 




1 


10 


_ 


_ 


_ 


13 - 


20 


4 


104 


6 


6 


73 


- 1 6 


- 


_ 


_ 


23 


2 


7 


5 


3 


2 


- 


- 


38 


- 


1 


- 


- 


- 


105 


6 


1 


126 


- 2 


_ 


1 


_ 


14 


_ 


7 


7 


- 


- 


1 


- 


78 


1 


10 


- 


5 


- 


106 


3 


4 


28 


1 


4 


_ 


1 


- 


19 


- 


8 


2 


- 


2 


6 


2 


1 


- 


- 


- 


- 


- 


107 


5 


5 


62 


_ 


_ 


_ 


1 


_ 


6 


1 


4 


4 


1 


1 


2 


- 


8 


2 


3 


- 


2 


- 


108 


5 


3 


119 


1 


21 


_ 


_ 


_ 


15 


- 


5 


8 


- 


- 


- 


- 


37 


1 


4 


- 


- 


- 


109 


7 


4 


107 


- 


26 


- 


_ 


- 


71 


- 


5 


4 


- 


1 


- 


- 


27 


- 


- 


- 


1 


- 


no 


3 


1 


10 


_ 


5 


- 


3 


_ 


13 


_ 


5 


5 


2 


1 


- 


- 


22 


- 


6 


- 


1 


- 


111 


11 


2 


45 


- 


6 


- 


1 


- 


10 


- 


3 


- 


- 


- 


4 


- 


64 


2 


1 


- 


- 


- 


112 


6 


4 


3 


- 


22 


- 


1 


- 


19 


- 


4 


1 


- 


- 


1 


- 


- 


- 


3 


- 


1 


- 


113 


2 


4 


51 


_ 


13 


1 


_ 


- 


35 


- 


4 


2 


- 


1 


1 


- 


13 


1 


1 


- 


- 


- 


114 


_ 


4 


- 


_ 


- 


- 


_ 


- 


7 


- 


4 


3 


- 


1 


3 


- 


- 


1 


- 




- 


- 


115 


6 


4 


37 


- 


2 


- 


_ 


- 


25 


- 


4 


2 


- 


- 


3 


1 


24 


- 


2 


- 


1 


- 


116 




4 


- 


- 


- 


- 


_ 


- 


1 


- 


12 


6 


1 


2 


5 


- 


- 


- 


1 


- 


- 


- 


117 


1 


2 


29 


1 


_ 


_ 


_ 


_ 


14 


_ 


3 


3 


- 


- 


- 


- 


17 


2 


1 


- 


2 


- 


118 




3 


49 


_ 


3 


- 


1 


- 


18 


- 


2 


2 


- 


1 


1 


- 


- 


- 


- 


- 


~ 


- 


119 


8 


6 


77 


- 


5 


- 


_ 


- 


11 


- 


3 


3 


1 


- 


1 


- 


28 


- 


9 


- 




- 


120 


3 


3 


15 


_ 


36 


- 


— 


- 


5 


- 


6 


9 


- 


1 


- 


- 


2 


1 


- 


- 


10 


- 


121 




1 


3 


- 


- 


- 


- 


- 


7 


- 


2 


2 


- 


- 


- 


- 


- 


- 


1 


- 


1 


- 


122 


2 


5 


105 


1 


_ 


- 


1 


_ 


9 


1 


10 


4 


3 


2 


- 


- 


- 


- 


6 


- 


- 


- 


123 


1 


5 


2 


- 


15 


— 


- 


- 


5 


- 


6 


1 


1 


1 


— 


- 


— 


~ 


2 


~ 


~ 


~ 


124 


1^3 


no 


me 


17 


i79 


- 


17 


- 


JtOd 


6 


209 


156 


15 


19 


2S 





396 


18 


103 


- 


33 


IS 


125 


1 


3 


85 


_ 


2 


— 


1 


_ 


13 


1 


6 


4 


1 


2 


_ 


_ 


4 


- 


2 


- 


1 


- 


126 




_ 


89 


- 


- 


- 


_ 


- 


31 


- 


6 


3 


_ 


2 


- 


- 


1 


- 


1 


- 




- 


127 


_ 


2 


110 


3 


3 


_ 


_ 


- 


- 


- 


13 


- 




- 


- 


- 


- 


- 


6 


- 


1 


- 


128 


_ 


3 


6 


_ 


1 


- 


_ 


_ 


4 


1 


3 


1 


1 


- 


_ 


- 


- 


- 


1 


- 


- 


- 


129 


_ 


1 


31 


- 


- 


- 


_ 


- 


16 


- 


5 


2 


- 


- 


3 


- 


9 


1 


1 


- 


1 


- 


130 


9 




16 


_ 


_ 


_ 


_ 


- 


1 


_ 


10 


2 


2 


2 




- 


2 


1 


- 


- 


- 


- 


131 


1 


1 


1 


- 


- 


- 


1 


- 


11 


- 


1 


2 


- 


- 


- 


- 


- 


- 


2 


- 


- 


- 


132 


7 


2 


9 


1 


6 


- 


1 


- 


1 


- 


4 


1 


- 


2 


- 


- 


- 


- 


4 


- 


- 


- 


133 




_ 


2 


_ 


- 


- 


- 


- 


_ 


_ 


2 


3 


- 


1 


1 


1 


1 


1 


- 


- 


- 


- 


134 


1 


2 


3 


- 


- 


- 


- 


- 


1 


_ 


4 


1 


1 


- 


1 


1 


10 


- 


7 


- 


1 


- 


135 


1 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


1.36 


1 


4 


32 


_ 


- 


- 


- 


- 


6 


_ 


- 


5 


- 


_ 


- 


- 


- 


- 


- 


- 


- 


- 


137 


1 


4 


22 


- 


- 


- 


- 


- 


3 


- 


3 


5 


- 


- 


1 


- 


- 


- 


2 


- 


2 


- 


138 




2 


150 


2 


2 


- 


- 


- 


6 


_ 


1 


3 


- 


1 


- 


- 


2 


- 


- 


- 


- 


- 


139 


10 


3 


- 


1 


- 


- 


1 


- 


5 


- 


7 


4 


1 


- 


- 


- 


1 


- 


- 


- 


- 


- 


140 


2 


8 


39 


_ 


12 


_ 


2 


- 


1 


_ 


25 


28 


- 


2 


- 


- 


19 


- 


- 


- 


- 


4 


141 


1 


5 


71 


- 


1 


- 


- 


- 


8 


- 


3 


6 


- 


- 


1 


- 


9 


2 


1 


- 


- 


- 


142 




7 


_ 


2 


_ 


_ 


_ 


- 


— 


_ 


4 


2 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


143 


2 


1 


7 


- 


1 


- 


_ 


- 


4 


- 


2 


1 


- 


- 


- 


- 


- 


- 


1 


- 


- 


- 


144 




— 


65 


1 


10 


_ 


_ 


_ 


10 


2 


1 


2 


- 


- 


- 


- 


1 


- 


- 


- 


- 


- 


145 


11 


7 


9 


- 


2 


- 


1 


- 


23 


_ 


12 


9 


4 


1 


7 


- 


63 


- 


10 


- 


11 


3 


146 


1 


- 


20 


- 


- 


- 


- 


- 


3 


- 


1 


2 


- 


- 


- 


- 


- 


- 


- 


- 


1 


- 


147 


1 


2 


1 


- 


17 


- 


- 


- 


13 


_ 


1 


1 


_ 


1 


1 


- 


1 


2 


- 


- 


- 


- 


148 


4 


2 


1 


- 


10 


- 


- 


- 


6 


- 


2 


2 


1 


1 


1 


- 


1 


- 


3 


- 


- 


- 


149 


3 


3 


_ 


- 


_ 


_ 


_ 


_ 


12 


1 


1 


1 


- 


_ 


1 


- 


- 


- 


- 


- 


- 


- 


150 




5 


2 


- 


- 


- 


- 


- 


6 


- 


- 


2 


- 


- 


- 


- 


3 


- 


- 


- 


- 


- 


151 


_ 


- 


3 


_ 


2 


_ 


_ 


_ 


4 


_ 


1 


- 


- 


- 


_ 


- 


6 


- 


- 


- 


- 


- 


152 


5 


3 


18 


- 


13 


- 


- 


- 


S 


- 


3 


- 


- 


- 


- 


- 


28 


1 


- 


- 


- 


- 


153 


1 


2 


54 


- 


8 


- 


- 


- 


14 


1 


- 


2 


- 


- 


- 


- 


12 


3 


- 


- 


- 


- 


154 




1 


- 


1 


- 


- 


- 


- 


- 


- 


1 


2 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


155 


_ 


_ 


12 


_ 


1 


_ 


_ 


_ 


12 


_ 


6 


1 


_ 


- 


_ 


- 


20 


1 


4 


- 


1 


1 


156 


4 


2 


1 


- 


- 


- 


_ 


- 


3 


- 


2 


3 


- 


- 


- 


- 


- 


- 


1 


- 


- 


- 


157 




1 


_ 


_ 


_ 


_ 


_ 


_ 


_ 


_ 


2 


3 


_ 


_ 


_ 


- 


1 


- 


- 


- 


- 


- 


158 


_ 


- 


14 


1 


3 


- 


_ 


- 


9 


- 


1 


- 


_ 


- 


- 


- 


- 


- 


2 


- 


1 


- 


159 


14 


6 


50 


1 


1 


_ 


_ 


_ 


24 


_ 


4 


4 


_ 


1 


_ 


- 


34 


3 


1 


- 


1 


- 


160 


_ 


- 


17 


2 


4 


_ 


1 


- 


6 


- 


5 


2 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


161 


- 


1 


7 


- 


2 


- 


- 


- 


1 


- 


5 


3 


- 


- 


- 


- 


- 


- 


5 


- 


- 


- 


162 


1 


— 


1 


— 


9 


— 


— 


— 


3 


— 


1 


— 


1 


— 


~ 


-* 


6 


~ 


7 


•" 


1 


~ 


163 



254 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Cases and Deaths from Diseases Dangerous 









63A 


19A 


1 


J 


61A 


19B 


J 

10 








An- 








Ep. 










Popu- 
lation 


terior 
Polio- 


Chicken 


Diph- 


Cere- 
bro- 


Ger- 
man 


In- 






esti- 




Pox. 


theria. 


spinal 


Mea- 


fiuenza . 




Cities and Towns grouped 
IN Order of Population. 


mated 
as of 

July 1, 
1920. 


mye- 
litis. 








Menin- 
gitis. 


sles. 




6 






CO 




CQ 




QO 




02 




« 




02 


c 






CO 




OO 


J3 


03 




i 


C3 


i 

CO 


9} 


cc 


5 








oj 


Si 




C) 


c3 


S 




o 


u 


V 




Qi 


>J 






o 


Q 


o 


Q 


u 


Q 


o 





o 


Q 


o 


o 


164 


Hanover 


3,020 


1 


_ 


_ 
















24 


1 


165 


Medway, . 






3,002 


- 


- 


- 


— 


4 


_ 


1 


_ 


_ 


_ 


1 




166 


Pepperell, . 






2,958 


_ 


_ 


— 


_ 


_ 


_ 




_ 


_ 


_ 




2 


167 


Holden, . 






2,895 


_ 


_ 


3 


— 


_ 


_ 


_ 


_ 


1 


_ 


141 


1 


168 


Bourne, 






2,880 


1 


1 


3 


_ 


_ 


_ 


_ 


_ 






21 


2 


169 


Holliston, . 






2,867 


3 




5 


_ 


3 


_ 


_ 


_ 


„ 


_ 


30 




170 


Scituate, 






2,849 


1 


_ 


1 


_ 


1 


_ 


_ 


_ 


^ 


_ 






171 


Westford, . 






2,833 


_ 


_ 


42 


_ 


10 


_ 


_ 


_ 


_ 


_ 


64 


3 


172 


Wilmington, 






2,820 


2 


_ 


2 


_ 


1 


_ 


_ 


_ 


_ 


_ 


3 




173 


North Brookfield, 






2,812 


_ 


_ 




_ 


1 


_ 


_ 


_ 


_ 


_ 


20 


1 


174 


Dighton, . 






2,775 


- 


- 


- 


- 




_ 


_ 


_ 


_ 


_ 


5 


3 


175 


Ayer, . 






2,759 


1 


- 


41 


1 


6 


_ 


_ 


_ 


_ 


_ 


43 


1 


176 


Kingston, . 






2,721 


_ 


_ 


_ 


_ 




1 


_ 


_ 


1 


_ 


18 


2 


177 


Wilbraham, 






2,719 


_ 


— 


_ 


_ 


_ 




_ 


_ 




_ 


6 




178 


Lancaster, . 






2,710 


_ 


_ 


_ 


_ 


7 


_ 


_ 


_ 


1 


_ 


90 


1 


179 


Sharon, 






2,634 


1 


_ 


4 


_ 


2 


_ 


_ 


_ 




_ 


70 




180 


Norton, 






2,632 


_ 


_ 


_ 


_ 


1 


_ 


1 


_ 


_ 


_ 




2 


181 


Weston, 






2,587 


_ 


_ 


4 


_ 


6 


_ 




_ 


_ 


_ 


54 


1 


182 


Sutton, 






2,569 


_ 


_ 


5 


_ 


1 


_ 


_ 


_ 


_ 


_ 


76 




183 


Groton, 






2,520 


2 


_ 


25 


_ 


2 


_ 


_ 


_ 


_ 


_ 


28 


1 


184 


Groveiand, 






2,507 


1 


_ 


5 


_ 


2 


1 


_ 


_ 


_ 


_ 


54 


1 


185 


Hopkinton, 






2,500 


1 


- 


- 


- 




1 


- 


- 


- 


- 


7 


2 


186 


Towns under 2,500. 


206,109 


23 


6 


S51 


1 


155 


12 


3 


2 


$ 


- 


S288 


88 


187 


Hull, 


2,483 


3 


1 


7 


_ 


6 


_ 


_ 


„ 


_ 




32 


2 


188 


Rehoboth, 






2,465 








_ 




„ 


_ 


_ 


_ 


_ 


23 


2 


189 


Charlton, . 






2,401 


_ 


_ 


2 


^ 


3 


_ 


_ 


_ 


_ 


_ 


1 




190 


Shirley, 






2,366 
2,343 


_ 


_ 




_ 


2 


^ 


_ 


_ 


_ 


_ 


1 


_ 


191 


Ashland, 






_ 


_ 


10 


_ 


4 


_ 


_ 


_ 


_ 


_ 


13 


2 


192 


East Longmeadow, 






2,340 


_ 


_ 




_ 


1 


_ 


_ 


„ 


_ 


_ 


2 


1 


193 


Avon, 






2,320 


- 


_ 


5 


_ 


2 


_ 


_ 


_ 


_ 


_ 




2 


194 


Harwich, . 






2,246 


_ 


_ 


3 


_ 


7 


_ 


_ 


_ 


_ 


_ 


19 


1 


195 


Bellingham, 






2,219 


_ 


_ 




_ 


1 


_ 


1 


_ 


— 


— 


1 


1 


196 


Douglas, 






2,206 


_ 


_ 


4 


_ 


2 


_ 




_ 


_ 


_ 


3 


2 


197 


Acton, 






2,167 


_ 


_ 


2 


_ 


1 


_ 


_ 


_ 


_ 


__ 


26 




198 


Duxbury, . 






2,165 


_ 


_ 


2 


_ 




_ 


_ 


_ 


_ 


_ 




3 


199 


Georgetown, 






2,162 


1 


_ 


_ 


_ 


_ 


_ 


_ 


_ 


_ 


_ 


30 


1 


200 


Williamsburg, . 






2,103 




_ 


_ 


_ 


5 


_ 


„ 


_ 


„ 


_ 


11 


1 


201 


Belchertown, 






2,072 


_ 


_ 


_ 


_ 


2 


__ 


_ 


_ 


_ 


_ 






202 


Southborough, . 






2,059 


5 


1 


_ 


_ 




_ 


_ 


_ 


_ 


_ 


3 


1 


203 


Rutland, . 






2,052 


1 




_ 


_ 


_ 


_ 


,„ 


_ 


_ 


_ 






204 


Millville, . 






2,036 




_ 


_ 


_ 


_ 


_ 


_ 


_ 


_ 


_ 


_ 


_ 


205 


Hamilton, . 






2,014 


_ 


-. 


2 


_ 


_ 


_ 


1 


_ 


_ 


_ 


24 


2 


206 


Ashburnham, 






2,007 


1 


_ 


_ 


_ 


_ 


_ 




_ 


_ 


_ 


116 




207 


Upton, 






2,000 




_ 


_ 


_ 


_ 


_ 


_ 


_ 


_ 


_ 




_ 


208 


Merrimac, . 






1,997 


_ 


_ 


10 


_ 


7 


1 


_ 


_ 


_ 


_ 


41 


_ 


209 


Sherborn, . 






1,977 


_ 


_ 


2 


_ 


2 




^ 


_ 


_ 


^ 




_ 


210 


Northfield, 






1,928 


• 


_ 




_ 




_ 


_ 


_ 


_ 


_ 


__ 


2 


211 


Colrain, 






1,922 


_ 


_ 


12 


_ 


2 


_ 


_ 


_ 


_ 


_ 


1 


3 


212 


Sheffield, . 






1,909 


_ 


— 


_ 


_ 


2 


_ 


_ 


1 


_ 


_ 


17 




213 


Brookfield, 






1,908 


_ 


_ 


23 


_ 




„ 


_ 




_ 


— 


192 


3 


214 


Raynham, 






1,898 


_ 


_ 


1 


_ 


_ 


_ 


_ 


_ 


_ 


_ 




2 


215 


Longmeadow, . 






1,886 


1 


_ 


8 


_ 


1 


_ 


_ 


_ 


_ 


_ 


15 


1 


216 


Northborough, . 






1,885 


_ 


_ 


3 


_ 


2 


_ 


_ 


_ 


_ 


_ 


9 




217 


Stockbridge, 






1,869 


_ 


_ 


2 


_ 


_ 


_ 


_ 


-, 


_ 


_ 


21 


_ 


218 


Townsend, 






1,864 


- 


- 


_ 


_ 


_ 


_ 


_ 


_ 


_ 


_ 


61 


1 


219 


Freetown, . 






1,861 


_ 


_ 


_ 


_ 


1 


1 


_ 


_ 


_ 


_ 


10 




220 


Lakeville, . 






1,855 


_ 


_ 


_ 


_ 


2 




„ 


_ 


_ 


_ 


18 


_ 


221 


Wayland, . 






1,851 


_ 


_ 


_ 


— 


3 


1 


_ 


_ 


_ 


_ 


11 


1 


222 


Westminster, 






1,844 


_ 


_ 


_ 


— 






_ 


— 


_ 


_ 


25 


1 


223 


Lunenburg, 






1,834 


— 


— 


3 


— 


— 


— 


- 


— 


- 


- 


24 





No. 34.] DIVISION OF COMMUNICABLE DISEASES. 255 



to the Public Health, 1920 — Continued. 



92 


6 


} 


19C 


38A 


7 




28-29 


30-35 


1 


8 


38C 


37 




Lobar 
Pneu- 
monia. 


Measles. 


Mumps. 


Oph- 
thalmia 
Neona- 
torum. 


Scarlet 
Fever. 


Tuber- 
culosis, 
Pulmo- 
nary. 


Tuber- 
culosis, 
Other 
Forms. 


Ty- 
phoid 
Fever. 


Whoop- 
ing 
Cough. 


Gonor- 
rhea. 


Syphi- 
lis. 




IK 

6 


S 

-.J 

a 

0) 






2 


i 

6 


sS 
P 




a 


O 


1 
to 

fi 




-a 
■*-> 

2 
P 




P 


00 

6 


a 
P 


o 


03 

-*^ 
oj 

p 


6 


GO 

P 


O 


jr. 

ca 
a 

P 


c 





% 


'1 




1 












9 


2 


_ 


_ 


1 


_ 


12 


_ 


1 


_ 


_ 


_ 


164 




1 


3n 


_ 




_ 


_ 


_ 


3 


_ 


2 


1 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


165 




3 


11 


_ 


6 


_ 


— 


- 


- 


_ 


3 


2 


- 


- 


- 


- 


- 


1 


1 


- 


- 


- 


166 


1 


7 


'> 


_ 


37 


_ 


_ 


_ 


2 


_ 


1 


1 


1 


1 


2 


1 


3 


- 


6 


- 


- 


- 


167 


4 


1 


6 


_ 




_ 


_ 


_ 


2 


- 


6 


10 


- 


- 


- 


- 


- 


- 


- 


- 


1 


2 


168 


4 


7 




_ 


1 


_ 


— 


_ 


8 


_ 


_ 


2 


- 


- 


- 


- 


2 


1 


- 


- 


1 


1 


169 


9 




3 


_ 


1 


_ 


_ 


_ 


6 


_ 


1 


- 


- 


- 


2 


1 


5 


- 


6 


- 


- 


- 


170 





1 


3? 


_ 


1 


— 


2 


- 


23 


- 


2 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


171 




? 


y?. 


_ 


8 


_ 


_ 


_ 


8 


- 


4 


1 


- 


- 


1 


- 


1 


- 


2 


- 


- 


- 


172 


3 


2 


I 


_ 




— 


_ 


_ 


8 


- 


3 


4 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


173 




1 




_ 


_ 


_ 


1 


- 


14 


- 


1 


2 


1 


- 


- 


- 


- 


- 


- 


- 


- 


- 


174 


4 


1 


8 


_ 


_ 


- 


8 


_ 


4 


- 


6 


2 


- 


- 


- 


- 


10 


- 


2 


- 


2 


- 


175 




3 




1 


_ 


_ 




_ 


2 


_ 


1 


_ 


- 


1 


2 


1 


- 


- 


1 


- 


- 


- 


176 






_ 


1 


1 


_ 


_ 


_ 


2 


- 


2 


5 


- 


- 


- 


- 


- 


- 


2 


- 


- 


- 


177 


14 


_ 


11 




11 


— 


1 


_ 


22 


- 


9 


_ 


1 


- 


- 


- 


3 


- 


13 


- 


5 


- 


178 




- 


85 
1 


- 


3 


- 


- 


- 


17 


— 


7 

1 


6 


~ 


~ 


1 


— 


2 


: 


3 
2 


: 


1 


1 


179 
180 


10 


_ 


15 


_ 


56 


_ 


_ 


_ 


3 


- 


1 


1 


- 


1 


- 


- 


9 


- 


- 


- 


- 


- 


181 


4 


7. 


8 


_ 




_ 


— 


_ 


12 


- 


5 


- 


- 


- 


1 


- 


1 


1 


3 


- 


- 


- 


182 


7 


?. 


39 


_ 


3 


_ 


-. 


_ 




_ 


1 


1 


_ 


- 


- 


- 


49 


- 


- 


- 


1 


- 


183 


3 


1 


6 


_ 


36 


_ 


2 


_ 


1 


_ 





- 


- 


- 


- 


- 


64 


- 


1 


- 


- 


- 


184 


1 




20 


- 


4 


- 


- 


- 


3 


- 


1 


4 


— 


— ■ 


1 


~ 


1 


— 


~" 




~ 


— 


185 


lOS 


ns 


1550 


5 


294 


- 


11 


- 


375 


2 


135 


405 


9 


18 


20 


1 


461 


19 


99 


- 


32 


1 


186 


1 


2 


7 


1 


fi 


_ 


_ 


_ 


7 


_ 


1 


2 


_ 


- 


2 


1 


39 


- 


- 


- 


_ 


^ 


187 


1 


t 








_ 


_ 


_ 


_ 


- 


1 


_ 


- 


- 


- 


- 


5 


- 


- 


- 


- 


- 


188 




1 


1 


_ 




- 


- 


— 


- 


- 


- 


- 


_ 


- 


1 


- 


- 


1 


- 


- 


- 


- 


189 


6 


?. 


9 


_ 


9 


- 


_ 




33 


- 


2 


1 


1 


- 


- 


- 


4 


- 


- 


- 


- 


- 


190 




3 


a 


_ 


2 


_ 


1 


_ 


9 


_ 


_ 


1 


_ 


- 


- 


- 


40 


1 


3 


- 


9 


- 


191 


_ 


1 


f> 


_ 




_ 


_ 


_ 


_ 


_ 


1 


1 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


192 


1 




82 


_ 


_ 


_ 


_ 


_ 


1 


- 


4 


2 


- 


- 


- 


- 


14 


- 


1 


- 


- 


- 


193 




_ 


11 


_ 


_ 


_ 


_ 


_ 




_ 


3 


4 


- 


- 


2 


- 


- 


- 


1 


- 


2 


- 


194 


__ 


1 


1 


_ 


_ 


_ 


_ 


_ 


_ 


- 


3 


2 


- 


1 


- 


- 


- 


- 


- 


- 


- 


- 


195 


1 


2 


19 


_ 


3 


_ 


_ 


_ 


2 


_ 


3 




_ 


_ 


- 


- 


10 


- 


- 


- 


- 


- 


196 




1 


136 


^ 


_ 


_ 


_ 


_ 


3 


- 


- 


- 


- 


- 


- 


- 


6 


- 


- 


- 


- 


- 


197 


„ 


1 


40 


- 


3 


- 


_ 


_ 


- 


- 


1 


1 


- 


- 


- 


- 


15 


- 


1 


- 


- 


- 


198 


_ 


1 


1 


_ 


3 


_ 


_ 


_ 


5 


_ 


1 


2 


- 


- 


- 


- 


- 


- 


1 


- 


- 


- 


199 


_ 




5 


_ 


2 


- 


- 


_ 


- 


- 


4 


1 


- 


- 


- 


- 


3 


1 


- 


- 


- 


- 


200 


_ 


1 


21 


_ 


_ 


- 


_ 


_ 


13 


1 


_ 


_ 


• _ 


- 


- 


- 


- 


- 


- 


- 


- 


- 


201 


_ 




16 


- 


1 


- 


_ 


_ 


2 


- 


- 


- 


- 


1 


- 


- 


- 


- 


1 


- 


- 


- 


202 


_ 


1 


1 


_ 


1 


_ 


_ 


_ 


1 


_ 


_ 


75 


_ 


- 


- 


- 


- 


- 


- 


- 


- 


- 


203 


_ 


1 




_ 


_ 


_ 


_ 


_ 


3 


- 


- 


1 


- 


1 


1 


- 


- 


- 


- 


- 


- 


- 


204 


_ 




4 


« 


1 


. 


_ 


_ 


5 


_ 


_ 


_ 


_ 


2 


- 


- 


1 


- 


2 


- 


- 


- 


205 


_ 


_ 


_ 


_ 


2 


_ 


_ 


_ 


4 


- 


1 


2 


- 


1 


- 


- 


2 


- 


- 


- 


- 


- 


206 


4 


1 


_ 


_ 


_ 


_ 


_ 


_ 


2 


_ 


2 


_ 


_ 


1 


- 


- 


1 


1 


1 


- 


- 


- 


207 






12 


_ 


1 


_ 


1 


_ 


2 


- 


3 


1 


- 


1 


- 


- 


5 


- 


4 


- 


- 


- 


208 


_ 


1 


7 


_ 


2 


_ 


2 


— 


7 


_ 


3 




— 


1 


- 


- 


20 


1 


44 


- 


20 


- 


209 


_ 




75 


_ 


3 


_ 


_ 


_ 


5 


1 


1 


1 


_ 


- 


- 


- 


- 


- 


- 


- 


- 


- 


210 


3 


3 


30 


1 


_ 


- 


- 


- 


28 


- 


1 


2 


- 


- 


1 


- 


1 


- 


1 


- 


- 


- 


211 






10 




_ 


_ 


_ 


__ 


_ 


„ 


1 


1 


-. 


1 


_ 


_ 


_ 


- 


- 


- 


- 


- 


212 


1 


_ 




_ 


1 


_ 


_ 


_ 


6 


_ 


1 


1 


_ 




- 


_ 


22 


- 


- 


- 


- 


- 


213 




3 


_ 


_ 




_ 


_ 


_ 




_ 


_ 


_ 


_ 


- 


- 


- 


- 


- 


- 


- 


1 


- 


214 


1 


1 


38 


- 


2 


- 


- 


- 


9 


- 


3 


1 


_ 


1 


- 


- 


3 


- 


- 


- 


- 


- 


215 


2 


_ 


20 


- 


- 


- 


- 


- 


6 


- 


2 


- 


- 


- 


1 


- 


8 


1 


- 


- 


- 


- 


216 


3 


2 


10 


- 


- 


- 


- 


- 


5 


- 


1 


- 


_ 


- 


- 


- 


9 


- 


- 


- 


- 


- 


217 






35 


_ 


_ 


_ 


_ 


_ 


_ 


_ 


1 


2 


- 


- 


- 


- 


- 


- 


- 


- 


1 


- 


218 


9 


1 


5 


_ 


1 


_ 


2 


_ 


_ 


_ 


3 


2 


_ 


_ 


_ 


- 


- 


- 


- 


- 


- 


- 


219 


- 




4 


- 


_ 


- 


1 


_ 


_ 


_ 


1 


133 


_ 


_ 


- 


- 


- 


- 


- 


- 


- 


- 


220 


1 


1 




_ 


_ 


_ 




_ 


6 


_ 






_ 


_ 


_ 


- 


- 


- 


- 


- 


- 


- 


221 


2 


1 


62 


_ 


_ 


_ 


_ 


- 




_ 


_ 


1 


_ 


_ 


- 


- 


- 


- 


9 


- 


- 


- 


222 


— 


— 


9 


— 


56 


— 


2 


— 


4 


— 


4 


2 


— 


** 


"- 


— 


12 


1 


" 


— 


— 


" 


223 



256 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Cases and Deaths from Diseases Dangerous 



Cities and Towns grouped 
IN Order of Population. 



Popu- 
lation 

esti- 
mated 

as of 
July 1, 

1920. 



63A 

An- 
terior 
Polio- 
mye- 
litis. 



19A 



Chicken 
Pox. 



C3 



Diph- 
theria. 



C3 

o 



61A 

Ep. 
Cere- 
bro- 
spinal 
Menin- 
gitis. 



19B 

Ger- 
man 
Mea- 
sles. 



10 



In- 
fluenza. 



Salisbury, . 

Chatham, . 

Carver, 

Essex, 

Hanson, 

Norwell, 

Southwick, 

Dennis, 

Marshfield, 

Newbury, . 

Westwood, 

Nahant, 

Rowley, 

Norfolk, 

West Newbury, 

Cheshire, . 

Buckland, . 

North Reading, 

Sunderland, 

Marion, 

Bedford, 

Oak Bluffs, 

Middleton, 

Millis, 

Mattapoisett, 

Shelburne, 

Tisburj', 

Lincoln, 

Sterling, 

Plainville, . 

Yarmouth, 

Hinsdale, . 

Whately, . 

Huntington, 

West Boylston, 

Edgartown, 

Pembroke, 

Lynnfield, . 

Chester, 

Sandwich, . 

Sudbury, . 

West Stockbridge 

Sturbridge, 

Orleans, 

Ru.ssell, 

West Brookfield 

Laiiesborough, 

Rochester, 

Littleton, . 

Conway, 

Dover, 

Erving, 

Harvard, . 

Topsfield, . 

Stow, 

Wen ham, . 

Tyngsborough, 

Hubbardston, 

Southampton, 

Ash field, 

Clarksburg, 

Brim field, . 

Mendon, 



1,779 
1,776 
1,742 
1,735 
1,734 
1,724 
1,724 
1,723 
1,710 
1,704 
1,636 
1,600 
1,600 
1,590 
1,587 
1.565 
1,564 
1,536 
1,518 
1,513 
1,505 
1,496 
1,495 
1,488 
1,476 
1,468 
1,459 
1,451 
1,450 
1,434 
1,410 
1,403 
1,400 
1,378 
1,370 
1,365 
1,337 
1,321 
1,308 
1,304 
1,295 
1,282 
1,264 
1,259 
1,250 
1,247 
1,235 
1,233 
1,229 
1,210 
1,208 
1,189 
1,177 
1,173 
1,138 
1,130 
1,112 
1,095 
1,033 
1,030 
1,016 
1,006 
990 



5 
11 



1 

4 

1 

16 



10 



10 
1 



34 



7 
23 



22 
8 



14 

I 

15 

19 



91 



1 

2 

10 
95 
27 
32 



48 

121 

43 

47 



17 
13 
50 



5 
34 
16 

4 

16 

118 

•> 



1 
13 
56 



48 
1 



15 
1 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 257 



to the Public Health, 1920 — Continued. 



92 

Lobar 
Pneu- 
monia. 


6 

Measles. 


19C 

Mumps. 


38A 

Oph- 
thalmia 
Neona- 
torum. 


7 

Scarlet 
Fever. 


28-29 

Tuber- 
culosis, 
Pulmo- 
nary. 


30-35 

Tuber- 
culosis, 
Other 
Forms. 


1 

Ty- 
phoid 
Fever. 


8 

Whoop- 
ing 
Cough. 


38C 

Gonor- 
rhea. 


37 

Syphi- 
lis. 




1 




CO 

O 


1 


d 


IS 

o 

Q 


en 

6 


P 




CO 

•S 


i 


CO 

Q 


O 


to 

J3 
.^^ 

O 
P 







i 

8 


tc 

..J 
<o 
P 




03 
P 


O 


(0 

C3 
P 


O 

o 
c 

3 


1 
1 
2 
2 

4 
1 

7 
3 
2 

3 
2 

4 

1 

1 
1 
4 

7 

1 

2 
3 

1 

1 


3 

1 

1 
1 

2 

1 

1 
1 

1 
3 

1 

1 

1 

1 

1 
2 
3 

2 
1 
4 

1 
3 

1 
1 

1 
1 
2 
1 
1 

1 
2 

1 


4 

1 

14 

30 
25 
19 
61 

1 

1 
2 
12 
5 
2 

3 

141 

13 

3 

6 

12 
19 

57 
2 
3 

3 

75 

3 
1 

6 

1 

2 
1 

7 

2 

2 

15 

35 
1 


1 


29 

1 

1 

1 

5 

1 

3 

1 

24 

2 

4 

2 

58 

1 
5 

1 
7 
2 

1 

21 


- 


1 
1 


- 


5 
13 
6 
9 
6 

3 
4 

4 
5 

2 
2 

1 
2 

27 
5 

1 
1 

1 

4 

24 

8 

1 

3 

3 

- 

2 
6 

5 

5 

1 
5 

1 
3 


~ 


2 
8 
1 

5 
4 

1 

6 

1 

3 
1 
2 

2 
2 
1 
3 

2 

3 

2 
1 
3 

1 

1 
1 

1 
3 


1 
3 

43 

1 

3 

3 

51 
2 

2 

3 

4 

1 
2 

1 
2 

1 
3 
2 

1 

1 
1 

1 
2 

5 
2 

1 


1 

1 

1 

1 
2 


1 

1 
1 

\ 

X 
1 


2 
1 

1 
1 

2 

1 


- 


26 
1 

5 
7 

1 

12 

35 

4 

3 

~i 
1 
5 

11 

7 

8 
4 

4 

7 

4 

8 

11 

5 

1 

1 


1 
1 

1 
1 

2 

2 

1 
1 


2 

1 

2 

1 
1 

1 
2 

4 

3 

1 
1 
1 

1 
4 

1 

1 
1 

4 
1 


- 


4 

1 
_ 

1 


• — 

1 


224 
225 
226 
227 
228 
229 
230 
231 
232 
233 
234 
235 
236 
237 
238 
239 
240 
241 
242 
243 
244 
245 
246 
247 
248 
249 
250 
251 
252 
253 
254 
255 
256 
257 
258 
259 
260 
261 
262 
263 
264 
265 
266 
267 
268 
269 
270 
271 
272 
273 
274 
275 
276 
277 
278 
279 
280 
281 
282 
283 
284 
285 
286 



258 



DEPAKTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Cases and Deaths from Diseases Dangerous 





Cities and To 
IN Order of 


WNS GROUPED 
POPUL.\TION. 


Popu- 
lation 

esti- 
mated 

as of 
July 1, 

1920. 


63A 

An- 
terior 
Polio- 
mye- 
litis. 


19A 

Chicken 
Pox. 


9 

Diph- 
theria. 


61A 

Ep. 
Cere- 
bro- 
spinal 
Menin- 
gitis. 


19B 

Ger- 
man 
Mea- 
sles. 


10 

In- 
fluenza. 


6 

C 
3 




I 


CO 

% 
P 


CO 

03 
U 


2 
Q 


CO 

% 

03 


CO 

c3 
a) 

P 


CO 

U 


CO 

03 

Q 


CO 

o 


CO 

A 

03 
O 

Q 


CO 

6 


CO 

cS 

5 


287 
288 
289 
290 
291 
292 
293 
294 
295 
296 
297 
298 
299 
300 
301 
302 
303 
304 
305 
306 
307 
308 
309 
310 
311 
312 
313 
314 
315 
316 
317 
318 
319 
320 
321 
322 
323 
324 
325 
326 
327 
328 
329 
330 
331 
332 
333 
334 
335 
336 
337 
338 
339 
340 
341 
342 
343 
344 
345 
346 
347 
348 
349 


Becket, 

Berkley, 

Gill, . 

Ashby, 

Charlemonf 

Brewster, 

Koyalston, 

New Marlb 

Burlington, 

Granby, 

Boylston, 

Wellfleet, 

Bernardstoi 

Leverett, 

Berlin, 

Granville, 

Princeton, 

Bolton, 

Enfield, 

Halifax, 

Boxford, 

Hampden, 

Petersham, 

Cummingtc 

Dana, 

Truro, 

Worthingto 

Plympton, 

New Salem 

Egremont, 

Chesterfield 

Eastham, 

Hancock, 

Sandisfield, 

Savoy, 

Pelham, 

Paxton, 

Blandford, 

Oakham, 

Warwick, 

Richmond, 

Florida, 

West Tisbu 

New Braint 

Westhampt 

Hawley, 

Carlisle, 

Heath, 

Greenwich, 

Rowe, 

Otis, . 

Leyden, 

Phillipston, 

Monroe, 

Plainfield, 

Windsor, 

Boxborough 

Monterey, 

Wales, 

Shutesbury 

Dunstable, 

Goshen, 

Chilmark, 


orouj 
1, 

n, 
n, 

, 

ry, 

ree, 

on. 


;h, 






988 
970 
961 
959 
951 
940 
935 
931 
918 
898 
856 
847 
842 
831 
822 
789 
780 
773 
734 
731 
709 
696 
696 
686 
686 
673 
670 
639 
610 
594 
585 
572 
566 
562 
546 
531 
528 
524 
501 
477 
475 
459 
446 
442 
436 
432 
427 
420 
400 
392 
390 
365 
353 
348 
344 
344 
336 
327 
327 
318 
315 
299 
294 


1 

1 

1 

1 


1 

I 

_ 
_ 


1 

4 

1 
38 

1 
3 

1 


1 


1 

1 
1 

1 
1 

5 

4 

1 
4 


1 

1 


- 


- 


1 
1 


- 


100 

54 

55 

4 

1 

6 

3 

12 

2 

145 
6 

8 

13 

3 

12 

1 
24 

13 
1 


1 

1 

1 

1 
1 

2 

1 

1 

1 

5 

1 

1 
1 

J 
1 



No. 



34.] 



DIVISION OF COMMUNICABLE DISEASES. 



259 



to the Public Health, 1920 — Continued. 



92 

Lobar 
Pneu- 
monia. 


6 

Measles. 


19C 

Mumps. 


38A 

Oph- 
thalmia 
Neona- 
torum. 


7 

Scarlet 
Fever. 


28-29 

Tuber- 
culosis, 
Pulmo- 
nary. 


30-35 

Tuber- 
culosis, 
Other 
Forms. 


1 

Ty- 
phoid 
Fever. 


8 

Whoop- 
ing 
Cough. 


38C 

Gonor- 
rhea. 


37 

Syphi- 
lis. 




03 


QQ 


i 
o 


in 

..J 


i 

a 


Q 


03 


03 

Q 


i 


02 

03 
5 


i 


03 


i 

03 

o 


QQ 


O 


CO 

t3 

Q 


6 


-a 

;5 




O 

a 


03 

u 


■.J 

d 

Q 


6 

c 

3 


1 
1 

1 

1 
1 
2 

4 

3 

1 

1 
1 

1 


2 

1 
1 

2 

_ 

1 
1 

2 

1 
1 
2 
4 

1 

2 
1 

1 

1 

_ 

1 
1 
1 

2 

1 

1 


7 

53 
1 

8 

39 

2 
1 
3 

1 
1 

2 

1 
3 

1 

18 
11 

2 
25 

1 

14 

2 

27 
3 

7 


1 
1 


1 

3 

1 
1 

14 

4 

1 


- 


- 


- 


2 
10 

2 

2 

1 
2 

5 
3 

2 

1 
2 

1 

1 
1 

1 
1 


- 


1 

1 

4 

1 

1 

1 
1 

1 

1 
2 

2 

1 
1 

2 

1 
1 

1 


1 
1 

1 

1 
1 

1 

1 
1 

3 

1 
1 

1 

1 

1 


1 
1 


1 


1 

1 

1 

1 


- 


8 
10 

5 

7 

4 
5 

3 

1 
4 

18 


1 
1 


1 

1 
1 


- 


- 


" 


287 
288 
289 
290 
291 
292 
293 
294 
295 
296 
297 
298 
299 
300 
301 
302 
303 
304 
305 
306 
307 
308 
309 
310 
311 
312 
313 
314 
315 
316 
317 
318 
319 
320 
321 
322 
323 
324 
325 
326 
327 
328 
329 
330 
331 
332 
333 
334 
335 
336 
337 
338 
339 
340 
341 
342 
343 
344 
345 
346 
347 
.348 
349 



260 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



o 
Z 



350 
351 
352 
353 
354 
355 
356 
357 
358 
359 
360 
361 
362 
363 
364 

65 

366 



Cases and Deaths from Diseases Dangerous 



Cities and Towns gkotjped 
IN Order of Population. 



Popu- 
lation 

esti- 
mated 

as of 
July 1, 

1920. 



63A 

An- 
terior 
Polio- 
mye- 
litis. 





oj 




OO 


J= 










^ 


c§ 


u 


W 


O 



19A 



Chicken 
Pox. 



Middlefield, 

Prescott, 

Washington, 

Tyringham, 

Wendell, . 

Alford, 

Mashpee, . 

Montgomery, 

Tolland, . 

Gay Head, 

Holland, 

Gosnold, 

Peru, . 

New Ashford, 

Mount Washington, 



Camp Devens, 

State Infirmary, Tewksburt, 



294 
278 
273 
271 
269 
266 
258 
245 
220 
190 
174 
160 
153 
92 
79 



19 



Diph- 
theria. 



O 



16 



61A 


19B 


Ep. 




Cere- 


Ger- 


bro- 


man 


spinal 


Mea- 


Menin- 


sles. 


gitis. 






OS 




« 


• 


,C 


• 


JS 


s 




S 




U 


« 


O 


Q 



10 



In- 
fluenza. 



U 



C3 

Q 



23 



In addition to the above there 






37 cases of dysentery, with 26 






occurred 3 cases of actino- 






deaths: — 




Cases. 


Deaths 


mycosis, with 1 death: — 


Cases. 


Deaths. 


Adams, 


. 


4 


2 


Barnstable, . . . ■ . 


1 


- 


Boston, 








4 


3 


Boston, 


1 


1 


Cambridge, 








1 


- 


Chelsea 


1 


~ 


Canton, 
Chicopee, . 








1 


1 
1 


17 cases of anthrax, with 4 






Fairhaven, . 








1 


- 


deaths: — 






Fall River, 








3 


3 


Boston 


2 


- 


Fitchburg, . 








- 


1 


Chelsea, 








1 


1 


Haverhill, . 








2 


- 


Lawrence, . 








1 


1 


Ipswich, 








- 


1 


Lowell, 








3 


1 


Maiden, 








- 


1 


New Salem, 








- 


1 


Maynard, . 








- 


1 


Newton, 








1 


- 


Medfield, . 








13 


- 


Peabody, . 








7 


- 


Milford, . 








- 


2 


Stoneham, . 








1 


- 


Montague, . 








1 


— 


Worcester . 








1 


- 


New Bedford, 








1 


1 








Newton, 








1 


- 


67 cases of dog bite (requiring 






North Adams, 








- 


3 


anti-rabic treatment) : — 






Quincy, 








1 


— 


Attleboro, .... 


3 


- 


Springfield, 








1 


1 


Barnstable, 








1 


- 


Sterling, 








3 


— 


Berkley, 








2 


- 


Taunton, . 








- 


1 


Beverly, 








1 


- 


Worcester, . 








- 


4 


Boylston, . 








3 


- 










Fall River, 








8 


- 


2 cases of hookwornr 


i: — 






Framingham, 








3 


- 


Beverly, 


. 


1 


- 


Grafton, 








7 


- 


Salem , 


. 


1 


~ 


Holden , 








1 


- 










Holyoke, . 








1 


- 


3 cases of leprosj 


', with S 






Lowell, 








9 


- 


deaths: — 








Methuen, . 








2 


- 


Boston, 




2 


- 


Middleborough, 








3 


- 


Gosnold, 


. 


- 


3 


New Bedford, 








3 


- 


Lowell, 




1 


— 


North Adams, 








1 


- 










Seekonk, 








1 


- 


60 cases of malari 


a, with t 


) 




South Hadley, 








1 


- 


deaths: — 








Stoughton, . 








1 


- 


Boston, 




. 


15 


^ 


Taunton, 








11 


- 


Brockton, . 




. 


3 


— 


Walpole, 








1 


- 


Cambridge, 




. 


2 


— 


Westminster, 








3 


- 


Camp Devens, 




. 


2 


- 


Winthrop, . 








1 


- 


Dedham, . 






• 


4 


~ 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 261 



to the Public Health, 1920 — Concluded. 



92 

Lobar 
Pneu- 
monia. 


6 

Measles. 


19C 

Mumps. 


38A 

Oph- 
thalmia 
Neona- 
torum. 


7 

Scarlet 
Fever. 


28-29 

Tuber- 
culosis, 
Pulmo- 
nary. 


30-35 

Tuber- 
culosis, 
Other 
Forms. 


1 

Ty- 
phoid 
Fever. 


8 

Whoop- 
ing 
Cough. 


38C 

Gonor- 
rhea. 


37 

Syphi- 
lis. 




O 


CO 
■*^ 

03 




6 


OQ 

1 


% 

O 


CD 




m 


CD 
P 


J 


00 

Q 


6 


CO 

P 


i 

6 


P 


00 

a 
O 


as 
P 




n 

.ia 

OS 


J 


(a 

JS 
■*^ 
03 
o 

p 


CO 

d 


2 

-4.4 

03 

p 


o 
Z 

o 

c 


1 
1 

1 
25 


1 

14 


8 

1 

2 
1 

7 
15 


2 


14 

47 


- 


- 


- 


1 
1 

5 

27 


- 


7 
51 


1 
1 

108 


11 


6 


- 


- 


1 
7 


- 


1 

51 
68 


- 


8 
20 


18 


350 
351 
352 
353 
354 
355 
356 
357 
358 
359 
360 
361 
362 
363 
364 

365 

366 



Deerfield, . 
Everett, 
Fall River, 
Fitchburg, . 
Framingham, 
Haverhill, . 
Holyoke, . 
Lawrence, . 
Lowell, 
Lynn, 

Mansfield, . 
Marlborough, 
Middleborough, 
Northbridge, 
Norwood, . 
Pittsfield, . 
Shelburne, . 
Taunton, 
Walpole, 
Whitman, . 
Winthrop, . 
Worcester, . 



16 cases of pellagra, with 14 
deaths: — 
Boston, 
Danvers, 
Lynn, 

Maynard, . 
Newburyijort, 
Northampton, 
Salem, 
Swampscott, 
Taunton, 
Waltham, . 
Wrentham, 
Worcester, . 

153 cases of septic sore throat, 
with 29 deaths: — 

Amherst, 

Arlington 



Cases. 


Deaths. 




1 


_ 


Attleboro, . 


2 


_ 


Boston, 


2 


. 


Brockton, . 


2 


_ 


Brookline, . 


1 


_ 


Cambridge, 


1 


_ 


Chelsea, 


1 


„ 


Clinton, 


2 


1 


Dedham, . 


1 


1 


Edgartown, 


1 


1 


Everett, 


2 




Fall River. 


1 


^ 


Greenfield, 


1 


_ 


Holyoke, . 


7 


_ 


Lancaster, . 


2 


_ 


Lawrence, . 


1 


1 


Leominster, 




1 


Lowell, 


1 




Lynn, 


1 


_ 


Maiden, 


1 


_ 


New Bedford, 


2 


_ 


Newburyport, 


1 




Newton, 
Northampton, 
Peabody, . 
Plymouth, . 


1 


_ 


Salem, 


4 




Saugus, 


1 




Sharon, 






Somerville, 


1 




Springfield, 


2 




Sutton, 






Taunton, . 


1 




Waltham, . 


1 




Warwick, . 


1 




Westfield. . 


3 




Whitman, . 


I 




Winchester, 
Winthrop, . 
Woburn, 
Worcester, . 


2 


- 




1 


- 





Cases. 


Deaths. 


2 




46 


13 


1 




1 




1 




2 




2 




1 




1 




1 




3 




- 




1 




1 




1 




1 




1 




1 




- 




4 




5 




2 




1 




1 




3 




1 




7 




1 




2 




- 




4 




2 




1 


- 


1 


- 


1 


- 


1 


- 


43 


1 


1 


- 


1 


- 


1 


- 



262 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



29 cases of tetanus 


, with 21 








Cases. 


deaths: — Cases. 


Deaths. 


Fall River, 


2 


Boston, 4 


3 


Fitchburg 


1 


Chicopee, . 










- 


Holyoke 


1 


Dan vers, 










- 


Lawrence, .... 


3 


Dennis, 










- 


Lowell 


3 


Easthampton, 










- 


Lynn, .... 


2 


Fall River, 










2 


Maiden, .... 


2 


Hadley, . 










1 


Medford 


3 


Holyoke, . 










1 


Montague, .... 


1 


Lawrence, . 










1 


New Bedford, 


1 


Lenox, 










- 


Peabody 


2 


North Adams, 










1 


Somerville, 


2 


Northampton, 










1 


Springfield, 


2 


Northbridge, 










- 


Taunton, .... 


1 


Peabody, . 










1 


Uxbridge 


1 


Pittsfield, . 










5 


Worcester 


3 


Quincy, 










1 






Revere, 










- 


5 cases of trichinosis: — 




Shirley, 










- 


Boston, .... 


4 


Springfield, 








3 


4 


Westfield 


1 


87 cases of trachoma: — 




29 cases of smallpox, with 1 




Athol 1 


- 


death: — 




Boston, 








44 


_ 


Boston, .... 


9 


Brockton, . 








1 


- 


Braintree 


1 


Cambridge, 








2 


- 


Chicopee 


3 


Chelsea, 








2 


- 


Lowell, .... 


1 


Easton, 








1 


- 


Methuen 


14 


Everett, 








2 


- 


Somerville, 


1 


Fairhaven, . 








4 


- 







Deaths. 



Cases and Deaths, with Case and Death Rates, per 100,000 PoprL.A.TioN ^ 
FOR All Reportable Diseases during the Year 1920. 



Disease. 


Cases. 


Deaths. 


Case 
Rate. 


Death 
Rate. 


Fatality 
Rate. 


Actinomycosis, 


3 


1 


.1 


.0 


33.3 


Anterior poliomyelitis, 




696 


140 


18.0 


3.6 


20.1 


Anthrax, 






17 


4 


.4 


.1 


23.5 


Chicken pox, .... 






5,355 


11 


138.4 


.3 


,2 


Diphtheria, .... 






7,513 


595 


194.2 


15.4 


7.9 


Dog bite, 






67 


- 


1.7 


- 


- 


Dysentery, .... 






37 


26 


1.0 


.7 


70.3 


Epidemic cerebrospinal meningitis. 






182 


129 


4.7 


3.3 


70.8 


German measles, 






484 


- 


12.5 


- 


- 


Gonorrhea, .... 






7,225 


4 


186.7 


.1 


.1 


Hookworm, .... 






2 


- 


.1 


- 


- 


Influenza, .... 






36,312 


1,700 


938.5 


43.9 


4.7 


Leprosy, 






3 


3 


.1 


.1 


100.0 


Malaria, 






60 


5 


1.6 


.1 


8 3 


Measles 






32,141 


347 


830.7 


9.0 


11 


Mumps, ..... 






5,962 


6 


154.1 


2 


1 


Ophthalmia neonatorum, 2 






1,638 


- 


42.3 


- 


- 


Pellagra, 






16 


14 


.4 


.4 


87.5 


Pneumonia, lobar, . 






5,558 


2,781 


143.6 


71.9 


50.0 


Scarlet fever 






10,260 


215 


265.2 


5.5 


2.1 


Septic sore throat, . 






153 


29 


4.0 


.7 


19.0 


Smallpox, .... 






29 


1 


.7 


.0 


3.4 


Syphilis, 






2,987 


225 


77.2 


5.8 


7.5 


Tetanus, 






25 


21 


.6 


.5 


S4.0 


Trachoma, .... 






87 


- 


2.2 


- 


- 


Trichinosis 






5 


- 


.1 


- 


- 


Tuberculosis, pulmonary. 






6,696 


3,743 


173.1 


96.7 


55.8 


Tuberculosis, other forms, 






800 


639 


20.7 


16.5 


79.9 


Typhoid fever, 






935 


96 


24.2 


2.5 


10.3 


Whooping cough. 






9,994 


542 


258.3 


14.0 


5.4 


Totals 






135,242 


11,277 


3,495.4 


291.5 


8.3 



1 Corrected population used. 



^ Includes suppuirative conjunctivitis. 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



263 



o 



•r. 

H 
Z 

o 






J 

< 



2 

O 

El. 
O 

K 
U 

w 

Q 

o 



« 


M CO 

to 


r* 


CO 


CO 


CO 


CO oo 


00 




N 


(M 

CO 


" g 


•.t* 


CM 

CO 

05 


3 

o 






lO 


t-^ 








t^ 




CO 
CO 






wi" 


H 




























I 

s . 

0) (h 


' « 


1 


CO 


CO 

C3 


- 


I -^ 


g 


i 


1 


CO 

oo 


1 1 


to 
(^ 

00 


o 

CM 


§^ 






i-H 


















■^ 




Q 




























1 

s . 

> s 


' {^ 


C<I 


<— < 


o 

CO 
CO 


»— 1 


^H I>> 


•<*' 
M 


s 


i 


£ 


1 "ti 






Z 




























t4 
2 


' 2 


M 


CO 

CO 




- 


1 M 


c^ 


00 

5 


1 


■^ 


i-H t^ 




00 




























u 




























o 
































m 


CO 




t^ 


CO M- 
CM 


oo 


05 


1 


CO 


1 OO 




05 


CD 




























o 




























03 




























-*^ 


1 CO 


t— t 


lo 


00 


CO 


M (M 


o 


o 


.-H 


o 


1 Ol 


(M 


oo 


3 


' o 




ȣ3 


c^ 




<M ^H 


*"• 


Jo 




»-H 






bC 




























3 




























< 






























^H CO 


1 


•o 


c^ 


CO 


CO -* 


r^ 


1^ 


_ 


CO 


1 ■* 


O 


s 


_>, 






g 








(M 


o 




1— 1 


'"' 


^^ 


CO 
CM 


"5 
























CvT 




^ 






























1 ^ 




C5 


CO 


1— 1 


-H t^ 


t-- 


« 


1 


-^ 


1 CI 


ss 


CD 


o 






o 








iO 


s 




C<l 




oo 

CM 


s 


5 
























lO 




i-s 






























1 1 


^n 


Oi 


oo 


c-^ 


1 o 


c^ 


IC 


1 


00 


1 -^ 


o 


^ 


C3 














GO 


CO 




Ci 




lO 

t^ 


CO 


S 
























in 










lO 




oo 


1 


CO 


to 


1 


r* 


1 OJ 


Oa 


GO 








CO 


t-^ 






CO 


CO 




(M 




■^ 


P 


*>-• 






CO 


•^ 








>ra 




(M 




^ 


t>- 


a 
























■^ 




<; 






























^H M< 




■^ 


Ci 


1 




c^ 


ec 


1 


tM 


1 ^ 


O 


lO 








t-* 


MO 




tM 


CO 


c^ 




cq 








£ 






CO 


»o 








>o 




•M 




o 


Oi 


03 




















(N 




CO 




S 




























1 


1 '^ 




C-1 


o 


oo 


1 CI 


I^ 


l« 


1 


r^ 


1 1 


<M 


U5 








^** 


^ 




C>4 


CO 


to 




o 




S 


CO 


X! In 






'^ 


to 








■a" 




-<*< 

s 




C5_ 


00 




1 c^ 


I 


00 


CO 


05 


1 00 


05 


oo 


1 


oo 


IM ■*• 


CO 


,_, 






CO 


CO 




<M 


■* 


05 




t— 




CO 


'f 






Ci 


Oi 








lO 




o 




o 


^ 




















lO 




CO 


1-H 


c3 




























•-3 








































^ 




























'm 




























a 


















































. 






'a 




• 




> 




• 


• 














o 




















































































" 




























"s 


• 










' 


* 




QQ 




























• rd 




























■** 










c 




























m 


















o 










O 


















>> 










h 


















..- i 

s — 

1 a 




o 
a 


.2 




• £ 
- 8 
£? 2 


1 
a 


C8 
2 




ci 




• 






1 1 

•1 1 

1 < < 


OS 
u 

c 

< 


c 

o 


S 




1 s 


O 


Xi 

u 

g 

c 
o 
C 


o 

8 


B 

3 
33 

C 
)-l 


S? .2 


CO 

1 


on 

E 



264 



DEPARTMENT OF PUBLIC HEALTH. [P. D. No. 34. 



o 



o 



m 
H 

o 



W 

< 



n 
o 

o 

o 

o 

w 
o 





00 


CO 


00 


s 


CO 


OS 


t^ 


»o 


t^ 


m 


o 


o 


iffl 


•^ 


Oi 


QQ 


CO 


w-i 


ud 


lo 


C<l 


oo 


<M 


00 




■5 


o 


s? 


S 


T. 




CD 




»c 


M 






05 








o 


00 


OS 


a> 


Oi 


aj 
































■2 






»o 


o 






ci" 








CO 






Oi 


to 


o 






























CO 


H 






























w^ 


1 


r^ 




CO 


t^ 


o 


•^ 


o 


.^ 


^ 


1 


00 


CO 


OS 


^ 


»o 






u? 








^ 








h- 


•o 


CO 


CO 






i-< 




TJ* 


Oi 






C4 








<o 






O 


Oi 


s^ 






























tc 


« 
































1 


CO 


1— t 


00 


00 


o 


1 


oo 


CO 


t~ 


1 


tn 


"2 


CO 


oo 


^ 


CO 




oo 


li^ 






-^ 








o 


CO 


00 


00 




>s 


^H 




c^ 


CO 






<M 








■^ 






CO 


^ 


OJ= 






























CO 


2; 
































ti 

o 


CO 


N 


o 


CO 


(O 


1 


r* 


CO 


a> 


1 


"2 


^^ 


r^ 


^^ 


SI 


o 


C<I 




c^ 


•^ 






o 








iO 


CO 


C<I 


Oi 


t* 






c^ 


in 






« 








o 




'^ 


CO 


•^ 


-S 






























»f5 


« 
































O 
































1 

S . 


r* 




c^ 


b- 


c^ 


1 


o 


CI 


t- 


, 


X5 


o 


00 


Ci 


C^ 


■^ 




CQ 


oo 






t^ 








t^ 


«o 


CI 


(M 


^ 


5 S3 


r-K 






(M 






CJ 








lO 




.-" 


*o 


Oi 


ao 






























CO 


a> 
































CO 
































3 


CO 


■^ 


CO 


CO 


CO 


1 


t^ 


^ 


oo 


1 


■5 


^ 


CO 


„ 


^__^ 






b- 








c^ 








CO 


>A 






31 


'^ 






<N 






N 








•^ 




^^ 


oo 


Oi 
CO 


<1 


































'^ 


"* 


CO 


t* 


CO 


■* 


CO 


lO 


00 


1 


a 


05 


S5 


o 


CO 


_>j 


-*** 




o> 


co 






o 








CO 


CO 


o 




o 








CO 






C4 








lO 






Ol 


CO 


"3 






























CO 


"-s 


































b* 


W 


CO 


W5 


CO 


, 


o 


^ 


<N 


1 


o 


t^ 


=2 


W3 


o 


a 


CO 




CO 




o 












'(J' 


t>- 


CO 


IT^ 


r^ 


a 






M 


r- 






IM 








CO 






OS 


oo 


3 






























o 


i-s 


































CO 


1 


lO 


CO 


to 




■^ 


1 


t^ 


1 


CO 


r- 


lO 


?S 


s 




■^ 




CO 








w 








t^ 


t^ 


■^ 


CO 


oo 






^ 


c^ 






C4 








CD 






•-< 


c^ 


§ 








VH 




















^H 






M 


1^ 


t^ 


00 


o 


1 


.-< 


CO 


•o 


c« 


t~ 


t-^ 


•* 


Oi 


*-4 




C^ 




oo 


■o 






»o 








03 


oo 


•^ 


00 


t^ 


h 


»-H 




CO 


CO 






C^l 








CO 






o 


1« 


0. 








^ 




















^ 


o 


< 


































\n 


1 


W5 


CO 


o» 


1 


00 


1 


CO 


1 


m 


CO 


CO 


c^ 


£? 


^ 




s 


c^ 






t^ 








ta 


oo 


CO 


-^ 


t^ 


»-H 




W3 


^. 






<M 








U5 






•"^ 


r- 


S3 








r-H 




















^^ 


^^ 


s 
































1 


m 


1 




Oi 


oo 


1 


t* 


1 


CO 


1 




OS 


C^ 


oo 


CO 


o 




s 


b- 

o 


T-« 




(M 








:S 


CO 


IM 


00 
00 


CO 

oo 

CO 


(S* 








»-l 






















>. 


u^ 


1 


lO 


■^ 


at 


1 


Ol 


1 


•* 


CO 


CO 


s: 


C^ 


o> 


s 


cd 


CO 




to 


*-H 






(M 








00 


00 


CO 


•^ 


2S 






00 








CO 








-^ 






r^' 




as 
































•-a 


































i 




• 


• 


' 




• 


• 


• 


• 


>> 

u 


n 

s 


• 


• 


• 




3 




















03 

a 
o 












C3 




. 




. 




• 


• 


• 


• 


e 


s 


• 




• 




C 

8 

03 




^ 




03 












"s 


.^ 




j3 








of 


1 


2 

■*^ 

2 

o 

(2 




• 


• 


• 


tn 


a 
.SS 

00 


o 


> 

•2 


8 






a 
O 


2 


'S 
o 

s 

3 


> 


1 

"a 
£ 


IS 


3 

c 


s 

o 
u 


O 

c 

15 

o 


"3 

3 

H 


"3 
o 

u 

3 


3 
'3 

o. 


a 
a 

O 

o 


13 



c 

3 



S 

o 



3 

p. 

3 



13 

3 



Division of Biologic Laboratories 



Benjamin- White, Ph.D., Director 

William A. Hinton, M.D., Assistant Director 

David L. Williams, M.D., Assistant Director 



12651 



i 



Kepokt of Division of Biologic Laboratories. 



Antitoxin and Vaccine Laboratory. 

1. Personnel. 

On Feb. 1, 1920, Dr. Benjamin White was appointed assistant di- 
rector of the Division and placed in charge of the Antitoxin and Vac- 
cine Laboratory. On June 1, 1920, Dr. M. J. Rosenau resigned as 
Director of the Division and Doctor White was appointed in his place, 
and Dr. David L. Williams was made assistant director. 

2. Produciion. 

The accompanying table, compiled from all available data, shows the 
amounts of the various biologic products prepared, distributed and in 
stock at the end of the fiscal years 1919 and 1920. 

Never before in the history of the laboratory have the reserve stocks 
of products been as large as they are at the present time. There is 
practically a year's supply of diphtheria antitoxin, of antimeningococcic 
and antipneumococcic serum in storage, which in addition to current 
production insures an adequate reserve to meet any epidemic emer- 
gency. 



Product. 



1. Diphtheria antitoxin: — 

Produced, .... 
Distributed, .... 
On hand 

2. Diphtheria plasma: — 

Produced, .... 

Used in concentration, . 

On hand 

3. Concentrated diphtheria antitoxin 

Produced 

Distributed, .... 
On hand, .... 



1919. 



Liters. 



Total 

11,000 Unit 

Doses. 



Units 
per C. C. 



602.28 

646.067 

72.3 



165.95 

109.05 

60. 



143,101 



16,028 



221 



147 



Liters. 



1920. 



Total 

1,000 Unit 

Doses. 



Units 
per C. C. 



769.1 

482. 
232.4 


179,756 


1,126.6 
725. 
569.1 


- 


158.6 

100.73 

55.2 


38,471 
60,720 



372 



381 
1,100 



268 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Pboduct. 


1919. 


1920. 


Liters. 


Total Doses. 


Liters. 


Total Doses. 


4. Antimeningococcic serum: — 

Produced, 

Distributed 

On hand 

5. Antipneumococcic serum. Type I: — 

Produced 

Distributed, 

On hand, 

6. Smallpox vaccine: — 

Produced 

Distributed, 

On hand, 

7. Typhoid paratyphoid vaccine: — 

Produced 

Distributed 

On hand 


86.5 

67.365 

31. 

23.800 
42.200 
36.925 

2.349 
3.247 

112.3 
74.123 


5,766 
4,565 

238 
422 
369.25 

140,940 
194,807 

112,300 
74,123 


317.665 
48.310 
47.2 

147.700 

44.4 

100.700 

4,844 
3.151 
1.624 

73.5 

49.191 

16.6 


21,177 
3,585 

1,477 

444 

1,007 

290,610 

189,064 

97,440 

73,500 
49,191 
16,600 




Outfits. 


Total Doses. 


Outfits. 


Total Doses. 


8. Schick outfits: — 

Produced 

Distributed, 

On hand, 


96 
96 


9,600 
9,600 


91 
63 
30 


9,100 
6,300 
3,000 




Liters. 


Total Doses. 


Liters. 


Total Doses. 


9. Diphtheria toxin-antitoxin: — 

Produced, 

Distributed 

On hand, 


1.108 


1,108 


6.443 
3.614 
2.829 


6,443 
3,614 
2,829 




Liters. 


Potency. 


Liters. 


Potency. 


10. Diphtheria toxin: — 

Produced, 

Used 

On hand, 


539. 

583. 

20. 


.006 
.006 
.006 


539. 

456. 

83. 


.0025 
.0025 
.0025 



These large supplies are due to two factors, one of which is the in- 
creased amounts of blood yielded by the horses, and the other is in- 
creased potency of all serums due to improvements in the methods of 
immunization. For example, the horses producing diphtheria anti- 
toxin are now producing serum containing nearly twice as many units 
per cubic centimeter as the serum produced in 1919. The higher 
potency of the serum at present produced enables physicians to ad- 
minister the proper number of units of antitoxin to the patient in 
about one-half the previous volume of fluid. The therapeutic effi- 
ciency of the serum is accordingly greatly enhanced. In addition, the 
horses are yielding from 30 to 40 per cent more serum. It is therefore 
possible with the same number of horses to produce more than twice 



No. 34.] DIVISION OF BIOLOGIC LABORATORIES. 269 

the total number of diphtheria units formerly produced, and the cost 
per 1,000 units is approximately halved. 

Changes in the procedure of vaccinating calves for the production of 
smallpox vaccine virus have increased the yield from each calf from 
60 to over 100 per cent. This means that the present yearly supply 
of nearly 200,000 doses can be produced from about two-thirds the 
usual number of calves, thereby reducing the cost of vaccine virus 
proportionately. 

3. Econoviics. 

Owing to the increased distribution of products and the prevailing 
high prices of all apparatus and supplies, the last annual appropriation 
for this laboratory barely covered the current expenses, and left no 
funds available for many urgently needed improvements. On account 
of the insufficient funds available and for the purpose of preparing 
and distributing the largest possible quantity of products at the lowest 
possible unit cost, many economies have been instituted and practiced. 
All supplies have been standardized, thereby reducing the number of 
articles on the stock list, and they have been purchased in quantity 
and usually on competitive bids. A considerable saving in the expense 
account has therefore been effected. 

4. Improvements. 

A new system of bookkeeping and of stock production and distribu- 
tion records is being installed which conforms with modern business 
systems, and whereby it is possible to make a more accurate and ac- 
cessible accounting of expenditures, equipment on hand, of production 
and finally of the production costs of each product. A full time clerk- 
stenographer has been added to the staff, who acts as chief clerk for 
the Division in addition to keeping all office records. This change re- 
lieves the trained laboratory assistants of clerical duties and enables 
them to devote their whole time to production. 

5. Educational. 

The teaching activities of the laboratory have been greatly expanded 
during the past year. Instruction in immunity, both theoretical and 
applied, and demonstrations of the preparation and use of biologic 
products have been given to more than 300 persons, comprising 
groups from medical societies, from medical and technical schools and 
colleges, as well as individual physicians, nurses, public health workers 
and students. 



270 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Although such lectures and demonstrations cause considerable incon- 
venience, they constitute one of the most valuable functions of the 
laboratory. It is the intention of the Director to welcome all such 
classes, any medical societies and interested individuals, because in 
such a way we can not only acquaint the medical profession and pub- 
lic health workers of the Commonwealth with the details of the pro- 
duction of biologic products, but we can also stimulate a more lively 
and widespread interest in the application of these products in the 
diagnosis, prevention and treatment of infectious diseases. 

6. Needs. 

(a) Personnel. — The present staff is too small to perform the added 
work entailed by the increased production. In the estimate already 
submitted for the 1921 budget, a request was made for one more 
laboratory assistant, Grade I. Since this estimate was submitted, 
however, it has been found necessary to increase further the personnel. 
If this laboratory is to meet the requirements of the Hygienic Labora- 
tory of the United States Public Health Service, under whose license 
the products are prepared and distributed, it will be necessary to con- 
centrate all diphtheria antitoxin. This process involves constant and 
careful attention and warrants the employment of a full-time laboratory 
assistant. It is desirable that a chemist be obtained for this work, who 
could also assist in other processes in the laboratory, especially during 
vacation seasons. In addition to this, if the new regulations of the 
Hygienic Laboratory are to be complied with in all details, it will be 
necessary to add to the staff another trained bacteriologist. Further- 
more, although the main function of such a laboratory as the Anti- 
toxin and Vaccine Laboratory is the production of biologic products 
for the needs of the Commonwealth, it is also well within its scope to 
investigate and develop new methods, not only for the improvement 
of its present products but also for the production of new biologic 
agents. The procedures as now carried out in the immunization of 
horses and in the preparation and testing of antitoxin and other serums 
and vaccines should be made to yield scientific dividends in the way 
of new and useful data. The present burden of work carried by the 
employees of the present staff makes it impossible to take advantage 
of this exceptional opportunity, but with the addition of these two 
assistants some of the facilities offered might be utilized to good 
advantage. 

(6) Funds. — The increased appropriation requested in the estimate 
for the 1921 budget is required not only to meet the increased over- 



No. 34.] DIVISION OF BIOLOGIC LABORATORIES. 



271 



head charges but also to replace many antiquated and worn-out items 
of apparatus and equipment, and also to provide for the heavy ex- 
penses incident to the more elaborate tests required by the Federal 
government. 

(c) Laboratory Accommodations. — The buildings in which the ac- 
tivities of the Antitoxin and Vaccine Laboratory are now housed are 
inadequate for the number of workers and the volume of work done. 
If the laboratory's activities are to expand even at the present rate, it 
soon will be necessary either to enlarge and add to the present build- 
ings or to provide suitable accommodations elsewhere. The buildings 
now occupied are not the property of the Commonwealth but are 
leased from the Bussey Institution of Harvard University. Under the 
present circumstances it is not advisable to carry out many of the 
urgent improvements, and it is also impossible at present to enlarge 
the buildings to accommodate the workers and the work. 

The problem of providing for the expansion and permanent housing 
of the laboratory's activities is soon to be met and it is now being 
studied in all its aspects. 

Wassermann Laboratory. 

1. Routine Tests. 

During the past year the activities of the Wassermann Laboratory 
have been confined to the execution of tests established during the 
previous years. Its personnel has not changed in number, but the 
volume of its work shows a noteworthy increase over that of 1919, as 
indicated in the following table: — 





1916. 


1917. 


1918. 


1919. 


1920. 


Wassermann tests, 


25,497 


28,524 


27,534 


31,485 


36,953 


Gonococcus fixation tests 


- 


- 


- 


222 


1,726 


Diagnostic examinations for Division of Ani- 
mal Industry: — 
(a) Complement fixation tests for glanders, 


985 


1,330 


646 


122 


221 


(b) Examinations for rabies, 


47 


67 


61 


84 


166 


(c) Pathologic and bacteriologic examina- 
tions. 


10 


3 


45 


79 


64 



2. Coviylemeyit Fixation Tests in Tuberculosis. 

In addition to performing the increasing number of routine tests, an 
investigation has been carried on to determine the utility of the com- 
plement fixation test as a clinical aid in the diagnosis of tuberculosis. 



272 DEPARTMENT OF PUBLIC HEALTH. [P. D. No. 34. 

The various methods advocated by other workers as well as several 
original modifications have been studied. This investigation indicates 
that in its present stage of development the complement fixation test 
in tuberculosis does not possess suflficient diagnostic or prognostic value 
to be used as an aid in the clinical determination of tuberculosis. 



3. Complement Fixation Tests in Gonococcal Infections. 

During the past year the gonococcus fixation test has been utilized 
to some extent as a clinical aid in the diagnosis of gonococcal infec- 
tions. Its chief use has been in the determination of "cures," and 
hence, in a decision, as to the communicability of the disease. The 
demand for this test has not been as great as was expected, although 
many of the best clinicians value it as an aid in obscure cases. 

No small part of the work of the laboratory consists in the prep- 
aration of standardized amboceptor and standardized antigen, which 
is distributed to municipal, public health and hospital laboratories in 
the State for use in Wassermann testing. 

4. Costs. 

The careful economy practiced during the past year is apparent 
when it is stated that the cost of Wassermann examinations was 25 
cents per test during the present fiscal year and that this cost in- 
cludes the overhead of statistical investigations. The cost in 1916 
was a fraction less than 20 cents, but in that year the amount in- 
cluded no charge for statistical investigations, and the scale of salaries 
and the price of supplies were on a much lower level than during the 
present year. 



I 



Division of Hygiene 



Merrill E. Champion^, M.D., Dir color 



[273] 



Keport of Division of Hygiene. 



Changes in Personnel. 

During the year just past there has been a great increase in the 
scope of the Division's work, together with a shrinkage in the size of 
its personnel. We have gained a cHnic physician and a health in- 
structor in mouth hygiene and lost a chief of the Subdivision of Pub- 
lic Health Nursing, together with two nurse health instructors. The 
Division is at present badly undermanned. 

In March, 1920, Miss Blanche Wildes, chief of the Subdivision of 
Public Health Nursing, resigned to accept a position with the New 
England Division of the American Red Cross. In September, 1920, 
Miss Hazel Wedgwood and in October Miss Harriet Wedgwood re- 
signed as health instructors to accept much more lucrative positions 
with the Red Cross in other States. The loss of these three experi- 
enced and efficient workers at the height of their usefulness to the 
State, because of the poor salaries paid by this State, is most un- 
fortunate. 

In April, 1920, Miss Evelyn C. Schmidt, who had already been with 
us as a temporary appointee as health instructor in mouth hygiene, 
was made a permanent employee. In June Dr. Mary Putnam, who 
likewise had been with us previously as a temporary appointee, was 
appointed clinic physician on a permanent basis. 

In November, 1920, Dr. Edwin N. Kent, who had given vaUant and 
gratuitous service as supervisor of mouth hygiene, resigned this po- 
sition and was appointed consultant in mouth hygiene. 

In March Miss Josephine M. Cullen resigned as stenographer to ac- 
cept a position in the office of a practicing physician. Miss Winifred 
A. McPeake was appointed to the position of junior stenographer in 
April, 1920, and Miss Anna E. Curran was employed in a similar 
position in September, 1920. 



Lines of Work. 

The work of the Division for the past year will be discussed under 
headings indicating the different activities which are being carried on. 



276 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Investigations. 

During the year 1919-20 two extensive pieces of investigation were 
carried on by nurse health instructors in the Division of Hygiene. 
One of these dealt with the present status of the midwife in Massa- 
chusetts. A group of nine cities and towns was chosen in which to 
make the study. The basis of choice was that the population of the 
communities should be representative of the different races present in 
any number in this State. Consequently, a study was made of con- 
ditions as they existed at that time in Boston, Fall River, Brockton, 
Fitchburg, Springfield, Barre, Pittsfield, Provincetown and Westfield. 
The nurses making the investigation were thoroughly experienced in 
that type of work. 

It will be recalled that, according to law, in Massachusetts the 
midwife has no standing except that she is obliged to report the births 
she attends. On the other hand, if she attends any births, she is 
liable to prosecution for practicing medicine without a license. It 
would seem as if prohibition of this sort would be sufficient to drive 
the midwife out of the State. As a matter of fact, however, diligent 
inquiry in the nine cities and towns mentioned uncovered the presence 
of 117 midwives. Without any question there are others practicing 
there who were not found. The midwife is an important factor in the 
confinement of the mother of foreign birth, the reasons for this fact 
being that these women are accustomed to having a midwife in the 
home country and also prefer a midwife because she combines house- 
work with medical care, all for a comparatively reasonable fee. 

Much of the information obtained during this investigation came 
only in a roundabout way and some of it came in confidence. Many 
of the midwives visited were apparently making an honest attempt to 
carry on their work in a cleanly manner; others were not of a suf- 
ficiently high type to recognize the need of cleanliness. Probably it 
may be said with justice, however, that as a result of legal restriction 
the tendency has been for the poorer midwife rather than the better 
one to survive as the former is more willing to take chances with the 
law. The results of the work of the midwife as measured by mor- 
tality statistics were reasonably good in the cities and towns studied. 
As a matter of fact, however, too much reliance cannot be placed upon 
this because the midwife when in difficulty generally falls back upon 
some physician to help her out, and also because there are no statistics 
available on the morbidity which may result from the practice of the 
midwife. 

It is difficult to say at present just what change should be made in 



No. 34.] DIMSION OF HYGIENE. 277 

existing practice as regards michvives. It certainly can hardly be 
considered an ideal arrangement to have a poorly trained individual 
handling obstetrics. She is useful only because a certain group insists 
upon having her and also because she does, in a certain measure, solve 
the problem of caring for the family at the time of the mother's 
confinement. More maternity clinics, some arrangement for provid- 
ing those willing to do housework, and education of the foreign-born 
mother as to the need of the best possible medical care at the time of 
her confinement, represent probably the most satisfactory, though of 
necessity, a slow solution of the midwife problem. 

A second investigation undertaken last year by the Division was 
one into the open-air school problem of the State. All such schools in 
Massachusetts were visited, their methods of procedure studied, and 
the results collected so far as was possible. Questionnaires sent to 
similar institutions in other States furnished a basis for comparison. 
It was hoped that possibly some standards might be evolved which 
would enable us to estimate with some degree of assurance the number 
of children in a given community who should be in such special schools 
and also the probable cost of such care. We have come to the con- 
clusion, however, that much more work is necessary throughout the 
country on this problem before any such standards can be formulated. 

Food and its Relationship to Health. 

The nutrition work of this Division has been increasing very rapidly 
during the year which has just passed. The demands upon the time 
of our health instructor in foods have increased in two directions. On 
the one hand, communities throughout the State have been asking 
with increasing frequency for talks to school children and to groups 
of adults interested in a general way in the problem of food and its 
relationship to health. On the other hand, there has l)een an increas- 
ing number of consultations with this Department with regard to the 
establishment of new pieces of nutrition work, either under the aus- 
pices of some municipality or under private agencies. The work has 
thus grown to such an extent that one person is no longer able to 
handle it. The advice to towns and to private agencies is, of course, 
the more important phase of the work in that it means the extension 
of the educational facilities to a larger group of people. For this 
reason the assistance we have given to cities and towns in the way of 
talks on food will have to be curtailed unless our force is augmented. 

During the past year an advisory committee on nutrition was 
formed, made up of representatives of the larger organizations inter- 
ested in this subject. Several meetings of this committee were held 



278 DEPAETMEXT OF PUBLIC HEALTH. [Pub. Doc. 

and much discussion ensued which proved to be helpful in the De- 
partment's work. 

A special edition of our bimonthly bulletin, " The Commonhealth," 
has been issued which is devoted to setting forth the different phases 
of the nutritional problem and the way in which it is being handled 
by the different interested agencies in the State. 

Mouth Hygiene. 

Educational work along the lines of mouth hygiene has been de- 
veloping with startling rapidity. Although a comparatively new move- 
ment, it apparently has made an appeal to the public imagination far 
in excess of that made by other phases of public health work which 
have been for a much longer period before the public eye. The Di- 
vision of Hygiene began its activities in this field last year with the 
appointment of a public-spirited dentist as supervisor of mouth hy- 
giene. The service rendered the State in this instance was gratuitous 
but of the greatest value. An advisory committee on dental hygiene 
was also established, consisting of a group of well-known dentists whose 
interest in the preventive side of dentistry is sufficient to make them 
willing to serve on such a committee. Later in the year a temporary 
appointment was made of a health instructor in mouth hygiene. 
This position proved to be of such value that an appropriation was 
secured in 1920 which enabled us to make this a permanent appointment. 

In mouth hygiene, as in nutrition, the first step taken was in the 
direction of talks and literature designed to reach the general public 
and to inform it as to the importance of the care of the mouth and 
teeth. The health instructor in mouth hygiene visited many cities 
and towns, talking to the school children and speaking before adult 
audiences. Various pamphlets on the subject were written and dis- 
tributed in very large numbers. A letter was prepared to be read in 
all the schools in order to reach in a more personal way the many 
thousands of school children in the State. A dental hygiene exhibit 
was prepared which has been shown at fairs and during health weeks. 

The second phase of the work has now been reached. The demand 
for lectures continues as great as ever and in addition we are receiving 
an increasing number of calls for expert advice as to the best ways of 
starting dental work in the different cities and towns. It is easy to 
see that if we are to furnish this advice and if we are to keep up 
with the duty of preparing new written material from time to time, 
we must have the services of at least one person for this work alone. 
For this reason a second health instructor in mouth hygiene is being 
asked for this year. 



No. 34.] DIVISION OF HYGIENE. 270 

Cliuici' for flic Child in the Rural Connuimtty. 

During the agricultural fair season of 1919, as mentioned in my 
last annual report, an attempt was made on a small scale to reach the 
child in the rural districts through the offer of free medical examina- 
tion hy a competent pediatrician. It Avas felt that the results of this 
experiment justified the extension of the work. An appropriation was 
obtained for 1920 to place this activity upon a permanent basis. One 
clinic physician was appointed, and a tentative plan was made to 
cover the more inaccessible parts of the State during the summer and 
fall. Two objects were kept in view: to paint a comprehensive pic- 
ture of the actual conditions under which the country child grows up 
and the result as seen in the cliild, and to arouse local interest in im- 
proving these conditions. 

The clinic physician started in June, 1920, to carry out this pro- 
gram. The Berkshires were selected as representing the most isolated 
farming district. An additional fact of great interest was that here 
could be found a chance to study the conditions under which our 
country children of native stock live. A few weeks were spent at the 
inception of the work in visiting the small towns of this territory, mak- 
ing calls upon local physicians, teachers, school boards and others to 
explain what we had in mind and particularly to emphasize that our 
work was intended to be preventive rather than curative. Many of 
the larger towns were also visited in order to determine the hospital 
and dispensary facilities which might be useful to those found in need 
of such service. Real co-operation was obtained from many, par- 
ticularly farm bureaus, the Red Cross and school authorities. There 
was very little antagonism on the part of any one, although, as was 
naturally to be expected, the majority'' of those reached were rather 
indifferent, probably because of the novelty of the undertaking. 

These rural clinics were conducted in as simple a manner as possible. 
The examinations were thorough, but the use of expensive accessories 
was discouraged. Instead of using an automobile fitted up as a clinic, 
the local schoolhouse or similar building was used. It was intended 
that the community should be impressed in every way possible with 
the fact that nothing was being done which they might not reasonably 
hope to duplicate. Our purpose from the very start was to show the 
community the existing need for better supervision of the health of its 
children and to show them how such supervision could best be carried 
out by themselves with what assistance in advice and demonstration 
the State could give. In every instance where the children were ex- 
amined, an attempt was made to have the parents present in order 



280 DEPARTIMENT OF PUBLIC HEALTH. [Pub. Doc. 

that the facts discovered might be discussed with them. If defects 
were found which called for treatment, the case was at once referred 
to the family physician if there were one. Where public health nurses 
were available they were urged to follow up the children who were 
shown to be suffering from defects in order that they might aid the 
parents to have these defects corrected. 

Most of the school examinations were made in the entry way of one- 
room school buildings, the door into the schoolroom being closed for 
privacy and the door overlooking the hillside being left open for light 
and air. The children were dismissed from class one at a time without 
interrupting the school routine, and examined as completely as was 
possible under such conditions. Posture, nutrition, musculature, os- 
seous system and any deformities were noted. Heart and lungs were 
gone over and the possibility of abdominal disease was kept in mind. 
Then the head, eyes, nasopharynx, teeth, scalp, skin and glands were 
considered, also the nervous condition and general well or ill being. 
So far as time permitted, diet and habits were discussed and suitable 
advice given. A record was kept of all examinations, and copies of 
a summary were sent to the superintendent, teacher or some one else 
sufficiently interested to volunteer to follow up the cases needing over- 
sight. In almost all of the small towns visited there was no school 
nurse or visiting nurse of any kind. 

During the summer twenty-eight clinics were held and nearly 1,600 
children examined. From a study of the records of the first 200 school 
children examined, between the ages of five and fifteen years, living 
on farms in an unusually healthful section of the Berkshires, the fol- 
lowing facts appear: Eighty-five per cent of these children have de- 
caying teeth. Only 10 per cent have had any dental care whatsoever. 
Sixteen and five-tenths per cent have pathologically enlarged tonsils. 
Fourteen and five-tenths per cent have adenoids so hypertrophied as 
to interfere seriously with respiration. Fourteen and five-tenths per 
cent have vision so defective as to be evident without special tests. 
Two and five-tenths per cent have scoliosis; 2 per cent, kyphosis; 5 
per cent, enlarged thyroids; 2.5 per cent, heart symptoms; 1.5 per 
cent, chronic otitis media. A notable fact, and one which reflects 
upon the administration of health laws as regards school children, is 
that 50.5 per cent of these school children have not been successfully 
vaccinated. 

Cancer Control. 

Our activities in the direction of cancer control have followed the 
lines laid down last year. We have continued our relationship with 
the Cancer Commission of Harvard University, which has enabled us 



No. 34.] DIVISION OF HYGIENE. 281 

to offer free diagnosis to all physicians of the State for pathological 
specimens suspected of being cancerous. A special booklet on the 
subject of cancer was sent out to physicians in the State. 

Edncaiional Work. 

Our educational work carried on through health weeks, moving 
pictures, lectures, including those with the stereopticon view, pam- 
phlets and demonstrations on the care of the baby have been con- 
tinued this year as in previous years. An exhibit on mouth hygiene 
has been added and is proving of great value, also one on the school 
lunc?h. 

As many as possible of the agricultural fairs were reached again this 
year. Noteworthy among these was the Eastern States Exposition at 
Springfield, where we had the use of a small, well-arranged, separate 
building, through the courtesy of Mrs. Storrow. At most of the fairs 
we had, in addition to the demonstrations by the nurse in charge of 
our exhibit, additional demonstrations by a dental hygienist and a 
nutritionist. In a number of instances the home demonstration agents 
of the Massachusetts Agricultural College joined with us for this 
purpose. Our pediatrician also weighed and measured children at 
many of the fairs and advised with such parents as were interested in 
improving the health of their children. 

The Division has issued a number of new or revised pamphlets this 
year, including "The School Lunch," "Fly Danger," "Cancer Facts 
Every Adult Should Know," "Suggested List of Books on Hygiene 
for the Town Library," "Instructions for Home Care of the Mouth," 
" How Cooking affects the Digestibility of Foods," " Do You Know 
That" (a pamphlet on mouth hygiene), "The Baby and You" (re- 
vised edition), "Carbohydrate Foods" (revised edition), "The Control 
^f Ophthalmia Neonatorum," "School Health Program," "Illustrated 
Lectures and Moving Pictures." 

We have purchased for use throughout the State two moving-pic- 
ture films entitled "An Equal Chance" and "Mouth Hygiene." The 
former film has to do with the importance of the public health nurse; 
the title of the latter explains its subject-matter. 

Our prenatal and postnatal letter service has been continued during 
the year. New requests for prenatal letters have been received to 
the number of over 2,000; requests for postnatal letters, exclusive of 
those being carried along from our prenatal letter file, number about 
500. 

Two interesting developments of our lecture service during the past 
year deserve to be recorded. The first was the giving of a series of 



282 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



three talks before the students of the normal schools of the State on 
public health subjects. These lectures were arranged through the 
courtesy of the State Department of Education. It is planned to repeat 
this course during the coming year. The second was a series of talks 
to nurses in training given largely through the District Health Officers 
and their nursing assistants, but participated in by the Division of 
Hygiene, by the presentation of the subjects of child hygiene in gen- 
eral and school nursing in particular. This course, also, is to be re- 
peated during the coming year. 

Statistical tables relative to health weeks, exhibits and lectures 
follow: — 

Exhibits were given at the following places for health weeks or 
health days from Dec. 1, 1919, to Nov. 30, 1920: — 



Barre^ (twice). 

Bolton. 

Boston ^ (five times) . 

CUnton. 

Hardwick^ (t\sice). 

Harvard. 

Hingham. 

Lancaster. 

Lee. 

Leicester. 



Lowell. 

Ludlow. 

North Adams. 

North Brookfield. 

Quincy. 

Soraerville. 

Uxbridge. 

Winchendon. 

Worcester. 



Exhibits were given at the following agricultural fairs : — 



Athol. 

Nantucket. 

Springfield. 



Walpole. 

Ware. 

Westport. 



Lectures were given on the following subjects during the year: — 

Legislation, 19 

Preventable Diseases, . . .17 

Sanitation, 14 

Work of State Department of 

PubUc Health, .... 4 

Rural Sanitation, .... 1 
Wear and Tear Diseases of Adult 

Life, 1 



Mouth Hj'giene, 


. 267 


Public Health, 


. 102 


Venereal Diseases and Social 


Hy- 


giene, .... 


. 95 


Foods, .... 


. 69 


Child Welfare, 


. 53 


School Hygiene, 


. 39 


Communicable Diseases, 


. 37 


PubUc Health Nursing, 


. 32 


Personal Hygiene, . 


. 24 


Tuberculosis, . 


. 20 



Total, 



. 794 



1 Different sections of the town. 



Xo. 34.] 



DIVISION OF HYGIENE. 



283 



Lectures were given during the year, by months, with the approxi- 
mate number of people reached, as follows: — 



Month. 



Lectures. 



Number 
present. 



1919. 

December, ..... 

1920. 

January 

February, ..... 

March, 

April, 

May 

June, 

July 

August, 

September 

October 

November, ..... 
Totals, ..... 



62 



794 



11,997 



.50 


9,580 


26 


2,886 


68 


6,867 


168 


20,342 


177 


18,444 


80 


8,467 


24 


1,278 


7 


265 


13 


1,627 


56 


4,518 


63 


9,039 



95,310 



During the fiscal year ending Nov. 30, 1920, lectures were given in 
the following cities and towns: — 



Abington, 










1 


Brookline, 










2 


Acton, 










3 


Burlington, 










1 


Acushnet, 










1 


Cambridge, 










6 


Agawam, . 










2 


Canton, 










1 


Amherst, . 










4 


Chatham, 










2 


Andover, . 










4 


Chelsea, 










5 


ArHngton, 










5 


Chesterfield, 










3 


Ashby, 










2 


Chnton, . 










10 


Attleboro, 










1 


Concord, . 










1 


Barnstable, 










11 


Conway, . 










1 


Barre, 










8 


Cummin gton, 










1 


Becket, 










1 


Danvers, . 










1 


Bedford, . 










2 


Dedham, . 










1 


Belchertown, 










5 


Deerfield, 










6 


Billerica, . 










3 


Dighton, . 










2 


Bolton, 










2 


Easthampton, 










1 


Boston, . 










132 


Easton, 










6 


Boxford, . 










1 


Everett, 










2 


Braintree, 










3 


Fall River, 










3 


Brewster, . 










1 


Falmouth, 










1 


Bridgewater, 










7 


FiTCHBURG, 










9 



284 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Foxborougli, 
Framiugham, 
Gardner, . 
Gloucester, 
Goshen, . 
Grafton, . 
Granby, 
Greenfield, 
Grot on, 
Groveland, 
Hadley, . 
Hanover, . 
Hanson, . 
Hard wick, 
Harvard, . 
Harwich, . 
Haverhill, 
Hingham, 
Holden, . 

HOLYOKE, 

Hopedale, 

Huntington, 

Lancaster, 

Lawrence, 

Lee, . 

Leicester, . 

Lenox, 

Leominster, 

Lexington, 

LOAVELL, . 

Ludlow, . 
Lynn, 

Malden, . 

Marblehead, 

Mattapoisett, 

Medford, 

Melrose, 

Middleborough 

Milford, . 

Millbury, . 

Milton, . 

Natick, 

Needham, 

Newburyport, 

Newton, . 

North Adams, 

Nortil\mpton, 



2 


Northborough, 




4 


North Brookfield, 


3 


Norton, . 


1 


Norwell, . 




1 


Norwood, 




3 


Orleans, . 




1 


Oxford, 




7 


Petersham, 




1 


Pittsfield, 




1 


Princeton, 




9 


QUINCY, . 




9 


Randolph, 




1 


Reading, . 




8 


Revere, . 




3 


Richmond, 




3 


Rockport, 




16 


Rutland, . 




14 


Salem, 




4 


Sandwich, 




4 


Saugus, . 




1 


Scituate, . 




6 


Shelburne, 




1 


Shirley, 




5 


Shrewsbury, 




1 


Somerville, 




5 


Southampton, 




1 


Southbridge, 




5 


Spencer, . 




8 


Springfield, 




55 


Sterling, . 




1 


Stoneham, 




16 


Sunderland, 




5 


Sutton, 




2 


Swampscott, 




3 


Topsfield, 




1 


Townsend, 




1 


Uxbridge, 




6 


Wakefield, 




1 


Walpole, . 




1 


\Valtil\m, 




1 


Ware, 




1 


Wareham, 




1 


Watertown, 




4 


Webster, . 




13 


Wellfleet, . 


9 


Westborough, . 


9 


West Boylston, 





No. 34.] 



DIVISION OF HYGIENE. 



285 



Westfield, 


4 


Williamsburg, . 


2 


Westhampton, 


. 3 


Winchendon, . 


. . 7 


Westport, 


. . 3 


Winchester, 


. 8 


West Springfield, 


1 


Winthrop, 


2 


Weymouth, 


. 1 


WOBURN, . 


1 


Whitman, 


. 2 


Worcester, . 


. 84 



This makes a total of 148 cities and towns in Massachusetts where 
lectures were given by Department lecturers. 



Special ]]'ork. 

Reference was made in the last annual report of this Division to 
the situation in Massachusetts as regards maternal and infant mor- 
tality. It was pointed out that the trend of the total mortality of 
infants under one year of age in this State is downward, with occa- 
sional rises like that of 1918. The total rate for 1919 was lower than 
we have yet had in this State. It was further pointed out, however, 
that the infant mortality during the first four weeks of life is not 
diminishing and that the mortality among women fifteen to forty-five 
years of age from causes due directly to childbirth is increasing in this 
State. 

Certain bills introduced into last year's Legislature looked towards 
financing an effort to reduce this mortality amongst mothers and 
babies. No bill was passed during 1920 but a resolve which created 
a special commission to study the whole question of the protection of 
mothers and infants was passed instead. The Director of the Di- 
vision of Hygiene served as director of investigations at the request of 
the special commission. The results of the study of the commission 
are available in the report to the special session of the Legislature held 
in December, 1920. It is fitting, however, to point out here a few of 
the facts brought out by the investigation because of their far-reach- 
ing bearing upon infant and maternal mortality in Massachusetts. 

It has been generally considered that poverty is one of the great 
underlying causes of infant mortality. Studies by the Children's Bu- 
reau have shown that in the areas studied the infant mortality in- 
creased as the income of the fathers decreased. It has been generally 
assumed that this would be true of the maternal mortality and of the 
infant mortality during the first two or three weeks. The results of 
the Massachusetts investigation show that this is not so. More than 
half the mothers who died came from families where the total income 
was undoubtedly sufficient to pay for medical care. It was shown that 
none of the mothers who died had had what might reasonably be 



286 DEPARTMENT OF PUBLIC HEALTH. [P. D. No. 34. 

called adequate prenatal care. Furthermore, it was demonstrated in 
a study of a thousand cases that 50 per cent of the infants who died 
had one visit or none at all from a physician before death. Another 
interesting fact brought out was that most of the homes where mothers 
died showed, in the opinion of competent observers, fair or good hous- 
ing conditions. 

The logical conclusion to be drawn from the facts stated above seems 
to be that mothers and infants die in Massachusetts largely because 
of neglect of hygiene. This conclusion justifies us in continuing the 
plan we have always followed of directing our efforts towards the 
education of our citizens in matters of personal hygiene. It further 
confirms us in our belief that this can be most effectually done through 
the extension of public health nursing service in the homes of the 
citizens of the Commonwealth. 



Division of Tubeeculosis (Sanatoria) 



William J. Gallivan, M.D., Director 



[287] 



Eeport of Diyision of Tuberculosis (Sanatoeia). 



The Division of Tuberculosis was established Dec. 1, 1920, pur- 
suant to chapter 350 of the General Acts of 1919. By the provisions 
of this act the Board of Trustees of Hospitals for Consumptives was 
abolished and all the rights, powers, duties and obligations of said 
Board were transferred to the Department of Public Health. The 
Commissioner of Public Health was further directed by said act to 
establish a division within said Department to supervise the adminis- 
tration of the sanatoria. 

Previous to the passage of this act the tuberculosis work of the 
Department of Public Health was confined to the Division of Com- 
municable Diseases. An important step taken by this Division was 
the compilation of all known cases of tuberculosis in Massachusetts 
from Jan. 1, 1915, to Jan. 1, 1920. This work has been transferred to 
the Division of Tuberculosis. The Division of Tuberculosis therefore 
has the administrative supervision of the four State sanatoria, the 
supervision of all known cases of tuberculosis in the State, and the 
general supervision of all tuberculosis activity in the Commonwealth. 

We are fond of referring to the fact that Massachusetts was the 
first State in the Union to erect and maintain a hospital for consump- 
tives. Always a pioneer in all that pertains to the benefit of humanity 
this grand old Commonwealth blazed the trail in the effort to stamp 
out the great white plague, and in 1898 opened the doors of the first 
State sanatorium for consumptives in America at Rutland, Mass. The 
wheels of legislation necessary for this glorious achievement were 
started on Jan. 30, 1895, by the introduction of the following bill: — 

An Act to establish the Massachusetts Hospital for Consumptives and 

Tubercular Patients. 
Be it enacted, etc., as follows: 

Section 1. The governor, with the advice and consent of the council, shall 
appoint five persons who shall constitute the board of trustees of the Massa- 
chusetts hospital for consumptives and tubercular patients, and who shall hold 
office for temis of one, two, three, four and five years respectively, beginning -with 
the first Monday of July in the present year, and until their respective successors 
are appointed and qualified; and previous to the first Monday in July in each 
year hereafter, the governor shall in like manner appoint one such trustee to hold 
office for the term of five years, beginning with the first Monday in July of the 



290 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

year of his appointment, and until his successor is appointed and quahfied. Any 
such trustee may be removed by the governor with the advice and consent of 
the council for such cause as they may deem sufficient and as shall be assigned in 
the order for removal. Any vacancy occurring in said board shall be filled in 
like manner for the unexpired term. 

Section 2. The lands held by said trustees in trust for the Commonwealth 
for the use of said hospital, as hereinafter provided, shall not be taken for a 
street, highway or railroad without leave of the legislature specially obtained. 

Section 3. Said trustees shall be a corporation for the same purposes for 
which the trustees of each of the state lunatic hospitals are made a corporation 
under section five of chapter eighty-seven of the PubUc Statutes, with all the 
powers necessary to carry said purposes into effect. 

Section 4. Said trustees shall have authority to purchase in behalf of the 
Commonwealth suitable real estate as a site for said hospital, and to cause to be 
erected thereon suitable buildings for said hospital which shall furnish suitable 
accommodations for not less than two hundred patients and for the officers, em- 
ployees and attendants, and to provide for the equipment and furnishing of said 
buildings : Provided, howeve •, that the expenditure for carrying out the purpose 
of this act shall not exceed one hundred and fifty thousand dollars. No ex- 
penditure shall be made for the erection of buildings except for plans therefor, 
until said plans have been approved by the governor and council, and no such 
approval shall be given unless the governor and council shall be satisfied that the 
cost of the real estate and the erection and completion of buildings and the 
equipment and furnishing of the same ready for occupancy will not exceed one 
hundred and fifty thousand dollars. Said trustees shall have authority to make 
all contracts and employ all agents necessary to carry into effect the provisions 
of this act. 

Section 5. Said trustees shall have the same powers vested in them and 
shall be required to perform the same duties for the management and control of 
said hospital as are vested in and required of the trustees of the Massachusetts 
hospital for dipsomaniacs and inebriates. 

Section 6. When the buildings constructed under the provisions of this act 
are so far completed that in the opinion of said trustees they may be properly 
used for the purposes of said hospital said trustees shall notify the governor, who 
shall thereupon issue his proclamation establishing said hospital. 

Section 7. After the establishment of said hospital said trustees shall receive 
no compensation for their services, but they shall be reimbursed from the treas- 
ury of the Commonwealth for all expenses actually incurred by them in the per- 
formance of their official duties. The governor and council shall fix the com- 
pensation to be made to them for services rendered in the selection and purchase 
of real estate and the construction, equipment and furnishing of the hospital 
buildings. 

Section 8. Said trustees may appoint all necessary physicians, assistants 
and employees necessary for the proper administration of the affairs of said 
hospital and may incur all expenses necessary to the maintenance of the same; 
but the annual expense incurred under this section shall not exceed 
thousand dollars. 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 291 

Sectiox 9. Such inmates of said hospital able to pay for their board shall 
be charged for the same. The board of such inmates as have a legal settlement 
in some city or town shall be paid by said city or to%vn if such patients are re- 
ceived at said hospital on the request of the overseers of the poor of said city or 
touTi. The trustees may in their discretion receive other patients who have no 
means to pay for treatment; and the board of all such patients shall be paid from 
the treasury of the Commonwealth. 

Section 10. There shall be thorough visitations of said hospital by two of 
the trustees thereof monthly, and by a majority of them quarterly, and by the 
whole board semi-annually, at each of which a written account of the state of 
the institution shall be drawn up, which shall be presented at the annual meet- 
ing to be held between the first days of the months of October and November. 
At the annual meeting the trustees shall make a detailed report in the same man- 
ner as is required of the trustees of the state lunatic hospitals, and shall audit the 
report of the treasurer, which shall be presented at said annual meeting, and 
transmit it with their annual report to the governor and council. 

Section 11. The accounts and books of the treasurer shall at aU times be 
open to the inspection of the trustees. 

Section 12. This act shall take effect upon its passage. 

Many hearings were held on this measure; violent opposition as well 
as enthusiastic support was in evidence, but in June, 1895, the bill 
was passed and became a law. The three subsequent years were spent 
by the trustees in investigation, study and construction. The various 
problems of climate and altitude were carefully considered, and after 
a most thorough and painstaking study the town of Rutland was 
chosen as the best location for the sanatorium. 

The original capacity of the sanatorium was 150 beds. From time 
to time additional wards were added. Admission to the sanatorium 
was obtained only upon the certificate of experts appointed to make 
physical examinations and to certify for admission only cases which 
were favorable for arrest. In spite of such precaution the 350 beds 
in the sanatorium were constantly filled and a long waiting list of 
applicants for admission drew attention to the tuberculosis situation 
in Massachusetts. 

In 1907 an appropriation was made for the construction of three 
additional sanatoria. The work of constructing these institutions was 
entrusted to a newly organized Board of Trustees of Hospitals for 
Consumptives, and upon their completion the Board of Trustees of 
the Rutland State Sanatorium was abolished. 

The additional sanatoria were located at North Reading, Lakeville 
and Westfield, and opened their doors for the admission of patients 
in 1909 and 1910, respectively. The completion of these sanatoria 
made available 450 additional beds for consumptives. From time to 
time additions were made to these institutions so that to-day there 



292 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

are available for consumptives in the four State sanatoria 1,100 beds, 
as follows: Rutland, 350 beds; Lakeville, 275; Westfield, 275; 
North Reading, 200. 

Under the policy of the new Board of Trustees these sanatoria were 
rapidly filled and a waiting list was easily established. The custom of 
admitting to the Rutland Sanatorium only incipient cases was con- 
tinued. Residence at Rutland was limited to two years and all 
patients were admitted on a thirty days' trial. Cases which ap- 
peared unfavorable for arrest and cases which had completed their 
time limit were transferred from Rutland to the other sanatoria. 

Admission to the State sanatoria was open to persons, male and 
female, over fifteen years of age, except at Westfield where 165 beds 
were reserved for children between the ages of five and fifteen years. 
At Westfield a school with a modern curriculum was maintained so 
that children undergoing treatment might have educational oppor- 
tunities. 

At this time of our world's history let it be remembered that gen- 
eral hospitals had closed their doors to persons ill with pulmonary 
tuberculosis. Outside of the few private hospitals which harbored 
consumptives there was no "Inn at Bethlehem" for persons suffering 
from this disease. The medical profession could only recommend a 
change of climate, a form of treatment practiced by Hippocrates who 
lived in 400 B.C. Such treatment could be had only by the well-to-do. 
The poor consumptive had no alternative but to remain at home in- 
fecting unwittingly those who were near and dear to him. And so the 
wisdom of the policy of the trustees of admitting to the new sanatoria 
advanced cases of consumption is apparent. 

Such is the charge committed to our care: a group of sanatoria 
successfully administered for twenty-six years by unpaid Boards of 
Trustees, such as Massachusetts can always summon to her aid for 
advice and achievement. 

Additional milestones in the progress of tuberculosis work in Massa- 
chusetts are: first, the act of the State Department of Health declar- 
ing tuberculosis a disease dangerous to the public health; second, the 
dispensary act, requiring every city and every town containing a pop- 
ulation of 10,000 or more to maintain a dispensary for the diagnosis 
and treatment of needy patients afflicted with tuberculosis; third, the 
county hospital act. 

The early colonists who settled in Massachusetts recognized the 
danger to the community of communicable disease. One of the earliest 
acts on the statute books in Massachusetts is chapter 75 of the Re- 
vised Laws, requiring cities to make hospital provision for cases of 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 293 

sickness declared by the State Department of Health to be dangerous 
to the public health. In 1907, when tuberculosis was added to the 
list of such diseases, automatically it became necessary for cities to 
make provision for the hospital care of consumptives. This law was 
pretty generally violated in regard to care of tuberculosis patients. In 
1916 the county hospital act was passed, which provided that cities 
of 50,000 or more in population must maintain hospitals for tubercu- 
lous patients and that cities of less than 50,000 shall contract and 
support a county hospital. All the counties of the State have com- 
plied with this law except Worcester and Middlesex counties, and the 
district of Chelsea, Revere and Winthrop, the latter having been 
allowed to combine in meeting the requirements of the county act. 
Extension of time has been granted these counties for the fulfillment 
of their obligations on account of the abnormal conditions prevailing 
at the present time regarding the high cost of building material and 
labor. Five county hospitals are completed and functioning. The 
Essex County Tuberculosis Hospital is nearing completion and will 
admit patients at an early date. The total bed capacity of these 
county hospitals is as follows: Bristol County at Attleboro, 60 beds; 
Barnstable County at Bourne, 26 beds; Norfolk County at Braintree, 
71 beds; Plymouth County at South Hanson, 66 beds; Hampshire 
County at Northampton, 50 beds; Essex County at Middleton, 112 
beds. 

x\s a further result of this act there are in operation 14 municipal 
tuberculosis hospitals in the State, with a total bed capacity of 1,127 
beds; 8 private incorporated tuberculosis hospitals, with a total bed 
capacity of 179 beds. 

The dispensary act, passed in 1911, provided that every city and 
town of 10,000 population or over shall maintain dispensaries for the 
diagnosis of tuberculosis. As a result of this act there are 54 dis- 
pensaries functioning under the supervision of the State Department 
of Public Health. 

Such is the machinery which Massachusetts has provided for the 
conquest of consumption. 

The present time seems opportune to revise the policy governing the 
State sanatoria. With the excellent equipment which the State has 
provided in its chain of county and municipal tuberculosis hospitals, 
the time seems ripe to place the four State sanatoria on an even foot- 
ing and to admit to these institutions only cases favorable for arrest. 

The continued residence of patients in the sanatoria extending over 
a period of five to ten years will simply convert the sanatoria into 
homes for consumptives and will defeat the very object for which 



294 



DEPAETMENT OF PUBLIC HEALTH. [Pub. Doc. 



sanatoria strive. Sanatorium treatment aims to arrest the disease 
and to turn the patients back to society capable of self-support. The 
heartiest co-operation on the part of the patient is essential for this 
achievement. It is estimated that intensive sanatorium treatment of 
one or two years' duration should accomplish this object, and failure 
to record such results is believed to be due to lack of co-operation or 
to the unsuitability of the case for sanatorium treatment. Before such 
a policy can be put into effect much preliminary work is needed. 
Some of these preliminary steps have been taken and will be described 
under separate headings. 

Consultation Clinics. 

Medical literature teems with criticism of the general practitioner 
for failure to recognize the early signs and symptoms of pulmonary 
tuberculosis. Trite as this subject is, cases of pulmonary tuberculosis 
in a hopeless condition are still being referred to the sanatoria by 
general practitioners. In one instance a patient so referred died at 
the doors of the sanatorium. In another instance a case classified as 
pretuberculous was placed on the dangerous list immediately upon ad- 
mission and died in a few weeks. To meet this condition a series of 
consultation clinics has been inaugurated where general practitioners 
may secure, without charge, the diagnosis of an expert. These clinics 
consist of a high-grade consultation service. Patients examined at 
these clinics must be accompanied or referred by their family phy- 
sician, to whom a written report is made. The following table shows 
the location of these clinics: — 



City 
OR Town. 



Location. 



Time. 



Consultants. 



Worcester, 
Gardner, 

Fitchburg, 
Clinton, 
Lowell, . 

Lawrence, 

Haverhill, 

Woburn, 



Municipal Tuberculosis Dispensary, 

Belmont Hospital. 
Municipal Tuberculosis Dispensary, 

Municipal Building, 83 Pleasant 

Street. 
Municipal Tuberculosis Dispensary, 

366 Main Street. 
Municipal Tuberculosis Dispensary, 

Municipal Building. 
Municipal Tuberculosis Dispensary, 

City Hall. 

Municipal Tuberculosis Dispensary, 
37 Jackson Street. 

Municipal Tuberculosis Dispensary, 
City Hall. 

Municipal Tuberculosis Dispensary, 
Board of Health Rooms. 



1st Wednesday of each 
month, 2 to 5 p.m. 

2d Wednesday of each 
month, 2 to 5 p.m. 

3d Wednesday of each 
month, 2 to 5 p.m. 

4th Wednesday of each 
month, 2 to 5 p.m. 

1st Wednesday of each 
month, 2 to 5 p.m. 

2d Wednesday of each 
month, 2 to 5 p.m. 

3d Wednesday of each 
month, 2 to 5 p.m. 

4th Wednesday of each 
month, 2 to 5 p.m. 



Medical staff of the Rut- 
land State Sanatoriimi. 

Medical staff of the Rut- 
land State Sanatoriimi . 

Medical staff of the Rut- 
land State Sanatorium. 

Medical staff of the Rut- 
land State Sanatorium . 

Medical staff of the 
North Reading State 
Sanatorium. 

Medical staff of the 
North Reading State 
Sanatorium. 

Medical staff of the 
North Reading State 
Sanatorium. 

Medical staff of the 
North Reading State 
Sanatorium. 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 295 



City 
OR Town. 



Taunton, 
Brockton, 
Fall River, 
Plymouth, 

Pittsfield, 
Springfield, 
Holyoke, 
Adams, . 



Location. 



Municipal Tuberculosis Dispensary, 

City Hall. 
Municipal Tuberculosis Dispensary, 

Board of Health Office, City Hall. 
Municipal Tuberculosis Dispensary, 

Purchase Street. 
Municipal Tuberculosis Dispensary, 

Room G, Governor Bradford 

Building, Town Square. 
Municipal Tuberculosis Dispensary, 

House of Mercy Hospital. 
Municipal Tuberculosis Dispensary, 

137' 2 State Street. 
Municipal Tuberculosis Dispensary, 

City Hall Annex, Room 412. 
Municipal Tuberculosis Dispensary, 

Greylock Bank Building. 



Time. 



Consultants. 



1st Wednesday of each 

month, 2 to 5 p.m. 
2d Wednesday of each 

month, 2 to 5 p.m. 
3d Wednesday of each 

month, 2 to 5 p.m. 
4th Wednesday of each 

month, 2 to 5 p.m. 

1st Wednesday of each 

month, 2 to 5 p.m. 
2d Wednesday of each 

month, 2 to 5 p.m. 
3d Wednesday of each 

month, 2 to 5 p.m. 
4th Wednesday of each 

month, 2 to 5 p.m. 



Medical staff of the Lake- 

ville State Sanatorium. 
Medical staff of the Lake- 

ville State Sanatorium. 
Medical staff of the Lake- 

ville State Sanatorium. 
Medical staff of the Lake- 

ville State Sanatorium. 

Medical staff of the West- 
field State Sanatorium. 

Medical staff of the West- 
field State Sanatorium. 

Medical staff of the West- 
field State Sanatorium . 

Medical staff of the West- 
field State Sanatorium. 



Facilities for consultation are provided at each State sanatorium for 
every day of the week (Saturdays, Sundays and holidays excepted) 
between the hours of 2 and 5 o'clock. 

Attendance at these clinics is not restricted to the inhabitants of the 
cities named. Physicians are invited to make use of any clinic, it 
being inferred that they will select the one nearest their home city or 
town. 

The Department of Public Health earnestly pleads for the co-oper- 
ation of the family physician in this consultation service. 

Further extension of this service will require additions to the sana- 
toria staff and plans are already in preparation for this step, which 
will increase the number of men properly trained for this work. 



Examination Clinics. 

No report of the progress in tuberculosis work in this State would 
be complete without recording the untiring efforts of the Massa- 
chusetts Anti-Tuberculosis League in securing expert examination of 
contacts. In cities and towns of 10,000 population and over, such 
service is rendered by tuberculosis dispensaries, as provided by chap- 
ter 576, Acts of 191L In smaller towns where no such provision is 
made, the League has vigorously prosecuted its work and has ap- 
pealed to the sanatoria for assistance. Willing co-operation has been 
granted by the creation of a series of examination clinics. Upon due 
notice from the League, the sanatoria staff will examine all cases pro- 
vided by the League. This service provides expert diagnosis for 
cases of contacts and suspects which the case finding activity of the 
Massachusetts Tuberculosis League provides. 



296 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Observation Hospital. 

Everybody agrees that the diagnosis of early pulmonary tubercu- 
losis is oftentimes a very difficult matter. In many cases it requires 
expert observation extending over a period of weeks. Under our 
existing statutes only cases definitely classified as tuberculous can be 
admitted to the State sanatoria. An observation hospital, conducted 
on the same plan as the Psychopathic Hospital follows in its intensive 
study of mental diseases, seems desirable. From this hospital cases 
properly classified could be referred to the various sanatoria and tu- 
berculosis hospitals. 

Subsidy. 

Cities and towns which under certain conditions provide hospital 
care for bacillary cases of pulmonary tuberculosis are reimbursed by 
the State at the rate of S5 per week for each person. Further legis- 
lation extended the granting of this subsidy for hospital care of non- 
bacillary cases. For the year ending Nov. 30, 1920, this Division has 
received 2,481 claims for subsidy. Of this number, 1,662 claims, 
amounting to $135,720.05, were approved. 

Examination of Prisonees. 

At the request of Mr. Sanford Bates, Commissioner of the Depart- 
ment of Correction, a physical examination, with particular reference 
to the diagnosis of pulmonary tuberculosis, was made of the inmates 
of jails, prisons and houses of correction in the State. This examina- 
tion was made by the staffs of the various State sanatoria, with the 
following results: — 

Number of prisoners examined, 1,500 

Active pulmonary tuberculosis, 7 

Further observation, 43 

Public Health Nurses. 

Local boards of health are entrusted with the supervision of dis- 
eases declared dangerous to the public health which occur within their 
territory. For this purpose public health nurses are employed. In 
order to stimulate interest in the supervision of cases of pulmonary 
tuberculosis the Division has organized the public health nurses of all 
the cities and towns in the State into groups based upon the terri- 
torial assignments of the District Health Officers. It is planned to 
have these nurses meet at the various sanatoria, where tuberculosis 
problems will be discussed and sanatorium conditions observed. 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 297 



Consultants. 

The need of consultants in diseases other than tuberculosis in the 
State sanatoria is becoming more pressing. Patients in these institu- 
tions often develop intercurrent complications which retard their im- 
provement. Particularly is this true in cases of diseases of the nose, 
throat, eye and ear. Defective teeth are a frequent source of com- 
plaint. Surgical conditions frequently arise and mental cases are not 
infrequent. To meet these conditions it is planned to place at an 
early date in each sanatorium a full-time dental hygienist supple- 
mented by a part-time dentist. Part-time consultants in the various 
diseases mentioned must soon be furnished to insure the full measure 
of care which Massachusetts provides for her afflicted ones. 

Follow-up Work. 

There is on file in this Division a list of all known cases of tuber- 
culosis reported within the past five years. This list numbers about 
20,000 cases. Supervision of these cases comes within the duties of local 
boards of health. In every case an original history card is required, as 

follows : — 

DEPARTMENT OF PUBLIC HEALTH 

Tuberculosis 

(City or Town) Date 

Form of disease S. M. W. Sex 

Name of patient, Pos- sputum date, Age 

(Surname first) Neg. sputum date, Color 

Residence, Birthplace, 

Last previous address. Nationality, 

In U. S., 
Where is the patient at this date, In this place. 

Reported (to local Board of Health) (to Dept. of Public Health) 

(Section 52, Revised Laws, 75) 

Institutional History 

Date of Sanatorium Date of Condition Date of Condition Sputum 

application or hospital admission on admission discharge on discharge 

Occupation now. Full or part time 

Occupation when illness began, Does working make patient worse. 

Present medical supervision (name of physician, or dispensary, if any). 

Illness began. Present condition, 

If not working, how does patient spend time. 

Personal hygiene (including care of sputum). 

Home sanitation. Occupation sanitation. 

Anything to suggest cause of disease or source of infection, 

What immediate help, if any, should patient have. 

Condition of other members of household, 

(If tuberculous, give names) 
Remarks (including briefly, family and personal history — with names and dates of respiratory dis- 
eases, if any). 
Husband's full name. 



(Signature of tuberculosis worker or investigator) 
If minor, father's full name. 



298 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Follow-up work is continued by this Division. Every six months 
a report of these cases is required, as follows:- — 



DEPARTMENT OF PUBLIC HEALTH 
Division of Tuberculosis 

Follow-up Card 



Town . 










Name Address 


Date. 


Supervision. 


Work. 


Sputum. 


Remarks (including any special 
feature of case). 















NORTH READING STATE SANATORIUM. 



Resident Officers. 



Carl C. MacCorison, M.D., 
Earle C. Willoughby, M.D., 



Joseph W. Redd-x, M.D., 
Kathrtn V. Daily, 
MiRA B. Ross, . 
J. Ellis Doucette, 
Daniel J. Scott, 
Edward Leary, 



Superintendent. 
Assistant Superintendent 

and Physician. 
Assistant Physician. 
Sxiperintendent of Nurses. 
Matron. 
Steward. 
Chief Engineer. 
Head Farmer. 



REPORT OF THE SUPERINTENDENT. 

To the Director of the Division of Tuberculosis, Department of Public Health, 

Room 365, State House, Boston, Mass. 

I have the honor of presenting to you the report of the North Reading State 
Sanatorium for the year ending Nov. 30, 1920. 

The records show that during the year 471 patients have been treated, and 
279 have been admitted. There were 68,919 daj^s of treatment in the year 
as against 63,103 days of treatment for the preceding year. The lowest daily 
census was 172 and the highest 203. The daily average number of patients 
was 188.30, which is SJ per cent more than that of the preceding year. 

There have been admitted during the year 3, or 1.09 per cent, incipient; 143, 
or 51.25 per cent, moderately advanced; 127, or 45.48 per cent, advanced; 2, 
or .71 per cent, nontuberculous ; 3, or 1.09 per cent, not determined. 

There has been a daily average of 68 bed cases, — approximately 36 per cent 
of the daily population. 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 299 

Of the patients discharged, the average duration of residence in the sana- 
torium was 209 days, as opposed to 315 days for the preceding year; the longest 
residence of any one person was 1,948 days, and the shortest, 1 day. 

Of the 279 cases admitted, 231, or 82.79 per cent, were inside workers. Two 
hundred and six cases were admitted from cities and to\\iis having a popula- 
tion of 25,000 or more, as follows: Boston, 95; Cambridge, 3; Chelsea, 6; 
Everett, 13; Fall River, 2; Haverhill, 2; LawTence, 10; Ljmn, 12; Lowell, 
16; Maiden, 16; Medford, 3; Newton, 5; Revere, 3; Salem, 4; Somerville, 16. 

One hundred and nine cases have been supported from private funds; 224 by 
cities and to^\^ls; 100 entirely by the State; 11 by the Bureau of War Risk 
Insurance; and 13 private cases have either become State or town charges. 
There were remaining on November 30, 18 private cases, 24 city or town cases, 
35 State cases, 37 unknown cases, and 2 Bureau of War Risk Insurance cases, 
making a total of 186. 

Of the patients discharged during the year, 93 males and 68 females had 
gained in weight, the total gain being 1,848 pounds. The average male gain 
was 11.38 pounds, and the average female gain was 11.6 pounds; 4 patients 
remained stationary; 56 had lost; 47 had died; and 17 were not considered. 

Three patients, or 1.05 per cent, have been discharged arrested; 14, or 4.91 
per cent, apparently arrested; 32, or 11.22 per cent, quiescent; 100, or 35.08 
per cent, improved; 55, or 19.29 per cent, unimproved; 47, or 16.49 per cent, 
have died; 11.93 per cent were not considered (duration of stay being less than 
one month); and 2, or .70 per cent, nontuberculous. The decrease in the 
number of deaths over that of preceding years is due to the fact that many 
very ill patients were discharged, their relatives preferring to have them pass 
away at home. 

The average age was 31.43 years. One hundred and twenty-eight patients 
were foreign born, and 89 were American born but of foreign parentage. Twenty- 
four patients admitted have been previously treated at this sanatorium. 

The total cost of maintenance for the year ending Nov. 30, 1920, was $159,- 
531.40; deducting $1,008.72 from miscellaneous sources leaves a net amount 
expended for maintenance of $158,522.68. The net per capita cost per week 
was $16.1896. There has been collected from private patients 18,220.25, and 
from cities and towns $21,102.05. Further details will be found in succeeding 
pages of this report. 

Medical Report. 

Our problem relative to the care of bed cases is becoming more difficult. The 
increase in admissions of advanced and moderately advanced cases needing 
bed treatment has demonstrated more forcibly than ever the necessity of pro- 
viding additional wards for this type of case. Our inability to care for bed 
cases on open pavilions accounts for the low census of the past year. 

Although an appropriation was granted for the employment of a full-time 
dentist, we were unable to find a competent man who was wiUing to accept the 
position. 



300 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Clinics. 
In addition to the consultation clinics held at Lowell, Lawrence, Haverhill 
and Woburn, many patients have come directly to the sanatorimn for exam- 
ination and advice. Quite frequently we have been handicapped in arriving 
at a positive diagnosis in obscure cases, and we feel that an X-ray machine 
would be of material assistance to us in overcoming this difficulty. 

Recommendations. 

Our present equipment for fire protection is practically worthless. The 
buildings east of the power plant are entirely unprotected, owing to lack of 
sufficient water pressure. Should a fire occur in the institution, we would have 
to depend principally upon hand fire extinguishers and the water in our 25,000- 
gallon tank, with a maximum pressure of about 60 pounds. Our water supply 
has given us a great deal of trouble in the power plant, owing to excessive 
scaling of the boilers. I would recommend that the sum of S24,470 be ap- 
propriated for the installation of a fire protective system, as per plans and 
specifications submitted in 1917. 

An X-ray outfit would be of great assistance to us in the examination of 
patients, and I would recommend that the sum of $5,370.22 be appropriated 
for the purchase of an outfit. 

We have had frequent vacancies from time to time in our engineering depart- 
ment the past year. So many, in fact, that it has been absolutely impossible 
for us to make the necessary repairs in the engine room and about the institu- 
tion. I would recommend that we employ an additional mechanic for a period 
of three months, or until such time as we can catch up on the necessary repairs. 

Improvements. 
The new chapel and nurses' dormitory was completed in June. Additional 
henhouses have been built, and about 1 acre of sprout land cleared for cultiva- 
tion. Work was started on the cottage for the chief engineer and steward in 
September. In all probability this cottage will be ready for occupancy about 
the middle of February. 

Medical Staff. 

Dr. C. P. Harkins resigned on June 29, 1920, from the staff, and Dr. Joseph 
W. Reddy was appointed to fill the vacancy. 

Acknowledgments. 

The patients and employees appreciate the faithful services of the Catholic, 
Protestant, and Jewish chaplains, who in addition to their regular services have 
brought comfort and cheer by their frequent visits. 

We wish especially to thank the First National Exhibitors for their many 
favors. 

We acknowledge with grateful thanks the gifts, from various individuals and 
churches, of magazines, books, a Bible, various woolen and knit articles, and 
the candy, fruit and flowers sent in at Christmas time. 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 301 

I wish to thank the heads of departments and the employees for their co- 
operation and assistance. I am deeply grateful to the Director of the Division 
of Tuberculosis for his support and advice during the year. 

Very truly, 

Carl C. MacCorison, 

Superintendent. 

TREASURER'S REPORT. 

To the Commissioner of Public Health . 

I respectfully submit the following report of the finances of this institution 
for the fiscal year ending Nov. 30, 1920: — 



Balance Dec. 1, 1919, 



Cash Account. 



$1,801 04 



Receipts. 



Institution Receipts. 
Board of inmates: — ■ 
Private, 
Cities and towns, 



Sales: — 

Food 

Clothing and materials, 

Furnishings and household supplies, 

Medical and general care, .... 

Heat, light and power, 

Farm and stable : — 

Pigs and hogs .S19 00 

Ice 5 25 

Vegetables 2 33 

Sundries 416 99 



$8,220 25 




21,102 05 






$29,322 30 




$55 37 




169 56 




40 85 




33 34 




30 75 





Grounds, 
Repairs, ordinary. 



Miscellaneous receipts: — 
Interest on bank balances, 
Sundries, . . . . 



443 


57 


8 


03 


14 


66 


$139 


75 


72 


84 



796 13 



212 59 



Refund, account of previous year's business. 



30,331 02 
23 70 



Receipts from Treasury of Commonwealth. 
Maintenance appropriations: — 

Balance of 1919, $10,877 10 

Advance money (amount on hand November 30) , . . 8,000 00 

Approved schedules of 1920 134,635 96 



Special appropriations, 
Total, 



153,513 06 
40,533 34 

$226,202 16 



302 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Payments. 
To treasury of Commonwealth: — 

Institution receipts, $30,331 02 

Refunds, account of maintenance, . . . $76 56 

Account of other 23 70 

100 26 

,431 28 



Maintenance appropriations: — 

Balance November schedule, 1919 $12,678 14 

Eleven months' schedules, 1920, . . . $134,635 96 

Less returned, 76 56 

134,559 40 

November advances, 6,710 64 



Special appropriations: — 

Approved schedules $40,533 34 

November advances, 129 91 



153,948 18 



40,663 25 



Balance Nov. 30, 1920: — 

In bank, $679 93 

In office, 479 52 



1,159 45 

Total $226,202 16 

Maintenance. 

Balance from previous year, brought forward, ...'.... $789 48 

Appropriation, current year, 163,355 00 



Total $164,144 48 

Expenses (as analyzed below) , 159,531 40 



Balance reverting to treasury of Commonwealth, $4,613 08 

Analysis of Expenses. 
Personal services : — 

Carl C. MacCorison, superintendent, .... 

Medical, 

Administration 

Kitchen and dining-room service, 

Domestic, 

Ward service (male), 

Ward service (female), 

Engineering department, 

Repairs, 

Farm, 

Stable, garage and grounds, 



Religious instruction: — 
Catholic, 
Hebrew, 
Protestant, . 



Amount carried forward. 



$3,600 00 




3,504 57 




5,132 04 




7,940 17 




10,005 48 




2,977 40 




9,442 00 




6,361 89 




3,306 94 




3,547 36 




2,058 50 






$57,876 35 




$600 00 




500 00 




500 00 






1,600 00 






$59,476 35 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 303 

Amount brought forward, $59,476 35 

Travel, transportation and office expenses: — 

Advertising, $37 97 

Postage, 199 07 

Printing and binding, 487 18 

Stationery and office supplies, 557 12 

Telephone and telegraph, 334 59 

Travel, 408 38 

Freight H 75 

2,036 06 

Food : — 

Flour ^2,213 35 

Cereals, rice, meal, etc., 953 18 

Bread, crackers, etc., 53 39 

Peas and beans (canned and dried) , ^ . . . . 424 62 

Macaroni and spaghetti, 68 20 

Potatoes 1.242 85 

Meat 14.626 72 

Fish (fresh, cured and canned), 1,729 73 

Butter 5.126 43 

Butterine, etc., 451 60 

Cheese 144 65 

Coffee 634 75 

Tea 145 67 

Cocoa, 49 54 

Whole milk 14,092 08 

Milk (condensed, evaporated, etc.) 127 31 

Eggs (fresh) 5,550 45 

Sugar (cane), 3,255 15 

Fruit (fresh) 452 01 

Fruit (dried and preserved) 1,356 18 

Lard and substitutes, 84 84 

Molasses and syrups, 101 66 

Vegetables (fresh) 348 56 

Vegetables (canned and dried) 1,559 80 

Seasonings and condiments, 578 14 

Yeast, baking powder, etc., 358 00 

Sundry foods 271 79 

Freight 699 13 

56,699 78 

Clothing and materials : — 

Boots, shoes and rubbers, $283 04 

Clothing (outer), 490 65 

Clothing (under) 109 05 

Hats and caps, 75 

Socks and smallwares, 48 26 

Freight 4 88 

936 63 

Furnishings and household supplies: — 

Beds, bedding, etc., $2,142 17 

Carpets, rugs, etc., 133 12 

Crockery, glassware, cutlery, etc., 632 37 

Dry goods and smallwares, 112 38 

Electric lamps 237 01 



Amounts carried forward, $3,257 05 $119,148 82 



304 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Amounts brought forward, $3,257 05 $119,148 82 

Furnishings and household supplies — Concluded. 

Fire hose and extinguishers, 40 32 

Furniture, upholstery, etc 302 02 

Kitchen and household wares, 1,172 93 

Laundry supplies and materials, 458 45 

Lavatory supplies and disinfectants, 390 39 

Table linen, paper napkins, towels, etc., .... 562 27 

Freight, 102 41 

6,285 84 

Medical and general care: — 

Books, periodicals, etc., $65 30 

Entertainments, games, etc., 794 07 

Funeral expenses, 30 00 

Ice and refrigeration, 144 62 

Laboratory supplies and apparatus, 54 51 

Medicines (supplies and apparatus), 1,550 05 

Medical attendance (extra), 83 00 

Sputum cups, etc., 346 14 

Tobacco, pipes, matches 139 73 

Sundries 8 00 

Freight 92 84 

3,308 26 

Heat, light and power : — 

Coal (bituminous), $5,515 85 

Freight and cartage, 4,905 73 

Coal (anthracite), 1,028 26 

Freight and cartage, 476 54 

Gas 34 93 

Oil, 292 26 

Operating supplies for boilers and engines 252 27 

Freight, 8 94 

12,514 78 

Farm : — 

Bedding materials $64 30 

Blacksmithing and supplies, 41 10 

Carriages, wagons and repairs, 32 03 

Dairy equipment and supplies, 279 87 

Fencing materials, 142 75 

Fertilizers, 794 02 

Grain, etc., 3,223 93 

Hay, 209 11 

Harnesses and repairs, 1 25 

Other live stock, 293 00 

Labor (not on pay roll) 2,245 26 

Spraying materials, 47 52 

Stab le and barn supplies, 24 

Tools, implements, machines, etc., 381 81 

Trees, vines, seeds, etc., 198 57 

Veterinary services, supplies, etc., 135 60 

Sundries, 23 73 

Freight 286 16 

8,400 25 

Amount carried forward, $149,657 95 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 305 

Amount brought forward, S149,C57 95 

Garage, stable and grounds: — 

Automobile repairs and supplies, .$1,410 21 

Bedding and materials, 73 75 

Blacksmithing and supplies .35 05 

Carriages, wagons and repairs, 25 88 

Grain 241 75 

Hay, 23 68 

Harnesses and repairs, 13 95 

Rent, 425 00 

Poad work and materials, 38 50 

Spraying materials, 5 20 

Tools, implements, machines, etc., 407 10 

Trees, vines, seeds, etc., 7 75 

Sundries, 1 25 

Freight, 15 68 

2,724 75 

Repairs, ordinary: — / 

Cement, lime, crushed stone, etc., $74 29 

Electrical work and supplies, 257 57 

Hardware, iron, steel, etc., 194 21 

Labor (not on pay roll), 35 00 

Lumber, etc. (including finished products), .... 460 70 

Paint, oil, glass, etc., 497 72 

Plumbing and supplies, 392 78 

Steam fittings and supplies, 483 01 

Tents, awnings, etc 259 82 

Tools, machines, etc., 218 94 

Boilers, repairs, 153 30 

Engines, repairs, 38 47 

Sundries, 254 09 

Freight, 93 08 

3,412 98 

Repairs and renewals : — 

Repairing piazza floors, $172 40 

Shingling two pavilions, 337 49 

Drying tumbler 893 31 

Henhouse 1,102 12 

Repairing tank and tower, 126 00 

National marking machine, 383 99 

Collar and cuff press, 289 65 

Bed casters 263 93 

Partitioning sleeping rooms, 166 83 

3,735 72 

Total expenses for maintenance, $159,531 40 

Special Appropriations. 

Balance Dec. 1, 1919 $30,927 63 

Appropriations for current year, 16,500 00 

Total $47,427 63 

Expended during the year (see statement below), . . . $40,533 34 
Reverting to treasury of Commonwealth, 5 58 

40,538 92 

Balance Nov. 30, 1920, carried to next year, $6,888 71 



306 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Object. 


Act or Resolve. 


Whole 
Amount. 


Expended 

during 
Fiscal Year. 


Total 

Expended 

to Date. 


Balance 

at End of 

Year. 


Nurses' hall and chapel, 

Cottage for engineer and 
steward. 


Chap. 211, 1919, 
Chaps. 225, 629, 1920, 


$48,150 00 
16,500 00 


$30,922 05 
9,611 29 


$48,144 42 
9,611 29 


$5 58* 
6,888 71 




$64,650 00 


$40,533 34 


$57,755 71 


$6,894 29 
- -ns 



Balance reverting to treasury of the Commonwealth, 
Balance carried to next year, 



$5 58 
6,888 71 \ 



Total as above $6,894 29 



Resources and Liabilities. 

Resources. 

Cash on hand, 

November cash vouchers (paid from advance money) : — 

Account of maintenance, $6,710 64 

Account of special appropriations, . . . 129 91 



$1,159 45 



6,840 55 



Due from treasury of Commonwealth from available appropriation, account 
of November, 1920, schedule, 



$8,000 00 
16,972 00 



Liabilities. 



Schedule of November bills, 



$24,972 00 
$24,972 00 



Per Capita, 

During the year the average number of inmates has been 188.30. 

Total cost for maintenance, $159,531.40. 

Equal to a weekly per capita cost of $16.2926. 

Receipt from sales $796.13. 

Equal to a weekly per capita of $0.0813. 

All other institution receipts, $212.59. 

Equal to a weekly per capita of $0.0217. 

Respectfully submitted, 

Carl C. MacCorison, 

Treasurer. 

Examined and found correct as compared with the records in the office of the Auditor 

of the Commonwealth. 

Alonzo B. Cook, 

Auditor. 



VALUATION. 



Real estate, . 
Personal estate, 



. $217,242 50 
82,226 54 

$299,469 04 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 307 



SPECIAL REPORT. 

The following special report is prepared in accordance svith a resolution of 
the National Conference of Charities and Corrections, adopted May 15, 1908: — 

Population. 



Males. 



Females. 



Totals. 



Number of inmates present at beginning of fiscal year, 

Number received during the year 

Number discharged during the year 

Number at end of fiscal year 

Daily average attendance (i.e., number of inmates actually 

present) during year. 
Average number of officers and employees during the year, . 



112 
141 
149 

104 

106.75 

43.58 



80 

138 

136 

82 

81.55 

30.78 



192 
279 
285 
186 
188.30 
74.36 



Expenditures. 
Current expenses : — 

1. Salaries and wages, 

2. Clothing, 

3. Subsistence, ..... 

4. Ordinary repairs and improvements, 

5. Office, domestic and outdoor expenses, 

Total, 



$57,876 35 

936 63 

72,522 82 

3,412 98 

21,046 90 



$155,795 68 



Extraordinary expenses, 



Grand total. 



3,735 72 



$159,531 40 



Summary of Current Expenses. 
Total expenditure, ....... 

Deducting extraordinary expenses, ..... 



Deducting amount of sales, 



Total, . 



$159,531 40 
3,735 72 

$155,795 68 
1,008 72 

$154,786 96 



Dividing this amount by the daily average number of patients — 188.30 — gives a 
cost for the year of S822.90, equivalent to an average weekly net cost of $15.82. 



308 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



STATISTICAL TABLES. 
Table 1. — Admissions and Discharges. 





Males. 


Females. 


Totals. 


Patients in the sanatorium Dec. 1, 1919 


112 


80 


192 


Number of patients admitted from Dec. 1, 1919, to Nov. 30, 
1920, inclusive. 

Number discharged from Dec. 1, 1919, to Nov. 30, 1920, in- 
clusive. 

Number of deaths (included in preceding item), 


141 

149 
21 


138 

136 

26 


279 

285 

47 


Number remaining in the sanatorium Nov. 30, 1920, . 


104 


82 


186 


Daily average number of patients 


103.86 


83.40 


187.26 



Table 2. — Civil Condition of Patients admitted. 





Males. 


Females. 


Totals. 


Married, 


73 


65 


138 


Single 


59 


65 


124 


Widowed, 


8 


8 


16 


Divorced 


1 


- 


1 


Totals 


141 


138 


279 





TvBLE 3. — Age of Patients admitted 








Males. 


Females. 


Totals. 


14 to 20 years, 




13 


19 


32 


20 to 30 years, 




46 


63 


109 


30 to 40 years. 




32 


36 


68 


40 to 50 years. 




40 


17 


57 


Over 50 years, 




10 


3 


13 


Totals, . 


141 


138 


279 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 



309 



Table 4. — Nativity and Parentage of Patients admitted. 







Males. 


Females. 


Totals. 


Places of Nativity. 


a 
.2 




£ 

O 


c 
.2 




£ 

IS 

J3 

O 


a 

.2 
v> 


£ 

1 


2 

o 


United States: — 




















Massachusetts, 


58 


15 


16 


65 


19 


22 


123 


34 


38 


Other New England States 


7 


6 


5 


7 


6 


3 


14 


12 


8 


Other States, . 




4 


2 


4 


10 


10 


8 


14 


12 


12 


Total native. 


69 


23 


25 


82 


35 


33 


151 


58 


58 


Other countries: — 






















Austria, . 




- 


- 


- 


1 


1 


- 


1 


1 


- 


Australia, 




- 


- 


1 


- 


- 


- 


- 


- 


1 


Belgium, . 




1 


1 


1 


- 


- 


- 


1 


1 


1 


Canada, . 




20 


29 


32 


17 


23 


25 


37 


52 


57 


England, . 




3 


4 


3 


4 


4 


4 


7 


8 


7 


Finland, . 




1 


2 


2 


- 


- 


- 


1 


2 


2 


France, 




- 


1 


- 


1 


2 


2 


1 


3 


2 


Germany, 




- 


1 


- 


1 


7 


9 


1 


8 


9 


Greece, 




5 


5 


5 


- 


- 


- 


5 


5 


5 


Holland, . 




- 


- 


- 


1 


1 


1 


1 


1 


1 


Ireland, . 




9 


27 


27 


14 


33 


32 


23 


60 


59 


Italy, 




5 


7 


7 


4 


4 


4 


9 


11 


11 


Japan, 




1 


1 


1 


- 


- 


- 


1 




1 


Poland, . 




2 


2 


2 


4 


5 


5 


6 




7 


Portugal, . 




2 


3 


4 


1 


4 


2 


3 




6 


Roumania, 




1 


1 


1 


- 


- 


- 


1 




1 


Russia, 




19 


23 


20 


6 


8 


7 


25 


31 


27 


Scotland, . 




1 


3 


1 


1 


4 


3 


2 




4 


South America, 




- 


1 


- 


1 


- 


- 


1 




- 


Spain, 




- 


1 


- 


- 


- 


- 


- 




- 


Sweden, . 




1 


4 


3 


- 


3 


2 


1 




5 


Switzerland, . 




- 


- 


- 


- 


1 


1 


- 




1 


Wales, 




- 


- 


2 


- 


- 


1 


- 




3 


West Indies, 




1 


1 


1 


- 


- 


- 


1 




1 


Total foreign, 


72 


117 


113 


56 


100 


98 


128 


217 


211 


Unknown, 




- 


1 


3 


- 


3 


7 


- 




10 


Grand totals. 


141 


141 


141 


138 


138 


138 


279 


279 


279 



310 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 5. — Residence of Patients admitted. 



Place. 



Number. 



Amesbury, 
Andover, . 
Arlington, 
Ashburnham, 
Athol, 
Bedford, . 
Belmont, . 
Beverly, . 
Boston, . 
Cambridge, 
Chelsea, - 
Concord, . 
Danvers, . 
Dighton, . 
Dracut, . 
Essex, 
Everett, . 
Fall River, 
Foxborough, 
Framingham, 
Gardner, . 
Gloucester, 
Haverhill, 
Holliston, 
Hudson, . 
Ipswich, . 
Lawrence, 
Leominster, 
Lowell, 
Lunenburg, 
Lynn, 



1 

1 

2 

1 

1 

1 

4 

2 
97 

3 

6 
1 
1 
1 
1 
1 

13 
2 
1 
1 
1 
4 
3 
1 
1 
1 

10 
1 

16 
1 

12 



Place. 



Number. 



Maiden, . 
Marlborough, . 
Medford, . 
Melrose, . 
Methuen, 
Middleton, 
Milford. . 
Milton, 
Natick, . 
Newton, . 
North Reading, 
Norwood, 
Peabody, 
Pittsfield, 
Quincy, . 
Reading, . 
Revere, . 
Rockport, 
Salem, 
Somerville, 
Stoneham, 
Townsend, 
Wakefield, 
Waltham, 
Watertown, 
Westford, 
Wilmington, . 
Winchester, 
Woburn, . 
Total, 



16 
2 
3 
3 
3 
1 
2 
1 
1 
5 
3 
1 
2 
1 
1 
2 
3 
1 
4 
16 
1 
1 
2 
1 
i 
1 
1 
3 
2 



279 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 311 



Table 6. — Occupation of Paiients admitted. 



Attendant nurse, . 
Baker, 

Blacksmith, . 
Bookbinder, . 
Bookkeeper, . 
Buyer, . 
Carpenter, 
Cashier, . 
Chauffeur, 
Cigarmaker, . 
Civil engineer, 
Clerk, . 
Courier, . 
Curator, . 
Dressmaker, . 
Electric worker, 
Elevatorman, 
Expressman, . 
Factory worker, 
Fireman (stationary) 
Foundryman, 
Housewife, 
Housework, . 
Janitor, . 
Junk collector. 
Laboratory worker. 
Laborer, . 
Laundry worker, . 
Lens grinder, . 
Lineman, 
Linotype operator, 
Longshoreman, 
Machinist, 
Manager, 
Mate, 

Metal worker. 
Mill worker, . 



Males. 



1 
1 

2 

1 

10 

2 
1 
1 
6 



1 
1 
1 
14 
1 



1 

2 
1 

10 
1 
1 
2 
1 
1 

10 
1 
2 

3 

6 



Females. 



11 



55 
15 



Totals. 



5 
1 
1 

'"1 
6 
1 

10 
1 
2 
1 
1 

14 
2 

1 
3 
1 
1 

1 

25 
1 

2 

55 

15 

1 

2 

1 

10 
4 
1 
2 

1 
1 

10 
1 
2 
3 

10 



312 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 6. — Occu-pation of Patients admitted — Concluded. 





Males. 


Females. 


Totals. 


Musician, 


2 


- 


2 


No occupation, 


1 


6 


7 


Nurse, 


- 


2 


2 


Nursemaid, 


- 


1 


1 


Painter, 


2 


- 


2 


Peddler, 


2 


- 


2 


Photographer, 


2 


- 


2 


Plumber 


2 


- 


2 


Polisher (metal) 


1 


- 


1 




2 


- 


2 


Poultryman 




- 








- 




Roofer, 




- 








2 




Salesman, 




- 








- 




Shipper, 




- 








- 




Steam fitter, 




- 








5 




Student 




6 








- 




Teacher, 




1 








- 




Telephone operator 




2 








- 




Trainman, 




- 








- 




Varnisher (piano), 




- 








- 


, 


Waiter 


3 


3 


6 




141 


138 


279 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 313 



Table 7. — Condition on Admission. 





Males. 


Females. 


Totals. 


Incipient 


- 


3 


3 


Moderately advanced 


67 


76 


143 


Advanced 


70 


57 


127 


Non-tuberculous, 


2 




2 


Not determined, 


2 


2 


4 


Totals 


141 


138 


279 




T-V • 7 







Table 8. — Condition on Discharge. 



Males. 



Females. 



Totals. 



Arrested, 

Apparently arrested. 
Quiescent, 
Improved, 
Unimproved, . 
Died, 

Not considered, 
Non-tuberculous, . 
Totals, . 



3 
20 

58 
29 
21 
18 



3 
11 
12 
42 
26 
26 
16 



149 



136 



3 

14 
32 
100 
55 
47 
34 



285 



Table Q. — Deaths. 













Males. 


Females. 


Totals. 


Length of Residence 
AT Sanatorium. 


Duration of uisease. 
















Males. 


Females. 


Totals. 


Under 1 month, 










- 


- 


- 


- 


3 


3 


1 to 2 months. 










- 


- 


- 


1 


4 


5 


2 to 3 months. 










- 


- 


- 


2 


2 


4 


3 to 4 months. 










- 


- 


- 


5 


3 


8 


4 to 5 months. 










- 


1 


1 


1 


1 


2 


5 to 6 months, 










- 


- 


- 


- 


1 


1 


6 to 7 months. 










1 


- 


1 


- 


- 


- 


7 to 8 months. 










1 


1 


2 


- 


- 


- 


8 to 9 months, 










- 


- 


- 


1 


1 


2 


9 to 10 months, 










- 


- 




1 


1 


2 


10 to 12 months, 










1 


- 


1 


- 


2 


2 


12 to 18 months. 










5 


8 


13 


4 


3 


7 


18 to 24 months, 










2 


2 


4 


3 


- 


3 


Over 2 years, . 










11 


14 


25 


3 


5 


8 


Totals, . 


21 


26 


47 


21 


26 


47 



314 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 10. — Cause of Death. 



Males. 



Females. 



Totals. 



Tuberculosis of the lungs, 

Mitral regurgitation of heart, 

Parenchymatous nephritis 

Aortic insufficiency of heart and chronic interstitial nephritis. 
Totals, 



21 



21 



23 
1 
1 
1 



26 



44 
1 
1 
1 



47 



WESTFIELD STATE SANATORIUM. 



Re.?ident Officehs. 



Henry D. Chadwick, M.D., 
Roy Morgan, M.D., 
Heman B. Chase, M.D., . 
Russell H. Bethell, D.M.D., 
Emily B. Morgan, . 
Benjamin J. Sandiford, . 
Robert J. Goldberg, 



Superintendent. 

Assistant Superintendent. 

Physician. 

Dentist. 

Superintendent of Nurses. 

Chief Engineer. 

Farmer. 



REPORT OF THE SUPERINTENDENT. 

To the Commissioner of Public Health. 

I have the honor to submit the eleventh annual report of the Westfield State 
Sanatorium for the year ending Nov. 30, 1920. 

Days of Treatment. 

The dailj' average number of patients has been 265.25. This is equivalent 
to 96,816 hospital days, and represents the busiest year and the greatest service 
that has been performed by the sanatorium since it was opened in 1910. 

Number treated and Classification. 

Three hundred and fourteen new patients were admitted. This, together 
with the 265 that remained in the sanatorium Dec. 1, 1919, makes a total of 
579 patients that have received treatment during the year. Of those admitted, 
26 per cent were classified as incipient, 37 per cent as moderately advanced 
and 36 per cent as advanced. Table No. 7 shows the subdi^^sions according 
to symptoms, A class meaning mild, B class moderate and C class severe. The 
daily average number of bed patients was 85, — 37 males and 48 females. 

Length of Residence. 

The average length of stay, considering all patients discharged, has been 
312.5 days. This is 57.5 days less than the pre\dous year. Table No. 8 shows 
the condition of patients discharged. The folloAving comparison is interesting 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 315 

as showing how the number of apparently arrested cases depends upon the 
average length of stay : — 





1918. 


1919. 


1920. 


Average length of stay (days) 

Apparently arrested cases (per cent), 


417 

47 


370 
44 


312 
43 


: 1 



There are many children that could be discharged after from three to six 
months' sanatorium care if they had suitable living conditions at home. Where 
such is not the case, we have to keep them a longer time to insure as complete 
an arrest as possible. We also in such cases try through local authorities to 
have the home conditions improved before the child is dischai'ged. 

Support of Patients. 

Of the 314 patients admitted, 31 paid their own board, 189 were supported 
by cities and towns, 8 were State minor wards, 59 were State charges, and the 
status of 27 has not been determined. The receipts from private patients 
were 13,922.70, and from cities and to^\^ls, $38,264.49. The gross per capita 
cost of maintenance per week was 114.24. Deducting sales the per capita cost 
was $14.13. This is $1.68 more than 1919. 

Gain in Weight. 

Two hundred and nineteen patients, or 70 per cent, of those discharged 
gained; 92, or 30 per cent, failed to gain. The average of those that gained 
was 11.6 pounds. Separating the discharged patients into two groups, we 
find that 71 over sixteen years of age gained an average of 8.4 pounds; 148 
under sixteen years of age gained an average of 12.6 pounds. 



Dentistry. 

The care of the patients' teeth occupies the full time of one dentist. His 
work is a very important adjunct to the medical care of the patients. Nearly 
every patient admitted needs dentistry in order to eliminate local sources of 
infection or to improve mastication. Dr. John McCoy, our former dentist, 
resigned on May 8 to go into private practice. He was succeeded by Dr. Russell 
H. Bethell. The following gives a summary of the work that has been done 
during the year : — 



Number of patients examined, 
Prophylaxis, . 
Amalgam fillings, 
Cement fillings, 
Temporary fillings, 
Pulp cappings, 
Treatments, . 



318 
335 
350 
300 

80 
100 

75 



316 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Surgical dressings and irrigations, 

Canal dressings, 

Canal fillings, 

Extractions, . 

X-rays of teeth. 

X-rays of antra, 



Total operations and treatments, ..... 

Of the 318 patients examined, the work of 230 is completed. 



75 
30 

50 

220 

10 

1 



1,944 



Conditions on Discharge. 

Of the 311 patients discharged, 43 per cent were apparently arrested, 16.7 
per cent quiescent, 7.07 per cent improved, 14.4 per cent unimproved and 
12.8 per cent died. Seventeen patients remained less than thirty days and 
were not considered in this tabulation. 



Sanatorium School. 

The craft shop is getting more popular with the adult patients each year. 
A large number of baskets have been made and they meet with a ready sale. 
The product of the shop sold during the past year has advertised the quaUty 
of the goods so well that we have customers for all the baskets that the patients 
can make. The money received is sufficient to purchase most of the material 
used, although many of the baskets are given to the patients who make them. 
The average school attendance has been as follows : — 



Grade I, . 
Grade II, . 
Grade III, 
Grade IV, 
Grade V, . 
Grade VI, 
Grade VII, 
Grade VIII, 
Domestic science, 
Manual training, 

Total, 

Total enrollment. 



11.509 
14.467 
13.980 
15.800 
19.560 
16.970 
11.060 
11.590 
6.900 
16.800 



138.636 
371 



Out-Patient Department. 

We have maintained an out-patient examination service for several years. 
The number of patients that come for advice has steadily increased. This 
past year 118 patients came for examination, — 79 males and 39 females; 55 of 
them were found to have active pulmonary tuberculosis. 

Since September a consultation clinic has been held monthly in each of the 
following cities, — Springfield, Holyoke, Pittsfield and Adams. In addition, 
examination clinics have been held in co-operation with the Hampden County 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 317 

Tuberculosis Association in Three Rivers, Ludlow, West Springfield, Palmer, 
East Longmeadow and Westfield. A total of 148 people have been examined at 
these clinics, classified as follows : — 

Active tuberculosis, ............ 34 

Further observation, ............ 41 

Healed or quiescent tuberculosis, ......... 8 

Negative, .............. 65 

Two other clinics were held at the requests of the boards of health of Chicopee 
and of Adams. At each of these, about 20 patients were examined. 

We have also examined 160 undernourished children at the Fort Meadow 
School in Westfield and 120 pupils of the Thomdike School in Palmer. In each 
of these schools there were several children who had evidence of active tuber- 
culosis. Twenty-eight per cent of the 700 children in the Fort Meadow School 
were found to be more than 7 per cent underweight. Of this number, about 
80 were found on physical examination to have signs of bronchial gland tuber- 
culosis. Most of these children would respond to home treatment if they were 
properl}^ advised and directions were followed as to correcting faulty habits of 
diet and living. School nurses to follow up these infected children could do 
much to prevent later development of pulmonary tuberculosis. 

Improvements. 

During the past year we have torn down the old farmhouse and rebuilt upon 
its site a new farmhouse and dormitory for the head farmer and farm help. This 
much needed improvement will enable us to house our farm help in a com- 
fortable manner. The old bam, which was on the property when purchased 
by the State, has always been an unsightly structure and of little use because 
it was so poorly constructed. We have remodeled it b}^ removing the top of 
the fourth story, rebuilding the roof and floors and reinforcing the frame. It 
is now a very useful building. 

An X-ray machine has been installed and has been of great value in the 
medical work of the institution. We feel that we can make a more careful 
diagnosis and treat our patients in a more scientific manner because of the 
aid we get from this equipment. 

Additional Improvements requested. 

A special appropriation has been requested to provide more fire protection 
by extending a 4-inch water main from the power house to the school and farm 
buildings and the installation of hydrants at advantageous points along the 
line. 

I have renewed the request for the purchase of 28.8 acres of land o\med by 
Rosina Pignatare, which adjoin our property. This is desirable for use as a 
natural play ground for the boys to keep them away from the highway and 
river, and one section is badly needed for a pasture. We have rented it for 
the past two years but cannot use it to the best advantage unless we own it. 



318 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Acknowledgments. 

Religious services have been held each Sunday by the Catholic, Protestant 
and Jemsh chaplains. The same chaplains have continued in service for sev- 
eral years. Their interest in the work of the institution and their devotion to 
the patients' welfare are worthy of much praise. 

I am much indebted to Dr. Frederick T. Clark of Westfield, ocuUst and 
oral surgeon, for his gratuitous service to many of our sanatorium patients. 
Correction of eye strain and operative treatment of nasal obstructions and 
sinus disease have benefited a number of patients, and their period of treat- 
ment in the sanatorium has thereby been much shortened. 

For the conscientious service of the heads of the departments and the faith- 
ful work of their employees in carrjdng on the work of the institution, I am 
extremely grateful. It has been a trying year on account of the labor situation 
and the high prices of all supplies and materials, but in spite of these condi- 
tions we have cared for more patients than ever before and this work has been 
accomplished with fewer employees. 

Respectfully submitted, 

Henry D. Chad wick, 
• Superintendent. 

TREASURER'S REPORT. 

To the Commissioner of Department of Public Health. 

I respectfully submit the following report of the finances of this institution 
for the fiscal year ending Nov. 30, 1920: — 

Cash Account. 
Balance Dec. 1, 1919, Sil98 41 

Receipts. 
Institution Receipts. 
Board of inmates: — 

Private, ?63,922 70 

Cities and towns 38,264 49 

$42,187 19 

Sales: — 

Food • ^383 43 

Clothing and materials 1 00 

Heat, light and power, 20 98 

Farm and stable: — 

Cows and calves, .... $725 00 

Pigs and hogs, . . . . 113 00 

Vegetables H 75 

Sundries 271 80 

1,121 55 

Repairs, ordinary, 15 00 

1,541 96 



Amounts carried forward 843,729 15 $198 41 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 319 

Amounts brought forward §43,729 15 Sl9S 41 

Miscellaneous receipts: — 

Interest on bank balances, .... $182 26 

Sundries, 35 09 

217 35 

43,946 50 

Receipts from Treasury of Commonwealth. 

Maintenance appropriations: — 

Balance of 1919, $5,447 48 

Advance money (amount on hand November 30), . . 10,000 00 
Approved schedules of 1920 177,065 93 

192,513 41 

Special appropriations, 16,962 89 

Total, $253,621 21 

Payttients. 

To treasury of Commonwealth, institution receipts $43,946 50 

Maintenance appropriations: — 

Balance November schedule, 1919 $5,645 89 

Eleven months' schedules, 1920, 177,065 93 

November advances, 9,759 79 

192,471 61 

Special appropriations : — 

Approved schedules, 16,962 89 

Balance Nov. 30, 1920: — 

In bank $202 35 

In office 37 86 

240 21 

Total $253,621 21 

Maintenance. 

Appropriation, current year, $196,503 00 

Expenses (as analyzed below) 196,485 66 

Balance reverting to treasury of Commonwealth $17 34 

Analysis of Expenses. 
Personal services: — 

Henry D. Chad wick, superintendent, $3,900 00 

Medical, 3,584 59 

Administration, 3,424 81 

Kitchen and dining-room service, 12,376 60 

Domestic 6,838 02 

Ward service (male) , 3,477 07 

Ward service (female) 10,379 75 

Industrial and educational department, .... 3,704 00 

Engineering department, 9,373 58 

Repairs, 2,926 31 

Farm, 20,108 90 

Stable, garage and grounds, 2,904 45 

$82,998 08 

Amount carried forward, $82,998 08 



320 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Amount brought forward, . . . §82 998 08 

Religious instruction : — 

Catholic $600 00 

Hebrew 249 60 

Protestant 340 00 

1,189 60 

Travel, transportation and office expenses: — 

Advertising, $20 12 

Postage 135 66 

Printing and binding, 8 31 

Stationery and office supplies, 587 09 

Telephone and telegraph, 699 11 

Travel 380 16 

Freight, 10 93 

1,841 38 

Food: — 

Flour, $2,529 77 

Cereals, rice, meal, etc., 1,409 49 

Bread, crackers, etc., 187 62 

Peas and beans (canned and dried), 417 54 

Macaroni and spaghetti, • . 96 39 

Potatoes 555 50 

Meat, 13,127 21 

Fish (fresh, cured and canned), 1,505 44 

Butter, 3,816 71 

Butterine, etc 536 70 

Peanut butter, 31 33 

Cheese 113 18 

Coffee 449 06 

Tea, 134 30 

Cocoa, 70 85 

Milk (condensed, evaporated, etc.), 83 43 

Eggs (fresh), 6,956 20 

Egg powders, etc., 102 96 

Sugar (cane), 2,465 12 

Fruit (fresh), 386 65 

Fruit (dried and presers-ed) , 1 ,950 67 

Lard and substitutes, 873 13 

Molasses and syrups, 185 53 

Vegetables (fresh), 951 

Vegetables (canned and dried), 857 11 

Seasonings and condiments, 487 53 

Yeast, baking powder, etc., 196 42 

Sundry foods, 168 48 

Freight 264 47 







39,968 30 


Clothing and materials : — 






Boots, shoes and rubbers, .... 


SllO 23 




Clothing (outer), 


541 74 




Clothing (under) 


84 70 




Dry goods for clothing 


206 98 




Hats and caps 


2 00 




Socks and smallwares, .... 


34 24 


979 89 






Amount carried forward, 


$123,977 25 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 321 

Amount brought forward, $126,977 25 

Furnishings and household supplies: — 

Beds, bedding, etc., $2,152 91 

Carpets, rugs, etc., 200 49 

Crockery, glassware, cutlery, etc., 1,051 14 

Dry goods and smallwares, 641 12 

Electric lamps, 261 66 

Furniture, upholstery, etc., 391 81 

Kitchen and household wares, 1,247 45 

Laundry supplies and materials, 1,519 55 

Lavatory supplies and disinfectants, 1,573 40 

Table linen, paper napkins, towels, etc., .... 599 74 

Sundries 262 50 

Freight 132 67 

10,034 44 

Medical and general care: — 

Books, periodicals, etc., $55 60 

Entertainments, games, etc., 168 00 

Funeral expenses, 60 00 

Ice and refrigeration, 168 80 

Laboratory supplies and apparatus, 269 22 

Manual training supplies, 130 77 

Medicines (supplies and apparatus) 1,657 02 

Medical attendance (extra), 93 45 

School books and supplies, 266 92 

Sputum cups, etc., 469 13 

Sundries, 1 40 

Freight 25 56 

3,365 87 

Heat, light and power: — 

Coal (bituminous), $7,936 93 

Freight and cartage, 5,374 81 

Coal (anthracite), 631 02 

Freight and cartage, 232 21 

Oil 239 04 

Operating supplies for boilers and engines, .... 426 81 

Freight, 18 81 

14,859 63 

Farm : — 

Bedding materials, $290 29 

Blacksmithing and supplies, 142 10 

Carriages, wagons and repairs, 68 11 

Dairy equipment and supplies, 174 07 

Fencing materials, 77 00 

Fertilizers, 855 57 

Grain, etc., 8,801 68 

Hay, 2,291 82 

Harnesses and repairs 34 26 

Cows 947 50 

Rent, 25 50 

Spraying materials, 141 50 

Stable and barn supplies, 223 50 

Tools, implements, machines, etc., 466 58 

Trees, vines, seeds, etc., 346 08 

Amounts carried forward, $14,885 53 $155,237 1ft 



322 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Amounts brought forward, $14,885 56 $155,237 19 

Farm — Coti. 

Veterinarj' services, supplies, etc., 102 87 

Freight 576 46 

Tractor, 1,325 00 

16,889 89 

Garage, stable and grounds: — 

Motor vehicles, $2,500 00 

Automobile repairs and supplies, 2,178 14 

Rent 240 00 

Road work and materials, 26 74 

Tools, implements, machines, etc., 16 95 

Trees, vines, seeds, etc., 117 42 

Freight 3 73 

5,082 98 

Repairs, ordinarj': — 

Cement, lime, crushed stone, etc., $208 50 

Electrical work and supplies, 563 12 

Hardware, iron, steel, etc., 835 97 

Labor (not on pay roll) 1,744 65 

Lumber, etc. (including finished products), .... 1,15226 

Paint, oil, glass, etc 1,138 82 

Plumbing and supplies, 1,185 09 

Roofing and materials, 259 36 

Steam fittings and supplies, 1,569 82 

Tents, awnings, etc., 80 35 

Tools, machines, etc., . 726 56 

Boilers, repairs, 86 07 

Engines, repairs 205 08 

Sundries, 11 13 

Freight, 183 28 

9,950 06 

Repairs and renewals : — 

Asbestos slate roofing and labor, $4,355 82 

Boiler instruments 358 58 

X-ray apparatus, 2,239 16 

Repairs on house and barn, 2,371 98 

9,325 54 

Total expenses for maintenance $196,485 66 



Special Appropriations. 

Appropriations for current year, $24,090 00 

Expended during the year (see statement below) , 16,962 89 

Balance Nov. 30, 1920, carried to next year, $7,127 11 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 323 



Object. 


Act or Resolve. 


Whole 
Amount. 


Expended 

during 
Fiscal Year. 


Total 

Expended 

to Date. 


Balance 

at End of 

Year. 


Purchase of land, 

Remodeling farmhouse and 

dormitory. 
Remodeling barn. 

Installing engine and genera- 
tor. 


1920 

1920 

1920 

1920 


$1,890 00 

10,000 00 

5,700 00 

6.500 00 


$9,988 23 
5,662 76 
1,311 90 


$9,988 23 
5,662 76 
1,311 90 


$1,890 00 

11 77 

37 24 

5,188 10 




$24,090 00 


$16,962 89 


$16,962 89 


$7,127 11 



Resources and Liabilities. 

Resources. 

Cash on hand $240 21 

November cash vouchers (paid from advance money), ac- 
count of maintenance 9,759 /9 



Due from treasury of Commonwealth from available appropriation, account 
of November, 1920, schedule, 



Liabilities. 



Schedule of November bills, 



$10,000 00 
9,419 73 



),419 73 
$19,419 73 



Per Capita. 

During the year the average number of inmates has been 265.25. 

Total cost for maintenance, $196,485.66. 

Equal to a weekly per capita cost of $14.2453. 

Receipt from sales, $1,541.96. 

Equal to a weekly per capita of $0.1117. 

All other institution receipts, $42,404.54. 

Equal to a weekly per capita of $3,074. 



Respectfully submitted, 

Henry D. Chad wick, 

Treasurer. 



Examined and found correct as compared with the records in the office of the Auditor 
of the Commonwealth. 



Land, 

Buildings, . 
Miscellaneous, 

Total, . 
Personal estate. 



Total valuation. 



VALUATION. 



Alonzo B. Cook, 

Auditor. 



$13,524 00 

176,206 29 

60,487 77 



$240,218 06 
88,945 29 

$329,163 35 



324 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



SPECL\L REPORT. 

The follo^\ing special report is prepared in accordance M'ith a resolution of 
the National Conference of Cha/ities and Corrections, adopted Maj^ 15, 1906: — 



Populotion. 





Males. 


Females. 


Totals. 


Number received during the year 


162 


152 


314 


Number passing out of the institution during the year, . 


162 


149 


311 


Number at end of fiscal year in the institution, . 


131 


135 


266 


Daily average attendance (i.e., number of inmates actually 

present) during the year. 
Average number of employees and officers during the year, . 


132.339 
57 


132.918 
41 


265.25 
98 



Expenditures. 
Current expenses: — 

1. Salaries and wages, 

2. Clothing, 

3. Subsistence, . . . ... 

4. Ordinary repairs, .... 

5. Office, domestic and outdoor expenses, 

Total, ..... 



$84,187 68 

979 89 

39,968 30 

9,950 06 

61,399 73 

!»196,485 66 



Extraordinary expenses: — 

1. Permanent improvements to existing buildings and construction, . 16,962 89 

Grand total, 8213,448 55 



Summary of Current Expenses. 
Total expenditures, ....... 

Deducting extraordinary expenses, ..... 



Deducting amount of sales, . . 
Total, . 



$213,448 55 
16,962 89 

$196,485 66 
1,541 96 

55194,943 70 



Dividing this amount by the daily average number of patients — 265.25 — gives a cost 
for the year of $734.94, equivalent to an average weekly net cost of $14.13. 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 






STATISTICAL TABLES. 

Table 1. — ■ Admissions and Discharges. 



Number of patients admitted Dec. 1, 1919, to Nov. 30, 1920, 

inclusive. 
Number of patients discharged Dec. 1, 1919, to Nov. 30, 1920, 

inclusive. 
Number of deaths (included in preceding item). 

Number in sanatorium Dec. 1, 1919 

Number remaining Nov. 30, 1920, 



Males. 



162 
162 

131 
131 



Females. 



152 
149 

132 
135 



Totals. 



314 
311 

263 
266 





Table 2. 


— Civil Condition of Patients admitted. 






Males. 


Females. 


Totals. 


Married, 
Single, . 
Widowed. 


. 





30 
125 

7 


19 
126 

7 


49 

251 

14 


Totals, 

r— 


162 


152 


314 

5 



T 


ABLE 3. — Ages of Patients admitted. 






Males. 


Females. 


Totals. 


1 to 13 years, . 




72 


( t 


149 


13 to 20 years, 




29 


30 


59 


21 to 30 years. 




22 


23 


45 


31 to 40 years. 




23 


17 


40 


41 to 50 years, 




11 


3 


14 


51 to 60 years, 




4 


1 


5 


60 years, 




1 


1 


2 


Totals. 


162 


152 


314 



326 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 4. — Nativity and Parentage of Patientf^ admitted. 





Males. 


Females. ■ 1 


Totals. 


Places of Nativity. 


i 

d 
.2 

Pi 


E 

o 

.£3 
1 


2 

.s 

o 


i 

a 
.2 

(2 


2 

o 

.a 
-** 


1 

CO 

M 

o 


a 
.2 

Ol 


2 


E 

2 

*^ 
o 


United States: — 


















\ 


Massachusetts, 


104 


37 


30 


100 


32 


33 


204 


69 


63 


Other New England States, 


10 


8 


9 


10 


7 


12 


20 


15 


21 


Other States. . 


16 


10 


9 


8 


9 


1 


24 


19 


16 


Total native. 


130 


55 


48 


118 


48 


52 


248 


103 


100 


Other countries: — 




















Armenia 


- 


1 


1 


1 


1 


1 


1 


2 


2 


Asia 


1 


1 


1 


- 


- 


1 


1 


1 


2 


Austria, .... 


1 


5 


5 


- 


2 


2 


1 


7 


6 


Azores, .... 


- 


1 


1 


- 


- 


- 


i 


1 


1 


Bohemia, .... 


- 


- 


1 


- 


- 


- 




- 


1 


Canada 


10 


24 


25 


11 


24 


28 


21 


48 


53 


Czecho-Slovakia, 


1 


- 


- 


- 


- 


- 


1 


- 


- 


Denmark, 


- 


- 


- 


1 


1 


2 


1 


1 


2 


England 


3 


5 


4 


1 


5 


4 


4 


10 


8 


Finland 


- 


- 


- 


1 


3 


3 


1 


3 


3 


France, .... 


1 


1 


1 


- 


- 


1 


1 


1 


2 


Germany, 


- 


1 


1 


- 


1 


2 


_ 


2 


3 


Greece 


- 


2 


2 


- 


1 


1 


- 


3 


3 


Ireland, . . . . 


3 


23 


26 


3 


23 


21 


6 


46 


47 


Italy 


2 


7 


8 


1 


7 


6 


3 


14 


14 


Poland, . . . . 


- 


3 


2 


3 


5 


4 


3 


8 


6 


Porto Rico, 


1 


- 


- 


- 


- 


- 


1 


- 


- 


Portugal, . . . . 


- 


2 


2 


- 


1 


1 


- 


3 


3 


Russia, . . . . 


1 


4 


4 


3 


6 


6 


4 


10 


10 


Scotland, . . . . 


3 


4 


5 


1 


2 


1 


4 


6 


6 


Sweden 


- 


2 


1 


- 


2 


2 


- 




3 


Switzerland, 


- 


- 


- 


- 


1 


1 


- 




1 


Syria 


1 


1 


1 


- 


- 


- 


1 




1 


Turkey 


- 


- 


- 


1 


1 


- 


1 




- 


Wales 


- 


1 


- 


- 


- 


- 


- 




— 


West Indies, 


- 


- 


1 


- 


- 


- 


- 




1 


Total foreign, 


28 


88 


90 


27 


86 


87 


55 


174 


178 


Unknown, 


4 


19 


22 


7 


18 


14 


11 


37 


14 


Grand total. 


. 162 


162 


162 


152 


152 


152 


314 


314 


314 
-J 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 327 



Table 5. — Residence of Patients admitted. 



Place 

Adams, 

Amesbury, 

Bedford, . 

Beverly, . 

Boston, 

Brockton, 

Brookline, 

Cambridge, 

Chelsea, . 

Chicopee, 

Concord, . 

Dartmouth, 

Dennis, . 

Dudley, . 

East Bridgewater, . 

Easthampton, . 

Everett, . 

Fall River, 

Falmouth, 

Fitchburg, 

Gardner, . 

Gloucester, 

Grafton, . 

Greenfield, 

Haverhill, 

Holyoke, . 

Hudson, . 

Lancaster, 

LawTence, 

Leominster, 

Longmeadow, . 

Lowell, 

Ludlow, . 

Lynn, 

Maiden, . 

Marlborough, . 



Number. 



4 
1 
1 

2 

43 
2 
1 
2 
1 
4 
1 
1 
1 
1 
1 
3 
7 

13 
1 



2 
3 
1 
8 
1 
1 
3 

10 
1 
6 
2 

12 
3 
7 



Place. 



Number. 



Medford, . 
Melrose, . 
Montague, 
New Bedford, 
Newton, . 
North Adams, 
Northampton, 
Northbridge, . 
North Brookfield, 
Norwood, 
Peabody, 
Pittsfield, 
Plymouth , 
Quincy, . 
Salem, 
Somerville, 
Southbridge, 
South Hadley, 
Spencer, . 
Springfield, 
Templeton, 
Tewksbury, 
Tyngsborough, 
Uxbridge, 
Watertown, 
Webster, . 
West borough, 
Westfield, 
Westfield State I 
Westford, 
West Springfield, 
Williamstown, 
Winchester, 
Worcester, 
Total, 



Sanatorium 



4 
1 
1 

5 

2 
7 
4 
1 
1 
1 
1 
8 
1 
1 
2 

5 
3 
4 
1 

42 
1 
2 
1 

2 
2 

4 
1 

13 
4 
1 
5 
1 



314 



328 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 6. — Occvpations of Patievts admitted. 



Males. 



Females. 



Totals. 



Baker, 

Bookbinder, . 
Cabinetmaker, 
Car inspector, 
Carpenter, 
Chauffeur, 
Cigarmaker, . 
Civil engineer, 
Clerk, . 
Domestic, 
Dyer, 

Errand boy, . 
Gardener, 
Hospital attendant 
Hotel clerk, . 
Housewife, 
Janitor, . 
Laborer, . 
Machinist, 
Marble cutter. 
Meat cutter, . 
Mill hand, 
Nurse, 
Office, . 
Orderly, . 
Painter, . 
Paper worker. 
Plumber, 
Printer, . 
Salesman, 
School, . 
Shipping clerk. 
Shoemaker, 
Steelworker, . 
Stenographer, 
Stonecutter, . 
Teacher, 
f : 



1 

2 
4 
1 
1 
14 
2 

2 
3 
2 
1 
3 
2 

85 
2 
2 
1 



20 



14 
4 
1 



94 



1 
1 
1 

1 
4 
3 
1 
1 
9 
3 
1 
1 
1 
3 
2 

20 
1 
2 
4 
1 
1 

28 
6 
1 
2 
3 
2 

1 
3 
2 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 329 



Table 6. — Occtipations of Patients admitted — Concluded. 



Males. 



Females. 



Teamster, 

Telephone operator, 
Toolmaker, 
Waiter, . 
Weaver, . 
None, 

Totals, 



162 



152 



Totals. 



314 





Table 7. - 


— Condition on 


Admission 


• 










Males. 


Females. 


Totals. 


Incipient: — 












A 






39 


38 


77 


B 






2 


4 


6 


C 






- 


1 


1 


TWoderately advanced: — 












A. . . . 






35 


39 


74 


B 






25 


18 


43 


C 






- 


- 


- 


Tar advanced : — 












A, . . . 






28 


26 


54 


B, . . . 






26 


18 


44 


C. . . . 






7 


7 


14 


"N^ontut>prculous. 






- 


1 


1 










Totals, . 


162 


152 


134 



Table 8. — Condition on Discharge 








Males. 


Females. 


Totab. 


Apparently arrested 


70 


64 


134 


Quiescent 


30 


22 


52 


Improved 


13 


9 


22 


Unimproved 


18 


27 


45 


Died 


20 


20 


40 


Nontuberculoiis 


- 


1 


1 


Not considered (stayed less than thirty days), . 


11 


6 


17 


Totals 


162 


149 


311 

3 



330 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 9. — Deaths. 



Duration op Disease. 



Under 1 month, 
1 to 3 months, 
3 to 6 months, 
6 to 9 months, 
9 months to 1 year, 

1 to 2 years, . 

2 to 5 years, . 
5 to 10 years, . 
Over 10 years. 

Totals, . 



Males. 


Females. 


Totals. 


Length of Residence 
AT Sanatorium. 












Males. 


Females. Totals. 


- 


- 


- 


1 


- 


1 


- 


- 


- 


2 


- 


2 


3 




3 


7 


3 


10 


2 


1 


3 


1 


10 


11 


- 


2 


2 


5 


2 


7 


5 


10 


15 


3 


3 


6 


4 


4 


8 


1 


2 


3 


6 


2 


8 


- 


- 


- 


- 


1 


1 


- 


- 


- 


20 


20 


40 


20 


20 


40 



Table 10. — Cause of Death. 



Males. 



Females. 



Totab. 



Tuberculosb of lungs, .... 
Tuberculosis of lungs and bowels. 
Tuberculosis of lungs and kidney. 
Tuberculosis of lungs and larynx, 
Tuberculosis of lungs, kidney and larynx. 

Accidental drowning 

Totals 



17 
1 



20 



17 

1 
1 
1 



34 
1 
1 

2 

1 
1 



40 



LAKEVILLE STATE SANATORIUM. 



Resident Officers. 



Sumner Coolidge, M.D., 
MiNOT W. Gale, M.D., . 
Frederick P. Moore, M.D., 
Mrs. Mart M. Coakley, 
Mrs. Harriet M. Gassett, 
Robert A. Kennedy, 
Thomas Francis Mahoney, 



Superintendent. 
Assistant Superintendent. 
Senior Assistant Physician, 
Steward. 
Head Matron. 
Operating Engineer. 
Head Farmer. 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 331 



REPORT OF THE SUPERINTENDENT. 

To the Commissioner of Public Health. 

I have the honor to submit he^e^\•ith the report of the Lakeville State Sana- 
torium for the year ending Nov. 30, 1920. 

There were remaining in the institution on Nov. 30, 1919, 232 patients. 
This, together with 504 admitted during the year, brings the total number of 
patients cared for to 736, as against 704 for the year 1919. 

The daily average number of patients for the year has been 231, which shows 
that we carried 19 more empty beds throughout the year than in any pre\aous 
5'ear since the institution was opened, a total daily average of 42. 

The average stay of 485 patients discharged was 176| days, or 13f days 
less than the pre\'ious year. The longest residence was 2,393 days and the 
shortest was 1 day. 

The average of 104.8 bed parients daily maintains approximately the per- 
centage of the pre^•ious year, showing that as the years pass we are taking 
care of sicker patients, as a whole, than in former years. 

The total days of treatment for the year just finished was 84,671, 7,305 less 
than in 1919. 

The following table shoeing the classification of cases admitted indicates 
no improvement in the class of patients cared for, and also shows discrepancies 
between the sanatorium classification and that of the outside practitioners. 



Classification 

on Appli- 
cation Blank. 



Incipient, 

Moderately advanced, 
Far advanced, 
Not classified, . 
Apparently arrested, 
Not examined, 
Totals, 




Our Classifica- 
tion 
on Admission. 



Table 8 shows a shght improvement over the preceding year in the condi- 
tion of patients discharged. 

Of the 736 cases cared for, the proportion of self-supporting cases shows a 
slight improvement over 1919. There were 75 private cases, 273 tovm cases, 
and 144 State cases. The unusually large number of 200 settlements still 
remain undetermined at the end of the year. Forty-six ex-service men have 
been cared for, of whom 44 were acknowledged by the Bureau of War Risk 
Insurance. 

Of the 485 patients discharged during the year, 196 made an average gain 
of 14.13 pounds. The greatest gain for a man was 45^ pounds and for a woman 
43j pounds. 



332 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Medical Report. 

No innovations have been introduced in medical treatment during the year. 
Hehotherapy has been practiced as in the previous j^ear, although the complica- 
tions calling for this treatment have been fewer than in 1919. 

As usual tubercular laryngitis heads the list of complications. There were 
65 cases of this complication, 14 cases of fistula in ano, 11 cases of tubercular 
adenitis, 7 cases of pleurisy, 7 cases of tubercular peritonitis, and 5 cases of 
nephritis. Besides these cases 32 other distinct complications were met with. 

Of 3,017 sputum examinations, 1,084 were positive and 1,933 were negative. 

Six hundred and twenty-five urinalyses were made, which disclosed 5 cases 
of nephritis and 1 of diabetes. 

The tuberculosis clinic at Middleborough was discontinued in July and was 
not resumed in the autumn because the field was covered by the consultation 
chnic plan which was instituted in September. 

Work performed. 

An attempt was made to continue occupational therapy throughout the 
year by the assignment of suitable patients to small duties of a helpful char- 
acter. The results have been fragmentary on account of the small number of 
patients who were well enough to put on regular exercise. 

The aggregate number of work hours of patients during the year was 9,700, 
1,304 hours less than in 1919. The following list of canned goods represents 
the combined work of the janitor's department with the patients. 

Farm Produce canned and 'preserved. 



Cans, No. 
10. 



Cans, No. 
3. 



2-quart 
Cans. 



Pounds. 



Barrels. 



Strawberries, . 

Cherries, . 

Plums 

Pears, 

String beans, . 

Lima beans, 

Peas, 

Corn, 

Tomatoes, 

Ketchup, . 

Piccalilli, . 

Currant jelly, . 

Cucumber pickles. 



146 
20 
249 
158 
564 
231 
152 

1,516 



3,036 



616 
1.307 



1,923 



141 
327 



468 



1,400 



1,400 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 333 



Improvements. 

An appropriation was made available during the year for the purchase of 
an SO-kilowatt generator unit and for a temporary shelter for young stock at 
the dairy barn. Plans were completed for the installation of the generator 
and it was ordered in midsummer. Delivery has been delayed, however, so 
that at this writing the machine has not yet been shipped. The necessary pro- 
vision has been made for the protection of young stock by building a part of 
the permanent foundation of the addition at the dairy barn which was 
requested. 

The sewerage system has been extended by the addition of 800 feet of absorp- 
tion trenches, and 3,600 square yards of road about the sanatorium grounds 
have been macadamized. 

Farm. 

The results obtained on the farm during the year just ended have been fairiy 
satisfactory. The earUest planted garden crops were considerably damaged 
by the cold and rain, but the main crops have been of good quality and of 
average quantit5^ 

By improved methods in the curing of bacon and ham we are now in a posi- 
tion to produce all classes of pork products which are used in the sanatorium, 
and the installation of illumination in the poultry plant has already shown 
remarkable results in egg production. 

Recommendations. 

Again our first recommendation is that the institution be provided with an 
adequate storehouse. Present conditions under which supplies are stored and 
handled are unbusinesslike and wasteful as the supplies cannot be properiy 
protected, and handling under present conditions is verj^ expensive. Estimated 
cost, $1,200. 

Our next recommendation in order of importance is an addition to the dairy 
barn to provide storage for hay produced on the farm and to provide quarters 
for young stock which it is necessary for us to raise if we are to eradicate tuber- 
culosis from the herd. Estimated cost, $9,500. 

I also recommend the erection of a 30,000-gallon tank for additional water 
supply, and a duplicate pumping unit at the pumping station. 

There is verj' urgent need for a moving-picture apparatus, and an X-ray 
equipment. The moving picture should be installed at once. 

The chapel should be enlarged by extending the building about 20 or 25 
feet in a southerly direction, providing anterooms for the various uses of enter- 
tainers, speakers and clergA'men who ser\'e us from time to time. This enlarge- 
ment will also furnish an excellent room for the X-ray apparatus. 

The poultry plant should be made more complete by slightly increasing its 
capacity, and by the installation of an incubation plant. It does not seem rea- 
sonable to spend $1,200 or $1,300 per year for day old chicks when the same 
can be hatched on the place at about half that cost. 



334 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

I urgently recommend also a definite policy in regard to the providing of 
quarters by the institution for permanent married employees. In Lake\'ille 
this may best be done by purchasing a small property which will soon come into 
the market, with two houses already built, and the purchase of a small lot situ- 
ated conveniently near to the sanatorium for the erection of new houses. 

The farm is adequate if the available good land can be reclaimed, although 
it has not sufficient pasturage. Additional pasture land is available adjoining 
the dairy farm which should be purchased as soon as practicable. 

Changes in Personnel. 

During the year the resignation of Dr. George M. Sullivan was accepted, and 
Dr. Minot W. Gale, then assistant physician, was promoted to the position of 
assistant superintendent. For the position of assistant physician made vacant 
by the promotion of Dr. Gale we were fortunate in obtaining the services of Dr. 
Frederick P. Moore, formerly assistant superintendent of the Norfolk State 
Hospital. 

Acknowledgments. 

I wish to express my appreciation of the faithful services of the Catholic, 
Protestant and Jewish clergymen who have attended to their respective religious 
ministrations during the year. 

The heads of departments and their subordinates have maintained a helpful 
attitude through the hardest year in the history of the institution. 

Gifts of flowers and books to the patients are also gratefully acknowledged. 

Respectfully submitted, 

Sumner Coolidge, 

Superintendent. 

TREASURER'S REPORT. 

To the Commissioner of Public Health. 

I respectfully submit the following report of the finances of this institution 
for the fiscal year ending Nov. 30, 1920: — • 

Cash Account. 
Balance Dec. 1, 1919 S314 81 

Receipts. 
Institution Receipts. 
Board of inmates: — 

Private $4,193 06 

Cities and towns 29,753 90 

Reimbursements, charitable, .... 246 28 

Other reimbursements, War Risk patients' 

board 380 86 

$34,574 10 



Amounts carried forward, $34,574 10 $314 81 



Ko. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 335 

Amounts brought forward, $34,574 10 $314 81 

Sales: — 

Travel, transportation and office expenses, . $89 85 

Clothing and materials, 60 00 

Furnishings and household supplies, . . 63 31 

Medical and general care, .... 21 18 

Farm and stable: — 

Cows and calves, 

Grease, 



Hides, 

Vegetables, 
Use of teams. 
Sundries, . 



$40 00 
514 72 
12 76 
128 40 
2 25 
133 19 



831 32 

Repairs, ordinary 4 50 

1,070 16 

Miscellaneous receipts: — 

Interest on bank balances, 164 14 



35,808 40 



Receipts from Treasury of Commonwealth. 
Maintenance appropriations: — 

Balance of 1919 $7,625 10 

Advance money (amount on hand November 30), . . 8,000 00 

Approved schedules of 1920 182,943 98 



198,569 08 

Special appropriations, 1,932 38 



Total $236,624 67 

Payments. 
To treasury of Commonwealth: — 

Institution receipts, $35,808 40 

Refunds, account of maintenance, 158 43 

Income account of 1919 not paid over until 1920 account, 23 40 

$35,990 23 



Maintenance appropriations: — 

Balance November schedule, 1919, $7,918 94 

Eleven months' schedules, 1920, . . . $182,943 98 
Less returned 158 43 



— 182,785 55 

November advances, 3,498 32 



Special appropriations: — 

Approved schedules, $1,932 38 

Less returned , 2 43 



Balance Nov. 30, 1920: — 

In bank, $4,240 99 

In office 260 69 



194,202 81 



1,929 95 



4,501 68 



Total, $236,624 67 



336 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Maintenance. 

Appropriation, current year, $201,810 48 

Expenses (as analyzed below) 198,740 87 



Balance reverting to treasury of Commonwealth, S3,069 61 

Analysis of Expenses. 
Personal services : — 

Sumner Coolidge, M.D., superintendent* . . • • . $3,600 00 

Medical 3,637 74 

Administration, 5,061 91 

Kitchen and dining-ioom service 5,545 03 

Domestic, 16,221 36 

Ward service (male) 6,301 01 

Ward service (female) 5,482 64 

Engineering department, 7,202 57 

Repairs 4,970 43 

Farm, 26,231 45 

Stable, garage and grounds 1,990 97 

$86,245 11 

Religious instruction : — 

Catholic. $600 00 

Hebrew • • 101 44 

Protestant 430 00 

1,131 44 

Travel, transportation and office expenses: — 

Postage, $177 44 

Printing and binding, 163 38 

Stationery and office supplies 413 11 

Telephone and telegraph, 320 64 

Travel 781 22 

Sundries, 75 98 

Freight, 15 60 

1,947 37 

Food: — 

Flour $2,972 56 

Cereals, rice, meal, etc 852 27 

Bread, crackers, etc., 88 17 

Peas and beans (canned and dried), . - . . • 400 14 

Macaroni and spaghetti, 73 02 

Potatoes, 444 25 

Meat, 10.838 23 

Fish (fresh, cured and canned) , 2,171 58 

Butter, , 4,586 00 

Cheese 148 96 

Coffee 399 63 

Tea, 170 07 

Cocoa 50 59 

Milk (condensed, evaporated, etc.) 39 60 

Eggs (fresh), 2,084 55 

Sugar (cane), 3,882 31 

Fruit (fresh) 296 81 

Fruit (dried and preserved), 256 06 

Amounts carried forward $29,754 80 $89,323 92 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 337 

Amounts brought forward, $29,754 80 $89,323 92 

Food — Con. 

Lard and substitutes, 434 50 

Molasses and syrups, 44 51 

Vegetables (fresh), 11 b5 

Seasonings and condiments, 723 90 

Yeast, baking powder, etc., 137 54 

Sundry foods, 53 02 

Freight 545 36 

31,771 18 

Clothing and materials: — 

Boots, shoes and rubbers $1 50 

Clothing (outer) 13 10 

Freight, 35 

4 95 

Furnishings and household supplies: — 

Beds, bedding, etc., $650 66 

Carpets, rugs, etc., 187 06 

C^ocker5^ glassware, cutlery, etc., 464 56 

Dry goods and smallwares, 346 94 

Electric lamps, 197 11 

Furniture, upholstery, etc. 225 82 

Kitchen and household wares 1,977 62 

Laundry supplies and materials, 750 40 

Lavatory supplies and disinfectants, 518 26 

Table linen, paper napkins, towels, etc., .... 445 98 

Sundries, 54 46 

Freight, 127 21 

5,946 08 

Medical and general care: — 

Books, periodicals, etc., $30 13 

Entertainments, games, etc., 324 25 

Funeral expenses 228 50 

Ice and refrigeration, 187 74 

Laboratory supplies and apparatus, 212 16 

Medicines (supplies and apparatus) 2,120 50 

Medical attendance (extra), 13 50 

Sputum cups, etc 712 56 

Sundries, 3 00 

Freight, 34 01 

■ 3,866 35 

Heat, light and power: — 

Coal (bituminous) $6,790 59 

Freight and cartage 4,249 60 

Coal (anthracite), 366 74 

Freight and cartage 335 18 

Oil, 474 99 

Operating supplies for boilers and engines, .... 398 05 

Sundries 180 05 

Freight 31 84 

12,827 04 

Amount carried forward, $143, /49 52 



338 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Amount brought forward, $143,749 52 

Farm : — 

Bedding materials, $229 34 

Blacksmithing and supplies, 248 64 

Carriages, wagons and repairs, 68 12 

Dairy equipment and supplies, 455 04 

Fencing materials 226 44 

Fertilizers 4,266 24 

Grain, etc 18.046 34 

Hay 4.574 64 

Harnesses and repairs, 244 20 

Cows, 890 00 

Other live stock 947 58 

Labor (not on pay roll), 1,527 14 

Rent 303 76 

Spraying materials, . • 308 06 

Stable and barn supplies, 237 53 

Tools, implements, machines, etc., 2,026 86 

Trees, vines, seeds, etc., 1-108 35 

Veterinary services, supplies, etc., 223 56 

Sundries 407 76 

Freight 2,897 28 

39,236 88 

Garage, stable and groimds: — 

Motor vehicles ^3,792 50 

Automobile repairs and supplies 2,515 45 

Carriages, wagons and repairs, 498 56 

Road work and materials 212 37 

Spraying materials 27 75 

Tools, implements, machines, etc 448 15 

Trees, vines, seeds, etc., 257 53 

Freight 114 85 

7,867 16 

Repairs, ordinary: — 

Brick '^Q 60 

Cement, lime, crushed stone, etc 608 61 

Electrical work and supplies, 437 50 

Hardware, iron, steel, etc., 723 43 

Labor (not on pay roll) 509 41 

Lumber, etc. (including finished products), .... 1,30945 

Paint, oil, glass, etc 1'196 02 

Plumbing and supplies, 477 11 

Roofing and materials 217 32 

Steam fittings and supplies, 124 47 

Tents, awnings, etc 313 38 

Tools, machines, etc., 583 92 

Boilers, repairs, ^^^/^ 

Dynamos, repairs, ■^"'* ^"^ 

Engines, repairs 196 00 

Sundries 10^ ^^ 

"-«" '— 7,23325 

Repairs and renewals: — 

Repair old house, ^^4 06 

Total expenses for maintenance $198,740 87 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 339 



Special Appropriations. 

Balance Dec. 1, 1919, S2,500 00 

Appropriations for current year, 11,505 00 

Total, • $14,005 00 

Expended during the year (see statement below) , 1,849 82 

Balance Nov. 30, 1920, carried to next year, $12,155 18 



Object. 


Act or Resolve. 


Whole 
Amount. 


Expended 

during 
Fiscal Year. 


Total 

Expended 

to Date. 


Balance 

at End of 

Year. 


Shelter for young stock. 
Generator unit, . 
Purchase of land. 


Chap. 629, 1920, 
Chap. 629, 1920, 
Chap. 153, 1919, 


S2,500 00 
9,005 00 
2,500 00 


$1,696 52 
153 30 


$1,696 52 
153 30 


$803 48 
8,851 70 
2,500 00 


1 


$14,015 00 


$1,849 82 


$1,849 82 


$12,155 18 



Resources and Liabilities. 

Resources. 

Cash on hand $4,501 68 

November cash vouchers (paid from advance money), ac- 
count of maintenance, 3,498 32 

$8,000 00 

Due from treasury of Commonwealth from available appropriation, account 

of November, 1920, schedule 7,796 89 

$15,796 89 
Liabilities. 
Schedule of November bills $15,796 89 

Per Capita, 

During the year the average number of inmates has been 231.34. 

Total cost for maintenance, $198,740.87. 
Equal to a weekly per capita cost of $16,520. 
Receipt from sales, $1,070.16. 
Equal to a weekly per capita of $0.0889. 
All other institution receipts, $34,738.24. 
Equal to a weekly per capita of $2.8877. 

Respectfully submitted, 

SuiklNER COOLIDGE, 

Treasurer. 

Examined and found correct as compared with the records in the office of the Auditor 
of the Commonwealth. 

Alonzo B. Cook, 

Auditor. 



340 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



VALUATION. 



Land. 



Grounds (63 acres), 

Woodland (10 acres), 

Mowing (42 acres). 

Tillage (53 acres), 

Orchard (5 acres). 

Pasture (13 acres), 

Waste and miscellaneous (23 acres) , 



Buildings and Equipment 



Institution and buildings. 
Farm, stable and grounds, 
Miscellaneous, 



$8,868 50 

535 70 

2,019 25 

4,502 90 

442 66 

696 41 

1,018 96 



$117,394 50 
23,642 87 
83,782 88 



Present value of all personal property as per inventory of Nov. 30, 1920, 
Grand total, ......... 



$18,084 38 



224,820 25 

$242,924 63 
115,192 25 

$358,116 88 



SPECIAL REPORT. 

The following report is prepared in accordance with a resolution of the Na- 
tional Conference of Charities and Corrections, adopted May 15, 1906: — 



Population. 










Males. 


Females. 


Totals. 


Number of patients at beginning of year 

Number received during year 

Number discharged or died during the year. 

Number at end of fiscal year, 

Daily average attendance {i.e., number of inmates actually 

present) during the year. 
Average number of officers and employees during the year, 

r 


150 
351 
424 
166 
206 
94 


82 
153 
192 

85 
129 

24 


232 
504 
616 
251 
335 
118 



Exfenditures. 
Current expenses: — 



1. Salaries and wages, .... 

2. Clothing 

3. Subsistence, ..... 

4. Ordinary repairs and improvements, 

5. Office, domestic and outdoor expenses, . 


$86,245 11 

14 95 

31,771 18 

7.887 31 

72,822 32 


$198,740 87 
1,849 82 


Total, ...... 

Extraordinary expenses : — 

1. Shelter for young stock, 

2. Generator unit, ..... 


$1,696 52 
153 30 







Grand total, ..... 


$200,590 69 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 341 



Summary of Current Expenses. 
Total expenditures, ....... 

Deducting extraordinary expenses, .... 

Deducting amount of sales, ...... 

Total, 



$200,590 69 
1,849 82 

$198,740 87 
1,070 16 

$197,670 71 



Dividing this amount by the daily average number of patients — 231.34 — gives a cost 
for the year of $854,459, equivalent to an average weekly net cost of $16,434. 



STATISTICAL TABLES. 
Table 1. — Admissions and Discharges. 





Males. 


Females. 


Totals. 


Number of patients admitted Dec. 1, 1919, to Nov. 30, 1920, 

inclusive. 
Number of patients discharged Dec. 1, 1919, to Nov. 30, 1920, 

inclusive. 
Number of deaths (included in preceding item), 

Number remaining in sanatorium Nov. 30, 1920, 

Daily average number of bed patients Dec. 1, 1919, to Nov. 

30, 1920. 
Daily average number of patients, 


351 
335 

89 
166 

58 
148 


153 
150 
42 
85 
46 
83 


504 
485 
131 
251 
104 
231 



Table 2. — Civil Condition of Patients admitted. 



Males. Females. 



Totals. 



Married, . 
Single, 
Widowed, 
Divorced, 
Totals, 



160 

170 

18 

3 



351 



79 

65 

6 

3 



153 



239 

235 

24 

6 



504 





Table 3. - 


— Age of Patients admitted 








Males. 


Females. 


Totals. 


14 to 20 years, 




. 


19 


22 


41 


20 to 30 years, 






124 


06 


190 


30 to 40 years, 






91 


43 


134 


40 to 50 years, 






80 


17 


97 


Over 50 years, 






37 


5 


42 


Totals, . 


351 


153 


504 



342 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 4 


. — Nativity and Pa 


rentage 


of Pat 


lents a 


imttted 


• 






Males. 


Females. 


Totals. 


Places of Nativity. 


Patients. 


2 


o 


03 

■s 

.2 


2 
1 


■s 


a 

1 




2 

1 


United States: — 




















Massachusetts, 


121 


37 


31 


65 


19 


20 


186 


56 


51 


Other New England States, 


17 


13 


12 


10 


9 


5 


27 


22 


17 


Other States, . 


18 


10 


16 


12 


15 


17 


30 


25 


33 


Total native, 


156 


60 


59 


87 


43 


42 


243 


103 


101 


Other countries: — 




















Albania, .... 


1 


1 


1 


- 


- 


- 


1 


1 


1 


Armenia 


7 


7 


7 


- 


- 


- 


7 


7 


7 


Austria 


2 


2 


2 


- 


- 


- 


2 


2 


2 


Azores, .... 


1 


1 


1 


- 


- 


- 


1 


1 


1 


Canada, .... 


28 


41 


44 


8 


12 


13 


36 


53 


57 


Cape Verde Islands, 


4 


4 


4 


- 


- 


- 


4 


4 


4 


China, .... 


1 


1 


1 


- 


- 


- 


1 


1 


1 


Denmark, 


- 


1 


1 


- 


- 


- 


- 


1 


1 


England 


7 


11 


9 


7 


10 


7 


14 


21 


16 


Europe, .... 


- 


- 


- 


1 


1 


1 


1 


1 


1 


Finland, .... 


4 


5 


5 


3 


3 


3 


7 


8 


8 


France 


- 


2 


1 


- 


- 


- 


- 


2 


1 


Germany, 


- 


4 


1 


1 


1 


1 


1 


5 


2 


Greece 


17 


17 


17 


2 


2 


2 


19 


19 


19 


Ireland, .... 


21 


62 


69 


13 


35 


39 


34 


97 


108 


Italy, . . . . 


26 


29 


30 


4 


5 


5 


30 


34 


35 


Lithuania, 


1 


2 


2 


1 


1 


1 


2 


3 


3 


Madeira, .... 


- 


- 


- 


1 


1 


1 


1 


1 


1 


Newfoundland, 


1 


3 


3 


1 


1 


1 


2 


4 


4 


Norway, .... 


4 


4 


4 


1 


1 


1 


5 


5 


5 


Nova Scotia, . 


6 


12 


14 


7 


10 


11 


13 


22 


25 


Poland 


10 


10 


11 


2 


5 


5 


12 


15 


16 


Portugal 


6 


6 


6 


4 


4 


4 


10 


10 


10 


Russia 


29 


32 


29 


7 


8 


8 


36 


40 


37 


Scotland, . . . . 


5 


10 


7 


2 


3 


3 


7 


13 


10 


Spain, . . . . 


1 


1 


1 


- 


- 


- 


1 


1 


1 


Sweden, . . . . 


7 


12 


10 


- 


2 


2 


7 


14 


12 


Switzerland, 


- 


- 


1 


- 


- 


- 


~ 


- 


1 


Syria, . . . . 


3 


3 


3 


1 


1 


1 


4 


4 


4 


Turkey, . . . . 


2 


2 


2 


- 


- 


- 


2 


2 


2 


West Indies, 


- 


- 


- 


- 


- 


1 


- 


— 


1 


Total foreign, . 


194 


285 


286 


66 


106 


110 


260 


391 


396 


Unknown, 


1 


6 


6 


- 


4 


1 


1 


10 


7 


Grand totals, 


351 


351 


351 


153 


153 


153 


504 


504 


504 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 343 



Table 5. — Residence of Patients admitted. 



Place. 


Number. 


Place. 


Number. 


Adams, 


2 


Leominster 


5 


Andover, . 










2 


Lexington, 








1 


Arlington, 
Athol, 










4 
2 


Longmeadow, . 
Lowell, 








1 
19 


Avon, 










1 


Lynn, 








13 


Bedford, . 










1 


Maiden, . 








10 


Belmont, . 










2 


Marblehead, . 








1 


Beverly, . 










2 


Marlborough, . 








6 


Boston, 










169 


Maynard, 








1 


Braintree, 












Medford, . 








1 


Bridgewater, . 












Merrimac, 








1 


Brockton, 










11 


Methuen, 








1 


Buffalo. N. Y., 












Middleborough, 








10 


Cambridge, 










12 


Milford, . 








4 


Chelmsford, 












Millbury, 








1 


Chelsea, . 










11 


Natick, . 








1 


Clinton, . 












Needham, 








1 


Concord, . 












New Bedford, . 








26 


Danvers, . 










2 


Newton, . 








6 


Dedham, 










2 


Northbridge, . 








2 


Essex, 










2 


Norton, . 








1 


Everett, . 










9 


Norwood, 








2 


Fairhaven, 










1 


Ormbay, Conn., 










Fall River, 










23 


Pawtucket, R. I., 










Framingham, 










4 


Peabody, 










Freetown, 










1 


Providence, R. I., 










Gardner, . 










5 


Quincy, . 








10 


Gay Head, 










1 


Randolph, 










Gloucester, 










5 


Reading, . 










Hardwick, 










1 


Revere, . 










Haverhill, 










3 


Rockport, 










Holderness, N. 


H.. 








1 


Saugus, . 










Holyoke, . 










1 


Somerset, 










Hopkinton, 










1 


Somerville, 








12 


Hudson, . 










1 


Southbridge, . 










Lakeville, 










1 


Spencer, . 










Lawrence, 

1 










9 


Springfield, 











344 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 5. — 


- Residence of Patients admitted — 


- Concluded. 


Place. 


Number. 


Place. 


Number. 


Stoneham, 






1 


Watertown, 




2 


Stoughton, 








1 


Webster, . 












Sturbridge, 








1 


Westborough, 












Taunton, 








6 


Weston, . 












Upton, 








1 


Winchendon, 












Wakefield, 








2 


Winchester, 












Walpole, . 








2 


Woburn, . 












Waltham, 








1 

1 


Worcester, 
Total, 










20 


Warren, . 


504 



Table 6. — Occiipations of Patients admitted. 





Males. 


Females. 


Totals. 


Actor, 


1 


- 


1 


Agricultural extension leader, 


1 


- 


1 


Attendant 


- 


4 


4 


Baker 


2 


- 


2 


Barber 


5 


- 


5 


Beltmaker, 


1 


- 


1 


Blacksmith, 


1 


- 


1 


Bookbinder, 


- 


1 


1 


Bookkeeper, 


- 


2 


2 


Brakeman, 


2 


- 


2 


Brassworker, 




- 


1 


Bricklayer 




- 


1 


Brickmason, 




- 


1 


Butcher, 




- 


1 


Butler 




- 


1 


Cabinetmaker 




- 


3 


Canvasser 




- 


1 


Card room in mill, 




- 


1 


Car inspector, 




- 


1 


Carpenter, 


4 


- 


4 


Chair shop, 


2 


- 


2 


Chauffeur, 


5 


- ' 


5 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 345 



Table 6. — Occupations of Patients admitted — Continued. 



Males. 



Females. 



Totals. 



Chemical laboratory worker, 
Chorus girl, . 
Cigarmaker, . 

Clerk 

Coal passer, . 

Coal sampler. 

Cobbler, 

Conductor, 

Contractor, 

Cook, .... 

Coppersmith, 

Corset factory. 

Cotton factory. 

Creamery hand, 

Dairyman, 

Domestic, 

Draftsman, 

Dressmaker, . 

Driver 

Druggist, 

Electrical salesman. 

Electrician, 

Engineer, 

Errand boy, . 

Expressman, . 

Factory: .... 

Farmer 

Fireman, 

Fisherman, 

Foreman shoe factory, . 

Freight carrier, 

Fruit dealer, . 

Gardener, 

General helper. 

Granite works, 

Hairdresser, . 

Hatter, .... 



1 
23 
1 
1 
1 
1 
1 
4 
1 

2 
1 
1 



1 

1 
1 
3 
6 
1 
1 
1 
4 
1 
2 
1 
1 
3 
4 
1 
1 



1 
1 
1 
24 
1 
1 
1 
1 
1 
4 
1 
2 
9 
1 
1 
3 
1 
1 
1 
1 
1 
3 
6 
1 
1 
4 
4 
1 
2 
1 
1 
3 
4 
1 
1 
1 
1 



346 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 6. — Occupations of Patients admitted — Continued. 



Males. Females. 



Totals. 



Horse trainer, 
Hotel worker, 
Housekeeper, . 
Hoiisewife, 
Iceman, . 

Inspector in library. 
Iron and wire worker. 
Janitor, . 
Jeweler, . 
Journalist, 
Junk dealer, . 
Kitchenmaid, 
Labor agent, . 
Laborer, . 
Laundress, 
Leading rigger. 
Leather worker. 
Linen worker. 
Longshoreman, 
Machine operator, . 
Machinist, 
Magician, 
Mason, . 
Metal polisher. 
Meter reader, . 
Mill operative, 
Molder, . 
Motorman, 
Mule spinner. 
Munition worker, . 
Nailnaaker, 
None, 
Nurse, 
Nursemaid, 
Office clerk, . 
Office work, . 
Orderly, . 



1 
1 

3 
1 
1 
1 
1 

1 
35 

1 
5 
1 
1 
1 
24 
1 
3 
1 
2 
9 
3 
1 
2 
1 
1 



10 
64 



1 
1 

10 

64 
1 
2 
3 
1 
1 
1 
1 
1 
1 

35 
4 
1 
6 
1 
1 
2 

24 
1 
3 
1 
2 

15 
3 
1 
2 
1 
1 
2 

4 
1 
3 
4 

2 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 347 



Table 6. — Occupations of Patients admitted — Continued. 



Packer, . 
Painter, . 
Paper hanger. 
Pattern maker. 
Peddler, . 
Pharmacist, . 
Piano maker, . 
Piano tuner, . 
Plasterer, 
Plumber, 
Police officer, . 
Postman, 
Post office clerk, 
Poultryman, . 
Potter, . 
Printer, . 
Purser, . 
Railroad porter. 
Real estate dealer, 
Restaurant, . 
Retoucher in studio. 
Rubber work. 
Saleslady, 
Salesman, 
Scholar, . 
Seaman, . 
Sheet metal, . 
Shipbuilder, . 
Shipper, . 
Shirt waist factory, 
Shoe repairer. 
Shoe worker, . 
Sign painter, . 
Silk cutter, 
Singer, . 
Spinner, . 
Spring winder, 

r 



Males. 



Females. Totals 



2 
2 
3 
1 
3 
1 

1 
29 
1 
1 
1 
3 



2 

3 
2 
4 
3 
1 
3 
1 
2 
1 
30 
1 
1 
1 
4 
1 



348 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 6. — Occupations of Patients admitted — Concluded. 



Males. 



Females. 



Totals. 



Steam fitter, .... 

Stenographer, 

Steward, .... 

Stitcher, .... 

Stone cutter, .... 

Stove molder, 

Straw shop 

Student, .... 

Superintendent, rubber works, 

Tailor 

Tailoress, .... 

Tanner, 

Teacher, .... 

Teamster, .... 
Telegraph messenger. 
Telephone operator. 
Tinsmith, .... 
Toolmaker, .... 

Waiter 

Waitress, . . 

Watchman, .... 
Weaver, ..... 
Winder tender. 

Totals 

r 



10 
2 
3 
1 
1 
7 

1 

10 



351 



1 
2 
1 
4 
8 
1 
1 
4 
1 
8 
1 
2 
1 

10 
2 
4 
1 
1 
7 
1 
1 

12 
1 



153 



504 



Table 7. — Condition on Admission. 





Males. 


Females. 


Totals. 


Incipient 






2 


1 


3 


Moderately advanced, .... 










187 


87 


274 


Advanced, 










145 


62 


207 


Not classified 










15 


2 


17 


Nontuberculous 










- 


- 


- 


Not examined 










2 


- 


2 


Apparently arrested, 










- 


1 


1 


Totals, 


351 


153 


504 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 349 



Table S. — 


- Condition 


on Discharge 








Males. 


Females. 


Totals. 


Apparently arrested, 


• 


■ 




9 


11 


20 


Quiescent, 














8 


8 


16 


Improved, 














142 


37 


179 


Unimproved, . 














25 


34 


59 


Died, .... 














88 


43 


131 


Not considered. 














63 


17 


80 


Nontuberculous, . 














- 


- 


- 


Totals, 


335 


150 


485 


r .... .- ... _.... — . ._-. 













Table 9. 


— Deaths. 








DUKATXON OF DISEASE. 


Males. 


Females. 


Totals. 


Length op Residence 
AT Sanatorium. 














Males. 


Females. Totals. 


Under 1 month, 


- 


1 


1 


1 23 


3 


26 


1 to 2 months, 












4 


1 


5 


1 

11 


4 


15 


2 to 3 months. 












2 


- 


2 


, 7 


6 


13 


3 to 4 months. 












6 


1 


7 


i 5 


3 


8 


4 to 5 months. 












- 


- 


- 


7 


2 


9 


5 to 6 months. 












5 


3 


8 


6 


3 


9 


6 to 7 months. 












9 


1 


10 


- 


2 


2 


7 to 8 months. 












3 


- 


3 


! 4 


1 


5 


8 to 9 months, 












1 


2 


3 


: 3 


4 


7 


9 to 10 months, 












- 


1 


1 


' 3 




4 


10 to 11 months. 












1 


1 


2 


2 




3 


11 to 12 months, 












6 


2 


8 


2 




3 


12 to 18 months, 












20 


8 


28 


1 ' 




4 


18 to 24 months, 












3 


1 


4 


1 

1 




5 


Over 2 years, . 












24 


16 


40 


12 . 


6 


18 


Unknown, 












5 


4 


9 


- 


- 


- 


Totals, 






89 


42 


131 


89 


42 


131 



Table 10. — Cause of Death. 



Males. 



Females. 



Totals. 



Phthisis pulmonalis, 
Suicide, . 
Influenza, 
Totals, 



89 



41 



42 



129 
1 
1 



131 



350 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



RUTLAND STATE SANATORIUM. 



Resident Officers. 



Ernest B. Emerson, M.D., 
Leon A. Alley, M.D., 
Halbert C. Hubbard, M.D., 
William B. Davidson, M.D., 



William J. O'Connor, D.M.D., 
Delta E. Nardi, 
Cora A. Phillips, . 
Walter C. Brown, . 
Joseph A. Carroll, 



Superintendent. 

Assistant Superintendent. 

Physician. 

Physician. 

Physician. 

Physician. 

Dentist. 

Superintendent of A'urses. 

Head Matron. 

Chief Engineer. 

Farmer. 



REPORT OF THE SUPERINTENDENT. 

To the Commissioner of Public Health. 

Dear Sir: — The annual report of the Rutland State Sanatorium for the 
year ending Nov. 30, 1920, is hereby submitted. 

During the year there have been expended $301,330.01 for maintenance and 
$3,317.51 from the appropriation authorized by chapter 55, Resolves of 1918. 

The details of these disbursements are contained in the report of the treasurer. 

There were 359 patients in the sanatorimn at the beginning of the year and 
356 at the close. The largest number present at one time was 372 and the 
smallest was 311. The daily average number of patients was 345.27. There 
were 548 cases admitted during the year; 179 incipient, 200 moderately ad- 
vanced, 150 advanced and 19 unclassified. Including deaths, there were 551 
discharged, and the average duration of residence was seven months and twenty- 
five daj's. Of those discharged, 362 gained 4,107 pounds, an average gain of 11.35 
pounds per person. Including deaths, there were 135 who lost 978 pounds, an 
average loss of 7.24 pounds per person, and 54 neither gained nor lost. Of the 
discharges, there were 25 arrested cases, 2 more than last year; 34 apparently 
arrested, 10 more than last year; 187 quiescent, 37 more than last year; 118 
improved and 65 unimproved. There were 45 patients not considered, the 
duration of treatment being less than one month. There were 62 deaths, 38 
more than last year. There were 15 discharged nontuberculous. 

The following table shows the classification on the application blank and our 
classification on admission. The variation in the classification of cases suggests 
a different method of admission: — 



Our Classifica- 
tion 
on Admission. 




No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 351 

At the present time patients are assigned to the sanatorium on the application 
of the attending physician, and during the past year, with no waiting list or at 
least a waiting list of only a few days, the disease could not have progressed 
from mcipiency to far advanced between the tune of application and admission. 
In many instances the real condition of the patient has not been indicated on 
the application blank, and frequently patients mdicated on the application 
blank as suitable for sanatorium treatment have arrived in the last stages and 
should not have been subjected to the hardship of the journey to Rutland. 
Some of these patients have passed away within two weeks and 25 per cent of 
the deaths occurred witliin four months after arrival. The rule that patients 
may be transferred or discharged after the thirty-day period of observation, if 
found unsuitable for sanatorium treatment, is frequently unworkable for the 
reason that we do not feel that we should subject them to the hardship of travel. 
Consequently, many beds are filled with incurables while the early and favor- 
able case for treatment is compelled to wait until the disease has progressed 
beyond the point when anything more than temporary relief can be expected. 
If the sanatorium is to be conducted for the relief and cure of the greatest num- 
ber, our facilities should be resented, I believe, for those patients who have a 
reasonable chance for improvement at least, and not taken over by those more 
properly classified in the municipal hospitals. I would suggest that applicants 
for admission be referred either to one of the consultation clinics or to the sana- 
torium for final examination before admission. Including the State sanatoria, 
there are twenty points in the State, and more could be established, where these 
examinations may be made without involving any great hardship on the part of 
the patient. It would seem to me that any patient imable to attend one of these 
clinics would in the majority of cases at least be an unsuitable case for sana- 
torium treatment and should be sent to the local hospital. 



Medical. 

Staff meetings have been held once a week, when administrative, medical 
and other questions have been freely discussed and suggestions offered. These 
meetings have been of great value not only to the superintendent but also to the 
assistant physician, to whom a broader perspective of the problem has been 
presented than that obtained when duties and responsibilities end Tvath ward 
and clinical work. 

Weekly clinics have also been held, when the new cases have been presented 
by the different members of the staff for examination, diagnosis and classifica- 
tion. 

A course of six lectures in early diagnosis and methods of treatment of pul- 
monary tuberculosis was given at the sanatorium by the medical staff under 
the auspices of the Wachusett Medical Improvement Society. These exercises 
were well attended by the physicians of the neighboring towns, and it is pro- 
posed to repeat the course the coming yesiv. 

Consultation clinics in the diagnosis of pulmonary tuberculosis initiated by 
the Department of Public Health in September have been conducted in Worces- 



352 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



ter, Clinton, Gardner and Fiichburg. The response of the profession has been 
most gratifying and has shown the need for such a point of contact between tlie 
sanatorium and the phj^sician in general practice. There have been 92 exam- 
inations. 

During the year Dr. William J. O'Connor has made 1,452 dental examinations 
and treatments. The following table shows briefly the scope of this work: — 



Prophylactics, . 
Amalgam fillings, 
Cement fillings, 
Gutta-percha fillings 
Temporary fillings, 
Pulp treatments, 
Treatment cases, 
Surgical dressings, 
Extractions, 
Abscess cases, . 
Mouth washes, 
Vincent's disease, 
Inlays, 

Repairs to plates. 
Bridges, . 
Plates, 
Crowns, . 
X-rays, . 
Repairs to bridges. 



142 

205 

78 

118 

142 

22 

301 

8 

110 

42 

44 

4 

68 

12 

54 

14 

67 

78 

4 



Dr. Marj^ E. Gaffney resigned under date of Sept. 15, 1920, to accept the 
superintendency of the Woman's Hospital in Philadelphia. Dr. David E. Mann 
resigned Oct. 15, 1920, to accept a position at the National Sanatorium, Johnson 
City, Tenn. The resignations of Dr. Gaffney and Dr. Mann are much regretted. 
Both had rendered good service, and with their knowledge of tuberculosis the 
call to broader fields is distinctly our loss. Neither of these vacancies has been 
filled. 

Miss Delya E. Nardi continues in charge of the training school for nurses. 

In order to maintain the standard of nursing required by the State Board of 
Registration of Nurses the traming school has been affiliated with that of the 
Milford Hospital. There are 8 probationers, 6 juniors and 8 seniors now in 
training. 

The following have been awarded diplomas: Jane L. Cross, Mary Belz, Mary 
E. O'Brien, Helen Trombley, Freida Katz, Mary E. Moore, Alice B. McDonald 
and Alice Tucker. 

Entertainments and diversion so far as compatible with the physical condition 
of our patients have been provided throughout the year. A Camera Club, 
Debating Society and a Garden Club were organized and afforded much en- 
tertainment, and, in some instances, a considerable degree of profit for the 
members. The Garden Club was organized rather late in the spring on account 
of the unsettled conditions on the farm. The plowing and other heavj' work 
necessary to prepare the land for garden crops was done by the regular farm 
force. This land was then turned over to the Garden Club, with seeds, tools 
and overalls, and left to the management and direction of the patients them- 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 353 

selves with no supervision whatever other than medical. The results more than 
justified the experiment by the amount of produce raised, the season's supply 
of fresh vegetables, and by the improved physical condition of the patients tak- 
ing part in this work. 

Numerous talks and demonstrations have been given to the patients on 
health subjects, particularly those relating to tuberculosis, by members of the 
staff. These talks have been universally attended and we believe that, as a 
result of them, there has been better co-operation between patients, physicians 
and nurses. 

Entertainments have been provided by members of the household, the Red 
Cross, the Knights of Columbus, Commimity Service and players from the 
Polls Theatre of Worcester. 

Farm. 

Charles E. Chapman, head farmer, resigned May 19, 1920, and Joseph A. 
Carroll was appointed to that position May 25, 1920. 

Recommendations. 

Plans and specifications have been submitted for a building to provide 
quarters for 42 employees now located in dormitories adjacent to the wards and 
using toilets, lavatories and locker rooms in common with the patients. Non- 
tuberculous employees will not submit to these conditions, and the ex-patient 
who has become an employee is entitled to the privacy of his own room. 
Furthermore, the overcrowding results in more or less friction between patients 
and employees. The removal of these employees to a separate building will 
increase the capacity of the institution without proportionately increasing the 
number of workers. The dormitories now occupied by emploj^ees would afford 
space for reading and recreation rooms. At the present time there is no place, 
with the exception of the toilets and lavatories, where patients may congre- 
gate in the evening or go during the day where heat is provided. The lack 
of such facilities is a hardship particularly during the winter months. It is 
estimated that the building described in the specifications can be erected at the 
present time for S96,000. 

I recommend that S10,000 be appropriated for the installation of steel lockers 
to replace the present wooden lockers, which are obsolete and unsanitary. Also 
that $4,000 be appropriated for the erection of a garage. Attention has been 
called to the condition of our roofs in a previous report and I recommend an 
appropriation of $16,000 for repairs and renewals be included in the estim.ate 
for maintenance for the ensuing year. 

In closing, I wish to acknowledge the loyalty and fidelity of the members of 
the household who have made it possible to carry through the work of the year. 
I am furthermore obligated to you for your courtesy and many suggestions 
which have gone far in improving our service. 

Respectfully, 

Ernest B. Emerson, 

S^iperintcndent. 



354 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



TREASURER'S REPORT. 

To the Commissioner of Public Health. 

I respectfully submit the following report of the finances of this institution 
for the fiscal year ending Nov. 30, 1920: — 

Cash Account. 
Balance Dec. 1, 1919 $1,128 94 

Receipts. 
Institution Receipts. 
Board of inmates: — 

Private, $8,556 32 

Cities and towns 40,103 91 

Reimbursements, charitable, State minor 

wards, 52 00 

$48,712 23 

Sales: — 

Furnishings and household supplies, . . $28 65 

Medical and general care, 282 46 

Farm and stable: — 

Cows and calves, .... $316 00 i 

Hides, 31 61 

Ice 7 72 

Sundries, 108 64 

463 97 

Repairs, ordinary 55 79 

830 87 

Miscellaneous receipts: — 

Interest on bank balances, .... $432 78 

Sundries 193 29 

626 07 

50.169 17 

Receipts from Treasury of Commonwealth. 

Maintenance appropriations: — 

Balance of 1919, $19,065 29 

Supplementary schedule, 3,504 33 

Advance money (amount on hand November 30), . . 20,000 00 
Approved schedules of 1920 267,735 26 

310,304 88 

Special appropriations, 3,317 51 

Total, $364,920 50 

Payments. 

To the treasury of Commonwealth, institution receipts, .... $50,169 17 

Maintenance appropriations: — 

Supplementary November schedule $3,504 33 

Balance November schedule, 1919, 20,194 23 

Eleven months' schedules, 1920 267,735 26 

November advances 8,513 81 

299,947 63 

Amount carried forward, $350,116 80 

1 Adjustment entry, March 4, 1920, treated as income, ciirrent year, by Auditor instead of refund, 
account of previous year's business. 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 355 

Amount brought forward, S350,116 80 

Special appropriations: — 

Approved schedules 3,317 51 

Balance Nov. 30, 1920: — 

In bank, $7,578 16 

In office 3,908 03 

11,486 19 

Total, §364,920 50 

Maintenance. 

Balance from previous year, brought forward $3,722 33 

Appropriation, current year, 304,280 00 

Total, $308,002 33 

Expenses (as analyzed below), 301,330 01 

Balance reverting to treasury of Commonwealth, $6,672 32 

Analysis of Expenses. 
Personal services : — 

Ernest B. Emerson, M.D., superintendent, .... $3,546 77 

Medical, 8,443 52 

Administration 8,161 82 

Kitchen and dining-room service, 20,441 25 

Domestic 15,548 99 

Ward service (male), 9,886 01 

Ward service (female) 14,500 29 

Engineering department 12,960 74 

Repairs 4,907 02 

Farm 11.099 01 

Stable, garage and grounds, 5,612 48 



$115,107 90 



Religious instruction: — 

Catholic $600 00 

Hebrew 600 00 

Protestant, 600 00 



Travel, transportation and office expenses: — 

Advertising, $6 40 

Postage 255 00 

Printing and binding, 467 56 

Stationery and office supplies, 683 42 

Telephone and telegraph 1,228 62 

Travel 517 08 

Sundries, 12 25 

Freight 14 01 



1,800 00 



3,184 34 



Amount carried forward, $120,092 24 



356 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Amount hr ought forward, $120,092 24 

Food: — 

Flour, $4,268 64 

Cereals, rice, meal, etc 1,783 62 

Bread, crackers, etc., 212 22 

Peas and beans (canned and dried), 1,261 92 

Macaroni and spaghetti, 134 97 

Potatoes, 3,572 29 

Meat, 30,667 71 

Fish (fresh, cured and canned), 2,393 26 

Butter 9.722 95 

Butterine, etc., 56 70 

Cheese, 164 77 

Coffee 1.449 60 

Tea 228 10 

Cocoa, 80 68 

Whole milk 15,132 90 

Milk (condensed, evaporated, etc.), 165 33 

Eggs (fresh) 7,621 82 

Sugar (cane) 4,377 34 

Fruit (fresh) 1,03539 

Fruit (dried and preserved), 3,407 92 

Lard and substitutes, 35 00 

Molasses and syrups, 637 08 

Vegetables (fresh) 828 96 

Vegetables (canned and dried) 1,470 31 

Seasonings and condiments, 1,242 11 

Yeast, baking powder, etc., 158 79 

Sundry foods, 6 39 

Freight 1-082 57 

93,199 34 

Clothing and materials: — 

Clothing (outer), . . .' $215 31 

Dry goods for clothing, 24 33 

239 64 

Furnishings and household supplies: — 

Beds, bedding, etc., $2,689 36 

Carpets, rugs, etc., 8 10 

Crockery, glassware, cutlery, etc., 1,250 02 

Dry goods and smallwares, 150 02 

Electric lamps, 700 57 

Fire hose and extinguishers 741 32 

Furniture, upholstery, etc., 340 41 

Kitchen and household wares 2,053 12 

Laundry supplies and materials 468 53 

Lavatory supplies and disinfectants, 1,253 98 

Table linen, paper napkins, towels, etc., .... 692 86 

Freight, 107 39 

10,455 68 

Medical and general care: — 

Books, periodicals, etc., $196 83 

Entertainments, games, etc., 354 39 

Funeral expenses, 50 00 

Amounts carried forward, $601 22 $223,986 90 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 357 

Amounts hroicght forward $60122 $223,986 90 

Medical and general care — Con. 

Gratuities 23 03 

Ice and refrigeration, 279 82 

Laboratory supplies and apparatus 605 07 

Medicines (supplies and apparatus) , 2,623 89 

Medical attendance (extra), 100 00 

Sputum cups, etc., 975 87 

Tobacco, pipes, matches, 12 75 

Water 3,492 93 

Freight, 73 31 

8,787 89 

Heat, light and power: — 

Coal (bituminous), $18,386 58 

Freight and cartage, 10,466 84 

Coal (anthracite), 344 23 

Freight and cartage 157 76 

Charcoal 50 00 

Electricity • 120 00 

Oil, 884 71 

Operating supplies for boilers and engines 307 02 

Sundries 7 22 

Freight, 9 86 

30.734 22 

Farm: — 

Bedding materials, $379 81 

Blacksmithing and supplies, 204 34 

Carriages, wagons and repairs, 14 70 

Dairy equipment and supplies, 42 16 

Fencing materials 141 11 

Fertilizers, 1-513 63 

Grain, etc 11,758 46 

Harnesses and repairs, 340 42 

Horses 600 00 

Cows ■ 2,025 00 

Other live stock, 479 00 

Laboi;(not on pay roll), 209 25 

Spraying materials, 87 20 

Stable and barn supplies, 107 06 

Tools, implements, machines, etc., 997 12 

Trees, vines, seeds, etc. 913 62 

Veterinary services, supplies, etc., 314 73 

Sundries 13 00 

Freight 279 24 

20,419 85 

Garage, stable and grounds: — 

Motor vehicles $3,555 99 

Automobile repairs and supplies, 2,849 64 

Bedding and materials, 45 92 

Blacksmithing and supplies 179 45 



Amounts carried forward, $6,631 00 $283,928 86 



358 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Amounts brought forward, $6,631 00 $283,928 86 



Garage, stable and grounds — Con. 
Carriages, wagons and repairs. 

Grain, 

Harnesses and repairs. 
Spraying materials, 
Stable supplies, .... 
Tools, implements, machines, etc., 
Trees, vines, seeds, etc., 
Freight, 



Repairs, ordinary: — 

Cement, lime, crushed stone, etc., . 
Electrical work and supplies, . 
Hardware, iron, steel, etc., 

Labor (not on pay roll) 

Lumber, etc. (including finished products). 

Paint, oil, glass, etc., 

Plumbing and supplies, .... 
Roofing and materials, .... 
Steam fittings and supplies, 
Tools, machines, etc., .... 

Boilers, repairs 

Dynamos, repairs, 

Engines, repairs, 

Freight, 



Repairs and renewals : - 
Boiler repairs, 1919, 
Linoleum, 
Freight on scales. 



6 50 




393 33 




49 00 




13 75 




30 38 




44 08 




13 29 




25 






7,181 58 




$395 04 




299 72 




446 61 




2,589 07 




789 86 




1,248 84 




633 82 




447 80 




530 58 




663 23 




506 59 




361 91 




121 37 




94 65 






9,129 09 


$679 97 


406 24 




4 27 






1,090 48 





Total expenses for maintenance, . $301,330 01 



Special Apphopriations. 

Balance Dec. 1, 1919 

Appropriations for current year, 



Total 

Expended during the year (see statement below) , 

Balance Nov. 30, 1920, carried to next year. 



%4,411 77 



$4,411 77 
3,317 51 

$1,094 26 



Object. 


Act or Resolve. 


Whole 
Amount. 


Expended 

during 
Fiscal year. 


Total 

Expended 

to Date. 


Balance 

at End of 

Year. 


Kitchen, service and store- 
house buildings, 


Chap. 55, 1918, . 


$55,000 00 


$3,317 51 


$53,905 74 


$1,094 26 




J55,000 00 


$3,317 51 


$53,905 74 


$1,094 26 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 359 



Resources and Liabilities. 

Resources. 

Cash on hand $11,486 19 

November cash vouchers (paid from advance money), ac- 
count of maintenance, 8,513 81 

$20,000 00 

Due from treasury of Commonwealth from available appropriation, account 

of November, 1920, schedule, 10,090 42 

$30,090 42 

Liabilities. 

Schedule of November bills, including supplementary November, 1919, 

schedule of $218, $30,090 42 

Per Capita. 

During the year the average number of inmates has been 345.27. 

Total cost for maintenance, $301,330.01. 

Equal to a weekly per capita cost of $16.7834. 

Receipt from sales, $830.87. 

Equal to a weekly per capita of $0.04627. 

All other institution receipts, $49,338.30. 

Equal to a weekly per capita of $2.7480. 

Respectfully submitted, 

Leon A. Alley, 
Treasurer. 

Examined and found correct as compared with the records in the office of the Auditor 
of the Commonwealth. 

Alonzo B. Cook, 

Auditor. 

VALUATION. 

Land. 
Grounds (42.147 acres) $17,945 80 

Lawns and buildings, 32.147 acres. 

Roads, 10 acres. 

Woodland (77.71 acres) 2,683 65 

Mowing (84.74 acres) 8,474 00 

Tillage (46.26 acres) 4,670 25 

Tillage, 37.16 acres. 

Garden, 9.10 acres. 

Orchard (1.64 acres), 328 00 

Pasture (76.58 acres) 1,182 60 

Waste and miscellaneous (35.65 acres), . . 1,671 90 

Rough pasture, 10.95 acres. 

Meadow swamp land, 18.22 acres. 

Sewer beds, 5.98 acres. 

New coal trestle, .50 acres. 

$36,956 20 

Sewerage system 15,508 32 

$52,464 52 

Amount carried forward, $52,464 52 



360 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Amount brought forward, $52,464 52 

Buildings. 

Institution buildings $482,885 44 

Farm, stable and grounds, 25,175 00 

Miscellaneous, 29,536 25 

537,596 69 

Total $590,061 21 

Present value of all personal property as per inventorj^ of Dec. 1, 1920, . 106,152 59 

Grand total $696,213 80 



SPECIAL REPORT. 

The following report is prepared in accordance with a resolution of 
the National Conference on Charities and Corrections, adopted May 
15, 1906: — 

Pojiulation. 





Males. 


Females. 


Totals. 


Number received during the year, 

Number passing out of the institution during the year, 

Number at end of fiscal year in the institution, . 

Daily average attendance (i.e., number of inmates actually 

present during the year). 
Average number of employees and officers during the year. 


325 

334 

182 

180.53 

119.60 


223 
217 
174 

164.74 
52.68 


548 

551 

356 

345.27 

172.28 



Expenditures 
Current expenditures: — 

1. Salaries and wages, 

2. Clothing, 

3. Subsistence, .... 

4. Ordinary repairs, 

5. Office, domestic and outdoor expenses, 

Total 



$115,107 90 

239 64 

93,199 34 

9,129 09 

82,563 56 



$300,239 53 



Extraordinary expenses: — 

1. Permanent improvements to existing buildings, 

Summary of Current Exyenses. 
Total expenditures, ........ 

Deducting extraordinary expenses, . . . . . 

Deducting amount of sales, ...... 

Total 



1,090 48 



$301,330 01 

$301,330 01 
1,090 48 

$300,239 53 

630 87 

$299,608 66 



Dividing this amount by the daily average number of patients — 345.27 — gives a 
cost for the year of $864,884, equivalent to an average weekly net cost of $16.63. 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 301 



STATISTICAL TABLES. 

Table L — Admissions and Discharges. 





Males. 


Females. 


Totals. 


Number of patients in sanatorium Nov. 30, 1920, 


193 


166 


359 


Number admitted Dec. 1, 1919, to Nov. 30, 1920, 


325 


223 


548 


Number discharged Dec. 1, 1919, to Nov. 30, 1920, 


334 


217 


551 


Number remaining in sanatorium Nov. 30, 1920, 


182 


174 


356 


Daily average number of patients, 


180.53 


164.74 


345.27 


Died (included in number discharged), .... 


32 


30 


62 



Table 2. — Civil Condition of Patients admitted. 





Males. 


Females. 


Totals. 


Single 


161 


112 


273 


Married 


152 


97 


249 


Widowed, 


10 


14 


24 


Divorced 


2 


- 


2 


Totals 


325 


223 


548 



Table 3. — Age of Patients admitted. 



Males. 



Females. 



Totals. 



Under 14 years, 
14 to 20 years, 
20 to 30 years, 
30 to 40 years, 
40 to 50 years, 
Over 50 years. 
Totals, 



37 

164 

84 

36 

4 



325 



1 

41 

110 

52 

17 

2 



223 



1 

78 
274 
136 

53 
6 



548 



362 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 4. — Nativity and Parentage of Patients admitted. 





'Males. 


Females. 




Totals. 




Places of Nativity. 


00 

a 
a 

(2 


2 

01 

..J 


o 
o 


to 

a 
.2 

(2 


u 

JS 

Id 


CO 

f-l 
o 
ji 
■*^ 
o 


a 

o 


2 
o 

JS 


tn 
o 

o 


United States: — 




















Massachusetts, 


151 


55 


61 


110 


33 


30 


261 


88 


91 


Other New England States, 


25 


24 


20 


15 


12 


14 


40 


36 


34 


Other States, . 


15 


16 


14 


11 


11 


8 


26 


27 


22 


Total native. 


191 


95 


95 


136 


56 


52 


327 


151 


147 


Other countries (25), 


134 


225 


223 


87 


163 


169 


221 


388 


392 


Unknown, 


- 


5 


7 


- 


4 


2 


- 


9 


9 


Grand totals. 


325 


325 


325 


223 


223 


223 


548 


548 


548 



Table 5. — Reside7ice of Patients admitted. 



Place. 


Number. 


Place. 


Number. 


Boston, 

Cambridge 

Chelsea 

Lawrence, 

Lowell, 


200 
16 
10 
13 
10 
11 


Salem, 

Somerville, 

Springfield 

Worcester, 

Other cities and towns (85), . 

Total 


9 

9 

12 

61 

197 


Lynn, 


548 



Table 6. — Occupations of Patients admitted. 



Males. 



Females. 



Totals. 



Accountant, 

Attendant, 

Baker, 

Barber, . 

Bartender, 

Blacksmith, 

Bookkeeper, 

Box nailer, 

Brakeman, 




No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 363 



Table 6. — Occupations of Patients admitted — Continued. 



Males. 



Bridgeman, 
Carpenter, 
Cashier, . 
Chauffeur, 
Cigarmaker, . 
Clerk, . 
Colorist, . 
Conductor, 
Cook, 
Corsetifire, 
Cutter, clothing, 
Cutter, meat. 
Cutter, shoe, . 
Cutter, stone. 
Dentist, . 
Designer, machine. 
Dishwasher, . 
Draftsman, 
Dressmaker, . 
Dyer, 

Electrician, 
Engineer, 
Engineer, civil, 
Factory, . 
Fireman, 
Florist, . 
Foreman, section. 
Foundry, 
Garage man, . 
General work, 
Glassblower, . 
Guard, . 
Hairdresser, . 
Hatter, . 
Housewife, 
Housework, . 
Iceman, . 



1 

6 
1 
8 
1 

25 



2 
2 
1 
1 
1 
1 
1 
2 

1 
3 
2 
1 

54 
3 
1 
1 
1 
1 

13 
1 



Females. Totals 



20 
1 



29 



"4 

27 



1 

6 
2 
8 
1 
45 
1 
3 
6 
1 
2 
2 
1 
I 
1 
1 
1 
2 
3 
1 
3 
2 
1 
83 
3 
1 
1 
1 
1 

17 
1 
1 
1 
1 
74 
27 





364 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc 



Table 6. — Occupations of Patients admitted — Continued. 



es. 


Females. 


Totals 


1 


- 


1 


2 


- 


2 


2 


- 


2 


1 


- 


1 


18 


- 


18 


- 


2 


2 


1 


- 


1 


3 


- 


3 


- 


1 


1 


2 


- 


2 


25 


- 


25 


1 


- 


1 


1 


- 


1 


1 


- 


1 


1 


- 


1 


2 


- 


2 


1 


- 


1 


- 


1 


1 


3 


- 


3 


- 


3 


3 


1 




1 


- 


1 


1 


3 


12 


15 


1 


3 


4 


2 


6 


8 


- 


7 


7 


1 


- 


1 


1 


- 


1 


2 


- 


2 


2 


- 


2 


1 


- 


1 


3 


- 


3 


1 


- 


1 


1 


1 


2 


4 


- 


4 


1 


- 


1 


1 


_ 


1 



Insurance agent, 

Ironworker, 

Janitor, . . . . 

Junkdealer, 

Laborer 

Laundress, 
Letter carrier. 
Lineman, 

Lodging-house keeper, . 
Longshoreman, 
Machinist, 
Manager, assistant, 
Manager, hotel. 
Manager, store. 

Marine 

Mechanic, 

Merchant, 

Messenger, 

Metal worker, 

Milliner, . . . . 

Molder 

Needlework, . 

No work. 

Nurse, student, 

Nurse, trained. 

Nursemaid, . 

Oiler, ship, 

Optician, 

Orderly, . . . . 

Painter 

Pharmacist, . 
Plumber, 
Pressor, clothes, 
Pressman, 

Printer 

Printer, wallpaper, 
Proprietor, bowling alley, 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 365 



Table 6. — Occupations of Patients admitted — Concluded. 



Males. 



Females. 



Publisher, music, . 
Real estate, 
Repairer, auto. 
Repairer, engine, . 
Repairer, shoe. 
Roofer, . 
Sailor, 
Salesman, 
Ship builder, . 
Shipper, . 
Sign writer. 
Soldier, . 
Steam fitter, . 
Stenographer, 
Student, 
Tailor, . 
Teacher, school, 
Teamster, 

Telephone operator. 
Upholsterer, . 
Waiter, . 
Wireworker, . 
Totals, . 



1 
1 
1 
2 
3 
1 
1 

12 
5 
2 
1 
4 
3 
1 



325 



223 



Totals. 



1 
1 
1 

2 
3 
1 

1 

14 

5 

2 

1 
4 
3 
3 

13 
4 
2 
4 
6 
1 
7 
9 



548 



Table 7. — Condition on Admission. 



Males. 



Females. 



Totals. 



Per Cent. 



Incipient, 

Moderately advanced. 
Far advanced, 
Unclassified, 
Totals, . 



113 

120 
79 
13 



325 



66 

80 

71 

6 



223 



179 

200 

150 

19 



548 



32.66 

36.50 

27.37 

3.47 



100.00 



366 



DEPARTMENT OF PUBLIC HEALTH. [P. D. No. 34. 



Table 8. — • Condition on Discharge. 



Males. 



Females. 



Totals. 



Arrested, 

Apparently arrested, 
Quiescent, 
Improved, 
Unimproved, . 
Died, 

Nontuberculous, . 
Not considered. 
Totals, 



12 
18 
120 
84 
27 
32 
13 
28 



334 



13 
16 
67 
34 
38 
30 
2 
17 



217 



25 
34 
187 
118 
65 
62 
15 
45 



551 



Table 9. — Deaths. 





^„ T 


~V,„ 








Males. 


Females. 


Totals. 


Length of Residence 
AT Sanatorium. 


















Males. 


Females. 


Totals. 


Under 1 month, 


- 


- 


- 


- 


3 


3 


1 to 2 months. 












- 


- 


- 


2 


- 


2 


2 to 3 months. 












- 


- 


- 


2 


2 


4 


3 to 4 months. 












- 


- 


- 


3 


2 


5 


4 to 5 months, 












- 


- 


- 


2 


3 


5 


5 to 6 months. 












- 


- 


- 


4 


3 


7 


6 to 7 months, 












- 


- 


- 


3 


5 


8 


7 to 8 months. 












- 


- 


- 


3 


2 


5 


8 to 9 months. 












- 


- 


- 


2 


1 


3 


9 to 10 months. 












- 


- 


- 


4 


1 


5 


10 to 11 months. 












- 


- 


- 


2 




2 


11 to 12 months. 












2 


2 


4 


2 


2 


4 


12 to 18 months. 












4 


5 


9 


2 


4 


6 


18 to 24 months. 












3 


5 


8 


1 


1 


2 


Over 2 years, . 












8 


5 


13 


- 


1 


1 


Unknown, 












15 


13 


28 


- 


- 


- 


Totals, . 


32 


30 


62 


32 


30 


62 



Table 10. — Cause of Death. 





Males. 


Females. 


Totals. 


Phthisis pulmonalis 


32 


30 


62 


Totals 


32 


30 


62 



Repoet of State Examinees of Plumbees 



James C. Coffey, Chairman 



[3671 



Eeport of State Examinees of Plumbers. 



Information concerning Examinations for Plumbers, showing the Place and Date 
of Examination and Number examined, together with the Results of the Ex- 
aminations, etc. 



Examinations. 


Examined. 


Passed. 


Refused. 


Boston, Dec. 6, 1919, 




90 


12 


78 


Lowell, Dec. 20, 1919, . 












18 


5 


13 


Boston, Jan. 3, 1920, . 












70 


15 


55 


Pittsfield, Jan. 17, 1920, 












17 


1 


16 


Boston, Feb. 7, 1920, . 












70 


8 


62 


Springfield, Feb. 21, 1920, 












40 


5 


35 


Boston, Mar. 6, 1920, . 












101 


11 


90 


Fall River, Mar. 20, 1920, 












32 


4 


28 


Boston, Apr. 3, 1920, . 












86 


13 


73 


Worcester, Apr. 17, 1920, 












51 


7 


44 


Boston, May 1, 1920, . 












96 


20 


76 


Lowell, May 15, 1920, . 












34 


7 


27 


Boston, June 5, 1920, . 












96 


17 


79 


Pittsfield, June 19, 1920, 












17 


6 


11 


Boston, July 3, 1920, . 












93 


23 


70 


Boston, Sept. 4, 1920, . 












93 


17 


76 


Springfield, Sept. 18, 1920, 












26 


5 


21 


Boston, Oct. 2, 1920, . 












91 


12 


79 


Fall River, Oct. 16, 1920, 












14 


3 


11 


Boston, Nov. 6, 1920, . 












55 


6 


49 


Worcester, Nov. 20, 1920, 













38 


4 


34 


Totals, . 


1,227 


201 


1,026 




Masters. 


Journeymen. 


Total. 


Licenses granted on account of examination, Dec. 1, 

1919. to Dec. 1. 1920. 
Probationary licenses issued during year, . 


77 


123 
6 


200 



370 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Registratioxs. 



Masters. 



Journej'men. 



December, 1919, 
January, 1920, 
February, 1920, 
March, 1920, . 
May, 1920, . 
June, 1920, 
July, 1920, 
August, 1920, . 
September, 1920, 
October, 1920, 
November, 1920, 
Totals, . 




Meetings, 54 Examinations, 



2^ 



Fees received. 



Paid to the 
Treasurer of 
the Common- 
wealth. 



1,227 examination fees, at $0.50, . . . . 
97 master plumber licenses issued, at $2, 
148 journejrmen plumber licenses issued, at SO. 50, 
1,803 master plumber renewals issued, at $0.50, . 
4,247 journeymen plumber renewals, at $0.50, 

Back fees, at $0.50 

Total 

Interest during May, 1920 



$613 50 

194 00 

74 00 

901 50 

2,123 50 
167 00 



$4,073 50 
1 74 



$4,075 24 



No. 34.] 



EXAMINERS OF PLUMBERS. 



371 



For carrying out the Provisions of the Act relative to the Examination of Plumbers. 

Salaries, S3,068 06 

Examiners' wages, 

Traveling, 

Express, 

Printing, 

Postage. 

Books, stationery and typewriting supplies, 

Plumbers' materials, • • • 

Extra services, 

Cleaning, 

Office supplies, 

Telephone and lighting, 106 16 

Miscellaneous, • • • " 

Total. S4,831 87 

Unexpended balance, 7 99 



460 00 


510 94 


34 97 


349 56 


79 44 


42 32 


30 25 


105 15 


17 00 


19 77 


106 16 


8 25 



Summary of Registration. 



Certificate holders (individuals), 

Licenses, year ending May 1, 1920 (individuals), 



4621 
1,821 = 



2,283 



$4,839 86 



Masters. Journeymen. 



461 
2,966 



3,427 



' Holding journeymen also, 311. 



- Holding journeymen also, 1,593. 



Number of last master license issued up to Aug. 1, 1920, 2,845 

Number of last journeyman license issued up to Aug. 1, 1920, 6,573 



Masters, 



Deceased Plu77ibers reported to Examiners. 
. 7 I Journeymen, 



Papers written in 1920 and Pamphlets 

ISSUED 



[373] 



Papers written in 1920 and Pamphlets issued. 



Papers written by Members of the State Departaient of Public Health 

DURING THE YeAR 1920. 

Division of Administration. 

Eugene R. Kelley, M.D., Commissioner of Public Health. 

"The Development of Nutrition Activities by the Massachusetts Depart- 
ment of Public Health." The Commonhealth, Vol. 7, No. 4, July- 
August, 1920. 

"The Development of Mouth Hygiene Activities in the Department of 
Public Health." The Commonhealth, Vol. 7, No. 5, September- 
October, 1920. 

"The Control and Prevention of Bubonic Plague." Current Events, Bos- 
ton Chamber of Commerce, November, 1920. 

"Some General Considerations Relative to the Tuberculosis Problem." 
Annual Report, Massachusetts Tuberculosis League, Vol. II, No. 5, 
June, 1920. 

Division of Sanitary Engineering. 

Mr. X. H. Goodnough. 

"Boating and Fishing in Ponds and Reservoirs used as Sources of Water 
Supply." Journal of the New England Water Works Association, Vol. 
XXXIV, No. 3, 1920. 

Mr. Arthur D. Weston, 

"Epidemic of Gastro-Enteritis in Peabody, Mass., October, 1913." Jour- 
nal of the New England Water Works Association. Vol. XXXIV, No. 
3, 1920. 

Division of Communicable Diseases. 

Stanley H. Osborn, M.D. 

"Health Dividends You Have Drawn." Boston Medical and Surgical 
Journal, May 13, 1920; also in The Commonhealth, Vol. 7, No. 2, 
March-April, 1920. 

"Influenza in Massachusetts." The Commonhealth, Vol. 7, No. 3, May- 
June, 1920. 

"Anthrax Problem in Massachusetts." American Journal of Public Health, 
August, 1920. 

Stanley H. Osborn, M.D., and Edith A. Beckler, S.B. 

"Once a Typhoid Carrier Always a Tj^jhoid Carrier." The Journal of In- 
fectious Diseases, August, 1920. 



376 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Louis L. Williams, Jr., M.D. 

"The Carrier in an Outbreak of Diphtheria." The Commonhealth, Vol. 
7, No. 2, March-April, 1920. 
Mary R. Lakeman, M.D. 

"Study Groups. A Feature of the Program of the Sub-Division of Venereal 
Diseases, Massachusetts Department of Public Health." Journal of 
Social Hygiene, Vol. VI, No. 4, October, 1920. 
George T. O'Donnell, M.D. 

"Causes of Typhoid Fever in Massachusetts." American Journal of Public 
Health, June, 1920. 
Francis A. Finnegan, M.D. 

"Institutional Control of Diphtheria." Boston Medical and Surgical 
Journal, Jan. 22, 1920. 

Division of Hygiene. 
Merrill E. Champion, M.D. 

"School Hygiene." The Commonhealth, Vol. 7, No. 3, May-June, 1920. 
"A Nutritional Program for Massachusetts." The Commonhealth, Vol. 
7, No. 4, July-August, 1920. 

Mary Ritnam, M.D. 

"A Survey of Rural Children in Western Massachusetts." The Common- 
health, Vol. 7, No. 6, November-December, 1920. 

Edwin N. Kent, D.M.D. 

"Mouth Hygiene and Public Health." The Commonhealth, Vol. 7, No. 
5, September-October, 1920. 

Hazel Wedgwood, R.N. 

"Child Welfare." The Com.monhealth, Vol. 7, No. 3, May-Jime, 1920. 

Alzira Wentworth Sandwall, S.B. 

"The School Lunch." The Commonhealth, Vol. 7, No. 1, January- 
February, 1920. 

"How Cooking Affects the Digestibility of Foods." The Commonhealth, 
Vol. 7, No. 2, March-April, 1920. 

"Nutrition Activities in Massachusetts." The Commonhealth, Vol. 7, 
No. 4, July-August, 1920. 

Evelyn C. Schmidt, D.H. 

"What is an Oral Hj^gienist?" The Commonhealth, Vol. 7, No. 5, Sep- 
tember-October, 1920. 

Division of Water and Sewage Laboratories. 
Mr. H. W. Clark. 

"Bacillus Coli and Bacillus Aerogenes." The Commonhealth, Vol. 7, No. 

3, May- June, 1920. 
"A Study of Massachusetts Water Supplies and the Tji^hoid Rate." Jour- 
nal of the New England Water Works Association, Vol. XXXIV, No. 
3, 1920. 



No. 34.] PAPERS AND PAIMPHLETS ISSUED. 377 



Division of Biologic Laboratories. 

William A. Hinton, M.D. 

"A Standardized Method of Performing the Wassermann Reaction." 
American Journal of Sj^jhilis, Vol. IV, October, 1920. 

Division of Tuberculosis. 
William J. Gallivan, M.D. 

"A Plea for a Department of Tuberculosis in Medical Schools." Boston 
Medical and Surgical Journal, Vol. 183, p. 348, Sept. 16, 1920. 

Pamphlets issued by the State Department of Public Health. 

A Health Creed for Massachusetts Boys and Girls. 

Cancer: Facts wliich eveiy Adult should know. 

Carbohydrate Foods. 

Constipation. 

Diet No. 1. The Breast-fed Baby. 

Diet No. 2. The Bottle-fed Baby. 

Diet No. 3. Diet for Child from Ten Months to Eighteen Months. 

Diet No. 4. Diet for Child from Eighteen Months to Two Years. 

Diet for the Mother. 

Diphtheria Bulletin. 

Do you know that — 

Encephalitis Lethargica. 

Fly Danger. 

Food for Children from Two to Six Years Old. 

Food for the Child. 

Foodwaj's to Health. 

Food : What it is and what it does. 

Health Habits. 

Height and Weight Tables: Adults. 

How Cooking affects the Digestibility of Foods. 

Infantile Paralysis: Committee Report, State and Provincial Boards of 

Health. 
Infantile Paralj^sis in Massachusetts in 1909. 
Infantile Paralysis in Massachusetts, 1907-12. 
Influenza Bulletin. 
Lime Water as a Mouth Wash. 

List of Illustrated Lectures and Moving Pictures on Public Health Work. 
Mosquitoes and Malaria. 
Posture and its Relation to Health. 
Simple Facts about Digestion. 
The Abatement of Nuisances. 
The A B C of Eating. 
The Baby and You. 



378 DEPARTMENT OF PUBLIC HEALTH. [P.D.Xo.34. 

The Control of Ophthalmia Neonatorum. 

The Food of Working Women in Boston. 

The Home Care of the Mouth. 

The Importance of Minerals in the Diet. 

The Importance of Mouth Cleanliness. 

The Occurrence of Infantile Paralysis in Massachusetts in 1908. 

The Venereal Diseases. 

The 1916 Epidemic of Poliomyelitis. 

Tissue-forming Foods. 

Vitamines or Accessory Food Factors. 



INDEX 



13791 



INDEX. 



229, 



237, 240, 241, 248 



report of 



Abington, water supply 
Accord Pond, analysis of water 
Actinomycosis 
Acton, water supply 
Adams, water supply . 
Administration, Division of . 
Amesbury, water supply 
Amethyst Brook reservoirs, analysis of water 
Amherst, water supply 
Andover, water supply 
Anterior poliomyelitis . 
Anthrax 

Antimeningococcic serum 
Antipneumocoecic serum 
Antitoxin and Vaccine Laboratory 
Economics . 
Educational work of 
Improvements 
Needs .... 
Personnel 
Production . 
Appropriations and expenditures 
Administration, Division of 
Arsphenamine, manufacture and distribut 
Biologic Laboratories, Division of . 
Communicable Diseases, Division of 
Venereal Diseases, Subdivision of 
Food and Drugs, Division of . 
Hygiene, Division of . . . 

Penikese Hospital 
Plumbers, State Examiners of 
Recapitulation .... 
Sanitary Engineering, Division of . 
Tuberculosis sanatoria: 

Appropriations of, special . 
Expenditures of . . . 

Tuberculosis (Sanatoria), Division of 
Water and Sewage Laboratories, Division 
Arsphenamine .... 

Manufacture and distribution of 
Artichoke River, analysis of water 
Ashburnham, water supply . 
Ashby Reservoir, analysis of water 
Ashfield, water supply 
Ashland, water supply 
Ashland Reservoir, analysis of water 
Ashley Brook, analysis of water 
Ashley Lake, analysis of water 



ion o 



of 



250, 



252, 



PAGE 

56, 67 
58,69 
243, 260, 262, 263 
. 61,72 
56, 61, 67 
19 
. 61, 72 
. 56, 67 
. 56, 67 
. 56, 67 
254, 256, 258, 260, 262, 263 
243, 260, 262, 263 
268 
268 
267 
269 
269 
269 
270 
267 
267 
36 
36 
40 
39 
37 
38 
39 
37 
43 
42 
44 
41 

46 

45 

42 

41 

214 

40 

59 

56,67 

57, 68 

56,67 

61.72 

56,67 

59,70 

59 



382 



INDEX. 



Assabet River, condition of . 
Assawompsett Pond, analysis of water . 
Athol, water supply .... 
Attleboro, water supply 
Aust'n Brook Reservoir, analysis of water 
Avon, water supply .... 
Ayer, water supply .... 

Bacillus coli and bacillus aerogenes 
Bacillus coli in the water of swimming pools 
Bacterial measurement of the degree of pollution of 
Bacteriological Laboratory, report of 

Diphtheria .... 

Pneumococcus type determination 

Typhoid fever 
Barnstable, water supply 
Barre, water supply 
Easin Pond Brook, analysis of water 
Bassett Brook, analysis of water . 
Beaman Reservoir, analysis of water 
Bear Hole Brook, analysis of water 
Bear Swamp Brook, analysis of water 
Bedford, water supply 
Big Sandy Pond, analysis of water 
Billerica, water supply 
Biologic Laboratories, Division of 

Appropriations and expenditures of 

Report of . . 

Antitoxin and "Vaccine Laboratory 
Wassermann Laboratory 
Birch Reservoir, analysis of water 
Black Brook, analysis of water 
Blackstone River, condition of 
Blandford, water supply 
Eondsville (Palmer), water supply 
Bottomly Reservoir, analysis of water 
Braintree, water supply 
Breed's Reservoir, analysis of water 
Bridgewater, water supply . 
Brockton, water supply 
Brookfield (East), water supply 
Brookline, water supply 

Buckman Brook Reservoir, analysis of water 
Buckmaster Pond, analysis of water 
Buttery Brook Reservoir, analysis of water 



Cady Brook, analysis of water 
Cambridge, water suppl.v 
Camps, water supplies of 
Cancer control 
Canton, water supply . 
Cape Pond, analysis of water 
Cerebrospinal meningitis 
Charles River: 

Analysis of filtered water 

Condition of 



water 



57,68 
56, 57. 67, 68 
53 
280 
62,72 
60,70 
237, 240, 241 248, 250, 252, 254, 256, 258, 260 

59,70 

Ill 



P.\GE 
111 

60,71 
56,67 
61, 72 
57,68 
61,72 
61,72 

121 

125 

134 

210 

210 

211 

211 

61,72 

56,67 

58, 69 

56,67 

59,70 

60,71 

56,67 

61,72 

56,67 

61,72 

32 

39 

267 

267 

271 

58, 69 

60,70 

111 

56, 67 

64,74 

61,71 

62,72 

58,69 

62,72 

56,67 

62,72 

62,72 

56,67 

59 

60,71 



INDEX. 



383 



Chelmsford, water supply 

Chelmsford (North), water supply 

Cheshire, water supply 

Chester, water supply . . . ■ 

Chestnut Hill Reservoir, analysis of water 

■Chicken pox 243,248 

Chicopee, water supply 
Chicopee (Fairview), water supply 
Chicopee River, condition of 
Clinics: 

Child in the rural community, for the 
Tuberculosis .... 

Venereal disease .... 
Advertising of . 
Directors of, meeting of 
Clinton, water supply .... 
Codding Brook reservoirs, analysis of water 
Cohasset, water supply 
Cold Brook Reservoir, analysis of water 
Collinsville (Dracut), water supply 
Color, removal of, from water 
Colrain (Griswoldville), water supply 
Commissioner of PubHc Health, report of 
Communicable diseases: 

Epidemiological significance of age distribution 
Incidence of, by months 
Outbreaks of . . . ■ • 

Sex distribution of .... 

Communicable Diseases, Division of 

Appropriations and expenditures of 
Report of . . . . ■ • 

Bacteriological Laboratory, report of 
Epidemiologist, report of . . . 

Health officers, report of . . . 

Penikese Hospital .... 

Venereal Diseases, Subdivision of, report of 
Concord, water supply .... 

C'oncord River, condition of . . . ■ 

Connecticut River, condition of . 
C'ook Allen Reservoir, analysis of water 
Coolej' Brook (Chicopee), analysis of water . 
Cooley Brook (Longmeadow), andysis of water 
Corrosion of pipes, investigation in regard to . 
Crystal Lake (Gardner), analysis of water 
Crystal Lake (Haverhill), analysis of water . 
Crystal Lake (Wakefield), analysis of water . 



250 



m ce 



252, 254, 256, 258, 260 



tan 



PAGE 

62.72 
62,72 
57, 68 

57, 68 
56,67 

262, 263 

57,68 

62,72 

112 

279 

294, 295 

212 

215 

216 

57 

58,69 

62,72 

58, 69 
62. 72 

131 

57,68 

4 

221 

263 

229 

228 

22 

37 

197 

210 

221 

203 

219 

211 

57, 68 

112 

112 

59,70 

57,68 

58,69 

119 

57, 68 

58, 68 
60.71 



Dalton, water supply . 

Danvers, water supply 

Dedham, water supply 

Deerfield, water supply 

Deerfield (South), water supply 

Deerfield River, condition of 

Dike's Brook Reservoir, analysis of water 

Diphtheria 210, 224, 228, 233, 236, 240, 241 



57,68 
57,68 
62, 72 
62,72 
57, 68 
112 
57,68 
248, 250, 252, 254, 256, 258, 260, 262, 263 



384 



INDEX. 



Diphtheria antitoxin 

Concentrated 
Diphtheria plasma 
Diphtheria toxin 
Diphtheria toxin-antitoxin . 
Disease prevalence 
Diseases dangerous to the public health 

Cases and deaths from . 
Doane Pond, analysis of water 
Dog bite ..... 
Douglas, water supply 
Dow's Brook Reservoir, analysis of water 
Dracut, water supply . 
Dracut (Collinsville) , water supply 
Dry Brook, analysis of water 
Dudley, water supply . 
Duxbury, water supply 
Dysentery ..... 



East Brookfield (Brookfield), water supply 

Easthampton, water supply . 

East Mountain Reservoir, analysis of water 

Easton (North Easton) , water supply . 

Edgartown, water supply 

Educat'onal work of: 

Biologic Laboratories, Division of . 
Health officers .... 
Hygiene, Division of . . . 

Venereal Diseases, Subdivision of . 
Egremont (South) , water supply . 
Egypt Brook Reservoir, analysis of water 
Elder's Pond, analysis of water 
Epidemic cerebrospinal meningitis 
Epidemiologist, report of . . . 

Cases and deaths from diseases dangerous to the public health 

Cases and deaths, with case and death rates, per 100,000 population for all 

reportable diseases 
Epidemiological significance of age distribution in certain communicable 

diseases ..... 
Incidence of communicable diseases by months 
Outbreaks of communicable diseases 
Anterior poliomyelitis 
Diphtheria 
Influenza . 
Measles 
Scarlet fever 
Septic sore throat 
Typhoid fever . 
Whooping cough 
Progress made in past five-year period 
Sex distribution of communicable diseases 
Exhibits ....... 

Fairhaven, water supply .... 

-Fairview (Chicopee), water supply 

Fall Brook Reservoir, analj^sis of water . 



243, 260 



243, 260, 



PAGE 

267 

267 

267 

268 

268 

13 

205 

245 

59,70 

262, 263 

62,72 

58, 69 

62,72 

62,72 

56, 67 
62, 72 
62,72 

262, 263 

62,72 
62, 72 
57,68 
62,73 
62,73 

269 
204 
281 
215 

57, 68 
57,68 
60, 71 

262, 263 
221 
245 

262 

221 
263 
229 
229 
233 
230 
232 
233 
234 
234 
233 
235 
228 
282 

62,73 

62,72 

58, 69 



INDEX. 



385 



Fall River, water supply 

Falmouth, water supply 

Falulah Brook, analysis of water . 

Farnham Reservoir, anatysis of water 

Filters: 

Intermittent sand, in operation thirty-three years 

Trickling, operation of . 
Fitehburg, water supply 
Flow of streams .... 
Follow-up work (tuberculoses) 
Fomer Reservoir, analysis of water 
Food and Drugs, Division of 

Appropriations and expenditures of 

Report of . 
Food and its relationship to health 
Foxborough, water supply 
Fox Brook, analysis of water 
Framingham, water supply . 
Framingham reservoirs, analysis of water 
Franklin, water supply 
Freeland Brook, analysis of water 
French River, condition of . 
Fresh Pond, analysis of water 
Fulling Mill Pond, analysis of water 

Gardner, water supply 

Gas company's wastes, purification of 

Gates Pond, analysis of water 

German measles 243, 248, 250, 

Glanders .... 

Glen Brook reservoirs, analysis of water 

Gloucester, water supply 

Gonorrhea 242, 249, 251 

Cases reported 
Goodale Brook, analysis of water 
Grafton, water supply . 
Granville, water supply 
Gravel Pond, analysis of water 
Great Barrington, water supply 
Great Barrington (Housatonic), water supply 
Great Pond (North Andover), analysis of water 
Great Pond (Randolph), analysis of water 
Great Pond (Weymouth), analysis of water 
Great Quittacas Pond, analysis of water 
Great South Pond, analysis of water 
Greenfield, water supply 
Green River, analysis of water 
Griswoldville (Colrain), water supply 
Groton, water supply . 
Groton (West Groton), water supply 

Hadley, water supply . 
Haggett's Pond, analysis of water 
Hart's Brook Reservoir, analysis of water 
Haskell Brook Reservoir, analysis of water 
Hatchet Brook reservoirs, analysis of water 



253, 



252, 254, 2 



255, 257, 259, 261 



6, 258, 260 



PAGE 

57, 68 
57, 68 
57, 68 
60,70 

129 
126 

57, 68 
54,91 

297 

58, 69 
34 
39 

137 

277 

62, 73 

60, 71 

62, 73 

56, 67 
62, 73 
56,67 

112 

57, 68 
58 

57, 68 
125 

58, 69 
262, 263 

243 

57,68 

57, 68 

262, 263 

219 
57,68 
62,73 
62,73 
59,69 
57, 68 
57, 68 

59, 70 
60,70 
60,71 
59,70 
60,70 
57, 68 
57,68 

57, 68 
62, 73 
62, 73 

58, 68 
56,67 
58,68 
57,68 
60,71 



38G 



INDEX. 



Hatfield, water supply 

Hathaway Brook, analysis of water 

Haverhill, water supply 

Hawkes Reservoir, analysis of water 

Haynes Reservoir, analysis of water 

Health districts, changes in . 

Health ofBcers, report of . . . 

Hick's Spring, analysis of water 

High-service reservoir, analysis of water 

Hingham, water supply 

Hinsdale, water supply 

Holliston, water supply 

Holyoke, water supply 

Hookworm ..... 

Hocsick River, condition of . 

Hopkinton, water supply 

Hopkinton Reservoir, analysis of water . 

Horn Pond, analysis of water 

Housatonic (Great Barrington), water supply 

Housatonic River, -condition of 

Hudson, water supply .... 

Huntington, water supply 

Hygiene, Division of . 

Appropriations and expenditures of 
Report of .... . 

Personnel, changes in 
Work, lines of . 

Cancer control . . .. . 

Clinics for the child in the rural communit 

Educational .... 

Exhibit .... 

Food and its relationship to health 

Investigations 

Lectures .... 

Mouth hygiene 

Special ..... 



260 



PAGE 

58,68 

59,70 

58, 68, 69 

59,69 

58,69 

206 

206 

63,74 

58, 69 

58, 62, 69 

58,69 

63,73 

58,69 

262, 263 

113 

63, 73 

56,67 

57 

57,68 

113 

58, 69 

58, 63, 69 

30 

37 

274 

274 

274 

280 

279 

281 

282 

277 

276 

282 

278 

285 



Infant and child hygiene .......... 

Infant mortality ............ 

Influenza 230, 242, 248, 250, 252, 254, 256, 258, 260, 262, 

Intermittent sand filters in operation thirty-three years . ' . 

Investigations by Division of Hygiene ........ 



Ip.swich, water supply . 
Ipswich River, analj'sis of water 



5 

285 
263 
129 
276 
58, 69 
60 



Jails and houses of correction, inspection of 
Johnson's Pond, analysis of water 
Jonathan Pond, analysis of water . 



216 

58, 68 
60, 71 



Keeping fit campaign . 

Kendall Reservoir, analysis of water 

Kenoza Lake, analysis of water 

Kent Reservoir, analysis of water . 

Kingston, water supply 

Kitchen Brook, analysis of water . 



217 
61,71 
58,69 
61,71 
63, 73 
57,68 



INDEX. 



387 



Laboratory problem of the department 
Lake Averic, analysis of water 
Lake Cochituate, analysis of water 
Lake Pleasant, analysis of water 
Lake Saltonstall, analysis of water 
Lake Williams, analysis of water 
Lakeville State Sanatorium . 

Report of superintendent of 

Report of treasurer of . 

Special report of . 

Statistical tables of 

Valuation of 
Laurel Lake, analysis of water 
Lawrence, water supply 
Leaping Well Reservoir, analysis of water 
Lectures .... 

Lee, water supply 

Legislative recommendations 

Leicester, water supply 

Leicester (Cherry Valley and Rochdale Water District), water suppl 

Leicester Reservoir, analysis of water 

Lenox, water supply 

Leominster, water supply 

Leprosy .......... 10, 

Lincoln, water supply . 

Liquid chlorine or bleach, the effect of low temperature upon steriliza 

by means of 
Little Quittacas Pond, analysis of water 
Little South Pond, analysis of water 
Littleton, water supply 
Lobar pneumonia .... 242, 249, 251, 253, 255, 257, 

Longham Reservoir, analysis of water . 
Longmeadow, water supply .... 

Long Pond (Falmouth), analysis of water 

Long Pond (Great Barrington), analysis of water 

Lowell, water supply ..... 

Lower Hobbs Brook Reservoir, analysis of water 
Lower Holden Reservoir, analysis of water 
Lynn, water supply ..... 

Malaria ....... 

Manchester, water supply .... 

Mann Reservoir, analysis of water 
Mansfield, water supply .... 

Marblehead, water supply .... 

Marion, water supply ..... 

Marlborough, water supply .... 

Marshfield, water supply .... 

Massachusetts Hospital for Consumptives and Tubercular Patients 

establish the 
Maternal mortality 
Mattapoisett, water supply . 
Maynard, water supply 
McClellan Reservoir, analysis of water 

Measles. . . 222,228,232,235,240,241,249,251,253,255,257,259, 

Medfield, water supply 





PAGE 


, ^ 


17 


, , 


60,71 


, 


56,67 


, 


59, 70 


. 


58,69 


, , 


59,69 




330 




331 




334 


.r- 


340 




341 


. 


340 


, 


58 


, 


58,69 


. 


60,71 


, , 


282 




58,69 


, 


19 




63, 73 


, 


63, 73 




61, 71 


, , 


58, 69 




58, 69 


243, 260, 


262, 263 




58,69 


of water 






133 


, , 


59, 70 




60,70 




63, 73 


259, 261, 


262, 264 


. 


60,71 


, , 


58, 69 


, , 


57, 68 


, 


57,68 




63, 73 




56,67 


. 


61,71 


58, 59, 69 


243, 260, 


262, 263 


. 59, 63, 69, 73 




61, 71 




63, 73 




63 




63, 73 




59, 69 




63,73 


n act to 






289 




285 




63,73 




59,69 




57,68 


259, 261, 


262, 263 


. 


63,73 



388 



INDEX. 



Medway, water supply 
Meetinghouse Pond, analysis of water 
Merrimac, water supply 
Merrimack River: 

Analysis of filtered water 

Condition of . . , 

Flow of ... 

Methuen, water supply 
Metropolitan Water District, water supply 
Middleborough, water supply 
Middleton Pond, analysis of water 
Midwife investigation . 
Milford, water supply . 
Mill Brook, analysis of water 
Millburj', water supply 
Miller's River, condition of . 
Millham Brook Reservoir, analysis of water 
Millis, water supply 
Millvale Reservoir, analysis of water 
Monson, water supply 
Montague, water supply 
Montgomery Reservoir, analysis of water 
Morse Reservoir, analysis of water 
Morton Brook, analysis of water . 
Mountain Street Reservoir, analysis of water 
Mouth hygiene .... 
Muddy Pond Brook, analysis of water 

Mumps 244, 249. 251 

Muschopauge Lake, analysis of water 

Nagog Pond, analysis of water 
Nantucket, water supply 
Nashua River: 

Condition of 

Flow of . . . 

Rainfall on drainage area 
Natick, water supply . 
Needham, water supply 
Neponset River, condition of 
New Bedford, water supply . 
Newburyport, water supply . 
Newton, water supply . 
North Adams, water supply 
North Attleborough, water supply 
Northampton, water supply 
North Andover, water supply 
Northborough, water supply 
Northbridge, water supply . 
North Brookfield, water supply 
North Chelmsford (Chelmsford), water supply 
North Easton (Easton), water supply 
Northfield, water supply 
North Pond, analysis of water 
North Reading State Sanatorium 

Report of superintendent of 

Report of treasurer of . 



J53, 



255,2 



57, 259, 261 



PAGE 

6.3, 73 
57,68 
63, 73 

5S, 69 
113 
97 
63, 73 
56,67 
63, 73. 74 
57.68 
276 
59,70 
60 
63,74 
113 
59,69 
63, 74 

58, 69 
63,74 

59, 70 
60,71 
58.69 
57,68 
59,70 

278 

60, 71 
, 262, 263 

60,70 

57,68 
59, 63, 70 

113 

94, 99, 100 

96 

63,74 

63,74 

114 

59, 70 

59, 63, 74 

63, 74 

59.70 

64,74 

59,70 

59,70 

59,70 

59,70 

59.70 

62.72 

62.73 

59.70 

59.70 

298 

298 

301 



INDEX. 



389 



North Reading State Sanatorium — Concluded. 

Special report of . 

Statistical tables of 

Valuation of 
North River, condition of 
North Watuppa Lake, analysis of water 
Norton, water supply . 
Norwood, water supply 
Notch Brook Reservoir, analysis of water 
Nursing assistants 

Oak Bluffs, water supply 

Observation hospital 

Onset (Wareham), water supply 

Open-air schools . 

Ophthalmia neonatorum . . . 244, 249, 251 

Orange, water supply . 

Oxford, water supply . 



alth 
Public 



Palmer, water supply . 

Palmer (Bondsville), water supply 

Pamphlets issued by the State Department of Public He 

Papers written by members of the State Department of 

Peabody, water supply 

Pellagra ..... 

Penikese Hospital 

Appropriations and expenditures of 
Pentucket Lake, analysis of water 
Pepperell, water supply 
Personnel problems 

Phillipston Reservoir, analj-sis of water 
PittsP.eld, water supply 
Plague problems .... 
Plainville, water supply 
Plumbing Board, special 
Plumbers, State Examiners of: 

Appropriations and expenditures of 

Report of . 
Plymouth, water supply 
Pneumococcus type determination 
Police departments 

Pollution of water, bacterial measurement of the degree 
Prisoners, examination of 
Provincetown, water supply 
Public Health Council, report of . 
Public health nurses 
Public health nursing . 

Rabies ..... 

Rainfall: 

In Massachusetts . 

On Nashua River drainage area 

On Sudbury River drainage area 
Randolph, water supply 
Reading, water supply 
Removal of color from water 
Reportable diseases, cases and deaths, with case and death rates 
Rivers, examination of ....... 



253, 



Health 



of 



55,2 



57, 259, 261 



244, 261 



PAGE 

307 

308 

306 

114 

57,68 

64,74 

59, 64, 74 

59,70 

204 

64,74 
296 

60,71 

277 

262, 264 

59, 70 

64,74 

59,70 

64, 74 

377 

375 

59, 70 

262, 264 

219 

43 

58, 69 

64,74 

7 

56,67 

59,70 

S 

74 

18 

42 

309 

60,70 

211 

216 

134 

296 

64,74 

3 

296 

16 

243 

54,90 

96 

92 

60,70 

64,74 

131 

262 

111 



390 



INDEX. 



Roaring Brook, analysis of water . 

Rockport, water supply 

Running Gutter Brook Reservoir, analysis of water 

Russell, water supply .... 

Rutland, water supply 

Rutland State Sanatorium . 

Report of superintendent of . 

Report of treasurer of . 

Special report of . 

Statistical tables of . . . 

Valuation of .... 

Sacket Brook, analysis of water 
Salem, water supply .... 
Salisbury, water supply 
Sandy Pond, analysis of water 
Sanitary Engineering, Division of . 

Appropriations and expenditures of 

Report of . 

Scarlet fever . . 225,233.236,240,241,249,251 

Schick outfits ..... 

Scituate, water supply 

Scott Reservoir, analysis of water 

Septic sore throat .... 

Sewerage and sewage disposal works, examination of 
Sewerage facilities, difficulties of providing, in certain 
Sharon, water supply .... 

Shaw Pond, analysis of water 

Sheffield, water supply 

Shelburne (Shelburne Falls), water supply 

Shelburne, water supply 

Shellfish, studies of ... . 

Shirley, water supply .... 

Shrewsbury, water supply 
Silver Lake, analysis of water 
Smallpox ...... 

Smallpox vaccine .... 

Snake Brook Reservoir, analysis of water 
Social service ..... 

Southbridge, water supply . 

South Egremont (Egremont), water supply 

South Hadley, water supply 

Spencer, water supply 

Spot Pond, analysis of water 

Springfield, water supply 

Spring Pond, analysis of water 

Sterilization of water by means of liquid chlorine or 

perature upon 
Stockbridge, water supply 
Stony Brook Reservoir, analysis of water 
Stoughton, water supply 
Sudbury Reservoir, analysis of water 
Sudbury River: 

Condition of .... 

Flow of .... . 

Rainfall of drainage area 



districts 



253, 



255, 



bleach, the 



57, 259, 261 



234, 244, 261 



effect 



244 



60, 



of low tern 



PAGE 

57,68 
60,70 

58, 68 
00,70 
60,70 

350 
350 
354 
360 
361 
359 

60,70 

60,71 

64, 74 

58,69 

20 

41 

49 

, 262, 264 
268 
64,74 
57, 68 
, 262, 264 
100 
53 
64.74 
60,71 
64,74 
60,71 
60,71 
123 
64,74 
64,74 
56, 67 
, 262, 264 
268 
60, 71 
214 
60,71 
57,68 
64, 71, 74 
60,71 
56, 67 
60,71 

59, 70 

133 

60, 71 
56,67 
60, 71 
56,67 



112 
91, 99, 100 
92 



INDEX. 



391 



PAGE 

Suntaug Lake, analysis of water . . . . . . . . . 59, 70 

Supplement ............ 47 

Swan Pond, analysis of water ......... 57 

Swimming pools, B. coli in the water of ....... 125 

Syphilis 219, 242, 249, 251, 253, 255, 257, 259, 261, 262, 264 



. 227, 249, 251, 253, 255, 257, 259, 261, 
226, 228, 238, 240, 241, 249, 251, 253, 255, 257, 259, 



Taunton, water supply 

Taunton River, condition of 

Tetanus ...... 

Thunder Brook, analysis of water 
Tillotson Brook Reservoir, analysis of water 
Tisbury, water supply .... 

Trachoma ...... 

Trichinosis ..... 

Trickling filters, operation of 
Tuberculosis 

Other forms 
Pulmonary . 
Tuberculosis sanatoria: 

Appropriations of, special 
Expenditures of . 
Tuberculosis (Sanatoria), Division of 
Appropriations and expenditures of 
Report of . 

Consultants 

Consultation clinics 

Examination clinics . 

Examination of prisoners 

Follow-up work 

Lakeville State Sanatorium, report of 

Massachusetts Hospital for Consumptives and T 
act to establish .... 

North Reading State Sanatorium, report of 

Observation hospital .... 

Public health nurses .... 

Rutland State Sanatorium, report of . 

Subsidy ...... 

Westfield State Sanatorium, report of . 
Typhoid fever . . 211, 234, 239, 240, 241, 249, 251 

Typhoid paratyphoid vaccine 
Typhus fever ...... 

Upper Hobbs Brook Reservoir, analysis of water 
Upper Holden Reservoir, analysis of water 
Upper Naukeag Lake, analysis of water 
Uxbridge, water supply 

Venereal diseases .... 

Infection, sources of . . . 

Lapsed cases .... 

Statistics ..... 

Venereal Diseases, Subdivision of: 

Appropriations and expenditures of 
Report of .... . 

Advertising .... 

Arsphenamine .... 



244, 



244, 
244, 



ubercular Patients, an 



253, 



255, 257, 259, 261 



60,71 

114 

262, 264 

57,68 

60,71 

64,74 

262, 264 

262, 264 

126 

10 

262, 264 

261, 264 

46 
45 

28 
42 
289 
297 
294 
295 
296 
297 
330 

289 
298 
296 
296 
350 
296 
314 

262, 264 
268 
244 

56 
61,71 
56,67 
64,74 

15 

217 
214 
211 

38 
211 
215 
214 



392 



INDEX. 



Venereal Diseases, Subdivision of — Concluded. 
Report of — Concluded. 
Clinics 

Meeting of directors of 
Courts 
Educational 
Industrial 

Infection, sources of . 

Jails and houses of correction, inspection of 
Keeping fit campaign 
Lapsed cases 
Police departments 
Social service 
Statistics .... 

Wachusett Lake, analysis of water 
Wachusett Reservoir, analj^sis of water 
Wakefield, water supply 
Walden Reservoir, analysis of water 
Wallace Reservoir, analysis of water 
Walpole, water supply 
Waltham, water supply 
Wannacomet Pond, analysis of water 
Ware, water supply 
Wareham, water supply 
Wareham (Onset), water supply . 
Wassermann Laboratory, report of 

Complement fixation tests in gonococcal infections 

Complement fixation tests in tuberculosis 

Costs ..... 

Routine tests .... 

Water, consumption of, in cities and towns 
Water and Sewage Laboratories, Division of 

Report of . 

Water and sewerage facilities, difficulties of providing, in certain districts 
Water supplies: 

Analyses of ground-water sources . 

Analyses of surface-water sources . 

Comparison of, by chemical analysis 

Sanitary protection of public . 
Water supply investigation, special 
Water supply statistics 
Wayland, water supply 
Webster, water supply 
Wellesley, water supply 
Wells, examination of, private 
Wenham Lake, analysis of water 
Westborough, water supply . 
West Brookfield, water supplj' 
Westfield, water supply 

Westfield Little River, analysis of filtered water 
Westfield State Sanatorium . 

Report of superintendent of 

Report of treasurer of . 

Special report of . 

Statistical tables of 

Valuation of 



PAGE 

212 
216 
217 
215 
215 
217 
216 
217 
214 
216 
214 
211 

57,68 
56,67 
60,71 
58,69 
57,68 
64,74 
64, 74, 75 

59, 70 
64,75 
64,75 
60,71 

271 

272 

271 

272 

271 

88 

21 

117 

53 

61,72 
56,67 
65 
55 
12 
75 

60, 71 
64,75 
64,75 

52 

60, 71 

64, 75 

64,75 

60,71 

60, 71 

314 

314 

318 

324 

325 

323 



INDEX. 



393 



Westford, water supply 

West Groton (Groton) , water supply 

Weston, water supply . 

Weston Reservoir, analysis of water 

West Springfield, water supply 

Weymouth, water supply 

White Pond, analysis of water 

White Reservoir, analysis of water 

Whiting Street Reservoir, analysis of water 

Whooping cough 223, 228, 233, 235, 240, 241. 249 

Williamsburg, water supply . 

Williamstown, water supply 

Winchendon, water supply . 

Winchester, water supply 

Windsor Reservoir, analysis of water 

Woburn, water supply 

Worcester, water supply 

Worthington, water supply . 

Wrentham, water supply 

Wright and Ashley Pond, analysis of water 



251, 



253, 255, 257, 259, 261 



PAGE 

64, 75 
62,73 
65,75 
56,67 
60,71 
60,71 
59,69 
58,69 
58,69 
262, 264 
60, 71 
61,71 
65,75 
61,71 
57 
65,75 
61,71 
65,75 
65,75 
58, 69 



a P'l 



i 



BOSTON UNIVERSITY 




1 1719 02753 8000 



BOSTON UNIVERSITY 

LIBRARIES 

NOT TO BE TAKEN 

FROM THIS ROOM