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

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BOSTON UNIVERSITY 
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Public Document 



No. 34 



Cfte Commontoealtl) of Massachusetts 



ANNUAL REPORT 



OF THE 



Department of Public Health 



FOR THE 



Year ended November 30, 1921 




BOSTON 
WRIGHT &;;POTTER PRINTING CO., STATE PRINTERS 

32 DERNE street 



Publication of this Document 

appboved by the 
Supervisor of Administration. 



CONTENTS. 



Report of the Public Health Council . 
Report of the Commissioner of Public Health 
Retaining of Efficient Personnel 
Disease Prevalence 
Venereal Diseases 
Institutions 
Plague Problems 
Oil-refining Industry Problems 
Plumbing Report 
Water Supply Problems 
Problems of Hygiene . 
Maternity Benefits 
Other Problems of Hygiene 
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 

Antotixin and Vaccine Laboratory 
Wassermann Laboratory 
Division of Food and Drugs 
Appropriations and Expenditures for the Year ended Nov. 30 
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 
Water Supply and Sewage Disposal 
Division of Sanitary Engineering 
Division of Water and Sewage Laboratories 
Division of Tuberculosis 
State Examiners of Plumbers 
Bubonic Plague Investigation 
Neponset River . 
Penikese Hospital 
Recapitulation 
Water Supply and Sewerage 
Care of Inland Waters 

Water Supply and Sewerage 
Water Supplies 
Difficulties of providing Water and Sewerage 

Districts . 
Rainfall and Flow of Streams 



1921 



Facilities 



in Certain 



BOSTON UNiVthSiTi' Lii^HAHIES 



IV 



CONTENTS. 



the Valley of the 



Neponset 



Water Supply and Sewerage — Concluded. 
Care of Inland Waters — Concluded. 

Water Supply and Sewerage — Concluded. 
Examination of W^ater Supplies 
Sanitary Protection of Public Water SuppHes 
Examination of Sewer Outlets discharging into the Se 
Sewage-disposal Systems 

Objectionable Conditions due to Lack of Sewerage 
Examination of Rivers 

Aberjona River 
Assabet River 
Blackstone River . 
Charles River 
Chicopee River 
Concord and Sudbury Rivers 
Connecticut River 
Deerfield River 
French River 
Hoosic River 
Housatonic River . 
Merrimack River . 
Millers River 
Nashua River 
Neponset River 

North River in Peabody and Salem 
Taunton River 
Other Rivers 
Protection of the Public Health in 
Oil Refineries 

Water-supply Needs and Resources 
Supplement 

Report of Division of Sanitary Engineering 
Difficulties of providing Water and Sewer 
The Sanitary Protection of Public Water Supplies 
Examination of Sewer Outlets discharging into the 
Objectionable Conditions due to Lack of Sewerage 
Nuisances from Noxious Trades 
Water-supply Needs and Resources 
Protection of the Pubhc Health in the Valley of the Neponset 
Examination of PubHc Water Supplies 

Analyses of the Water of Public Water Supplies 
Water Supply Statistics 
Consumption of Water 
Rainfall 

Flow of Streams . 
Sudbury River 
Nashua River 
Merrimack River 

Sudbury, Nashua and Merrimack Rivers 
Examination of Rivers . - • • 

Aberjona River 
Assabet River 
Blackstone River 
Charles River 
Chicopee River 
Concord and Sudbury Rivers 
Connecticut River 
Deerfield River 



age Facilities in 



Sea 



River 



Certain Distr 



River 



lets 



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CONTENTS. 



Supplement — Continued. 

Report of Division of Sanitary Engineering — Concluded. 

Examination of Rivers — Concluded. page 

French River 99 

Hoosic River .......... 99 

Housatonic River .......... 99 

Merrimack River .......... 99 

Millers River 99 

Nashua River .......... 100 

Neponset River .......... 100 

North River in Peabody and Salem ...... 100 

Taunton River . . . . . . . . . . 101 

Other Rivers 101 

Examination of Sewage-disposal Works . . . . . . .102 

Report of Division of Water and Sewage Laboratories . . .113 

Character of the Sewage used at the Lawrence Experiment Station . .116 

Operation of Septic Tanks . . . . . . . . .118 

Purification of Sewage by Aeration. — Activated Sludge .... 120 

Operation of Trickling Filters . . . . . . . .122 

Operation of Contact Filters ........ 124 

Intermittent Sand Filters operated with Untreated Sewage . . .125 

Mechanical Filtration of Merrimack River Water ..... 127 

Slow Sand Filtration of Water treated with Aluminum Sulphate . . 130 

Removal of Color from Water ........ 131 

Filtration of Water as polluted as Merrimack River Water below Lawrence 135 
Lawrence City Filters .......... 136 

Report of Division of Food and Drugs ....... 141 

Milk 146 

Foods Other than Milk 146 

Drugs 152 

Liquor ............ 153 

Cold Storage 154 

Bakeries ............ 155 

Slaughtering ........... 156 

Arsphenamine ........... 157 

Pro.secutions . . . . . . . . . • .158 

Summary of Milk Samples examined ....... 170 

Summary of Food Samples examined . . . . . . .171 

Summary of Drug Samples examined . . . . . . .172 

Summary of Liquor Samples examined ....... 172 

Cold-storage Statistics . . . . . . . • .174 

Report of Division of Communicable Diseases ...... 193 

Subdivision of Venereal Diseases ........ 208 

Penikese Hospital . . . . . . - . .210 

Report of Epidemiologist for 1921 ....... 211 

Cases and Deaths from Diseases dangerous to the Public Health . . 219 

Cases and Deaths, with Case and Death Rates, per 100,000 Population for 

All Reportable Diseases during the Year 1921 . . . . 237 

Incidence of Communicable Diseases by Months, 1921 .... 238 

Report of Division of Biologic Laboratories ....... 241 

Antitoxin and Vaccine Laboratory ....... 243 

Production and Distribution of Biologic Products .... 243 

Improvements .......... 244 

Expenses ........... 245 

Personnel ........... 245 

Educational Activities ......... 246 

Resume ........... 247 

Wassermann Laboratory ......... 247 



VI 



CONTENTS. 



Supplement — Concluded. 

Report of Division of Hygiene 

General Survey . . . . . 

Cancer ..... 

Health Exhibit and Health Weeks . 

Advisory Committee on Health Weeks 

Follow-up Work .... 

Agricultural Fairs 

Nutritional Activities 

Pamphlets, Lantern Slides and Lectures 

Mouth Hygiene .... 

Investigative Work 

Child Hygiene Clinics . 

The Commonwealth 

Lectures to Training Schools for Niirses 

Boston Health League . 

Courses for Continuation School Teachers 

Parent-Teacher Association . 

Mental Hygiene .... 

Relative Importance of the Different Activities o 
Hygiene ..... 

New Needs ..... 

Infant Mortality with Reference to Future Work 

Infant Mortality during 1921 . 
Report of Di\'ision of Tuberculosis (Sanatoria) 
Lakeville State Sanatorium . 

Report of the Superintendent 

Valuation ..... 

Special Report .... 

Statistical Tables .... 

Treasurer's Report 
Rutland State Sanatorium . 

Report of the Superintendent 

Valuation ..... 

Special Report .... 

Statistical Tables .... 

Treasurer's Report 
Westfield State Sanatorium . 

Report of the Superintendent 

Valuation ..... 

Special Report .... 

Statistical Tables .... 

Treasurer's Report 
North Reading State Sanatorium . 

Report of the Superintendent 

Valuation ..... 

Special Report .... 

Statistical Tables .... 

Treasurer's Report 
Report of the Board of State Examiners of Plumbers 
Report of the Drainage Board 
Green Harbor District 
Salisbury Drainage District . 
Weweantic River Drainage District 
Herring River Project .... 
Nova Scotia Trip .... 

Papers written in 1921 and Pamphlets issued 



the 



Division of 



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Cije Commontoealtf) of g^assacfjusetts; 



Department of Public Health, 
Boston, Jan. 18, 1922. 

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 ended Nov, 30, 1921. 

Respectfully, 

EUGENE R. KELLEY, M.D., 

Commissioner of Public Health. 



SEVENTH ANNUAL REPORT 



OF THE 



Depaetment of Public Health of Massachusetts. 



For the fiscal year ending Nov. 30, 1921, 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. 

J. E. Lamoureux, M.D., 1924. Richard P. Strong, M.D., 1923.2 

Roger I. Lee, M.D., 1924. Warren C. Jewett, 1922. 

George C. Whipple, S.B., 1923. Sylvester E. Ryan, 1922. 
William T. Sedgwick, Ph.D. ^ 

During the year 14 formal meetings of the Council were held, as 
well as many meetings of the standing and special committees of the 
Department. The standing committees for the year were as follows: • — 

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

Preventive Medicine and Hygiene. 
Drs. Lamoureux, Lee, Ryan and Strong. 

Food and Drugs. 
Drs. Lamoureux and Ryan and Mr. Jewett. 

Laboratory Work and Research. 
Drs. Strong and Kelley and Professor Wliipple. 

Publications. 
Drs. Ryan and Lamoureux and Professor Whipple. 

Following the sad death of Prof. William T. Sedgwick, on Jan. 25, 
1921, the following memorial was written by Dr. Lamoureux and 
spread upon the records of the Public Health Council: — 

» Died Jan. 25, 1921. 2 Appointed Feb. 23, 1921. 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



William 9^. S^ebgtotrk 

iSionrer in moVrn putlir l)raltl) srcirnrr. 

3I/eac()f rt nationally lowi. 

J^ul^ort itttrrnaitonaUg apprr riatrb. 

(&mmrilli>rt unfeersall^ ^^^4)^ ^^^* 
tlji^^^e k>ebirate> b^ ii)e Ipfubltr 
?l|ralil) (tounrtl, of tolficl) l)f toHj^ 
an ortijinal mrmbet*, in ^turet 
rfmfmbranrr of l)i5 rljarminij 
personality, a^ a man; [ji^ toiAom, 
aif an abtiii^f r; l^i^ boun)ilrj?> artitittj 
anb ijoo^ toill as a ro-morkrr. 



The Council also records with regret the death, on July 13, 1921, of 
Dr. William J. Gallivan, Director of the Division of Tuberculosis 
(sanatoria), and formerly a member of the Public Health Council. 
Dr. Lamoureux wrote the following memorial on Dr. Gallivan's death, 
which has been spread upon the records of the Public Health Council. 



No. 34.] ANNUAL REPORT. 



3n iHemoriam 



Mften Hife 

fjas; enbotoeti one ioiti): 

ja quick mtnb to grasp tfjc special science of fjis profession, 
^ clear epe to betect tfje approbeb recent abbancement, 
la gifteb tongue tfjat carries conbiction, 
^ profounb bnotolebge of Ijuman nature, 
^ magnetic personality, 
Cntfjusiasm, born of sincerity, 
tlTact, coupleb \oit\) optimism, 
Jfirmness, associateb toitb justice, 

tfjose arounb bim finb sucb an existence so inbispen= 
sable as to beliebe it perpetual. 

mnUam 3. #aUit)an 

bias tbe apostle of prebention, tfje prism tbrougb bjbicb tbe 
Spectrum of sanitarp sciences bjoulb reacb tbe masses in tbe 
form of principles anb practices of b^altbful libing. 

OTfjen ©eatfi 

snatcbes, in a moment, sucb a powerful force, tbe 
sbocfe, in tbe department of public ^ealtb, is all tbe more 
Sebere; tbe bacuum, tbe more betoilbering ; tbe regret, tbe more 
lasting. tTbat otbers map not forget, tbe public ^ealtb 
Council bebicates tbis page of its recorbs to tbe lobing memorp 
of a lopal, genial anb beboteb companion. 



Can 



6 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

At a meeting of the Public Health Council held on Jan. 10, 1922, it 
was voted that the report of the Department's activities for the fiscal 
year 1921 as submitted by the Commissioner be approved and adopted 
as the report of the Department of Public Health for the fiscal year 
1921. 

SEVENTH ANNUAL REPORT OF THE COMMISSIONER OF PUBLIC 

HEALTH. 

To the Public Health Council. 

Gentlemen: — Since my last annual report this Department has 
sustained serious losses through death. 

Prof. William T. Sedgwick, a member of the Public Health Council 
from the organization of the present Department in 1914, died on 
Jan. 25, 1921. 

His work and influence have been widely commemorated and re- 
viewed both by the Department and elsewhere. The deep and con- 
tinuing sense of loss of his wise counsel and of the stimulus of his 
enthusiasm for the progress of health endeavor everywhere is shared 
by us all. 

Dr. William J. Gallivan, Director of the Division of Tuberculosis, 
died on July 13, 1921. 

Like Professor Sedgwick, Dr. Gallivan had been a member of the 
Public Health Council from its organization in 1914, only resigning 
from it to accept appointment as Director of the sanatoria and other 
tuberculosis activities of the Department after the reorganization of 
the State government in 1919. Dr. Gallivan brought to his new duties 
wide experience, vast enthusiasm, sound judgment and a personality 
which positively radiated human sympathy and fellowship. These 
qualities, added to his years of interest in the anti-tuberculosis cause, 
made him an ideal administrator for the intricate and far-reaching 
tuberculosis program, of this Commonwealth. He had really just 
reached the point where he himself felt that he had all the details of 
his new field thoroughly in hand when his sudden and untimely death 
deprived us of a beloved colleague and the Commonwealth of one of 
its most useful and devoted public servants. 

It is a sad and peculiar coincidence to be obliged to report in a single 
year a third death of a former officer of this Department, — Mr. James 
C. Coffey, for many years chairman of the Board of Examiners of 
Plumbers of this Department and the executive officer of the Worces- 
ter Board of Health. Because of failing health Mr. Coffey resigned 
from his position on the Board of Examiners of Plumbers early in the 
year. Just as this report is being drafted we have to record his sud- 



No. 34.] 



ANNUAL REPORT. 



den death on December 2. Mr. Coffey had always been most faithful 
in attendance upon the meetings of his Board and otherwise concerned 
in the proper carrying out of the duties of his position. He also had 
for years been an honored unofficial adviser of the Commissioner and 
District Health Officers of his district on all matters on health adminis- 
tration touching upon the relations of this Department with city and 
town boards of health. 

It is perhaps suggestive of the magnitude of cardiac disease as a 
health problem to-day that all three of these men should have died in 
the same manner, suddenly and while "carrying on" actively in the 
battle of life. 

Dr. Sumner H. Remick, superintendent of the Sassequin Sanatorium 
of New Bedford, was appointed Director of the Division of Tubercu- 
losis, to fill the vacancy caused by the death of Dr. Gallivan, and Mr. 
Charles J. O'Brien of Chicopee, chairman of the Board of Examiners 
of Plumbers, to fill the vacancy due to the resignation of Mr. Coffey. 

As now constituted the executive organization of the Department is 
as follows : — 



Division of — 

Administration. 

Sanitary Engineering 

Water and Sewage Laboratories 

Communicable Diseases 

Food and Dnigs 

Biologic Laboratories 

Hygiene 

Tuberculosis (sanatoria) 



Director. 

X. H. Goodnough, C.E. 
H. W. Clark. 
Bernard W. Carey, M.D. 
Hermann C. Lythgoe, S.B. 
G. Benjamin White, Ph.D. 
Merrill E. Champion, M.D. 
Sumner H. Remick, M.D. 



All the divisions are now in charge of expert full-time officials, and 
I feel that I can conscientiously report to you that they are without 
exception doing most efficient work at the lowest possible cost in their 
individual spheres of activity. Furthermore, with the able assistance 
of our District Health Officers and sanatoria superintendents, these 
gentlemen have this year achieved a degree of teamwork and spirit of 
co-operation among their various staffs and the multitude of official and 
non-official health agencies throughout the State which I feel has per- 
haps never before been equalled and from which I confidently an- 
ticipate great returns in public benefit in the immediate future. 

Prior to discussing briefly the individual work of these divisions of 
the Department, I wish to call to your attention certain occurrences, 
problems and features of the past year's work or possible future de- 
velopments suggested by our year's experience which I consider 
worthy of special notice. 



8 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Retaining or Efficient Personnel. 

It is a distinct pleasure to be able to report that the problem of 
retaining tried and efficient personnel in the face of the competition of 
the superior rates of compensation offered by other organizations for 
skilled health workers in all lines has lightened materially during the 
past year. 

While our rates of compensation in certain lines, particularly nursing 
and bacteriology, are still markedly below prevalent rates paid for 
persons of equivalent training and experience in other places, the 
marked depression in engineering and chemical lines in industry and 
the general condition of economic uncertainty have enabled us to retain 
the services of experienced personnel to a very much greater degree 
than for any year since the beginning of the war, with a very ad- 
vantageous reaction upon the work of the Department. 

Disease Prevalence. 

So far as our records go, and they are very complete from the date 
of the establishment of the State Board of Health fifty-two years ago, 
I believe we are justified in making the unqualified assertion that the 
year 1921 has no parallel in the history of the Commonwealth in its 
freedom from epidemics. 

Neither poliomyelitis nor influenza recurred in epidemic form, al- 
though there was grave apprehension concerning both at the beginning 
of the year, and a new record has been established of freedom from 
serious outbreaks of our more commonly prevalent diseases. 

One typhoid epidemic, due to infection of a single unpasteurized 
milk supply, practically covers the entire story of serious epidemics for 
the year. There were in all 114 cases in this outbreak. A small in- 
stitutional outbreak of septic sore throat and a small group of small- 
pox cases might be added from the standpoint of completeness, al- 
though the number of individuals involved in each were relatively 
insignificant. 

One has to go back over a series of previous reports to grasp the full 
significance of this remarkable immunity from serious epidemics. It 
is, however, necessary to make a careful distinction between epidemic 
conditions and those of unusual average prevalence. Thus, while 
diphtheria has been checked sufficiently so that no epidemic has oc- 
curred at any given time or locality during the year, yet the average 
diffused prevalence of this disease has been higher than usual. This 
is a matter of grave concern, although the number of fatalities may 
now be estimated with high degree of certainty not to exceed those of 
recent previous years. 



No. 34.] ANNUAL REPORT. 9 

The degree with which our sporadic typhoid is now averted and 
serious epidemics prevented or controlled at their inception is beauti- 
fully illustrated by the fact that the single epidemic of this disease 
already referred to, which would have contributed so small a relative 
percentage to the total deaths to have been scarcely noticeable a few 
years back, was a large factor this year in preventing the repetition of 
our phenomenal low total of typhoid fatalities of a year ago. 

A few words of special emphasis may not be amiss in reference to 
the experience of this Commonwealth with three communicable dis- 
eases during the past year. 

The first of these is poliomyelitis. 

In 1920 the Commonwealth experienced a much more severe visita- 
tion from this justly dreaded malady than has ever been popularly 
appreciated, amounting to one-third of the fatalities of the great 
epidemic of 1916. Many careful students of this disease felt that this 
recrudescence after three years of relative freedom from it would prove 
to be merely the forerunner of a much more serious outbreak during 
the present year. Fortunately this prophecy proved erroneous! 
There was a considerable increase in the number of cases for July of 
this year over July, 1920, and for a few weeks it looked extremely 
probable that the situation would become grave. However, instead 
of increasing in frequency as the summer progressed, as has been the 
case in all previous years, before the end of August it was very clear 
that the disease was on the wane, and the three autumn months 
simply record a fairly rapid return to usual endemic prevalence. Why 
the disease should so suddenly and spontaneously disappear as an 
epidemic problem after all the preliminary indications of a very serious 
outbreak we have at present no adequate knowledge or even satis- 
factory hypothesis. 

The second of our communicable diseases whose behavior is worthy 
of special note during this year is diphtheria. 

Diphtheria and sanitary science have fought to a draw for several 
years past. 

Following the sensational reduction in diphtheria deaths as a result 
of the general utilization of diphtheria antitoxin in the late nineties, 
and the effective demonstration of the fact that antitoxin could be 
depended on to save practically 100 per cent of cases if administered 
in the early stages of the attack, it was not unnaturally assumed by 
the medical profession, sanitarians and general public alike that this 
method could be more and more effectively extended with each year's 
passing until deaths would become negligible. Time and practical 
experience showed that this roseate forecast was destined never to be 
fulfilled. 



10 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

A careful painstaking study of 1,000 consecutive diphtheria deaths 
conducted by the staff of this Department a few years ago is prob- 
ably the clearest proof on record of the futility of ever expecting that 
all cases would be reached in the early stage. For a time it seemed 
almost as if we were beaten and a permanent death toll from this 
most controllable of all epidemic diseases of from 600 to 800 young 
children yearly in this Commonwealth must be anticipated indefi- 
nitely, this condition being due to the impossibihty of parents and, 
to a lesser degree, of physicians discriminating sufficiently early be- 
tween the numerous milder inflammatory involvements of the throat 
and the malignant diphtheritic inflammation. 

Due to the researches of Dr. Schick of Vienna, a few years ago an 
extremely simple, painless and harmless procedure was discovered by 
which in the hands of an experienced observer the susceptibility of 
any individual to diphtheria can be determined with great precision. 
Along with this came the introduction of a safe and simple method for 
the active artificial immunization against diphtheria of those found 
to be susceptible. This immunity is certainly of several years' dura- 
tion and in many, perhaps most, instances is probably retained for life. 
This year under the stimulation of the staff of this Department 
many cities and towns are putting into effect active campaigns for 
popularizing this method of diphtheria prevention. The task of de- 
termining the susceptibility of each child whose parents can be 
persuaded to see the advantage of this procedure and, if found sus- 
ceptible, of carrying out immunization, is a huge undertaking. Never- 
theless with the certainty that its universal application would mean 
the practical elimination of diphtheria as a cause of sickness and death, 
local health officials and the medical and nursing professions generally 
are all over the State urging the adoption of the plan. I confidently 
predict that within the next five years we will witness a spectacular 
reduction in our diphtheria problems as the result of increasing utiliza- 
tion of the Schick test and toxin-antitoxin immunization of sus- 

ceptibles. -j ,.• 

The third disease I wish to present for your special consideration is 

tuberculosis. u-u-+- 

Tuberculosis of the lungs, or consumption, is at present exhibiting 
an unprecedented and highly gratifying decline in fatality. In the 
annual report for last year this phenomenon was discussed, therefore 
I will not go into the matter extensively again. It is important, how- 
ever to call to your attention that whereas a year ago I estimated 
that' our 1920 death rate per 100,000 of population would not exceed 
100, that as a matter of fact when the figures for the year were avail- 
able it fell substantially below that figure, the rate being 96.7. 



No. 34.] ANNUAL REPORT. 11 

The really amazing feature of this year has been the steady pro- 
gression of this decline at substantially the same curve of recession as 
last year. It now seems very safe to estimate that the total number 
of deaths from this cause for the entire State in 1921 will not exceed 
3,300, which is at the rate of approximately 85 deaths per 100,000, a 
reduction of 38 per cent since 1918. The reasons for this remarkable 
decline are complex and not all due to direct anti-tuberculosis ac- 
tivity. We must expect years when the rate will be stationary, other 
years when it will increase, but, on the whole, the conclusion seems 
most justifiable that the battle against consumption is entering upon 
a phase of great and permanent gains. 

Venereal Diseases. 

The experience of the past year in venereal disease work has been 
peculiarly trying but at the same time most illuminating. It has 
been trying because the cessation of the Federal funds for the further- 
ance of venereal disease work in the several States necessitated the 
cutting down of our program and the reducing of essential personnel 
in a field where there existed every reason from a public health stand- 
point to desire expansion of program and additions to personnel. It 
has also been illuminating because it has demonstrated how deep and 
genuine the interest is in this campaign, and that our method of at- 
tack upon the problem was along sound lines. 

The attendance at clinics is increasing in a sound, substantial fashion 
at nearly all the newer clinic centers; the demand for arsphenamine 
for syphilitic treatment has increased steadily, although still only a 
fraction of the total possible utilization; the medical staffs of the 
various clinics have continued to manifest the same enthusiastic in- 
terest in their work as formerly; and there have begun to come to the 
notice of health departments opinions from specialists, general prac- 
titioners, institutional workers and others to the effect that the venereal 
disease campaign of education and early treatment has already begun 
to take effect; that infections are apparently less frequent and in- 
fected persons are seeking pToper advice and treatment much earlier 
and following treatment more thoroughly. All of these reports are 
encouraging, but should not blind us for a moment to the fact that 
the problem is still a tremendous one and that we have no more than 
made a fair beginning. 

In offset to these optimistic reports, the workers of the Massa- 
chusetts Charitable Eye and Ear Infirmary report that children with 
eye manifestations of congenital syphilis are coming to the notice of 
their clinic in larger numbers than ever before. 

The temptation is strong at this point to cite and discuss briefly 



12 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

the statistics on venereal disease work, but to do so would lead to too 
great amplification of this report. 

Suffice to say that the crying need above all others in the further- 
ance of the venereal disease campaign is for more follow-up workers to 
discover fresh foci of infection from the evidence readily available in 
the routine reports of clinics and physicians, to get these persons 
under treatment for their own benefit and the protection of the public 
health, and to see that those individuals once seeking treatment per- 
sist until permanent benefit is assured. This last is the most pressing 
and most difficult of all the many problems involved in the venereal 
disease and sex hygiene campaign. 

Institutions. 

Here the most outstanding feature of the year has been the per- 
manent closure of the leprosarium on Penikese Island, following the 
transference of the inmates to the new Federal leprosarium at Car- 
ville, La. The inmates will receive the definite advantages of resi- 
dence in a warmer climate, of being members of a much larger leprous 
community, with all the advantages of greater social opportunities that 
this means, and of being placed where they can receive the advantage 
of every advance in the treatment of the disease to an even greater 
extent than could possibly be done for them with the relatively small 
personnel at Penikese. By legislative resolve the Commissioner of Pub- 
lic Health and the State Supervisor of Administration were designated 
a special board for disposing of the property. The island has been 
advertised for sale and bids received for its purchase, but all such bids 
up to the present have been so far below the actual investment by the 
Commonwealth in the institution that it did not seem wise to accept; 
therefore, for the present, the island is left in the charge of a care- 
taker, awaiting some permanent disposal by sale or otherwise that 
will seem to give some appreciable return either financially or in use- 
fulness to the Commonwealth. 

The work of the four tuberculosis sanatoria under the direction of 
this Department has gone along usual hues during the past year. 
One gratifying feature has been the noticeable increase in efficiency 
of these institutions as the year progressed, due to the greater will- 
ingness of institutional employees to remain and do faithful work. 
This result has been of course due principally to the industrial depres- 
sion, which in turn resulted in a cessation of the constant drawing 
away from institutional positions of employees through the higher 
wage standard prevaiHng in industry. In a similar manner there is 
no doubt that the fiUing of our institutions and re-estabhshment of 



No. 34.] ANNUAL REPORT. 13 

waiting lists for both sexes (except for males in one sanatorium), fol- 
lowing the experience of empty beds in all of them for the past few 
years, is due to financial depression plus more energetic community 
tuberculosis work than ever before. This has occurred in spite of 
substantial addition to total tuberculosis bed capacity in the State 
as a whole by the completion and opening of new county and mu- 
nicipal institutions or additions to existing institutions. 

At first glance this condition might be presumed to indicate an in- 
crease in prevalence of consumption. Practically all evidence points 
to the contrary. Aside from the impressive evidence of the lowered 
death rate, all the testimony of case workers on tuberculosis, tubercu- 
losis specialists and others indicates a decrease in morbidity rather 
than the contrary. There have always been many more persons 
suffering from pulmonary tuberculosis who would be personally bene- 
fited and whose families would be greatly protected by their residence 
in a sanatorium or tuberculosis hospital than there are patients in 
sanatoria. But in time of great industrial activity with workers at 
a premium, hundreds of tuberculous persons will refuse to give up 
work, whereas in times of financial depression it is relatively easy to 
persuade such sufferers to take advantage of sanatorium treatment. 

Too high praise cannot be given to the spirit of enthusiasm with 
which the superintendents and the members of their staff have sug- 
gested methods of increasing the medical influence of these institutions. 
The consultation service, which was referred to in my last report, 
has worked out on the whole exceedingly well. It has meant long 
hours, exposure and hard work for our institutional staffs without any 
additional pecuniary reward. But it has also meant that in a steadily 
increasing number of instances they have been able to diagnose and 
to personally assist in the prompt admission to a sanatorium of in- 
dividuals whose lung process is still relatively early and hence with a 
much greater chance for good recovery, and in the satisfaction of this 
service for fellow humanity they have had their highest reward. 

Reference has already been made to the sudden death during this 
past year of the well-beloved Director of our Tuberculosis Division, 
Dr. William J. Gallivan. Dr. Sumner H. Remick, for the past eight 
years superintendent of the Sassequin Sanatorium of New Bedford, 
succeeded Dr. Gallivan, commencing his duties with the Department 
on Dec. 1, 1921. He is taking up the arduous duties of his new posi- 
tion with tact and enthusiasm that speak well for the future progress 
of this great field of the Department's activities. 



14 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Plague Problems. 

This subject was dealt with in some detail in the previous annual 
report and reasons given why it was deemed advisable to recommend 
special action by the Legislature to carry out, in co-operation with the 
several municipalities, a rodent survey of the various ports of the 
State. The Legislature appropriated a sum of money at the special 
session of 1920 to enable a preliminary survey and report based 
thereon to be submitted at the regular session of the 1921 Legislature. 

The matter was presented carefully, and this Department, backed 
strongly by the Boston Chamber of Commerce and other civic or- 
ganizations, and city departments of health, recommended that an 
additional sum of money be appropriated for this purpose, pointing 
out that such work was purely preventive and not based upon any 
existing evidence that the rats of our ports were already infected. 
This project was reported favorably by the ways and means com- 
mittee of the House and passed that body, but on being referred to 
the. Senate was rejected apparently on the grounds that the danger 
was no more imminent than for several previous years, and that in the 
last analysis it was a responsibility resting primarily upon the Federal 
and municipal governments. In view of this attitude there do not 
seem to be any new grounds for urging passage of this appropriation 
beyond those already presented to the same Legislature in its last 
session, and therefore no legislative recommendation for this coming 
year will be made. 

OiL-KEFINING INDUSTRY PROBLEMS. 

During the past year a new public health and nuisance problem of 
the first magnitude has come to the front in this State. This situ- 
ation has arisen from the putting into operation of three new large 

oil-refining plants. 

These refineries use Mexican crude oil exclusively, which is brought 
directly to the refineries in tank vessels. These Mexican oils contain 
considerable quantities of sulphur and sulphur compounds, and the 
nuisance features have arisen from odors which are due principally to 
the escape into the atmosphere of sulphur in various forms. There 
have also been shore and beach nuisances due to the accidental escape 
of crude oil or partially refined oil products directly into the water, or 
reaching it by leakage from underground oil conduits. In numerous 
instances, however, it has been clearly demonstrated that oil on the 
water of harbors or deposited on beaches has come in large part not 
from the oil works but from deliberate or accidental discharge of such 
oil by oil-carrying or oil-burning vessels. At all events the situation 



No. 34.] ANNUAL REPORT. 15 

created has been one of peculiar difficulty. On the one hand is the 
undeniable benefit to all New England from the establishment of 
these plants. This is due to the fact that these companies could for 
the first time lay down gasoline, fuel oil, lubricating oil and other oil 
products and by-products in the New England market at prices which 
allowed this section to compete upon more equal terms with those 
sections nearer to this country's sources of crude oil. Furthermore, 
the availability of fuel oil for purposes of heat and power alike means 
much to a region which has passed through the recurring coal famine 
crises of the past few years. 

To offset these great advantages, however, it is intolerable and not 
to be thought of that any industry, however important and desirable, 
should operate in such a fashion as to seriously jeopardize the health, 
comfort or even jesthetic enjoyment of hundreds of our citizens. There 
seemed to be relatively little expert knowledge or previous experience 
to guide either sanitarians or oil-refining managements as to the 
chemical nature of these obnoxious odors, the points in the various 
refining processes which are most responsible for the dissemination of 
these odors, the best means of eliminating or overcoming these odors, 
and the mechanical engineering devices necessary to accomplish this 
result. Added to this is the fact that in the case of the plant concern- 
ing which there has been the most serious complaint, complete changes 
in the financial and operating organizations took place during the 
year, all of which has made progress difficult. 

The Department, upon a petition properly presented in accordance 
with statute by citizens affected, held public hearings, made careful 
investigations through its own engineering staff, coupled with personal 
inspections by the members of the Council of the Department, and 
made a finding sustaining the allegations of the petitioners. It was 
found that the plant as then conducted constituted an offensive trade 
so operated as to produce a serious public nuisance, and the Depart- 
ment therefore ordered the closing of the plant. The new manage- 
ment referred to petitioned for a suspension of this order pending the 
installation and a test of new devices, changes in methods of operation 
and structural repairs and improvements which they believed would 
overcome the obnoxious features of their operations. This was 
granted, but owing to the apparent grave lack of definite engineering 
knowledge as to how to eliminate and overcome those odors, and un- 
certainty as to the points in the processes that were chiefly responsible 
for the obnoxious conditions complained of, very slow and unsatis- 
factory progress was made. 

Public sentiment in the communities adjacent to the works, which 
in the beginning was very much in favor of retaining the industry and 



16 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

inclined to put up with disagreeable odors in the hope of their early 
elimination, became definitely out of patience as the summer pro- 
gressed, and new hearings were demanded and held in which the 
majority of the protestants seemed to insist upon complete and im- 
mediate closure of the plant. While sympathizing deeply with the 
citizens affected thereby it did not appear to the Department that the 
situation was so hopeless of correction as to justify ordering the com- 
plete, and probably permanent, shut down of a plant representing the 
investment of several millions of dollars and the beginning of an in- 
dustry of incalculable benefit to all New England, the source of live- 
lihood for several hundreds in a time of financial depression, and by 
that time in the hands of a management who gave evidence of a sin- 
cere intent to co-operate by putting into effect every improvement 
from which it seemed probable that any benefit might be obtained. 

Nevertheless, as the season wore on into autumn and complaints 
of the most vigorous character relative to odors emanating from the 
plant persisted, this Department became convinced that more radical 
changes were necessary, and in this view the management of the plant 
finally concurred. 

By this time it was quite generally agreed by all concerned that 
defects in the original construction of a very essential part of the 
equipment known as the "coking stills" accounted for escape of some 
of the most serious odors, and accordingly the Department on Oct. 11, 
1921, ordered this part of the works to be shut down until recon- 
structed and completely equipped with a system for carrying all 
odors generated in this process into furnaces maintained at high enough 
temperature to insure the complete breaking up of these odors. This 
work has just been completed, and the company has petitioned for 
revocation of the order of closure. Revocation did not seem war- 
ranted to the Department until a further trial of these devices over a 
sufficient period of time with the plant in full operation demonstrates 
to how great a degree this serious problem has been solved. 

All the staff and members of this Department concerned with these 
problems are convinced that these questions are still far from being 
completely and satisfactorily solved even though great improvement is 
demonstrated in this plant. Although the operations of only one of the 
three oil-refining plants in the State have been brought to the official 
cognizance of this Department by formal petition, complaints have 
been numerous concerning the other two plants; and in the case of 
one other at least, preliminary steps have been taken by aggrieved 
citizens living adjacent thereto to bring the question of possible 
nuisance through the operation of the plant before the Department 
for adjudication and action. Numerous complaints have come to our 



No. 34.] ANNUAL REPORT. 17 

attention from citizens of this Commonwealth relative to the noxious 
odors emanating from a refinery of similar character operating in 
another State closely adjacent to the State line. I have already with 
your advice and approval incorporated in the estimates of the Division 
of Sanitary Engineering for the ensuing year requests for additional 
funds to enable this Department to carry on further studies and in- 
vestigations of this subject. 

Furthermore analyses of the "flue gases" from furnaces using fuel 
oil from Mexican sources show a percentage of sulphur compounds 
thrown off which with the increasing use of fuel oil may and in fact 
very probably will unfavorably affect in time the chemical content of 
the atmosphere of large cities and centers of industry generally. 

It is important that thorough-going chemical research on this prob- 
lem be undertaken by this Department at once and carried through 
a series of years; and as soon as it appears that the question of 
atmospheric pollution is one which will lead to serious economic and 
public health considerations, to also begin to carry out in collabora- 
tion with industry and our technical schools researches for the most 
efficient and economical methods of preventing or overcoming such 
detrimental results of modern industrial progress. 

Plumbing Report. 

At the beginning of this year legislation was submitted for the 
purpose of rendering more uniform and more simple the regulations, 
restrictions and specifications governing plumbing installation in the 
various cities and towns now operating under plumbing regulations. 
It was also hoped that this legislation would, by providing for certain 
simple minimum requirements applicable throughout the State, greatly 
improve the standards of plumbing efficiency in the numerous small 
towns which at present have no system whatever of plumbing regula- 
tion or plumbing inspection. 

This legislation was opposed by some on the basis of its being an 
invasion of local rights and by others on grounds which were not clear 
or easily to be understood. The Legislature postponed consideration 
of the measure until the present session. I then requested the Special 
Plumbing Board appointed by this Department to continue its studies, 
with a view to further perfecting proposed legislation looking towards 
a simplified and improved plumbing code for introduction at this 
session. 

In the meantime the Federal Department of Commerce, under the 
leadership of Mr. Hoover, has taken up and is making a thorough 
study of this problem, and the Plumbing Board of this Department 



18 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

feels that great and far-reaching improvements in American plumbing 
procedure are likely to result from this investigation. Therefore the 
Board has recommended that the plumbing regulations now m use m 
this Commonwealth be left undisturbed until the conclusion of the 
Federal studies. In this recommendation I strongly concur. 

Water Supply Problemb. 
There seems to be no occasion for any detailed reference to these 
questions in this report, inasmuch as the special report on this subject 
of the Joint Board composed of this Department and the Metropolitan 
District Commission will soon be filed with the Legislature. 

Problems or Hygiene. 
In contrast to lines of health work wherein control of infection by 
combined police power and group restriction methods, or control of 
environment by sanitation of public necessities and utilities, or assur- 
ance of safe and pure food supply take a prominent place, the newer 
aspects of health work centering upon the individual, wherem the 
building up of stronger and- more vigorous physique from prenatal 
existence to old age is the great aim sought, loom larger each year 
Everywhere the conviction that "health pays" is growing. ^ With 
the growth of this sentiment there is an increased interest in the 
mechanisms by which the doctrines of hygiene are to be spread. In- 
creasing appreciation of the fact that all these measures are essentially 
educational and that childhood is the period of life m which the m- 
dividual can best learn and put into practical application the prin- 
ciples of personal hygiene is resulting inevitably in a closer and closer 
rapprochement between health and educational authorities which is 
greatly to be desired. 

Maternity Benefits. 
For the past three years in this State one aspect of hygiene has 
been prominently brought to the front by the legislative discussions 
and debates over so-called "maternity benefit" proposals. 

There has always been very wide divergence of view as to what was 
meant by this term in the minds of various groups and individuals. 
So far as this Department is concerned, I think there has never been 
any material change of viewpoint. The great objective sought by the 
Department always has been more effective and intelligent trammg 
in the duties of motherhood and child care. , i, j 

The chief means advocated have been always educational methods 
reaching directly to the mothers of the Commonwealth. 



No. 34.] ANNUAL REPORT. 19 

The agency, aside from printers' ink, which has seemed to this De- 
partment always most promising for accomplishing these results is the 
public health nurse. 

We have advocated such degree of direct bedside and household 
nursing service by these public health nurses as would be a necessary 
incidental to such training of housewives in the principle of infant and 
maternal hygiene, or as might be necessary to supply imperatively 
needed nursing assistance for which no other nursing agency was 
available. But we have never stood for the principle of the State re- 
placing by either cash or trained personnel the bedside nursing serv- 
ices of our local communities, or for the principle of the State taking 
over the moral responsibility of each community to care for its own 
needs in these directions. 

The fact that two successive Legislatures debated these proposals, 
with the second one having before it the specific and unanimous rec- 
ommendations of a special recess commission, with no definite legis- 
lative action resulting, shows that there is as yet no clearly defined 
public opinion on the subject. A committee of this Council has re- 
cently reported on this subject in substance as follows: — 

1. The discussion has brought out clearly that certain groups of our citizens 
are opposed to the fundamental principle of Federal or State "benefits," whether 
these take the form of cash payments to mothers or free medical or nursing 
service. 

2. It does not appear that there is any considerable group opposing the pro- 
posal to more extensively carry out a campaign of hygienic education designed 
to meet the needs of mothers and prospective mothers. 

3. There has been far from general acceptance among the medical profession 
in regard to the interpretation of the findings of the Commission, and to a 
lesser extent the validity of the statistics accepted and reported by the Com- 
mission has been questioned. It may be added that the Special Recess Com- 
mission on Maternity Benefits itself very strongly emphasized the difficulty of 
getting at all the facts bearing on the question, and regretted that the time 
and funds at their disposal made the series of cases directl}^ investigated and 
reported all too brief. 

In view of these facts and inasmuch as the passage of the so-called 
Sheppard-Towner act by Congress has made available, if the contin- 
gent financial requirements are met by the State, a sufficient sum of 
money to enable very extensive educational investigation and re- 
search work to be carried out in the fields of maternal and infant 
hygiene for the five-year period which the act covers, this Department 
has definitely recommended that the Massachusetts General Court 
accept the provisions of this Federal legislation rather than press for 



20 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

an immediate enactment of the much farther reaching recommenda- 
tions of the Massachusetts Special Commission on Maternity Benefits. 

This so-called Federal Sheppard-Towner act appropriates for a period 
limited to five years certain sums of money — $1,480,000 for the first 
and $1,240,000 for the four following years — to be distributed among 
the several States for the purposes of this act, subject to certain con- 
ditions. Most important of these conditions are: (1) that each State 
must by legislative action accept the act, and (2) must appropriate 
equal amounts to the amounts due the State by Federal allotment, 
after certain initial outright grants for organization purposes have 
been deducted for which no matching is required. The conditions of 
allotment have been very ingeniously fixed in such fashion as to guar- 
antee to each State a substantial sum regardless of population, and 
beyond this point allotments are upon a basis of the ratio which the 
population of the State bears to the total population of continental 
United States. For Massachusetts the amounts due from the Federal 
funds will be approximately $41,000 for the first year and $36,000 
thereafter. 

It must be clearly recognized that the amounts of money made avail- 
able from the Federal and State sources together will be entirely in- 
sufficient to carry out any State-wide assistance by furnishing bedside 
care to mothers and infants by an extension of our present voluntary 
privately financed district nursing systems, which was the essence of 
the Special Commission's plan. Obviously, these sums of money from 
Federal sources would be so minute a fraction of the total necessary 
for carrying out the plans proposed for cash payments to needy 
mothers that it does not seem likely that any one will argue that such 
type of legislation is made easier financially for Massachusetts on ac- 
count of this Federal legislation. 

Other Problems of Hygiene. 
Aside from the special field of maternal and infant hygiene this 
Department has been keenly awake to its opportunities and duties in 
other phases of hygiene during the past year. 

1. In the matter of general health education by the exhibit method, 
the Department has consistently followed out the policy of taking its 
exhibit only to communities where a concrete demand existed for an 
advance step in community service in some aspect of hygiene. Our 
funds and personnel for this type of work are exceedingly limited in 
comparison to the total expenditures of this Department, but never- 
theless the exhibit has been shown in over a score of communities 
with definite tangible results following in nearly all instances. 

2. Nutrition Work. — Here the Department's work has been, I be- 



No. 34.] ANNUAL REPORT. 21 

Heve, of particular value. Unfortunately, with only one expert 
worker available, we cannot begin to meet the demands for instruc- 
tion. There is no phase of our work which I feel needs expansion so 
much as our nutrition work. Numerous special projects of great 
possible significance cannot be carried out because of the inability of 
one worker to cover the field. 

How deep the relationship is between faulty nutrition in early life 
and the multitude of ailments and infirmities of the flesh that man is 
heir to in later life we are just beginning to comprehend dimly. 

The problem in such a portion of the world as the United States is 
still further complicated by the fact that so many very intelligent, 
well-informed people have but one conception of malnutrition, that it 
means quantitative insufficiency of food or partial starvation, and 
hence resent the idea that malnutrition is a problem of American 
families generally, not realizing it is not a question of "how much" 
but a question of "what kind" and "how balanced" that determines 
whether child or adult is obtaining proper nutrition. 

The implications of the possible degree of relationship between 
faulty childhood nutrition and subsequent tuberculous development 
are so great that I for one do not feel justified in accepting in its en- 
tirety this relationship as definitely proved, but certainly the respon- 
sibility for correcting faulty nutrition in children as a possible, even a 
probable, means of preventing adult tuberculosis is now so great that 
from this angle alone I feel we ought to have much greater personnel 
at work on the nutrition problem. 

3. Dental Hygiene. — Closely pressing nutrition for first place among 
the problems of personal hygiene, and most intimately associated with 
nutrition, comes dental or mouth hygiene. The extent of the prob- 
lems of faulty teeth is almost staggering. Such facts as surveys of 
typical Massachusetts towns showing an average of seven cavities per 
mouth for all the school children are needed to inake us comprehend 
it. The fact that our high sugar content and otherwise wrongly bal- 
anced, predominantly soft food dietaries are rapidly increasing sus- 
ceptibility to dental decay among our children, and that proper dental 
habits plus intelligent nutrition habits can in many cases prevent any 
dental decay occurring in the average child, shows the direct relation- 
ship of the hygiene of nutrition to mouth hygiene. 

The entire dental profession is wide awake as to the significance of 
and tremendous increase in interest in this question. Their co-opera- 
tion with this Department has been most hearty and inspiring. They 
show us the facts in unmistakable language. It is up to the Amer- 
ican public to take action. If dental decay meant at the worst 
simply gradual loss of teeth and substitution of false teeth, the prob- 



22 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

lem would be serious enough. But we know that the local effects of 
toothache, tooth decay and tooth loss are of minor significance com- 
pared to the far-reaching, irreparable bad results in relation to the 
development of the entire body that follow from tooth decay in child- 
hood, and the frequent general disease complications of serious nature 
associated with focal infections in the teeth and teeth pockets of the 
jaw in adult life. 

To touch upon the brighter side of the picture, however, I wish to 
call to your special attention that part of the report of the Division 
of Hygiene which tells how great is the expansion of community ef- 
fort throughout the State to meet the demands of the mouth hygiene 
problem. 

4. School hygiene, the cancer problem, the midwife question, ex- 
pansion of public health nursing service and many other problems of 
hygiene are being carefully studied by our Division of Hygiene, but 
to do justice to them all would lead us too far afield for a report of 
this character. 

5. I wish to call to your attention the remarkable interest shown 
in the series of round table conferences on health work which this 
Department has recently held. In this series of meetings originally 
planned for six afternoons, an attempt was made to bring out some 
of the most salient features of modern public health problems. The 
list was not exhaustive. Great subjects such as sanitary engineering 
and pure food, which occupy much of the Department's attention and 
resources, were not even touched upon. 

The attendance was largely of a representative nature. Many 
women's organizations sent representatives whose instructions were to 
attend in order to more intelligently explain to their fellow members 
what the aims and objectives of health workers in general and of this 
Department in particidar really were. By request, two supplemental 
conferences were held devoted particularly to nutrition, dental hy- 
giene and methods of public health education. The question arises 
whether meetings of similar character ought not to become an annual 
feature of the Department's work. 

6. Mental Hygicrie. — Finally, I wish to present for your considera- 
tion the question of whether the time is not nearly at hand when we 
should seriously address ourselves to the problem of mental hygiene, 
although I am not prepared at present to make any definite recom- 
mendations in reference to this subject. 

As to the pressing need of more attention being paid to it there can 
be no debate. The bald statement that at present one out of every 
twenty odd deaths occurring in this Commonwealth is among in- 
mates of our mental hospitals tells the whole story. Nor is there any 



No. 34.] ANNUAL REPORT. 23 

reason to doubt that preventive principles applied to the problems of 
mental life will bear fruit as certainly as they do in the field of phy- 
sical hygiene. The problem of mental hygiene is unquestionably 
closely bound up with the problem of school hygiene. The uncertain 
factors are such matters as methods of approach and the working 
technique to be employed. 

There is already a most vigorous voluntary organization, the Massa- 
chusetts Mental Hygiene Association, actively attacking the problem 
of insanity prevention and mental hygiene in general. It needs and 
greatly deserves much stronger financial and moral support from our 
citizens. 

The State Department of Mental Diseases has been established 
principally for the management of the mental hospitals. Its principal 
job hitherto has consisted in taking care, as it were, of the wasted 
mental by-products of a civilization of high-nerve tension which has 
never worked out any adequate provision for mental hygiene. 

Nevertheless, that Department by its admirably conceived mental 
clinics held throughout the State has already taken an important step 
in the direction of prevention, although naturally patients seeking 
these clinics are in large measure interested in the subject from the 
pathological side rather than from the purely mental hygiene aspect. 

Like all other forms of hygiene, mental hygiene must be an ag- 
gressive beneficent force if it is to reach its full possibilities. Its 
principles must be brought to bear upon the mental life of every 
person and early in life, rather than to be reserved for that group in 
whom symptoms of mental stress or instability are already observable. 

It is my understanding that at present the Massachusetts Depart- 
ment of Mental Diseases is in much the same situation with reference 
to mental hygiene as we find ourselves in this Department. They are 
earnestly advocating greater attention to this question as a challenging 
problem to our body politic, but are by no means certain just how 
the Commonwealth can best attack the question. 

It therefore looks as if both departments must seriously consider 
the matter and endeavor to determine, by joint consideration, if it 
seems desirable, which department seems most logically the official 
agency of the Commonwealth that ought to develop the possibilities 
of the subject. 

It is by no means certain that further study may not lead to other 
conclusions. It may be that the whole matter might be best devel- 
oped by the voluntary society already referred to, or by the Depart- 
ment of Mental Diseases, but surely some body ought to be getting 
at the problem and that without undue longer delay. 



24 DEPAETMENT OF PUBLIC HEALTH. [Pub. Doc. 



Legislative Recommendations. 

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

1. An act accepting the provisions of an act of Congress relative to the pro- 
motion of the welfare and hygiene of maternity and infancy and for other pur- 
poses and providing for co-operation with the Federal government. 

2. An act relative to the analysis of liquor by the Department of Public 
Health. 

3. An act relative to the publication of certain information by the Depart- 
ment of Pubhc Health. 

4. An act relative to the examination of vinegar. 

5. An act relative to the purchase of land in Westfield. 

6. A resolve relative to the reappropriation of certain funds to be used in 
connection with the work of the sanitary improvement of the Neponset River. 



Division of Administration. 

The work of this Division has followed much the same lines as 
previous years. 

In the matter of personnel, it is necessary to record the deeply re- 
gretted retirement, due to ill health, of one of the best known and 
most universally respected employees of the Department, Miss Sarah 
E. LeMaster, for many years bookkeeper to the Department. 

Miss Helen G. Condon, who had been for several years assistant 
bookkeeper, was promoted to the position thus made vacant. 

It was decided to make no changes in the matter of institutional 
accounting following the transfer of the tuberculosis sanatoria and the 
Leper Hospital to this Department in December, 1919. But, never- 
theless, the increased administrative routine in such matters as appli- 
cations for appointment, civil service requirements, discharge notices, 
etc., has added very materially to the pressure of work always too 
great for the amount of personnel employed in this Division. The 
time is rapidly approaching when, in spite of all efforts at economy in 
administration and in spite of the policy of decentralizing routine 
administrative matters to the respective divisions of the Department, 
it will not be possible for the present system to keep up with the 
ever-increasing load of administrative obligations falling upon this 
Division. 

At present, as for all previous years since the Department was or- 
ganized, the secretary to the Commissioner, who is also secretary to 
the Public Health Council, to a large degree performs the duties of a 



No. 34.] ANNUAL REPORT. 25 

director of the Division of Administration as well; but with the con- 
stantly expanding duties and organization of the Department, the 
triple load is rapidly becoming entirely too heavy for one individual 
to carry. 

Division of Sanitary Engineering. 

The total number of applications for advice with reference to water 
supply, drainage and sewerage received by this Division during the 
year was 216, an increase of 40 per cent over the highest year since 
1915. For a number of years during and since the war water works 
and sewerage construction has been extremely limited because of the 
high cost of labor and materials, but the past year has shown an in- 
creased activity in this line of work. 

The rainfall for the year was about the average throughout the 
State as a whole, but an excessive rainfall in the summer aided in pre- 
venting a shortage of water in many places where difficulty in obtain- 
ing an adequate water supply would no doubt have been experienced 
during the year. As it was, the short period of low rainfall extending 
from August to October, inclusive, depleted some of the sources which 
are being used in excess of their capacity. A high summer rainfall 
has also had a good effect in aiding the maintenance of satisfactory 
sanitary conditions in the streams, though the amount of waste dis- 
charged into the inland waters of the State during the year has been 
less than usual on account of the business depression. In consequence 
of these conditions, little complaint has been made of the pollution of 
streams during the year. 

The Department through this Division has made return to the 
Treasurer of the Commonwealth and to the Board of Assessors of 
each of the municipalities mentioned in chapter 655 of the Acts of the 
year 1911, entitled "An Act relative to the Protection of the Public 
Health in the Valley of the Neponset River," and acts in addition 
thereto, of schedules and plans showing the parcels of land which it 
finds to have been benefited by the work done or changes made under 
that legislation. The Department has also made application to the 
Supreme Judicial Court, in accordance with the law requesting the 
court to appoint three commissioners to determine what proportion of 
one-half of the total expense incurred under the acts above referred to 
shall be paid by the various municipalities mentioned in said chapter 
655, and the commissioners have been appointed by the court. 

A large amount of work has been required of the Division during the 
year in the investigation of complaints of offensive odors from oil re- 
fineries and of the pollution of adjacent waters by oil escaping there- 
from. These complaints have been widespread, and thorough investi- 



26 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

gations have been made so far as practicable to determine the sources 
of the odors and the means of prevention. Changes have been made 
and apphances provided to prevent the escape of odor and oil at each 
of the refineries, and a material improvement has been effected m the 
control of the more objectionable odors; but much remains to be done, 
and a further study of the problem is needed in order to devise ade- 
quate means of preventing objectionable conditions complamed of 
about these refineries and of preventing the escape of oil which pol- 
lutes adjacent waters. 

The special investigation of water supply needs and resources has 
been prosecuted during the year, and the results will be presented m a 
separate report jointly with the MetropoHtan District Commission. 

Division or Water and Sewage Laboratories. 

During the year 1921 the Division of Water and Sewage Laboratories 
made 7,600 chemical, 2,750 bacterial and 2,270 microscopical analyses 
of water, sewage, filter effluents, etc. 

A large part of the work was done to determine the quahty of the 
public water supplies and of the effluents of filters treating or purify- 
ing public water supplies, the condition of the rivers, the character of 
the sewage entering rivers or passing to filtration areas, the degree of 
purification obtained at these areas, the character of factory wastes, 
and the quality of the effluents from filters receiving factory wastes, 

etc. ■ 

Other work was done calling for special determinations of lead, 
manganese, carbonic acid, etc., in connection with corrosion, ground 
water supplies and similar subjects, and a large number of analyses 
made of spring waters, water from domestic wells, ice supplies, etc. 

Considerable analytical and bacterial work was carried on to de- 
termine the quality of shellfish from different areas of the State and 
also the condition of the waters over these areas. 

Many investigations were made along the lines usually covered by 
this Division in regard to methods for the disposal of wastes and 
sewage, and an especially interesting and important investigation was 
made in regard to the wastes from twenty-four tanneries, leather 
works, glue works, gelatin works, etc. These wastes, after some pre- 
liminary treatment in settling tanks, etc., enter and badly clog the 
Salem-Peabody sewers. 

Wastes and odors from rubber factories and from the large oil dis- 
tilleries now in operation in the State, the odors and wastes from 
which appear to be a serious cause of trouble, were investigated. 

Special studies were made of methods for the treatment and dis- 



No. 34.] ANNUAL REPORT. 27 

posal of sewage, of the condition and efficiency of certain municipal 
sewage disposal areas, of the efficiency of small septic tanks for 
houses, factories, etc., and of many general questions in regard to the 
disposal of sewage by trickling filters, by aeration and activated sludge 
and similar tanks, etc. 

Purification of water by means of chemical coagulants and rapid 
sand filtration has, because of new questions arising during the past 
two years concerning this method and the results obtained by it, ac- 
quired new importance, and hence more complete studies are being 
carried on by us at Lawrence than ever before and with better equip- 
ment than before available. As the question of utilizing the waters 
of the more or less polluted rivers of the eastern portion of the State 
for the domestic water supply of this portion after filtration has been 
agitated and urged by certain people in connection with the investi- 
gation of the water supply needs and resources of the State, a study of 
the results that can be obtained by various treatments of such waters 
is being made in order to accumulate new and reliable data. 

Besides those studies already enumerated, many special chemical 
and bacterial studies were made during the year, both upon laboratory 
methods and technique and upon questions submitted to this Division 
for explanation. 

Division of Communicable Diseases. 

There have been no outbreaks of any great magnitude during the 
year save one of typhoid fever, with 129 cases and 7 deaths, which oc- 
curred in Waltham, and which, although not definitely proved, appears 
to have been transmitted by milk. The continued high incidence of 
typhoid fever in Adams (23 cases from July 27 to November 14) called 
for an intensive investigation. It was discovered that the drinking 
water had become contaminated by a faulty system which utilizes 
the river water for washing and mill purposes and the town supply for 
drinking. Since correction, no further cases have been reported save 
a few resulting from contact. Milford had a small outbreak of 14 
cases, all of which occurred upon one milk route. No carrier was found, 
and the conclusions of our investigation appear to point to the pos- 
sibility of transmission through the return of infected milk bottles. 

The sudden increase in the reported incidence of anterior poliomy- 
elitis in July and August caused a grea/t deal of apprehension lest we 
were to experience an outbreak simflar to that of 1916. The peak of 
this increased prevalence was quickly reached and reporting quickly 
subsided. In no community did it appear to be epidemic save at a 
boys' camp in Becket. Here 75 boys became suddenly ill with acute 



28 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

gastrointestinal symptoms, but within a few days all recovered. 
Within the next fourteen days 6 cases developed in the camp, all of 
which proved to be true cases of anterior, poliomyelitis. Careful in- 
vestigation failed to bring to light any new facts as to the transmission 
or etiology. 

The high incidence of diphtheria has also caused much concern. It 
has appeared in unusual amounts in every large city of the State. 
We are not certain whether this increase is an actual one or whether 
the increased interest in diphtheria prompts more laboratory ex- 
aminations to be made of suspicious throats, and the subsequent better 
reporting of the condition accounts for the unusual amount of diph- 
theria officially recorded. One favorable comment, however, may be 
made, and it is that for the first time in our history our fatality rate 
is below 7. This is of course indicative of the results that are to be 
obtained by the increasing use of the diagnostic laboratory and of the 
earlier treatment that will of necessity be instituted. Much of our 
effort of the past few years among physicians and the laity has been 
to introduce and to popularize the use of the Schick test for the de- 
tection of those susceptible to infection from exposure to diphtheria, 
with subsequent immunization with the toxin-antitoxin mixture where 
it may be indicated. Results of this educational work are now ap- 
parent. Here and there in all sections of the State are springing up 
clinics where school children may have this test applied if their parents 
so desire. The school department of the city of Boston, the Evans 
Memorial Out-Patient Department in Boston, Lynn, Newton, Hing- 
ham, Clinton, W'altham, Brockton and Cambridge are actually main- 
taining free Schick clinics or performing the Schick test at school 
clinics. Several of our State and municipal hospitals have adopted 
this procedure as a routine measure. Special lectures to medical 
societies and hospital groups with demonstration of procedure, together 
with interpretation of the test, have been given with increasing interest 
shown. 

Cases of dog bite have increased markedly during the past year, and 
while the number of cases may be considered insignificant, even this 
small number is entirely unnecessary if proper restraint might be 
exercised for a period of time. 

The total number of smallpox cases reported this year is 37. These 
may be divided into three groups: one in Methuen, due to an un- 
recognized case in a Canadian who came to Methuen, with a total of 
12 cases; the second group in Salem and Gloucester, with 9 cases 
occurring in workmen who had returned from Jamaica, and their 
families; the third group in Worcester of 6 cases were infected by a 
man who broke quarantine in Utica, N. Y., where he was being held 



No. 



34.] 



ANNUAL REPORT. 



29 



as a suspected case. He left Worcester and was finally apprehended 
in Peoria, III. 

On March 1, 1921, encephalitis lethargica was declared a disease 
dangerous to the public health. The difficulties of diagnosis were fully 
appreciated as well as the fact that a certain percentage of our diagnoses 
would be incorrect and our statistics of little value. However, with 
encephalitis lethargica a reportable disease, we may investigate into its 
etiology, mode of transmission, communicability, etc. There have 
been 117 cases reported, with 73 deaths for this year. All of these 
cases have been investigated, yet our findings have been practically 
negative. However, clinicians are spending much time and study 
upon this condition which will in time shed much light on this disease. 
The reported incidence for all communicable diseases will show a 
marked decrease for the year. For the twelve months past there 
have been 77,367 cases reported and for a period of eleven months 
6,962 deaths. This compared with the statistics of last year (135 242 
cases and 11,277 deaths) is most favorable. It is interesting to note 
that the percentage of deaths of six of the more common communicable 
diseases to the death rate from all causes for the last forty years is 
decreasing. 





1880. 


1890. 


1900. 


1910. 


1920. 


Diphtheria 


2,394 


1,626 


1,475 


679 


591 


Measles 


236 


114 


330 


240 


352 


Scarlet fever 


574 


196 


391 


254 


214 


Pulmonary tuberculosis 


5,494 


5,791 


5,199 


4,503 


3,645 


Typhoid fever 


882 


835 


632 


411 


95 


Whooping cough 


230 


363 


337 


183 


546 




9,810 


8,925 


8,364 


6,270 


5,443 


Total deaths from all causes 


36,589 


43,528 


51,156 


54,407 


53,632 


Per cent due to above communicable 
diseases. 


26 


20 


16 


11 


10 



The following table gives the total number of cases and deaths re- 
ported for the year, i.e., calendar year, 1921: — 



30 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



















Cases. 


Deaths. 




Cases. 


Deaths. 


Actinomycosis . . • • 


2 


1 


Pellagra " . 




14 


14 


Anterior poliomyelitis 


233 


47 


Pneumonia, lobar 




4,080 


1,818 


Anthrax 


6 


- 


Scarlet fever 




8,331 


189 


Chicken pox . . . • 


8,324 


8 


Septic sore throat 




140 


42 


Diphtheria . . . ■ 


9,100 


603 


Smallpox . 




37 




Dog bite 


118 


- 


Syphilis . 




2,497 


198 


Dysentery . . . • 


25 


23 


Tetanus . 




39 


25 


Encephalitis lethargica . 


1171 


74 


Trachoma 




97 


1 


Epidemic cerebrospinal menin- 


164 


58 


Trichinosis 


10 


gitis. 
German measles 


649 


- 


Tuberculosis, pulmonary 


6,168 


3,304 


Gonorrhea . • - • 


5,563 


5 


Tuberculosis, other forms 


827 


551 


Influenza 


735 


155 


Typhoid fever . 




917 


121 


Leprosy 


1 


1 


Whooping cough 




5,703 


197 


Malaria 


49 


2 


Rabies 




1 


3 


Measles 


17,827 


174 


Hookworm 




1 




Mumps 


3,952 


6 


Typhus fever . 




2 


1 






Ophthalmia neonatorum . 


1,573 


- 


Total . 




77,302 


7,621 



1 Made reportable March 1 . 



For the work of the Subdivision of Venereal Diseases the following 
table, showing the figures for 1919, 1920 and 1921, indicates at a 
glance the continued progress in this field: — 





1919. 


1920. 


1921. 


Ampoules of arsphenamine distributed 


21,667 


26,782 


38,473 


Cases reported by nimiber: 










9,435 


7,225 


5,563 


Gonorrhea 










4,127 


2,986 


2,497 


Syphilis 










21 762 


59,280 


37,802 


Pamphlets distributed 










4,035 


2,815 


2,478 


Smear examinations 










32,390 


37,207 


42,957 


Wassormann examinations 








Figures for all State-approved clinics: 










4,492 


7,314 


4,197 


New patients 










49,005 


142,367 


98,473 


Total treatments 








Lapsed cases: 










1,4211 


1,344 


1,147 


Reported ..•••' 










616 


365 


327 


Returned to treatment 









1 Cases reported by name 



from State institutions are included with the lapsed cases up to April, 1919. 



No. 34.] ANNUAL REPORT. 31 

A brief survey of the past three years shows upon the whole satis- 
factory progress. The interest of both physicians and laity gives 
evidence of the soundness of our program. This before long should 
be reflected in a decrease in the admissions to our institutions, par- 
ticularly in those where untreated or unrecognized syphilis has been 
such a large predisposing factor. 

The Bacteriological Laboratory continues to show an increase in its 
activities, the number of examinations made for the past year being 
33,729, as compared with 28,637 for twelve months of the last fiscal year. 



Total Nuviber of Examinations made, 1921. 

Diphtheria 22,778 

Tuberculosis . 4,541 

Typhoid fever: 

Widaltest 1,646 

Culture test 724 

Malaria 93 

Gonorrhea 2,489 

Pneumonia 483 

Miscellaneous 975 



Total 33,729 

The routine inspection of hospitals, jails and houses of correction, 
and dispensaries has been done as in past years. 

The Leper Hospital at Penikese Island closed its doors to patients 
on March 10, 1921, the patients being removed to Carville, La. The 
island and buildings are now under the care of a caretaker and have 
been offered for sale. 

Under date of Dec. 22, 1920, the Legislature directed the Depart- 
ment to conduct a survey of the seaport cities and towns of the Com- 
monwealth to see what steps, if any, were necessary for the preven- 
tion and control of bubonic plague, and appropriated the sum of $5,000 
for this purpose. Because of the limitation of the appropriation it 
was not deemed advisable to establish a laboratory for this work, and 
therefore arrangements were made with the Boston Department of 
Health for the examination of rats which might be caught along the 
water front. A force of four rat trappers was employed and the 
water front of the city of Boston systematically trapped. Approxi- 
mately 6,200 rats were obtained, and although none showed evidence 
of plague infection there were several suspicious rats obtained. On 
further study by the Boston Health Department, Professor Rosenau 
of Harvard Medical School, and the Hygienic Laboratory at Wash- 



32 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

ington, these were found to be not true cases of bubonic plague. All 
other cities and towns of the seacoast were surveyed and a report 
made to the Legislature under date of Feb. 21, 192L Owing to the 
limited appropriation and because of the fact that it was made for the 
specific purpose of making a survey, we were obliged to discontinue 
our labors on or about the 1st of May. This work has been con- 
tinued by the city of Boston, and is about to be undertaken by the 
cities of New Bedford and Fall River. 

The health organization in Barnstable County has been established, 
and is apparently serving its purpose well. Reports submitted by the 
executive officer show that much time is being spent in school in- 
spection and in obtaining a better milk supply for this area. 

There have been a few changes in personnel in the Division during 
the past year. Dr. Jonathan E. Henry,- epidemiologist, resigned to 
enter the United States Naval Service, and Dr. Leland M. French was 
appointed to fill this position. Dr. Howard A. Streeter, chief of the 
Subdivision of Venereal Diseases, resigned to become health officer of 
the city of Manchester, N. H., and Dr. Albert Pfeiffer has been pro- 
moted from epidemiologist to chief of the subdivision. 

The work of the District Health Officers and nursing assistants has 
continued along the same lines as in the past years. More demand 
has been made upon the field force for lectures and for assistance in 
diagnosing the obscure or atypical communicable disease. Lectures to 
nurses in training, nursing groups, parent-teacher's associations and 
medical societies have become a very large item in the field activity. 

The investigation of disease is more and more taken over by the 
local authorities, who have profited and are profiting by the advice 
and demonstration given by the District Health Officer and his nursing 
assistant. 

Much time has been spent in demonstrating the use of the Schick 
test and toxin-antitoxin immunization in institutions and with local 
boards of health. Assistance has been given to Brockton, Quincy, 
Clinton and Lancaster in making tuberculosis surveys. 

All together the year's work has been devoted toward building up 
programs with the local authorities and the voluntary organizations 
throughout the State rather than initiating new programs or carrying 
out special investigations. 

Division of Tuberculosis. 

The activities of the Division of Tuberculosis for the year 1921 may 
be briefly summed under the following heads: — 



No. 34.] ANNUAL REPORT. 33 

1. Supervision of sanatoria and dispensaries. 

2. Consultation clinics. 

3. Examination clinics. 

4. Nurses' associations. 

5. Follow-up work. 

The four State institutions have had a very successful year. The 
labor situation, so acute during 1920, which laid many additional bur- 
dens on the superintendents, has been alleviated, and at present each 
sanatorium has a full quota of workers. Not as many patients have 
been treated during the year as formerly, due to three facts, — fewer 
cases have been reported, the sharp decline in the death rate, and the 
filling of county hospitals. 

This Division desires in the future to reserve the beds in the sana- 
toria at Rutland, North Reading and Lakeville for typical sanatorium 
cases only, and to send more children to Westfield as fast as oppor- 
tunity will permit. 

Residence for patients at sanatoria should be limited to a period of 
eighteen months to two years. Every favorable case is given fair 
trial in this period, and no unfavorable case can be benefited by a 
longer stay. 

The consultation clinics, although not as yet utilized by the phy- 
sicians as anticipated, have been of distinct value and well worth the 
time and money expended. During the year 623 persons have been 
examined; 260 showed definite signs of active tuberculosis, 289 were 
negative, and 74 still under observation. Greater effort should be 
made to popularize this service and extend it to other centers. 

The examination clinics, which have become very popular, ought to 
be increased in number and held in centers not provided with a dis- 
pensary. Clinics have been held in Ludlow, West Springfield, Palmer, 
East Longmeadow, Chester, Agawam, Southwick and Williamstown, 
and will soon be held in Brimfield, West Springfield and Lee. Three 
hundred and seventy-two cases have been examined since May, 1920. 

By the enthusiasm and attendance at the meetings of the Public 
Health Nurses' Associations, we feel that the inspiration gained by 
the individual nurse at such times enables her to give better service 
to the community, and fills a great need in her life and work. In 
getting together and discussing difficulties and problems, many knotty 
questions are easily solved, and they carry to their work that warm 
feeling of co-operation which makes for more efficient work in any 
department. 

On May 23 the Public Health Nurses' Association of the first four 
districts united in an all-day conference at the Lakeville State Sana- 



34 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

torium. The work of the nurses is invaluable in public health work, 
and we hope to develop this feature by holding frequent conferences 
in our State, county and local institutions. 

The importance of following up the discharged patient has been 
realized, and steps have been taken by the Department to carry it 
out. Ten thousand follow-up cards have been issued to the District 
Health Officers' nursing assistants, and already between 5,000 and 
6,000 have been filled out and returned to our files. In this way the 
nurses keep in touch with all discharged cases either by personal visits 
or visits made by public health nurses under the supervision of the 
District Health Officer's nurse. With the 23,000 record cards now on 
file, and the follow-up cards being filed, very valuable information will 
be in our hands, and these statistics must be of great value to the 
Department during the coming year. 

Division of Hygiene. 

No activities along radically new lines have been started by the 
Division of Hygiene during the past year, but existing activities have 
been strengthened and broadened. 

The chief object of the Division has been to come into as close 
touch as possible with the diverse agencies of the State which are 
interested to a greater or less degree with child health. Much time 
has been spent, for example, in trying to bring about close co-oper- 
ation between the Parent-Teacher Association and the Department 
of Public Health. In the belief that no true interest in a subject can 
be fostered without a real knowledge gained by first-hand investigation, 
an attempt has been made to get the various Parent-Teacher Associ- 
ations to study their own local problems after gathering themselves all 
possible facts bearing upon these problems. Help has been offered by 
this Department in analyzing the facts and suggesting lines of en- 
deavor. 

Lectures to the training schools for nurses throughout the State 
were continued last year under the general management of the Di- 
vision, the lectures on child hygiene, in particular, being given by 
members of this Division. 

The principle of advisory committees to the Department was ex- 
tended during the year in the estabhshment of an Advisory Committee 
on Health Weeks. This committee includes representatives of health 
committees and departments of thirteen State-wide organizations. Its 
purpose is to bring to bear upon any community desiring to conduct 
a health week all the assistance which can be afforded by these State- 
wide organizations and their local branches. 

During the past year the Division co-operated with the Division of 



No. 34.] ANNUAL REPORT. 35 

Vocational Education of the State Department of Education in a 
summer course to continuation school teachers on methods of teaching 
hygiene. The Division also participated in a very important series 
of public health conferences conducted by members of the whole 
Department and others. These conferences were designed to present 
in outline form some of the essentials of modern public health. 

Much new information has been assembled during the year respect- 
ing the nutrition activities of the different cities and towns of the 
Commonwealth. We are more and more in a position to offer advice 
and assistance to those wishing to start new lines of work. The same 
is true of mouth hygiene. A State-wide survey of mouth conditions 
among typical groups of school children is now in progress. Studies 
of general health conditions among rural children were continued by 
the pediatrician of the Division. 

A considerable volume of new educational material on the preser- 
vation of health was produced to meet what seemed to be a real need. 
This material falls into two classes, — that designed for general use 
by the public and that intended for those who in turn will employ 
the facts contained therein for the instruction of larger groups. The 
latter method seems one peculiarly suited to a State advisory body, 
and is likely to produce the maximum results at a minimum expense. 

The policy has been continued of trying to make our bimonthly 
bulletin, "The Commonhealth," a source of inspiration to health 
workers throughout the State, as well as the vehicle of authoritative 
information on all phases of constructive health activity. Certain 
issues of this magazine during the past year have been devoted mainly 
to special articles on nutrition, on aspects of communicable disease 
control, and on cancer; also to a discussion of certain investigations 
made by the staff of the Division into the problems of the open-air 
school and the midwife. 

Division of Biologic Laboratories. 
I. Antitoxin and Vaccine Laboratory. 

The outstanding features of the work of this laboratory may be 
classified as follows : — 

1. Increase in production of biologic products. 

2. Improvements in the methods of testing biologic products. 

3. Improvements in the physical condition of the laboratory and its equip- 
ment. 

4. Extension of the educational activities of the laboratory. 

5. Authorization of sale of surplus products. 



36 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Marked increase is shown in the production of products distributed 
by this laboratory, notably in the case of — 

(a) Diphtheria antitoxin: The amount of this product distributed 
during the past year exceeds the amounts distributed in any previous 
year in the history of this laboratory. This increase may be ac- 
counted for by the activities of the Department directed toward the 
prevention of diphtheria and .the increased number of cases of diph- 
theria occurring during the autumn of 1921. 

(b) Schick outfits: The great increase in the number of Schick out- 
fits distributed may be considered as a response to the educational 
activities of the Department in popularizing the Schick test. 

(c) Diphtheria toxin-antitoxin mixture: The increased amount of 
this product distributed during the past year may be taken as the 
result of the educational activities in popularizing active immuni- 
zation against diphtheria. The demand for this product is steadily 
increasing. 

Im,provements in Method. — ■ (a) Diphtheria antitoxin: Through the 
appointment of a qualified chemist, the Division has greatly increased 
the amount of concentrated antitoxin distributed, — much to the 
satisfaction of the medical profession, — and a still further increase in 
the future has been made possible. 

(b) The methods for testing the sterility of all products have been 
entirely revised and amplified. The expense of instituting and con- 
tinuing this work constitutes a large item of increased cost, but it is 
entirely justified by the greater security given to physicians in the 
use of biologic products. Every lot of every product now issued from 
this laboratory is tested in full conformity with the requirements of 
the United States Hygienic Laboratory. 

(c) The method of testing antimeningococcic serum has been revised, 
resulting in greater accuracy in the determination of the potency of 
this serum. 

(d) Not only has the actual amount of vaccine virus been increased, 
but additional purity tests — some in addition to Federal require- 
ments — have been instituted, still further insuring the purity of this 
product. 

(e) Diphtheria toxin-antitoxin mixture: As a result of conferences 
with members of the Hygienic Laboratory, with Dr. Park of the New 
York City Health Department, and others, the method for preparing 
this product has been standardized in this as in other laboratories of 
the country, thereby insuring its proper potency, purity and harmless- 
ness. 

The physical condition of the laboratory has been improved and 
the work has been facilitated by the addition of new apparatus and 



No. 34.] 



ANNUAL REPORT. 



37 



the installation of an incubator room, which is operating most satisfac- 
torily, enabling us to produce all the diphtheria toxin required and to 
carry out the elaborate sterility tests on products required by the 
Federal government. 

Educational Activities . — Dnring the past year a large number of 
physicians as well as boards of health, both individually and in society 
groups, have visited the laboratory and have been given demonstra- 
tions in all the processes involved in the preparation and testing of 
biologic products. Classes from the Harvard Medical School, Boston 
University Medical School, Massachusetts Institute of Technology, 
Simmons College and other educational institutions have been given 
similar demonstrations. 

The total demonstrations in the laboratory and the number of per- 
sons in attendance follow: demonstrations, 12; attendance, 526. 

Addresses and demonstrations on the Schick test have been given 
as follows: number, 27; attendance, 1,915. 

The tabulation of products distributed during the past two years 
follows: — 



Product. 



1919-20. 1 



Diphtheria antitoxin (1,000 unit doses) . 
Antimeningococcic serum (15 c.c. bottles) 
Antipneumococcic serum (100 c.c. bottles) 

Schick outfits 

Toxin-antitoxin mixture (1 c.c. ampoules) 
Bacterial vaccine (1 c.c. ampoules) 
Vaccine virus (capillary tubes) 



202,755 

4,030 

482 

120 

2,474 

44,913 

185,862 



1920-21. 



261,664 

3,474 

625 

919 

6,974 

58,433 

198,849 



I Twelve months from November 1 to October 30. 



The Legislature of 1921 authorized the sale of surplus products of 
this laboratory. It is not intended to actively compete with com- 
mercial biologic laboratories, but merely to dispose of excess stock from 
time to time before it becomes inert by lapse of time. The demands 
for all types of our products within the Commonwealth have been so 
heavy during the year past that practically no sales have yet been 
made under this authorization, but it is anticipated that in the future 
considerable income may accrue to the Commonwealth from this 
source. 



38 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



II. Wassermann Laboratory. 

The work of this hxboratory has been confined to the execution 
of its routine duties. The actual number of tests has increased by 
between 15 and 25 per cent, while the number of positive rabies ex- 
aminations has so greatly increased that it would appear that a mdd 
epidemic of this disease has been prevalent among dogs. 

An important statistical investigation on the incidence of syphilis 
in pregnant women has been concluded and will shortly come to 
publication. This investigation also bears on the incidence of syphilis 
in the population of the Commonwealth as a whole and on the preva- 
lence of the disease in the different race groups of the State. 

Division of Food and Drugs- 
The Food and Drug Division carries out certain provisions of the 
laws relating to slaughtering, cold storage, bakeries, soft drink fac- 
tories, the adulteration of milk, food and drugs, the exammation of 
liquors and drugs, chemicals and poisons for police authorities, as well 
as the manufacture of arsphenamine. In addition to this work, the 
Division has made analyses of coal, soap, alleged poisonous food, Famo 
an alleged gasoline intensifier, and linseed oil for the Departments of 
Correction, Public Welfare, Mental Diseases, Attorney-General and 

Public Safety. . , a i 

There has been an unusual amount of co-operative work. Analyses 
of various sorts have been made for the local health officers or in- 
spectors of twelve cities and towns. Investigations not requirmg an 
analysis have been made for four cities and towns. In return the 
local boards of health of five cities and towns have permitted the 
chemists of this Department to utilize their laboratories on field in- 
vestigation of milk, etc. The inspectors in five cities and towns have 
assisted this Department in cases involving prosecutions, and m ad- 
dition a number of instances of co-operation arose between this Di- 
vision and the United States Department of Agriculture. Several 
boards of health have called upon the Division for assistance in making 
their preliminary inspections of the bakeries required by the regulations 
promulgated to carry out the provisions of the bakery law of 1920. 

The outstanding feature of the year's work has been the enormous 
increase in liquor samples, which, formerly amounting to about 50 or 
100 samples per year, increased to about 1,500 during 1919 and 1920, 
and to about 4,000 in 1921, with indication of a probable mcrease to 
about 5,000 before the close of the next fiscal year. 

Bakery inspections were made in thirty-six cities and towns, and 



No. 34.] ANNUAL REPORT. 39 

the local boards of health were then directed to cause the necessary- 
corrections to be made. Second inspections being now made by this 
Division indicate a decided laxity on the part of a few local authori- 
ties in carrying out the provisions of this law. 

An investigation of soft drink factories was made in the latter part 
of the year by two inspectors in co-operation with the agents of the 
local boards of health. 

The total number of samples collected and examined this year is the 
largest on record. The milk throughout the State was found to be 
unusually free from adulteration. Our persistent campaign to remedy 
this evil, possibly assisted by a milk surplus, seems to be bearing fruit. 
Nothing unusual was encountered in the regular food and drug adulter- 
ation work, conditions being greatly improved over those existing eight 
or ten years ago. In the case of drugs, the retail druggist is fast be- 
coming a dispenser of articles made by a few large wholesale houses, in 
contradistinction to conditions some years ago when such articles were 
made on his own premises. This condition has resulted in a material 
improvement in the purity of the drugs on the market. Certain drugs, 
such as lime water, zinc ointment, magnesium citrate solution, spirit 
of nitrous ether, still being made by retail druggists, have a high ratio 
of adulteration, but not so high, however, as was prevalent in former 
years. 

There was an unusual number of extensions of time in storage 
granted this year. It appeared early in the season that there would 
be about 1,000,000 pounds of surplus butter stock remaining unsold 
at the expiration of one year's storage, owing to large importations of 
Danish butter during that season when storage butter would usually 
have been sold. The question of granting these unusual extensions 
was carefully considered by the food and drug committee of the Coun- 
cil and by the entire Council before any extensions were granted. A 
number of extensions were also granted on fish; but owing to the fact 
that very little storage fish was sold last winter because of the open 
season, and owing to the light catch during the present year, the cold- 
storage holdings for fish at present, even with the old stock on hand, 
are much below the normal figures. 

In the production of arsphenamine, the Division has supplied all 
the demands put upon it for this drug, the distributions during the 
present fiscal year being about 10,000 doses of 0.6 gram each more 
than were distributed during the last fiscal year, the comparative 
figures for the past three years being as follows: — 

1919 . . . . • 18,550 

1920 24,972 

1921 37,117 



40 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



In accordance with the provisions of section 23 of chapter 111 of the 
General Laws, a statement of the prosecutions by the Department 
under chapter 94 of the General Laws follows: — 



Milk: 
Low standard 
Cream removed 
Watered 



Misuse of milk bottles 

False advertising: 
Cocoa . 
Olive oil 
Eggs . 



MLsbranded: 
Compound oil 
Grape juice 
Olive oil 
Eggs . 



Adulterated: 
Vanilla extract 
Grape juice 
Maple sugar 
Olive oil 

Sausage (starch) . 
Sausage (colored) 
Soft drinks . 
Vinegar (low in acid) 



Drugs 



Decomposed food: 

Eggs 

Butter 

Canned corn 

Kream Krist (cooking fat) 

Shrimp . . . . 



Cold storage: 
Eggs not marked ...... 

Absence of sign "Cold Storage Eggs" 
Holding goods in storage exceeding twelve months 
Absence of sign "Cold Storage Goods" . 
Representing cold storage goods as fresh . 
Operating a warehouse without a license . 

Slaughtering: 
Illegal use of stamp 
Slaughtering in absence of inspector 
Selling unstamped meat 
Selling diseased meat . 
Failure to condemn diseased meat 
Slaughtering without license 



Totals 



Conviction. 



Discharged. 



Filed without 
Plea. 



16 

4 
26 



1 
1 
1 

15 

16 

3 

18 
6 



76 
2 
2 

11 
1 
1 



254 



17 



11 



Number of prosecutions, 282. 



No. 34.] ANNUAL REPORT. 41 



Appropriations and Expenditures for the Year ended Nov. 30, 

1921. 

Division of Administration. 

Appropriation for personal services $21,100 00 

Expended for personal services 20,553 61 

Balance $546 39 

Appropriation for expenses $10,100 00 

Brought forward from 1920 to cover sundry charges .... 14 33 

$10,114 33 

Travel ....*. $608 69 

Express 48 75 

Printing and binding 1,733 30 

Books and subscriptions 82 54 

Advertising 44 33 

Stationery, maps and blue prints 827 39 

Postage 1,481 60 

Telephone and telegraph messages 714 36 

Typewriting supplies and repairs 53 1 1 

Sundry office supplies 247 98 

Multigraph supplies and repairs 40 74 

Furniture 138 55 

Messenger service 226 30 

Miscellaneous 117 30 

Total $6,364 94 

Unexpended balance 3,749 39 

$10,114 33 
Division of Hygiene. 

Appropriation for personal services $22,000 00 

Expended for personal services 20,118 44 

Balance $1,881 56 

Appropriation for expenses $22,000 00 

Brought forward from 1920 280 35 

$22,280 35 



42 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Travel $3,457 37 

Express 485 84 

Postage 1,728 00 

Printing and binding 8,619 35 

Telephone and telegraph 43 70 

Books and subscriptions 423 62 

Stationery, maps and blue prints 244 95 

Tyi^ewriting supphes and repairs 306 66 

Furniture and office supphes 443 70 

Laboratory supplies 90 95 

Special investigation 2,500 00 

Educational work 2,335 63 

Extra services 119 85 

Auto maintenance 643 55 

Miscellaneous 239 18 

Total $21,682 35 

Unexpended balance 598 00 

$22,280 35 
Division of Communicable Diseases. 

Appropriation for personal services $56,740 00 

Expended for personal services . . . . . . . • 55,666 19 

Balance $1,073 81 

Appropriation for expenses $22,350 00 

Brought forward from 1920 6 47 

Credit account of refunds 15 78 

$22,372 25 

Travel $12,870 61 

Express 40 35 

Printing and binding 1,096 04 

Postage 609 03 

Telephone and telegraph 576 80 

Books and maps 521 39 

Office supplies and stationery 570 74 

Typewriting supplies 79 65 

Furniture 143 85 

Office rent and light 1,265 76 

Extra services 242 08 

Laboratory and experimental work 3,636 50 

Animals 118 ^^ 



.No. 34.] ANNUAL REPORT. 43 

Food for animals $28 22 

Labor 26 75 

Miscellaneous 50 65 

Total $21,877 12 

Unexpended balance 495 13 

$22,372 25 
Subdivision of Venereal Diseases. 

Appropriation for personal services $6,670 00 

Credit by cash received from United States government . . . 5,109 46 

$11,779 46 

Expended for personal services 9,676 26 

Balance $2,103 20 

Appropriation for expenses $15,000 00 

Credit by cash received from United States government during 1921 9,623 98 

$24,623 98 

Credit by refund account of damages to shipment .... 12 54 

$24,636 52 

Travel $1,895 70 

Express 54 19 

Printing and binding 318 48 

Postage 15 53 

Telephone and telegraph . . . 12 95 

Office supplies and stationery 9 94 

Typewriting supplies . ... -. ..... 50 09 

Furniture 45 30 

Books, reprints and educational material 1,360 71 

Clinic subsidies 17,104 14 

Miscellaneous 3 35 

Total $20,870 38 

Unexpended balance 3,766 14 

$24,636 52 
Division of Biologic Laboratories. 

Antitoxin and Vaccine Laboratory. 

Appropriation for personal services $28,760 00 

Expended for personal services 28,610 41 

Balance $149 59 



44 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Appropriation for expenses $24,700 00 

Travel $134 83 

Express 190 42 

Printing 482 98 

Telephone and postage 209 22 

Stationery, office supplies and furniture 968 96 

Rent 2,058 32 

Water, gas, electric lighting and heating 1,463 89 

Ice 738 68 

Apparatus, chemicals and laboratory supplies 10,631 44 

Shipping materials 94 59 

Purchase of animals 2,003 61 

Food for animals 3,915 35 

Stable supplies 64 85 

Labor and materials 977 48 

Miscellaneous 565 84 

Total $24,500 46 

Unexpended balance 199 54 

$24,700 00 
Wassermann Laboratory. 

Appropriation for personal services $6,100 00 

Credit by cash received from United States government during 1921 4,743 45 

$10,843 45. 

Expended for personal services 8,920 28 

Balance $1,923 17 

Appropriation for expenses $3,600 00 

Credit by cash received from United States government during 1921 2,797 75- 



$6,397 75- 



Travel S2 20 

Express 33 88 

Printing 455 18 

Telephone and postage 650 81 

Books and stationery 214 57 

Apparatus, chemicals and laboratory supphes 890 18 

Shipping materials . • • 180 39 

Purchase of animals 1,570 94 

Food for animals 681 70' 



No. 34.] ANNUAL REPORT. 45 

Labor and materials $430 47 

Ice 148 80 

Miscellaneous 103 61 

Total $5^362 73 

Unexpended balance 1 035 02 

$6,397 75 
Division of Food and Drugs. 

Appropriation for personal services 129,930 00 

Expended for personal services 29 825 51 

Balance $104 49 

Appropriation for expenses $11,000 00 

Brought forward from 1920 . . . 13 98 

Credit account of refund 39 00 

$11,052 98 

Travel $6^19 12 

Express 35 43 

Printing 573 21 

Telephone and postage 462 89 

Books, maps and stationery 266 03 

Typewriting supplies and repairs 99 01 

Mimeograph and office supplies 376 86 

Apparatus and chemicals 2,042 68 

Sundry laboratory supplies 106 26 

Branding outfits 73 08 

Samples 623 69 

Extra services 19 05 

Miscellaneous 249 88 

Total $11,047 19 

Unexpended balance 5 79 



$11,052 98 

Manufacture and Distribution of Arsphenamine. 

Appropriation for personal services $6,500 00 

Credit by cash received from United States government during 1921 4,774 35 

$11,274 35 
Expended for personal services 9,523 06 

Balance $lj51 29 



46 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Appropriation for expenses $4,666 00 

Credit by cash received from United States government during 1921 4,321 29 

$8,987 29 
Credit by refunds 69 84 

$9,057 13 

Travel $8971 

Express 161 49 

Printing ........•••■•• 2309 

Telephone and postage 48 78 

Rent • • • • 1^440 00 

Water, heat and light 606 15 

T,^ 63 27 

Ice 

Apparatus, chemicals and laboratory supphes . . • . • 4,717 58 

Services testing arsphenamine . . ... . • • 83333 

Animals 48100 

Royalty on arsphenamine distributed 287 73 

Shipping f« 

Labor •"^ **1 

20 
Miscellaneous 

Total . . . .'...' • $8,903 83 

Unexpended balance 153 30 

$9,057 13 
Water Supply and Sewage Disposal. 
Division of Sanitary Engineering. 
Appropriation for personal services $33,000 00 

1 • Q9 Q7ft 91 

Expended for personal services ....•••• o^,»'" ^J- 

Balance $2979 

Appropriation for expenses ' . . • . $6,850 00 

Brought forward from 1920 310 00 

$7,160 00 

Travel $4,369 09 

T? . . 10 42 

Express . 

Printing and bindmg it] ql 

Telephone and postage iq 

Maps, blue prints and books 286 19 

Stationery, drawing materials and typev/riting supphes ... 961 80 

Apparatus and materials . . . . • 



No. 34.] ANNUAL REPORT. 47 

Special investigation $44 12 

Services, collecting samples and reading gauges 381 90 

Labor 54 70 

Miscellaneous 61 34 

Total $7,157 03 

Unexpended balance 2 97 

$7,160 00 
Division of Water and Sewage Laboratories. 

Appropriation for personal services $28,000 00 

Expended for personal services 27,805 51 

Balance $194 49 

Appropriation for expenses $6,825 00 

Credit by refunds 156 45 

$6,981 45 

Travel . . " $391 02 

Express 1,760 17 

Printing and binding 209 54 

Telephone and postage 53 72 

Maps, blue prints and books 10 00 

Stationery, typewriting supplies and office equipment . . . 176 67 

Apparatus and materials 3,228 19 

Labor 658 10 

Rent 150 00 

Miscellaneous 18 50 

Total ' . $6,655 91 

Unexpended balance 325 54 

$6,981 45 
Division of Tuberculosis (Sanatoria). 

Appropriation for personal services $15,860 00 

Expended for personal services 13,486 90 

Balance $2,373 10 

Appropriation for expenses $3,000 00 

Brought forward from 1920 . 274 60 

$3,274 60 



48 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Travel 11,263 77 

Postage 360 00 

Printing 903 78 

Telephone 74 10 

Books and subscriptions 22 30 

Stationery 128 34 

Office equipment 195 67 

Typewriter supplies 94 17 

Miscellaneous 42 00 

Total $3,084 13 

Unexpended balance 190 47 



$3,274 60 

Appropriation to cover payment of subsidies to which certain cities 
and towns are entitled under the provisions of chapter 597, Acts 
of 1911, as amended by chapter 290, General Acts of 1917 . . $138,000 00 

Expended 136,444 34 

Balance $1,555 66 

State Examiners of Plumbers. 

Appropriation for the year ended Nov. 30, 1921 .... $4,700 00 

Appropriation for 1920 deficiency 57 78 

Brought forward from 1920 57 99 

$4,815 77 

Salaries $3,500 00 

Travel 741 79 

Express 48 61 

Printing 152 40 

Postage 50 88 

Books and stationery 99 19 

Telephone and lighting 106 83 

Plumbers' materials 6 00 

Extra services 58 90 

Cleaning 28 75 

Miscellaneous 22 42 

Total $4,815 77 

Bubonic Plague Investigation. 

Appropriation $5,000 00 

Salaries $3,611 40 

Travel 64 54 



No. 34.] ANNUAL REPORT. 49 

Express 

Books and maps 

Field supplies 

Educational material 

Miscellaneous 

Total 

Balance returned to treasury 

$5,000 00 
Neponset River. 

Appropriation for the apportionment and assessment of betterments 

upon certain real estate in the Neponset Valley .... $4,500 00 
Expended for services 1,441 90 



$18 58 


7 25 


371 48 


95 71 


4 05 


$4,173 01 


826 99 



Balance $3,058 10 



Penikese Hospital. 

Appropriations for the maintenance of Penikese Hospital, including 
necessary expense for preparation and transportation of the in- 
mates to the United States Hospital, and any other expenses 
incidental to the closing of Penikese Hospital, and subsequent 

care of State's property $17,162 00 

Transfer from Governor's fund 1,770 70 

$18,932 70 

Personal services $7,515 18 

Travel, transportation and office expenses 1,251 45 

Food 1,907 88 

Clothing and materials 385 26 

Furnishings and household supphes 520 63 

Medical and general care 1,433 36 

Heat, Hght and power 4,160 57 

Farm and stable 1,490 75 

Repairs, ordinary 267 61 

Total $18,932 69 

Appropriation to cover expenses connected ■vvith advertising and 

sale of Penikese Island ^ $140 00 

Expended 110 86 

Balance $29 14 

I Transferred by the Governor and Council from their appropriation for extraordinary expenses. 



50 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Recapitulation. 



For the Division of Administration 

For the Division of Hygiene 

For the Division of Communicable Diseases 

For the Subdivision of Venereal Diseases . 

For the Division of Biologic Laboratories: 
Antitoxin and Vaccine Laboratory . 



Wassermann Laboratory 



For the Division of Food and Drugs 



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 Penikese Hospital 

For advertising and sale of Penikese Hospital 
For bubonic plague investigation . 



Appro- 
priation plus 
Credits. 



Total Appro- 
priation. 



For the apportionment and assessment of betterments upon 
real estate in Neponset Valley. 



Totals 



$31,200 00 

14 33 

44,000 00 

280 35 

79,090 00 

22 25 

21,670 00 

14,745 98' 

53,460 00 

9,700 00 

7,541 201 

40,930 00 

52 98 

11,166 00 

9,165 481 

39,850 00 

310 00 

34,825 00 

156 45 

18,860 00 

274 60 



Expended. 



r 4,700 00 
115 77 



$31,214 33 
44,280 35 
79,112 25 
36,415 98 

53,460 00 
17,241 20 

40,982 98 

20,331 48 

40,160 00 

34,981 45 

19,134 60 

138,000 00 

4,815 77 

18,932 70 

140 00 

5,000 00 

4,500 00 



$588,703 09 



$26,918 55 
41,800 79 
77,543 31 
30,546 64 

53,110 87 
14,283 01 

40,872 70 

18,426 89 

40,127 24 

34,461 42 

16,571 03 

136,444 34 

4,815 77 

18,932 69 

110 86 

4,173 01 

1,441 90 



$560,581 02 



1 Received from United States government. 



No. 34.] ANNUAL REPORT. 51 



WATER SUPPLY AND SEWERAGE. 



Department of Public Health, 
Boston, Jan. 18, 1922. 

To the General Court of Massachusetts. 

The Department of Public Health presents herewith a report of its 
doings for the year which ended Nov. 30, 1921, under the provisions 
of laws relative to the oversight and care of inland waters, including 
advice to cities, towns and others in regard to water supply, drainage 
and sewerage and questions relating thereto. 



CARE OF INLAND WATERS. 
Water Supply and Sewerage. 

The Department received during the year 216 applications, an 
increase of 40 per cent over the highest year since 1915. Of these, 
153 were in relation to water supplies, 10 to sources of ice supply, 16 
to sewerage, drainage and sewage disposal, 10 to pollution of streams, 
and 27 to miscellaneous matters. 



Water Supplies. 

As has been stated in the reports of the Department of recent 
years, water works construction has been extremely limited during 
and since the war because of high cost of labor and materials; but the 
past year has shown a somewhat increased activity in this form of 
construction, and although no new works have been installed several 
municipalities and fire districts have found it necessary to make ex- 
tensions to existing systems in order to carry them through a short 
period of low rainfall in the latter part of the year. The town of 
Norwood has installed additional wells in order to increase the capacity 
of its ground water supply in the valley of Purgatory Brook, and the 
city of North Adams found it necessary again to take water from 
certain deep wells located in a thickly populated part of the city, while 
the town of Methuen has taken steps toward securing an additional 
supply of water from the ground near the Merrimack River. The 
total number of cities and towns in the State supplied with water 



52 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



wholly or in part from public works at the end of the year 1921 was 
216, the aggregate population of which in 1920 was 3,702,549. The 
remaining towns, 138 in number, have no general system of water 
supply, though in many of them there are cases in which either 
several houses are supplied through a common pipe, or a small district 
or public institution is served, usually from a spring on a neighboring 
hillside, under the control of an association or company formed for 
the purpose. The aggregate population of the towns not provided 
with public water supplies in 1921 was 149,807, according to the census 
of 1920, and there are now only 13 towns, having in 1920 a population 
in excess of 2,500, which are not provided with public water supplies. 
They are the following: — 



Town. 



Population 
(Census of 1920). 



Tewksbury 
Templeton 
Somerset 
Warren . 
West port 
Seekonk . 
Wilbraham 
Wilmington 
Sutton . 
Hanover 
Dighton . 
Harvard . 
Bourne . 
Total 



4,450 
4,019 
3,520 
3,467 
3.115 
2,898 
2,780 
2.581 
2,578 
2.575 
2,574 
2,546 
2,530 



39,633 



In many of these towns public water supplies are very badly needed, 
not only for public comfort, convenience and fire protection, but prin- 
cipally for the protection of the public health, since well waters, which 
are the usual sources of supply in these towns, are usually more or 
less polluted and in many cases unfit for use. In many such villages 
the sewage for a great many years has been disposed of by discharge 
into vaults and cesspools, and the seepage from such places, which 
tends to flow to a lower level, often finds its way into a well in the 
neighborhood where the ground water is lowered on account of the 
draft for domestic use. 



No. 34.] ANNUAL REPORT. 53 



Difficulties of Providing Water and Sewerage Facilities in Certain 

Districts. 

Attention was called in the last two reports 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 im- 
portant 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 a public water supply or an effective system of sewerage or 
drainage, unless at excessive cost. 

The attention of the Department has again been called to a number 
of such districts where houses, sometimes in considerable numbers, 
have been constructed on rocky soil where the ledge has little or no 
earth covering and where it is impracticable or exceedingly difficult 
and expensive to lay pipes for water supply and sewerage. The 
agency developing such lands and the purchaser often fail to realize 
or give little heed to the difficulties likely to be met with in maintain- 
ing satisfactory sanitary conditions in and about such premises, and 
the municipality usually refuses to extend proper water supply and 
sewerage service to such districts, at least until the streets are built to 
an established grade and accepted by the city or town. In other 
cases, areas of low, wet land have been built upon where proper drain- 
age is impracticable except at an expense which may be far in excess 
of the value of the property involved. 

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 1921 was slightly below normal as deduced 
from observations at a number of rainfall stations in the State hav- 
ing continuous records of forty-seven years or more. Excessive rains 
occurred during the latter part of June and early part of July, several 
stations reporting over 10 inches between June 28 and July 16. 

In the Wachusett watershed, located near the middle of the State, 
the total rainfall for 1921 was 45.66 inches or 0.33 inches in excess of 
the normal for this watershed. The rainfall exceeded the normal in 
the months of February, April, July and November. The greatest 



54 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

deficiency occurred in August, amounting to 2.06 inches, followed by 
a deficiency of 1.43 inches in September and 1.18 inches in October, 
a total of 4.67 inches for the three months. 

The flow of the Nashua River during 1921 was also slightly in ex- 
cess of the normal. Owing to the excessive precipitation in Novem- 
ber and December of 1920 and the very mild winter of 1920-21, the 
flow of the Nashua River in the month of January was in excess of 
the normal, though the rainfall was below it. The flow in the months 
of May and July was greatly in excess of the normal, while the great- 
est deficiency occurred in June, the flow being only slightly over half 
the normal. Deficiencies also occurred in the months of February, 
March, April, August, September and October. 

The deficiency in rainfall from the middle of July to November 
threatened a shortage of water in some places; but the excessive rains 
of November removed the danger, and the use of emergency supplies, 
except in the case of one city, became for the time being unnecessary. 

Examination of Water Supplies. 
Most of the sources of public water supply have been inspected as 
usual during the past year, and samples of water from nearly all of 
the supplies have been analyzed at intervals as in previous years. 

Sanitary Protection of Public Water Supplies. 
Rules and regulations were established by the Department during 
the year for the sanitary protection of the water supply of the Adams 
Fire District and of the water supply of Newburyport taken from the 
reservoirs on the Artichoke River, and the rules and regulations were 
re-established for the water supply of Haverhill, a question having 
arisen as to whether they had been properly adopted at an earlier date. 
The water supplies of the following cities and towns are now covered 
by rules and regulations: — 



Abington and Rockland. 

Adams. 

Amherst. 

Andover. 

Attleboro. 

Braintree. 

Brockton and Whitman. 

Cambridge. 

Chester. 

Chicopee. 

Concord. 

Dalton. 



Danvers and Middleton. 

Easthampton. 

Fall River. 

Falmouth. 

Fitchburg. 

Gardner. 

Great Barrington (Housatonic) . 

Greenfield. 

Haverhill. 

Hingham and Hull. 

Holden. 

Holyoke. 



No. 34.] 



ANNUAL REPORT. 



55 



Hudson. 
Lee, 

Leicester (Cherry Valley and Roch- 
dale) . 
Leominster. 
Lincoln and Concord. 
Lynn. 

Marlborough. 
Majaiard. 
Montague. 
Newburyport. 
Northampton. 
North Andover. 
Northborough. 
Norwood. 
Peabody. 
Pittsfield. 



Pljanouth. 

Randolph and Holbrook. 

Rockport. 

Russell. 

Rutland. 

Salem and Beverly. 

Springfield. 

Springfield and Ludlow. 

Stockbridge. 

Taunton. 

Wakefield. 

Westfield. 

West Springfield. 

Weymouth. 

Williamsburg. 

Winchester. 

Worcester. 



Examination of Sewer Outlets discharging into the Sea. 

In connection with the improvements in and about Plymouth a plan 
was presented to the Department early in the summer for the exten- 
sion of the main sewer outlet of the Plymouth sewerage system. This 
work has been completed, and has effected an improvement in the 
disposal of sewage from this town. Very little change has been made in 
the conditions surrounding the various other main sewer outlets dis- 
charging into the sea or into tidal estuaries. Some of these are highly 
objectionable, and their improvement is greatly needed, as noted in 
previous reports, but the outlets discharging into deep water continue 
to be satisfactory. 

In 1914 the Department approved plans for a sewerage system for 
the town of Hull, including a proposed outlet into the sea. The sys- 
tem has not been constructed, and offensive conditions are caused in 
some of the thickly settled sections of the town in the summer season 
by the lack of proper means of sewage disposal. An adequate sewer- 
age system is an immediate necessity in these areas. 



Sewage Disposal Systems. 
At Andover the sewerage system has been extended to include 
Shawsheen Village. The quantity of sewage has exceeded the capacity 
of the sewage disposal works for a number of years, and with ad- 
ditional sewage from the newer districts of the town now requiring dis- 
posal only a portion of the sewage can be treated upon the present 
filters, A large mill and a large number of dwelling houses have been 



56 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

constructed very near the filter beds, and near the end of the year a 
plan was presented providing for the abandonment of this sewage dis- 
posal works and the disposal of the sewage elsewhere. 

At Brockton the new additional sewage disposal works, comprising 
a series of large settling tanks and 1| acres of trickling filters, have 
been practically completed during the year, and will soon be placed in 
operation. 

Several of the sewage disposal works in the State, particularly those 
at Clinton, Framingham, Milford, Natick and Norwood, have been 
heavily overloaded during the year, and at some of these places, 
namely, at Clinton and Milford, considerable quantities of sewage 
have been allowed to overflow without treatment. At Framingham 
the load on the sewage filters is greater in comparison to the area 
than at any other plant in the State, but it has been possible by 
careful management to prevent the overflow of any considerable 
quantity of sewage, though sewage stands on the surface of the filters 
sometimes for long periods. 

At Gardner and Northbridge additional sewerage facilities have been 
provided. At Milford the underdrainage system was thoroughly re- 
constructed during the past year, but a considerable addition to the 
filtration area is necessary in order to treat all the sewage and prevent 
the serious pollution of the Charles River. Considerable quantities 
of sewage have been allowed to overflow without treatment from the 
sewerage systems at Andover, Easthampton, Leicester, Pittsfield, 
Southbridge and Spencer, but no material difficulty has been en- 
countered in the treatment of the sewage at Attleboro, Concord, 
Hopedale, Hudson, Marlborough, North Attleborough and North- 
bridge. 

At Worcester the work of improving the sewage disposal works as 
required by chapter 171, Special Acts of the year 1919, has been car- 
ried on during the year, and the amount of work done and the ex- 
penditures made to date comply fully with the requirements of the act. 

Objectionable Conditions due to Lack of Sewerage. 

Attention has previously been called in the annual reports of this 
Department to the objectionable conditions due to the lack of ade- 
quate sewerage facilities in many of the larger towns. In many towns 
which have been provided with public water supplies for long periods 
and where the sewage is disposed of largely by means of cesspools, the 
ground is becoming saturated with sewage and local waters are be- 
coming more and more seriously polluted. With the improvement now 
rapidly taking place in the conditions affecting the construction of 



No. 34.] ANNUAL REPORT. 57 

works, it is to be expected that adequate provision for sewage disposal 
in such towns will not be much longer delayed. Among the towns 
referred to are the following: — 



Braintree. 

Danvers. 

Hull. 

Mansfield. 

Marblehead. 

Maynard. 



Rockland. 

Stoughton. 

Webster. 

Weymouth. 

Whitman. 

Winchendon. 



Plans for sewerage systems in most of these towns have already 
been prepared. 

Examination of Rivers. 

The distribution of the rainfall in the year 1921 has been on the 
whole favorable for the maintenance of satisfactory sanitary conditions 
in the rivers of the State, for the reason that the flow was exception- 
ally large during the spring and the greater part of the summer and 
was not extraordinarily low at any other period of the year. Manu- 
facturing also was considerably decreased by the business depression, 
and the quantity of manufacturing wastes discharged into the rivers 
was less than normal. 

Aberjona River. 

The results of the analyses of samples of water from the Aberjona 
River show no material change from the last two or three years. 
Complaint was made during the year relative to the pollution of this 
stream, however, and the conditions complained of have not been 
wholly removed. It is probably impracticable to remedy satisfac- 
torily the remaining sources of pollution of the main stream until a 
sewer is constructed in general accordance with the plan accompanying 
the report of this Department authorized by chapter 34 of the Re- 
solves of 1918 and chapter 14 of the Resolves of 1919 (see House 
Document No. 1216, dated Jan. 14, 1920). 

Assabet Ricer. 

The results of the analyses of samples of water from the Assabet 
River show that from a point above Westborough a slight increase in 
pollution has taken place as far down as the town of Hudson, while 
below Hudson the pollution is more marked. Below Maynard, also, 
the pollution is greater than in 1920, though not as great as in certain 
earlier years. 



58 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Blackstone River. 

The results of analyses of samples of water from the Blackstone 
River above the Worcester sewage disposal works indicate a less ob- 
jectionable condition than has been the case in several years in the 
past, but below the sewage disposal works the river has shown more 
evidence of pollution than during the past two years. The same is 
true below Millbury, though farther down the valley its condition has 
shown little change in the last few years. 

Charles Riccr. 

The Charles River immediately below Milford has been more pol- 
luted than at any time since 1910, a condition due largely to the 
overflow of sewage during the reconstruction of the underdrainage 
system of the Milford sewage disposal works. At Medway and Med- 
field, also, the river shows signs of greater pollution, but farther down 
the stream there has been little change as compared with the condi- 
tions in former years. The factories along this stream and its tribu- 
taries have not been operated to capacity during the year, and there 
has been less pollution by factory waste than in previous years. 

Chicopee River. 

The condition of the Chicopee River and its tributaries has in gen- 
eral been about the same as last year. The Ware River, one of the 
main tributaries, has on the whole been less objectionable during the 
year than in recent years, due to the high rainfall of the summer and 
a reduction in the amount of manufacturing. The Seven Mile River, 
the main feeder of the Quaboag River, one of the three main tribu- 
taries of the Chicopee, has been badly polluted for a number of years 
by the overflow of sewage from the sewerage system of the town of 
Spencer. This sewage is causing very objectionable conditions in the 
water of Quaboag Pond, farther down the river. It will be necessary 
to prevent the overflow of sewage from the Spencer sewerage system 
into the Seven Mile River in order to protect the public health in the 
valley of this river below Spencer. 

Concord and Sudbury Rivers. 
The condition of the Sudbury River has not been objectionable 
during the year, and the same is true of the Concord River to a point 
near its entrance into the city of Lowell where it has been polluted 
at times as in previous years. 



No. 34.] ANNUAL REPORT. 59 



Connecticut River. 
The condition of the Connecticut River, which is polluted by sew- 
age in large quantities from the cities and towns along its banks, has 
shown little change as compared with previous years, and there is 
very little evidence of increasing pollution of the main stream excepting 
in the immediate neighborhood of some of the main sewer outlets. 
These conditions have been remedied in several instances by the ex- 
tension of the sewer outlets to a proper distance from the shore. 
Mill River below Northampton has shown evidence of greater pollu- 
tion than during the last two years, and the same is true of the 
Manhan River at the mouth. 

Deerfield River. 

The condition of the Deerfield River has not been objectionable 
during the year. 

French River. 

The French River below Webster has shown more evidence of pol- 
lution than in 1919 or 1920. This condition is likely to continue 
until the sewage of the town of Webster is purified before discharge 
into the stream. Plans for disposal works were approved by this 
Department some years ago, but the works have not yet been con- 
structed. 

Hoosick River. 

There has been a marked increase in the pollution of the Hoosick 
River below North Adams as compared to 1920, and during the year 
the Department has again recommended that the sewage of the city 
of North Adams be removed from the river and properly purified. 

Housatonic River. 

The branches of the Housatonic River above Pittsfield have shown 
a slight increase in the amount of pollution in the past year, and the 
condition of the West Branch below Pittsfield was objectionable during 
the period of low flow in the late summer and fall. The main stream 
immediately below Pittsfield has shown more evidence of pollution 
than in 1920, but at Stockbridge and Great Barrington conditions 
have not changed materially in the last two or three years. 

Merrimack River. 
The Merrimack River below Lawrence has shown a greater degree 
of pollution than in 1920, though the conditions have not been as 
objectionable as during the three years previous to 1920. Above 



60 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Haverhill a slight increase in pollution has been noted, but below 
Haverhill the condition of the river has not changed materially as 
compared with its condition last year. 

Millers River. 

The Millers River has shown less evidence of pollution below 
Gardner than at any time for several years, and lower down its 
course its condition has not been materially different from that of 
previous years. 

Nashua River. 

The North Branch of the Nashua River below Fitchburg has shown 
greater evidence of pollution than in 1920. A large quantity of 
manufacturing waste, together with sewage from public sewers which 
overflows at times of storm, is discharged into the river in this city. 

The sewage of the city of Leominster, excepting that from a very 
small section of the city which is still being diverted to an experi- 
mental filter, is discharged untreated into Monoosnock Brook, and 
flows thence into the North Branch of the river below the city. 

The North Branch of the Nashua River at its mouth has shown 
more evidence of pollution than in 1920, and this is also true of the 
South Branch below Clinton. The main stream below the confluence 
of the two branches has been on the whole in a slightly better con- 
dition than during the last few years. 

Neponset River. 

The results of the analyses of samples of water from the Neponset 
River show a slight increase in pollution just above and just below 
Hawes Brook, and the same is true of Hawes Brook at the mouth. 
At points farther downstream an improvement has taken place, and in 
Hyde Park and at the mouth the river has been in better condition 
than for many years. 

North River hi Peabody and Salem. 

The North River in Peabody and Salem has been the cause of 
very serious complaint during the year, and the condition of this 
stream was the subject of a hearing before the Department in re- 
sponse to a petition from the city of Salem. The following recom- 
mendation was made relative to this stream: — 

The Department of Public Health has considered the petition of the city of 
Salem requesting a hearing upon the condition of North River and such action 
by this Department as it may deem necessary to abate an alleged nuisance 



No. 34.] ANNUAL REPORT. 61 

therein, and in response to this petition has examined the locality and has 
given a hearing as requested in the petition. 

The Department finds that a nuisance exists in the North River caused by 
the discharge of foul organic matters of various kinds into the river or upon 
its banks, whence it is washed into the stream at times of rain. One of the chief 
causes of complaint appears to be the surcharging of the trunk sewer, the carry- 
ing capacity of which has been found to be greatly reduced at times by deposits 
therein. These deposits result from a variety of causes. The manufacturing 
wastes before being discharged into the sewers are generally passed through 
settling tanks or other fonn of treatment, but there are indications that wastes 
from different processes after entering the sewers cause a precipitation of soUd 
matters which collects on the bottom and sides of the trunk sewer. Further- 
more, examinations have shown that in the operation of the pumps the sewage 
is at times ponded in the trunk sewer, reducing the velocity of flow and thus 
tending to cause deposits therein. It is evident that the capacity of the force 
main is but Uttle in excess of the usual flow of sewage, making proper operation 
of the system increasingly difficult as time goes on. 

In order to prevent the discharge of waste matters into the North River and 
remove the nuisance therein, it is important first to investigate fully the causes 
of the present nuisance, the means necessary for its prevention, and to devise 
a suitable plan for reUef. Such an investigation will involve an expenditure of 
a considerable sum of money for which no provision has been made in the 
appropriations available to this Department. The Department recommends 
that the city of Salem, either alone or in conjunction with the city of Peabody, 
petition the Legislature for an order directing a thorough investigation of the 
whole question of the condition of North River and of the trunk sewer and 
its appurtenances and the preparation of a practicable plan for the removal of 
the nuisance now existing in North River. The investigation should be com- 
mitted to such agency as the Legislature may direct, and a suitable sum of 
money provided to defray the necessary expenses of the work. 

Taunton River. 
The condition of the Salisbury Plain River below Brockton and 
that of the Coweeset River below the Brockton sewage filters has 
varied considerably from year to year of late. The results of analyses 
indicate in general a slight improvement in the condition of the former 
stream during the past year, while the reverse is true of the latter. 
The condition of the Coweeset River should show improvement when 
the new Brockton sewage disposal works now just completed are put 
into operation. The Town River, into which the Coweeset River dis- 
charges, has been slightly more polluted than during 1920 both above 
and below Bridgewater. Above Taunton the main river has been more 
noticeably polluted than in 1920, but less than in earlier years, while 
below Taunton at Berkeley bridge the condition of the river has been 
more objectionable than in 1920. 



62 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Other Rivers. 

The examinations of other rivers have shown no change in their 
condition worthy of note. 



Protection or the Public Health in the Valley of the Nepon- 

SET River. 

Under the provisions of chapter 655 of the Acts of the year 1911, 
and legislation in amendment thereof and in addition thereto, the 
Department of Public Health has made returns to the Treasurer of 
the Commonwealth and to the board of assessors of each of the mu- 
nicipalities mentioned in said legislation of schedules and plans, show- 
ing the parcels of lands which it finds have been benefited by the 
work done or by changes made under said legislation. Returns have 
also been made of the areas of said parcels and the names of the 
owners or occupants thereof, so far as they can be ascertained, together 
with the amount of the benefits which the Department finds accruing 
to each of said parcels. 

Under further provisions of said legislation, the Department of 
Public Health has made application to the Supreme Judicial Court, 
requesting the court to appoint three commissioners to determine 
what proportions of one-half of the total expense incurred under the 
acts above referred to shall be paid by the various municipalities 
mentioned in the acts, and the commissioners have been appointed 
by the court. 

Oil Refineries. 

Several petitions have been received during the year relative to 
odors from offensive trades, particularly from oil refineries. Three 
refineries have been established in this Commonwealth since the war, 
— one at East Braintree, one at Fall River and one at Everett, — 
where the crude oil treated contains considerable quantities of sulphur, 
and the gases given off, if not properly controlled, are extremely of- 
fensive. Furthermore, the pollution of waters near the refineries by 
oil has been a serious matter and a difficult one to control satisfac- 
torily. 

The complaints relative to the pollution of the air and water by 
these refineries, particularly the odors therefrom, have been wide- 
spread, and a large amount of work has been necessary in the investi- 
gation of complaints and of methods of relief. 

Changes have been made and appliances provided to prevent the 
escape of odor and oil at each of the refineries, and a great improve- 



No. 34.] ' ANNUAL REPORT. 63 

ment has been effected in the control of the more objectionable odors. 
Much more remains to be done, and more study of this problem is 
necessary in devising adequate means of preventing the escape of 
these odors and also in preventing the escape of oil which pollutes 
neighboring waters. 

The refineries are located near thickly settled communities and at 
points unsuited for any purpose where danger of the escape of ob- 
jectionable odor is involved, while suitable locations might probably 
have been found in the beginning and the danger of nuisance largely 
avoided. It is most important that locations proposed for offensive 
trades or processes that are likely to result in offensive odors or the 
pollution of inland waters shall be selected under expert advice before 
the works are constructed for such purposes. 



Water Supply Needs and Resources. 

The work of investigating the water supply needs and resources of 
the State, under the provisions of chapter 49 of the Resolves of 1919, 
has been carried on as rapidly as possible during the year jointly with 
the Metropolitan District Commission, and a report thereon will be 
presented in a separate document. 

EUGENE R. KELLEY, M.D., 

Commissioner of Public Health. 



SUPPLEMENT 



[65] 



Division of Sanitary Engineeeing 



X. H. GooDNOUGH, Director 



[67] 



Eepoet of Division of Sanitary Engineering. 



In carrying out the duties of this Division which relate in general 
to the oversight and care of inland waters, including advice to cities, 
towns and persons relative to water supply, drainage and sewerage 
and questions relating thereto, the Department during the year 1921 
has acted upon 216 applications, an increase of 40 per cent over the 
highest number received in any year since 1915. Of these applications, 
153 related to water supply, 10 to sources of ice supply, 16 to sewer- 
age, drainage and sewage disposal, 10 to pollution of streams, and 
27 to miscellaneous matters. 

Very few additions or enlargements of the water supply and sewer- 
age systems in the cities and towns have been made during the past 
few years chiefly because of the high cost of materials and labor. 
For several years, also, the rainfall has exceeded the average and has 
been evenly distributed, so that the yield of sources of water supply 
has greatly exceeded their dependable capacities. The most note- 
worthy addition to any of the sources of water supply in the State is 
that of Norwood, where a new group of tubular wells was completed 
in the latter part of the year. 

The total number of cities and towns in the State is 355, an in- 
crease of one over the year 1920 caused by the establishment of East 
Brookfield as a separate town on Jan. 3, 1921. The former city of 
Methuen reassumed the town form of government on April 16, 1921, 
and the town of Westfield became a city on Jan. 1, 1921. Of the 38 
cities and 317 towns in the State, 217 were supplied with water 
wholly or in part from public works at the end of the year 1921. No 
new works, however, were installed during the year, but a portion of 
the works formerly classified under the town of Brookfield have been 
taken over by the town of East Brookfield, thereby adding one to 
the number of municipalities supplied with water for the year 1921. 
According to the census of 1920, the aggregate population of those 
cities and towns which are provided with public water supplies was 
3,702,549, while that of the 138 towns which have no general system 
of water supply was 149,807. There are now 13 towns, having in 1920 
a population in excess of 2,500, which are not provided with public 
water supplies. They are the following: — 



70 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Town. 


Population 
(Census of 1920). 


Town. 


Population 
(Census ofl920). 


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 

Total (13 tow 


ns) . 




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


Wilbraham . 


39,633 



A public water supply is greatly needed in the thickly populated 
parts of many of these towns not only for public comfort, convenience 
and fire protection but especially for the protection of the public 
health. As a rule, the water supplies commonly used in these mu- 
nicipalities are taken from wells in thickly settled areas, and such 
sources are usually polluted by sewage from neighboring vaults and 
cesspools, continuous seepage from which through a long period of 
years has gradually saturated the ground in their vicinity and has a 
tendency to flow toward the wells which are usually the low points 
in the water table in such localities. A public supply is the only satis- 
factory solution of this health problem in such towns. 



Difficulties of providing Water and Sewerage Facilities in 

Certain Districts. 

Attention was called in the last two reports to the problem in water 
supply and sewerage brought about by the development of lands for 
occupation for 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 sew^erage 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 again been called to a number 
of such districts where houses, sometimes in considerable numbers, 
have been constructed on rocky soil where the ledge has little or no 
earth covering, so that it is impracticable or exceedingly difficult and 
expensive to lay pipes for water supply and sewerage. Both the agency 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



71 



developing such lands and the purchaser often fail to realize or give 
little heed to the difficulties likely to be met with in maintaining 
satisfactory sanitarj^ conditions in and about such premises, and the 
municipality usually refuses to extend proper water supply and sewer- 
age service to such districts, at least until the streets are built to an 
established grade and accepted by the city or town. 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. 

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

The Sanitary Protection of Public Water Supplies. 

Under the provisions of chapter 111 of the General Laws, rules and 
regulations were established by the Department during the past year 
for the sanitary protection of the water supply of the Adams Fire 
District and of the city of Newburyport, and rules and regulations were 
re-established for the water supply of Haverhill, a question having 
arisen as to whether the rules had been properly adopted at an earlier 
date. Rules and regulations have been made by the Department for 
the protection of the water supplies of the following cities, towns and 
districts: — 



Abington and Rockland. 

Adams. 

Amherst. 

Andover. 

Attleboro. 

Braintree. 

Brockton and Whitman. 

Cambridge. 

Chester. 

Chicopee. 

Concord. 

Dalton. 

Danvers and Middleton. 

Easthampton. 

Fall River. 

Falmouth. 

Fitchburg. 

Gardner. 

Great Barrington (Housatonic) . 



Greenfield. 

Haverhill. 

Hingham and Hull. 

Holden. 

Hoh'oke. 

Hudson. 

Lee. 

Leicester (Cherry Valley and 

Rochdale) . 
Leominster. 
Lincoln and Concord, 
Lynn. 

Marlborough. 
Maynard. 
Montague. 
Newbur>T3ort. 
Northampton. 
North Andover. 
Northborough. 



72 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Norwood. 

Peabody. 

Pittsfield. 

Plymouth. 

Randolph and Holbrook. 

Rockport. 

Russell. 

Rutland. 

Salem and Beverly. 

Springfield. 



Springfield and Ludlow. 

Stockbridge. 

Taunton. 

Wakefi-eld. 

Westfield. 

West Springfield. 

Weymouth. 

WilUamsburg. 

Winchester. 

Worcester. 



Examination of Sewer Outlets discharging into the Sea. 

In connection with the improvements in and about Plymouth a plan 
was presented to the Department early in the summer for the exten- 
sion of the main sewer outlet of the Plymouth sewerage system. This 
work has been completed and has effected an improvement in the dis- 
posal of sewage from this town. Very little change has been made in 
the conditions surrounding the other main sewer outlets discharging 
into the sea or into tidal estuaries. Some of these are highly objection- 
able and their improvement is greatly needed as noted in previous 
reports, but the outlets discharging into deep water continue to be 
satisfactory. 

In 1914 the Department approved plans for a sewerage system for 
the town of Hull, including a proposed outlet into the sea. The sys- 
tem has not been constructed and offensive conditions are caused in 
some of the thickly settled sections of the town in the summer season 
by the lack of proper means of sewage disposal. An adequate sew- 
erage system is an immediate necessity in these areas. 



Objectionable Conditions due to Lack of Sewerage. 

Attention has previously been called in the annual reports of this 
Department to the objectionable conditions due to the lack of ade- 
quate sewerage facilities in many of the larger towns. In many towns 
which have been provided with public water supplies for long periods 
and where the sewage is disposed of largely by means of cesspools, the 
ground is becoming saturated with sewage, and local waters are be- 
coming more and more seriously polluted. With the improvement now 
rapidly taking place in the conditions affecting the construction of 
works, it is to be expected that adequate provision for sewage dis- 
posal in such towns will not be much longer delayed. Among the towns 
referred to are the following: — 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



Braintree. 

Danvers. 

Hull. 

Mansfield. 

Marblehead. 

Maynard. 



Rockland. 

Stoughton. 

Webster. 

Weymouth. 

Whitman. 

Winchendon. 



Plans for sewerage systems in most of these towns have already 
been prepared. 

Nuisances fkom Noxious Teades. 

Several petitions have been received during the year relative to 
odors from offensive trades, particularly from oil refineries. Three 
refineries have been established in this Commonwealth since the war, 
— one at East Braintree, one at Fall River and one at Everett, where 
the crude oil treated contains considerable quantities of sulphur, and 
the gases given off, if not properly controlled, are extremely offensive. 
Furthermore, the pollution of waters near the refineries by oil has 
been a serious matter and a diflRcult one to control satisfactorily. 

The complaints relative to the pollution of the air and water by 
these refineries, particularly by the odors therefrom, have been wide- 
spread, and a large amount of work has been necessary in the investi- 
gation of complaints and of methods of relief. 

Changes have been made and appliances provided to prevent the 
escape of odor and oil at each of the refineries, and a great improve- 
ment has been effected in the control of the more objectionable odors. 
Much more remains to be done and further study of this problem is 
necessary in devising adequate means of preventing the escape of 
these odors and also in preventing the escape of oil which pollutes 
neighboring waters. 

The refineries are located near thickly settled communities and at 
points unsuited for any purpose where danger of the escape of ob- 
jectionable odor is involved. If the danger had been rcognized in the 
beginning, suitable locations might probably have been found and the 
nuisance avoided. It is most important that locations proposed for 
offensive trades or processes that are likely to result in offensive odors 
or the pollution of inland waters shall be selected with proper care be- 
fore the works are constructed for such purposes. 



74 DEPARTMENT OF PUBLIC HEALTPI. [Pub. Doc. 



Water Supply Needs and Resources. 

The work of investigating the water supply needs and resources of 
the State, under the provisions of chapter 49 of the Resolves of 1919, 
has been carried on as rapidly as possible during the year jointly 
with the Metropolitan District Commission, and a report thereon has 
been presented in a separate document. 

Protection of the Public Health in the Valley of the Nepon- 

SET River. 

Under the provisions of chapter 655 of the Acts of the year 1911, 
and legislation in amendment thereof and in addition thereto, the 
Department of Public Health has made returns to the Treasurer of 
the Commonwealth and to the board of assessors of each of the mu- 
nicipalities mentioned in said legislation of schedules and plans, show- 
ing the parcels of land which it finds have been benefited by the work 
done or by changes made under said legislation. Returns have also 
been made of the areas of said parcels and the names of the owners 
or occupants thereof, so far as they can be ascertained, together with 
the amount of the benefits which the Department finds accruing to 
each of said parcels. 

Under further provisions of said legislation, the Department of 
Public Health has made application to the Supreme Judicial Court, 
requesting the court to appoint three commissioners to determine 
what proportion of one-half of the total expense incurred under the 
acts above referred to shall be paid by the various municipalities 
mentioned therein, and the commissioners have been appointed by 
the court. 

Examination of Public Water Supplies. 

The public water supplies throughout the State have been ex- 
amined as usual during the year by the engineers of this Division, 
and the w^aters of the various sources have been analyzed chemically 
and microscopically, the latter in the case of surface waters, and bac- 
teriological examinations have been made of these waters where such 
tests appeared to be necessary or desirable. There have been four 
cases where emergency supplies have been found necessary because of 
the brief period of low rainfall in the months from August to October, 
inclusive. The following are the average yearly results of chemical 
analyses of samples of water from public sources examined in the 
year 1921. 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



/o 



Analyses of the Water of Public Water Supplies. 
Averages of Chemical Analyses of Surface-water Sources for the Year 1921. 





[Parts in 100,000.] 
















Som-ce. 




w 

a 
o . 


Ammoni.\. 






1 




ALBUMINOID. 




City or Town. 




t 


CO 




• 


O 


S « 
— .2 

m 03 


o 


13 


C 


6 
"C 


•3 


Metropolitan Water 
District. 


Wachusett Reservoir, upper end 


.25 


3.66 


.0016 


.0137 


.0024 


.23 


1.0 


Wachusett Reservoir, lower end 


.13 


3.45 


.0011 


.0102 


.0014 


.21 


1.0 




Sudbury Reservoir 


.14 


4.03 


.0013 


.0125 


.0022 


.25 


1.3 




Framingham Reservoir No. 3 . 


.15 


3.94 


.0016 


.0124 


.0016 


.25 


1.4 




Hopkinton Reservoir . 


.54 


4.47 


.0016 


.0147 


.0020 


.32 


1.2 




Ashland Reservoir 


.56 


4.47 


.0017 


.0165 


.0021 


.26 


1.3 




Framingham Reservoir No. 2 . 


.74 


6.15 


.0046 


.0199 


.0027 


.56 


1.6 




Lake Cochituate 


.13 


6.78 


.0014 


.0188 


.0047 


.58 


2.5 




Chestnut Hill Reservoir . 


.14 


3.94 


.0012 


.0114 


.0018 


.28 


1.4 




Weston Reservoir 


.12 


4.19 


.0011 


.0118 


.0020 


.26 


1.2 




Spot Pond 


.08 


3.67 


.0012 


.0131 


.0021 


.30 


1.3 




Tap in State House . 


.13 


3.90 


.0006 


.0103 


.0015 


.26 


1.4 




Tap in Revere .... 


.06 


3.85 


.0006 


.0103 


.0011 


.29 


1.4 




Tap in Quincy .... 


.11 


3.93 


.0005 


.0095 


.0011 


.28 


1.3 


Abington 


Big Sandy Pond 


.08 


3.65 


.0019 


.0120 


.0026 


.70 


0.7 


Adams (Fire Dis- 
trict). 


Dry Brook 


.19 


7.40 


.0006 


.0081 


.0007 


.15 


4.9 




Bassett Brook .... 


.00 


4.45 


.0018 


.0032 


.0001 


.14 


2.9 


Amherst 


Amethyst Brook large reservoir 


.42 


4.24 


.0027 


.0107 


.0016 


.16 


0.7 




Amethyst Brook small reservoir 


.18 


3.52 


.0026 


.0098 


.0026 


.16 


0.9 


Andover 


Haggett's Pond .... 


.12 


4.69 


.0020 


.0143 


.0028 


.33 


1.6 


Ashburnham . 


Upper Naukeag Lake 


.05 


2.68 


.0018 


.0090 


.0012 


.16 


0.4 


Ashfield . 


Bear Swamp Brook 


.21 


4.52 


.0011 


.0102 


.0005 


.14 


2.3 


Athol 


Phillipston Reservoir . 


.56 


4.00 


.0013 


.0280 


.0103 


.12 


1.1 




Buckman Brook Reservoir 


.19 


3.58 


.0009 


.0150 


.0030 


.12 


0.8 




Inlet of filter .... 


.35 


3.62 


.0011 


.0146 


.0027 


.13 


1.0 




Outlet of filter .... 


.41 


3.87 


.0016 


.0144 


.0030 


.13 


1.0 


Barre 


Reservoir 


.17 


4.22 


.0037 


.0242 


.0079 I 


.21 


1.0 


Blandford (Fire Dis- 
trict). 
Brockton 


Freeland Brook .... 
Silver Lake .... 


.08 
.10 


3.50 
3.80 


.0014 
.0014 


.0053 
.0098 


.0008 
.0011 


.30 
.52 


1.5 
0.9 


Cambridge . 


Lower Hobbs Brook Reservoir 


.17 


5.48 


.0024 


.0200 


.0027 


.40 


2.1 




Upper Hobbs Brook Reservoir 


.43 


6.60 


.0038 


.0241 


.0040 


.42 


2.4 




Stony Brook Reservoir 


.43 


6.75 


.0027 


.0200 


.0038 


.46 


2.4 



f6 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Averages of Chemical Analyses of Surface^ater Sources, etc. — Continued. 





[Parts in 100,000.] 
















Source. 


"o 
O 


1 
> 

W 
a 
o . 

2 c 


Ammonia. 


6 
O 








ALBUMINOID. 




City or Town. 


e2 


a 

K 

m 


i 

o 

a 

1 


Cambridge — Con. 


Fresh Pond .... 


.20 


6.93 


.0057 


.0198 


.0044 


.55 


2.9 


Cheshire 


Thunder Brook .... 


.00 


6.22 


.0007 


.0027 


.0002 


.11 


5.0 




Kitchen Brook .... 


.00 


6.57 


.0004 


.0023 


.0001 


.07 


4.6 


Chester ^Fire Dis- 


Austin Brook Reservoir 


.10 


3.75 


.0006 


.0086 


.0008 


.09 


1.6 


trict). 


Horn Pond 


.10 


3.25 


.0006 


.0130 


.0018 


.10 


1.6 


Chicopee 


Morton Brook .... 


.02 


3.99 


.0014 


.0040 


.0009 


.20 


1.0 




Cooley Brook .... 


.31 


4.37 


.0027 


.0078 


.0014 


.18 


1.2 


Clinton . 


Tap in town .... 


.14 


4.55 


.0005 


.0115 


.0023 


.18 


1.5 


Colrain (Griswold- 


McClellan Reservoir . 


.01 


7.82 


.0007 


.0055 


.0001 


.15 


5.0 


ville). 
Concord . 


Nagog Pond .... 


.02 


3.83 


.0009 


.0094 


.0009 


.33 


1.1 


Dalton (Fire Dis- 


Egypt Brook Reservoir 


.18 


3.91 


.0016 


.0098 


.0012 


.12 


1.5 


trict). 


Windsor Reservoir 


.30 


5.50 


.0026 


.0152 


.0023 


.13 


2.6 




Cady Brook .... 


.11 


5.42 


.0006 


.0060 


.0004 


.12 


2.7 


Danvers . 


Middleton Pond .... 


.53 


4.83 


.0044 


.0201 


'.0040 


.35 


1.2 




Swan Pond 


.24 


4.89 


.0018 


.0174 


.0020 


.34 


2.0 


Egremont (South) 


Goodale Brook .... 


02 


4.85 


.0000 


.0014 


- 


.11 


2.9 


Fall River . 


North Watuppa Lake 


.11 


3.96 


.0017 


.0144 


.0024 


.47 


0.9 


Falmouth 


Long Pond 


.04 


3.76 


.0011 


.0087 


.0015 


.99 


0.4 


Fitch BURG 


Meetinghouse Pond . ... 


.08 


3.19 


.0023 


.0154 


.0023 


.18 


0.9 




Scott Reservoir .... 


.11 


3.46 


.0033 


.0189 


.0055 


.21 


0.7 




Wachusett Lake .... 


.15 


3.33 


.0026 


.0170 


.0025 


.15 


0.7 




Falulah Brook . . . - 


.15 


3.35 


.0023 


.0120 


.0019 


.17 


0.7 




Ashby Reservoir 


.30 


3.61 


.0051 


.0183 


.0030 


.16 


0.7 


Gardner . 


Crystal Lake .... 


.06 


5.33 


.0020 


.0147 


.0024 


.31 


2.1 


Gloucester . 


Dike's Brook Reservoir 


.26 


4.03 


.0027 


.0120 


.0013 


.68 


0.4 




Wallace Reservoir 


.60 


4.78 


.0015 


.0194 


.0040 


.80 


0.5 




Haskell Brook Reservoir . 


.16 


3.88 


.0015 


.0085 


.0008 


.68 


0.4 


Great Harrington 


East Mountain Reservoir . 


.04 


5.22 


.0024 


.0097 


.0013 


.10 


4.3 


(Fire District). 


Green River .... 


.00 


9.95 


.0008 


.0045 


.0006 


.13 


9.4 


Great Harrington 


Long Pond 


.05 


7.50 


.0002 


.0164 


.0020 


.14 


6.0 


(Housatonic). 
Greenfield (Fire 
District No. 1). 


Glen Brook Upper Reservoir . 
Glen Brook Lower Reservoir 


.05 
.04 


6.50 
6.95 


.0084 
.0054 


.0090 
.0088 


.0002 
.0012 


.40 
.34 


4.2 
4.0 


Hadley (Water Sup- 
ply District). 


Hart's Brook Reservoir 


.11 


4.97 


.0136 


.0099 


.0021 


.19 


1.7 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



77 



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

[Parts in 100,000.] 











"3 
O 


1 

o 
> 

w 

a 
o . 

2 ^ 
■S 2 

TO c3 


Ammonia. 


6 

a 
o 






Source. 


6 


ALBUMINOID. 




City or Town. 


"3 


T3 
C 

a 

CO 


1 


Hatfield . 


Running Gutter Brook Reservoir 


.08 


7.17 


.0025 


.0045 


.0004 


.24 


2.5 


Haverhill . 


Johnson's Pond .... 


.16 


5.10 


.0013 


.0140 


.0022 


.43 


2.2 




Crystal Lake 




.13 


3.68 


.0007 


.0130 


.0013 


.32 


1.3 




Kenoza Lake 




.15 


5.29 


.0011 


.0156 


.0033 


.39 


2.1 




Lake Saltonstall . 




.04 


6.40 


.0018 


.0154 


.0025 


.60 


2.8 




Pentucket Lake . 




.10 


4.79 


.0013 


.0145 


.0025 


.41 


1.9 




Millvale Reservoir 




.56 


5.77 


.0019 


.0177 


.0020 


.33 


2.0 


Hingham 


Accord Pond 




.18 


3.41 


.0012 


.0111 


.0013 


.49 


0.6 




Fulling Mill Pond 




.67 


5.71 


.0091 


.0275 


.0094 


.69 


1.5 


Hinsdale (Fire Dis- 
trict). 

HOLYOKE 


Reservoir 

Whiting Street Reservoir 




.08 
.04 


2.67 
5.21 


.0007 
.0027 


.0083 
.0125 


.0015 
.0020 


.10 
.18 


0.5 
2.7 




Fomer Reservoir . 




.31 


3.97 


.0016 


.0095 


.0014 


.15 


1.5 




Wright and Ashley Pond 




.06 


5.47 


.0024 


.0115 


.0015 


.15 


2.7 




High Service Reservoir 




.04 


4.27 


.0030 


.0148 


.0024 


.16 


1.7 




White Reservoir . 




.18 


3.61 


.0061 


.0154 


.0046 


.14 


1.4 


Hudson 


Gates Pond 




.06 


3.84 


.0032 


.0163 


.0048 


.24 


1.2 


Huntington (Fire 

District). 
Ipswich . 


Cold Brook Reservoir 
Dow's Brook Reservoir 




.06 
.23 


3.80 
5.59 


.0012 
.0012 


.0048 
.0151 


.0004 
.0035 


.14 

.60 


1.3 

2.0 


Lawkence 


Merrimack River, filtered 




.42 


6.15 


.0043 


.0079 


- 


.49 


1.3 


Lee .... 


Codding Brook Upper Reservoir 


.10 


3.76 


.0006 


.0072 


.0003 


.11 


1.5 




Codding Brook Lower Reservoir 


.08 


4.36 


.0018 


.0069 


.0005 


.16 


1.9 




Basin Pond Brook 


.41 


4.63 


.0015 


.0105 


.0010 


.09 


1.6 


Lenox 


Reservoir 






.03 


7.37 


.0005 


.0063 


.0012 


.14 


5.9 




Laurel Lake 






.06 


14.59 


.0109 


.0179 


.0026 


.26 


14.2 


Leominster . 


Morse Reservoir . 






.17 


2.86 


.0028 


.0115 


.0014 


.16 


0.5 




Haynes Reservoir 






.20 


2.87 


.0045 


.0165 


.0021 


.15 


0.5 




Fall Brook Reservoir 






.10 


3.08 


.0018 


.0103 


.0016 


.18 


0.7 


Lincoln . 


Sandy Pond 






.03 


4.02 


.0009 


.0121 


.0017 


.31 


0.9 


Longmeadow . 


Cooley Brook 






.07 


4.78 


.0024 


.0068 


.0017 


.24 


2.5 


Lynn 


Birch Reservoir 






.10 


4.73 


.0045 


.0155 


.0022 


.56 


1.7 




Breed's Reservoir 






.23 


5.66 


.0047 


.0158 


.0027 


.59 


2.0 




Walden Reservoir 






.31 


6.28 


.0024 


.0158 


.0016 


.64 


2.5 




Hawkes Reservoir 






.52 


7.51 


.0045 


.0248 


.0037 


.69 


2.8 



'8 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Averages of Chemical Analyses of Surface^ater Sources, 


etc. - 


- Continued. 




[Parts in 100,000.] 










Source. 




a 
> 

c 
o 


Ammonia. 










ALBUMINOID. 




City or Town. 




■d 


. 






o 
O 


Residue 
ration. 


6 




"a 
a 

a 

03 


6 


a> 
a 
-a 

03 


Manchester 


Gravel Pond .... 


.09 


4.48 


.0014 


.0130 


.0017 


.76 


1.0 


Marlborough 


Lake Williams 




.08 


5.14 


.0022 


.0145 


.0029 


.47 


2.0 




Milham Brook Reservoir 




.46 


5.51 


.0035 


.0179 


.0043 


.30 


1.6 


Maj'nard 


White Pond 




.18 


3.33 


.0009 


.0115 


.0024 


.24 


0.8 


Milford . 


Charles River, filtered 




.14 


6.22 


.0005 


.0047 


- 


.28 


2.3 


Montague > 


Lake Pleasant 




.02 


2.80 


.0094 


.0098 


.0023 


.15 


0.5 


Nantucket 


Wannacomet Pond 




.13 


7.85 


.0093 


.0265 


.0118 


2.21 


1.7 


New Bedford 


Little Quittacas Pond 




.37 


3.83 


.0020 


.0156 


.0022 


.43 


0.7 




Great Quittacas Pond 




.54 


4.20 


.0019 


.0160 


.0023 


.44 


0.7 


Newbtjrypoht 


Artichoke River . 




.32 


6.72 


.0080 


.0283 


.0058 


.62 


2.6 


North Adams 


Notch Brook Reservoir 




.04 


7.42 


.0026 


.0067 


.0016 


.10 


5.7 




Beaman Reservoir 




.02 


6.83 


.0017 


.0101 


.0019 


.12 


4.9 


Northampton 


Middle Reservoir 




.18 


4.73 


.0028 


.0106 


.0019 


.14 


1.7 




Mountain Street Reservoir 




.07 


4.59 


.0009 


.0065 


.0009 


.12 


1.7 


North Andover 


Great Pond 




.12 


4.73 


.0018 


.0161 


.0033 


.44 


1.9 


Northborough 


Lower Reservoir 




.72 


5.14 


.0028 


.0234 


.0039 


.24 


1.0 




Upper Reservoir 




.73 


5.35 


.0018 


.0221 


.0048 


.25 


1.1 


Northbridge . 


Cook Allen Reservoir 




.00 


3.11 


.0002 


.0024 


.0002 


.20 


0.7 


North Brookfield . 


Doane Pond 




.43 


4.12 


.0066 


.0260 


.0066 


.21 


0.8 




North Pond 




.37 


3.48 


.0104 


.0316 


.0096 


.18 


0.8 


Northfield 


Reservoir . 




.08 


3.10 


.0002 


.0042 


.0004 


.13 


1.0 


Norwood 


Buckmaster Pond 




.14 


4.30 


.0100 


.0273 


.0087 


.45 


1.6 




Outlet of filter . 




.06 


3.73 


.0017 


.0070 


- 


.46 


1.5 


Orange . 


Reservoir .... 




.08 


3.37 


.0005 


.0027 


.0000 


.13 


0.7 


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


Lower Reservoir 
Spring Pond 




.20 
.32 


4.07 
6.44 


.0019 
.0069 


.0122 
.0144 


.0024 
.0021 


.17 
.70 


0.9 
2.5 




Suntaug Lake 




.08 


5.90 


.0057 


.0149 


.0029 


.91 


2.3 


PiTTSFIELD 


Ashley Lake 




.15 


3.67 


.0035 


.0150 


.0029 


.16 


1.5 




Ashley Brook 




.10 


7.21 


.0013 


.0114 


.0029 


.13 


6.1 




Hathaway Brook 




.03 


9.81 


.0009 


.0046 


.0004 


.14 


8.0 




Mill Brook .... 




.35 


4.68 


.0012 


.0137 


.0018 


.10 


1.9 





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



No. 34.] DIVISION OF SANITARY ENGINEERING. 



79 



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





[Parts in 100,000.] 
















Source. 




eon Evapo- 
n. 


Ammonia. 


6 








.\LBUMINOID. 




City or Town. 




13 








"o 
O 


-5.2 


6 


"3 


a 


O 


1 


PiTTSFIELD — Con. 


Sacket Brook .... 


.08 


8.08 


.0017 


.0061 


.0006 


.14 


6.1 




Farnham Reservoir 




.34 


3.90 


.0020 


.0148 


.0022 


.08 


1.5 


Plymouth 


Little South Pond 




.01 


3.18 


.0016 


.0136 


.0023 


.61 


0.2 




Great South Pond 




.01 


2.94 


.0018 


.0117 


.0024 


.60 


0.2 


Randolph 


Great Pond 




.43 


5.28 


.0008 


.0165 


.0037 


.49 


1.5 


Rockport 


Cape Pond . 




.24 


10.60 


.0021 


.0155 


.0032 


3.75 


1.8 


Russell . 


Black Brook 




.18 


4.02 


.0005 


.0079 


.0007 


.15 


1.3 


Rutland . 


Muschopauge Lake 




.03 


3.45 


.0006 


.0087 


.0004 


.29 


0.8 


Salem 


Wenham Lake 




.43 


7.27 


.0088 


.0221 


.0038 


.76 


2.5 




Longham Reservoir 




1.15 


7.23 


.0053 


.0247 


.0038 


.78 


1.9 


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

Southbridge . 


Ipswich River at pumping sta- 
tion. 
Fox Brook 

Hatchet Brook Reservoir No. 3 


.91 
.01 

.19 


10.87 
6.73 

3.56 


.0080 
.0001 

.0021 


.0232 
.0031 

.0138 


.0080 
.0003 

.0029 


.70 
.12 

.15 


4.7 
4.0 

0.7 




Hatchet Brook Reservoir No. 4 


.21 


3.20 


.0016 


.0142 


.0023 


.16 


0.6 


South Hadley (Fire 
District No. 1). 


Leaping Well Reservoir 
Buttery Brook Reservoir . 


.07 
.18 


3.21 
5.04 


.0015 
.0024 


.0103 
.0102 


.0027 
.0029 


.15 
.31 


0.8 
1.2 


Spencer . 


Shaw Pond 


.02 


2.55 


.0008 


.0113 


.0012 


.21 


0.7 


Springfield . 


Westfield Little River, filtered . 


.13 


3.64 


.0004 


.0066 


- 


.12 


1.1 


Stockbridge . 


Lake Averic .... 


.08 


6^71 


.0010 


.0123 


.0024 


.13 


4.6 


Stoughton 


Muddy Pond Brook . 


.05 


4.35 


.0004 


.0044 


.0011 


.34 


0.8 


Taunton 


Assawompsett Pond . 


.28 


3.64 


.0023 


.0140 


.0016 


.41 


0.6 




Elder's Pond .... 


.11 


3.78 


.0022 


.0128 


.0016 


.43 


0.7 


Wakefield 


Crystal Lake .... 


.16 


5.96 


.0070 


.0182 


.0028 


.75 


2.0 


Wareham (Onset) . 


Jonathan Pond .... 


.01 


3.10 


.0008 


.0086 


.0014 


.62 


0.3 


Wayland 


Snake Brook Reservoir 


.76 


5.06 


.0029 


.0207 


.0039 


.23 


1.8 


Westfield 


Montgomery Reservoir 


.46 


3.82 


.0047 


.0150 


.0019 


.16 


0.5 




Tillotston Brook Reservoir 


.11 


3.54 


.0017 


.0062 


.0005 


.17 


0.8 


West Springfield . 


Bear Hole Brook 


.07 


6.97 


.0049 


.0087 


.0019 


.18 


3.8 




Bear Hole Brook, filtered . 


.01 


6.62 


.0008 


.0033 


- 


.21 


4.0 


Weymouth 


Great Pond .... 


.60 


4.74 


.0028 


.0150 


.0037 


.38 


0.5 


Williamsburg . 


Reservoir 


.09 


4.63 


• .0002 


.0063 


.0005 


.16 


2.2 


Williamstown 


Reservoirs 


.02 


.7.28 


.0004 


.0029 


- 


.12 


5.2 


Winchester 


North Reservoir ... 


.02 


4.14 


.0022 


.0128 


.0015 


.36 


1.6 



80 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



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

[Parts in 100,000.] 









o 

6 


a 

OS 

> 

w 

a 
o . 

£ ^ 
-5 9 

tn c3 


Ammoni. 


i. 


6 








Soiirce. 


6 


ALBUMINOID. 




City or Town. 


■3 



•0 
■d 

a 

m 

3 


i 

a 

03 


Winchester — Con. . 


South Reservoir . 




.02 


3.98 


.0026 


.0112 


.0019 


.35 


1.5 




Middle Reservoir 




.08 


3.75 


.0034 


.0162 


.0017 


.34 


1.4 


Worcester . 


Bottomly Reservoir . 




.24 


4.67 


.0029 


.0161 


.0034 


.23 


1.6 




Kent Reservoir . 




.20 


5.12 


.0023 


.0163 


.0036 


.19 


1.4 




Leicester Reservoir 




.14 


4.02 


.0037 


.0156 


.0038 


.20 


1.2 




Mann Reservoir . 




.19 


4.70 


.0018 


.0152 


.0016 


.19 


1.6 




Upper Holden Reservoir 




.12 


3.27 


.0012 


.0106 


.0013 


.20 


1.0 




Lower Holden Reservoir 




.09 


3.12 


.0012 


.0098 


.0010 


.19 


1.1 




Kendall Reservoir 




.14 


3.72 


.0016 


.0118 


.0016 


.17 


1.2 



Averages of Chemical Analyses of Ground-water Sources for the Year 1921. 

[Parts in 100,000.] 











Ammonia. 




Nitrogen 

AS — 






City or Town. 


Source. 


O 


O o 


6 


"2 
'o 

il 

< 


6 
c 

O 
.57 










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

Adams (Fire Dis- 
trict). 

Amesbury 


Tubular wells . 


.00 


9.02 


.0001 


.0014 


.0830 


.0000 


3.5 


.012 


Tubular wells . 
Tubular wells . 


.00 
.40 


12.11 
13.89 


.0001 
.0049 


.0019 
.0040 


.14 
.50 


.0200 
.0098 


.0000 
.0001 


9.4 
6.9 


.010 
.341 


Ashland . 


Tubular wells, old supply . 


.00 


6.60 


.0002 


.0015 


.57 


.0055 


.0000 


2.2 


.077 




Tubular wells, new supply 


.00 


5.27 


.0003 


.0023 


.41 


.0072 


.0000 


2.0 


.008 


Attleboro 


Large well .... 


.00 


5.18 


.0005 


.0035 


.44 


.0115 


.0000 


2.1 


.008 


Auburn . 


Tubular wells . 


.00 


7.82 


.0001 


.0013 


.56 


.1037 


.0000 


3.4 


.012 


Avon 


Wells 


.00 


6.47 


.0006 


.0025 


.47 


.1483 


.0000 


2.2 


.006 


Ayer . . . 


Large well .... 


.00 


6.83 


.0008 


.0018 


.55 


.0693 


.0000 


3.1 


.016 




Tubular wells . 


.00 


6.17 


.0011 


.0021 


.36 


.0123 


.0000 


2.9 


.021 


Barnstable 


Tubular wells . 


.00 


4.23 


.0006 


.0011 


1.04 


.0033 


.0000 


0.6 


.025 


Bedford . 


Large well .... 


.00 


5.02 


.0002 


.0024 


.30 


.0060 


.0000 


2.6 


017 


Billerica . 


Old wells .... 


.14 


9.78 


.0009 


.0058 


.48 


.0255 


.0005 


3.1 


.307 




New wells .... 


.07 


11.77 


.0017 


.0057 


.36 


.0090 


.0000 


4.3 


.243 


Braintree 


Filter-gallery 


.35 


6.13 


.0017 


.0163 


.62 


.0340 


.0000 


1.9 


.023 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



81 



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

[Parts in 100,000.] 





Source 


o 

6 


o o 

3 =5 


Ammonia. 


6 

o 

.61 


Nitrogen 

AS — 


1 




City or Town. 


6 


A 

< 




CO 

o 
-t-> 

'S 


1 


Bridgewater 


Wells . 


. .00 


5.57 


.0005 


.0014 


.0346 


.0000 


1.4 


.022 


Brookline 
•Canton . 


Tubular wells 

gallery, filtere 
Springdale well 


and filter- .05 
d. 

. .04 


9.13 
5.20 


.0004 
.0002 


.0052 
.0027 


.73 
.44 


.0265 
.0227 


.0000 
.0000 


4.1 
1.7 


.007 
.016 




Well near Henry 


's Spring . . 09 


5.47 


.0001 


.0023 


.44 


.0325 


.0000 


1.9 


.012 


■Chelmsford (North 
Chelmsford Fire 
District). 

Chelmsford (Water 
District). 

Chicopee CFairview) 


Tubular wells 

Tubular wells 
Tubular wells 


. .08 

00 

. .02 


5.28 

9.02 
5.84 


.0086 

.0003 
.0015 


.0074 

.0019 
.0022 


.45 

.72 
.25 


.0620 

.1323 
.0625 


.0002 

.0009 
.0000 


1.9 

3.3 

1.8 


.013 

.009 
.037 


■Cohasset . 


Tubular wells 


. .11 


13.42 


.0004 


.0061 


1.77 


.1378 


.0000 


5.1 


.011 




Filter-gallery 


. .70 


14.00 


.0510 


.0064 


.89 


.0080 


.0000 


5.3 


.360 




Dug well, filtere 


d . . .04 


8.69 


.0037 


.0056 


1.12 


.0257 


.0001 


3.2 


.013 


Dedham . 

Deerfield (Fire Dis- 
trict). 
Douglas . 


Large well an 

wells. 
Wells . 

Tubular wells 


i tubular .01 
. .00 
. .00 


11.08 
4.87 
5.22 


.0010 
.0003 
.0006 


.0040 
.0020 
.0011 


1.07 
.17 
.42 


.1300 
.0033 
.0498 


.0001 
.0000 
.0001 


4.4 
2.0 
1.6 


.011 
.016 
.018 


Dracut (Water Sup- 
ply District). 

Dracut (Colli ns- 
ville). 

Dudley . 


Tubular wells 
Tubular wells 
Tubular wells 


. .00 
. .10 
. .00 


8.65 
5.60 
3.77 


.0003 
.0005 
.0002 


.0015 
.0040 
.0014 


.67 
.30 
.23 


.1050 
.0150 
.0067 


.0001 
.0000 
.0000 


4.1 
2.3 
1.1 


.007 
.092 
.012 


Duxbury (Fire and 

Water District) . 
East Brookfield 


Tubular wells 
Tubular wells 


. .00 
. .00 


4.70 
4.30 


.0001 
.0000 


.0012 
.0011 


.79 
.20 


.0105 
.0062 


.0000 
.0000 


0.8 
1.0 


.006 
.005 


Easthampton 


Tubular wells 


. .00 


6.47 


.0002 


.0011 


.21 


.0187 


.0000 


3.8 


.007 


Easton (North 
Easton Village Dis- 
trict). 

Edgartown 


Well . 
Large well . 


. .00 
. .00 


5.21 
3.47 


.0001 
.0002 


.0020 
.0016 


.49 
.95 


.0546 
.0023 


.0000 
.0000 


1.8 
0.8 


.009 
.007 


Fairhaven 


Tubular wells 


. .28 


8.97 


.0005 


.0077 


.97 


.1133 


.0000 


3.2 


.014 


Foxborough (Water 

Supply District). 
Framingham . 


Tubular wells 
Filter-gallery 


. .00 
. .00 


5.15 
13.00 


.0004 
.0169 


.0012 
.0046 


.49 
2.05 


.0380 
.0157 


.0001 
.0002 


1.8 
5.7 


.007 
.009 


Franklin . 


Tubular wells 


. .00 


5.93 


.0003 


.0009 


.59 


.0293 


.0000 


1.8 


.007 


Grafton . 


Filter-gallery 


. .01 


10.65 


.0003 


.0027 


1.18 


.1225 


.0000 


4.2 


.011 


Granville 


Well . 


. .02 


4.13 


.0003 


.0019 


.11 


.0050 


.0001 


1.6 


.040 


Groton . 


Large well . 


. .03 


6.23 


.0002 


.0018 


.21 


.0067 


.0000 


3.0 


.007 


Groton (West Groton 
Water Supply Dis- 
trict). 

Hingham 


Tubular wells 
Wells . 


. .00 
. .10 


5.20 
5.38 


.0004 
.0010 


.0016 
.0057 


.17 
.65 


.0088 
.0142 


.0000 
.0000 


2.7 
1.5 


.008 
.013 


Holliston 


Large well . 


. .31 


4.52 


.0017 


.0131 


.37 


.0060 


.0000 


1.5 


.025 


Hopkinton 


Tubular wells 


. .00 


11.20 


.0007 


.0024 


.79 


.2300 


.0000 


4.3 


.015 



82 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



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

[Parts in 100,000.1 











Ammonia. 




Nitrogen 

.\s — 






City or Town. 


Source. 


O 




6 

1 


Albu- 
minoid. 


6 
a 

■c 

_o 

o 

.23 








a 
S 


Huntington (Fire 

District). 
Kingston 


Tubular wells . 


00 


5.30 


.0002 


0015 


.0117 


0000 


2.1 


021 


Tubular wells . 


00 


4.30 


.0007 


.0018 


.77 


.0147 


0001 


1.2 


014 


Leice.titer (Water Sup- 
ply District). 

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

Littleton . 


Wells 

Wells 


10 
19 


6.90 
4.30 


.0002 
.0017 


.0031 
.0117 


.31 

.27 


.0850 
.0100 


0001 
0000 


2.3 
1.6 


.017 
.012 


Tubular wells . 


.00 


3.97 


.0002 


.0009 


.20 


.0130 


.0000 


1.7 


.007 


Lowell . 


Boulevard wells (tubular) 


.48 


6.42 


.0373 


.0051 


.37 


.0182 


.0002 


2.4 


.344 




Boulevard wells, filtered . 


.03 


5.46 


.0005 


.0029 


.42 


.0327 


.0000 


2.1 


.019 


Manchester 


Wells 


.00 


11.50 


.0001 


.0014 


1.85 


.1297 


.0000 


3.9 


.015 


Mansfield (Water 

Supply District). 
Marblehead 


Large well .... 
Inlet of filter 


.00 
.24 


4.72 
11.71 


.0002 
.0068 


.0014 
.0101 


.32 
1.31 


.1144 
.0098 


.0000 
.0000 


1.7 
5.1 


.007 
.101 




Outlet of filter . 


.18 


12.35 


.0004 


.0078 


1.29 


.0092 


.0000 


4.9 


.013 




Wells 


.10 


14.63 


.0002 


.0051 


1.83 


.0138 


.0000 


5.8 


.015 


Marion 


Tubular wells . 


.00 


5.35 


.0003 


.0013 


.60 


.0285 


.0000 


1.2 


.012 


Marshfield 


Wells 


.00 


14.15 


.0093 


.0025 


3.63 


.0840 


.0096 


3.6 


.015 


Mattapoisett . 


Tubular wells . 


.00 


5.78 


.0005 


.0017 


.85 


.0576 


.0000 


2.6 


.012 


Medfield 


Spring .... 


.00 


4.07 


.0008 


.0021 


.31 


.0113 


.0000 


1.4 


.008 


Medway . 


Wells 


.00 


6.57 


.0006 


.0018 


.60 


.0341 


.0000 


2.8 


.007 


Merrimac 


Tubular wells . 


.00 


8.12 


.0003 


.0018 


.54 


.0223 


.0000 


3.3 


.009 


Methuen . 


Tubular wells . 


.27 


7.52 


.0040 


.0075 


.45 


.0241 


.0000 


3.2 


.083 


Middleborough (Fire 


Well 


.28 


6.67 


.0084 


.0058 


.55 


.0356 


.0001 


2.4 


.592 


District). 


Filtered water . 


.02 


6.08 


.0006 


.0043 


.62 


.0378 


.0000 


2.2 


.021 


Millbury . 


Well 


.01 


4.55 


.0004 


.0029 


.29 


.0230 


.0001 


2.1 


.016 


Millis 


Spring .... 


.00 


11.03 


.0002 


.0020 


.84 


.2300 


.0000 


4.9 


.008 


Monson . . . 


Large well .... 


.17 


3.77 


.0003 


.0043 


.20 


.0070 


.0000 


0.7 


.020 


Nantucket 


Wells in Wyers Valley 


.00 


4.77 


.0000 


.0011 


1.53 


.0083 


.0000 


1.3 


.013 


Natick 


Large well .... 


.00 


9.88 


.0006 


.0022 


.85 


.0373 


.0001 


5.0 


.007 


Needham 


Wells 


.00 


6.83 


.0004 


.0017 


.65 


.0713 


.0001 


2.7 


.017 




Hicks Spring 


.00 


8.30 


.0004 


.0021 


.93 


.2377 


.0000 


2.8 


.007 


Newburyport 


Wells and Artichoke River, 


.12 


6.41 


.0005 


.0091 


.68 


.0210 


.0000 


2.8 


.030 


Newton . 


filtered. 
Tubular wells and filter- 


.00 


5.85 


.0001 


.0019 


.40 


.0220 


.0000 


2.1 


.006 


No. Attleborough . 


gallery. 
Wells 


.00 


6.83 


.0005 


.0015 


.56 


.0433 


.0001 


2.6 


.007 


Norton 


Tubular wells . 


.00 


4.83 


.0001 


.0011 


.39 


.0050 


.0000 


1.3 


.011 


Norwood . 


Tubular wells . 


.11 


7.9e 


.0015 


.0049 


.53 


.0339 


.0000 


3.4 


.066 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



83 



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

[Parts in 100,000.] 



— Concluded. 









c 
o 


Ammonia. 




Nitrogen 

AS ■ — 






City or Town. 


Source. 


u 

o 
"o 
O 


o o 
a O, 


6 


Albu- 
minoid. 


6 

c 
'C 
_o 

O 
.93 






c 


2 


Oak Bluffs 


Springs .... 


.00 


1 
5.03 


.0000 


.0007 


.0113 


.0000 


0.8 


Oil 


Oxford . 


Tubular wells . 


.00 


5.43 


.0002 


.0014 


.37 


.0433 


.0000 


2.1 


.007 


Palmer (Bonds ville) 


Tubular wells . 


.00 


7.33 


.0002 


.0017 


.24 


.0190 


.0000 


2.2 


.009 


Pepperell 


Tubular wells . 


.00 


3.67 


.0001 


.0014 


.20 


.0062 


.0000 


1.5 


.010 


Provincetown . 


Tubular wells . 


.02 


17.18 


.0007 


.0013 


7.51 


.0065 


.0001 


4.4 


.025 


Reading . 


Filter-gallery 


.75 


10.35 


.0125 


.0154 


.92 


.0173 


.0000 


2.7 


.320 




Filtered water . 


.21 


15.40 


.0004 


.0051 


.76 


.0075 


.0002 


6.9 


.089 


Salisbury 


Well 


.18 


8.13 


.0010 


.0062 


.56 


.0073 


.0000 


3.3 


.028 


Scituate . 


Tubular wells . 


.00 


15.92 


.0002 


.0020 


2.89 


.1483 


.0000 


5.2 


.015 


Sharon 


Well 


.00 


14.10 


.0003 


.0010 


2.39 


.2420 


.0000 


6.6 


.008 




Tubular wells . 


.00 


5.24 


.0002 


.0019 


.54 


.0344 


.0000 


2.0 


.007 


Sheffield . 


Spring .... 


.00 


3.50 


.0000 


.0006 


.10 


.0050 


.0000 


2.3 


.005 


Shkley fShirley Vil- 
lage Water Dis- 
trict). 

Shrewsbury 


Well 

Tubular wells . 


.00 
.00 


4.60 
4.57 


.0004 
.0002 


.0010 
.0018 


.42 
.44 


.0935 
.0290 


.0000 
.0000 


1.3 
1.6 


.009 
.005 


South Hadley (Fire 

District No. 2). 
Uxbridge 


Large well .... 
Tubular wella . . . 


.00 
.00 


3.85 
6.43 


.0003 
.0002 


.0006 
.0015 


.24 
.54 


.0460 
.0797 


.0000 
.0000 


1.1 

1.9 


.008 
.006 


Walpole . 


Tubular wells . 


.00 


5.20 


.0001 


.0012 


.45 


.0427 


.0000 


1.9 


.023 


Waltham 


Old well . . . . 


.09 


9.89 


.0044 


.0035 


.71 


.0160 


.0000 


3.9 


.069 




New well .... 


.00 


6.85 


.0005 


.0030 


.52 


.0169 


.0000 


3.2 


.007 


Ware 


Wells 


.00 


7.15 


.0001 


.0013 


.62 


.2000 


.0000 


3.1 


.008 


Wareham (Fire Dis- 
trict). 
Webster . 


Tubular wells • 

Wells 


.00 
.00 


2.97 
4.92 


.0002 
.0007 


.0015 
.0018 


.56 
.36 


.0030 
.0117 


.0001 
.0000 


0.6 
1.7 


.008 
.014 


Wellesley . 


Tubular wells . 


.00 


9.95 


.0006 


.0023 


1.02 


.0958 


.0000 


4.2 


.009 




Well at Williams Spring . 


.00 


14.40 


.0006 


.0022 


1.11 


.5200 


.0000 


5.6 


.016 




Filter-gallery 


.00 


9.32 


.0011 


.0025 


.91 


.0772 


.0000 


4.1 


.008 


Westborough . 


Filter basin 


.01 


4.11 


.0023 


.0086 


.30 


- 


- 


1.4 


.017 


West Brookfield 


Tubular wells . 


.00 


4.63 


.0001 


.0011 


.31 


.0787 


.0000 


1.8 


.010 


Westford . 


Tubular wells . 


.00 


3.90 


.0008 


.0048 


.19 


.0060 


.0000 


2.2 


.005 


Weston 


Well 


.21 


6.88 


.0010 


.0080 


.49 


.0163 


.0000 


3.0 


.010 


Winchendon . 


Old wells . . . . 


.23 


4.12 


.0023 


.0028 


.16 


.0080 


.0000 


1.9 


.174 




New wells .... 


.16 


4.35 


.0003 


.0039 


.15 


.0080 


.0000 


0.9 


.008 


WOBURN . 


Filter-gallery 


.00 


13.20 


.0010 


.0036 


1.43 


.0463 


.0000 


6.2 


.007 


Worthington (Fire 

District). 
Wrentham 


Springs .... 
Tubular wells . 


.02 
.00 


2.70 
3.90 


.0006 
.0004 


.0012 
.0012 


.15 
.27 


.0300 
.0103 


.0001 
.0000 


1.0 
1.5 


.015 
.008 



84 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Water Supply Statistics. 

During the year ending Nov. 30, 1921, no new water supplies were 
introduced in the cities and towns of Massachusetts and very few ex- 
tensions were made to existing supplies. The establishment of the 
town of East Brookfield, however, which had a separate water supply 
from the town of Brookfield, increases by one the number of munici- 
palities supplied with water in 1921. 

Consumption of Water. 

The consumption of water in the various cities and towns where 
records of the consumption are kept is shown in the following table. 
In towns used extensively as summer resorts, large quantities of water 
are used by summer visitors and this amount is credited to the per- 
manent population of the town, making the figures of per capita daily 
consumption of water larger than is actually the case; while in certain 
municipalities having but a small part of their population supplied 
with water from the public works, the per capita consumption figures 
are probably smaller than is actually the case. There is also a certain 
number of cases where the consumption of water per person is greatly 
increased by the use of excessive quantities of water for manufacturing 
or other purposes. 

The consumption of water in 1921 was in many places lower, and 
in some places considerably lower, than in previous years. This re- 
duction has been due to a number of causes, all of which have a ten- 
dency to reduce water consumption from municipal works. Chief 
among these are the exceedingly mild winter, which was one of the 
mildest experienced in New England for many years, and the excessive 
rainfall of the summer, especially in the eastern part of the State. 
The year was also characterized by a severe financial depression, re- 
ducing greatly the volume of business, and the quantity of water used 
for manufacturing, mechanical and general industrial purposes was 
much less than usual. The records of consumption are shown in the 
following table: — 



No. 34.] DrV'ISION OF SANITARY ENGINEERING. 



85 



Consum'ption of Water in Various Cities and Towns in 1921. 





Esti- 
mated 
Popu- 
lation. 


Average Daily 
Consumption. 




Esti- 
mated 
Popu- 
lation. 


Average Daily 
Consumption. 


City ok Town. 


Gallons. 


Gallons 
per 

Inhabit- 
ant. 


CiTT OR Town. 


Gallons. 


Gallons 
per 

Inhabit- 
ant. 


Metropolitan Water 
District;! 
Arlington . 


1,216,642 
19,421 


117,407,400 
1,100,300 


97 
57 


Bridgewater 
Brockton 




8,438 
67,047 


213,000 
2,991,000 


25 
45 


Belmont 


11,283 


678,300 


60 


Brookline 




38,600 


3,519,000 


91 


Boston 


748,585 


85,609,200 


114 


Cambridge 




109,868 


10,860,000 


99' 


Chelsea 


43,184 


3,101,300 


72 


Canton . 




6,010 


382,000 


64 


Everett 


40,600 


3,530,600 


87 


Chelmsford 




5,782 


133,000 


2S 


Lexington . 


6,512 


441,700 


68 


Clinton . 




12,979 


829,000 


64 


Malden 


49,143 


2,468,700 


50 


Concord 




6,461 


592,000 


92 


Medford . 


40,743 


1,853,900 


46 


Danvers and 

dieton. 
Dedham 


Mid- 


12,303 


1,463,000 


119 


Melrose 


18,468 


1,064,700 


58 




10,792 


738,000 


68 


Milton 


9,538 


402,500 


42 


Dracut . 




5,532 


116,000 


21 


Nahant 


1,318 


182,100 


138 


Dudley . 




3,701 


159,000 


4a 


QUINCT 


49,316 


4,269,500 


87 


Duxbury 




1,553 


98,000 


63 


Revere 


29,552 


1,958,600 


66 


East Bridgewater . 


3,486 


121,000 


35. 


Somerville 


94,338 


6,919,400 


73 


East Longmeadow . 


2,435 


38,000 


16 


Stoneham . 


7,949 


610,400 


77 


Easton . 


5,041 


179,000 


36 


Swampscott 


8,253 


718,800 


87 


Edgartown 




1,190 


82,000 


69 


Watertown . 


22.445 


1,624,400 


72 


Fairhaven 




7,493 


410,000 


55 


Winthrop . 


15,994 


873,000 


55 


Fall River 




120,485 


6,971,000 


58 


Abington and Rock- 
land. 
Acton 


13,453 


608,000 


45 


Falmouth 




3,500 


406,000 


116 


2,164 


117,000 


54 


FlTCHBTJHG 




41,304 


4,437,000 


107 


Acushnet 


3,213 


40,000 


12 


Foxborough 




4,213 


337,000 


80 


Agawam 


5,117 


194,000 


38 


Pramingham 




17,268 


1,025,000 


5» 


Amesbnry 


10,335 


514,000 


50 


Franklin 




6,508 


326,000 


50 


Andover 


8,326 


600,000 


72 


Gardner 




17,090 


692,000 


40 


Ashbiirnham . 


2,012 


117,000 


58 


Gloucester 




22,947 


1,536,000 


67 


Attleboro . 


19,981 


1,102,000 


55 


Grafton 2 




7,014 


164,000 


23 


Avon 


2,178 


96,000 


44 


Greenfield 




16,030 


1,509,000 


94 


Barnstable 


4,836 


167,000 


35 


Groton . 




2,185 


144,000 


66 


Bedford . 


1,362 


62,000 


46 


Groveland 




2,705 


46,000 


17 


Beverly 


22,561 


1,543.000 


68 


Haverhill 




54,770 


5,717,000 


104 


Billerica . 


3,726 


482,000 


129 


Holliston 




2,707 


127,000 


47 


Braintree 


10,827 


955,000 


88 


Holyoke 




60,203 


6,848,000 


114 



> Figures for metropolitan consumption are exclusive of Newton and are based entirely on meter read- 
ings. District result based on pumpage, but will vary slightly from the above. 
2 Based on 184-day period. 



86 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Consumption of Water in Various Cities and Towns in 1921 — • Continued. 





Esti- 


Average Daily 
Consumption. 






Esti- 


Average Daily 
Consumption. 














CiTT OR Town. 


mated 
Popu- 
lation. 


Gallons. 


Gallons 
per 

Inhabit- 
ant. 


City or Town. 


mated 
Popu- 
lation. 


Gallons. 


Gallons 
per 

Inhabit- 
ant. 


Hudson . 


7,776 


297,000 


38 


North Brookfield . 


2,610 


284,000 


109 


Ipswich . 


6,201 


373,000 


60 


Norton . 




2,374 


150,000 


63 


Lancaster 


2,461 


82,000 


33 


Norwood 




12,957 


1,231,000 


95 


Lawrence 


95,072 


4,203,000 


44 


Oak Bluffs . 




1,047 


212,000 


202 


Lenox 


2,691 


286,000 


106 


Orange . 




5,395 


149,000 


28 


Lincoln . 


1,042 


223,000 


214 


Peabody 




19,737 


3,276,000 


166 


Littleton 


1,286 


46,000 


36 


Pepperell 




2,468 


162,000 


66 


Lowell . 


113,716 


6,537,000 


57 


Pittsfield 




42,195 


5,904,000 


140 


Ludlow . 


7,713 


211,000 


27 


Plainville 




1,365 


36,000 


26 


Lynn 


99,817 


7,665,000 


77 


Plymouth 




13,068 


1,453,000 


111 


Manchester . 


2,466 


292,000 


118 


Provincetown 


4,246 


295,000 


69 


Mansfield 


6,352 


472,000 


74 


Randolph and Hol- 
brooK. 


7,964 


514,000 


65 


Marblehead . 


7,324 


601,000 


82 


Reading . 


• 


7,565 


269,000 


36 


Marion . 


1.288 


97,000 


75 


Rockport 




3,878 


254,000 


65 


Marlborough 


15,028 


706,000 


47 


Salem . 




43,594 


5,664,000 


130 


Mattapoisett . 


1,277 


70,000 


55 


Salisbury 




1,701 


126,000 


74 


Maynard 


7,150 


325,000 


45 


Saugus . 




11,004 


562,000 


51 


Medway . 


2,978 


133,000 


45 


Scituate . 




2,534 


347,000 


137 


Merrimac 


2,187 


127,000 


58 


Sharon . 




2,467 


157,000 


64 


Methuen 


15,425 


851,000 


55 


Shirley . 




2,262 


82,000 


36 


Middleborough 


8,453 


416,000 


49 


Shrewsbury 




3,890 


111,000 


29 


Milford and Hope- 
dale. 
Millbury 


16,248 


819,000 


50 


Southbridge 




14,251 


770,000 


54 


5.725 


313,000 


55 


Springfield 




134,943 


12,279,000 


91 


Millis . 


1,494 


45,000 


30 


Stockbridge 




1,764 


271,000 


154 


Montague and Err- 


8,970 


688,000 


77 


Stoughton 




6,865 


403,000 


59 


ing. 1 
Nantucket 2 . 


2,797 


292,000 


104 


Taunton 




37,333 


3,237,000 


87 


Natick . 


10,907 


639,000 


59 


Tisbury . 




1,275 


151,000 


118 


Needham 


7,106 


433,000 


61 


Uxbridge 




5,477 


383,000 


70 


New Bedford 


123,546 


9,368,000 


76 


Wakefield 




13,073 


620,000 


47 


Newburyport 


15,679 


1,320,000 


84 


Walpole . 


•. 


5,446 


778,000 


143 


Newton 


46,643 


3,762,000 


81 


Waltham 




31,068 


1,941,000 


62 


North Andover 


6,326 


440,000 


70 


Ware 




8,525 


473,000 


55 


North Attleborough 


9,238 


520,000 


56 


Wareham 




4,415 


182,000 


41 


North bridge . 


10,358 


772,000 


75 


Webster . 




13,397 


678,000 


51 



I Does not include supply at Montague Center. 



Does not include supply at Siasconset. 



No. 34.] DIVISION OF SANITAEY ENGINEERING. 



87 



Consumption of Water in Various Cities and Towns in 1921 — Concluded. 





Esti- 
mated 
Popu- 
lation. 


Average Daily 
Consumption. 


City or Town. 


Esti- 
mated 
Popu- 
lation. 


Average Daily 
Consumption. 


City or Town. 


Gallons. 


Gallons 
per 

Inhabit- 
ant. 


Gallons. 


Gallons 
per 

Inhabit- 
ant. 


Wellesley 

West Bridgewater . 

West Brookfield . 

Westfield 

Westford 

Weston . 


6,224 
2,941 
1,281 
18,643 
3,235 
2,282 


543,000 
107,000 
36,000 
2,159,000 
144,000 
148,000 


87 
36 
28 
116 
45 
65 


Weymouth 
Whitman 

WoBURN 

Worcester . 
Wrentham 


15,275 

7,147 

16,606 

183,165 

2,886 


1,168,000 

255,000 

1,732,000 

14,975,000 

88,000 


76 
36 
104 
82 
30 



Rainfall. 

The rainfall for the year 1921 w^as very slightly below the normal, 
as shown by records of long-continued observations in various parts 
of the State. These records indicate that the normal is 44.59 inches, 
while the record for 1921 was 43.70, a deficiency of 0.89 of an inch. 
The rainfall exceeded the normal in the months of April, June, July 
and November, the greatest excess occurring in the latter part of June 
and in July, when several stations in the eastern portion of the State 
reported over 10 inches of rain betw^een June 28 and July 16. The 
greatest deficiency in any month occurred in October, when the average 
rainfall was 1.45 inches, or 2.25 inches less than the normal. Notable 
deficiencies occurred also in the months of August and September, the 
total for the three months amounting to 5.66 inches. Even this short 
period of deficient rainfall threatened a shortage of water in a number 
of places, but the excessive rains of November prevented further de- 
crease in the yield of sources of supply. 

The following table gives the normal rainfall in the State for each 
month as deduced from observations at various places for a long 
period of years, together with the average rainfall at those places for 
each month during the year 1921, and the departure from the normal: — 



88 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Month. 


Normal 
Rainfall 
(Inches). 


Rainfall 

in 1921 

(Inches). 


Excess or 

Defi- 
ciency in 

1921 
(Inches). 


Month. 


Normal 
Rainfall 
(Inches). 


Rainfall 

in 1921 

(Inches). 


Excess or 

Defi- 
ciency in 

1921 
(Inches). 


January 
February 
March 
April 
May . 




3.73 
3.67 
3.94 
3.63 
3.65 
3.28 
3.81 


2.67 
2.89 
2.90 
5.43 
2.93 
3.58 
7.87 


—1.06 
—0.78 
—1.04 
+1.80 
—0.72 
+0.30 
+4.06 


August 
September 
October . 
November 
December 
Totals 


4.18 
3.47 
3.70 
3.87 
3.66 


2.28 
1.96 
1.45 
7.47 
2.27 


—1.90 
—1.51 
—2.25 
+3.60 
—1.39 


June 
July. 


44.59 


43.70 


—0.89 



Flow of Streams. 

Sudbury River. 

The average flow of the Sudbury River during the year 1921 was 
788,000 gallons per day per square mile of drainage area, or about 
19 per cent below the normal flow for the past forty-seven years. 
The flow was above the normal in the months of May and July, but 
less than the normal in the other ten months of the year. The 
greatest excess occurred in the month of July, and the greatest de- 
ficiency in the month of April. The average flow for the driest six 
months, June to November, inclusive, was 294,000 gallons per day 
per square mile, or about 22 per cent below the normal flow for that 
period during the past forty-seven years. 

In order to show the relation between the flow of the Sudbury 
River during each month of the year 1921 and the normal flow of 
that stream, as deduced from observations during forty-seven years, 
from 1875 to 1921, inclusive, the following table has been prepared. 
The drainage area of the Sudbury River above the point of measure- 
ment is 75.2 square miles. 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



89 



Table showing the Average Daily Flow of the Sudbury River for Each Month in 
the Year 1921, 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 Floio. 







1 




Normal Flow. 


Actual Flow in 1921. 


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








1.756 

2.484 

4.229 

3.051 

1.698 

.776 

.312 

.346 

.346 

.598 

1.132 

1.470 


1.135 

1.605 

2.733 

1.972 

1.098 

.501 

.201 

.223 

.223 

.387 

.732 

.950 


1.511 
1.307 
3.513 
1.770 
2.565 

.265 
1.580 

.091 

— .089 

— .151 
1.032 
1.186 


.976 

.845 
2.270 
1.144 
1.658 

.171 
1.021 

.059 

— .058 

— .098 
.667 
.766 


—.245 
—1.177 

—.716 
—1.281 

+ .867 

— .511 
+1.268 

— .255 
—.435 
—.749 

— .100 

— .284 


—.159 

— .760 
—.463 
—.828 
+ .560 
—.330 
+ .820 

— .164 

— .281 

— .485 

— .065 
—.184 


Average 
t 


for V 


i^hole 


year 


1.511 


.977 


1.219 


.788 


— .292 


— .189 



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 six years, 
from 1916 to 1921, inclusive, together with the average for a period 
of forty-seven years, from 1875 to 1921: — 



^(^infall, in Inches, received and collected on the Sudbury River Drainage Area. 







1916. 


1917. 


1918. 


1919. 


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. 


Rain- 
fall. 


Rain- 
fall 
col- 
lected. 


Per 
Cent 
col- 
lected. 


January 

February 

March 

April 

May . 

June 

July . 

August 

September 

October 

November 

December 




1.53 
5.91 
4.16 
4.19 
3.43 
4.77 
5.17 
2.01 
1.80 
1.49 
2.28 
3.22 


1.680 

2.262 

3.245 

5.243 

2.567 

2.068 

1.044 

.139 

.044 

— .009 

.189 

.562 


109.8 

38.2 

78.1 

125.1 

74.9 

43.4 

20.2 

6.9 

2.5 

-.6 

8.3 

17.4 


3.50 

2.68 
4.96 
2.41 
4.93 
4.23 
1.11 
6.40 
1.52 
5.65 
1.31 
2.81 


.909 

1.216 

3.940 

2.425 

2.632 

1.802 

.076 

.361 

.100 

.860 

.757 

.678 


25.9 

45.5 

79.4 

100.5 

53.4 

42.7 

6.8 

5.6 

6.6 

15.2 

57.6 

24.2 


3.47 
3.58 
2.50 
4.43 
1.16 
3.65 
4.07 
1.61 
8.60 
1.04 
2.75 
3.68 


.486 

2.914 

3.896 

2.530 

1.141 

.319 

.171 

— .096 

1.100 

.490 

.843 

1.673 


14.0 
81.3 

156.2 

57.1 

98.8 

8.7 

4.2 

-6 
12.8 
47.0 
30.7 
45.5 


3.52 
3.40 
4.79 
2.93 
4.60 
1 86 
5.47 
3.75 
5,28 
2.16 
5.90 
1.98 


2.329 

1.477 

4.9)6 

2.957 

2.301 

.193 

.533 

.164 

1.232 

.498 

2.202 

1.952 


66.1 

43.4 

102.7 

ICl.O 

50.0 

10.4 

9.8 

4.4 

23.3 

23.1 

37.3 

98.6 


Totals 
avera 


and 

ges . 


39.96 


19.034 


47.6 


41 51 


15.756 


38.0 


40.54 


15.467 


38.2 


45.64 


20.754 


45.5 



90 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



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

— -Concluded. 

















Mean for 






1920. 






1921. 




FORTY- 


SEVEN' Years, 
















1875-1921 




Month. 




Rain- 


Per 




Rain- 


Per 


• 


Rain- 


Per 




Rain- 


fall 


Cent 


Rain- 


fall 


Cent 


Rain- 


fall 


Cent 




fall. 


col- 


col- 


fall. 


col- 


col- 


fall. 


col- 


col- 






lected . 


lected. 




lected. 


lected. 




lected. 


lected. 




3.26 


.556 


17.1 


2.78 


1.742 


62.7 


3.99 


2.025 


50.7 


February 

March 

April 

May . 

June 

July . 

August 

September 

October 








6.49 
4.45 


1.239 
9.262 


19.1 
207.9 


4.10 
2.72 


1.361 
4.050 


.33.2 
148.8 


4.15 
4.30 


2.608 
4.876 


62.9 
113.4 








5.19 


5.017 


96.6 


5.30 


1.973 


37.2 


3.62 


3.404 


94.1 








3 45 


3.292 


95.6 


3.23 


2.957 


91.6 


3.30 


1.958 


59.3 








6.67 


2.929 


43.9 


3.82 


.295 


7.7 


3.17 


.866 


27.3 








2.04 


.506 


24.9 


6.86 


1.822 


26.6 


3.71 


.359 


9.7 








1.78 
3.53 
1.01 
5.68 


- .070 

.110 

-.046 

1.154 


-4.0 

3 1 

-4.6 

20.3 


1.20 
1.88 
1.12 

7.95 


.105 

— .199 

-.175 

1.152 


8.7 

—5.3 

— 15.6 

14.5 


3.76 
3.38 
3.62 
3.83 


.398 

.386 

.690 

1.263 


10.6 
11.4 
19.1 
33.0 


December 






5.11 


2.141 


41.9 


2.54 


1.367 


53.8 


3.77 


1.694 


45.0 


Totals 


and 


averf 


iges . 


48.66 


26.090 


53.6 


43.50 


16.550 


38.0 


44.60 


20.527 


46.0 



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



Yield of the Sudbury River 


Drainage 


; Area in 


Gallons 


per Day 


per Square Mile. ^ 
















Mean for 


Month. 


1916. 


1917. 


1918. 


1919. 


1920. 


1921. 


Forty-seven 

Years, 

1875-1921. 


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




942,000 
1,356,000 
1,820,000 


510,000 

755,000 

2,209,000 


273,000 
1,809,000 
2,187,000 


1,306,000 

917,000 

2,759,000 


312,000 

743,000 

5,192,000 


976,000 

845,000 

2,270,000 


1,135,000 
1,605,000 
2,733,000 




3,037,000 


1,405,000 


1,466,000 


1,713,000 


2,911,000 


1,144,000 


1,972,000 




1,439,000 


1,476,000 


639,000 


1,290,000 


1,846,000 


1,658,000 


1,098,000 




1,198,000 


1,044,000 


185,000 


112,000 


1,696,000 


171,000 


501,000 




585,000 


43,000 


96,000 


299,000 


284,000 


1,021,000 


201,000 




78,000 


202,000 


—54,000 


92,000 


—39,000 


59,000 


223,000 




26,000 


58,000 


637,000 


713,000 


64,000 


—58,000 


223,000 




—5,000 
110,000 


482,000 
438,000 


274,000 
489,000 


279,000 
1,275,000 


—26,000 
669,000 


—98,000 
667,000 


387,000 
732,000 




315,000 


380,000 


938,000 


1,095,000 


1,200,000 


766,000 


950,000 


Average for whole 
year . 


904,000 


750,000 


736,000 


988,000 


1,239,000 


788,000 


977,000 


Average for driest 
six months 


186,000 


267,000 


269,000 


458,000 


360,000 


294,000 


376,000 



1 The drainage area of the Sudbury River used in making 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. 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



91 



Nashua River. 

The average flow of the South Branch of the Nashua River at the 
outlet of the Wachusett Reservoir, CHnton, during the year 1921 was 
1,092,000 gallons per day per square mile, or 0.5 of 1 per cent in excess 
of the normal for the past twenty-five years. Owing to the excessive 
precipitation in the latter part of 1920 and the very mild winter of 
1920-21, the flow of the Nashua River in the month of January was in 
excess of the normal, though the rainfall was below the average. The 
flow in the months of May and July was greatly in excess of the normal, 
while the greatest deficiency occurred in June, the flow being only slightly 
more than half the normal. Deficiencies also occurred in the months 
of February, March, April, August, September and October. 

In order to show the relation between the flow of the Nashua River 
during each month of the year 1921 and the normal flow of that 
stream as deduced from observations during twenty-five years, 1897 
to 1921, inclusive, the following table has been prepared. The drain- 
age 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 1913, 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 overflowing from the Worcester area. 



Table showing the Average Daily Flow of the South Branch of the Nashua River 
for Each Month in the Year 1921, in Cubic Feet per Second per Square Mile 
of Drainage Area, and in Million Gallons per Day per Square Mile of Drain- 
age Area; also, Departure from the Normal Floiv. 











Normal Flow. 


Actual Flow in 1921. 


Excess or 


Deficiency. 




Cubic Feet 


Million 


Cubic Feet 


Million 


Cubic Feet 


Million 




per 


Gallons per 


per 


Gallons per 


per 


Gallons per 




Second 


Day 


Second 


Day 


Second 


Day 




per Square 


per Square 


per Square 


per Square 


per Square 


per Square 




Mile. 


Mile. 


Mile. 


Mile. 


Mile. 


Mile. 


January .... 


1.813 


1.172 


2.187 


1.413 


+ .374 


+ 241 


February 








2.086 


1.348 


1.651 


1.067 


— .435 


— 281 


March 








4.112 


2.658 


3.883 


2 510 


— .229 


— 148 


April . 








3.320 


2.146 


2.988 


1 931 


— .332 


—.215 


May 








1.998 


1.292 


3.205 


2.071 


+1.207 


+ .779 


June . 








1.236 


.799 


.743 


.480 


— .493 


— .319 


July . 








.722 


.467 


1.579 


1.021 


+ .857 


+ .554 


August 








.618 


.400 


.380 


.246 


— 238 


— 154 


September 








.556 


.359 


.176 


.114 


— 380 


— 245 


October 








.722 


.467 


.245 


.158 


— .477 


— 309 


November 








1.203 


.778 


1.224 


.791 


+ .021 


+ .013 


December .... 


1.821 


1.177 


1.970 


1.273 


+ .149 


+ .096 


Average 


for V 


vhole 


year 


1.682 


1.087 


1.690 


1.092 


+ .008 


+ .005 



92 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



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 six years, 
1916 to 1921, inclusive, together with the average for the past twenty- 
five years: — 



Rainfall, in Inch 


es, received and collected on the Nashua River Drainage A 


rea. 




1916. 


1917. 


1918. 


1919. 


Month. 




Rain- 


Per 




Rain- 


Per 




Rain- 


Per 




Rain- 


Per 




Rain- 


fall 


Cent 


Rain- 


fall 


Cent 


Rain- 


fall 


Cent 


Rain- 


fall 


Cent 




fall. 


col- 


col- 


fall. 


col- 


col- 


fall. 


col- 


col- 


fall. 


col- 


col- 






lected. 


lected. 




lected. 


lected. 




lected. 


lected. 




lected. 


lected. 


January . 


1.60 


2.346 


146.7 


3.37 


1.224 


36.3 


2.97 


.864 


29.1 


3.23 


2.392 


74.1 


February 




5.98 


3.030 


50.7 


3.05 


1.476 


48 3 


4.25 


3.260 


76,6 


3.51 


1,279 


36.5 


March 




3.32 


3 374 


101.5 


4.21 


4.409 


104.8 


2 24 


4.614 


206.0 


5.27 


5,621 


106.7 


April 




3 65 


5,696 


156 


1.80 


2.5.35 


140.6 


3.47 


2.775 


80.0 


2 57 


2,954 


115.0 


May . 




3.34 


3.028 


90.7 


3.89 


2.350 


60.5 


1.07 


1.201 


112.8 


6.06 


3,931 


64.9 


June 




6,57 


3.546 


53.9 


4.47 


2.122 


47.4 


4.57 


.902 


19.8 


2.01 


.798 


39.6 


July . 




5.66 


1.937 


34.2 


1.22 


.471 


38.8 


2.80 


.499 


17.8 


5.00 


.713 


14.3 


August 




1.72 


.506 


29.5 


4.46 


.552 


12.4 


2.82 


.284 


10.1 


4.17 


.467 


11.2 


September 


4.21 


.506 


12.0 


1.20 


.144 


12.0 


7.18 


1.041 


14.5 


6.78 


1.887 


27.8 


October . 


1.42 


.250 


17.6 


6.03 


.990 


16.4 


1.58 


.609 


38.6 


2.35 


.884 


37.6 


November 


3.15 


.554 


17.6 


1.25 


.540 


43.1 


3.08 


1.004 


32.6 


6.01 


3.168 


52.7 


December 


2.81 


.820 


29.2 


2.31 


.694 


30,0 


3.74 


1.884 


50.4 


2.09 


2.305 


110.4 


Totals and 


























averages . 
t 


43.43 


25.593 


58.9 


37.26 


17.507 


47.0 


39.77 


18.937 


47.6 


49.05 


26.399 


53.8 

















]\ 


BAN FOR 






1920. 






1921. 




Twenty-five Years, 
















1897-1921 




Month. 




Rain- 


Per 




Rain- 


Per 




Rain- 


Per 




Rain- 


fall 


Cent 


Rain- 


fall 


Cent 


Rain- 


fall 


Cent 




fall. 


col- 


col- 


fall. 


col- 


col- 


fall. 


col- 


col- 






lected. 


lected. 




lected. 


lected. 




lected. 


lected. 


January .... 


3.17 


1.153 


36.4 


2.67 


2.521 


94.3 


3.55 


2.091 


58.9 


February 








6.26 


1 210 


19.3 


4.07 


1.719 


42.2 


3.90 


2.188 


56.1 


March 








4.26 


8.356 


196.0 


2.87 


4.477 


156.1 


4.04 


4.741 


117.2 


April 








6.13 


6.031 


98.4 


6.51 


3.329 


51.1 


3.87 


3.705 


95.7 


May . 








4. 01 


3.695 


92.1 


3.01 


3.695 


123.0 


3.41 


2.304 


67.6 


June 








6.07 


3.317 


54.6 


3.75 


.828 


22.1 


3.78 


1.379 


36.5 


July . 








4.33 


1.443 


33.3 


6.41 


1.821 


28.4 


4.18 


.832 


19.9 


August 








2.91 


.584 


20.1 


1.94 


.438 


22.6 


4.00 


.713 


17.8 


September 






6.39 


.931 


14.6 


2.35 


.197 


8.4 


3.78 


.620 


16.4 


October 






.63 


.731 


116.1 


2.00 


.282 


14.1 


3.18 


.833 


26.2: 


November 






5.49 


2.246 


40.9 


7.31 


1.366 


18.7 


3.63 


1.343 


37.0 


December 






6.01 


4.619 


76.9 


2.77 


2.271 


82.1 


4.01 


2.100 


52.4 


Totals 


and 


avers 


iges . 


55.66 


34.316 


61.7 


45.66 


22.944 


50.3 


45.33 


22.849 


50.4 



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



No. 34.] DIVISION OF SANITARY ENGINEERING. 



93 



Yield of the Nashua River Drainage Area in GaJJo7is per Day per Square Mile. ^ 



Month. 


1916. 


1917. 


1918. 


1919. 


1920. 


1921. 


Mean for 

Twenty-five 

Years, 

1897-1921. 


January 


1,315,000 


686,000 


484,000 


1,341,000 


646,000 


1,413,000 


1,172,000 


February . 




1,816,000 


916,000 


2,024,000 


794,000 


725,000 


1,067,000 


1,348.000 


March 




1,891,000 


2,472,000 


2,590,000 


3,155,000 


4,685,000 


2,510,000 


2,658,000 


April . 




3,300.000 


1,468,000 


1,608,000 


1,711,000 


3,498,000 


1,931,000 


2,146,000 


May . 




1,697,000 


1,317,000 


673,000 


2,204,000 


2,071,000 


2,071,000 


1,292,000 


June . 




2,054,000 


1,229,000 


523,000 


462,000 


1,922,000 


480,000 


799,000 


July . 




1,086,000 


264,000 


280,000 


400,000 


809,000 


1,021,000 


467,000 


August 




284,000 


309,000 


159,000 


262,000 


327,000 


246,000 


400,000 


September 




294,000 


84,000 


603,000 


1,093,000 


540,000 


114,000 


359,000 


October 




140,000 


555,000 


341,000 


495,000 


409,000 


158,000 


467.000 


November 




321,000 


313,000 


582,000 


1,835,000 


1,301,000 


791,000 


778,000 


December . 




460,000 


389,000 


1,056,000 


1,292,000 


2,590,000 


1,273.000 


1,177,000 


Average for whole 


1,215,000 


834,000 


902,000 


1,257,000 


1,629,000 


1,092,000 


1.087.000 


Average for driest 
six months. 


432,000 


320,000 


412,000 


752,000 


870,000 


468,000 


543.000 

-3 



1 The drainage area 
cent of the whole area 
per cent in 1905, to 5.1 
per cent in 1911, to 6.8 
cent in 1916, to 7.4 per 



used in making up these records included water surfaces amounting to 2.2 per 
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 1906, to 6 per cent in 1907, to 7 per cent in 1908, 1909 and 1910. to 6.5 
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 1917 and 1918, and to 7.5 per cent in 1919, 1920 and 1921. 



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 the dry months. Records of the quantity of water wasted 
have been kept by the Metropolitan District Commission and its 
predecessors, and these quantities have been deducted from the flow 



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



94 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



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 1921 
amounted to 1.412 cubic feet per second, or 913,000 gallons per day, 
per square mile of drainage area, or 4 per cent below the normal flow 
for the past forty-two years for which records are available. The 
flow was in excess of the normal in the months of January, March, 
July, August and December, and less than the normal in the other 
seven months of the year. 

In order to show the relation between the flow of this stream dur- 
ing each month of the year 1921 and the normal flow as deduced 
from observations during forty-two years, from 1880 to 1921, in- 
clusive, the following table has been prepared: — 



Table shoiving the Average Monthly Floiv of the Merrimack River at Lawrence for 
the Year 1921, in Cubic Feet per Second per Square Mile of Drainage Area; 
also, Departure from the Normal Floiv. 



Month. 



Normal Flow, 
1880-1921. 



Actual Flow 
in 1921. 



Excess or 
Deficiency. 



January 

February 

March .... 

April .... 

May .... 

June .... 

July .... 

August .... 

September 

October 

November 

December 

Average for whole year 



1.277 
1.373 
2.769 
3.439 
2.212 



1.250 
.748 
.661 
.646 
.806 
1.115 
1.278 



1.465 



1.679 

.995 

3.689 

2.700 

1.957 

.597 

1.031 

.683 

.425 

.475 

1.057 

1.652 



1.412 



+ .402 
—.378 
+ .920 

— .739 

— .255 

— .653 
+ .283 
+ .022 
—.221 

— .331 
—.058 
+ .374 



-.053 



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



No. 34.] DIVISION OF SANITARY ENGINEERING. 



95 



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

Mile. 



Month. 


1916. 


1917. 


1918. 


1919. 


1920. 


1921. 


Mean for 
Forty-two 

Years, 
1880-1921. 


January 


1.527 


1.023 


.466 


1.314 


.570 


1.679 


1.277 


February . 




1.674 


.770 


.819 


.872 


.618 


.995 


1.373 


March 




1.735 


2.316 


1.983 


3.383 


4.082 


3.689 


2.769 


April . 




4.323 


3.242 


3.337 


2.542 


6.002 


2.700 


3.439 


May . 




2.733 


2.124 


1.540 


2.741 


3.545 


1.957 


2.212 


June . 




3.101 


3.037 


.757 


1.007 


1.607 


.597 


1.250 


July . 




1.531 


1.024 


.553 


.539 


.746 


1.031 


.748 


August 




.924 


.629 


.470 


.401 


.678 


.683 


.661 


September 




.972 


.549 


.847 


.653 


.680 


.425 


.646 


October 




.798 


.613 


.991 


.699 


1.051 


.475 


.806 


November . 




.743 


.882 


1.126 


1.648 


.921 


1.057 


1.115 


December . 




1.154 


.569 


1.492 


1.331 


3.258 


1.652 


1.278 


Average for whole 


1.768 


1.398 


1.198 


1.427 


1.980 


1.412 


1.465 


Average for driest 
six months. 


1.020 


.711 


.791 


.825 


.947 


.711 


.871 



Sudbury, Nashua and Merrimack Rivers. 

The following table shows the weekly fluctuations during the year 
1921 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. 



96 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table showing the Average Weekly Floiv of the Sudbury, South Branch of the 
Nash^ia and the Merrimack Rivers for the Year 1921, in Cubic Feet per Sec- 
ond per Square Mile of Drainage Area. 





Flow in Cubic Fi 


3ET 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. 


Nashua 






River. 






River. 


Jan. 2 


1.459 


2.016 


1.877 


July 3 


2.945 


3.898 


.914 


9 


2.694 


2.891 


2.246 


10 


2.068 


1.698 


1.019 


16 


2.281 


3.3.33 


1.844 


17 


1.451 


1.054 


1.413 


23 


1.046 


1.522 


1.627 


24 


.441 


.589 


.850 


30 


.607 


1.071 


1.012 


31 


1.084 


1.452 


.718 


Feb, 6 


.726 


1.281 


.912 


Aug. 7 


.583 


.616 


.789 


13 


1.071 


1.620 


1.108 


14 


.154 


.389 


.703 


20 


1.616 


2.002 


1.006 


21 


.127 


.487 


.663 


27 


1.140 


1.394 


.952 


28 


— .190 


.092 


.605 


Mar. 6 


5.146 


4.315 


1.943 


Sept. 4 


-.205 


.132 


.464 


13 


4.541 


6.148 


4.488 


11 


—.081 


.089 


.396 


20 


3.260 


3.068 


4.066 


18 


— .109 


.085 


.403 


27 


1.939 


2.870 


3.948 


25 


— .028 


.377 


.431 


Apr. 3 


2.066 


2.149 


3.677 


Oct. 2 


— .059 


.157 


.447 


10 


1.720 


1.819 


2.537 


9 


— .107 


.236 


.458 


17 


1.2.33 


2.405 


2.016 


16 


— .209 


.117 


.407 


24 


1.694 


3.999 


2.619 


23 


— .188 


.481 


.519 










30 


— .165 


.249 


.580 


May 1 


2.862 


6.805 


3.222 


Nov. 6 


— .066 


.435 


.580 


8 


4.650 


4.217 


3.201 


13 


.620 


.591 


.602 


15 


2.941 


3.097 


1.794 


20 


.946 


1.473 


.917 


22 


1.203 


1.517 


1.689 


27 


.944 


1.563 


1.916 


29 


1.514 


1.821 


1.259 










June 5 


.639 


.916 


.820 


Dec. 4 


4.164 


2.978 


1.584 


12 


.091 


.497 


.639 


11 


1.385 


1.225 


1.875 


19 


— .135 


.127 


.555 


18 


1.463 


2.199 


1.260 


26 


—.198 


.372 


.482 


25 


2.196 


2.478 


2.190 


L ^ : 



Examination of Rivers. 

The distribution of the rainfall in the year 1921 has been, on the 
whole, favorable for the maintenance of satisfactory sanitary condi- 
tions in the rivers of the State for the reason that the flow was ex- 
ceptionally large during the spring and the greater part of the sum- 
mer and was not extraordinarily low at any other period of the year. 
Manufacturing also was considerably decreased by the business de- 
pression, and the quantity of manufacturing w^astes discharged into 
the rivers was less than normal. 



No. 34.] DIVISION OF SANITARY ENGINEERING. 97 



Aberjona River. 

The results of the analyses of samples of water from the Aberjona 
River show no material change from the last two or three years. 
Complaint was made during the year relative to the pollution of this 
stream, however, and the conditions complained of have not been 
wholly removed. It is probably impracticable to remedy satisfac- 
torily the remaining sources of pollution of the main stream until a 
sewer is constructed in the easterly part of this watershed, in which 
are located the factories which now cause the most serious pollution 
of the river. 

Assabet River. 

The results of the analyses of samples of water from the Assabet 
River show that from a point above Westborough a slight increase in 
pollution has taken place as far down as the town of Hudson, while 
below Hudson the pollution was more marked. Below Maynard, also, 
the pollution was greater than in 1920, though not as great as in cer- 
tain earlier years. 

Blackstone River. 

The results of analyses of samples of water from the Blackstone 
River above the Worcester sewage disposal works indicate a less 
objectionable condition than has been the case in several years in the 
past, but below the sewage disposal works the river has shown more 
evidence of pollution than during the past two years. The same is 
true below Millbury, though farther down the valley its condition has 
shown little change in the last few years. 



Charles River. 

The Charles River immediately below Milford has been more pol- 
luted than at any time since 1910, a condition due largely to the 
overflow of sewage during the reconstruction of the underdrainage 
system of the Milford sewage disposal works. At Medway and Med- 
field, also, the river shows evidence of greater pollution, but farther 
down the stream there has been little change as compared with the 
conditions in former years. The factories along this stream and its 
tributaries have not been operated to capacity during the year and 
there has been less pollution by factory waste than in previous years. 



98 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Chicopee River. 

The condition of the Chicopee River and its tributaries has in 
general been about the same as last year. The Ware River, one of 
the main tributaries, has, on the whole, been less objectionable during 
the year than in recent years, due to the high rainfall of the summer 
and a reduction in the amount of manufacturing. The Seven Mile 
River, the main feeder of the Quaboag River, one of the three main 
tributaries of the Chicopee, has been badly polluted for a number of 
years by the overflow of sewage from the sewerage system of the town 
of Spencer. This sewage is causing very objectionable conditions in 
the water of Quaboag Pond farther down the river. It will be neces- 
sary to prevent the overflow of sewage from the Spencer sewerage 
system into the Seven Mile River in order to protect the public 
health in the valley of this river below Spencer. 

Concord and Sudbury Rivers. 

The condition of the Sudbury River has not been objectionable 
during the year, and the same is true of the Concord River to a point 
near its entrance into the city of Lowell, where it has been polluted 
at times as in previous years. 

Connecticut River. 

The condition of the Connecticut River, which is polluted by sewage 
in large quantities from the cities and towns along its banks, has 
shown little change as compared with previous years, and there is 
very little evidence of increasing pollution of the main stream ex- 
cepting in the immediate neighborhood of some of the main sewer 
outlets. These conditions have been remedied in several instances by 
the extension of the sewer outlets to a proper distance from the shore. 
Mill River below Northampton has shown evidence of greater pollu- 
tion than during the last two years, and the same is true of the 
Manhan River at the mouth. 

• 
Decrfield River. 

The condition of the Deerfield River has not been objectionable 
during the year. 



No. 34.] DIVISION OF SANITARY ENGINEERING. 99 



French River. 

The French River below Webster has shown more evidence of pol- 
lution than in 1919 or 1920. This condition is likely to continue 
until the sewage of the town of Webster is purified before discharge 
into the stream. Plans for disposal works were approved by this 
Department some years ago, but the works have not yet been con- 
structed. 

Hoosick River. 

There has been a marked increase in the pollution of the Hoosick 
River below North Adams as compared to 1920, and during the year 
the Department has again recommended that the sewage of the city 
of North Adams be removed from the river and properly purified. 



Housatonic River. 

The branches of the Housatonic River above Pittsfield have shown 
a slight increase in the amount of pollution in the past year, and the 
condition of the West Branch below Pittsfield was objectionable during 
the period of low flow in the late summer and fall. The main stream 
immediately below Pittsfield has shown more evidence of pollution 
than in 1920, but at Stockbridge and Great Barrington conditions 
have not changed materially in the last two or three years. 

Merrimack River. 

The Merrimack River below Lawrence has shown a greater degree 
of pollution than in 1920, though the conditions have not been as 
objectionable as during the three years previous to 1920. Above 
Haverhill a slight increase in pollution has been noted, but below 
Haverhill the condition of the river has not changed materially as 
compared with its condition last year. 

Millers River. 

The Millers River has shown less evidence of pollution below Gard- 
ner than at any time for several years, and lower down its course its 
condition has not been materially different from that of previous years. 



100 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Nashua River. 

The North Branch of the Nashua River below Fitchburg has shown 
greater evidence of pollution than in 1920. A large quantity of 
manufacturing waste, together with sewage from public sewers which 
overflows at times of storm, is discharged into the river in this city. 

The sewage of the city of Leominster, excepting that from a very 
small section of the city which is still being diverted to an experi- 
mental filter, is discharged untreated into Monoosnock Brook and 
flows thence into the North Branch of the river below the city. 

The North Branch of the Nashua River at its mouth has shown 
more evidence of pollution than in 1920, and this was also true of the 
South Branch below Clinton. The main stream below the confluence 
of the two branches has been on the whole in a slightly better condition 
than during the last few years. 

Neponset River. 

The results of the analyses of samples of water from the Neponset 
River show a slight increase in pollution just above and just below 
Hawes Brook, and the same is true of Hawes Brook at the mouth. At 
points farther downstream an improvement has taken place, and in 
Hyde Park and at the mouth the river has been in better condition 
than for many years. 

North River in Peabody and Salem. 

The North River in Peabody and Salem has been the cause of very 
serious complaint during the year, and the condition of this stream 
was the subject of a hearing before the Department in response to a 
petition from the city of Salem. The following recommendation was 
made relative to this stream: — 

The Department of Public Health has considered the petition of the city of 
Salem requesting a hearing upon the condition of North River and such action 
by this Department as it may deem necessary to abate an alleged nuisance 
therein, and in response to this petition has examined the locaUty and has given 
a hearing as requested in the petition. 

The Department finds that a nuisance exists in the North River, caused by 
the discharge of foul organic matters of various kinds into the river or upon its 
banks whence it is washed into the stream at times of rain. One of the chief 
causes of complaint appears to be the surcharging of the trunk sewer, the carry- 
ing capacity of which has been found to be greatly reduced at times by deposits 



No. 34.] DIVISION OF SANITARY ENGINEERING. 101 

therein. These deposits result from a variety of causes. The manufacturing 
wastes before being discharged into the sewers are generally passed through 
settling tanks or other form of treatment, but there are indications that wastes 
from different processes after entering the sewers cause a precipitation of solid 
matters which collects on the bottom and sides of the trunk sewer. Furthennore, 
examinations have shown that in the operation of the pumps the sewage is at 
times ponded in the trunk sewer, reducing the velocity of flow and thus tending 
to cause deposits therein. It is eiadent that the capacity of the force main is 
but little in excess of the usual flow of sewage, making proper operation of 
the system increasingly difficult as time goes on. 

In order to prevent the discharge of waste matters into the North River and 
remove the nuisance therein, it is important, first, to investigate fully the causes 
of the present nuisance, the means necessary for its prevention, and to devise 
a suitable plan for relief. Such an investigation wiU involve an expenditure 
of a considerable sum of money for which no provision has been made in the 
appropriations available to this Department. The Department recommends 
that the city of Salem, either alone or in conjunction with the city of Peabody, 
petition the Legislature for an order directing a thorough investigation of the 
whole question of the condition of North River and of the trunk sewer and its 
appurtenances, and the preparation of a practicable plan for the removal of 
the nuisance now existing in North River. The investigation should be com- 
mitted to such agency as the Legislature may direct, and a suitable sum of 
money provided to defray the necessary expenses of the work. 



Taunton River. 

The condition of the Salisbury Plain River below Brockton, and 
that of the Coweeset River below the Brockton sewage filters, has 
of late varied considerably from year to year. The results of analyses 
indicate in general a slight improvement in the condition of the 
former stream during the past year, while the reverse is true of the 
latter. The condition of the Coweeset River should show improve- 
ment when the new Brockton sewage disposal works now just com- 
pleted are put into operation. The Town River into which the 
Coweeset River discharges has been slightly more polluted than 
during 1920 both above and below Bridge water. Above Taunton 
the main river has been more noticeably polluted than in 1920 but 
less than in earlier years, while below^ Taunton at Berkeley Bridge 
the condition of the river has been more objectionable than in 1920. 

Other Rivers. 

The examinations of other rivers have shown no change in their 
condition worthy of note. 



102 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Examination of Sewage Disposal Works. 

The following tables contain statistics concerning the more impor- 
tant sewage disposal works in the State and the average results of 
analyses of samples of sewage and effluent. 

In general the quantity of sewage received at most of the sewage 
disposal works has been slightly less than in 1920 and except in a 
few cases has been of about the usual strength. 

At Andover a large mill and many dwelling houses have been 
constructed recently close to the filter beds and a sewerage system 
has been extended to include this new settlement, which is known as 
Shawsheen Village, but much of the sewage from this new section of 
the town has been discharged untreated into the Shawsheen River 
during the year. The quantity of sewage delivered at the disposal 
works for a number of years has exceeded their capacity, and near 
the end of the year a plan was presented providing for the abandon- 
ment of this sewage disposal works and the disposal of the sewage 

elsewhere. 

At Brockton the additional sewage disposal works, comprising a 
series of large settling tanks and 1| acres of trickling filters, had been 
practically completed at the end of the year and will soon be placed 
in operation. 

Several of the sewage disposal works in the State, particularly 
those at Clinton, Framingham, Milford, Natick and Norwood, have 
been heavily overloaded during the year, and at some of these places, 
namely, at Clinton and Milford, considerable quantities of sewage 
have been allowed to overflow without treatment. At Framingham 
the load on the sewage filters is greater in comparison to the area 
than at any other plant in the State, but it has been possible through 
the careful management which these filters have received to prevent 
the overflow of any considerable quantity of untreated sewage, 
though sewage stands on the surface of the filters sometimes for 
long periods. 

At Gardner and Northbrldge additional sewerage facilities have 
been provided. At Milford the underdrainage system of the filter 
beds was thoroughly cleaned during the past year, but a large addi- 
tion to the disposal works is necessary in order to treat all the sewage 
and prevent the serious pollution of the Charles River by untreated 
sewage. 

Considerable quantities of sewage have also been allowed to over- 
flow without treatment from the sewerage systems at Easthampton, 
Leicester, Pittsfield, Southbridge and Spencer, but no material diffi- 



No. 34.] DIVISION OF SANITARY ENGINEERING. 103 

culty has been encountered in the treatment of the sewage at Attle- 
boro, Concord, Hopedale, Hudson, Marlborough, North Attleborough 
and Northbridge. 

At Worcester the work of improving the sewage disposal works, as 
required by chapter 171, Special Acts of the year 1919, has been 
carried on as rapidly as practicable during the year. Nearly all 
excavation was completed at the end of the year and a few of the 
hoppers of the Imhoff tanks were in place. The walls and flooring 
for the trickling filters were also well under way and excavation 
begun for the secondary settling tanks. 



104 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 






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No. 34.] DIVISION OF SANITARY ENGINEERING. 



109 



Table No. 5. — Average Results of Analyses of Monthly Samples of Effluent 

from Sand Filters. 









[Parts in 100,000.] 












Free 
Am- 
monia. 


Total 
Albu- 
minoid 

Am- 
monia. 


Chlor- 
ine. 


Nitrogen as — 




CiTT OR Town. 


Ni- 
trates. 


Ni- 
trites. 


L:on. 


Andover' 


2.13 


.1161 


7.74 


.3561 


.0189 


.438 


Brockton 1 . 






4.13 


.0943 


8.84 


.1194 


.0059 


1.515 


Clinton 1 






1.80 


.0885 


4.35 


.1245 


.0051 


2.436 


Concords 






.03 


.0121 


3.60 


.7119 


.0006 


.014 


Easthampton 2 






.87 


.0657 


5.65 


.5680 


.0112 


.790 


Framingham 1 






2.60 


.0945 


8.78 


.3003 


.0135 


1.563 


Franklin 2 






1.64 


.0663 


4.07 


.1722 


.0154 


.477 


Gardner (Gardner area) ' 






1.28 


.0878 


7.78 


1.6617 


.0135 


.215 


Gardner (Templeton area) 






2.22 


.1540 


9.38 


1.2842 


.0749 


.149 


Hopedalei 






1.72 


.0675 


6.22 


2.7231 


.0027 


.081 


Hudson .... 






2.07 


.0985 


9.68 


1.2508 


.0344 


.120 


Leicester' 






1.30 


.0625 


4.61 


.2550 


.0109 


.316 


Marion .... 






.45 


.0394 


4.78 


.4877 


.0041 


.093 


Marlborough! . 






.58 


.0304 


6.74 


1.8043 


.0077 


.060 


Milford .... 






2.53 


.0885 


5.68 


.4588 


.0118 


1.050 


Natick 






2.00 


.0555 


7.19 


.1443 


.0082 


.987 


North Attleborough 2 . 






.04 


.0092 


2.84 


.6259 


.0029 


.019 


Northbridge^ 






.12 


.0151 


2.95 


.9805 


.0212 


.021 


Norwood .... 






1.39 


.0755 


14.30 


.3147 


.0425 


.615 


Pittsfieldi .... 






.86 


.0684 


5.01 


.4467 


.0307 


.260 


Southbridge* 






3.60 


.0815 


6.98 


.1815 


.0071 


1.790 


Spencer 2 .... 






.05 


.0151 


3.73 


.9673 


.0029 


.045 


StockbridgeJ .... 






.28 


.0372 


2.75 


.4387 


.0108 


.115 


Westboroughi 






1.47 


.0649 


5.92 


.1235 


.0081 


.828 


Worcester* .... 






1.87 


.0688 


9.30 


.9888 


.0098 


2.420 



> Regular samples from two or more underdrains in one average. 
2 Six samples. 
' Four samples. 



* Eleven samples. 
6 Five samples. 



no 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table No. 6. 



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

[Parts in 100,000.) 





Free Ammonia. 


Tot, 

NOID 


\h Albumi- 
Ammonia. 


Chlorine. 




City or Town. 


bSS 

03 
& 
o 
CO 

-s 
.2 

"ft 
ft 

< 


n 

3 

m 


13 

> 
o 

s 

s 


s 

.2 

"ft 
ft 
< 


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3 

m 


o 
S 

u 
CI 
O 

o 


6 

a> 
tc 

.2 

■ft 
a 
< 


.4^ 

c 

3 

m 


Rate of Operation 
Even Distribution 
Ions per Acre per D: 


Andover 


3.40 


2.13 


37 


.53 


.1161 


78 


8.78 


7.74 


67,000 


Brockton . . .... 


3.76 


4.13 


- 


.46 


.0943 


80 


6.98 


8.84 


- 


Clinton 


2.69 


1.80 


33 


.64 


.0885 


86 


5.02 


4.35 


49,000 


Concord 


2.02 


.03 


99 


.37 


.0121 


97 


3.67 


3.60 


104,000 


Easthampton 


4.75 


■ .87 


82 


.61 


.0657 


89 


6.88 


5.65 


- 


Framingham 


3.91 


2.60 


34 


1.43 


.0945 


93 


11.90 


8.78 


54,000 


Franklin . 


1.81 


1.64 


9 


.23 


.0663 


71 


3.16 


4.07 


79,000 


Gardner (Gardner area) . 


12.30 


1.28 


90 


1.91 


.0878 


95 


8.35 


7.78 


[ 80,000 

J 


Gardner (Templeton area) 


4.14 


2.22 


46 


.45 


.1540 


66 


8.06 


9.38 


Hopedale 


6.83 


1.72 


75 


.71 


.0675 


90 


7.10 


6.22 


- 


Hudson 


5.06 


2.07 


59 


.47 


.0985 


79 


11.14 


9.68 


54,000 


Leicester 


2.84 


1.30 


54 


.62 


.0625 


90 


4.24 


4.61 


- 


Marion 


1.75 


.45 


74 


.29 


.0394 


86 


3.42 


4.78 


- 


Marlborough 


4.45 


.58 


87 


.60 


.0304 


95 


8.78 


6.74 


47,000 


Milford 


3.14 


2.53 


19 


.47 


.0885 


81 


6.10 


5.68 


93,000 


Natick 


3.09 


2.00 


35 


.45 


.0555 


88 


7.36 


7.19 


69,000 


North Attleborough .... 


1.32 


.04 


97 


.16 


.0092 


94 


3.78 


2.84 


113,000 


Northbridge 


3.20 


.12 


96 


.31 


.0151 


95 


2.78 


2.95 


50,000 


Norwood 


2.29 


1.39 


39 


.37 


.0755 


80 


12.07 


14.30 


- 


PiTTSFIELD 


2.09 


.86 


59 


.34 


.0684 


80 


4.81 


5.01 


83,000 


Southbridge 


4.43 


3.60 


19 


.48 


.0815 


83 


8.38 


6.98 


118,000 




2.51 


.05 


98 


.55 


.0151 


97 


4.13 


3.73 


- 


Stockbridge 


1.67 


.28 


83 


.29 


.0372 


87 


3.38 


2.75 


- 


Westborough 


2.33 


1.47 


37 


.54 


.0649 


88 


5.08 


5.92 


79,000 


Worcester ..... 


3.16 


1.87 


41 


.95 


.0688 


93 


9.63 


9.30 


51,000 



1 See also Table No. 7. 



No. 34.] DIVISION OF SANITARY ENGINEERING. 



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Division of Water and Sewage 
Laboeatories 



H. W. Clark, Director 



[1131 



Eepoet of Division of Water and Sewage 

Laboratories. 



During the year 1921 this Division made 9,360 chemical, 2,105 
microscopical and 2,706 bacterial analyses, as shown in a following 
summary. The results of a large part of this work are given in the 
tables of analyses in the report of the Division of Sanitary Engineer- 
ing. Much of this analytical work was carried on to determine the 
quality of the public water supplies of the State and of the effluents 
from filters treating or purifying such supplies, the condition of the 
rivers, the character of the sewage entering rivers or passing to filtra- 
tion areas, the degree of purification obtained at these areas, the 
character of factory wastes, and the quality of the effluents from 
filters receiving such wastes. 

Considerable work was done in regard to corrosion of service pipes, 
the determination of lead, manganese, carbonic acid, etc., in special 
samples of water, and many analyses of spring waters, water from 
domestic wells, ice supplies, etc., were made. Further than this, 
considerable analytical and bacterial work w^as carried on to determine 
the quality of shellfish from different areas of the State and also the 
condition of the water over these areas. Special studies were made 
of methods for the treatment and disposal of sewage, of the condition 
and efficiency of certain municipal sewage disposal areas, of the effi- 
ciency of small septic tanks for houses, factories, etc., and of many 
general questions concerning the treatment of trade wastes, the dis- 
posal of sewage by trickling filters, aeration, activated sludge tanks 
and similar processes. 

The purification of water by means of chemical coagulants and 
rapid sand filtration has, because of new questions arising during the 
past two years concerning this method and the results obtained from 
it, acquired new importance, hence more complete studies are being 
carried on at the experiment station than ever before and with better 
equipment than previously available. 

Besides the work already mentioned, many special chemical and 
bacterial investigations were made during the year, both upon lab- 
oratory methods and technique and upon questions submitted to this 
Division for explanation. It is impossible to give in detail all the 



116 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

work of the Division, but a brief summary of some of the work car- 
ried on at the Lawrence Experiment Station is reported in the follow- 
ing pages. 

The following table summarizes the analytical work of the Division 
during the year: — 

State House Laboratories. 

Samples from public water supplies : 

Surface waters 2,396 

Ground waters 1,055 

Samples from domestic wells, ice supplies, etc 212 

Samples from rivers 1,037 

Samples from sewage disposal works : 

Sewages 402 

Effluents 600 

Samples of wastes and effluents from factories 87 

Samples of sea water from various locations 25 

Miscellaneous samples (partial analyses) 48 



5,862 



Microscopical examinations 2,105 

Special examinations of water for manganese and lead .... 437 
Other special examinations 89 

2,631 

Lawrence Experiment Station. 

Chemical examinations on account of investigations concerning the dis- 
posal of domestic sewage and factory wastes, filtration and other treat- 
ment of water supplies and swimming pools, ice supplies, etc. . . . 1,978 

Mechanical and chemical examinations of sand 83 

Bacterial examinations of water from pubHc water supplies, sewage efflu- 
ents, ice, etc 1,564 

Bacterial examinations in connection with methods of purification of 
sewage and water 1,103 

Bacterial examinations of samples of sheUfish 39 

4,767 

Character of the Sewage used at the Lawrence Experiment 

Station. 

Since 1915 sewage has been pumped to the station through a pipe 
about 1,850 feet long from the Osgood Street sewer on the south side 
of the Merrimack River at a point above the entrance of any trade 



No. 34.] WATER AND SEWAGE LABORATORIES. 



117 



waste, and the following table gives the average analyses for the year 
of the sewage used. "Regular sewage" is the average of samples 
collected four times daily of the sewage as pumped; "settled sewage" 
is the average of sedimentation of the regular sewage. The average 
analysis of the sewage applied during the year to Filters Nos. 1, 4 and 
9A is given in the table. A second table gives the total solid matters 
and the solid matters in suspension in the sewage as pumped and in 
the settled sewage. This settled sewage is applied to some of the 
filters and used in activated sludge Tank No. 485 and in certain other 
experiments described later. 

Average Analyses. 

Regular Sewage. 
[Parts in 100,000.] 



Ammonia. 






Chlorine. 


Oxygen 
consumed. 






ALBUMINOID. 


KjELDAHIi 1-N ITKOO JIIIV . 


Bacteria per 

Cubic 
Centimeter. 


Free. 


Total. 


In 
Solution. 


Total. 


In 
Solution. 


3.93 


.89 


.47 


1.62 


.87 


8.2 


5.08 


1,170,000 



Settled Sewage. 



4.14 



.69 



.42 



1.29 



.82 



7.0 



4.23 



730,000 



Sewage applied to Filters Nos. 1, 4 and 9 A. 



3.43 



.56 



1.14 



7.5 



4.09 



1,170,000 



Average Solids. 

Regular Sewage. 
[Parts in 100,000.] 



Unfiltered. 


Filtered. 


In Suspension. 


Total. 


Loss on 
Ignition. 


Fixed. 


Total. 


Loss on 
Ignition. 


Fixed. 


Total. 


Loss on 
Ignition. 


Fixed. 


63.0 


30.5 


32.5 


44.4 


16.3 


28.1 


18.6 


14.2 


4.4 



Settled Sewage. 



52.2 



25.5 


26.7 


40.7 


18.1 


22.6 


11.5 


7.4 



4.1 



118 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Operation of Septic Tanks. 

Since June, 1920, two septic tanks, Nos. 507 and 508, have been in 
operation at the station. Each of these tanks is constructed of 
concrete. Tank No. 507 is 4 feet long, 2 feet wide and 40 inches deep, 
with a sloping bottom, and has a capacity of 185 gallons. The sewage 
enters the tank through a trapped inlet and discharges through a 
pipe reaching 15 inches below the surface. A baffle is placed one- 
third of the distance from the inlet, extends to within 8 inches of the 
surface, and reaches to within 10 inches of the bottom of the tank. 
A trapped outlet is provided for the escape of gas, and air is carefully 

excluded. 

Tank No. 508 consists of two compartments, each of the same size 
and construction as Tank No. 507 except there are no baffles within 
the tank. The overflow of the first compartment passes into the 
second 6 inches below the surface of the liquid in the second compart- 
ment and 2 feet 8 inches from the outlet of the tank. From this 
tank air is also excluded and its inlet and outlet are trapped, and 
there is a trapped outlet for the escape of gas. 

Fresh sewage was applied to Tank No. 507 and regular station 
sewage to Tank No. 508. Into the first tank 90 gallons of sewage 
were passed daily, and into the second, 185 gallons, giving approxi- 
mately two days' storage of this sewage in each tank. During the 
year and one-half of operation, up to Nov. 30, 1921, the following 
results were obtained: — 

Very little gas was given off by either tank, although the effluent 
from Tank No. 508 had a strong odor of hydrogen sulphide during 
certain days. At times a considerable amount of suspended matter 
passed away in the effluents from each tank, but these effluents were 
always much clearer than the applied sewage, indicating the removal 
of colloids. Thirty-one per cent of the samples of effluent from each 
tank were stable on incubation. On April 5, after about ten months' 
operation, both tanks were opened and careful measurements made 
of the sludge. It was found by these measurements that during the 
operation of Tank No. 507, 52 per cent of the total entering sludge 
and 41 per cent of the organic matter of the sludge had been destroyed 
or had passed away in the effluent. Of the total sludge entering Tank 
No. 508, 60 per cent had been destroyed, and of the organic matter 
in the sludge, 62 per cent. Each tank contained a considerable volume 
of wet sludge; that in Tank No. 507, for instance, filled 26 per cent 
by volume of the tank, this sludge being 6.13 per cent solid matter, 
of which about half was organic matter. The first compartment of 



No. 34.] WATER AND SEWAGE LABORATORIES. 



119 



Tank No. 508 had 28 per cent of its capacity occupied by sludge, and 
the second compartment, 20 per cent, this sludge containing on exam- 
ination about 6 per cent of solid matter of which approximately half 
was organic matter. 

Reviewing the experiments up to date it can be said that the 
percentage of sludge digestion in these tanks is not materially different 
from that obtained in other septic tanks operated at the station in 
former years, but the effluents from these tanks have been clearer 
and much less offensive. In previous experimental work the exclusion 
of air has not been as complete as in the operation of these tanks. 

Tables showing the average analysis of the sewage applied to and 
of the effluent from these tanks follow: — 

Average Analyses. 

Station Sewage applied to Closed Septic Tank No. 507. 
[Parts in 100,000.] 



Ammonia. 


Kjeldahl Ni- 


Chlorine. 


Oxygen 

con- 
sumed. 


Fata. 






ALBUMINOID. 


trogen. 


Bacteria 
per Cubic 
Centi- 
meter. 


Free. 


Total. 


In So- 
lution. 


Total. 


In So- 
lution. 


3.95 


.87 .51' 


1.65 


1.01 


5.5 


4.80 


4.4 


4,170,000 



Effluent from Closed Septic Tank No. 507. 



3.64 



.41 



.29 



.79 



.56 



5.4 



2.61 



1.6 754,000 



Regular Sewage applied to Closed Septic Tank No. 508. 



3.71 



.75 



.40 



1.47 



.78 



7.2 



4.48 



3.4 



1,330,000 



Effluent from Closed Septic Tank No. 508. 



3.28 



.30 



.20 



.58 



.37 



6.7 



2.03 



1.0 



326,000 



120 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Average Solids. 

Station Sewage applied to Closed Septic Tank No. 507. 
[Parts in 100,000.] 



Unfiltered. 


Filtered. 


In Suspension. 


Total. 


Loss on 
Ignition. 


Fixed. 


Total. 


Loss on 
Ignition. 


Fixed. 


Total. 


Lofss on 
Ignition. 


Fixed. 


73.4 


33.5 


39.9 


49.6 


20.2 


29.4 


23.8 


13.3 


10.5 



48.7 



Effluent from Closed Septic Tank No. 507. 



19.3 



29.4 



42.2 



14.9 



27.3 



6.5 



4.4 



2.1 



54.8 



37.3 



Regular Sewage applied to Closed Septic Tank No. 508. 



26.5 



13.6 



28.3 



39.1 



16.1 



23.0 ,1 15.7 

ii 



Effluent from Closed Septic Tank No. 508. 



23.7 



33.7 



11.3 



22.4 



3.6 



10.4 



2.3 



5.3 



1.3 



Purification of Sewage by Aeration. — Activated Sludge. 

Activated sludge Tank No. 485, started in April, 1917, has always 
been operated by the continuous flow method. It consists of three 
compartments about 75 inches deep and 30 inches in diameter, the 
capacity of each compartment being 230 gallons or a total of 690 
gallons. The overflow from the last compartment passes through 
settHng tanks with a combined capacity of 760 gallons. The greater 
part of the sludge collects in the flrst settling tank and is pumped 
back to the activated sludge tank at frequent intervals. Sludge from 
the second settling tank is drawn off daily into a third tank where it 
is aerated and every few days pumped back to the activated sludge 
tank. Tank No. 485 is aerated through perforated brass pipes placed 
in the bottom of the tank, and the total amount of air applied is 
equal to 3.25 cubic feet per gallon of sewage treated. Theoretically 
the sewage passes through the tank in six and one-half hours. Usually, 
dissolved oxygen is present in the last two sections of the activated 
sludge tank and about 50 per cent of the time in the first section. 
Eighty-seven per cent of the samples of effluent taken during the year 
were stable, and the average nitrates in this effluent averaged 0.27 



No. 34.] WATER AND SEWAGE LABORATORIES. 



121 



part in 100,000. During the year the amount of dry sludge removed 
from the tank was equivalent to 724 pounds per 1,000,000 gallons of 
sewage , treated, and this sludge contained 5.94 per cent of nitrogen 
and 3.7 per cent of fats. As the difference between the solids in sus- 
pension in the applied sewage and in the effluent from the tank was 
equivalent to 967 pounds per 1,000,000 gallons, apparently 243 
pounds were lost by oxidation. 

Slate aerating Tank No. 509, put in operation in July, 1920, has 
been operated in such a way as to compare its results with the opera- 
tion of Tank No. 485. This tank has a surface area of aboat 15 
square feet, is 6 feet deep and holds 650 gallons. It contains a stack 
of layers of slate held 2 inches apart by concrete blocks, these slates 
occupying, however, only 4.3 per cent of the total capacity of the 
tank. It is aerated by means of perforated brass pipes like Tank No. 
485. The volume of air used per gallon of sewage treated and the 
period of aeration have been the same in both tanks, but No. 509 has 
been operated on the fill and draw plan. During the year 67 per 
cent of the samples from this tank were stable, but the sludge was 
not as stable as that from Tank No. 485. 

Tables showing the character of the sewage applied to and of the 
effluent from these tanks follow: — 

Average Analyses. 

Sewage applied to Activated Sludge Tank No. ^85. 
[Parts in 100,000.] 



Appeab- 


Ammonia. 


KjELDAHL 




Nitrogen 


a 

a 
o 


3 


ANCE. 




AJLBUMINOID. 


NiTROGE.N. 


AS — 


3 

o 










d 
o 




c 

o 








n 


..^ 














Q 








■^ s 


-3 


i 


6 


"3 
..J 


_3 


3 


_3 






1 


a 

a 




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o 




O 


a 
1— t 


o 




ja 






X 


H 


O 


^ 


H 


E- 


y—i 


O 


2; 


;? 


O 


m 


- 


3.34 


.83 


.42 


1.60 


.82 


7.3 


- 


- 


4.92 


730,000 



Effluent from Activated Sludge Tank No. 485. 



0.7 



.60 


2.68 


.24 


.18 


.43 


.34 


8.0 


.27 


.0204 


1.32 



532,000 



Sewage applied to Slate Aerating Tank No. 509. 



- 


3.38 


.72 


.44 


1.42 


.90 


6.6 


- 


- 


4.12 



1,170,000 



Effluent from Slate Aerating Tank No. 509. 



1.2 .62 1.77 



.26 



.20 



.54 



.42 



5.8 



21 .0179 1.50 655,000' 



122 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Average Solids. 

Sewage applied to Activated Sludge Tank No. 485. 
[Parts in 100,000.] 



Unfiltered. 



Total. 



65.3 



32.1 



Loss on 
Ignition. 



30. 



Fixed. 



34.5 



Filtered. 



Total. 



50.1 



Loss on 
Ignition. 



Fixed. 



21.5 



28.6 



In 


SCSPENSIO 


N. 


Total. 


Loss on 
Ignition. 


Fixed. 


15.2 


9.3 


5.9 



Efluent from Slate Aerating Tank No. 509. 



11.7 



20.4 



28.5 



10.2 



18.3 



3.6 



Effluent from Activated Sludge Tank No. 485. 


37.5 


12.2 


25.3 


34.9 


10.6 


24.3 


2.6 


1.6 


1.0 


Sewage applied to Slate Aerating Tank No. 509. 


53.8 


26.9 


26.9 


38.3 17.5 

1 


20.8 


15.5 


9.4 


6.1 



1.5 



2.1 



Operation of Trickling Filters. 

Ten trickling filters were in operation during 192L Filter No. 
135, the oldest and in its twenty-second year of operation, received 
sewage at the rate of 1,358,000 gallons per acre daily and all samples 
of its effluent were stable. This filter is operated as an example of per- 
manency, and contains 10 feet in depth of fine broken stone; its 
construction has been described in many experiment station reports. 

Two sets of trickling filters were in operation during the year. 
One set, Nos. 452 to 455, inclusive, 4, 6, 8 and 10 feet in depth, re- 
spectively, is constructed of broken stone that will pass a l|-inch 
screen but be retained by a ^-inch screen; a second set, Nos. 472 to 
475, inclusive, also 4, 6, 8 and 10 feet in depth, respectively, is con- 
structed of very coarse broken stone. These filters were operated to 
continue the study of depth of filtering material and trickling filter 
efficiency. The filters in both sets were operated at rates in propor- 
tion to their depth, namely, about 180,000 gallons for each foot of 
depth of material. The following tables show that with both sets the 
deeper filters operating at rates two and one-half times as great as 
the shallower filters produced better effluents; that the effluents from 



No. 34.] \YATER AND SEWAGE LABORATORIES. 



123 



the filters of finer material, Nos. 452 to 455, inclusive, were about 
equal in stability, — all the samples from the shallowest and deepest 
filter being stable; and that of the coarser set of filters the deepest 
filter produced an effluent of the most stable quality although operated 
at a very high rate. 

As an example of what can be expected of refiltration of a trickling 
filter effluent. Filter No. 502 was put in operation in January, 1920, 
and is constructed of 6 feet in depth of crushed stone that will pass a 
2-inch screen but be retained by a 1-inch screen. The effluent from 
Filter No. 473, after sedimentation, has been applied at the rate of 
4,350,000 gallons per acre daily. 

Tables showing the character of the efiluent from each filter follow : — 



Average Analyses. 

Effluents from Trickling Filters Nos. 133, 452, 453, 454, 455, 472, 473, 474, 475, 502 and 

Applied No. 502. 

[Parts in 100,000.] 







Quantity 
applied. 

Gallons 

per Acre 

Daily. 


A 


MMONIA 




Kjel- 
dahl 
Nitro- 
gen. 


Chlo- 
rine. 


Nitrogen 

AS — 


Oxygen 

con- 
sumed. 


Bacteria 
per 
Cubic 
Cen- 
timeter. 


Filter 


Free. 


ALBUMINOID. 


Number. 


Total. 


In So- 
lution. 


Ni- 
trates. 


Ni- 
trites. 


135 . . 


1,358,000 


2.33 


.43 


.23 


.86 


6.7 


1.69 


.0157 


2.65 


229,000 


452 




706,000 


2.99 


.54 


.30 


1.09 


6.8 


1.39 


.0270 


3.08 


260,000 


453 




1,090,000 


3.15 


.47 


.29 


.99 


6.6 


1.37 


.0465 


2.92 


215,000 


454 




1,450,000 


2.53 


.51 


.27 


1.00 


6.7 


1.52 


.0330 


2.96 


245,000 


455 




1,820,000 


2.35 


.45 


.26 


.93 


6.7 


2.13 


.0187 


2.79 


226,000 


472 




730,000 


3.28 


.54 


.29 


1.14 


6.6 


.62 


.0744 


3.02 


364,000 


473 




1,100,000 


3.33 


.51 


.32 


1.10 


6.2 


.80 


.0386 


3.10 


291,000 


474 




1,460,000 


2.80 


.54 


.29 


1 1.10 


6.7 


.96 


.0251 


2.90 


335,000 


475 




1,820,000 


2.27 


.51 


.30 


1.04 


6.5 


1.74 


.0343 


2.96 


212,000 


502 




4,350,000 


2.78 


.43 


.20 


.81 


6.6 


.98 


.0336 


2.43 


347,000 


A. 502 . 


- 


3.05 


.51 


.28 


1.03 


6.5 


.59 


.0285 


2.88 


291,000 



124 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Average Solids. 

Effluents from Trickling Filters Nos. 135, 452, 453, 464, 455, 472, 473, 474, 475, 502 and 

Applied No. 502. 







[Parts in 


100,000.] 














Ui 


■^TILTERED. 


Filtered. 


In Suspen.sion. 


Filter Number. 


TotaL 


Loss on 
Igni- 
tion. 


Fixed. 


Total. 


Loss on 
Igni- 
tion. 


Fixed. 


Total. 


Loss on 
Igni- 
tion. 


Fixed. 


135 


49.0 


19.7 


29.3 


38.8 


14.2 


24.6 


10.2 


5.5 


4.7 


452 


52.1 


21.4 


30.7 


38.2 


13.8 


24.4 


13.9 


7.6 


6.3 


453 


47.5 


18.6 


28.9 


36.0 


12.6 


23.4 


11.5 


6.0 


5 5 


454 


49.7 


19.8 


29.9 


37.9 


13.8 


24.1 


11.8 


6.0 


5.8 


455 


52.1 


22.9 


29.2 


41.2 


16.4 


24.8 


10.9 


6.5 


4.5 


472 


48.2 


18.6 


29.6 


34.4 


11.0 


23.4 


13.8 


7.6 


6.2 


473 


47.3 


19.2 


28.1 


37.1 


14.2 


22.9 


10.2 


5.0 


5.2 


474 


48.9 


19.9 


29.0 


36.6 


13.1 


23.5 


12.3 


6.8 


5 5 


475 


53.1 


23.0 


30.1 


40.2 


16.0 


24.2 


12.9 


7.0 


5.9 


502 


44.7 


17.7 


27.0 


35.9 


12.6 


23.3 


8.8 


5.1 


3.7 


A. 502 . . ' . 


45.0 


18.2 


26.8 


35.6 


13.4 


22.2 


9.4 


4.8 


4.6 



Operation of Contact Filters. 

One contact filter, No. 175, is kept in operation at the station for a 
study of permanency and for illustration of this method of purifica- 
tion. This filter, started in 1901, is constructed of 39 inches in depth 
of coke, all of which will pass a 1-inch screen, 75 per cent a |-inch 
screen and practically none a J-inch screen. During 1921 the filter 
was flooded daily with settled sewage, stood full four hours before 
draining and was allowed to rest every sixth week. The effluent was 
well-nitrified during the year and all samples collected were stable. 
Due to clogging, the material of this filter has been removed and 
washed twice during its period of operation, — once in 1911 and 
again in 1920. 

The following table gives the average analysis of its effluent: — 



No. 



34.] 



^YATER AND SEWAGE LABORATORIES. 



125 



Average Analyses. 

Effluent from Contact Filter No. 175. 
[Parts in 100,000.] 







Ammonia. 






Nitrogen 

AS — 




_o 








c 
o 
so 
o 




•a 

0) 

E 

3 

03 

o 




Quantity 
applied. 

Gallons 
per Acre 




ALBUMINOID. 


3 

o 






c 
o 




6 


a: 

Si 


O 




Daily. 




3 
o 


o 
m 

a 


2 


_o 


is 




>. 
X 

O 


5g 

« 


352,000 


1.38 


.31 


.22 


.66 


6.7 


2.35 


.0374 


1.98 


364,000 



Average Solids. 

Effluent from Contact Filter No. 175. 
[Parts in 100,000.) 



Unfiltered. 


Filtered. 


In Suspension. 


Total. 


Loss on 
Ignition. 


Fixed. 


Total. 


Loss on 
Ignition. 


Fi.xed. 


TotaL 


Loss on 
Ignition. 


Fixed. 


46.5 


20.1 


26.4 


42.2 


17.5 


24.7 


4.3 


2.6 


1.7 



Intermittent Sand Filters operated with Untreated Sewage. 

Filters Nos. 1, Ij. and 9 A. 

Each of these three sand filters is 1/200 of an acre in area, and at 
the end of the year Filters Nos. 1 and 4 had been operated contin- 
uously for nearly thirty-four years and Filter No. 9A for thirty-one 
years. Regular sewage without preliminary clarification has always 
been applied to them, and for many years it has been the practice to 
apply only as much sewage to each filter as can be purified without 
materially increasing the amount of organic matter stored within the 
filter. 

The following table gives data concerning the operation of these 
filters: — 



126 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 











Actual 


Volume of 






Effective 




Volume of 


Sewage 


Filter Number. 


Depth 


Size of 


Date first 


Sewage 


applied daily 


(Feet). 


Sand 


operated. 


applied since 


during 1921 






(Millimeter). 




Start 
(Gallons). 


(Gallons per 
Acre). 


1 


5 


.48 


Dec. 10, 1888 


3,198,700 


.31,500 


4 


5 


.04 


Dec. 19, 1887 


1,159,700 


19,700 


9A 


5 


.17 


Nov. 18, 1890 


2,689,400 


35,200 



For many years the surfaces of Filters Nos. 1 and 9 A have been 
trenched and ridged late in the fall and leveled in the spring. The 
surface of Filter No. 4 is arranged in circular trenches, 14 inches wide, 
and filled to a depth of 12 inches with sand of an effective size of 
0.48 millimeter. Sewage is applied to these trenches, grass being 
allowed to grow on the ridges. In winter board coverings are put 
over the trenches in all three filters. They were put on Nov. 26, 1920, 
and removed April 4, 1921. The surfaces of the filters were dug over 
to a depth of from 8 to 10 inches twuce and raked eleven times. An 
examination of the sand in Filters Nos. 1 and 9A is made about the 
first of July each year. The greater part of the stored organic matter 
is found in the upper foot of sand, and there has been a gradual in- 
crease although it has fluctuated from year to year. The sand that 
was removed from Filter No. 9 A in November, 1920, was washed with 
a crude, improvised washer and replaced July 8, 1921. About one- 
sixth of the sand was lost in washing, and the organic matter, as 
indicated by albuminoid ammonia, was reduced 49 per cent. In some 
laboratory experiments 83 per cent of the albuminoid ammonia was 
removed by washing. 

Average Analyses. 

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



Temperature 
(Degrees F.). 


Ammonia. 


Chlor- 
ine. 


Nitrogen 

AS — 


Oxygen 

con- 
sumed. 


Alka- 
linity. 


Bacteria 
per 


Ap- 
plied. 


Efflu- 
ent. 


Free. 


Albumi- 
noid. 


Ni- 
trates. 


Ni- 
trites. 


Cubic 
Cen- 
timeter. 


59 


54 


.3055 


.0526 


6.1 


2.49 


.0015 


.45 


-1.8 


5,750 



Effluent from. Filter No. 4- 



59 



49 



.0319 



.0207 



6.7 



2.21 



.0020 



.34 



-1.7 



250 



Effluent from Filter No. 9A. 



59 



56 



.8660 



.0621 



6.3 



1.53 



.0007 



.57 



—0.2 



9,150 



No. 34.] WATER AND SEWAGE LABORATORIES. 



127 



Sand Analyses. 

Albuminoid Avimonia in First Foot of Sand in Filters A'os. 1 and 9 A. 

[Parts in 100,000.] 



Year. 


Filter No. 1. 


Filte 


r No. 9A. 


1910 . 




66,1 




56.5 


1915 . 




74.9 




81.1 


1918 . 




106.0 




86.3 


1919 . 




91.4 




68.0 


1920 . 




112.2 




92.3 


1921 . 




124.0 




32.61 



• Sand wa.shed. 



Mechanical Filtration of Merrimack River Water. 

Filter No. 520. 

Studies in regard to the purification of Merrimack River water by 
coagulation and rapid filtration were begun in ]May in order to learn 
more definitely than ever before the efficiency of this method when 
treating a water as badly polluted as this but containing little sus- 
pended matter. The filter used was constructed of concrete, 25 inches 
square, and contained 30 inches in depth of sand of an effective size 
of 0.44 millimeter. Below the sand were 15 inches of graded gravel 
held upon a brass strainer of the usual mechanical filter type. While 
provision was made for the use of compressed air for washing the 
filter, it was found that more satisfactory results could be obtained 
with this small filter by washing with filtered water. The rate of 
operation of the filter was automatically controlled. The raw water 
and the aluminum sulphate applied were passed into a mixing tank 
and then into a baflfled sedimentation basin giving approximately 
three hours' storage. The filter was operated for two months at the 
rate of 50,000,000 gallons per acre daily and from that time until 
the end of the year at a 70,000,000-gallon per acre daily rate. The 
amount of aluminum sulphate used varied from 1.5 to 2.5 grains per 
gallon according to the quality of the water filtered and necessary for 
maximum color and bacterial removal. The average run of the filter 
between washings was twenty-four hours, and the volume of filtered 
water used in washing, 2.3 per cent. While the color of the river 
water averaged about 0.45 part, it was increased during July follow- 
ing heavy rains to 0.75 part. Daily determinations of bacteria, color, 



128 



DEPART:MEXT of public health. [Pub. Doc. 



alkalinity, etc., were made of the effluent from the filter but somewhat 
less frequently of the applied water. The following tables show the 
results obtained both in color removal and bacterial efficiency. The 
average color of the applied water was 0.45 and of the filter effluent 
0.07, and as good color removal was obtained when the color of the 
water was 0.75 as when at its lowest point. Perhaps the most significant 
bacterial result was the removal of B. coli. The B. coli score of the 
effluent during the year was 12, that is, the average number of coli 
found in each 100 cubic centimeters. At times, especially when the 
larger amount of aluminum sulphate was used, the bacterial efficiency 
of the fflter was much greater than this, as shown by the tables. 

As there has been considerable discussion of late in regard to after- 
growths of bacteria in the effluents from mechanical water fflters, 
alleged to be due to the passage of colloids through such filters espe- 
cially at times of high color of the applied water, the breaking of these 
colloids and the release of bacteria, investigations along this line were 
made during the year. In this investigation thirty-seven samples of 
the effluent from the filter, collected at different periods, were studied. 
After immediate analysis the remainder of each sample was kept seven 
days in a 20° C. incubator and again examined. In 7 of these samples 
there was an increase of bacteria in the four-day count; in 5, a decrease; 
and in 25, no change. In the twenty-four hour 37° C. count, 34 of the 
samples were unchanged. In none of them was there an increase in 
the B. coli score but there was a decrease in 22, and 15 were un- 
changed. It was found during the operation of this filter that such 
slow coagulation of the river water occurred at low temperatures that 
it was almost impossible to obtain satisfactory fflter results during such 
periods. 

Average Chemical Analyses. 

River Water applied to Mechanical Filter No. 520. 
[Parts in 100,000.] 





Ammoni.^.. 


Oxygen 
consumed. 


Iron. 


Alkalinity. 




Color. 


Free. 


ALBUMINOID. 


Soap 
Hardness. 




Total. 


In Solution. 


.42 


.0181 


.0201 


.0156 


.51 .080 


1.4 


1.5 



Effluent from Mechanical Filter No.. 520. 
[1.75 to 2.0 grains per gallon of aluminum sulphate used.] 



.06 



.0106 



.0052 



.13 



.012 



0.7 



1.8 



Xo. 34.] WATER AND SEWAGE LABORATORIES. 129 

Average Chemical Analyses — Concluded. 

River Water applied to Mechanical Filter M'o. 520. 
[Parts in 100,000.] 





Ammo.n'i.4. 


Oxygen 
consumed. 


Iron. 


Alkalinity. 




Color. 


Free. 


ALBUMINOID. 


Soap 
Hardness. 




Total. 


In Solution. 


.48 


.0206 


.0218 


.0184 


.58 


.067 


1.4 


1.5 



Effluent from Mechanical Filter No. 520. 
[2.0 to 2.5 grains per gallon of aluminum sulphate used.] 



.07 



.0104 



.0054 



.14 



.006 



0.5 



Average Bacterial Analyses. 

Merrimack River Water. 



B.1CTERI.*. PER Cubic 
Centimeter. 


Per Cent of S.\.mples containing B. Coli. 




Four Days, 


TWENTY-FOUR HOURS, 
37° C. 


.001 CO. 


.01 c.c. 


0.1 c.c. 


1.0 c.c. 


10 c.c. 


B. Coli in 
100 c.c. 


20° C. 


Total. 


Red. 




2,800 


850 


130 





57 


100 


100 


- 


6,100 



River Water after Coagulation applied to Mechanical Filter A'o. 520. 
[1.75 grains per gallon of alimiinum sulphate used.] 



240 


150 


25 


- 





29 


71 


100 


330 


Effluent from Mechanical Filter No. 520. 


29 


2 





- 


- 


14 


45 


18 


Merrimack River Water. 


2,610 


350 


68 


■ 




38 


91 


100 


- 


4,500 



River Water after Coagulation applied to Mechanical Filter No. 520. 
[2.0 grains per gallon of aluminum sulphate used.] 



340 



80 



n 



40 



80 



100 



440 



130 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Average Bacterial Analyses — Concluded. 

Effluejit from Mechanical Filter No. 520. 



Bacteria per Cubic 
Centimeter. 


Per Cent of Samples containing B. Coli. 




Four Days, 


TWENTT-FODR HOURS, 
37° C. 


.001 c.c. 


.01 c.c. 


0.1 c.c. 


1.0 c.c. 


10 c.c. 


B. Coli in 
100 c.c. 


20° C. 


Total. 


Red. 




24 


1 





- 


- 





9 31 


12 



Mrrimack River Water. 



1,800 



480 



77 



67 



100 



100 



River Water after Coagulation applied to Mechanical Filter No. 520. 
[2.25 grains per gallon of aluminum sulphate used.] 



84 



20 







67 



100 



Effluent from Mechanical Filter No. 520. 



11 



43 



Merrimack River Water. 



1,860 



170 



67 



100 



100 



River Water after Coagulation applied to Mechanical Filter No. 520. 
[2.5 grains per gallon of aluminum sulphate used.] 



680 



27 







50 



100 



100 



Eflw nt from Mechanical Filter No. 520. 



31 



7,000 



70 



7,000 



550 



Slow Sand Filtration of Water treated with Aluminum 

Sulphate. 

Filter No. 519 was started May 20, 1921, is 1/20,000 of an acre in 
area, and contains 4| feet in depth of sand of an effective size of 0.23 
millimeter. It was operated at a rate of 5,000,000 gallons per acre 
daily, and water was applied to it that had received the same treat- 



No. 34.] WATER AND SEWAGE LABORATORIES. 



131 



ment as the water applied to Filter No. 520, that is, river water that 
had received from 1.5 to 2.5 grains per gallon of aluminum sulphate 
and that had been settled at least three hours. This filter filtered 
three times as much water between scrapings as the mechanical filter 
did between washings; the average removal of bacteria was slightly 
lower than that of the mechanical filter but the removal of B. coli was 
much better, the score being 1, and during one hundred and eighty- 
five days of operation it was scraped five times. 

Effluent from Sand Filter No. 519. 

















[Part.s in 


100,000.] 






















i 




Nitrogen 










Bacteria per 


Per Cent of 








Ammonia. I 












Cubic 


S-AMPLES containing 












AS — 


■6 








Centimeter. 


B. Coli. 




































■B 














!R 


n 


twenty- 












1^ 






O 








d 






CD 


o 


four HOURS, 












o 






S 


6 






S3 

8 




>> 


OS 




37° C. 
















1 




1 


6 




a 
1 

j3 






a 

01 

>> 


p 






Q 
o 


o 


ID 


o 


6 




6 
6 
o 


d 

6 


O 


o 


fe 


H 


o 

.64 


S 


S 


O 


KH 


< 


02 


fe 


H 


Pi 


o 


o 


o 


" 


-■ 


ri 


.07 


.0023 


.0052 


.024 


.0002 


.15 


.010 


0.5 


1.7 


22 


9 





- 


- 








31 


1 



Removal of Color from Water. 

Operation of the three filters of sand impregnated with ferric and 
aluminum hydroxide described in the last four reports has been con- 
tinued and six similar filters were started during the year, the rate of 
operation of all of them being 5,000,000 gallons per acre daily. Filters 
of this t^^pe after a period of operation need to be regenerated by 
dissolving out as much as possible of the stored organic matter with 
caustic soda, this being done by dissolving the soda in a certain volume 
of water and passing this solution through the filter several times. 
The six filters started during 1921 were operated for the purpose of 
determining the most efficient amount of aluminum hydroxide to use 
in the sand and the most economical amount of caustic soda to use 
in regenerating the filters. 

Filter No. 488, started in May, 1917, has a depth of 4 feet and 
contains sand of an effective size of 0.25 millimeter, and when it was 
first put into operation an amount of ferric sulphate equal to 64.5 tons 
per acre was precipitated as ferric hydroxide throughout the filter, 
this amount being equivalent to 0.72 pounds of ferric sulphate per 
cubic foot of sand. During its period of operation up to the end of 
1921 the filter has been regenerated thirty times, with an average 
period of operation between treatments of forty-eight days. The 



132 DEP.\RT:MEXT of public health. [Pub. Doc. 

amount of caustic soda used during the year averaged 0.47 grain per 
gallon of water filtered, the average amount during the entire period 
of operation, 0.49 grain. The amount of ferric sulphate per gallon of 
water filtered will decrease regularly with the period of operation as 
little or no ferric hydroxide will need to be added to that now in the 
sand. The amount of sulphate precipitated in the sand is equivalent 
to 0.13 grain per gallon of water filtered since the filter was started. 
The average amount of free carbon dioxide in the effluent from this 
filter during 1921 was 0.4 part, the same as in the applied canal 
water, and the increased amount of mineral matter in the effluent was 
0.14 part in 100,000. 

Filter No. 494, put into operation in January, 1918, is of the same 
size and depth and contains the same grade of sand as Filter No. 488. 
When first put in operation an amount of aluminum sulphate equal to 
80.5 tons per acre was precipitated as hydroxide throughout the sand. 
During its period of operation this filter has been treated with caustic 
soda twenty-four times, with an average period of forty-five days' 
operation between treatments. The amount of caustic soda used per 
gallon of water filtered equaled 0.52 grain. The aluminum sulphate 
used during the period of operation has been equivalent to 0.21 grain 
per gallon of water filtered. This filter does not increase the free 
carbon dioxide in the effluent above the amount present in the raw 
water. 

Filter No. 496, put in operation in September, 1918, contains 4 feet 
in depth of sand of an effective size of 0.25 millimeter, and this filter 
receives the mixed effluents from Filters Nos. 488 and 494. During 
its entire period of operation up to the end of 1921, it was treated 
with caustic soda seven times, with an average period of operation of 
one hundred and seventeen days between treatments. The amounts 
of caustic soda and ferric sulphate used per gallon of water filtered 
during the whole period of operation of this filter were equivalent to 
0.20 and 0.09 grain, respectively. The average color of the effluent 
from this filter was 0.07 part in 100,000, the same as that of mechani- 
cal Filter No. 520, in the operation of which approximately 2 grains of 
aluminum sulphate per gallon were used. 

The following tables give the results of the operation of these three 
filters from the time each was started to the end of 1921. In connec- 
tion with these results the following facts can be noted: Filter No. 
488 was scraped very lightly three times in 1917 and once in 1920; 
Filter No. 494 was scraped once in 1920; Filter No. 496 was operated 
without any removal of sand. During the year Filter No. 496 reduced 
the color, albuminoid ammonia and oxygen consumed of the applied 
water 50, 34 and 36 per cent, respectively. The bacterial efficiency of 



No. 34.] WATER AND SEWAGE LABORATORIES. 



133 



the combined filters, namely, Nos. 488, 494 and 496, was 98.2 per 
cent total bacteria and 99.88 per cent B. coli. 

Six new filters, Nos. 512 to 517, inclusive, were started Feb. 2, 1921. 
These are 1/80,000 of an acre in area and contain 4h feet in depth of 
sand of an effective size of 0.23 millimeter. Filters Nos. 512 and 513 
contain 75 tons per acre of commercial aluminum sulphate precipitated 
as aluminum hydroxide throughout the sand, Filters Nos. 514 and 515, 
150 tons, and Filters Nos. 516 and 517, 225 tons. These amounts are 
equivalent to 0.76, 1.53 and 2.29 pounds, respectively, of aluminum 
sulphate per cubic foot of sand. In regenerating these filters, the first 
of each pair received 5 tons of caustic soda per acre and the second 
10 tons. 

Studying carefully all the results of these six filters obtained during 
the year, there appears to be no practical difference in the degree of 
purification effected by the different amounts of aluminum sulphate 
used although the filters with the larger amounts of sulphate, Nos. 
514 to 517, inclusive, ran longer between treatments than did the 
filters with 75 tons. Washing out the excess caustic from Filters 
Nos. 516 and 517 required, however, approximately twice as long as 
this operation with the other four filters. It would seem, therefore, 
that of the three amounts of alum tried in these experiments 150 tons 
per acre is the most efficient. As stated previously, one of each of the 
three pairs of filters containing the same amount of aluminum hydrox- 
ide was treated with 5 tons of caustic and the other with 10 tons. 
The larger amounts in every case removed more of the stored organic 
matter. However, the purification effected by the filters treated with 
the smaller amounts was practically the same as that by the filters 
receiving the larger amount. Probably satisfactory results would be 
obtained b}' the regular use of 5 tons with an occasional 10-ton treat- 
ment. The percentage of the organic matter collected by the alumi- 
num or ferric hydroxide which was removed by the caustic treatment 
is shown in a following table. The average increase in mineral matter 
in the efl^luents from these six filters due to residual soda was 0.41 
part in 100,000. 

Per Cent removed by Treatment with NaOH. 





Filter No. 




488. 


494. 


495. 


512. 


513. 


514. 


515. 


516. 


517. 


Color 


42 


49 


61 


39 


46 


28 


42 


13 


31 


Albuminoid ammonia 


36 


40 


41 


38 


51 


37 


43 


12 


27 


Oxygen consumed 


42 


48 


35 


37 


41 


32 


34 


16 


28 



134 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Per Cent Reduciion of Organic Matter. 











Filter N 


o. 










488. 


494. 


496. 


512. 


513. 


514. 


515. 


516. 


517. 


Color 


75 


64 


50 


73 


73 


73 


78 


76 


71 


Albuminoid ammonia 


55 


46 


34 


46 


49 


49 


54 


57 


52 


Oxygen consumed 


58 


54 


36 


60 


60 


63 


67 


63 


67 



Further Data obtained from the Operation of Filters Nos. 512 to 517, inclusive. 



Tons of aluminum sulphate per acre precipi- 
tated in filter. 
Number of days between regenerations . 

Grains of caustic soda per gallon of water fil- 
tered. 
Approximate percentage of wash water . 



Filter No. 



512. 



75 

67 

.21 

3.7 



513. 


514. 


515. 


516. 


75 


150 


150 


225 


67 


89 


89 


90 


.42 


.16 


.32 


.16 


3.7 


2.8 


2.8 


5.5 



517. 



225 

90 
.32 

5 5 



Average Chemical Analyses for the Entire Period of Operation, 1917 to 1921, 

inclusive. 

Merrimack River Water applied to Filters Nos. 1^88 and 494- 

[Parts in 100,000.] 



Appearance. 


Ammoni.v. 


Chlo- 
rine. 


Nitrogen 

AS — 


Oxygen 

con- 
sumed. 


Iron. 


Alka- 
linity. 






Color. 


Free. 


ALBUMINOID. 


Ni- 
trates. 


Ni- 
trites. 


Soap 
Hard- 


Tur- 
bidity. 


Total. 


In So- 
lution. 


ness. 


0.2 


.41 


.0157 


.0179 


.0137 


.44 


.022 


.0007 


.54 


.0503 


1.0 


1.2 



.14 



Effluent from Filter No. 488. 



.0073 



.0075 



.44 



.024 



.0011 



.22 



.0155 



1,3 



1.3 



.16 



Effluent from Filter No. 494- 



.0079 



.0085 



.44 



.023 



.0009 I .25 



.0199 



1.3 



1.4 



Effluent from Filter No. 496. 



.07 



.0029 



.0052 



.44 



} .025 



.0004 



.15 



.0160 



1.3 



1.4 



No. 34.] WATER AND SEWAGE LABORATORIES. 



135 



Average Bacterial Analyses far the Entire Period of Operation, 1917 to 1921, 

inclusive. 

Merrimack River Water applied to Filters Nos. 488 and 494. 



Bacteria per Cubic 
Centimeter. 


Per Cent of Samples containing B. Coli. 




Four 

Days. 20° 

C. 


TWENTY-FOUR 
HOURS, 37° C. 


.001 c.c. 


.01 c.c. 


0.1 c.c. 


1.0 c.c. 


10 c.c. 


B. Coli 
in 100 c.c. 


Total. 


Red. 




5,890 


566 216 


2.4 


47 


94 


100 


- 


7,340 



Effluent from Filter No. 488. 



2,870 



73 



0.2 



16 



58 



88 



225 



Effluent from Filter No. 494. 



3,720 



84 



0.5 



15 



58 



83 



241 



767 



32 



Effluent from Filter No. 496. 



1.7 



17 



44 



35 



Summary of Results for Entire Period of Operation, 1917 to 1921, inclusive. 

[Parts in 100,000.] 





Per Cent Reduction by 
Filter No. 


Per Cent removed by NaOH 
FROM Filter No. 




488. 


494. 


49S. 


488. 


494. 


496. 


Color 

Albuminoid ammonia . 
Oxygen consumed 


66 
58 
59 


61 
52 
54 


47 
35 
36 


57 
37 
45 


52 
43 
50 


61 
81 
97 



Filtration- of Water as polluted as Merrimack River Water 

BELOW Lawrence. 

Filter No. 521 was started on July 21, 1921, is 1/20,000 of an acre 
in area and contains 4| feet in depth of sand of an effective size of 
0.23 millimeter. To it was applied a very polluted water, as shown 
in the following tables, and its rate of operation was 5,000,000 gallons 
per acre daily until October 17 when it was reduced to 2,500,000. 
During a period of operation of one hundred and fifty days it was 
scraped four times. 



136 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Average Chemical Analyses. 

Merrimack River below Lawrence. 

[Parts in 100,000.] 



Appeakance. 


Ammonia. 


Chlo- 
rine. 


Nitrogen 

AS — 


Oxygen 

con- 
sumed. 


Iron. 


Alka- 
linity. 


Soap 
Hard- 
ness. 




Color. 


Free. 


albuminoid. 


Ni- 
trates. 


Ni- 
trites. 


Tur- 
bidity. 


rp„,„. In So- 
Total, i^ition. 


0.3 


.50 


.0310 .0508 


.0254 


.74 


.017 


.0007 


1.04 


- 


1.6 



0.3 



.45 



.29 



Water applied to Filter A'o. 521. 



.0589 



.0489 



.0158 



.68 



.021 



.0012 



.78 .251 



1.6 



Effluent from Filter No. 521. 



.0127 



.0117 



.67 



.048 



.0018 



.34 



.037 



1.4 



Average Bacterial Analyses. 

Merrimack River below Lawrence. 



1.6 



Bacteria per Cubic 
Centimeter. 


Per Cent of 
B.^cteria removed. 


Per Cent of Samples containing 
B. CoLi. 




Four 


TWENTT-FOUR 
HOURS, 37° C. 


Four 
Days, 
20° C. 


twenty-four 
HOURS, 37° C. 


.0001 
c.c. 


.001 
c.c. 


.01 
c.c. 


0.1 
c.c. 


1.0 
c.c. 


10 
c.c. 


B. Coli 

in 
100 c.c. 


Days, 
20° C. 


Total. 


Red. 


Total. 


Red. 




13,000 


3,300 


1,520 


- 


- 





83 


100 


100 


- 


- 


85,000 


Water applied to Filter No. 521. 


9,200 


2,600 


940 


- 


- 


- 





30 


83 


100 


- 


1 


32,000 


Effluent from Filter No. 521 . 


440 


135 


13 


95.2 


94.8 


98.6 











33 


80 


97 


300 



Lawrence City Filters. 

The city of Lawrence takes its water supply from the Merrimack 
River, which is polkited by the sewage and trade wastes of the cities 
and towns above. Since 1893 this water supply has been purified by 



No. 34.] WATER AND SEWAGE LABORATORIES. 



137 



slow sand filtration, and since 1918 liquid chlorine has been applied 
to the effluents from the filters. Two filters are in use, — the older 
one, 2.2 acres in area, is divided into three sections by concrete walls, 
and contains 4 feet in depth of sand of an effective size of approxi- 
mately 0.25 millimeter. Until 1917 this filter was entirely uncovered, 
but during 1917 and 1918 the easterly section was rebuilt and made 
a concrete filter, with bottom, sides and roof. In 1907 a covered 
filter, three-fourths of an acre in area, was constructed. This second 
filter contains about 4 feet in depth of sand of an effective size of 
approximately 0.25 millimeter. The average amount of liquid chlorine 
applied to the effluents from these filters during 1921 was 0.44 part 
per 1,000,000. 

The following tables present the bacterial and chemical results of 
operation. The first table shows the number of B. coli in 100 cubic 
centimeter samples of effluent collected directly at the filters and in 
samples collected during the past four years from other points on the 
distribution system. This table is arranged to show the results during 
the comparatively warm months, May to October, inclusive, and 
during the colder months, November to April, inclusive. Other tables 
give the regular average bacterial analyses of the water applied to 
and of the effluents from these filters, from the distributing reservoir, 
etc., and the average chemical analyses of the river water applied to 
and of the effluents from the filters, etc. 



Number of B. Coli in 100 Cubic Centimeters by Scoring Method. 







November to April, inclusive. 


Mat to October, inclusive. 




1918. 


1919. 


1920. 


1921. 


1918. 


1919. 


1920. 


1921. 


Merrimack River, in 
Old city filter . 
New city filter 
Both filters' . 
Reservoir 
City Hall tap . 
Experiment Station 


take 
tap 




14,300 
73 
25 
42 
58 
18 
32 


29,000 

170 

45 

100 

33 

33 

195 


14,300 
34 
16 
28 
12 
16 
14 


25,200 
7 
15 
3 
3 
2 
9 


6,300 
22 
33 
25 
9 
8 
14 


9,900 
32 
12 
23 
19 
2 
10 


9,300 
3 

12 
7 
2 

3 


10,800 
8 
11 
7 
2 
2 
1 



1 Since December, 1819, chlorine has been added to the mixed effluents of both filters before pumping 
to the reservoir. 



138 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Average Bacterial Analyses. 
Merrimack River. — • Intake of the Lawrence City Filters. 



Bacteria per Cubic 
Centimeter. 


Per Cent of 
Bacteria removed. 


Per Cent of Samples containing 
B. CoLi. 




Four 


TWENT1 
HOURS, 


-FOUR 

37° C. 


Four 
Days, 
20° C. 


twenty-four 
HOURS, 37° C. 


.001 
c.c. 


.01 
c.c. 


0.1 
c.c. 


1.0 
c.c. 


10 
c.c. 


B. Coli 

in 
100 c.c. 


Days, 
20° C. 


Total. 


Red. 


Total. 


Red. 




5,400 


500 


85 


- 


- 


- 


11 


62 


100 


100 


- 


18,000 




Effluent from Lawrence City Filter (Old Filter) . 






16 


3 





99.7 


99.4 


100 


- 


- 





5 


27 


7 


Effluent from Lawrence City Filter {New Filter). 


17 


3 





99.7 


99.4 


100 


- 


- 





10 


40 


13 




Mixed Effluents as pumped to the Distributing Reservoir. 






14 


4 





- 


- 




- 


- 





1 


34 


5 


Water from the Outlet of the Distributing Reservoir. 


39 


3 





- 


- 


- 


- 








29 


3 


Water from a Tap at Lawrence City Hall. 


37 


4 





- 


- 


- 


- 


- 








23 


2 


Water frojn a Tap at the Lawrence Experiment Station. 


26 


5 





- 


- 


- 


- 


- 





3 


25 


5 



No. 34.] WATER AND SEWAGE LABORATORIES. 



139 



Average Chemical Analyses. 

Merrimack River. — Intake of the Lawrence City Filters. 

[Parts in 100,000.] 



fe 


Appear- 


Ammonia. 




Nitrogen 








ance. 






AS 




o 






ALBUMINOID. 






1 




tn 




1 


s' 


S 


"S 


a 
_o 

_3 

"o 


.1 
o 


2 




§ 
o 

a 


a 


C 

"a 

§ 


s 


3 


o 


ti 


O 


h- ( 








X 


o 


H 


Eh 


O 


fe 


H 


Q 


2; z 


o 


►-H 


53 


el- 


.42 


.0144 


.0184 


.0150 


.43 


.016 


.0005 


.56 


.0520 


1.2 



Effluent from Lawrence City Filter {Old Filter) . 



55 



0.1— 



.41 



.0124 



.0083 



.51 



.027 .0002 .39 .0760 1.3 



Effluent from Lawrence City Filter (New Filter) . 



54 



.33 



.0044 



.0082 



.43 



.019 



.0002 



.39 .0370 1.2 



Water from the Outlet of the Distributing Reservoir. 



54 



.38 



.0068 



.0083 



.48 



.030 



.0001 



.37 



.0720 



1.3 



Water from a Tap at Lawrence City Hall. 



55 



0.1- 



.42 



.0043 



.0079 



.51 



029 .0001 



.35 



.0750 1.3 



Water from a Tap at the Lawrence Experiment Station. 



55 



0.1— 



.37 



.0021 



.0073 



.48 



.030 



.0002 



.35 .0760 1.3 



Average Solids. 

Merrimack River above Lawrence. 
[Parts in 100,000.] 



Unfiltered. 


Filtered. 


In Suspension. 


Total. 


Loss on 
Ignition. 


Fixed. 


Total. 


Loss on 
Ignition. 


Fixed. 


Total. 


Loss on 
Ignition. 


Fixed. 


6.28 


2.43 


3.85 


5.59 


2.14 


3.45 


0.69 


0.29 


0.40 



Merrimack River below Lawrence. 



11.23 



5.06 



6.17 



9.14 



4.08 



5.06 



2.09 



0.98 



1.11 



Division of Food and Deugs 



Hermann C. Lythgoe, Director 



(1411 



Eeport of Division of Food and Drugs. 



During the year 1921 the Division of Food and Drugs of the Massa- 
chusetts Department of Pubhc Health has been engaged in the usual 
routine work of the enforcement of the milk, food, drug, cold storage, 
slaughtering, bakery and soft drink laws, and in the examination of 
samples submitted by police authorities, and also in the manufacture 
of arsphenamine. 

One inspector was discharged on May 31 and was not replaced. 
This naturally produced a reduction in the number of samples collected, 
which number is 3.4 per cent below the average of the previous five 
years. In proportion to the number of inspectors left, a reduction of 
10 per cent of the samples would be expected. 

During the present year there has been examined the largest number 
of samples on record, consisting of 7,103 samples of milk, 2,560 samples 
of foods, 605 samples of drugs, 247 samples of narcotic drugs, etc., 
submitted by police authorities, 3,831 samples of liquor submitted by 
police authorities, and 8 miscellaneous samples, consisting of coal, 
Famo, etc., examined for the State institutions and the Attorney- 
General's office, making a total of 14,354. 

During the previous five years, the lowest number of samples was 
9,928 in 1917. The highest number was 12,819 in 1919. Of the milk 
samples, the lowest number in the previous five years was 7,058 in 
1917, and the highest was 9,738 in 1919. Of the food samples, the 
lowest in the previous five years was 1,382 in 1918, and the highest 
was 2,319 in 1916. 

The amount of liquor submitted is increasing enormously, and if 
the present rate of increase continues, the work will be more than 
can be taken care of by the present force before the end of the next 
fiscal year. For this reason I have recommended that sufficient money 
be appropriated to employ an additional chemist should such be 
needed. 

There have been 282 prosecutions, — slightly less than those of the 
past four years. The total amount of the fines imposed was $4,936, 
which sum is somewhat less than the amount imposed during any one 



144 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



of the preceding five years. Of the eases, 254 were convicted, 17 were 
found not guilty, and 11 were placed on file without plea. 

One of the contributing factors to the small number of cases was 
the unusual purity of the milk supply. 

The court cases are summarized in the following table: — 



Conviction. 



Discharged. 



Filed without 
Plea. 



Milk: 

Low standard 

Cream removed 

Watered .... 
Misuse of milk bottles 

False advertising: 
Cocoa .... 
Olive oil ... 

Eggs .... 

Misbranded; 
Compound oil 
Grape juice . 
Olive oil ... 

Eggs .... 

Adulterated: 
Vanilla extract 
Grape juice . 
Maple sugar . 
Olive oil ... 

Sausage (starch) 
Sausage (colored) . 
Soft drinks 
Vinegar (low in acid) 

Drugs .... 

Decomposed food: 

Eggs .... 

Butter .... 

Canned corn . 

Kream Krist (cooking fat) 

Shrimp .... 
1 



IG 
4 

2() 
5 

1 
1 

7 

1 
1 
6 
3 

I 
1 

1 

15 
16 

3 
18 

6 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



145 





Conviction. 


Discharged. 


Filed without 
Plea. 


Cold storage: 

Eggs not marked 

Absence of sign "Cold Storage Eggs" .... 
Holding goods in storage exceeding twelve months 
Absence of sign "Cold Storage Goods" 
Representing cold-storage goods as fresh 
Operating a warehouse without a license 

Slaughtering: 

Illegal use of stamp 

Slaughtering in absence of inspector .... 

Selling unstamped meat 

Selling diseased meat 

Failure to condemn diseased meat .... 
Slaughtering without license 


76 
2 

2 
11 

1 
1 

2 
7 
4 
1 


3 

1 

1 
1 
1 


2 


Totals 


254 


17 


11 




282 



The following table gives a summary of the confiscations during the 
past year: — 



Article. 



Number of 
Confiscations. 



Weight 
(Pounds). 



Eggs 

Poultry . 
Game 
Meat 
Fish . 
Cheese 
Grapes 
Kream Krisp 
Vegetables 
Walnuts . 
Totals 



4 
1 
1 

44 
4 
1 
1 
1 
1 
1 



59 



1,560 

70 

37 

13,628 

1,320 

1,016H 
3,596 

83 

50 
300 



21,660}^ 



146 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Milk. 

The inspectors collected 6,902 samples of milk, 3 per cent of which 
were found to be adulterated by the addition of water. This figure 
is the lowest in years and is due to various circumstances. In the 
first place, there has been a surplus of milk, resulting primarily from 
its high price, under which condition the temptation to water would 
naturally be reduced. 

In the early part of the year, the small milk dealers complained to 
this Department of the sale of watered milk from their producers, 
which complaints were investigated, and the producers were con- 
victed. During the months of January, February, March and April 
an unusual amount of watered milk was obtained. In fact, more than 
half the watered milk was obtained during these four months instead 
of during the months of July, August and September, as is usual. It is 
not at all improbable that the prosecutions instituted so early in the 
season had some bearing on the curtailment of adulteration. 

The quality of the average milk sold throughout the State, as 
shown by our figures, does not differ materially from that of previous 
years. These figures are a,s follows: — 

Per Cent. 

Total solids 12.47 

Fat 3.76 

Solids not fat 8.71 

These figures represent the average of 6,518 samples found upon 
examination to be free from adulteration. 



Foods Other than Milk. 

There were 2,560 samples of food examined, which is rather more 
than usual. This increase was due to an unusual examination of 
butter for the presence of excessive moisture, and to ascertain whether 
or not it was fit for extension of time in storage; to increased exam- 
ination of soft drinks; and to increased examination of vinegar. 

The butter sold in this State is practically all obtained from other 
States. The law requires this Department to adopt the standards of 
the United States Department of Agriculture, which standards re- 
quire a fat content of not less than 82| per cent. It was ascertained 
that a great deal of the butter coming into this State came in some- 
what below this standard, in some instances as low as 77 per cent. 
Correspondence with the Department of Agriculture relative to this 
condition resulted in a declination to enforce the standard on the 



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

part of the United States Department of Agriculture. The reason for 
this is obvious since the United States standard has no standing in 
the United States courts. 

The revision of the law resulted in a necessary change of wording 
of section 13 of chapter 208 of the Acts of 1917, which change (Gen- 
eral Laws, chapter 94, section 185) automatically revoked the butter 
standard adopted by this Department. This error in the statute has 
been corrected, and it will be necessary for this Department to 
readopt the standard. 

Owing to unusual requests for extension of time in storage, a number 
of samples of butter were examined for their relative rancidity, and 
practically all of the 114 adulterated samples of butter were such as 
showed a relatively high rancidity, which would not, however, render 
the article unfit for food, but would naturally interfere with its 
keeping quality if kept in storage for any length of time. In making 
this examination, the amount of free fatty acids was determined on 
all the samples. It was found that samples requiring more than 10 
cubic centimeters of tenth normal alkali to neutralize the free fatty 
acids in one gram of butter fat were distinctly off in flavor according 
to the original records of the inspector making the preliminary inspec- 
tions in the warehouse. 

When the figures for all the butter examined were arranged in a 
summation series and plotted on Whipple's logarithmic probability 
paper, the curve was found to be concave up to 10 cubic centimeters 
and convex above 10 cubic centimeters, showing a different series of 
article above and below this figure. When the figures were separated 
into two series, each one plotted as a probability series. Extensions 
were therefore either granted or refused in accordance with the figures 
obtained as described. 

A number of samples of watered clams were obtained and consid- 
erable difficulty was encountered in the prosecution of a few cases, 
owing to the testimony of the clam diggers. For this reason an in- 
"^estigation was made in co-operation with the United States Depart- 
ment of Agriculture in the latter part of the year, by means of which 
information has been gathered which can be used next season to suc- 
cessfully combat the defence advanced by the clam diggers during the 
past season. 

In the examination of eggs, the Division has carried out the pro- 
cedure developed a few years ago, namely, to purchase eggs as sold 
in the retail stores; to note the advertising matter; and then to 
examine the eggs first by candling, whereby the fresh eggs are differ- 
entiated from those that are not fresh, and second, by determination 



148 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

of the ammonia by means of which figure the approximate age of the 
egg can be ascertained. If the eggs are not fresh, additional evidence 
is collected by the inspector, and the dealer is prosecuted either for 
selling cold-storage eggs without marking the same, or for selling eggs 
misbranded as fresh eggs, or for violation of the false advertising law 
by advertising as fresh eggs, eggs which were not fresh. Certain of 
the wholesale egg dealers have criticized the Department for adopting 
this procedure on the ground that all eggs which are edible and have 
not been in cold storage are entitled to be called "fresh eggs." The 
courts have, however, upheld the contention of this Department, and, 
until the findings are reversed, it is of course incumbent upon the 
Department to proceed in the same manner in the future. 

During the present season eggs came out of storage somewhat 
earlier than usual, and the violations which usually occur in the fall 
season were stopped rather earlier than usual. There were 93 cases 
in all relating to the sale of eggs, one of which was for the sale of 
rotten eggs. 

There were 15 samples of grape juice examined, 12 of which were 
found to be adulterated. These were all the product of one concern 
and consisted of sugar, water, color and dried grapes, the total amount 
of grapes computed as grape juice being less than 10 per cent. The 
manufacturer was convicted of misbranding and adulterating. 

The decomposed foods collected during the present year are some- 
what less than those obtained in former years. A number of samples 
of rancid butter were obtained, which were either confiscated or 
ordered renovated. Two lots of canned goods were found with 
swelled heads. Three samples of decomposed eggs were obtained; 
2 of decomposed bacon; 1 of decomposed nuts; 1 of decomposed 
shrimp; 3 of wormy confectionery; 4 of wormy figs; 2 of wormy 
macaroni; and 1 of wormy corn. 

It has been found that there is a seasonal variation in the sale of 
adulterated sausages in this State. There is very little adulteration 
of this product in the spring, summer and early fall. In fact, there 
is a period of very nearly nine months when no adulterated sausages 
are found, and, consequently, no prosecutions are instituted. It is 
not at all improbable that the sausage dealers may take this absence 
of prosecution to mean that the Department is paying no attention 
to sausages, because year after year the same dealers begin in the 
fall to put more cereal in their product than the law permits. It 
requires about three months' work to stop these violations. When 
one considers that each 1 per cent of starch added to a sausage will 
increase the water content to an extent of 4 per cent, it is evident 



No. 34.] DIVISION OF FOOD AND DRUGS. 149 

that for each additional pound of starch the sausage dealer can add 
4 pounds of water, and consequently make 4 per cent extra profit. 
The law prohibits the addition of more than 2 per cent of cereal or a 
product made from vegetable flour. These cereal products used con- 
tain starch varying from 40 to 80 per cent. It is impossible to actually 
determine the amount of cereal or other product added, but it is 
possible to determine the amount of starch added; therefore, when 
the examination shows the addition of 2 per cent of starch in a sample 
of sausage, it means that anywhere from 2 to 3| per cent of vegetable 
material has been added to the sausage. 

Many of the sausage dealers periodically submit samples to chemists 
in order to keep the starch content of their product as high as possible, 
be within the law, and at the same time violate the law by adding 
more than the permitted 2 pounds of material per 100 pounds of 
finished product. 

There were 8 samples of oleomargarine collected, representing 8 
different brands, which were examined to ascertain whether or not 
there was any deficiency in fat, as was the case with the butter 
samples. In all cases the fat content was well above that established 
for fat in butter, and the moisture content showed no excess in any 
of the samples examined. 

An unusual amount of adulteration was found in the case of olive 
oil. Eighty-six samples out of 228 collected were found to be adul- 
terated with cotton seed oil. These traced to a few Italian and Greek 
wholesale dealers, and after repeated prosecutions, the practice of 
selling adulterated oil was practically stopped. 

The inspectors visited nearly all the soft drink factories in the 
State, and, incidental to making sanitary inspections, obtained samples 
of the product. Out of 286 samples collected, 66 were found to con- 
tain saccharine. Wherever the manufacturer had been previously 
warned not to use saccharine, prosecutions were instituted, of which 
one resulted in acquittal; nine were placed on file without plea; and 
nineteen were convicted. None of these cases was appealed. 

The Monsanto Chemical Company, which manufactures practically 
all the saccharine used in this country, did not come to the relief of 
the users of their product, notwithstanding the fact that the salesmen 
informed the soft drink manufacturers that the chemical company 
would defend any cases brought against them by the Department of 
Public Health, and that the use of the article was not in violation of 
the law. We have been unable to ascertain the names of these sales- 
men, and thus have been unable to prosecute them for false advertis- 
ing of the goods which they were selling. 



150 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

A large number of samples of vinegar have been examined, many 
of which were found to be just under 4 per cent in acid. One firm, 
shipping considerable vinegar into this State, was found to be selling 
vinegar containing 3.95 per cent acetic acid upon an average of 35 
samples. 

When one considers that each four hundredths variation in the acid 
content means 1 per cent more profit for the sale of water, it is 
readily seen that it is to the financial interest of the vinegar manu- 
facturer to get his vinegar as close to 4 per cent as practicable. Many 
of the manufacturers who standardize their goods are not familiar with 
the use of indicators, and, therefore, are liable, in making the titra- 
tions, to err upon the side of alkalinity, particularly when using 
phenolphthalein as the indicator. This indicator is colorless in acid 
solution and red in alkaline solution. It also has the peculiarity of 
being practically neutral in solutions containing bicarbonate. The 
average untrained man would add the alkali until he obtained a good 
red color, thereby exceeding the neutral point by one-tenth or two- 
tenths of a cubic centimeter, which the trained chemist would not do. 
The alkali solution, if not properly kept, is liable to absorb carbon 
dioxide from the air, thereby producing bicarbonate during the titra- 
tion, with the effect of lowering the apparent alkalinity of the stand- 
ard alkali solution and apparently increasing the acidity of the vinegar. 

Examinations of standard acid furnished these vinegar dealers by 
certain chemists have shown that it is not unusual for such standardiz- 
ing acid to be stronger than it should be, and a person using such 
acid in making a standard alkali would make it too strong and his 
product would be too weak. 

The chart shows the variation in acidity of 407 samples collected 
between December, 1920, and April, 1921. It is significant that the 
largest "block" is just under the standard of 4 per cent. 

One of the laws relating to the sale of cider vinegar requires this 
Department to adopt methods of analyses which shall be those of 
the Association of OflScial Agricultural Chemists, and to publish these 
in the bulletin of the Department. This law has been inoperative for 
a number of years on account of its wording. It required the De- 
partment to adopt the methods published by the association. While 
these methods have been published, they were published by the Sec- 
retary of Agriculture, and not by the association. During the revision 
of the laws, the words "published by" were changed to the words 
"adopted by." It seems, however, desirable that this law should be 
repealed. It takes about three years for a method to be adopted by 
the association and it does not seem fair to the people of this Com- 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



151 



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407 Vinegar 5ample5 506-4.^6 Acidity 


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152 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

monwealth to prohibit the use of a method which can detect adul- 
teration because of the fact that the method has not been adopted 
by a certain association, over which the Commonwealth has no 
control. 

Miscellaneous samples examined are as follows: — 

Samples. 

Cider preserved with sodium benzoate 7 

Cocoa, advertised to contain 50 per cent of fat, actually containing but 25 

per cent of fat 1 

Delisco, a mixture of coffee, cereal and chicory, advertised as a substitute 

for coffee, and not properly labeled 2 

Condensed milk incorrectly labeled as to the dilution 3 

Imitation vanilla 2 

Hen feed containing arsenic, submitted by police authorities .... 1 

Drugs. 

There were 615 samples of drugs examined, 138 of which were found 
to be adulterated. 

It was formerly quite common to find adulterated camphorated 
oil, olive oil, spirit of camphor, spirit of peppermint, tincture of iodine 
and zinc oxide ointment because of the fact that these articles were 
prepared by retail druggists. At present they are prepared by large 
wholesale houses, and it is unusual to find such articles adulterated. 
Of the samples examined, lime water and sweet spirit of niter repre- 
sented practically the only preparations collected by this Department 
and actually made by the majority of the retail druggists. Forty- 
five per cent of the sweet spirit of niter and 17 per cent of lime water 
were found to be adulterated because of deficiency in the active 
ingredient. Either of these preparations can be accurately made and 
so kept that they can be dispensed the full U. S. P. strength. All 
druggists should realize the importance of keeping sweet spirit of 
niter as described in the Pharmacopoeia, namely, in amber colored 
bottles, tightly stoppered, in a cool place. Investigations made some 
years ago in this Department showed that this drug may be 
kept for a period of more than one year in the ice chest without any 
deterioration. 

A complaint was received from a citizen that a certain druggist was 
not furnishing proper lime water. The complainant went to the 
druggist and stated that she knew the lime water was not right 
because the baby had not been acting properly. The druggist there- 
upon informed her the lime water was all right; took it back; and 
threw it away. The complainant then sent another person to the 



No. 34.] DIVISION OF FOOD AND DRUGS. 153 

store to purchase some lime water, and brought it to the Department 
to be examined. It was found to be practically free from lime. An 
inspector of the Department then visited the drug store, purchased a 
sample, which was found practically free from lime, and the druggist 
was prosecuted and convicted. 

As a result of this complaint, other samples were collected through- 
out the State, and in many instances the retail druggist was very lax 
in preparing this drug so necessary for bottle-fed babies. The error 
on the part of the druggist was undoubtedly due to repeatedly using 
the old lime left in the bottle after the lime water was decanted. 
After a reasonable time this deposit becomes transformed into calcium 
carbonate, which is insoluble in water, and the druggist against whom 
the original complaint was made could very probably have been 
using the same "lime" for years and would always have as much 
left at the end of each operation as at the beginning. 

Because of the increased production of pharmacopoeial drugs by 
the wholesale houses, the adulteration of drugs in the State has been 
cut down to practically a minimum. 

LiQUOK. 

The liquor samples have greatly increased in number over those 
of previous years. One hundred and twenty-six cities and towns sub- 
mitted in all 3,831 samples of liquor, of which 2,356 were distilled 
liquors; 87 of these localities submitted less than 10 samples per 
locality during the year, representing in all, 283 samples. The other 
39 localities submitted more than 10 samples per locality. The city 
of Boston submitted 1,823 samples, the largest number from any 
locality. Cambridge submitted 336 samples; Fall River submitted 
155 samples; Springfield submitted 134 samples; Lawrence sub- 
mitted 122 samples; and Marlborough submitted 113 samples. The 
other localities each submitted less than 100 samples. 

There has been naturally an increase in the attendance of the 
chemists in the courts on account of the increase in the number of 
samples submitted. One of the chemists spent nearly two months in 
the Superior Court of Essex County, pending the trials of these cases, 
and a large number of calls have been made for the attendance of the 
chemist at the Superior Court in the Suffolk and Middlesex districts. 
The certificates, however, are used in the majority of the cases, but 
if the defence objects to the introduction of the certificate, it is neces- 
sary to summon the chemist to testify because of the unconstitu- 
tionality of such evidence. 



154 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Cold Storage. 

The amounts of goods on hand in the storage warehouses are ap- 
parently lower than those of any year since 1914, owing, in part, to 
the cessation of hostilities, and consequent reduction of the exports 
of meat and fish. The statistics of the holdings of food in this State 
go back only to August, 1920. 

There have been granted an unusual number of extensions of time 
in cold storage. It appeared during the early part of 1921 that there 
would be a surplus of butter in storage at the end of the twelve 
months' storage permitted by law, because of the unusual importa- 
tion of Danish butter into the United States. This butter usually 
goes to England, but the British Food Ministry kept an import 
embargo upon butter until the early spring. The rate of outgo of 
butter indicated that there would be about 1,150,000 pounds of 
storage butter unconsumed, upon which the time of storage would 
expire between June and August. This was so unusual that the 
matter was referred to the Council, resulting in a vote that extensions 
should be granted on such butter as was in proper shape for the 
extension. Owing to the removal of the import embargo by England, 
the Danish butter went to its natural market, and the amount of 
extensions actually granted was on 99 lots, representing a little less 
than 500,000 pounds. 

Another unusual condition occurred relative to storage fish. The 
winter of 1920 was unusually mild, plenty of fresh fish was on the 
market, and no opportunity occurred for the sale of considerable of 
the frozen fish. When the fishing season began in 1921, the amount 
of fish caught was less than usual. The owners of the frozen fish. 
then asked for extensions upon this fish, which requests were granted 
on nearly 2,500,000 pounds of fish. About 2,000,000 pounds of this 
fish was whiting, all of which is exported to other States. Notwith- 
standing these unusual extensions, the fish holdings this year are less 
than those of last year, and a number of fish freezers which were 
running during the past five years are now closed. 

The next largest item of extension is pork, — extension granted for 
nearly 1,000,000 pounds. This pork was practically all export pork, 
being cuts not sold in this country, and held in Massachusetts pending 
foreign shipment, which was delayed by certain import embargoes 
imposed by the countries to which the material was to be shipped. 
The total amount of extensions represented 1.85 per cent of the total 
amount of food placed in storage during the year. The average length 
of time for the extensions was less than three months. 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



155 



The following table gives a summary of these extensions: — 



Lots. 



Frozen eggs . 

Butter . . . . 

Venison 

Reindeer 

Poultry (broilers) 

Beef and beef products 

Pork . . . . 

Lamb and mutton 

Veal . . . . 

Fish . . . . 




Pounds. 



27,730 

489,882 

162 

16,779 

1,804 

87,853 

937,443 

60,270 

1,260 

2,493,169 



4,116,352 



There were 102 requests for extension refused; 1 request for per- 
mission to remove after the expiration of a year's storage was granted; 
and 139 lots were ordered removed from storage at the end of twelve 
months, upon which lots no request for extension had been made. 



Bakeries. 

The bakery law, passed in 1920, was amended during the 1921 legis- 
lative session by excluding stores from the requirement of registering 
as bakeries. The inspections made by this Department have been 
done by one inspector, who has inspected 701 manufacturing bakeries 
located in 27 cities and towns of this State. In carrying out this 
work, the inspector examines all the bakeries in each city or town 
he visits, in company with the agent of the local board of health, 
when such person can be persuaded to go with him. After the in- 
spections are made, the delinquencies of each bakery are written, 
and a list of these delinquencies is sent to the local board of health 
with the request that the board see that the violations are corrected. 

On account of the time consumed in making the first inspections, 
practically no follow-up work has been done, except in three localities. 
In a few instances there seemed to be little inclination on the part of 
the local authorities to see that the cleaning up work was done. In 
one case, a bakery was ordered closed and the local board of health 
then permitted a change to be made in the registration of this place, 
and a bakery was operated in the same place under the same condi- 
tions at the time our inspector made his second visit to this locality 



156 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

some months later. A meeting of the director of this Division, the 
inspector who made the inspection, and the District Health Officer 
with the local board of health convinced the board that they must 
get busy and clean up the dirty conditions which the inspector of this 
Department discovered. 

Of the 701 bakeries inspected, 57 per cent did not properly protect 
the products from contamination as provided by the law; 46 per cent 
had no garbage can, as provided by the regulations; in 38 per cent 
the apparatus and floors were not properly constructed and maintained 
as provided in the regulations; 33 per cent did not properly protect 
the products, as provided by law; and 30 per cent did not have 
adequate toilets, as provided by the law. Only 18 per cent of the 
bakeries were found to have cats in violation of the law. The number 
of domestic rooms connected with bakeries was much less than was 
anticipated, there being but six such instances, which seems an un- 
usually small number of violations, considering the numerous other 
violations noted, with all the powers given to local boards of health 
before and after the present law went into effect. It seems that one 
of the greatest difficulties encountered in the enforcement of this 
law is the insufficient appropriation of local boards of health. 

Slaughtering. 

There has been no change in procedure or the policy of the Division 
relative to slaughtering inspection. The veterinary inspectors have 
acted as instructors of local inspectors when necessary; they have in- 
vestigated the qualifications of nominees for the position of inspector 
of slaughtering; and when violations of the law have occurred, have 
presented the evidence to the courts. 

The reports of local inspectors to this Department have indicated 
in nearly all instances that the inspectors are not only properly quali- 
fied to make post-mortem examinations, but are doing so in a satis- 
factory manner. A summary of these reports shows a phenomenal 
increase in the confiscation of cattle by reason of generalized tubercu- 
losis. In 1915, 1916 and 1917, the confiscations of cattle for all causes 
were 2.29, 2.29 and 2.08 per cent, respectively, of which 86 to 87 per 
cent were for tuberculosis. In 1921 there were inspected 21,748 
carcasses of cattle, of which 667, or 3.07 per cent, were confiscated, 
610 of which, or 2.82 per cent of the total number, were confiscated 
for generalized tuberculosis. Since the larger part of these cattle are 
dairy cows, it is significant of a decided increase of tuberculosis in 
such cattle in this State. 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



157 



The following table gives a summary of the slaughtering inspectors' 
report for the year: — 





Number 
inspected. 


Number 
confiscated. 


Number contiscated 

FOR — 


Hog 
Cholera. 




Tuber- 
culosis. 


Im- 
maturity. 


Cattle 

Calves 

Hogs 


21,748 
98,782 
79,271 


667 

1,145 

680 


610 
12 

140 

1 


863 


273 



Arsphenamine. 

The arsphenamine production has been greater than at any other 
time since the work began. The Division has been able to produce a 
sufficient quantity of non-toxic arsphenamine to supply the needs of 
the Department. The amount distributed was 37,117 doses com- 
puted as of 0.6 gram per dose, which was 12,145 more such doses than 
was distributed during 1920, or an increase of 48.4 per cent. The 
drug has been put out in ampoules containing 0.4 gram, 0.6 gram, 
1.8 grams and 3.0 grams, and occasionally in smaller quantities. 

At the present rate of increase, the yearly distribution in twelve 
months will be in the neighborhood of 50,000 doses. The Division 
has practically reached its maximum capacity with the present ap- 
paratus. Should there be any marked increase in the demand for this 
drug, it will be essential to install larger units, which can be done 
without wasting the present units now used, as they can be utilized 
for other purposes in connection with the work. 

The percentage of toxic batches has been continually decreasing 
during the past three years, and the toxicity tolerance of our product 
has been increasing. The product made during the present year shows 
a decided improvement in purity over that made in 1920. 

The following tables are hercAvith submitted : — 

List of prosecutions. 

Summary of milk samples examined. 

Summary of food samples examined. 

Summary of drug samples examined. 

Summary of Uquor samples examined. 

List of articles, other than fish, placed in cold storage. 

List of fish placed in cold storage. 

List of articles, other than fish, on hand in storage on the first day of each month. 

List of fish on hand on the fifteenth day of each month. 



158 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



List of extensions of time in storage granted. 
List of extensions of time in storage refused. 
List of requests for permission to remove from storage granted. 
List of articles removed from storage, upon which no request for extension was 
made. 

Table No. 1. — ■ List of Prosecutions. 

For Sale of Milk not of Good Standard Quality. 



Name. 


Address. 


Court. 


Date. 


Result. 


Albriegena, John . 


Springfield 


Springfield 


Feb. 


16, 1921 


Conviction. 


Avezzi, Charles . 


West Springfield 


Springfiefd 


Nov. 


7, 1921 


Conviction. 


Chong, Harry 


Springfield 


Springfield 


Nov. 


7, 1921 


Conviction. 


Cochiafis, Jas. C. 


Springfield 


Springfield 


Nov. 


7, 1921 


Conviction. 


Couchiaftis, James 


Springfield 


Springfield 


Feb. 


16, 1921 


Conviction. 


Giarskahis, Christ 


Springfield 


Springfield 


Dec. 


16, 1920 


Conviction. 


Hindakis, Christus 


Springfield 


Springfield 


Nov. 


7, 1921 


Conviction. 


Lampros, Samuel 


Springfield 


Springfield 


Nov. 


7, 1921 


Conviction. 


Lemnolis, Peter . 


Springfield 


Springfield 


Nov. 


7, 1921 


Conviction. 


Palmer, George H. 


Springfield 


Springfield 


Nov. 


7, 1921 


Conviction. 


Papas, Andrew 


Springfield 


Springfield 


Feb. 


16, 1921 


Conviction. 


Rech, Frank 


Springfield 


Springfield 


Dec. 


16, 1920 


Conviction. 


Robbins, Edwin G. 


Springfield 


Springfield 


Feb. 


16, 1921 


Conviction. 


Stathis, Nicholas 


Springfield 


Springfield 


Feb. 


16, 1921 


Conviction. 


Truman, Samuel . 


Springfield 


Springfield 


Nov. 


7, 1921 


Conviction. 


Young, Charles . 


Springfield 


Springfield 


Dec. 


16, 1920 


Conviction. 



For Sale 


of Milk from which a 


Fori 


ion of the Cream had been removed. 


Goodman, Israel . 




Pittsfield 




Pittsfield . 


Aug. 5, 1921 


Conviction. 


Mozara, Michael . 


. 


Millis . 




Franklin . 


May 19, 1921 


Conviction. 


Noons, Joseph K. 




North Truro . 


. 


Provincetown 


Aug. 17, 1921 


Conviction. 


Supernent, Calvin 


■ 


Groton . 




Ayer . 


Dec. 13, 1920 


Conviction. 



For Sale of Milk containing Added Water. 



Adamson, Charles' 


West Rutland 


Worcester . 


Jan. 25, 1921 


Conviction. 2 


Adler, Samuel 


Medway . 


Franklin . 


Sept. 15, 1921 


Conviction. 


Bailey, John 


Pelham, N. H. 


Dracut 


Oct. 7, 1921 


Conviction. 



1 Evidence furnished by Mr. George D. Melican, milk inspector of Worcester; analysis made by this 
Department. 

2 Appealed. 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



159 



For Sale of Milk containing Added Water — Concluded. 



Name. 


Address. 


Court. 


Date. 


Result. 


Boyden, Almon F. 


Walpole . 


Walpole 


May 


6, 1921 


Conviction. 


Burke, John 




Westwood 




Dedham 


May 


9, 1921 


Conviction. 


Carr, John J. 




Pepperell 


t 


Ayer . 


Dec. 


13, 1920 


Conviction. 


Davis, Robert B. 




Way land 




Framingham 


Nov. 


4, 1921 


Discharged. 


Dicenso, Tony 




Medway . 




Franklin . 


May 


28, 1921 


Conviction. 


Driscoll, John A. 




Lexington 




Concord 


July 


11, 1921 


Conviction. 


Fecteau, Aldie 




Carlisle . 




Concord 


Aug. 


22, 1921 


Conviction. 


Fine, Simon 




Maiden . 




Maiden 


Mar. 


31, 1921 


Discharged. 


Fisher, Lewis G. C. 




Peabody 




Peabody 


June 


8, 1921 


Conviction. 


Gear, Joseph 




South Dartmouth . 


New Bedford 


Feb. 


11, 1921 


Conviction. 


Goss, Albert L. . 
Grouard, John S. 




West Windham, 

N. H. 
Nantucket 


Methuen 
Nantucket 


May 
Dec. 


25, 1921 
2, 1920 


Conviction. 
Conviction. 


Jannino, Joseph . 




Revere . 


Chelsea 


Mar. 


24, 1921 


Conviction. 


Martin, John K. 




Stoughton 


Stoughton . 


Dec. 


17, 1920 


Conviction, i 


McHugh, Omar . 




Harvard 


Clinton 


Mar. 


21, 1921 


Conviction. 


Mederos, Manuel ^ 




Fall River 


Fall River . 


Sept. 


13, 1921 


Conviction. 


Mulvey, Patrick . 




Lexington 


Concord 


July 


20, 1921 


Conviction. 


Proctor, Warren . 




Lunenburg 


Leominster 


Aug. 


13, 1920 


Conviction. 


Shattuck, Willie . 




Ayer 


Ayer . 


Apr. 


15, 1921 


Conviction. 


Shinost, Louis 




West Springfield 


Springfield 


Nov. 


30, 1921 


Conviction. 


Siegmund, Joseph 




Walpole . 


Walpole 


May 


23, 1921 


Conviction. 


Sutton, Frank A. ^ 




West Rutland 


Worcester . 


Jan. 


24, 1921 


Conviction. * 


Terzian, Samuel . 




Whitman 


Abington . 


Feb. 


14, 1921 


Conviction. 


Turner, John Wesley 




Salem 


Salem 


Dec. 


21, 1920 


Conviction. 


Vaughan, J. Ernest 




Whitman 


Abington . 


Feb. 


14, 1921 


Conviction. 



Misuse of Milk Bottles. 



Agnas, James 


Springfield 


Springfield 


June 7, 1921 


Conviction. 


Bidsacos, Costos 


Springfield 


Springfield 


June 7, 1921 


Conviction. 


Demetropoulos, Costos 


Springfield 


Springfield 


June 7, 1921 


Conviction. 


Kaleos, Daniel 


Springfield 


Springfield 


June 7, 1921 


Conviction. 


Nicolaon, Andrew 


Springfield 


Springfield 


June 7, 1921 


Conviction. 



1 Appealed. 

2 Sample submitted by Mr. Boisseau, milk inspector of Fall River; analysis made by this Department. 

3 Evidence furnished by Mr. George D. Melican, milk inspector of Worcester; analysis made by this 
Department. 



160 



DEPx\RTMENT OF PUBLIC HEALTH. [Pub. Doc. 



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

Cocoa. 
[Fake advertising.] 



Name. 


Address. 


Court. 


Date. 


Result. 


Zimmerman, Morris . 


Boston . 


Boston 


Mar. 8, 1921 


Conviction. 



Marcaroni, Alfio . 



Compound Oil. 
[Misbranding.] 



Lawrence 



Lawrence 



June 28, 1921 



Conviction. 



Peck,_ Edgar M. 



Extract of Vanilla. 
[Contained coumarin.] 



Whitman 



Abington 



Jan. 20, 1921 



Conviction. 



Chmielnicki, John 
Chmielnicki, John 



Grape Juice. 
[Contained 90 per cent sugar syrup with coloring matter.] 



South Boston 
South Boston 



South Boston 
South Boston 



May 16, 1921 
May 16, 1921 



Conviction, i 
Conviction, i 



Maple Sugar. 
[Contained cane sugar.] 



Chansky, Louis 



Boston 



Boston 



Mar. 28, 1921 



Conviction. 1 



Olive Oil. 
[Adulterated with foreign oil.] 



Alban, Inc., John A. . 
Armenia, George (2 counts) . 


New York City . 
Boston . 


United States 
District Court 
for New York. 

Boston 


Nov. 2, 1921 
July 28, 1921 


Conviction. 
Conviction. 


Armenia, Peter . 


Boston . 


Boston 


Dec. 1, 1920 


Discharged. 


Armenis, Peter 


Boston . 


Newburyport . 


Apr. 20, 1921 


Conviction. 


Armenis, Peter 


Boston . 


Boston 


June 9, 1921 


Discharged. 


Armenis, Peter . 


Boston . 


Boston 


June 10, 1921 


Conviction.' 


Armenis, Peter 


Boston . 


Boston 


June 10, 1921 


Conviction. ' 


Cotsis, George (8 counts) . 


Boston . 


Boston 


Dec. 1, 1920 


Conviction. 




1 App 


ealed. 







No. 34.] 



DIVISION OF FOOD AND DRUGS. 



161 



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

Olive Oil — Concluded. 
[Adulterated with foreign oil.] 



Name. 


Address. 


Court. 


Date. 


Result. 


Cotsis, George 


Boston . 


New Bedford 


May 


10. 1921 


Dismissed. 


Crespe, Joseph 


New Bedford 




New Bedford 


Mar. 


29, 1921 


Conviction. 


DeMauro, Joseph 


Lawrence 




Lawrence . 


June 


28. 1921 


Conviction, i 


Gracia, John 


New Bedford 




New Bedford 


May 


10, 1921 


Conviction. 


Leonardi, Santo . 


Lawrence 




Haverhill . 


July 


13, 1921 


Conviction.* 


Mihalopos, Anastasias L. 


Boston . 




Boston 


Dec. 


1, 1920 


Conviction. 


Moustos, Louis (8 counts) . 


Boston . 




Boston 


Dec. 


1, 1920 


Conviction. 


Moustos, Louis, and George 

Cotsis. 
Moustos, Louis 


Boston . 




Boston 


Mar. 


15, 1921 


Conviction. 


Boston . 




New Bedford . 


May 


10, 1921 


Dismissed. 


Papoulas, Theodore 


New Bedford 




New Bedford 


Dec. 


7, 1920 


Conviction. 


Rodigue, Antonio 


New Bedford 




New Bedford . 


Apr. 


5, 1921 


Conviction. 



Olive Oil. 
[False advertising.] 



Gonnella, Oreste 



Springfield 



Springfield 



Mar. 31, 1921 



Conviction. 



Olive Oil. 
[Misbranded.] 



Alban, Inc., John A. 

Armenis, Kostas 
Armenis, Peter 
Armenis, Peter 
Gotsis, Aristedes 
Leonardi, Santo 



New York City 

Boston . 
Boston . 
Boston . 
Boston . 
Lawrence 



United States 
District Court 
for New York. 

Boston 



Boston 
Boston 
Boston 
Haverhill 



Nov. 


2, 


1921 


Dec. 


17, 


1920 


June 


10, 


1921 


June 


10, 


1921 


Dec. 


17, 


1920 


July 


13. 


1921 



Conviction. 

Conviction. 
Conviction. * 
Conviction, i 
Conviction. 
Conviction. ' 



Sausage. 
[Contained starch in excess of 2 per cent.] 



Baldau, Frederick W. . 


Boston . 


Boston 


Mar. 8, 1921 


Conviction. 


Baldau, Frederick W. . 


Boston . 


Boston 


Mar. 8, 1921 


Conviction. 


Balkus, Andrew . 


Lynn 


Haverhill . 


May 4, 1921 


Conviction. 


Balkus, Andrew . 


Lynn 


Haverhill . 


May 4, 1921 


Conviction. 



1 Appealed. 



162 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



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

Satjsage — Concluded. 
[Contained starch in excess of 2 per cent.] 



Name. 



Address. 



Court 



Date. 



Result. 



Boston Sausage and Provi- 
sion Company. 

Boston Sausage and Provi- 
sion Company. 

Boston Sausage and Provi- 
sion Company. 

Boston Sausage and Provi- 
sion Company. 

Briggs, Harry M. 

Ferneaux, Henry J. 

Gritz, Michael 

Maguy, Gideon . 

Parks Sausage and Provision 

Company. 
Vonbank, Carl 

Vonbank, George 

Wilkinson, Wilfred A. . 



Boston 
Boston . 
Boston 
Worcester 
Methuen 
LawTence 
Adams . 
Fitchburg 
Boston . 
New Bedford 
New Bedford 
Lawrence 



Lowell 

Lawrence 

Lawrence 

Worcester 

Lawrence 

Lawrence 

Adams 

Fitchburg 

Lowell 

New Bedford 

New Bedford 

LawTence . 



Jan. 18, 1921 

Feb. 15, 1921 

Feb. 15, 1921 

Mar. 10, 1921 

Feb. 15, 1921 

Feb. 15, 1921 

Mar. 4, 1921 

May 13, 1921 

Feb. 4, 1921 

June 27, 1921 

June 27, 1921 

Feb. 15, 1921 



Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction, i 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 



Satjsage. 
[Contained coloring matter. 



Boepple, George, Company 


Worcester 


Worcester . 


Mar. 10, 1921 


Conviction. 


Costelow, Anthony 


Brockton 


Brockton . 


Dec. 22, 1920 


Conviction. 


Darling, L. B., Company . 


Worcester 


Worcester . 


Mar. 10, 1921 


Discharged. 


Ferneaux, Henry J. 


Lawrence 


Lawrence . 


Feb. 15, 1921 


Conviction. 2 



Soft Drinks. 
[Contained saccharine.' 



Barboza, John M. 
Campione, Cirino 
Catacchio, Tommaso 
Glinski, Frank 
Kelley, James H. 
Kline, Charles 
Liofsky, Max 
Lozoraitis, Peter . 
Lumenello, Anthony 
Machaj, John 



New Bedford 

LawTence 

Worcester 

Chicopee 

Worcester 

Fall River 

Springfield 

Worcester 

New Bedford 

Ipswich . 



New Bedford 
Lawrence . 
Worcester . 
Chicopee . 
Worcester . 
Fall River . 
Springfield 
Worcester . 
New Bedford 
Ipswich 



June 
June 
May 
Nov. 
May 
July 
June 
May 
June 
Oct. 



27, 


1921 


3, 


1921 


26, 


1921 


3, 


1921 


26, 


1921 


1, 


1921 


16, 


1921 


26, 


1921 


27, 


1921 


4, 


1921 



Conviction. 
Conviction. 2 

-3 

Discharged. 

_3 

Conviction. 
Conviction. * 

-3 

Conviction. 
Conviction. 



1 Fined -SIO; sentence suspended. 

2 Continued for sentence. 



' On file, without plea. 
* Appealed. 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



163 



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

Soft Drinks — Concluded. 





[Containing 


; saccharine.] 








Name. 


Address. 


Com-t. 


Date. 


Result. 


Melinsky, John 


Cambridge 


Cambridge 


June 


23, 1921 


Conviction. 


Neves, Joseph 


New Bedford . 


New Bedford 


June 


27, 1921 


Conviction. 


Puzine, Jacob 


Lawrence 


Lawrence . 


July 


8, 1921 


Conviction. 


Quitadamo, Michael A. 


Worcester 


Worcester . 


May 


26, 1921 


_i 


Rapolus, Stanislaw 


Indian Orchard 


Springfield 


Nov. 


4, 1921 


Conviction. 


Robins, Harris 


Worcester 


Worcester . 


May 


26, 1921 


-1 


Roscoe, Sylvester 


Worcester 


Worcester . 


May 


26, 1921 


_i 


Royal Bottling Company, 

Inc. 
Shapiro, Nathan E. 


Worcester 


Worcester . 


May 


26, 1921 


_i 


New Bedford . 


New Bedford 


June 


27, 1921 


Conviction. 


Stanieri, Vincent . 


Worcester 


Worcester . 


May 


26, 1921 


-1 


Stashis, Roman . 


Cambridge 


Cambridge 


July 


25, 1921 


Conviction. 


Tater, Israel 


Fitchburg 


Fitchburg . 


July 


19, 1921 


Conviction. 


Tinkoll, Morris 


Fall River 


Fall River . 


July 


1, 1921 


Conviction. 


Tsolakos, Peter . 


Cambridge 


Cambridge 


July 


18, 1921 


Conviction. 


Wheeler Bottling Company 


Lynn 


Lynn . 


Dec. 


7, 1920 


Conviction. 


Wilben Bottling Company . 


Worcester 


Worcester . 


May 


26, 1921 


_i 


Wincko, Peter 


Cambridge 


Cambridge 


Dec. 


10, 1920 


Conviction. 


York, Morton E. . 


Lynn 


Lynn . 


Dec. 


7, 1920 


Conviction. 



Vinegar. 
[Low in acid.] 



Archiambault, Arthur 
Dwyer, Michael J. 
Fomberstein, Myer 
Marra, William H. 
Monast, Claxite . 
Stampel, Morris . 
Whitcher, Frank . 



New Bedford 
Fall River 
Fall River 
Pittsfield 
Fall River 
Taunton 
Ayer 



New Bedford 
Fall River . 
Fall River 
Pittsfield . 
Fall River . 
Taunton 
Salem 



June 


14, 


1921 


Apr. 


22, 


1921 


May 


24, 


1921 


May 


27. 


1921 


Apr. 


22, 


1921 


May 


17, 


1921 


Mar. 


2, 


1921 



Conviction. 
Conviction. 
Conviction. 
Discharged. 
Conviction. 
Conviction. 
Conviction. 



Eggs. 
Decomposed; unfit for Food. 



Harrington, Daniel J. 



Springfield 



Springfield 



Dec. 16, 1920 



Conviction. 



On file, without plea. 



164 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Eggs — Continued. 
False Advertising — Sale of Stale Eggs as Fresh Eggs. 



Name. 


Address. 


Court. 


Date. 


Result. 


Bremner, Leon H. 


Taunton 


Taunton . 


Dec. 10, 1920 


Conviction. 


Great Atlantic and Pacific 

Tea Company, The. 
Kushner, Joseph . 


Newton 
Springfield 




Newton 
Springfield 


Nov. 2, 1921 
Oct. 28, 1921 


Conviction. * 
Conviction. 


Levine, Louis 


Newton 




Newton 


Nov. 2, 1921 


Conviction. 


Mailman, Charles A. . 


Boston . 




Newton 


Nov. 2, 1921 


Dismissed. 


Shepard, Ralph . 


Newton 




Newton 


Nov. 2, 1921 


Conviction. 


Tillman, Thomas 


Springfield 




Springfield 


Oct. 28, 1921 


Conviction. 


Wychnnas, Peter . 


Brockton 




Brockton . 


Dec. 22, 1920 


Conviction. 



MiSBRANDED. 



Branard, Harry H. 


Springfield 


Springfield 


Jan. 12, 1921 


Conviction. 


Flood, Nathan B. 


North Adams 


North Adams . 


Jan. 27, 1921 


Conviction. 


National Butter Company . 


Springfield 


Springfield 


Jan. 12, 1921 


Conviction. 



Selling Cold-storage Eggs without marking the Container. 



Altman, Max 

Anglim Market Company, 

Inc. 
Armon, Peter 

Balchnas, Stanislav P. 

Balestri, Joseph . 

Barkonicz, Benjamin . 

Barnes, William E. 

Beauchemin, Albert 

Beaudry, Alexander 

Bechick, Isaac 

Benoit, Edgar H. 

Besbris, Abraham 

Bigns, Walter . ' . 

Birstine, Morris . 

Bousquet, Levi O. 

Bresnahan, Patrick J. . 

Broudy, Isaac 

Brown, Mortimer 

Burgess, Eugene S. 



Holyoke . 

Brockton 

Brockton 

Brockton 

West Springfield 

Boston . 

Brockton 

North Adams 

Lowell 

Lowell 

Springfield 

Taunton 

Brockton 

Beverly . 

Taunton 

Holyoke . 

Holyoke . 

Marblehead 

Nantucket 



Holyoke 

Brockton . 

Brockton . 

Brockton . 

Springfield 

Boston 

Brockton . 

North Adams 

Lowell 

Lowell 

Springfield 

Taunton 

Brockton . 

Salem 

Taunton 

Holyoke 

Holyoke 

Marblehead 

Nantucket 



Dec. 


31. 


1920 


Dec. 


22, 


1920 


Dec. 


22, 


1920 


Dec. 


22, 


1920 


Dec. 


31, 


1920 


Dec. 


28, 


1920 


Jan. 


10, 


1921 


Jan. 


27, 


1921 


Nov. 


18, 


1921 


Dec. 


20, 


1920 


Dec. 


31, 


1920 


Dec. 


10, 


1920 


Dec. 


22, 


1920 


Jan. 


21. 


1921 


Dec. 


10. 


1920 


Dec. 


30. 


1920 


Dec. 


30, 


1920 


Jan. 


17. 


1921 


Dec. 


2. 


1920 



Conviction, i 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Discharged. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. 

Conviction. ^ 



' Appealed. 



2 Fined $10; sentence suspended. 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



165 



Eggs — Continued. 



Selling Cold-storage Eggs without 


MARKING THE C 


ONTAINER — Continued. 


Name. 


Address. 


Court. 


Date. 


Result. 


Buslewich, Hipolata . 


Lowell 


Lowell 


Nov. 18, 1921 


Conviction. 


Callivan, William 


Beverly . 


Salem 


Jan. 21, 1921 


Conviction. 


Carbone, Andrew 


Beverly . 


Salem 


Jan. 21, 1921 


Conviction. 


Carey, Arthur C. 


Nantucket 


Nantucket 


Dec. 2, 1920 


Conviction, i 


Cathcart, William R. . 


Nantucket 


Nantucket 


Dec. 2, 1920 


Conviction, i 


Cetlin, Charles . 


Newburyport 


Newburyport . 


Jan. 14, 1921 


Conviction. 


Chain, Henry 


North Adams 


North Adams . 


Jan. 27, 1921 


Conviction. 


Clo, John .... 


West Springfield 


Springfield 


Dec. 31. 1920 


Conviction. 


Czerwonka, Antoni 


Holyoke . 


Holyoke . 


Dec. 31, 1920 


Conviction. 


Deftos, Peter 


Brockton 


Brockton . 


Dec. 22, 1920 


Conviction. 


Denisevitch, Zachary . 


Forge Village . 


Ayer . 


Dec. 13, 1920 


Discharged. 


Dusseault, Isala . 


Taunton 


Taunton 


Dec. 10, 1920 


Conviction. 


Frye, Edmund R. 


Nantucket 


Nantucket 


Dec. 2, 1920 


Conviction. ' 


Golden, Julius 


Boston . 


Boston 


Dec. 28, 1920 


Conviction. 


Gomes, Charles . 


Taunton 


Taunton 


Dec. 10, 1920 


Conviction. 


Haley, Edward T. 


Marblehead 


Marblehead 


Jan. 17, 1921 


Conviction. 


Holland, William 


Nantucket. 


Nantucket 


Dec. 2, 1920 


Conviction. » 


Hooper, Lewis B. 


Marblehead . 


Marblehead 


Jan. 17, 1921 


Conviction. 


Jacques, Kostan . 


Taunton 


Taunton . 


Dec. 10, 1920 


Conviction. 


Janigan, John 


Brockton 


Brockton . 


Dec. 22, 1920 


Conviction. 


Koplovitz, Barnett 


Boston . 


Boston 


Feb. 9, 1921 


Conviction. 


Korontjis, Andrew 


Holyoke . 


Holyoke . 


Deo. 30, 1920 


Conviction. 


Kronich, William E. . 


Springfield 


Springfield 


Jan. 13, 1921 


Conviction. 


Lappin, Harry J. 


Lowell 


Lowell 


Nov. 18, 1921 


Conviction. 


Lipshitz, Jacob . 


Holyoke . 


Holyoke 


Dec. 30, 1920 


Conviction. 


Madey, Frank 


Holyoke . 


Holyoke 


Dec. 30, 1920 


Conviction. 


Marra, Timothy C. 


Holyoke . 


Holyoke 


Dec. 30, 1920 


Conviction. 


Menard, Adlard C. 


Holyoke . 


Holyoke 


Dec. 30, 1920 


Conviction. 


Morin, Mizael 


Holyoke . 


Holyoke 


Dec. 30, 1920 


Conviction. 


Nathan, Julius . 


Springfield 


Springfield 


Dec. 31, 1920 


Conviction. 


Ostrowsky, John . 


Holyoke . 


Holyoke . 


Dec. 30, 1920 


Conviction. 


Pagliaruli, Vitto . 


Beverly . 


Salem 


Jan. 21, 1921 


Conviction. 


Passlacque, John B. . 


Boston . 


Boston 


Dec. 28, 1920 


Conviction. 


Pouoplis, Stephen 


Springfield 


Springfield 


Oct. 28, 1921 


Conviction. 


Renzi, Antoni F. 


Beverly . 


Salem 


Jan. 21, 1921 


Conviction. 



Fined $10; sentence suspended. 



166 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Eggs — Concluded. 
Selling Cold-storage Eggs without marking the Container — Concluded. 



Name. 


Address. 


Court. 


Date. 


Result. 


Ricci, Michael 


Beverly . 


Salem ' . 


Jan. 21, 1921 


Conviction. 


Richard, Conrad . 


Graniteville . 


Ayer . 


Dec. 13, 1920 


Conviction. 


Roberts, John F. 


Nantucket 


Nantucket 


Dec. 2, 1920 


Discharged. 


Saladaka, Joseph 


Brockton 


Brockton . 


Dec. 22, 1920 


Conviction. 


Sanka, Anthamas 


Brockton 


Brockton . 


Dec. 22, 1920 


Conviction. 


Santoispirito, Manuel . 


Beverly . 


Salem 


Jan. 21, 1921 


Conviction. 


Scibella, Andrew P. 


Springfield 


Springfield 


Dec. 31, 1920 


Conviction. 


Shapiro, Morris J. 


Lowell 


Lowell 


Dec. 20, 1920 


Conviction. 


Sigda, Wojciech . 


Holyoke . 


Holyoke 


Dec. 30, 1920 


Conviction. 


Solin, William 


Springfield 


Springfield 


Jan. 12, 1921 


Conviction. 


Sousini, James 


Pittsfield 


Pittsfield . 


Aug. 26, 1921 


Conviction. 


Springer, Jacob . 


Boston . 


Boston 


Dec. 28, 1920 


Conviction, i 


Springer, Louis . 


Boston . 


Boston 


Dec. 28, 1920 


Conviction, i 


Stasz, Frank 


Holyoke . 


Holyoke 


Dec. 30, 1920 


Conviction. 


Sternberg, Benjamin . 


Springfield 


Springfield 


Oct. 28, 1921 


Conviction. 


Suchocki, Anthony 


Holyoke . 


Holyoke 


Dec. 30, 1920 


Conviction. 


Szewczuk, Stanley 


Holyoke . 


Holyoke 


Dec. 30, 1920 


Conviction. 


Tarvis, William . 


Provincetown 


Provincetown 


Aug. 17, 1921 


Conviction. 


Terry, Herbert 


Nantucket 


Nantucket 


Dec. 2, 1920 


Conviction. 2 


Tousignaut, Angelo 


Lowell 


Lowell 


Nov. 18, 1921 


Conviction. 


Vicivi, Carlo 


Beverly . 


Salem 


Jan. 21, 1921 


Conviction. 


Wilson, Jos. M. . 


Lowell 


Lowell 


Dec. 20, 1920 


Conviction. 


Wisberg, Isaac 


Fall River 


Fall River . 


Feb. 18, 1921 


Conviction. 


Wozdanowicz, Joseph . 


Holyoke . 


Holyoke 


Dec. 30, 1920 


Conviction, i 


Ziter, Edward 


North Adams 


North Adams . 


Jan. 27, 1921 


Conviction. 


Ab 


SENCB OF Sign "C 


'old Storage E 


ggs. " 


Hahn, Jacob 


Fall River 


Fall River . 


Feb. 18, 1921 


Conviction. 


Zucca, Frank 


Springfield 


Springfield 


Nov. 7, 1921 


Conviction. 




For Sale of De 


composed Food. 






Bui 


'TER. 




Mills Tea and Butter Cor- 


Boston . 


Maiden 


Jan. 6, 1921 


Conviction. 


poration. 











Appealed. 



• Fined $10; sentence suspended. 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



167 



For Sale of Decomposed Food — Concluded. 



Canned Sweet Corn. 



Name. 


Address. 


Court. 


Date. 


Result. 


Rosenbloom, Samuel . 


Revere . 


Charlestown 


Sept. 13, 1921 


Conviction, i 


Kream Krist. 


Terruso, Angelo . 


Dorchester 


Dorchester 


Nov. 18, 1921 


Conviction. 


Shrimp. 


Hyland, Thomas D. . 


Taunton 


Taunton . 


Feb. 10, 1921 


Conviction. 


Selling Decomposed Food. 


Spellman, Louis . 


New Bedford 


New Bedford 


Mar. 29, 1921 


Conviction. 



For Sale of Drugs deficient in Strength. 
Lime Water. 



Donovan, Thomas J. . 


Salem 


Salem 


Aug. 15, 1921 


Conviction. 


Gould & Co., James E. 


Maiden . 


Maiden 


Aug. 15, 1921 


Conviction. 


Kelley, Albert B. 


Lawrence 


Lawrence . 


Aug. 19, 1921 


Conviction. 


Ropes Drug Company 


Salem 


Salem 


Aug. 13, 1921 


Conviction. 


Western Refining Company 


Lowell . 


Lowell 


Aug. 18, 1921 


Conviction. 



Magnesium Citrate. 



Lowe, Charles W. 


Charlestown . 


Charlestown 


Feb. 28, 1921 


Conviction. 


Nobile, Giovanni H. . 


Revere . 


Chelsea 


Apr. 12, 1921 


Conviction. 


Smanai, Rudolph 


Springfield 


Springfield 


June 16, 1921 


Conviction, i 



Extract of Peppermint. 



Leonard, Willie J. 



Brockton 



Brockton . 



Apr. 21, 1921 



Conviction. 



1 Appealed. 



168 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



For Violation of the Laws relative to Cold Storage. 

Holding Articles of Food in Cold Storage for a Period Longer than Twelve 
Months without the Consent of the Department of Public Health. 



Name. 


Address. 


Court. 


Date. 


Result. 


Cannizzo, Joseph 
Corso, Santo 


Boston . 
Boston . 


South Boston . 
South Boston . 


Oct. 21, 1921 
Oct. 21, 1921 


Conviction. 
Conviction. 



Retailing Cold-storage Goods without displaying a Sign marked "Cold Storage 

Goods Sold Here." 



Besbris, Abraham 
Bousquet, Levi O. 
Gomes, Charles 
Jacques, Kostan 
Kitas, Peter 
Lavin, David 
LaRoche, Omer 
Levesque, Ovide 
Phillips, A. H., Inc. 
Phillips, A. H., Inc. 
Starr, James J. 



Taunton 

Taunton 

Taunton 

Taunton 

Springfield 

Springfield 

Springfield 

Fall River 

Springfield 

Springfield 

Springfield 



Taunton . 

Taunton . 

Taunton . 

Taunton 

Springfield 

Springfield 

Springfield 

Fall River . 

Springfield 

Springfield 

Springfield 



Dec. 

Dec. 

Dec. 

Dec. 

Dec. 

Nov. 

Dec. 

Feb. 

Dec. 

Jan. 

Nov, 



10, 1920 

10, 1920 

10, 1920 

10, 1920 

31, 1920 

7, 1921 

31, 1920 

18, 1921 

31, 1920 

12, 1921 

7, 1921 



Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 
Conviction. 



Representing Cold-storage Food as Fresh Food. 



Bogdonoff, Morris H. 



Lowell 



Lowell 



Apr. 25, 1921 



Conviction. 



Operating a Refrigerating Warehouse without a License issued by the Depart- 
ment OF Public Health. 



Fairmont Creamery Com- i Boston 
pany. 



Boston 



Apr. 29, 1921 



Conviction. 



For Violation of the Laws relative to Slaughtering. 
Illegal Use of Stamp. 



Boutwell, Flint H. 


Fitchburg 


Fitchburg . 


Jan. 13, 1921 


Conviction. 


Geissler, Jacob 


Sharon . 


Stoughton . 


Jan. 21, 1921 


Conviction. 


Smith, Sylvester . 


Belchertown . 


Northampton . 


Jan. 5, 1921 


Discharged. 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



169 



For Violation of the Laws relative to Slaughtering — Concluded. 

SLAtTGHTERING OR AUTHORIZING SLAUGHTERING IN THE ABSENCE OF INSPECTOR. 



Name. 


Address. 


Court. 


Date. 


Result. 


Albert, Phillip . 


New Bedford . 


New Bedford 


June 


28, 1921 


Conviction. 


AUyn, Edgar 




Westfield 


Westfield . 


Jan. 


27, 1921 


Conviction. 


Cohen, Morris 




New Bedford . 


New Bedford 


June 


28, 1921 


Conviction. 


Fredette, William 




New Bedford . 


New Bedford 


June 


28, 1921 


Conviction. 


Grasso, Andrew . 




Agawam 


Springfield 


Mar. 


31, 1921 


Conviction. 


Huntington, Edward 




Amherst 


Northampton . 


Feb. 


16, 1921 


_i 


Margolis, Simon . 




New Bedford . 


New Bedford . 


June 


28, 1921 


Conviction. 


McColgan, Robert 




Pittsfield 


Pittsfield . 


Mar. 


15, 1921 


Conviction. 


Wheeler, Perley . 




Northampton 


Northampton . 


Feb. 


16, 1921 


-I 



Selling, offering for Sale, or having in Possession with Intent to sell, Un- 
stamped Meat. 



Allyn, Edgar 


Westfield 


Westfield . 


Jan. 27, 1921 


Conviction. 


Cohen, Tom 


Methuen 


Lawrence . 


Mar. 17, 1921 


Conviction. 


Grasso, Andrew . 


Agawam 


Springfield 


Mar. 31, 1921 


Conviction. 


McColgan, Robert 


Pittsfield 


Pittsfield . 


Mar. 15, 1921 


Conviction. 



Sale of Diseased Meat. 



McFadden, James 
Willard, Frank A. 



Athol 
Leominster 



Athol 
Leominster 



Jan. 8, 1921 
Jan. 4, 1921 



Discharged. 
Conviction. ' 



As Inspector of Slaughtering failed to condemn Diseased Meat. 



Swann, William L. 



Athol 



. Athol 



Jan. 8, 1921 



Discharged. 



Slaughtering without License. 



Dixon, Ray O. 



Ware 



Ware 



Dec. 21, 1920 



Discharged. 



' Filed on plea of "not guilty." 



2 Apjjealed. 



170 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 






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No. 34.] 



DIVISION OF FOOD AND DRUGS. 



171 



Table No. 3. — Summary of Food Samples examined. 



Character of Sample. 



Genuine. 



Adulterated. 



Total. 



Butter .... 

Canned goods 

Cider .... 

Clams .... 

Cocoa .... 

Coffee .... 

Coffee substitutes 

Condensed milk . 

Confectionery 

Cream .... 

Dried fruits . 

Eggs .... 

Flavoring extracts 

Grape juice . 

Ice cream 

Maple sugar . 

Maple syrup 

Meat and meat products: 

Bacon 

Beef .... 

Sausages 
Miscellaneous 
Nuts .... 
Oleomargarine 
Olive oU . . . 
Scallops 

Shrimp .... 
Soft drinks . 
Spices .... 
Vinegar 

Totals . 



257 
4 
2 
5 
2 
12 



13 
24 
7 
139 
5 
3 
6 



2 

458 

105 

1 

8 

142 

1 

220 

8 

346 



114 
2 

7 



2 
3 
3 
2 
4 
280 
2 
12 



82 
7 
1 



1 

1 

66 

94 



371 

6 

9 

13 

3 

12 

2 

3 

16 

26 

11 

419 

7 

15 

6 

9 

1 

2 

2 

540 

112 

2 

8 

228 

1 

2 

286 

8 

440 



1,779 



781 



2,560 



172 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table No. 4. — 


Summa' 


ryoj 


Di 


"ug Sayr 


ipii 


;s ex 


immed. 






Chakacter of Sample. 


Genuine. 


Adulterated. 


Total. 


Blue ointment 


25 


4 


29 


Camphorated oil 


38 


1 


39 


Hydrogen dioxide solution 


14 


— 


14 




113 


23 


136 


Lime water 








Lithia tablets 


2 


- 


2 




4 


_ 


4 


Liquor 








Miscellaneous 


33 


1 


34 


Olive oil 


9 


- 


9 


Precipitated sulphur 


25 


4 


29 


Proprietary drugs 


1 


"" 


1 




27 


8 


35 


Spirits of camphor 


27 


1 


28 




114 


93 


207 


Spirits of peppermint 


1 


1 


2 


Tincture of iodine 


7 


^ 


7 


Zinc oxide ointment 


37 


2 


39 




477 


138 


615 


Table No. 5. — Summary of Liquor Samples examine 


i. 




Beer. 


Cider. 


Wines. 


Dis- 
tilled 
Liquors. 


Flavor- 
ing Ex- 
tracts. 


Alcohol. 


Miscel- 
aneous. 


Total. 










g 




3 


1 


10 


Abington . 






















Ayer . 






- 


3 


5 


27 


- 


27 


7 


69 


Berlin . 




^ 


- 


8 


2 


- 


- 


- 


- 


10 


Bevbrlt . 






- 


1 


7 


4 


- 


- 


- 


12 


Boston 






51 


5 


76 


1,372 


105 


100 


114 


1,823 


Brookline . 






11 


2 


3 


19 


- 


- 


10 


45 


Cambridge 






65 


9 


32 


137 


19 


11 


63 


336 












1 


69 


11 


1 


4 


86 


Chelsea 




















Dedham 






- 


- 


7 


6 


- 


1 


- 


14 


Everett 






- 


- 


2 


8 


- 


2 


- 


12 


Fall River 






13 


6 


2 


112 


5 


2 


15 


155 


FrrcHBURG . 






- 


3 


16 


8 


4 


1 


6 


38 


Gloucester 






- 


11 


1 


10 


- 


1 


7 


30 


Hudson 






4 


1 


1 


8 


1 


2 


5 


22 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



173 



Table No. 5. 


Summo 


ry of L 


iquor b 


amples 


exarmm 


3d — U( 


mclucle 


a. 




Beer. 


Cider. 


Wines. 


Dis- 
tilled 
Liquors. 


Flavor- 
ing Ex- 
tracts. 


Alcohol. 


Miscel- 
laneous. 


Total. 


Ipswich .... 


2 


- 


- 


10 


1 


- 


- 


13 


Lawkencb . 






63 


9 


1 


35 


- 


3 


11 


122 


LOWELli 






5 


1 


4 


53 


3 


15 


2 


83 


Lynn 






10 


- 


13 


52 


9 


2 


3 


89 


MaXiDEN 






- 


- 


2 


26 


- 


- 


1 


29 


Marlborough . 






48 


10 


22 


28 


- 


- 


5 


113 


Milford 






5 


- 


1 


4 


- 


- 


1 


11 


Newton 






- 


- 


- 


16 


1 


1 


- 


18 


North Adams . 






- 


10 


- 


1 


- 


- 


9 


20 


Orange 






- 


10 


- 


- 


- 


- 


- 


10 


Peabodt . 






1 


- 


2 


7 


1 


- 


1 


12 


QUINCT 






- 


- 


- 


11 


2 


1 


- 


14 


Reverb 






2 


1 


1 


29 


2 


- 


- 


35 


Rowley 






2 


4 


4 


1 


- 


- 


- 


11 


Shrewsbury 






4 


- 


- 


6 


- 


- 


- 


10 


SOMERVILLB 






- 


- 


4 


27 


1 


- 


2 


34 


Southbridge 






6 


- 


1 


7 


1 


- 


1 


16 


Springfield 






8 


2 


1 


78 


10 


35 


- 


134 


Stow . 






2 


- 


6 


8 


- 


- 


2 


18 


Taunton . 






5 


- 


- 


19 


- 


- 


1 


25 


Townsend . 






- 


- 


- 


11 


- 


- 


1 


12 


Wakefield . 






- 


- 


- 


10 


3 


- 


1 


14 


Westford . 






6 


- 


3 


4 


6 


- 


2 


21 


Winchendon 






1 


6 


5 


- 


- 


- 


- 


12 


Woburn 






- 


- 


- 


9 


- 


1 


- 


10 


Miscellaneous' 






42 


42 


33 


121 


15 


11 


19 


283 


Totab . 


356 


144 


258 


2,356 


202 


221 


294 


3,831 



» From 87 cities and towns submitting less than 10 samples during the year. 



174 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



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*M 


t~r 


•0 


tn 


CO 


Cfl 


VH 




• 


• 


• 


• 


♦ 


• 


• 


. 




u 


• 


t-l 




u 




























s 




>> 

3 


.d 


• 


• 




• 


+3 

M 

3 


.0 

s 




J2 


a 








3 

t-5 




1 


< 


>> 

03 


a 

a 
3 


•-3 


a 









> 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



175 















B 

o 

■to 



e 

Si. 



O 

m 

< 









OO 


oo '^ 


„ 


no 


»o 


lO 


o 


CO '* 


























t^ 






^ CO 


oo 


o 










•(spunoj)§aijTqM 


CO 


t^ 


Ir^ 


•ri c^ 


CO 
CO 


CM 


o 

CD 


c^ 

CO 


o 

CO 


CO "D 
»0 OS 












CO 


OS 


CO 


^ 


oo 


OS CD 














T-^ 






"^ 


^ -^ 




(M 


^O 


1 


lO t-- 


1 


1—1 


m 


o 


CM 


t^ <<** 










cs t^ 




CD 


CD 


05 


CD 




■(spuno^i) 


(M 


lO 




1—1 




oo 


CO 


>o 




CD O 


qsga;nM 


cq 


00 








"«** 


CM 

1— ( 




CO 


^ S 




^ 


o 


o 


IQ C<1 


OS 


CO 


r>- 


Ci 


CM 


t- o 




Tt* 


■Tt< 


1— t 


OS to 




CO 












a= 


(N 


b- 


M o 


o 


oo 


■^ 








•(spunoj^) pmbg 


o 


m 






OS 


oo 


CM 

OS 




lO 
WD 


oo o 

■^ i-O 




*— ( 


1— 1 




1-1 r}< 


■^ 


T-l 


1—1 




c<r 


cm" cm 






J 


o 


OS Oi 


I 


1 


1 


1 


o 


s ^ 
























(spunoj) -oja 


03 


i>- 


1:^ 


Tt< lO 














'uonoBing 's^piug 


CSI 


oo 


CO 


CO (T^ 

1— t 












^ g 












o 


lO 


o 


o 


OS 


OS OS 










CS 








o 












oo 


•^ 


t^ 


o 


CD 


**< 


1—1 




■(spunoj) ptjqs 












CO 


CD 

1— ( 


oo 


crs 


^ CO 
CO CO 


•(spunoj) 


s 


oo 


b- 


lO C^ 


CI 

CD 


o 

OS 


CD 


o 


»o 


oo "* 

CD CO 


(■oja'^noixP'saq 


J>- 




-^ 


■^ OS 


O 


o 






O 




-[aa;S '^{ooinqo 


05 
CO 




05 


OS lO 


CM 


oo 


CO 


^ 


CO 


CO r^ 


'aAa>(oog) uoonBg 
























o 


CO 


o 


o oo 


O 


»o 


wo 


to 


^ 


CM CD 




■^ 


1— 1 






I>- 


crs 










•(spunoj) 


<M 


lO 




ca -^ 




'<t* 


CO 








uouiiBg jaAitg 


o» 


CO 


oo 






■xt< 


CM 


cq 


^ 


CO OS 

1— t 1—1 






^ 


o 


Oi lO 


lO 


CO 


1^ 


1 


CO 


^ ^ 




CD 


















o r- 


•(spuno<£) 


lO 


OS 


o 


OS t^ 


lO 


oo 










UOUlIBg i\Vd 


s 


s 


t^ 


CM -^ 
CO CM 




CM 


1—1 






CO CO 




oo 


OS 


Ci 


05 OO 


F- 1 


oo 


CO 


Oi 


to 


CO oo 




oo 


to 




CO lO 


o 


to 


1— t 








•(spunoj) 




CO 


CO 
lO 


-4 o_ 

OS CO 


o 


oo_ 
cm" 


CO 


cq 

o 




CM t-^ 


jaaa5(0'Bj\[ 


^ 


!>. 


T-l 


(M 1-1 


OS 

»o 


!>. 


oo 

1—1 


-^ 


03 


CD OS 




OO 


o 


o 


O e3s 


t-» 


1—1 


CD 


o 


OO 


^ WD 
















■^ 


■^ 








Tt^ 


lO 


1— < 


oo o 


o 


•r>* 


't** 








•(spnnoj) Snijjajj 




oo 

CO 


CO 


1-i CM 


^ 


CO 
CM 


o 
oo 


o 


s 


CM WD 

^H OS 




CO 


<M 


w 


CO -* 


« 


oo 


^ 




CO 


CO CM 












M 


CO 


oo 


CO 


»fD 


O WD 






Oi 




t^ OS 


00 


o 


t^ 


lO 








oo 


!>■ 


oo 


CM C-i 


oo 


»o 










•(spnnoj) ^Tiqi]BH 


^ 


O 


»o 


§ S 


OS 

o 


s 


00 
00 


oo 

CO 


OO 


WD OS 
CO CO 




CO 


CO 


y—t 




.-* 


»— t 


















.-1 lO 


.-1 


oo 


oo 


^^ 


o 


S? '^ 


■(spnnoj) 3[0op 


s 


>o 

oo 


CO 


S S3 


CO 


o 


1—1 


^ 


o 


oo oo 


-pBjj pnu Jjooi 
-Fd '8>ltiH 'poo 


oo 


o 

CO 


oo 
»o 


Ol CO 


oo 

CO 


CM 


s 


■^ 


OS 

WD 


t— Ol 

t^ CI 

t^ OS 








lo 


<N tH 


o 


CD 


o 


1 


^ 


CO oo 












>o 


O 








-^ -^ 










O — 1 


.— t 


CO 










•(spunoj) saoosiQ 


»f5 


oo 






CO 


lO 


05 




S 


oo -rt< 
CM CD 






'"^ 
















«o 








o 


CM 


00 


r^ 


t~ 


S ^ 
























•(spnnoj) 

qsgja^^ng 


CO 
CO 


t— 1 




CO 




CM 

cm' 


o 

CO 


CO 
OS 




246,8 

245,4 




. 










1 


>o 


CM 


t^ 


00 OS 








C^l 


C<1 


CO 




03 


»o 


OJ 




•(spunoj) 

qsgatqa 






'^ 


oo 


CO 




o 

00 


o 


Oi 


CM OS 

1—1 




• 


• 


• 


• • 


• 


• 


• 


• 


u 
































>> 












o 






B 


>1 

5^ 


S3 

3 


■^ _ 








vx 
br 

<1 


s 


1 a 




Q 


3 

►-5 






03 


CI 


1-5 


^ 
^ 


Octo 
Nov 



176 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



o 



■•—I 



o 
o 



c 
Q 



05 



^ 



00 

d 
w 

Hi 

< 



^-1 


■~i 


05 


tv 


c 


Cf^ 


!~. 


>~i 


o 








^ 


•^ 


s 


o 


o 


•4^ 


O 


t; 


K 




•<s> 




•^ 




K 




CS 




tt5 




s 




o 




.^ 




-!=• 




(n 








f*. 




S 




C 




•<; 




•*^ 




S-. 




>« 




^ 








O 




Co" 




*1> 





II . ^ 1 


CO 


c^ 


1—1 


CO 


-H 


^ 


o 


_J 


j;5 


o 


OS 


o 


Miscella 
neous 
Meats 

(Pounds 


CO 


CO 


(M 


o 


!>. 




^ 


oq 




CD 


CO 


O) 


"^ 


■^ 


t- 


oo_ 


I>^ 


"^ 


t-H 


(M_ 


C>J 


■^ 


OS 


CO 


CO 


CO 


o 


-rt*" 


oo 




o 


»o 


rji" 


■^ 


CO 


OS 


iO 


o 


CO 


»c 


»o 


CO 


(M 


oo 


OJ 


»-* 


CO 


CO 


o_ 


o 


CO 


»o 


Os_ 


oo 


(M 


oo 


^rt* 


CD 


CM 


rj* 


c^ 


CO 


co' 


CO 


CM* 


CM 


00 


c^" 


■m" 


'"' 


1-H 


""" 


'73 




:^' 


::?; 


\cq 


::^ 
















S Sis 


CO 


CO 


o 


o 


1-H 


Tj« 


<M 


W3 


<M 


CO 




CM 


CO 


OS 


>c 




■^ 


t-- 


CO 


Oi 


CO 


CM 




CO 


oj o-a 


a> 


o 


t^ 




^^ 


CO 


<M 


"*. 


CO 






CO 


J2^ S 




























c^ 




CO 




»o 


lO 


oo 


CO 


t^ 


CO 


r^ 


III 


CO 


CO 




CO 




OS 


o 


o> 


OJ 


o 


I^ 


»o 


o^ 


oo^ 




(M 


o_ 


"^^ 


CO 


OS 


00 


oo 


OS 


o 


o 


o 


o 


CO 


CM 




^ 










^ 


























^ 


c^ 


oo 


1-^ 


"^ 


t^ 


Ol 


•« 


in 


CO 


o 


OS 


oo 


VI 


oo 


CV) 




CO 


CO 


t^ 


CO 


OJ 


oo 


-* 


o 


-* 


•^"S 


CO 


CO 


CO 


00^ 


CO 


Os_ 


oo 


CO 


CO 


OS 


CO 


"^ 


b C 


CO 


oo 


cf 




oo 


CO 


1^ 


CO 


>o 


OS 


oo 


r-T 


O 3 
^ O 


CO 


t^ 




CO 


oo 


C^l 


»o 




o 


OS 


•^ 


OS 


OS 


c^ 


t^ 


CO 


o 


CO 




00_ 


CO 


CO 


lO 


CM 


























5l 


o 


lO 

I—) 


l>r 


t-T 


CO 


lO 


CD 


CO 


CO 


o 


oo 


oo 


03 


CO 


l>. 






CO 


ca 


,c^ 


-* 


o 


CM 


'<** 


OS 


o 




o 


oo 


CO 


-rt* 


OS 




C-J 




CM 


t-- 


c^ 


■^ 


ai 


t-^ 


c^ 


ai 




•* 


o 


o 


oo 


oo 


























■^ 


c^r 


00 




»c 


'^ 


c^ 


oo 


Oi 


lO 


CD 


<* 


00 


oo 


o 


CD 


1— 1 


CD 




CO 


OS 


OS 




^' 


■^ 


o 


CO 


o 


00 


Os_ 


CO 


o 


OJ 


t^ 


CM 


t^ 


Ph 


























to 


uf 


lO 


iC 


■•l^ 


rjn" 


■^ 


ta 


-* 


CO 


'tp 


"'J' 


Miscella- 
neous 
Poultry 
(Pounds). 


CO 


■* 


o 


CO 


lO 


^ 


c» 


^^ 


t." 


W5 


CO 


^_, 


o 


CO 


-<s* 




CD 


00 


CO 


o 


oo 


-^ 




CO 


■^ 


(M_ 


oo 


»o 


lO 


t^ 


■^ 




CO 


-^^ 


»o 


OS 


























CO 


i>r 


'^ 


-^ 


CD 




cm" 


t^ 


OJ 


tc 


of 


M* 


CO 


■^ 


"^ 


t^ 


CO 


CO 


(M 


OS 


o 


C-1 


o 


»iO 


!>■ 


oo 


O) 


t>- 


CO 


>o 


CO 


■^ 


CO 


CO 


UD 


OS 


























x^ 


0)73 


CO 


__, 


CO 


CO 


U5 


u> 


en 


>o 


■^ 


CO 


'^ 


1^ 


CO 


M* 


■^ 


<M 


lo 


l>- 


ca 


oo 


OJ 


OS 


t^ 


CD 


OS 


f— 1 


t^ 


CD 


CO 


■* 


'^J* 


o_ 


OJ 


OS 


W5 


oo 


•^ ^ 




























s 


oo 


-^ 


CO 


oT 


oT 


00 


CO 


o 


tc 


CO 


o 




lO 


>:*• 


•o 


CO 


00 


(M 


■ct* 


t^ 


t-- 


»o 


'^ 


'**' 


■^ 


lO 


^ 


lO 


■* 


-^ 


OJ 


'"' 


'"' 


CM 




























IM 


*— < 


lO 


o 


CO 


1-H 


,_, 


o 


CO 


OS 


00 


o 


_ 05 


CO 


Oi 


»o 


^ 


Oi 


■* 


CO 


CO 


tn 


CD 


CM 


CO 


^■S 


o_ 


o^ 


<M 


CD 


CD 


CO 


00 


>o_ 


°l 


o 


r^ 


CM 


a 


o 


CO 


CO 


<^ 


o" 


CR 


tn 


CO 


o" 


of 


»o 




c^ 


I>- 


'^ 


r>- 


CM 


to 


o 


-* 


oo 


00 


!>. 


t^ 




c^ 




CD 


CO 


^^ 


(M 


'-' 








CM 


CL, 


*— ( 


1— • 


^-H 




















■ ' 


























03 ^-^ 






'-Ci 










:s 










11 


Ol 


o 


-r»< 


o 


t^ 


I^ 


-* 


00 


o 




CO 


1-H 


CO 


oo 


OS 




Ir^ 


>o 


1^ 


OS 


OS 


oo 


CI 




iC 


Oi^ 


o^ 




CD 


"t 


CO 




lO 


oo 


"* 


t>. 


























o ^ 




t-^ 


CO 


t^ 


»o 


00 


(M 


•^ 


OJ 


■* 


CO 


CM 


oo 


o 


'^ 


CM 


o 


■* 


>o 


CO 


t... 


»ra 


»o 


1:^ 


co^ 


oo^ 


CO 


o^ 


»o 


o> 


o 


»— 1 




1-H 


'tj^ 


^ 


im" 


(N 


oT 


CM 


""^ 














^~* 




cq 


<N 


t- 


c^ 


o 


o 


■* 


CM 


r^ 


lO 


CD 


CO 


CO 


CO 


cO 


kO 


CO 


o 


lO 


CM 


o 


o 


CM 




C<J 


lO 




oo 


CO 


«5 


<M 


CO 


CO 


05_ 


°l 


CO 


o :3 


oT 


of 




OS 


■^ 




CO 


CO 


o 




CD 


CM 


05 


CO 


to 


CD 


l:^ 




o 


CM 


oo 


■* 




00 


oo 


00 


oo 


l>. 


CO 


»o 


■^ 


CM 


^H 


Tjf 


lo 


iO 


























Broken- 
out 

Eggs 
(Pounds). 


^ 


CO 


OS 


CM 




C-J 


■^ 


o 


^ 


o 


CO 


O) 


oo 


00 


OS 


o 


»o 


U5 


.— 1 


OS 


y—t 


CD 


oo 


OS 






oo 


CO 


t-^ 


o 


o 


oo 


c^ 


CO 


Tt^ 




CO 


wf 


o 


*— 1 


"^ 


?o 




y^ 


OS 


CM 


os" 


S3 


o 


00 




»« 


OS 


Ol 


Oi 


OS 


oo 


OS 




*3 


lO 


CO 


CO 


CO 


CO 


■* 


•^ 


lO 


CO 


CO 


CO 


CO 




























o 


o 


o 


o 


o 


o 


o 


o 


o 


lO 


o 


o 




■rt^ 


CO 


r^ 


CO 


oo 


b- 


■^i- 




-rt< 


CO 


t^ 


iO 


fsS 


s 


■^ 


.— < 


co^ 


U5 


o_ 


CO 


CM 




t--. 


'"i. 


oo 


cs" 


CO 


i>r 


CO 


o 


CO 


h-T 




CM 


o 


CO 


i-T 


..''f s 


o 


00 




Id 


iF- 


Ira 


a> 


CO 


lO 


"^ 


•* 


o 


[a o 

B 


*o 






CM 


o 
o 


CO 


CO 


CO 


CO 
lO 


CO 


Os_ 
OS 


1-H 

CO 




"^ 


o 


CO 


00 


'^ 


N 


t^ 


!>. 


OS 


lO 


00 


UO 




lO 


oo 


o 


OS 


■* 


c^ 


CJ 


o 




CM 


oo 




oi" 


oo^ 


cm" 


os^ 


lO 
CD 


00 


•o 

CO 


oo 
°2" 


CM_ 


CO 


CM_ 


CO 


"§ 


CO 


CO 


CO 


UO 


o 


oo 


oo 


CO 


oo 


CO 


CM 


o 


-* 


.—1 


Oi_ 




o 




C~) 


CD 


oo 


oo 


CM^ 


o 


o 


t>r 


'^'" 


CO 


l-H* 


d" 


oo" 


i-T 


CO 


-^ 


■rtf 


cm" 




■^ 














1-H 


^H 


'"^ 


'"' 


*"* 




• 


• 


• 




• 


• 


• 


• 


t4 


• 


u 


§3 

Xt 

i 

o 

Q I 




x 

s 


3 


JH 






■ 


• 


<4J 

M 

3 


B 


§3 






3 

03 
^-3 






1 


1^ 


3 

1-5 


1-5 


a 

CD 


o 

o 

o 


> 

o 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



177 






IQ 



<1J 



c» 















>5 

C5 






o 

d 






CO 



d 
12; 

H 
1-3 

pq 
< 





t~ 


«o 


1— t 


t^ 


"5 


o 


(M -H 


t^ 


!>. 


OS 














CO 


CO 


'^ »o 


oo 


OS 


CO 




























•(spnnod^)SntiiqA\ 


CO 

o 


CM 


K 


CO 


(M 


o 


K 2 


00 
CM 


cm" 

CO 


cm" 








*— ' 


'-H 






■^ 


O iC 


CO 


o 


CD 


OO 




•^ 


CO 


CM 


cq 


" 


— 


CO CO 


■^ 


■* 


■^ 


CO 




t^ 


»o 


1 


to 


1 


1 


OS l-H 










•(spnnojj 


s 


:=; 










CM Oi 

OO o 


K 


o 
oo 


OS 


CO 


ijsss^nM 


^ 


CM 










*— 1 


OO 


CO 


CO 
CO 


1— < 




'^ 


''f 


O 


OS 


o 


r^ 








^ 














o 


OS 


Tj^ OO 


OS 


o 


o 














OS 


»o 


W3 OO 






^7 




•(spunoj) pmbg 


oo 

CM 


00 


^ 


oo 

CO 


s 


CO 


O l^ 


CM 


oo 


cm" 


in 












'— ' 


io 


OO CM 


CO 


lO 


CO 


t— 




'■' 


»— t 






1-H 


<N 


CM CM 


CM 


CM 


CM 


■•-< 




05 


CO 


OS 


CO 


CO 


1 


CO W5 


.n 








■(spunoj) -Dja 


'^ 


o 






s 




lO CO 

OO oo 


s 


CM 


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178 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Summary. 

Eequests for extension of time granted 236 

Eggs 4 

Butter 99 

Poultry 2 

Game 4 

Meat 41 

Fish 86 

Requests for extension of time not granted 102 

Butter 59 

Poultry 1 

Game 1 

Meat /. 31 

Fish 10 

Requests for permission to remove granted 1 

Meat 1 

Articles ordered removed from storage (no requests made) .... 139 

Eggs 6 

Butter 11 

Poultry 15 

Game H 

Meat 46 

Fish . 50 



Table No. 10. — Requests for Extension of Time granted on Goods in Cold 
Storage from Dec. 1, 1920, to Dec. 1, 1921. 

[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, frozen . 


1,140 


Aug. 2, 1920 


Jan. 1, 1922 


Armour & Co. 


Egg whites 






190 


Jan. 8, 1920 


Oct. 8, 1921 


Bigelow, H. J. 


Egg whites 






13,024 


Aug., 1920 


Dec. 1, 1921 


Layton, John, Company. 


Egg yolks 






13,376 


Aug., 1920 


Dec. 1, 1921 


Layton, John, Company. 


Butter . 






1,200 


June 16, 1920 


Sept. 16, 1921 


Boyle, D. A., & Co. 


Butter . 






2,666 


July 16, 1920 


Oct. 16, 1921 


Farnsworth, Benjamin & Mills. 


Butter . 






17,200 


Aug. 12, 1920 


Sept. 30, 1921 


Farnsworth, Benjamin & Mills. 


Butter . 






480 


June 16, 1920 


Sept. 16, 1921 


Goldsmith-Stockwell Company 


Butter . 






960 


June 17, 1920 

* 


Sept. 16, 1921 


Goldsmith-Stockwell Company 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



179 



Table No. 10. — Requests for Extension of Time granted on Goods in Cold 
Storage from Dec. 1, 1920, to Dec. 1, 1921 — Continued. 



Article. 


Weight 
(Pounds). 


Placed in 
Storage. 


Extension 
granted to — 


Name. 


Butter .... 


1,320 


June 


20 


1920 


Sept. 22 


1921 


Goldsmith-Stockwell Company. 


Butter . 








600 


June 


21 


1920 


Sept. 21 


1921 


Goldsmith-Stockwell Company. 


Butter . 








1,170 


July 


1 


1920 


Oct. 1 


1921 


Goldsmith-Stockwell Company. 


Butter . 








1,200 


July 


1 


1920 


Aug. 1 


1921 


Goldsmith-Stockwell Company. 


Butter . 








480 


July 


9 


1920 


Oct. 7 


1921 


Goldsmith-Stockwell Company. 


Butter . 








1,740 


July 


14 


1920 


Oct. 14 


1921 


Goldsmith-Stockwell Company. 


Butter . 








2,100 


July 


14 


1920 


Oct. 14 


1921 


Goldsmith-Stockwell Company. 


Butter . 








2,640 


July 


14 


1920 


Oct. 14 


1921 


Goldsmith-Stockwell Company. 


Butter . 








3,780 


July 


28 


1920 


Oct. 28 


1921 


Goldsmith-Stockwell Company. 


Butter . 








3,240 


July 


29 


1920 


Oct. 29 


1921 


Goldsmita-Stockwell Company. 


Butter . 








2,268 


July 


30 


1920 


Oct. 30 


1921 


Goldsmith-Stockwell Company. 


Butter . 








3,100 


July 


30 


1920 


Oct. 30 


1921 


Goldsmith-Stockwell Company. 


Butter . 








480 


Sept. 


18 


1920 


Dec. 18 


1921 


Goldsmith-Stockwell Company. 


Butter . 








945 


Sept. 


23 


1920 


Dec. 23 


1921 


Goldsmith-Stockwell Company. 


Butter . 








660 


Oct. 


25 


1920 


Jan. 1 


1922 


Goldsmith-Stockwell Company. 


Butter . 








1,320 


Nov. 


1 


1920 


Jan. 1 


1922 


Goldsmith-Stockwell Company. 


Butter . 








248 


July 


2 


1920 


Oct. 2 


1921 


Haire, William J., Company. 


Butter . 








186 


July 


2 


1920 


Jan. 2 


1922 


Haire, William J., Company. 


Butter . 








18,476 


July 


15 


1920 


Jan. 15 


1922 


Haire, WiUiam J., Company. 


Butter . 








1,046 


June 


5 


1920 


Sept. 5 


1921 


Lamson & Co. 


Butter . 








21,210 


Apr. 


25 


1920 


Nov. 26 


1921 


Lewis, Mears Company. 


Butter . 








4,640 


May 


3 


1920 


Dec. 5 


1921 


Lewis, Mears Company. 


Butter . 








1,281 


May 


3 


1920 


Dec. 5 


1921 


Lewis, Mears Company. 


Butter . 








3,155 


Maj' 


4 


1920 


Dec. 5 


1921 


Lewis, Mears Company. 


Butter . 








21,290 


May 


26 


1920 


Aug. 26 


1921 


Lewis, Mears Company. 


Butter . 








1,281 


June 


4 


1920 


Sept. 4 


1921 


Lewis, Mears Company. 


Butter . 








4,640 


June 


4 


1920 


Sept. 4 


1921 


Lewis, Mears Company. 


Butter . 








3,155 


June 


5 


1920 


Sept. 5 


1921 


Lewis, Mears Company. 


Butter . 








18,538 


July 


7 


1920 


Jan. 7 


1922 


Lewis, Mears Company. 


Butter . 








2,100 


July 


8 


1920 


Jan. 8 


1922 


Lewis, Mears Company. 


Butter . 








8,722 


July 


10 


1920 


Oct. 10 


1921 


Lewis, Mears Company. 


Butter . 








3,000 


July 


12 


1920 


Jan. 12 


1922 


Lewis, Mears Company. 


Butter . 








775 


June 


14 


1920 


Sept. 14 


1921 


Lewis, Mears Company. 


Butter . 








17,504 


June 


14 


1920 


Sept. 14 


1921 


Lewis, Mears Company. 


Butter . 








1,770 


July 


15 


1920 


Jan. 12 


1922 


Lewis, Mears Company. 


Butter . 








1,234 


July 


17 


1920 


Jan. 19 


1922 


Lewis, Mears Company. 



180 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table No. 10. — Requests for Extension of Time granted on Goods in Cold 
Storage from Dec. 1, 1920, to Dec. 1, 1921 — Continued. 



Article. 



Weight 
(Pounds). 



Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 



1,230 
3,000 
5,612 
3,024 
1,648 
2,245 
3,960 
1,950 

958 
1,111 
1,286 
1,335 
6,146 
7.035 
1,680 
10,354 
4,164 
2,850 

816 

1,282 

1,320 

2,867 

3,850 

9,900 

14,213 

4,500 

17,019 

2,180 

4,514 

4,575 

13,969 

3,024 

7,440 

5,455 

6,820 

12,810 



Placed in 
Storage. 



Extension 
granted to — 



Name. 



July 19, 1920 
July 19, 1920 
July 20, 1920 
July 24, 1920 
July 30, 1920 
July 30, 1920 
Aug. 2, 1920 
Aug. 5, 1920 
Aug. 6, 1920 
Aug. 6, 1920 
Aug. 6, 1920 
Aug. 6, 1920 
Aug. 6, 1920 
Aug. 6. 1920 
Aug. 17, 1920 
Aug. 19, 1920 
Aug. 27, 1920 
Aug. 30, 1920 
Sept. 1, 1920 
Oct. 6, 1920 
June 19, 1920 
June 4, 1920 
June 9, 1920 
June 12, 1920 
June 28, 1920 
July 2, 1920 
July 6, 1920 
July 7, 1920 
July 15, 1920 
July 15, 1920 
July 15, 1920 
July 22, 1920 
July 22, 1920 
July 24, 1920 
July 24, 1920 
July 28, 1920 



Jan. 19, 1922 
Oct. 19, 1921 
Jan. 20, 1922 
Oct. 24, 1921 
Jan. 30, 1922 
Jan. 30, 1922 
Feb. 2, 1922 
Feb. 5, 1922 
Nov. 6, 1921 
Nov. 6, 1921 
Nov. 6, 1921 
Nov. 6, 1921 
Nov. 6, 1921 
Nov. 6, 1921 
Nov. 17, 1921 
Sept. 19, 1921 
Nov. 27, 1921 
Nov. 30, 1921 
Dec. 1, 1921 
Jan. 5, 1921 
Jan. 1, 1922 
Dec. 4, 1921 
Sept. 9, 1921 
Dec. 12, 1921 
Sept. 28, 1921 
Oct. 2, 1921 
Jan. 6, 1922 
Sept. 7, 1921 
Sept. 15, 1921 
Sept. 15, 1921 
Jan. 15, 1922 
Oct. 22, 1921 
Oct. 22, 1921 
Jan. 24, 1922 
Jan. 24, 1922 
Jan. 28, 1922 



Lewis, Mears Company. 

Lewis, Mears Company. 

Lewis, Mears Company. 

Lewis, Mears Company. 

Lewis, Mears Company. 

Lewis, Mears Company. 

Lewis, Mears Company. 

Lewis, Mears Company. 

Lewis, Mears Company. 

Lewis, Mears Company. 

Lewis, Mears Company. 

Lewis, Mears Company. 

Lewis, Mears Company. 

Lewis, Mears Company. 

Lewis, Mears Company. 

Lewis, Mears Company. 

Lewis, Mears Company. 

Lewis, Mears Company. 

Lewis, Mears Company. 

Lewis, Mears Company. 

St. John's Preparatory School. 

Slayton & Boynton. 

Slayton & Boynton. 

Slayton & Boynton. 

Slayton & Boynton. 

Slayton & Boynton. 

Slayton & Boynton. 

Slayton & Boynton. 

Slayton & Boynton. 

Slayton & Boynton. 

Slayton & Boynton. 

Slayton & Boynton. 

Slayton & Boynton. 

Slayton & Boynton. 

Slayton & Boynton. 

Slayton & Boynton. 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



181 



Table No. 10. — Requests for Extension of Time granted on Goods in Cold 
Storage from Dec. 1, 1920, to Dec. 1, 1921 — Continued. 



Article. 


Weight 
(Pounds). 


Placed in 
Storage. 


Extension 
granted to — 


Name. 


Butter .... 


13,330 


July 


28 


1920 


Oct. 


28, 


1921 


Slayton & Boynton. 


Butter . 








4,650 


July 


29 


1920 


Oct. 


29, 


1921 


Slayton & Boynton. 


Butter . 








5,922 


July 


29 


1920 


Jan. 


29. 


1922 


Slayton & Boynton. 


Butter . 








7,200 


Aug. 


2 


1920 


Feb. 


2. 


1922 


Slayton & Boynton. 


Butter . 








9,858 


Aug. 


2 


1920 


Nov. 


2, 


1921 


Slayton & Boynton. 


Butter . 








6,820 


Aug. 


10 


1920 


Nov. 


10. 


1921 


Slayton & Boynton. 


Butter . 








6,867 


Aug. 


10 


1920 


Feb. 


10. 


1922 


Slayton & Boynton. 


Butter . 








7,440 


Aug. 


11 


1920 


Nov. 


11. 


1921 


Slayton & Boynton. 


Butter . 








15,958 


Aug. 


12 


1920 


Feb. 


12. 


1922 


Slayton & Boynton. 


Butter . 








5,000 


Aug. 


16 


1920 


Feb. 


16, 


1922 


Slayton & Boynton. 


Butter . 








5,980 


Aug. 


20 


1920 


Feb. 


20, 


1922 


Slayton & Boynton. 


Butter . 








11,594 


Aug. 


24 


1920 


Feb. 


24, 


1922 


Slayton & Boynton. 


Butter . 








620 


Aug. 


26 


1920 


Nov. 


26. 


1921 


Slayton & Boynton. 


Butter . 








1,456 


Aug. 


26 


1920 


Feb. 


26. 


1922 


Slayton & Boynton. 


Butter . 








2,961 


Aug. 


31 


1920 


Nov. 


31, 


1921 


Slayton & Boynton. 


Butter . 








620 


Sept. 


7 


1920 


Dec. 


7. 


1921 


Slayton & Boynton. 


Butter . 








3,720 


Sept. 


7 


1920 


Mar. 


7, 


1922 


Slayton & Boynton. 


Butter . 








6,760 


Sept. 


21 


1920 


Feb. 


21. 


1922 


Slayton &. Boynton. 


Butter . 








2.496 


Sept. 


22 


1920 


Mar. 


23, 


1922 


Slayton & Boynton. 


Butter . 








7,740 


Sept. 


27 


1920 


Mar. 


27, 


1922 


Slayton & Boynton. 


Butter . 








2,898 


July 


26 


1920 


Oct. 


15, 


1921 


Winer, M., Company. 


Butter . 








40 


July 


1 


1920 


Nov. 


22. 


1921 


Worthern, G. V. 


Broilers . 








984 


June 


29 


1920 


July 


29, 


1921 


Eastman. Frank B. 


Broilers . 








820 


Aug. 


12 


1920 


Sept. 


12, 


1921 


Eastman. Frank B. 


Venison . 








60 


Dec. 


7 


1920 


Feb. 


1, 


1922 


Hills. Edmund E. 


Venison . 








92 


Oct. 


8 


1920 


Jan. 


8. 


1922 


Keating, J. J. 


Venison . 








10 


Nov. 


19 


1919 


Jan. 


31. 


1922 


Smith, Stedman. 


Reindeer 








16,779 


Oct. 


25 


1920 


Jan. 


25. 


1922 


Batchelder & Snyder Company. 


Beef . . 








9,734 


Dec. 


2 


1919 


Feb. 


6, 


1921 


Morris & Co. 


Beef • . 








36,364 


Dec. 


6 


1919 


Feb. 


6. 


1921 


Morris & Co. 


Beef 








1,920 


Apr. 


6 


1920 


June 


4, 


1921 


Swift & Co. 


Beef 








10,200 


May 


6 


1920 


July 


1. 


1921 


Swift & Co. 


Beef 








5,600 


June 


1 


1920 


Aug. 


1, 


1921 


Swift & Co. 


Beef 








7,000 


July 


1 


1920 


Sept. 


1, 


1921 


Swift & Co. 


Beef 








2,500 


Aug. 


21 


1920 


Oct. 


21. 


1921 


Swift & Co. 


Beef 








3,100 


Nov. 


26 


1920 


Dec. 


26, 


1921 


Swift & Co. 



182 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table No. 10. — Requests for Extension of Time granted on Goods in Cold 
Storage from Dec. 1, 1920, to Dec. 1, 1921 — Continued. 



Ahticle. 



Weight 
(Pounds). 



Placed in 
Storage. 



Extension 
granted to — 



Name. 



Beef 

Beef shoulder clods ' 

Lamb 

Lamb 

Lamb 

Lamb fores 

Lamb fores 

Mutton 

Mutton 

Mutton 

Mutton 

Mutton 

Ox tails 

Ox tails 

Pork 

Pork 

Pork 

Pork 

Pork 

Pork 

Pork 

Pork 

Pork 

Pork 

Pork 

Pork 

Pork 

Pork butts 

Pork butts 

Pork butts 

Pork butts 

Pork trimmings 

Veal 

Butterfish 

Butterfish 

Butterfish 



6,135 

590 

24,500 

1,454 

885 

20,000 

3,538 

5,628 

630 

2,222 

3,000 

2,000 

97 

83,212 

83,539 

82,518 

83,916 

36,488 

63,333 

159,899 

49,869 

125,183 

85,855 

1,130 

592 

12,051 

12,629 

13,327 

17,501 

26,401 

1,260 

1,870 

2,200 

3,300 



July 20, 1920 
Sept. 10, 1920 
Nov. 20, 1920 

Oct. 20, 1920 
Nov. 1, 1920 
June 8, 1920 
Aug. 3, 1920 
July 14, 1920 
Aug. 18. 1920 
Nov. 30, 1920 
Nov. 30, 1920 
Aug. 18, 1920 
Sept., 1920 
Mar. 25, 1920 
Jan. 7, 1920 
Jan. 8, 1920 
Jan. 10, 1920 
Jan. 14, 1920 
Jan. 19. 1920 
Jan. 21, 1920 
Feb. 10, 1920 
Feb. 5, 1920 
Feb. 6, 1920 
Feb. 7, 1920 
May 13, 1920 
May 14, 1920 
Dec, 1919 
Dec, 1919 
Dec, 1919 
Dec, 1919 
June 18, 1920 
Nov. 20, 1920 
Oct. 20, 1920 
Oct. 27, 1920 
Nov. 23, 1920 



Oct. 

Jan. 

Jan. 

May 

Jan. 

Feb. 

July 

Dec 

Sept. 

Oct. 

Jan. 

Jan. 

Oct. 

Nov. 

May 

Mar. 

Mar. 

Mar. 

Mar. 

Mar. 

Mar. 

Apr. 

Apr. 

Apr. 

Apr. 

Oct. 

Oct. 

Dec. 

Dec. 

Dec. 

Dec. 

Aug. 

Jan. 

Jan. 

Jan. 

Jan. 



20, 1921 
15, 1922 

20, 1922 
22, 1921 
15, 1922 

1, 1922 

8, 1921 

1, 1921 

14, 1921 

18, 1921 
30, 1922 

30, 1922 
1, 1921 
1, 1921 

25, 1921 

7, 1921 

8, W21 
10, 1921 
14, 1921 

19, 1921 

21, 1921 
10, 1921 

5, 1921 

6, 1921 

7, 1921 
1, 1921 
1, 1921 
1, 1921 
1, 1921 
1, 1921 
1, 1921 

29, 1921 

20, 1922 

31, 1922 
31, 1922 
31, 1922 



Dorr, Arthur E., & Co., Inc. 
Handy, H. L., Company. 
Dorr, Arthur E., & Co., Inc. 
Hudner Markets. 
Freund, Simon. 
Dorr, Arthur E., & Co., Inc. 
Whitcomb, Frank S. 
Harris Abbatoir Co. 
Dorr, Arthur E., & Co., Inc. 
Dorr, Arthur E., & Co., Inc. 
Dorr, Arthur E., & Co., Inc. 
Dorr, Arthur E., & Co., Inc. 
Swift & Co. 
Swift & Co. 
Farnsworth, R. S. 

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. 
Squire, J. P., & Co. 

Squire, J. P., & Co. 

Squire, J. P., & Co. 

State Industrial School for Girls. 

State Industrial School for Girls. 

Weeeler, T. H., Company. 

Wheeler, T. H., Company. 

Wheeler, T. H., Company. 

Wheeler, T. H., Company. 

Batchelder & Snyder Company. 

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

Sesuit Fish Freezing Company. 

Sesuit Fish Freezing Company. 

Sesuit Fish Freezing Company. 



1 Part of a lot only; weight unknown. 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



183 



Table No. 10. — Requests for Extension of Time granted on Goods in Cold 
Storage from Dec. 1, 1920, to Dec. 1, 1921 — Continued. 



Article. 


Weight 
(Pounds). 


Placed in 
Storage. 


Extension 
granted to — 


Name. 


Cod .... 


10,500 


Jan. 


15 


1920 


Mar. 


15 


1921 


Furness, J. C, Company. 


Cod 






2,200 


May 


5 


1920 


Jan. 




1922 


Hunt, Cassius, & Co. 


Cod 






4,176 


May 


7 


1920 


Jan. 




1922 


Hunt, Cassius, & Co. 


Cod 






3,257 


May 


13 


1920 


Jan. 




1922 


Hunt, Cassius, & Co. 


Cod 






2,095 


May 


14 


1920 


Jan. 




1922 


Hunt, Cassius, & Co. 


Cod 






4,718 


May 


17 


1920 


Jan. 




1922 


Hunt, Cassius, & Co. 


Cod 






5,093 


May 


17 


1920 


Jan. 




1922 


Hunt, Cassius, & Co. 


Cod 






925 


May 


19 


1920 


Jan. 




1922 


Hunt, Cassius, & Co. 


Cod 






3,035 


May 


19 


1920 


Jan. 




1922 


Hunt, Cassius, & Co. 


Cod 






6,191 


May 


22 


1920 


Jan. 




1922 


Hunt, Cassius, & Co. 


Cod 






1,925 


June 


4 


1920 


Jan. 




1922 


Hunt, Cassius, & Co. 


Cod 






4,780 


June 


12 


1920 


Jan. 




1922 


Hunt, Cassius, & Co. 


Cod 






4,494 


July 


15 


1920 


Jan. 




1922 


Hunt, Cassius, & Co. 


Cod 






1,882 


June 


16 


1920 


Jan. 




1922 


Hunt, Cassius, & Co. 


Cod 






5.525 


Oct. 


21 


1920 


Jan. 


21 


1922 


Hunt, Cassius, & Co. 


Cod 






5,019 


Oct. 


30 


1920 


Feb. 


28 


1922 


Interstate Fish Corporation. 


Haddock 




5,000 


Aug. 


26 


1920 


Nov. 


15 


1921 


Batchelder & Snyder Company. 


Haddock 




2,225 


Aug. 


27 


1920 


Nov. 


15 


1921 


Batchelder & Snyder Company. 


Herring . 




3,200 


Dec. 


16 


1919 


Feb. 


16 


1921 


Mantia, G. 


Herring . 




33,000 


Jan. 


12 


1920 


Mar. 


12 


1921 


Mantia, J. 


Herring i 




36,800 


Dec. 


20 


1920 


Jan. 


20 


1921 


O'Hara Brothers. 


Herring . 




15,200 


Jan. 


12 


1920 


Mar. 


12 


1921 


Russo & Sons. 


Herring . 




2,400 


Aug. 


5 


1920 


Jan. 


31 


1922 


Sesuit Fish Freezing Company. 


Herring 1 




600 


Aug. 


6 


1920 


Jan. 


31 


1922 


Sesuit Fish Freezing Company. 


Herring 1 




400 


Aug. 


7 


1920 


Jan. 


31 


1922 


Sesuit Fish Freezing Company. 


Herring i 




800 


Aug. 


9 


1920 


Jan. 


31 


1922 


Sesuit Fish Freezing Company. 


Herring i 




3,400 


Aug. 


11 


1920 


Jan. 


31 


1922 


Sesuit Fish Freezing Company. 


Herring ^ 




2,400 


Aug. 


13 


1920 


Jan. 


31 


1922 


Sesuit Fish Freezing Company. 


Herring, sardine 
Herring, sardine' 




4,849 
12,000 


Dec. 
Jan. 


9 
12 


1919 
1920 


Feb. 
June 


9 
12 


1921 
1921 


Commonwealth Ice and Cold 

Storage Company. 
Mantia, G., & Sons. 


Mackerel 




1,400 


July 


3 


1920 


Aug. 


3 


1921 


Atlantic and Pacific Fish Com- 


Mackerel 




4,595 


June 


26 


1920 


Sept 


30 


1921 


pany. 
Batchelder & Snyder Company. 


Mackerel 




280 


June 


25 


1920 


Aug. 


1 


1921 


Cann's Sea Grill. 


Mackerel 




2,408 


June 


26 


1920 


Aug. 


1 


1921 


Cann's Sea Grill. 


Mackerel 




800 


June 


23 


1920 


Aug. 


1 


1921 


Clouter, Jesse. 



1 To be used for bait. 



184 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table No. 10. — Requests for Extension of Time granted on Goods in Cold 
Storage from Dec. 1, 1920, to Dec. 1, 19S1 —Continued. 



Article. 


Weight 
(Pounds). 


Placed in 
Storage. 


Extension 
granted to — 


Name. 


Mackerel 


1,792 


June 15, 1920 


Dec. 13, 1921 


Commonwealth Ice and Cold 














Storage Company. 


Mackerel 






500 


June 12, 1920 


Sept. 24, 1921 


Flint Fish Company. 


Mackerel 






650 


June 30, 1920 


Sept. 30, 1921 


Ingalls, George M. 


Mackerel 






1,310 


July 3, 1920 


Oct. 3, 1921 


Ingalls, George M. 


Mackerel 






555 


July 15, 1920 


Oct. 15, 1921 


Ingalls, George M. 


Mackerel 






900 


July 26, 1920 


Sept. 26, 1921 


Poole, J. R., Company. 


Mackerel 






2,500 


July 26, 1920 


Sept. 26, 1921 


Poole, J. R., Company. 


Mackerel 






14,000 


July 26, 1920 


Sept. 26, 1921 


Poole, J. R., Company. 


Mackerel 






269 


July 8, 1920 


Jan. 8, 1922 


Rich, H. A. 


Mackerel 






1,600 


July 8, 1920 


Jan. 8, 1922 


Rich, H. A. 


Pollock . 






93,666 


Oct. 20, 1920 


Jan. 1, 1922 


Colonial Cold Storage Company. 


Pollock . 






40,000 


Oct. 19, 1920 


Mar. 19, 1922 


Consolidated Weir Company. 


Pollock . 






73,402 


Oct. 15, 1920 


Mar. 1, 1922 


Interstate Fish Corporation. 


Pollock . 






66,500 


Nov. 15, 1920 


Feb. 15, 1922 


Interstate Fish Corporation. 


Pollock . 






33,800 


Mar. 11, 1920 


May 11, 1921 


Leach, Frank J., & Co. 


Pollock . 






1,430 


Mar. 22, 1920 


May 22, 1921 


Leach, Frank J., & Co. 


Pollock . 






1,620 


Mar. 22, 1920 


May 22, 1921 


Leach, Frank J., & Co. 


Pollock . 






3,600 


Mar. 11, 1920 


May 11, 1921 


Prior & Mahoney Company. 


Pollock . 






10,125 


Mar. 11, 1920 


May 11, 1921 


Prior & Mahoney Company. 


Pollock . 






2,143 


July 29, 1920 


Jan. 15, 1922 


Quincy Market Cold Storage and 
Warehouse Company. 


Pollock . 






900 


Aug. 18, 1920 


Jan. 15, 1922 


Quincy Market Cold Storage and 
Warehouse Company. 


Pollock . 






950 


Sept. 7, 1920 


Jan. 15, 1922 


Quincy Market Cold Storage and 
Warehouse Company. 


Pollock . 






2,250 


Sept. 10, 1920 


Jan. 15, 1922 


Quincy Market Co d Storage and 
Warehouse Company. 


Pollock . 






3,000 


Sept. 11, 1920 


Jan. 15, 1922 


Quincy Market Cold Storage and 
Warehouse Company. 


Pollock . 






2,100 


Sept. 27, 1920 


Jan. 15, 1922 


Quincy Market Cold Storage and 
Warehouse Company. 


Pollock . 






2,500 


Sept. 27, 1920 


Jan. 15, 1922 


Quincy Market Cold Storage and 
Warehouse Company. 


Pollock . 






2,000 


Sept. 29, 1920 


Jan. 15, 1922 


Quincy Market Cold Storage and 
Warehouse Company. 


Salmon . 






3,890 


Feb. 13, 1920 


Apr. 1, 1921 


Batchelder & Snyder Company. 


Scup 






19,685 


July 2, 1920 


Dec. 2, 1921 


Busalacchi Brothers. 


Squid I . 






160,000 


Aug. 25, 1920 


Jan. 1, 1922 


Cape Fish Products Company, 

Inc. 
ConsoUdated Weir Company. 


Squid 






200,000 


Aug. 1, 1920 


Apr. 17, 1922 


Squid 






291,600 


Sept. 1, 1920 


Apr. 1, 1922 


North Truro Cold Storage Com- 


Squid 






7,800 


Aug. 25, 1920 


Jan. 31, 1922 


pany. 
Sesuit Fish Freezing Company. 


Squid 






8,200 


Aug. 28, 1920 


Jan. 31, 1922 


Sesuit Fish Freezing Company. 


Squid 






3,600 


Aug. 30, 1920 


Jan. 31, 1922 


Sesuit Fish Freezing Company. 



1 To be vised for bait. 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



185 



Table No. 10. — Requests for Extension of Time granted on Goods in Cold 
Storage from Dec. 1, 1920, to Dec. 1, 1921 — Concluded. 



Article. 


Weight 
(Pounds). 


Placed in 
Storage. 


Extension 
granted to — 


Name. 


Sword fish 


600 


Aug. 6, 


1920 


Sept 


1, 


1921 


Cann's Sea Grill. 


Whiting . 








300,000 


Nov., 


1920 


Feb. 


28, 


1922 


Cape Cod Cold Storage Com- 


Whiting . 








50,000 


Nov., 


1919 


Feb. 


1, 


1921 


Consolidated Weir Company. 


Whiting . 








400,000 


Aug., 


1920 


Jan. 


31, 


1921 


Consolidated Weir Company. 


Whiting . 








425,814 


June 15, 


1920 


Dec. 


15, 


1921 


Interstate Fish Corporation. 


Whiting . 








1,300 


Nov., 


1919 


Feb. 


1, 


1921 


Mantia Brothers. 


Whiting . 








1,950 


Nov., 


1919 


Feb. 


1, 


1921 


Mantia Brothers. 


Whiting . 








5,000 


Aug. 9, 


1920 


Jan. 


31, 


1922 


Sesuit Fish Freezing Company. 


Whiting . 








5,600 


Aug. 5, 


1920 


Jan. 


31, 


1922 


Sesuit Fish Freezing Company. 


Whiting . 








7,200 


Aug. 6, 


1920 


Jan. 


31, 


1922 


Sesuit Fish Freezing Company. 


Whiting . 








6,000 


Aug. 7, 


1920 


Jan. 


31, 


1922 


Sesuit Fish Freezing Company. 


Whiting . 








8,000 


Aug. 11, 


1920 


Jan. 


31, 


1922 


Sesuit Fish Freezing Company. 


Whiting . 








17,800 


Aug. 13, 


1920 


Jan. 


31, 


1922 


Sesuit Fish Freezing Company. 



Table No. 11. 



Requests for Extension of Time not granted on Goods in Cold 
Storage from Dec. 1, 1920, to Dec. 1, 1921. 



Article. 


Weight Placed in 
(Pounds). Storage. 


Name. 


Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 


1,037 
20,140 

2,304 

11,340 

610 

120 

330 

1,500 

1,620 
720 
360 

1,488 
600 

1,080 
600 


June 8, 1920 
June 23, 1920 
June 10, 1920 
July 10, 1920 
June 16, 1920 
June 1, 1920 
June 2, 1920 
June 3, 1920 
June 3, 1920 
July 1, 1920 
July 7, 1920 
July 9, 1920 
July 10, 1920 
July 14, 1920 
July 18, 1920 


Alpine Chocolate Company. 
Boston Ice Cream Company. 
Covitz, M., & Son. 
Covitz, M., & Son. 
Fowle, Hibbard & Co. 
Goldsmith-Stockwell Company. 
Goldsmith-Stockwell Company. 
Goldsmith-Stockwell Company. 
Goldsmith-Stockwell Company. 
Goldsmith-Stockwell Company. 
Goldsmith-Stockwell Company. 
Goldsmith-Stockwell Company. 
Goldsmith-Stockwell Company. 
Goldsmith-Stockwell Company. 
Goldsmith-Stockwell Company. 



186 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table No. 11. — Requests for Extension of Time not granted on Goods in Cold 
Storage from Dec. 1, 1920, to Dec. 1, 1921 — Continued. 



Article. 



Weight 
(Pounds). 



Butter 
Butter 
Butter 
Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 



3,087 
1,200 
2,898 
3,000 
300 
240 
1,323 
1,124 
693 
3,224 
5,766 
2,274 
450 
4,800 
6,741 
17.400 
5,246 
5,340 
610 
6,060 
3,840 
8,160 
12,852 
11,403 
2,016 
10,206 
10,395 
11,718 
1,612 
7,623 
600 
7,421 
6,100 
840 
9,639 
5,040 



Placed in 
Storage. 



Name. 



July 18, 1920 
July 19, 1920 
Aug. 8, 1920 
Aug. 8, 1920 
Aug. 19. 1920 
Aug. 25, 1920 
Oct. 11, 1920 
Oct. 17, 1920 
Nov. 1. 1920 
Sept. 30. 1920 
Oct. 6. 1920 
July 10, 1920 
June 8, 1920 
June 10, 1920 
June 14. 1920 
June 15. 1920 
July 2, 1920 
July 7, 1920 
July 10, 1920 
July 10, 1920 
July 15. 1920 
July 15, 1920 
July 23, 1920 
July 28, 1920 
Aug. 11, 1920 
Aug. 12, 1920 
Aug. 18, 1920 
Aug. 18, 1920 
Aug. 20, 1920 
Aug. 20. 1920 
Aug. 24. 1920 
Aug. 24. 1920 
Aug. 26, 1920' 
Aug. 31, 1920 
Sept. 4. 1920 
Sept. 7, 1920 



Goldsmith-Stockwell Company. 
Goldsmith-Stockwell Company. 
Goldsmith-Stockwell Company. 
Goldsmith-Stockwell Company. 
Goldsmith-Stockwell Company. 
Goldsmith-Stockwell Company. 
Goldsmith-Stockwell Company. 
Goldsmith-Stockwell Company. 
Goldsmith-Stockwell Company. 
Haire. William J.. Company. 
Haire, William J.. Company. 
Lewis. Hears Company. 
Samoset Chocolate Company. 
Slayton & Boynton. 
Slayton & Boynton. 
Slayton & Boynton. 
Slayton & Boynton. 
Slayton «fe Boynton. 
Slayton & Boynton. 
Slayton & Boynton. 
Slayton & Boynton. 
Slaj-ton & Boynton. 
Slayton & Boynton. 
Slayton & Boynton. 
Slayton & Boynton. 
Slayton & Boynton 
Slayton & Boynton. 
Slayton & Boynton. 
Slayton & Boynton. 
Slayton & Boynton. 
Slayton & Boynton. 
Slayton & Boynton. 
Slayton & Boynton. 
Slayton & Boynton. 
Slayton & Boynton. 
Slayton & Boynton. 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



187 



Table No. 11. — Requests for Extension of Time not granted on Goods in Cold 
Storage frofn Dec. 1, 1920, to Dec. 1, 1921 —Continued. 



Article. 



Weight 
(Pounds). 



Placed in 
Storage. 



Name. 



Butter 
Butter 
Butter 
Butter 
Butter 
Butter 
Butter 
Butter 
Chickens 
Pigeons 
Beef . 
Beef . 
Beef . 
Beef . 
Beef . 
Beef . 
Beef . 
Beef . 
Beef . 
Beef . 
Beef . 
Beef . 
Beef . 
Beef . 
Beef . 
Beef . 
Beef . 
Beef . 
Beef . 
Beef . 
Beef . 
Beef . 
Beef . 
Beef . 
Beef . 
Beef . 



840 

3,360 

3,780 

5,940 

8,700 

12,960 

11,780 

1,000 

60 

1,530 

5,845 

75 

125 

68 

133 

1,858 

1,982 

2,862 

22,648 

27,129 

27,437 

30,876 

21,110 

21,310 

21,797 

23,227 

29,118 

31,066 

28,426 

30,364 

27,637 

31,393 

16,926 

32,112 

32,427 

21,544 



Sept. 

Sept. 

Sept. 

Sept. 

Sept. 

Oct. 

July 

June 

Dec. 

Oct. 

Oct. 

Jan. 

Jan. 

Feb. 

Apr. 

May 

May 

May 

Nov. 

Nov. 

Nov. 

Nov. 

Nov. 

Nov. 

Nov. 

Nov. 

Nov. 

Nov. 

Dec. 

Dec. 

Dec. 

Dec. 

Dec. 

Dec. 

Dec. 

Dec. 



15, 1920 

15, 1920 

16, 1920 

22, 1920 

23, 1920 

5, 1920 
30, 1920 

19, 1920 
18, 1921 
12, 1919 

2, 1920 

24, 1921 

29, 1921 

25, 1921 

12, 1921 

20, 1920 
20, 1920 
20, 1920 

6, 1919 
6, 1919 
6, 1919 
8, 1919 

13, 1919 
13, 1919 
13, 1919 
13, 1919 
13, 1919 
28, 1919 

1, 1919 

1, 1919 

10, 1919 

10, 1919 

17, 1919 

26, 1919 

27, 1919 

30, 1919 



Slayton & Boynton. 

Slayton & Boynton. 

Slayton & Boynton. 

Slayton & Boynton. 

Slayton & Boynton. 

Slayton & Boynton. 

Weiner, M. 

Westwood Farm Milk Company. 

Stevens, Genery, Company. 

Borst, Pierce Company. 

Armour & Co. 

Stevens, Genery, Company. 

Stevens, Genery, Company. 

Stevens, Genery, Company. 

Stevens, Genery, Company. 

Sears, Alfred, Company. 

Sears, Alfred, Company. 

Sears, Alfred, Company. 

Wilson & Co. 

Wilson & Co. 

Wilson & Co. 

Wilson & Co. 

Wilson & Co. 

Wilson & Co. 

Wilson & Co. 

Wilson & Co. 

Wilson & Co. 

Wilson & Co. 

Wilson & Co. 

Wilson & Co. 

Wilson & Co. 

Wilson & Co. 

Wilson & Co. 

Wilson & Co. 

Wilson & Co. 

Wilson & Co. 



188 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table No. 11. — Requests for Extension of Time not granted on Goods in Cold 
Storage from Dec. 1, 1920, to Bee. 1, 1921 — Concluded. 



Article. 



Weight 
(Pounds). 



Beef . 

Lamb 

Lamb 

Lamb fores 

Lamb fores 

Halibut 

Halibut . 

Mackerel 

Mackerel 

Mackerel 

Mackerel 

Mackerel 

Mackerel 

Salmon 

Whiting . 



32,154 

691 
75 

145 
3,000 
9,600 

300 
3,720 

325 

3,000 

3,600 

10,000 

347 
2,650 

399 



Placed in 
Storage. 



Dec. 

Nov. 

Apr. 

Dec. 

Oct. 

Nov. 

Sept. 

July 

Oct. 

Oct. 

Oct. 

Oct. 

Oct. 

July 

June 



Name. 



30. 


1919 


2. 


1920 


12, 


1921 


24, 


1921 


27, 


1920 


27, 


1920 


11. 


1920 


28, 


1920 


11. 


1920 


11, 


1920 


11, 


1920 


11, 


1920 


13, 


1920 


23. 


1920 


12. 


1919 



Wilson & Co. 

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

Stevens, Genery, Company. 

Stevens, Genery, Company. 

Nakashian, Charles. 

Batchelder & Snyder Company. 

Ocean Fish Company. 

Atwood & Co. 

Poole, J. R., Company. 

Poole, J. R., Company. 

Poole, J. R., Company. 

Poole, J. R., Company. 

Poole, J. R., Company. 

Atlantic & Pacific Fish Com- 
pany. 
Mantia, G. 



Table No. 12. — Requests granted for Permission to remove Articles which had 
been in Cold Storage longer than Twelve Months from Dec. 1, 1920, to Dec. 1, 
1921. 



Article. 


Weight 
(Pounds). 


Placed in 
Storage. 


Name. 


Beef 


190 


Jan. 20, 1919 


Swift & Co. 



Table No. 13. — Artichs ichich had been in Cold Storage longer than Twelve 
Months, and on uMch No Requests for Extension had been made, ordered re- 
moved, from Dec. 1, 1920, to Dec. 1, 1921. 



Article. 


Weight 
(Pounds). 


Placed in 
Storage. 


Name. 


Eggs 

Eggs (mixed) 

Egg whites 

Egg yolks 

Egg yolks 


2,610 

60 

60 

330 

60 


Aug. 13, 1920 
May 17, 1919 
June 25, 1919 
May 31, 1919 
June 3, 1919 


Alley, Green & Pipe. 
Goldsmith-Stockwell Company. 
Goldsmith-Stockwell Company. 
Goldsmith-Stockwell Company. 
Goldsmith-Stockwell Company. 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



189 



Table No. 13. — Articles ichich had been in Cold Storage longer than Twelve 
Months, and on ivhich No Requests for Extension had been made, ordered re- 
moved, from Dec. 1, 1920, to Dec. 1, 1921 — Continued. 



Article. 



Weight 
(Pounds). 



Placed in 
Storage. 



Name. 



Egg yolks 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Butter 

Broilers 

Broilers 

Broilers 

Broilers 

Chickens . 

Chickens . 

Chickens . 

Chickens . 

Chickens . 

Chickens . 

Chickens, Guinea 

Poultry . 

Gizzards . 

Gizzards . 

Turkey 

Duck 

Moose 

Pheasants 

Racoon 

Venison . 

Venison . 

Venison . 

Venison . 

Venison . 



20 


July 


2 


1919 


110 


July 


8 


1920 


200 


Apr. 


4 


1920 


30 


June 


25, 


1920 


30 


July 


7, 


1920 


30 


July 


27, 


1920 


660 


July 


9, 


1920 


6,300 


Aug. 


18, 


1920 


10,395 


Aug. 


18, 


1920 


20 


June 


12, 


1920 


290 


July 


9, 


1920 


11,867 


July 


12, 


1920 


165 


Aug. 


10, 


1920 


1,764 


May 


10, 


1920 


45 


Sept. 


15, 


1920 


77 


Oct. 


19, 


1920 


87 


Oct. 


11. 


1920 


592 


Oct. 


11, 


1920 


198 


Oct. 


26, 


1920 


53 


Oct. 


21, 


1920 


140 


Oct. 


26, 


1920 


145 


Sept. 


23. 


1920 


135 


Jan. 


26, 


1920 


1,233 


June 


9, 


1920 


200 


Sept. 


28. 


1920 


155 


Oct. 


14, 


1920 


10 


Jan. 


12, 


1920 


3 


May 


25, 


1920 


19 


Oct. 


22, 


1919 


445 


Nov. 


18, 


1920 


8 


Oct. 


6, 


1919 


25 


Oct. 


28, 


1920 


20 


Oct. 


20, 


1919 


22 


Oct. 


20, 


1919 


20 


Jan. 


12, 


1920 


20 


Nov. 


15, 


1919 



Goldsmith-Stockwell Company. 

Andrews, C. W. 

Eingold, Harold B. 

Green & Co. ' 

Horan, G. F. 

Horan, G. F. 

Legg, G. M. D. 

Slayton & Boynton. 

Slayton & Boynton. 

Smith, C. W., Company. 

Stone, C. H. 

Weiner, M., Company. 

Cann's Sea Grill. 

Eastman, F. B. 

Strong, Marson Company. 

Strong, Marson Company. 

Genoa Caf6. 

Genoa Caf6. 

Genoa Caf§. 

Gordon, Walter. 

Gordon, Walter. 

King Joy Company. 

Hosmer, F. H. 

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

Libby & Libby Company. 

Libby & Libby Company. 

McDonald, F. W. 

Shattuck, Dr. 

Chapin, Harry. 

Batchelder & Snyder Company. 

Beniman, W. H. 

Dunbar, P. W. 

Hoyt, C. L. 

Lasbury, J. F. 

McDonald, F. W. 

Richards, C. W. 



190 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table No. 13. — Articles which had been in Cold Storage longer than Twelve 
Months, and on which No Requests for Extension had been made, ordered re- 
moved, from Dec. 1, 1920, to Dec. 1, 1921 — Continued. 



Article. 



Venison . 

Game (miscellaneous) 

Beef .... 

Beef .... 

Beef .... 

Beef .... 

Beef .... 

Beef .... 

Beef . 

Beef .... 

Beef .... 

Beef .... 

Beef butts 

Beef loins 

Beef loins 

Beef shanks 

Beef trimmings 

Calves' heads . 

Ox tails . 

Sweetbreads 

Sweetbreads 

Lamb 



Lamb 

Lamb 

Lamb 

Lamb 

Lamb 

Lamb 

Lamb 

Lamb 

Lamb 

Lamb 

Lamb 

Lamb chops 

Lamb fores 



Weight 
(Pounds). 



Placed in 
Storage. 



18 
15 
1,500 
773 
1,469 
1,394 
2,578 
5,281 
3,136 
2,100 
1,160 
1,299 
325 
45 
55 
2,335 
2,281 
15 
100 
122 
222 
43 
70 
45 
210 
180 
200 
100 
1,465 
445 
85 
150 
150 
66 
800 



Name. 



Dec. 19, 1919 
Nov. 15, 1919 
Jan. 26, 1920 
Mar. 12, 1920 
Apr. 2, 1920 
May 15, 1920 
Nov. 20, 1920 
July 12, 1920 
Aug. 20, 1920 
Oct. 19, 1920 
Nov. 23, 1920 
Apr. 9, 1920 
Oct. 22, 1920 
Aug. 13, 1920 
Aug. 24, 1920 
Aug. 22, 1920 
Aug. 19, 1920 
Nov. 13, 1920 
July 23, 1920 
Oct. 9, 1920 
Oct. 23, 1920 
June 2, 1920 
May 18, 1920 
June 21, 1920 
Oct. 5, 1920 
July 31, 1920 
Aug. 31, 1920 
Aug. 17, 1920 
Aug. 20, 1920 
Aug. 24, 1920 
Aug. 21, 1920 
Aug. 17, 1920 
Oct. 28, 1920 
Sept. 20, 1920 
Aug. 13, 1920 



Woodward, A. H. 
DoUttle, Charles. 
Boston Beef Company. 

Brighton Dressed Meat Com- 
pany. 

Brighton Dressed Meat Com- 
pany. 

Brighton Dressed Meat Com- 
pany. 

Brighton Dressed Meat Com- 
pany. 

Libby & Libby Company. 

Libby & Libby Company. 

Lipsky, Louis. 

Lyman School for Boys. 

Mindick, M., Company. 

Strong, Marson Company. 

Hodder, W. W. 

Hodder, W. W. 

Libby & Libby. 

Libby & Libby. 

Strong, Marson Company. 

Hodder, W. W. 

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

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

Burns Brothers. 

Burns Brothers. 

John, Peter. 

John, Peter. 

Krantzman, Samuel. 

Krantzman, Samuel. 

Libby & Libby. 

Libby & Libby. 

Libby & Libby. 

Stevens, C. F. 

Thompson's Express. 

Turco, George. 

Brown, C. H. 

State Industrial School for Girls. 



No. 34.] 



DIVISION OF FOOD AND DRUGS. 



191 



Table No. 13. — Articles which had been in Cold Storage longer than Twelve 
Months, and on lohich No Requests for Extension had been made, ordered re- 
moved, from Dec. 1, 1920, to Dec. 1, i^^^ — Continued. 



Article. 


Weight 
(Pounds). 


Placed in 
Storage. 


Name. 


Mutton 


2,040 


Sept. 9, 1920 


Batchelder & Snyder Company. 


Mutton 












3,000 


June 15, 1920 


Blackstone Supply Company. 


Mutton 












215 


June 7, 1920 


Gaffney, James. 


Mutton 












40 


June 8, 1920 


John, Peter. 


Pork hearts 












1,900 


July 29, 1920 


Rounsvell, P. W. 


Pork kidneys 












500 


July 7, 1920 


Independent Beef Company. 


Pork loins 












75 


Dec. 16, 1919 


Tumavicus, B. A. 


Pork trimmings 










290 


Aug. 6, 1920 


Maggioli, N. 


Pork trimmings 










1,400 


June 3, 1920 


Maggioli, N. 


Pigs' feet . 










6,600 


Aug. 3, 1920 


Batchelder & Snyder Company. 


Hogs' plucks . 












607 


Oct. 28, 1920 


Cunningham, A. J. 


Sweetbreads 












40 


Sept. 8, 1920 


Strong, Marson Company. 


Sweetbreads 












510 . 


Nov. 1, 1920 


Strong, Marson Company. 


Bass, sea . 












20 


May 15, 1920 


Foley, M. F. 


Bluebacks 












1,066 


Aug. 14, 1920 


Tallman & Mack. 


Bluefish . 












840 


Oct. 8, 1920 


Batchelder & Snyder Company. 


Bonita 












186 


Oct. 17, 1920 


Globe Fish Company. 


Bonita 












150 


Sept. 12, 1920 


Mantia, S., & Co. 


Cod . 












732 


Mar. 31, 1920 


Powers, P. H. 


Crab meat 












400 


July 10, 1920 


Nickerson, W. H. 


Crab meat 












382 


July 16, 1920 


Nickerson, W. H. 


Crab meat 












200 


July 28, 1920 


Nickerson, W. H. 


Crab meat 












120 


Aug. 28, 1920 


Nickerson, W. H. 


Eels, sand 












1,190 


Aug. 4, 1919 


Globe Fish Company. 


Eels, sand 












175 


Aug. 20, 1920 


Globe Fish Company. 


Eels, sand 












175 


Oct. 21, 1920 


Globe Fish Company. 


Flounders 












2,173 


May 18, 1920 


Hunt, Cassius, & Co. 


Herring . 












18,600 


Jan. 2, 1920 


Mantia, S., & Co. 


Herring . 












525 


Nov. 16, 1920 


Russo & Sons. 


Herring, sardine 










105 


Nov. 25, 1919 


Cefalu, Joseph. 


Herring, sardine 










440 


May 1, 1920 


Mantia, S., & Co. 


Herring, sardine 










1,000 


Dec. 16, 1920 


Mantia, S., & Co. 


Lobster . 










25 


May 12, 1920 


Apollo Sea Grill. 


Lobster 










100 


May 24, 1920 


Apollo Sea Grill. 


Mackerel 










339 


July 28, 1920 


Calnan, E. C. 



192 



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



Table No. 13. — Articles which had been in Cold Storage longer than Tuclve 
Months, and on which No Requests for Extension had been made, ordered re- 
moved, from Dec. 1, 1920, to Dec. 1, 1921 — Concluded. 



Article. 



Weight 
(Pounds). 



Placed in 
Storage. 



Name. 



Mackerel 

Pollock 

Pollock 

Salmon 

Salmon 

Scup 

Scup 

Scup 

Scup 

Scup 

Scup 

Scup 

Shark 

Shark 

Shark 

Skatefish 

Skatefish 

Sole . 

Squid 

Squid 

Squid 

Squid 

Squid 

Squid 

Squid 

Tuna fish 

Whiting 

Whiting 



2,895 

2,473 

450 

91 

53 

6,300 

315 

1,700 

95 

2,660 

1,700 

5,560 

115 

540 

225 

490 

420 

700 

660 

1,050 

685 

900 

440 

400 

360 

324 

960 

1,600 



July 

July 

Aug. 

July 

Oct. 

July 

July 

May 

May 

June 

June 

July 

June 

June 

Oct. 

Nov. 

Nov. 

July 

July 

Aug. 

Oct. 

Sept. 

Oct. 

Sept. 

Sept. 

Aug. 

Nov. 

Dec. 



2, 1920 
29, 1920 

18, 1920 
8, 1920 
7, 1920 
1, 1920 

14, 1920 
20, 1920 

28, 1920 

6, 1920 
11, 1920 
10, 1920 

23, 1920 

29, 1920 

15, 1920 

19, 1919 
26, 1919 

20, 1920 
3, 1920 

19, 1920 
17, 1920 

20, 1920 

7, 1920 
19, 1920 

24, 1920 
10, 1920 

25, 1919 
3, 1920 



Star Fish Company. 
Shaw, H. C. 
Shaw, H. C. 
Clouter, Jesse. 
Pappalardo Brothers. 
Corse & Connanzo. 
Globe Fish Company. 
Mantia, S., & Co. 
Mantia, S., & Co. 
Mantia, S., & Co. 
Mantia, S., & Co. 
Tocco, Joseph. 
Mantia, G. 
Russo & Sons. 
Russo & Sons. 
Corso & Cannizzo. 
Corso & Cannizzo. 
Story, Simmons Company. 
Fisherman's Fish Company. 
Globe Fish Company. 
Globe Fish Company. 
Mantia, S., & Co. 
Mantia, S., & Co. 
Russo & Sons. 
Russo & Sons. 
Dondis, P. 
Mantia, S., & Co. 
Mantia, S., & Co. 



Division of Communicable Diseases 



Bernard W. Carey, Director 



[1S3I 



Eepoet of Division of Communicable Diseases. 



The total reported incidence and mortality from diseases declared 
dangerous to the public health shows a remarkable decrease from that 
reported annually during the past five years. A saving of over 3,600 
lives of our people is to be seen from the mortality rate of 1921 as 
compared with the rate for 1920, for which the efforts of those engaged 
in the control of communicable disease may rightly be credited with 
a large share. The accompanying table shows the deaths from com- 
municable diseases reported, as well as the total deaths from all causes 
for the past five years, and it is to be noted that the decrease in the 
deaths from communicable diseases plays no small part in the very 
creditable rate of 12.23, the rate for deaths from all causes per 1,000 
population. 



Year. 


Communicable Diseases 

(Rate per 

1,000 Population). 


All Causes (Rate per 
1,000 Population). 




Number. 


Per Cent. 


Number. 


Per Cent. 


1917 


11,627 


3.08 


56,628 


15.01 


1918 


32,945 


8.65 


78,842 


20.72 


1919 


12,342 


3.22 


52,345 


13.64 


1920 


11,277 


2.92 


53,632 


13.86 


1921 


7,619 


1.95 


47,748 


12.23 



The control of communicable disease must be divided and subdi- 
vided into the various factors which have made this control possible. 
There can be no doubt that the attention paid to procuring safe 
water supplies, adequate disposal of sewage, increased space for living, 
the better understanding and employment of personal hygiene, have 
all contributed their share to this problem. The direct influences, 
however, have reached beyond this in effectiveness, and the efforts of 
the local boards of health and local physicians in bringing about and 
enforcing local regulations for quarantine, and the immunization for 
those conditions for which specific immunity is to be had, are con- 
tributing very largely to the present-day success. 



196 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 




No. 34.] DIVISION OF COMMUNICABLE DISEASES. 197 

The year has been remarkably free from any outbreak of any 
magnitude nor, with the exception of diphtheria and scarlet fever, has 
there appeared to be any marked undue prevalence. The total num- 
ber of cases from all of the communicable diseases was 77,309, with 
a mortality of 7,621. Seven reportable diseases have furnished 79 
per cent of the total cases reported. These were chicken pox, diph- 
theria, gonorrhea, measles, scarlet fever, pulmonary tuberculosis and 
whooping cough, and 59 per cent of deaths are found accredited to 
these same diseases. 

Diphtheria with 9,100 cases and 603 deaths continues to be one of 
our major problems. There can be no doubt that the increased in- 
terest that public health workers are taking in diphtheria has resulted 
in a very considerable number of cases being properly diagnosed 
which in former years were classified as merely having infections from 
other sources. An increase of culturing of over 132 per cent in the 
past six years; the adoption in many of the smaller communities of a 
requirement for the taking of cultures for release; the search for the 
carrier and the missed case in school outbreaks; the increasing de- 
mand for toxin-antitoxin mixture for immunization; and the larger 
dosage of antitoxin for treatment, together with an increasing de- 
mand for lectures by organizations interested in public health ac- 
tivity, hold out hope for a material reduction in the incidence of this 
disease throughout the State. For the first time in our history a 
slight decrease in the fatality rate has been noted. 

The program developed and administered throughout the State by 
the Department for the detection of those susceptible to diphtheria 
by the use of the Schick test and their subsequent immunization by 
the use of the toxin-antitoxin mixture deserves some mention. A 
definite program has been arranged whereby through the District 
Health Officer communities have called to their attention the ad- 
vantages of inaugurating and carrying on a clinic at which children 
of school age may receive the benefits of this test. Upon request of 
the local board of health, and in certain instances the school author- 
ities, we have arranged for a demonstration to which the local phy- 
sicians, nurses and others interested in this work are invited. A few 
days prior to the appointed time the District Health Oflicer goes to 
the community, performs the test on a certain number of children 
and then at the conference reads the reactions which these children 
may give, and performs further tests on other children to demonstrate 
the exact technique to be used in carrying out the Schick test. This 
is augmented by a lecture on the need of intensive effort by local au- 
thorities if diphtheria is to be eradicated. Information is given as to 



198 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



the manufacture of the Schick material and the toxin-antitoxin mix- 
ture and a careful discussion of the various reactions which will be 
found in any large group of children. Effort is made to have the local 
physicians take up this procedure and in particular to have some 
physician either associated with the board of health or the school 
department undertake to carry it out among the school children. 
All of this work is done upon a voluntary basis, and only those chil- 
dren bearing a proper authorization from their parents or guardians 
are allowed to receive the test. There are at present nine clinics in 
operation in the following places: — 



Boston. 

Brockton. 

Clinton. 



Lawrence. 

Lynn. 

Newton. 



Northampton. 

Waltham. 

Winchendon. 



Certain hospitals are performing the test and immunization as a 
routine procedure for nurses and attendants, and in some instances 
inmates also are protected. Demonstrations have been held in many 

cities and towns. 

It must be remembered that if diphtheria control measures are to 
be efficacious the Schick test with the subsequent immunization of 
those found to be susceptible by the toxin-antitoxin mixture must be 
augmented by culturing for the diagnosis and release of diphtheria. 
More attention must be paid to the possibility of sources of infection 
arising in neighborhood contact and the elimination of the secondary 
case within the household already infected by the use of immunizing 
doses of antitoxin. The importance of this assertion is borne out by 
a glance at the fifty instances in the following table where secondary 
infection has occurred which might have been prevented if proper 
culturing for release had been done or if passive immunization had 
been given to other members of an infected household. 



Location. 



Population. 



43,100 



41,500 



Date of Report. 



First Case. 



Jan. 6 
Apr. 26 

Nov. 3 

May 3 
May 3 
June 30 
June 2 
Sept. 6, Sept. 6 
Oct. 27 



Secondary 
Cases. 



Jan. 11 

Apr. 28, Apr. 28, 

Mays 

Nov. 10 

May 23, June 10 
June 1(5 
July 6 

Aug. 17, Sept. 3 
Sept. 14 
Nov. 7 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



199 



Location. 



Population. 



D 

E 

F 
G 

H 
I 



J 

K 

L 



40,900 



39,000 
38,100 

19,800 
18,600 

18,600 
17,400 



16,600 

15,700 
15,600 



Date of Report. 



First Case. 



Jan. 26 
Feb. 21 
July 1 
Mar. 8 
Feb. 15 
Aug. 7 
Aug. 23 
Nov. 23 
Nov. 23 

Jan. 31 
Apr. 5 

May 7 
Oct. 18 

Oct. 22 
Nov. 8 
Nov. 19 

Feb. 15 
Mar. 15 
June 4 

June 6 
Sept. 30 
Oct. 6 
Nov. 29 

Mar. 22 
Nov. 2 
July 7 
Nov. 12 
Nov. 18 

Feb. 15 
Feb. 15 

Feb. 16 
May 2 
Aug. 30 
Feb. 24 
Sept. 29 
May 24 

May 12 
Sept. 17 

Sept. 30 

Jan. 25 
Jan. 29 



Secondary 
Cases. 



Feb. 14 
June 4 
July 6 
July 15 
July 15 
Aug. 17 
Nov. 21 
Nov. 29 
Nov. 29 

Mar. 18 
Nov. 4, Nov. 29 

May 13 
Oct. 22, Nov. 2, 

Nov. 4 
Oct. 26, Oct. 26 

Nov. 28 

Nov. 29 

Feb. 16, Feb. 19 
Apr. 22 
June 8 

June 23 

Oct. 13, Oct. 18 

Oct. 27 

Dec. 7 

Mar. 24, Dec. 7 

Nov. 7 

Nov. 8, Nov. 25 

Dec. 14 

Dec. 14 

Feb. 23 
Feb. 19, Feb. 19. 
Feb. 23 
Mar. 12 
June 23 
Sept. 17 
Feb. 28 
Oct. 6, Oct. 6 
Nov. 10 

May 23 
Sept. 24 

Nov. 17 

Feb. 4 
May 9 



There can be no doubt that a large proportion of the dinical cases 
of to-day have been due to the missed case or to the carrier, and it 
is becoming more and more evident that diligent search by culturing 
the pupils in the schoolroom from which the patient has come will 
show the infection to be from this source. Our experience during the 
year again emphasizes the vast amount of needless work in culturing 
whole buildings when the same results would have been obtained if 
but one or more rooms from which the cases had come were thor- 
oughly done. 

Typhoid fever, with 917 cases and 121 deaths, has received the same 



200 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

intensive investigation as has been given to it in former years. There 
have been but three instances where typhoid fever showed an un- 
usual prevalence: the Waltham outbreak, transmitted by milk, giving 
135 cases and 6 deaths; Adams, 23 cases due to the contamination of 
drinking water by river water through a faulty system at one of the 
mills; and Milford with 14 cases, all of which occurred on one milk 
route, possibly transmitted through the return of infected milk bottles. 
Further mention of these is made in the report of the epidemiologist. 
Owing to the fact that a large percentage of our male population is 
still protected by the vaccination against typhoid fever received during 
their military service, the females in the age group 20 to 40 pre- 
dominate, as was evidenced last year. The protection which was 
furnished by this vaccination is obviously becoming less and less as 
time goes on, and we must therefore not let the fact that previous 
vaccination has been performed lead us away from the possible diag- 
nosis of typhoid fever. The necessity of blood cultures for diagnosis 
and for the examination of urine and stools for typhoid bacilli is 
present and this service is still available for diagnosis and should be 
used. Here and there it is noted that local boards of health are in- 
cluding in their regulations for the control of typhoid fever and its 
spread as a requisite for release from supervision of the board of health 
that there shall be made examinations of stools and urine until two 
negative results have been obtained. This without doubt is a neces- 
sary step because secondary cases within the household are occurring, 
and also it is known that for a period of three or four months the 
convalescent may excrete the organisms. 

Lobar pneumonia continues to be one of our big problems and while 
there has been a decrease in the actual number of deaths from this 
condition it is to be noted that there were 4,080 cases with 1,818 
deaths, a death rate of 46.6. It appears that our greatest hope in the 
reduction of deaths from this condition lies in the increased use of the 
laboratory for the type determination of the pneumococcus which 
may be in the sputum and in the subsequent use of the pneumonia 
serum which is available for cases of Type I. The early use of Type 
I serum appears to be efficacious and this serum should be used in all 

suitable cases. 

The continuing interest in pulmonary tuberculosis with the declinmg 
mortality rate is a source of great satisfaction. If the rate of ten years 
ago had prevailed, we would have had for the past year at least 1,700 
more deaths from this condition. These favorable results have been 
obtained by the conscientious application of well-tried principles and 
practices of treatment and prevention carried out by devoted public 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 201 

health workers representing both official and nonofficial groups. The 
consultation clinic has in most sections of the State proved of tre- 
mendous value to the practicing physician, clearing up as it does the 
diagnosis of many doubtful cases. It furnishes as well added stimulus 
to the public health nurse and it is filling a gap in our program which 
has long been realized. 

Special studies have been made in many communities of the State 
during the year with most beneficial results, clearly demonstrating, 
however, in the large majority of instances, that more complete re- 
turns are to be obtained by additional assistance and by the employ- 
ment of more systematic methods in follow-up work of the reported 
case. We are not at all satisfied that the reported incidence repre- 
sents the true picture of tuberculous infection in this State but feel 
that we are working gradually toward procuring better results in 
reporting each year. Of special interest is the attempt of the local 
groups to furnish, through luncheons, greater nutrition to all school 
children, correcting at the same time such physical defects as exist 
and w^hich hold possibilities for the development of future tuberculosis. 

The subject of tuberculosis in forms other than pulmonary has 
caused much concern. More and more is it evident that these con- 
ditions are not adequately treated except in one or two institutions of 
the State, and here facilities are sadly inadequate to meet the demand. 
With a mortality nearly equaling that occurring in diphtheria, our 
serious attention should be given to this condition. It would appear 
that future progress in treating this condition must depend upon pro- 
curing special hospital facilities where prolonged residence may be the 
rule and where the specialized knowledge of the orthopedic surgeon 
may be available, combining, of course, all of the specialized care and 
treatment which tuberculosis always needs. 

The number of cases reported requiring antirabic treatment for the 
year 1921 has exceeded that of any year for which we have records. 
The increase over the preceding year has been 76 per cent. A brief 
review of the present methods employed for the prevention and con- 
trol of this condition quickly leads one to the conclusion that they 
are most inadequate, and we would again urge at least a State-wide 
quarantine and the restraining of dogs for a period of ninety days 
rather than the sporadic quarantine which is now in effect in places 
where a rabid dog has been discovered. This Department believes 
that the experimental work done in conveying immunity to dogs 
through their vaccination is of sufficient value to have it a statutory 
requirement for the issuing of a dog license, for it appears that the 
vaccine is efficacious; further, that any one who can afford to own a 



202 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

dog ought to be able to afford to procure this immunity; and that 
all dogs stray and unclaimed for a reasonable period of time should be 
forthwith destroyed. 

In January the Department was notified by the United States Pub- 
lic Health Service that it would no longer be possible to supply the 
antirabic virus because of the reduction in the appropriation for the 
work of the Hygienic Laboratory. It has therefore been necessary to 
recommend to local boards of health that the virus be purchased for 
the treatment of such cases as may require it. 

The scarlet fever which has been in evidence throughout the year, 
while fairly numerous in cases, has not been of a particularly severe 
type. In nearly all instances where a community has shown an un- 
due prevalence, it has been found upon investigation to be due to the 
missed case in school and has been of an extremely mild character. 
Systematic school inspection through teachers and school nurses under 
the supervision of the school physician will lessen the opportunity for 
exposure to this infection from this source. 

A remarkable decrease in both incidence and mortality rate for 
measles has been experienced over past years. It has been noted 
that several communities are apparently letting up on their quarantine 
measures for this condition because of their ineffectiveness. This is 
a mistake and we would urge the local boards of health to persistently 
place cases of measles in quarantine, placarding houses if for no other 
purpose than to give notice of the existence of this condition to 
other members of the community, and we would also reiterate the 
statement made many times that measles is not without danger and 
steps should be taken to scrupulously guard young children from this 
sort of infection. 

Smallpox with 37 cases and no deaths is indeed a glowing testi- 
monial to the efficacy of vaccination, this being more remarkable 
when other States of the country have shown an increasing incidence, 
of a more virulent type in many instances, during the year. 

Encephalitis lethargica was made reportable in March, 1921, and 
each case as it has been reported has been investigated in an attempt 
to establish some evidence of its mode of transmission, its communi- 
cability, and such other facts as would aid in the diagnosis and dif- 
ferentiation from simulating conditions. We have not been able to 
establish, with any degree of certainty, the position of encephalitis 
lethargica in its relation to diseases dangerous to the public health. 
We have found no evidence of secondary cases in the household or of 
association with a prior case and it appears that no great advancement 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 203 

has been made except in the clarification of pathological lesions and 
possibly in the differentiation from other conditions. 

In order that there might be uniform quarantine regulations adopted 
by local boards of health, our minimum rules and regulations have 
been revised so that at this time they represent the most accurate 
knowledge that we possess on this subject. All boards of health in the 
State have been circularized upon this subject and many have incor- 
porated these regulations in regulations of their own and they appear 
to be working most satisfactorily. The passage of a recent act by the 
Legislature, which made it obligatory that all regulations passed by a 
local board of health bearing a penalty clause should be approved by 
the Attorney-General, was the occasion for which a set of standard 
regulations was prepared by this Division for the guidance of the 
local boards of health in formulating their own regulations. These 
have been adopted in toto by a number of communities and in part 
by many others. We hope eventually to have these regulations the 
basis of a standard sanitary code to which all of the communities of 
the State may subscribe and enforce as their own, augmented as local 
needs may require. 

Under chapter 91, Resolves of 1920, the Massachusetts Department 
of Public Health was directed to investigate as to what measures, if 
any, were necessary for the prevention and control of bubonic plague, 
for which the sum of $.5,000 was appropriated. An investigation as 
to the physical conditions of water-front property was made in all of 
the seaport cities and towns of the Commonwealth. In conjunction 
with the Boston Department of Health a force of rat trappers was 
set to work in the city of Boston catching rats, which were examined 
in the bacteriological laboratory of the local health department. Over 
6,000 rats were caught and examined and no rat infected with plague 
was found. A small number of rats was thought to be suspicious, 
but the suspicions were not confirmed by experts in other laboratories. 
Serious attempts were made to interest these seaport cities and towns 
in a local survey, and this bids fair to produce results in the near 
future. The complete report of this investigation is to be found in 
House Document No. 1360 of the year 1921, in which recommenda- 
tions were made for an appropriation for the continuance of this 
work. This recommendation was received in the Legislature and 
referred to the next annual session. 

A special resolve calling upon this Department to investigate as to 
the need of laboratory facilities for the western section of the State 
to be established in Springfield or some other central point was passed 



204 DEPARTIMENT OF PI'BLIC HEALTH. [Pub. Doc. 

by the Legislature during the year. It was thought that a great 
saving of time would be effected in the laboratory diagnosis of com- 
municable disease; that a much earlier and wider distribution of our 
biologic products would result; and that an economy of adminis- 
tration in food and drug work for this section of the State might be 
made possible by the establishment of such a laboratory. Our in- 
vestigation showed that the amount of time to be saved in the ex- 
amination of laboratory specimens was practically negligible. Speci- 
mens were received at practically the same time from many of the 
extreme western cities and towns at the State House as at Springfield. 
The o-reatest saving of time varied from one-half hour to thirty hours. 
The use of the biologic products apparently depends on density of 
population rather than availability. It was our opinion that the 
saving of time to be gained was not sufficiently great to warrant the 
expenditure of the money necessary to establish the laboratory at this 

time. 

In April, 1921, a community health bureau was estabhshed on the 
Cape, known as the Cape Cod Health Bureau, under the direction of 
a full-time health officer, with the United States Public Health Serv- 
ice and the Red Cross co-operating. This Bureau was formed by 
11 towns joining together, appointing this full-time medical health 
officer to act as their agent, and in certain of the towns as school 
inspector as well. Assistance, as sanitary inspector, public health 
nurse and for office work, was furnished, together with transportation. 
Acting as agent for the local board of health and as school physician 
the health officer practically becomes the executive officer and carries 
out all of the public health activities in these communities. The 
work has been most successful. A very large number of carefully 
conducted examinations for physical defects among the school children 
has been carried out; notable work has been done in the study of the 
pollution of clams from this section; water supplies for schoolhouses 
have been carefully considered; and careful attention has been given 
to the problems of the control and prevention of communicable dis- 
ease, with the result that it appears the communities participating 
in this experiment are well satisfied and that it bids fair to become a 
permanent organization for the betterment of pubhc health for this 
section of the Commonwealth. 

The work of the District Health Officers and their nursing assistants 
has proceeded along routine lines, and in the absence of an outbreak 
or undue incidence of communicable disease it has been possible that 
much time could be devoted to assisting in rounding out the pro- 
grams of the local boards of health. Much time was spent in en- 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 205 

deavoring to interest local health authorities in the Schick test and 
immunization by the use of the toxin-antitoxin mixture. Lecturing 
to nurses, to normal schools, parent-teacher associations and other 
groups interested in pubHc health also took up considerable time. 
Consultation with physicians throughout the State is becoming more 
and more frequent and very material assistance has been given in this 
activity. By serving as director in many of the extra-governmental 
bodies interested and engaged in public health work, our District 
Health Officers are in a position to advise the proper direction of the 
activities of these bodies and prevent overlapping or duplication of 
effort in many instances. 

The following tabulation shows the number of routine inspections 
made : — 

Hospitals 125 

JaUs, lock-ups, etc 148 

Dispensaries 75 

The work of the nursing assistants, by force of circumstances, is 
largely directed to the follow-up of the reported cases of tuberculosis, 
and frequent conferences with the local public health nurse, the in- 
spection of records, and planning for special tuberculosis work in the 
various communities, such as tuberculosis surveys, consume most of 
her time and energy. This is somewhat of a deviation from the 
original plan, but appears to be unavoidable owing to the tremendous 
amount of time this work consumes and the ver^^ evident need which 
the local community presents. 

The following changes in the personnel of the Division have taken 
place: — 

January 1. Dr. Mary R. Lakeman, epidemiologist, Subdivision of Venereal 
Diseases, transferred to the Di\asion of Hygiene as assistant director. 

May 31. Dr. Jonathan E. Henry, epidemiologist, resigned. 

May 23. Dr. Leland M. French appointed as epidemiologist. 

June 30. Dr. Howard A. Streeter, chief of the Subdivision of Venereal Diseases, 
resigned. 

July 1. Dr. Albert Pfeiffer, epidemiologist, Subdivision of Venereal Diseases, 
promoted to position of chief of the subdivision. 

The work of the Bacteriological Laboratory has continued along 
the same general lines as in past years, with a marked increase in the 
number of specimens examined over previous years. It is of special 
interest to note that of 5,597 cultures taken from school children, but 
26 carriers were found. This low percentage is somewhat at variance 



206 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



with that found by workers in other laboratories throughout the 
country, yet it appears to represent the true picture of the situation 
in this State as each positive carrier in this group possessed virulent 
organisms as proved by animal inoculation. Specimens of blood 
examined for the Widal reaction increased by 100 or more specimens, 
with approximately 200 fewer specimens of feces and urine examined. 
This decrease in the number of examinations of feces and urine ap- 
pears to be a movement in the wrong direction, for it is our belief 
that there should be a steadily increasing number of specimens ex- 
amined in order that the patients may be returned without danger to 
the community. Of the specimens examined for the type of pneu- 
mococcus, the results have been as follows: — 




Per Cent. 



Type I 
Type II . 
Type III . 
Group IV 
No pneumococci 



21.2 
11.6 
21.4 
45.8 



It is to be noted that the high percentage in Group IV is due to the 
fact that physicians send specimens from cases suspected of being 
pneumonia rather than resulting from the examination of sputum from 
diagnosed lobar pneumonia cases. 

The following table shows the total number of examinations made, 
with the results: — 





Positive. 


Negative. 


'Atypical. 


Total. 


Diphtheria (primary) .' 


1,566 


14,563 




16,129 


Diphtheria (release) 


1,872 


4,450 




6,322 


Tuberculosis 


964 


3,565 




4,529 


♦Typhoid fever (Widal test) 


351 


1,260 


60 


1,671 


Typhoid fever (culture test) 


37 


683 




720 


Gonorrhea 


255 


2,246 




2,501 


Malaria 


2 


89 




91 


Miscellaneous 








1,4591 


Total 








33,422 



1 Including 486 pneumococcus type determinations, 23 diphtheria virulence tests, 60 animal inocula- 
tions for tubercle bacilli, 8 animal inoculations for anthrax bacilli, and 116 paratyphoid tests. 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 207 

The following gives the total number of biologic products and diag- 
nostic outfits distributed from the laboratory during the year ending 
Nov. 30, 1921: — 

Biologic Products. 
Diphtheria antitoxin: 

9,342 bottles of 1,000 units each .... 9,342 1,000-unit doses 

38,009 bottles of 3,000 units each .... 114,027 1,000-unit doses 

12,239 bottles of 5,000 units each .... 61,195 1,000-unit doses 

7,646 bottles of 10,000 units each .... 76,460 1,000-unit doses 



Total 261,024 1,000-unit doses 

Antimeningococcic serum : 

3,444 bottles of 15 cubic centimeters each . . 3,444 doses 
Antipneumococcic serum: 

649 bottles of 100 cubic centimeters each. Type 

I serum 649 doses 

Schick toxin: 

1,095 outfits of 50 doses each 54,750 doses 

32 cubic centimeters (bulk) 32 cubic centimeters 

Toxin-antitoxin mixture : 

9,414 cubic centimeters 9,414 doses 

Vaccine virus (smallpox) . 197,733 doses 

Bacterial vaccine (tj'phoid-paratj'phoid) : 

21,804 ampoules of 1 cubic centimeter each . . 21,804 doses 
340 bottles of 100 cubic centimeters each . . 34,000 doses 

Total 55,804 doses 

Normal serum 9,788 cubic centimeters 

Silver nitrate solution : 

54,176 ampoules . 54,176 doses 

Diagnostic Outfits. 

Diphtheria culture outfits 28,417 

Culture media 25 

Tuberculosis sputum outfits 6,266 

Pneumonia outfits 353 

Widal outfits 2;321 

Tj^jhoid culture outfits . . . 1,086 

Malaria-gonorrhea outfits 1,977 



208 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Subdivision of Venereal Diseases. 

The work of the Subdivision of Venereal Diseases has continued along 
the lines laid down for that of former years. Owing to the failure of 
Congress to appropriate the Kahn-Chamberlain fund, our appropri- 
ation became limited and it has been necessary to curtail our activities 
not only through the loss of several of the personnel but in reduction 
of the subsidy to the State-approved clinics as well. 

There are now 20 State-approved clinics throughout the State, 
which it is believed are doing excellent work. There has been a de- 
crease in the total of new cases at all clinics, there being 1,153 less 
cases than a year ago, yet the average monthly attendance has in- 
creased, being 1,915.7 more cases than of last year. 

The morbidity reports have fallen off markedly in both gonorrhea 
and syphihs. This reduction in the number of reported cases is due 
in a large measure we believe to the reduction in the actual number 
of cases. A second factor in the lessened number of reports is the 
fact that many physicians regarded the reporting of these conditions 
as a war measure and with the cessation of war have neglected to 
report the cases coming under their treatment. It is perfectly obvious 
that these cases are receiving more intensive and more adequate 
treatment than ever before. The demand for arsphenamine has in- 
creased during the year by 11,439 ampoules, and the Wassermann 
Laboratory examined 5,769 more specimens than the previous year. 

A very much appreciated activity of the Subdivision of Venereal 
Diseases has been the quarterly meeting of the clinic officials generally 
held in Boston, at which addresses have been made by men of promi- 
nence in their chosen field. This has proved to be a source of great 
stimulation for the clinic chiefs in the State-approved clinics and to 
our own force as well. The following subjects have been treated 
during the year: — 

" Neuros>TDhilis." A clinical meeting held at the Boston Psychopathic Hospital. 

"Arsphenamine and Pathology of Sjq^hilis." 

"Gonorrhea." A clinical meeting held at the Massachusetts General Hospital. 

"Syphilis." 

Our educational work and publicity is going along quietly and with 
a steady demand for our literature. Within 7,554 as many pamphlets 
were distributed as last year, when a special effort was made for dis- 
tribution of literature in connection with the "Keeping Fit Exhibit." 

The following tables give a statistical summary of the work in this 
State: — 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



209 



Jan. 1, 


1921, to Dec. 31, 1921. 








Total New 
Patients. 


Total 
Patients. 


Monthly 
Average of 

Total 
Patients. 


Total 

Treatments 

given. 


Number of 

Doses of 

Arsphena- 

mine. 


Attleboro 


38 


201 


16.7 


517 


296 


Boston City Hospital .... 


669 


7,214 


601.1 


7,594 


4,900 


Boston Dispensary . . 


1,433 


23,499 


1,958.2 


51,360 


15,079 


Massachusetts General Hospital 


2,021 


35,672 


2,972.6 


28,988 


8,758 


Massachusetts Homoeopathic Hospital . 


397 


5,994 


499.5 


8,257 


2,268 


Brockton 


87 


917 


76.4 


2,136 


735 


Fall River 


148 


1,301 


108.4 


4,962 


310 


Fitchburg 


57 


276 


23.0 


915 


203 


Haverhill 


44 


226 


18.8 


661 


193 


Holyoke 


46 


428 


35.6 


464 


228 


Lawrence 


140 


1,827 


152.2 


1,805 


530 


Lowell 


259 


2,627 


218.9 


4,806 


986 


Lynn 


119 


2,137 


178.0 


2,474 


563 


New Bedford 


283 


3,924 


327.0 


4,099 


970 


Pittsfield 


11 


94 


7.8 


417 


107 


Salem 


125 


820 


68.3 


1,528 


824 


Springfield 


180 


3,415 


284.5 


3,182 


1,287 


Worcester 


161 


2,055 


171.2 


3,296 


1,417 


I -■■.■: 


6.218 


92,627 


7,718.2 


127,461 


39,654 



Jan. 1, 1921, to Dec. 31, 1921. 

Cases reported by number: 

Gonorrhea 5,563 

Sj^hUis 2,497 

Total 8,060 

Cases reported by name (lapsed cases) 1,147 

Lapsed cases returned to treatment 327 

Ampoules of arsphenamine distributed 38,473 

Wassermann examinations 42,957 

Smear examinations ^ 2,478 

Pamphlets distributed 37,802 

Lectures 73 

State-approved clinics 18 

New cases admitted to clinics 6,218 

Average monthly attendance at clinics 7,718.2 

Total treatments given • 127,461 

.Tin signs, about 8,000 

1 Refers only to smear examinations made in State laboratory. Each clinic examines smears also. 

\ 



210 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Comparison. 









Monthly Average of 
New Patients. 


Monthly Average op 
Total Patients. 




1919. 


1920. 


1921. 


1919. 


1920. 


1921. 


Attleboro 


2.8 


2.6 


3.1 


11.5 


13.0 


16.7 


Boston City Hospital . 


45.8 


41.5 


55.7 


203.1 


358.0 


601.1 


Boston Dispensary 


149.3 


201.7 


119.4 


2,132.6 


2,382.9 


1,958.2 


Massachusetts General Hospital . 


247.1 


208.1 


168.4 


1,239.5 


1,706.0 


2,972.6 


Massachusetts Homoeopathic Hos- 
pital. 
Brockton 


25.1 
4.0 


28.9 
8.1 


33.0 

7.2 


191.4 
11.3 


285.9 
29.7 


499.5 
76.4 


Fall River . 






6.6 


8.5 


12.3 


66.3 


80.5 


108.4 


Fitchburg 






5.6 


3.7 


4.7 


10.3 


11.0 


23.0 


Haverhill i . 






- 


- 


3.6 


- 


- 


18.8 


Holyoke2 






- 


- 


3.8 


- 


- 


35.6 


Lawrence 






12.5 


9.8 


11.6 


54.8 


76.4 


152.2 


Lowell . 






7.0 


21,6 


21.5 


88.6 


106.4 


218.9 


Lynn 






12.5 


10.5 


9.9 


55.3 


82.5 


178.0 


New Bedford 






27.8 


26.3 


23.5 


178.1 


208.2 


327.0 


Pittsfield 






1.5 


1.4 


.9 


3.6 


5.6 


7.8 


Salem . 






1.8 


5.7 


10.4 


6.5 


25.6 


68.3 


Springfield ^ . 






- 


29.6 


15.0 


- 


171.8 


284.5 


Worcester 






11.6 


10.1 


13.4 


101.6 


126.6 


171.2 




561.0 


618.1 


517.4 


4,354.5 


5,670.1 


7,718.2 





1 Clinic opened Nov. 1, 1920. 2 Clinic opened April, 1920. ^ Clinic opened November, 1920. 

The averages for 1919 are based on a six-month period, from June 1 to Dec. 1, 1919. 
The averages for 1920 cover the year from Dec. 1, 1919, to Dec. 1, 1920. 
The averages for 1921 cover the year from Jan. 1, 1921, to Dec. 31, 1921. 



Penikese Hospital. 

Plans inaugurated some years ago by the Federal government to 
segregate in one institution in the United States all persons known to 
be suffering from leprosy have been finally completed. Federal en- 
actment has been passed placing in the United States Public Health 
Service a hospital situated at Carville, La., for this purpose. On 
March 10, 1921, all of the lepers remaining at Penikese, 13 in number, 
were transferred to the care of the Federal authorities. 

It is interesting to note that one of the two patients who were re- 
ported in 1920 as having improved sufficiently to be paroled has been 
released from the Carville institution. 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 211 

Under authorization from the Governor and his Council, the Super- 
visor of Administration and the Commissioner of Public Health, acting 
jointly, have endeavored to sell Penikese Island, but to date the bids 
received have been considered inadequate and further attempts are to 
be made. Such material as was available for use in other State insti- 
tutions has been removed to the mainland and so disposed of; mis- 
cellaneous supplies and household utensils have been disposed of 
locally; and a caretaker has been installed in order that the property 
remaining may be properly safeguarded. 



Report of Epidemiologist for 1921. 

General. — The year 1921 has been marked by relatively few out- 
breaks. Anterior poliomyelitis returned again this year with a much 
lessened incidence than last year, yet with a much wider distribution 
of cases. The spot map, showing the incidence for the year, shows 
vividly how the disease has centered itself about four foci. The un- 
usual occurrence of 6 cases at a boys' camp, after thorough investiga- 
tion left us as much in the dark as to its exact spread and etiology 
as before. 

The occurrence of smallpox at three different places at three dif- 
ferent times served to bring before us the need for sustained provac- 
cination work if we are to keep from this scourge. 

Encephalitis lethargica was declared dangerous to public health and 
as such was made reportable March 1, 1921. Investigation of cases 
by the Department has so far brought out no new or unpublished 
facts on this disease. 

The typhoid rate, which has been declining, narrowly escaped taking 
a sharp rise, due to three extensive outbreaks caused by milk con- 
taminated with typhoid bacilli. Pasteurization plus proper handling 
would have prevented these 175 odd cases with 6 deaths. 

Our nonpulmonary tuberculosis seems not to be getting the attention 
which is needful. With the reporting of 700 to 800 cases yearly and 
with 600 to 700 deaths, it is to be seen that the true incidence is far 
from being properly or completely reported. 

Over 1 per cent of the total deaths from tuberculosis in adults is 
due to original infection by bovine bacilli and in children probably 10 
per cent are due to the bovine type. The entrance of these germs into 
the body is probably almost always through the medium of milk. 
This does not take into consideration the harmful pathological con- 
ditions and undermining results caused by the presence of these 
germs in the body. Here, again, pasteurization of the milk supply 



212 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

would render our child population safe from bovine tubercle bacilli 
and would also prevent the occasional occurrence of milk-borne out- 
breaks of scarlet fever and septic sore throat. 

This year's total of dog bite requiring antirabic treatment marks the 
greatest number ever reported. When we consider that some countries 
never have a case of this condition within their confines, it would seem 
as if some further steps should be taken to combat this disease. 

Measles and whooping cough must always remain in the foreground 
of our endeavors in our attempt to protect the preschool group of chil- 
dren while the very great majority of deaths occur at these ages. 

With Schick work rapidly forging ahead, in another year the results 
of this work are bound to be apparent in a lessened number of cases 
of diphtheria. 

Scarlet fever must be combated chiefly through our school inspec- 
tional work, with the early recognition of missed cases and proper 
daily inspection by the school nurse under close supervision of the 
school physician. 

Influenza was not reported in large numbers this year. This would 
perhaps indicate that the supply of susceptibles has run out. 

Diseases on the premises of milk handlers have received careful and 
thorough attention, and in no case has any outbreak resulted. 

Interstate reciprocal notifications have been sent out as frequently 
as the opportunity presented itself; also, at frequent intervals, cor- 
respondence has taken place with the health representatives of neigh- 
boring States regarding pertinent matters which do not come under 
the scope of the interstate reciprocal notification. 

Our search for typhoid bacilli carriers has been constant but with 
perhaps not the best of success; however, four carriers were discovered 
this year. 

Actinoviy costs. — There were 2 cases reported, — one at Boston and 
one at Cambridge. 

Anterior Poliomyelitis. — There were 233 cases reported for the 
year. Since July 1, 193 of these reports were received. While this 
disease did not reach severe outbreak proportions in any locality, 
there has been a certain persistence in several centers. Thus from 
Boston, or its immediate neighborhood, 81 of the 193 cases were re- 
ported; 41 reports have come from in or around Lawrence and Haver- 
hill; 22 have come from in or around Pittsfield and North Adams, 
and 14 have come from Springfield; therefore, it will be noticed that 
from four foci 158 of the 193 cases were reported. The remainder 
of the cases was pretty generally scattered throughout the State. 

An unusual incident in the poliomyehtis history for this year was 
the occurrence of 6 cases during August at a boys' camp. The camp 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



213 



had been visited two weeks previously by an outbreak of gastro- 
enteritis. Whether this represented a form of poliomyehtis or some- 
how increased the susceptibility to poliomyelitis is a question impos- 
sible of answer. 

In three other instances there were more than one case in a house- 
hold. In two of the three the onsets were at the same time; in one 
the second case of the disease came twenty days after the first. 

The seasonal, age and sex incidence maintained the same con- 
stancy as in former years. 

Anthrax. — The anthrax cases have been reduced to relatively few 
in number. For the year there were reported 6 cases, with no deaths. 
This represents the least number of cases for ten years. Four cases 
were among workmen handling hides or hair, and 2 cases were traced 
to the use of new shaving brushes. The diagnosis of 4 cases was es- 
tablished by the Bacteriological Laboratory, while the diagnosis of 2 
cases was based on the clinical findings alone. 

Chicken Pox. — There were 8,324 cases reported; 270, or 3 per cent 
of the cases, were in adults twenty years and over. Chicken pox 
per se is of little import, but the danger of this disease being con- 
founded with mild cases of smallpox must always be borne in mind. 
Of 8 deaths attributed to chicken pox for the year, 4 deaths were com- 
plicated by broncho-pneumonia and were in individuals mostly under 
one year of age. 

Diphtheria still remains a tremendous problem. Although the num- 
ber of cases reported this year is greater than last, the death rate has 
remained the same and the fatality rate has declined somewhat. 
School and playground contacts were the chief sources of spread during 
the past year. The work of Schick testing and subsequent immuni- 
zation of those found to be susceptible has gained good headway, and 
it is to be expected that in another year the beneficial results of this 
work will be noted. 







Cases. 


Deaths. 


Case Rate 
per 100,000 
Population. 


Death Rate 
per 100,000 
Population. 


Fatality 
Rate. 


1911-1919 median .... 

1920, total 

1921, total 


6,998 
7,513 
9,100 


629 
595 
603 


203.1 
194.2 
233.2 


16.8 
15.4 • 
15.4 


8.1 
7.9 
6.6 



Dog Bite requiring Antirabic Treatment. — There were 118 cases 
reported for the year. This is an exceedingly large number and is the 
largest yearly total ever reported. Out of this number 3 died, 2 of 
whom refused treatment and 1 died in spite of the early institution of 



214 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



the Pasteur treatment. Approximately one-half of the cases requiring 
treatment has occurred in children fourteen years and under. 

Dysentery. — There were 25 cases reported. It is extremely ques- 
tionable how many of these were dysentery of amebic or bacillary 
origin. 

E7icephalitis Lethargica. — This disease was made reportable March 
1, 192L Previous to this time 59 cases had been reported volun- 
tarily by physicians, for the first two months of the year. For the 
remainder of the year 117 cases were reported. There were 74 deaths 
reported during the entire year. Each case has been investigated by 
the District Health Officer with a view to bringing out, if possible, 
some common etiological factor. The investigations so far have not 
brought out anything new or important in this new disease, but they 
have revealed that a number of cases reported as encephalitis leth- 
argica either have been later diagnosed as, or by sequellre, have proved 
to have been, some other disease. In several instances laboratory 
tests have made necessary the change of diagnosis from encephalitis 
to tuberculous meningitis. It appears from the history alone of sev- 
eral cases that the diagnosis of encephalitis was incorrectly made. 
Furthermore, it is to be expected that confusion between this disease 
and anterior poliomyelitis and tuberculous meningitis will take place 
because of the similarity of symptoms. There was a single instance 
of multiple infection, two boys, aged three and six years. The onsets 
of these cases were simultaneous. 

1921. 

117 

74 

3.0 

1.9 

63.2 



Total cases .... 
Total deaths .... 
Case rate per 100,000 population 
Death rate per 100,000 population 
Fatality rate .... 



Epidemic Cerebrospinal Mening 



_ ^ itis. — There were 164 cases reported 

for the year, with 58 deaths. This represents our best record since 
the disease was made reportable. Its incidence has been widespread 
in character. An outbreak of 3 cases at an immigration station 
among natives of the Cape de Verde Islands took place with 100 per 
cent mortality in spite of early diagnosis and hospital treatment. 
Nasopharyngeal cultures were taken from 160 contacts with a view to 
locating, if possible, any carriers. None was found and no cases de- 
veloped thereafter among that group. It would seem that the close 
housing necessary at quarantine played a major role in the spread of 
this disease. Epidemic cerebrospinal meningitis has been more or less 
of common occurrence at this immigration station. 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



215 





Cases. 


Deaths. 


Case Rate 
per 100,000 
Population. 


Death Plate 
per 100,000 
Population. 


Fatality 
Rate. 


1911-1919, median .... 

1920, total 

1921, total 


181 
182 
164 


147 

129 
58 


5.0 
4.7 
4.2 


4.1 
3.3 
1.5 


86.3 
70.8 
35.4 



German Measles. — There were 649 cases and no deaths. This dis- 
ease, not serious in itself, may occasionally be confounded with 
scarlet fever or perhaps measles and thus be the occasion of serious 
outbreaks. 

Glanders. — There were no cases of human glanders reported for 
this year. 

Gonorrhea. — There were 5,563 cases of this disease reported. 

Hookworm. — There was one case reported in a resident of Chelsea. 

Influenza. — There were 735 cases reported for the year. For 1920 
the deaths alone were three times this number. 

Leprosy. — There was one case of the nodular type reported in a 
West Indian negro. He had lived in the United States for nearly five 
years and had worked at Cambridge for the last seven months of this 
time. 

Malaria. — There were 49 cases reported for the year. It is felt 
that this disease is all too frequently diagnosed by clinical symptoms 
only and not confirmed by laboratory examinations of blood specimens. 
It would seem that investigation of these cases was indicated with a 
view to encouraging the use of the laboratory. In this way our 
malaria problem could be more definitely ascertained. 

Measles. — There were 17,827 cases reported for the year. This is 
about one-half the number reported for last year and constitutes a 
report of moderate size. This disease represents one not easy of con- 
trol, first, because of its extreme degree of infectiousness, and second, 
the idea prevailing among the laity that it is not serious and conse- 
quently preschool children are needlessly exposed to it. When parents 
are educated to its real dangers, then can we expect more satisfactory 
control of this disease. Our efforts are still aimed at the protection 
of the preschool children. 

Mumps. — There were 3,952 cases of this disease reported for the 
year. This represents a report of moderate size. There were 6 deaths 
attributed to mumps, which is about the usual number. 

Ophthalmia Neonatorum. — There were 1,573 cases reported for the 
year just past, many of which were reported because of a discharge 



216 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Encephalitis Lethargica, 1921. 



JO 

40 
30 
ZO 
iO 










1 


nciden 


ce by 


Mo7ith 


s. 












\ 






1 
















' 


\ 


^ 


^ 


^ 


r 






\ 



60 



SO 



40 



30 



— ao 



10 



Jo 



Jan. Feb. Mar. Apr. Maq June Juli| Auq. Sep-k Oct Nov. Dec. 



Jncidence by Age Groups. 

60 J J r 1 1 1 , 1 r , , ^ 1 60 

JO so 

40 40 

30 30 

ZO \- — ZO 

q I I I I I I I I I I I I \o 

1-4 5-9 10-14 15-19 20-24 25-29 30-3^ 35-39 40-4445-49 $0'J4 $5-}9 60 o^tr. 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 217 

due to silver nitrate which invariably cleared up in forty -eight hours; 
81, however, were discharged from a hospital as uncured. Only 1 
case was discharged with impaired vision. It would seem that a sys- 
tematic follow-up of the cases discharged uncured was quite essential; 
even though only 1 case showed impaired vision during the past year, 
the potentialities are great. 

Pellagra. — There were 14 cases of this disease reported for the 
year, 8 of which came from State institutions. 

Pneumonia, Lobar. — There were 4,080 cases and 1,818 deaths re- 
ported for the year. According to the number of typings done by the 
laboratory, one case in nine has a pneumococcus typing done. It 
should be urged that this practice be more generally adopted. Cases 
due to Type I pneumococcus should be treated by the specific serum 
which has marked curative powers. 

Scarlet fever totaled 8,331 cases for the year. When this assumes 
mild forms it is not easy of control. This has been true during the 
past year when the disease has been spread by contact with mild 
cases, generally through the medium of schools. It has not been un- 
common to learn that children were kept in school or on the street 
almost throughout the attack, it being so mild that no physician was 
called. It is believed that with the more constant use of the school 
nurse seeking the missed case the figures for scarlet fever will decline. 
During an outbreak there should be systematic inspection of the school 
children. This should be done daily and should be thorough. This 
should consist of throat, tongue and body inspection, with the fre- 
quent use of the clinical thermometer. All suspects, or children suf- 
fering from catarrhal conditions of the nose or throat, should be ex- 
fcluded from the school until their exact condition can be determined. 

Septic Sore Throat. — There were 140 cases reported and one out- 
break of 32 cases at one of the State sanatoria. This was traced to 
the assistant baker who prepared the food eaten by those who de- 
veloped this disease. 

Smallpox. — • During the year just ended 37 cases of smallpox were 
reported in this Commonwealth. For 1920, 29 cases came to the 
notice of the Department. The 37 cases reported represent 3 out- 
breaks and 12 scattered cases. 

1. The Methuen outbreak totaled 25 cases, 13 of which were re- 
ported last year and 12 were reported during January, 1921. This 
outbreak was traced to a family that had just moved from Canada. 

2. The second outbreak consisted of 9 cases, 7 at Salem and 2 at 
Gloucester. These cases were traced to a workman who returned to 
Salem from the Island of Jamaica and who was taken sick soon after 



218 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



leaving the island. It is considered possible that these cases were 
Alastrim or Kaffir pox, as this disease was epidemic at Jamaica at 
that time and subsequent examination of the records shows that no 
cases of smallpox were reported during this period. 

3. A Worcester outbreak consisted of 6 cases, which were traced, 
for the most part, to a person mildly sick with this disease who had 
traveled from the West coast to New York and thence to Massa- 
chusetts while in an infectious condition. 

Syphilis. — There were 2,497 cases of syphilis reported for the year. 

Tetanus was reported in 39 instances. 

Trachoma was reported in 97 instances. 

Trichinosis. — There were 10 cases reported for the year. Reports 
came from the following places: Boston, Winchester, Somerville, 
Maynard and Worcester. 

Tuberculosis, Pulmonary. — There were 6,168 cases reported for the 
year. This constitutes a favorable report. 

Tuberculosis, other forms, were reported in 827 instances. 





Cases. 


Deaths. 


Case Rate 
per 100,000 
Population. 


Death Rate 
per 100,000 
Population. 


Fatality 
Rate. 


1911-1919, median .... 

1920, total 

1921, total 


747 
800 
827 


855 
639 
551 


19.6 
20.7 
21.2 


24.4 
16.5 
14.1 


145.5 
79.9 
66.6 



Typhoid Fever. — There were 917 cases of typhoid reported for the 
year. This number was slightly less than last year, and was the least 
number of cases ever reported. The preponderance of cases in the 
age group twenty to forty was formerly among the males, but this 
year again shows that females are in excess for that age group. This 
is the second year that this has held true. This is considered to be 
a direct result of immunization against typhoid which men of that 
age received while serving in the Army and Navy. Of these cases, 
56 were imported, which constituted 6 per cent of the total number; 
103, or 11 per cent, were traced to direct contact; 156, or 17 per cent, 
were caused by the use of unpasteurized milk contaminated with ty- 
phoid bacilli. Four names have been added to our typhoid bacilli 
carriers, making a total now of 59. 

Last May Waltham was visited by a serious and widespread epi- 
demic of typhoid fever due to the use of raw milk contaminated by 
typhoid bacilli. Prolonged search failed to reveal the source of the 
infecting organism. The occurrence was on a 200-customer milk 
route. The number of those infected amounted to 135, with 6 deaths. 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



219 



Milford, like Waltham, suffered a milk-borne outbreak which was 
traced to an unrecognized case from whom bottles were collected dur- 
ing part of the illness. The possibility of a carrier was considered and 
several specimens from all milk handlers were examined. There were 
12 cases on this 400-quart milk route. Here, again, proper handling 
would have prevented the outbreak. 

Fitchburg, also, had 8 cases traced to a proved carrier whose milk 
was sold unpasteurized in that city. 

In Sherborn several cases were traced to contaminated milk. 

During July, August, September and October 23 cases of typhoid 
were reported from Adams. Careful investigation failed to reveal 
anything in common except the place of work. Examination of the 
water supply of this particular mill showed that polluted water was 
pumped through the mains about once a week. Steps were taken 
immediately to put an end to this. 





Cases. 


Deaths. 


Case Rate 
per 100,000 
Population. 


Death Rate 
per 100,000 
Population. 


Fatality 
Rate. 


1911-1919, median .... 

1920, total 

1921, total 


2,088 
935 
917 


246 

96 
121 


59.5 
24.2 
23.5 


6.6 
2.5 
3.1 


11.5 
10.3 
13.2 



Whooping Cough. — There were 5,704 cases reported for the year. 
This disease is undoubtedly most infectious before the characteristic 
whoop appears and before its nature is known. Accordingly the non- 
immunes in a given neighborhood had contracted the disease before 
the original case was diagnosed. This disease, like measles, is serious 
to the preschool group and, therefore, our efforts should be directed 
toward protecting them. 

Parents should be educated to the fact that the young child should 
be kept away from children having catarrhal conditions of the res- 
piratory system, which are usually the only symptoms that mark the 
early and infectious stage of whooping cough. 



220 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Cases and Deaths from Diseases Dangerous to the Public Health, 1921. 

Index to Line Numbers in the Table of Cases and Deaths from Diseases Dangerous 

to the Public Health, 1921. 



Abington 


. 110 


Cheshire 


. 227 


Granv-ille 


. 


Acton . 


. 195 


Chester 


. 246 


Great Barrington . 


Acushnet 


. 147 


Chesterfield . 


. 327 


Greenfield 


Adams . 


. 63 


Chicopee 


. 30 


Greenwich 




Agawam 


. 120 


Chilmark 


. 355 


Groton 




Alford . 


. 350 


Clarksburg . 


. 264 


Groveland 




Amesbury 


. 72 


Clinton 


62 


Hadley 

HaUfax 

Hamilton 

Hampden 

Hancock 

Hanover 




Amherst 
Andover 
Arlington 
Ashburnham 


. 116 
. 80 
. 42 
. 200 


Cohasset 
Colrain 
Concord 
Conway 


. 171 
. 221 
. 101 
. 284 




Ashby . 


. 290 


Cummington 


. 321 




Ashfield 


. 287 










Ashland 
Athol . 


. 183 

76 


Dalton . 
Dana . 
"Oanvers 


. 139 

. 309 

60 


Hanson 

Hardwick 

Harvard 




Attleboro . 


41 


,l_^ CA/H \ \jt yJ > 








Auburn 
Avon 


. 130 
. 194 


Dartmouth . 
Dedham 


96 
. 70 


Harwich 
Hatfield 




Ayer 


. 151 


Deerfield 
Dennis . 


. 162 

. 228 


Haverhill 
Hawley 




Barnstable 


. 123 


Dighton 


. 170 


Heath . 




Barre . 
Becket . 
Bedford 


. 146 
. 308 
. 238 


Douglas 
Dover . 
Dracut 


. 193 

. 288 
. 114 


Hingham 
Hinsdale 
Holbrook 




Belchertown . 


. 198 


Dudley 


. 143 


Holden 




Bellingham . 
Belmont 


. 196 
. 65 


Dunstable 
Duxbury 


. 333 

. 230 


Holland 
Holliston 

HOLYOKE 




Berkley 


. 282 
. 285 


East Bridgew, 


iter . . 144 


Hopedale 




Berlin . 


East Brookfie 


Id . . 283 


Hopkinton 




Bernardston . 


. 297 
. 37 


East LongmeE 


idow . 179 


Hubbardston 




Beverly 


Eastham 


. 328 


Hudson 




Billerica 


. 136 


Easthampton 


64 


Hull 




Blackstone 
Blandford 


. 135 
. 322 


Easton . 
Edgartown 


. 121 
. 262 


Huntington 




Bolton . 


. 300 


Egremont 


. 329 


Ipswich 




Boston 


3 


Enfield 


. 294 


Kingston 




Bourne 


. 178 


Erving . 


. 240 






Boxborough . 


. 343 


Essex . 


. 233 


Lakeville 




Boxford 


. 311 


Everett 


. 28 


Lancaster 




Boylston 


. 292 






Lanesborougl 




Braintree 


. 68 


Fairhaven 


. 89 


Lawrence 




Brewster 


. 302 


Fall River 


9 


Lee 




Bridgewater . 


. 83 


Falmouth 


. 145 


Leicester 




Brimfield 


. 299 


FiTCHBURG 


. 27 


I^enox . 




Brockton 


. 16 


Florida 


. 348 


Leominster 




Brookfield 


. 236 


Foxborough 


. 126 


Leverett 




Brookline 


. 29 


Framingham 


46 


Lexington 




Buckland 


. 235 


Franklin 


. 99 


Leyden 




Burlington 


. 281 


Freetown 


. 225 


Lincoln 
Littleton 




Cambridge . 


. 11 


Gardner 


. 47 


Longmeadow 




Canton 


. 106 


Gay Head 


. 360 


Lowell 




Carlisle 


. 318 


Georgetown 


. 201 


Ludlow 




Carver . 


. 304 


Gill 


. 286 


Lunenburg 




Charlemont . 


. 298 


Gloucester 


. 36 


Lynn . 




Charlton 


. 203 


Goshen 


. 357 


Lynnfield 




Chatham 


. 208 


Gosnold 


. 363 






Chelmsford . 


. 109 


Grafton 


. 94 


Malden 




Chelsea 


24 


Granby 


. 296 


Manchester 





No. 34.] DIVISION 


OF COMMUNICABLE DISEASES. 


221 


Mansfield 


. 100 


Pelham 


. 314 


Tattnton 


31 


Marblehead . 

Marion 

Marlborough 


91 

. 257 

54 


Pembroke 
Pepperell 
Peru . 


. 237 

. 184 
. 362 


Templeton 

Tewksbury . 

Tisbury 

Tolland 

Topsfield 

Townsend 


. 131 

. 128 
. 255 
. 358 
. 289 
. 223 


Marshfield . 
Mashpee 


. 252 
. 351 


Petersham 
Phillipston 


. 306 
. 334 


Mattapoisett 


. 256 


Pittsfield . 


25 


Maynard 
Medfield 
Medford 
Medway 


. 92 
. 141 
. 26 
. 155 


Plainfield 
Plainville 
Plymouth 
Plympton 


. 339 
. 239 
. 61 
. 323 


Truro . 
Tyngsborough 
Tyringham . 


. 313 
. 270 
. 349 


Melrose 


. 45 


Prescott 


. 356 


Upton . 


. 218 


Mendon 


. 278 


Princeton 


. 303 


Uxbridge 


. '117 


Merrimac 


. 192 


Provincetown 


. 127 






Methuen 


. 52 






Wakefield 


60 


Middleborough 


. 79 


QUINCY 


19 


Wales . 


. 320 


Middlefield . 


. 345 


Randolph 


. 125 


Walpole 


. 118 


Middleton 


. 263 


Raynham 


. 215 


Waltham 


. 32 


Milford 


. 58 


Reading 


88 


Ware . 


. 82 


Millbury 


. Ill 


Rehoboth 


. 199 


Wareham 


. 129 


Millis . 


. 224 


Revere 


. 33 


Warren 


. 150 


Millville 


. 187 


Richmond 


. 310 


Warwick 


. 344 


Milton . 


. 77 


Rochester 


. 273 


Washington . 


. 353 


Monroe 


. 361 


Rockland 


. 87 


Watertown . 


. 35 


Monson 


. 124 


Rockport 


. 138 


Wayland 


. 204 


Montague 


. 90 


Rowe . 


. 342 


Webster 


. 57 


Monterey 


. 347 


Rowley 


. 260 


Wellesley 


. 105 


Montgomery 


. 352 


Royalston 


. 291 


Wellfleet 


. 293 


Mount Washington 


. 365 


Russell 


. 249 


Wendell 


. 337 






Rutland 


. 214 


Wenham 


. 267 


Nahant 


. 243 






West Boylston 


. 212 


Nantucket 


. 167 


Salem . 


. 23 


West Bridgewater . 


. 156 


Natick . 


. 69 


Salisbury 


. 213 


West Brookfield . 


. 250 


Needham 
New Ashford 
New Bedford 
New Braintree 
New Marlborough 
New Salem . 


. 93 
. 364 
8 
. 332 
. 275 
. 316 


Sandisfield 
Sandwich 
Saugus . 
Savoy . 
Scituate 
Seekonk 


. 324 
. 229 
. 67 
. 326 
. 177 
. 157 


West Newbury 
West Springfield 
West Stockbridge . 
West Tisbury 
Westborough 
Westfield 


. 226 
. 56 
. 276 
. 340 
. 112 
44 


Newbury 


. 258 


Sharon . 


. 181 


Westford 


. 148 


Newburypobt 
Newton 


. 51 
. 22 


Sheffield 
Shelburne 


. 242 
. 232 


Westhampton 
Westminster . 


. 346 
. 254 


Norfolk 


. 266 


Sherborn 


. 222 


Weston 
Westport 

W/ 00+ wrr\r\fi 


. 190 
. 153 

9d^ 


North Adams 
North Andover 


. 38 
. 102 


Shirley . 
Shrewsbury . 


. 189 
. 132 


North Attleborough 
North Brookfield . 
North Reading 


. 78 
. 174 
. 247 


Shutesbury . 
Somerset 
Somerville . 


. 354 
. 142 
. 15 


Weymouth 
Whately 

W/ 111 t m Q n 


. 53 
. 253 


Northampton 


. 39 


South Hadley 


. 115 


vv ill tlilall . . 

Wilbraham 


. 161 


Northborough 
Northbridge . 


. 210 
. 73 


Southampton 
Southborough 


. 295 
. 205 


WilUamsburg 
Williamstown 


. 206 
. 140 


Northfield 
Norton 


. 207 
. 186 


Southbridge . 
Southwick 


. 55 

. 265 


Wilmington . 
Winchendon . 


. 168 
. 108 


Norwell 


. 248 


Spencer 


. 107 


Winchester 


71 


Norwood 


. 59 


Springfield . 


7 


Windsor 


. 325 


Oak Bluffs . 


. 277 


Sterling 
Stockbridge . 


. 251 
. 211 


Winthrop 

WoBURN 


. 50 
48 


Oakham 


. 317 


Stoneham 


. 84 


Worcester . 


5 


Orange 
Orleans 


. 119 
. 279 


Stoughton 
Stow . 


. 97 
. 269 


Worthington 
Wrentham 


.. 335 
. 158 


Otis 


. 336 


Sturbridge 


. 219 






Oxford . 


. 134 


Sudbury 
Sunderland . 


. 268 
. 245 


Yarmouth 


. 261 


Palmer 


. 74 


Sutton . 


. 176 


Camp Devens 


. 366 


Paxton 


. 315 


Swampscott . 


. 81 


Tewksbury State 


In- 


Peabodt 


. 43 


Swansea 


. 188 


firmary 


. 367 



222 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Cases and Deaths from Diseases Dangerous 









22 


25A 


10 


24 


25B 


40 






Popu- 
lation 


An- 
terior 
Polio- 


Chicken 


Diph- 


Ep. 

Cere- 
bro- 


Ger- 
man 


Gonor- 






esti- 


Pox. 


theria. 


spinal 


Mea- 


rhea. 




Cities and Towns grouped 
IN Order of Population. 


mated 

as of 

July 1, 


mye- 
litis. 










Menin- 
gitis. 


sles. 




• 
























o 




1921. 




m 




03 




CO 




03 




m 




m 






02 


j3 


03 


^ 


cr 


^ 


o5 


JS 


o5 


J3 


K 


ja 










c! 
O 






c3 




03 




1 








hH 






U 


Q 


O 


Q 


o 


p 


o 


P 


O 


P 


6 


Q 


1 


Massachusetts .... 


3,901,971 


233 


47 


8324 


8 


9100 


603 


164 


58 


649 


- 


5563 


5 


2 


Cities over 500,000. 




























3 


Boston 


748,888 


47 


12 


2083 


2 


2718 


148 


49 


27 


268 


- 


2595 


1 


4 


Cities over 150,000. 




























5 


Worcester 


185.140 


1 


- 


212 


- 


332 


29 


4 


3 


19 


- 


269 


- 


6 


Cities, 100,000-150,000. 


706,490 


S3 


1 


1347 


/ 


1631 


149 


34 


7 


78 


- 


1022 


1 


7 


Springfield .... 


138,028 


8 


1 


304 


_ 


246 


23 


4 


2 


18 


_ 


269 


_ 


8 


New Bedford 








124,895 


2 


_ 


155 


_ 


294 


27 


11 


1 


4 


- 


112 


- 


9 


Fall River . 








119,126 


2 


_ 


99 


1 


219 


23 


5 


2 


9 


- 


160 


1 


10 


Lowell 








114,268 


1 


_ 


91 




293 


36 


4 


1 


4 


- 


197 


_ 


11 


Cambridge 








109,969 


5 


- 


610 


- 


226 


n 


5 


1 


39 


- 


157 


- 


12 


Lynn . 




• 




100,204 


5 


— 


88 


- 


353 


29 


5 


— 


4 


~ 


127 


~ 


13 


T 

Cities, 50,000-100,000. 


4S3,54S 


41 


4 


756 


3 


1068 


74 


10 


5 


28 


- 


471 


g 


14 


Lawrence 


95,536 


15 


3 


148 


_ 


157 


19 


3 


2 


3 


_ 


138 


_ 


15 


Somerville 










95,061 


_ 


_ 


99 


2 


239 


28 


2 


1 


13 


- 


55 


- 


16 


Brockton 










67,506 


- 


_ 


139 


_ 


254 


7 


1 


- 


2 


- 


28 


- 


17 


Holyoke 










60,009 


2 


- 


57 


1 


51 


7 


1 


_ 


4 


- 


52 


2 


18 


Haverhill 










55,284 


20 


1 


213 


- 


248 


10 


2 


1 


4 


- 


161 


- 


19 


Quincy 










50,150 


4 


- 


100 


- 


119 


3 


1 


1 


2 


- 


37 


— 


20 


Cities and Towns, 25,000- 
50,000. 


525,784 


32 


7 


1216 


1 


1260 


80 


18 


6 


60 


- 


514 


- 


21 


Maiden 


49,165 


_ 


__ 


66 


_ 


171 


15 


2 


2 


4 


_ 


38 


_ 


22 


Newton 










46,983 


4 


1 


234 


_ 


150 


10 


1 


- 


13 


- 


22 


- 


23 


Salem 










44,212 


4 


1 


142 


1 


77 


3 


4 


2 


2 


- 


63 


- 


24 


Chelsea 










43,108 


2 


_ 


82 


_ 


77 


6 


_ 


_ 


6 


- 


87 


- 


25 


Pittsfield 










42,444 


5 


4 


63 


- 


114 


4 


1 


2 


- 


- 


25 


- 


26 


Medford 










41,731 


2 


_ 


67 


— 


100 


5 


_ 


_ 


12 


- 


22 


- 


27 


Fitchburg 










41,463 


1 


- 


25 


- 


98 


5 


- 




1 


- 


57 


- 


28 


Everett 










40,879 


6 


- 


193 


- 


1.33 


3 


4 




10 


- 


34 


- 


29 


Brookline 










39,092 


1 


_ 


225 


_ 


48 


2 


1 


- 


7 


- 


14 


- 


30 


Chicopee 










38,133 


2 


1 


9 


- 


87 


10 


2 


__ 


1 


- 


8 


- 


31 


Taunton 










37,445 


- 


- 


10 


- 


60 


5 


- 


- 


2 


- 


88 


- 


32 


Waltham 










31,155 


1 


- 


100 


_ 


70 


10 


- 


- 


2 


- 


16 


- 


33 


Revere 










29,974 


4 


- 


- 


- 


75 


2 


3 


— 


— 


_ 


40 


— * 


34 


Cities and Towns, 10,000- 
25,000. 


615,335 


53 


13 


1284 


- 


980 


55 


25 


6 


93 


- 


315 


- 


35 


Watertown .... 


23,017 


1 


_ 


52 


_ 


53 


3 


_ 


- 


4 


- 


11 


- 


36 


Gloucester 








22,464 


- 


- 


7 


- 


45 


4 


- 


- 


- 


- 


8 


— 


37 


Beverly 








22,435 


- 


- 


29 


- 


21 


2 


1 


- 


- 


- 


23 


- 


38 


North Adams 








22,360 


10 


2 


8 


- 


16 


- 


2 


- 


1 


- 


1 


- 


39 


Northampton 








22,044 


2 


- 


65 


- 


59 


8 


I 


2 


4 


- 


7 


— 


40 


Leominster 








20,407 


2 


2 


65 


- 


25 


3 


1 


- 


1 


- 


17 


- 


41 


Attleboro . 








20,126 


1 


1 


16 


- 


37 


2 


- 


- 


3 


- 


8 


- 


42 


Arlington . 








19,857 


2 


- 


49 


- 


22 


3 


- 


- 


9 


- 


14 


- 


43 


Peabody 








19,845 


— 


— 


25 


~ 


39 


5 


4 


1 


1 


— 


41 


" 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



223 



to the Public Health, 1921. 
































11 


101 


7 


13 


40A 


8 


38 


31, 


37, 


32-36E 




1 


9 




















37A 


37B 














Influ- 
enza. 


Lobar 
Pneu- 
monia. 


Measles. 


Miunps. 


Oph- 

thaimia 
Neona- 
torum. 


Scarlet 
Fever. 


Syphi- 
lis. 


Tuber- 
culosis, 
Pulmo- 
nary. 


Tuber- 
culosis, 
Other 
Forms. 


Ty- 
phoid 
Fever. 


Whoop- 
ins; 
Cough. 






tt 




GQ 




» 




M 




tt 




oi 




tD 




en 




03 




en 




a 


d 


* 


s: 


• 


J3 


01 


JZ 


CO 


-c 


K 


j: 


rfi 


^ 


0^ 


^ 


(A 


j: 


cc 


j: 


Ol 


JS 


K 


J3 


1 






















S 












2 


S 
^ 






..:, 
d 
ii 


o 
a 


O 





O 


Q 


o 


P 


O 


Q 


d 


p 


6 


P 


o 


P 


U 


P 


6 


P 


O 


P 


o 


P 


'^ 


735 


155 


4080 1818 


17827 


174 


3952 


6 


1573 


- 


8331 


189 


2497 


198 


6168 


3304 


827 


551 


917 


121 


5703 


197 


1 


150 


22 


1092 


453 


3373 


38 


682 


- 


491 


- 


1879 


53 


1186 


61 


1886 


752 


271 


116 


129 


24 


692 


32 


2 
3 


47 


2 


298 


115 


1156 


17 


63 


1 


222 


- 


437 


13 


135 


15 


247 


149 


39 


41 


33 


6 


183 


10 


4 
5 


7.9 


«5 


7^2 


U6 


?526 


4S 


m 


4 


512 


- 


1157 


9 


421 


24 


1186 


570 


178 


118 


ISO 


20 


1139 


63 


6 


_ 


7 


159 


59 


148 


3 


148 


1 


67 


^ 


347 


3 


111 


8 


169 


80 


27 


24 


22 


6 


110 


3 


7 


3 


2 


75 


28 


35 




73 


1 


178 


_ 


226 


1 


37 


7 


291 


127 


41 


27 


20 


4 


144 


9 


8 


13 


5 


167 


52 


396 


23 


102 


_ 


175 


_ 


120 


2 


45 


3 


193 


93 


33 


22 


77 


3 


373 


30 


9 


2 


2 


92 


48 


737 


11 


6 


- 


43 


- 


51 


- 


129 


- 


213 


67 


26 


26 


27 


16 


17 


6 


10 


39 


3 


149 


44 


895 


4 


175 


_ 


35 


_ 


255 


2 


49 


2 


193 


127 


33 


11 


14 


- 


403 


11 


11 


22 


3 


120 


45 


315 


2 


140 


2 


14 


- 


158 


1 


50 


4 


127 


76 


18 


8 


20 


1 


92 


4 


12 


9S 


i7 


m 


185 


1097 


7 


411 


- 


116 


- 


692 


21 


263 


18 


604 


373 


95 


48 


68 


11 


596 


18 


13 


8 


2 


64 


37 


161 


2 


37 


_ 


25 


^ 


170 


11 


99 


2 


168 


85 


23 


14 


23 


4 


77 


6 


14 


20 


2 


115 


40 


136 


2 


32 


- 


19 


- 


176 


2 


28 


3 


128 


59 


22 


6 


10 


2 


89 


4 


15 


2 


4 


72 


22 


22 


_ 


194 


_ 


50 


_ 


75 


2 


55 


3 


74 


19 


26 


11 


17 


3 


1&3 


2 


16 


1 


4 


30 


24 


29 


3 


22 


- 


9 


- 


39 


3 


19 


1 


89 


41 


3 


7 


5 


1 


15 


1 


17 


62 


3 


116 


31 


25 


- 


114 


- 


8 


- 


144 


3 


50 


7 


86 


41 


11 


5 


9 


1 


211 


4 


18 


5 


2 


57 


31 


724 


- 


12 


- 


5 


- 


88 


- 


12 


2 


59 


28 


10 


5 


4 


~ 


41 


1 


19 


47 


22 


573 


324 


199$ 


21 


152 


1 


98 


- 


1100 


37 


123 


22 


672 


337 


98 


82 


315 


31 


971 


19 


20 


8 


2 


84 


25 


71 


1 


4 




19 




153 


6 


8 


1 


71 


25 


15 


11 


7 


1 


29 


2 


21 


3 


1 


74 


34 


78 


1 


17 


- 


5 


- 


85 


1 


6 


- 


54 


23 


4 


2 


12 


- 


174 


- 


22 


1 


- 


38 


16 


65 


2 


29 


- 


7 


- 


50 


1 


8 


3 


50 


30 


4 


5 


5 


1 


32 


- 


23 


2 


1 


78 


23 


154 


3 


5 


_ 


29 


- 


122 


5 


29 


1 


76 


30 


10 


5 


11 


- 


36 


1 


24 


2 


2 


42 


22 


239 


- 


3 


- 


3 


- 


117 


12 


7 


1 


81 


37 


12 


16 


10 


6 


93 


2 


25 


1 


_ 


18 


9 


299 


_ 


5 


_ 


3 


- 


92 


1 


3 


- 


43 


27 


3 


2 


2 


- 


33 


4 


26 


1 


- 


50 


15 


864 


9 


22 


- 


2 


- 


13 


- 


17 


- 


50 


28 


3 


5 


13 


2 


1 


2 


27 


16 


_ 


55 


14 


58 




10 


_ 


9 


_ 


154 


3 


5 


- 


44 


20 


22 


7 


2 


- 


32 


1 


28 


3 


- 


21 


11 


39 


_ 


50 


- 


4 


- 


55 


1 


1 


- 


40 


20 


8 


5 


4 


1 


417 


1 


29 




10 


13 


9 


8 


_ 




_ 


4 


_ 


31 


1 


3 


_ 


40 


25 


4 


7 


4 


- 


1 


3 


30 


4 


2 


37 


21 


86 


1 


4 


1 


5 


- 


91 


3 


24 


14 


62 


45 


5 


8 


10 


3 


32 


1 


31 


4 


3 


49 


14 


28 


- 


3 


- 


6 


- 


65 


2 


4 


1 


26 


15 


2 


8 


132 


7 


91 


- 


32 


2 


1 


14 


11 


3 


4 




- 


2 


- 


72 


1 


8 


1 


35 


2 


4 


1 


3 


— 


" 


2 


33 


iOS 


2S 


540 


U2 


2927 


21 


735 


- 


78 


- 


16S8 


28 


173 


32 


833 


484 


81 


67 


159 


21 


563 


24 


34 


_ 


_ 


21 


4 


38 




3 




1 




32 




6 




24 


11 


6 


_ 


3 


_ 


9 


1 


35 


_ 


1 


8 


11 


7 


— 


5 


_ 


5 


_ 


58 


- 


5 


2 


54 


19 


1 


5 


10 


- 


17 


- 


36 


- 


- 


32 


7 


20 


_ 


20 


- 


4 


- 


38 


1 


16 


- 


20 


6 


3 


1 


5 


1 


36 


3 


37 


20 


1 


9 


3 


102 


1 


1 


- 


3 


- 


32 


1 


10 


- 


24 


15 


1 


2 


3 


1 


4 


- 


38 


- 


5 


20 


8 


150 


_ 


1 


- 


- 


- 


46 


- 


7 


12 


44 


49 


3 


3 


5 


- 


13 


- 


39 


1 


- 


32 


7 


427 


3 


5 


- 


2 


- 


47 


9 


4 


- 


32 


5 


2 


2 


4 


- 


16 


- 


40 


3 


3 


22 


10 


5 


_ 


48 


- 


1 


- 


61 


- 


11 


1 


26 


36 


5 


4 


3 


1 


25 


- 


41 


1 


■ _ 


8 


4 


116 


_ 


2 


_ 


1 


_ 


51 


_ 


_ 


- 


27 


18 


- 


- 


9 


- 


21 


- 


42 


1 


— 


13 


5 


4 


— 


67 


— 


3 


— 


49 


1 


7 


~ 


29 


8 


4 


5 


1 


~ 


21 


3 


43 



224 



DEPARTMENT OF PUBLIC PIEALTH. [Pub. Doc. 



Cases and Deaths from Diseases Dangerous 









22 


25A 


10 


24 


25B 


40 






Popu- 
lation 


An- 
terior 
Polio- 


Chicken 


Diph- 


Cere- 
bro- 


Ger- 
man 


Gonor- 






esti- 


Pox. 


theria. 


spinal 


Mea- 


rhea. 




Cities and Towns grouped 


mated 

as of 

July 1, 


mye- 
litis. 








Menin- 


sles. 






IN Order of Population. 








gitis. 


































o 




1921. 




cr 




oi 




« 




« 




CO 




m 






w 


JS 


ffj 


-Q 


M 


J3 


tn 


>a 


05 


J^ 


oi 


J3 


(1) 






M 


? 


m 


-*-» 

? 




-M 

? 


to 


ci! 


S 


c3 


^ 










7S 


a; 




ID 


OJ 


£ 


CC 


o 


03 


O 


c3 


<0 


i-i 






O 


Q 


'^ 


Q 


O 


P 


o 


p 


o 


Q 


o 


c 


44 


Westfield 


18,665 


2 


1 


21 




32 


4 


1 


1 






6 




45 


Melrose 






18,622 


3 


_ 


33 


_ 


68 


2 


— 


— 


8 


_ 


7 


— 


46 


Framingham 






17,403 


_ 


— 


105 


_ 


56 


_ 


1 


_ 


1 


_ 


4 


_ 


47 


Gardner 






17,159 


- 


- 


70 


_ 


19 


_ 


_ 


_ 


_ 


_ 


_ 


_ 


48 


Woburn 






16,625 


- 


- 


16 


- 


43 


- 


1 


_ 


6 


— 


10 


- 


49 


Greenfield . 






16,360 


3 


_ 


34 


_ 


20 


_ 


1 


_ 


5 


_ 


9 


_ 


50 


Winthrop 






16,307 


1 


— 


65 


_ 


3 


_ 


— 


_ 


7 


— 


9 


_ 


51 


Newburyport 






15,715 


3 


1 


64 


_ 


13 


2 


1 


- 


1 


_ 


5 


_ 


52 


Methuen 






15,562 


2 


1 


110 


_ 


26 


2 


_ 


- 


9 


- 


6 


- 


53 


Weymouth 






15,401 


2 




10 


— 


11 


_ 


1 


_ 


3 


_ 


1 


_ 


54 


Marlborough 






14,958 


_ 


_ 


13 


_ 


10 


2 


1 


_ 




_ 


1 


_ 


55 


South bridge 






14,254 


1 


1 


9 


- 


2 


_ 


2 


1 


_ 


_ 


4 


_ 


56 


West Springfield 






14,107 


_ 


_ 


3 


- 


12 


_ 


- 


- 


_ 


- 


7 


- 


57 


Webster 






13,477 


_ 


_ 


6 


- 


7 


1 


- 


- 


- 


- 


9 


- 


58 


Milford 






13,404 


— 


_ 


41 


_ 


8 




1 


_ 


4 


_ 


2 


- 


59 


Norwood . 






13,148 


5 


3 


39 


_ 


11 


_ 


1 


- 


2 


_ 


8 


- 


60 


Wakefield . 






13,102 


1 


1 


10 


— 


39 


_ 




_ 


1 


_ 


9 


_ 


61 


Plymouth . 






13,083 


-- 




41 


_ 


7 


1 


2 


_ 


2 


_ 


7 


- 


62 


Clinton 






12,912 


_ 


_ 


13 


_ 


7 


— 


1 


_ 


_ 


— 


12 


- 


63 


Adams 






12,888 


4 


_ 


6 


_ 


15 


3 


_ 


_ 


_ 


- 


6 


- 


64 


Easthampton 






11,708 


- 


- 


5 


- 


70 


2 


- 


_ 


_ 


_ 


8 


- 


65 


Belmont 






11,592 


1 


_ 


54 


- 


39 


1 


1 


- 


3 


- 


4 


- 


66 


Danvers 






11,087 


2 


_ 


11 


_ 


47 


1 


_ 


_ 


2 


_ 


13 


- 


67 


Saugus 






11,078 


_ 


— 


34 


- 


8 


1 


- 


_ 


3 


- 


1 


- 


68 


Braintree . 






10,970 


1 


- 


51 


- 


16 


_ 


_ 


- 


16 


- 


9 


- 


69 


Natick 






10,840 


_ 


_ 


2 


_ 


5 


— 


_ 


_ 




_ 


4 


_ 


70 


Dedham 






10,713 


_ 


— 


17 


_ 


3 


— 


- 


- 


_ 


_ 


6 


- 


71 


Winchester 






10,637 


1 


_ 


71 


- 


23 


1 


- 


- 


4 


- 


1 


- 


72 


Amesbury . 






10,507 


1 


_ 


7 


— 


31 


2 


— 


_ 


_ 


— 


10 


_ 


73 


Northbridge 






10,465 


_ 


_ 


2 


_ 


3 


_ 


— 


_ 


_ 


_ 


5 


_ 


74 


Palmer 






10,031 


2 




5 


- 


9 


- 


1 


1 


- 


- 


2 


- 


75 


Towns, 5,000-10,000. 


314,777 


19 


5 


894 


- 


620 


34 


8 


1 


69 


- 


194 


1 


76 


Athol 


9,795 


2 


_ 


7 


_ 


9 


1 


_ 


„ 


_ 


_ 


11 


_ 


77 


Milton 






9,629 


_ 


_ 


91 


- 


6 


_ 


- 


- 


10 


_ 


2 


- 


78 


North Attleborough 






9,187 


1 


1 


3 


— 


36 


3 


_ 


_ 




— 


5 


_ 


79 


Middleborough . 






8,397 


_ 


— 


23 


— 


3 


— 


_ 


— 


— 


- 


5 


_ 


80 


Andover 






8,360 


3 


_ 


25 


- 


20 


_ 


_ 


- 


- 




1 


- 


81 


Swampscott 






8,340 


4 


- 


26 


- 


8 


_ 


1 


1 


_ 




4 


- 


82 


Ware . 






8,266 


— 


— 


1 


_ 


2 


1 


— 


_ 


— 


_ 


_ 


_ 


83 


Bridgewater 






8,141 


_ 


_ 


40 


_ 


2 


_ 


_ 


- 


_ 


- 


7 


- 


84 


Stoneham . 






7,994 


_ 


_ 


14 


_ 


42 


_ 


_ 


_ 


1 


- 


3 


_ 


85 


Hudson 






7,875 


_ 


— 


2 


— 


5 


1 


_ 


_ 


_ 


— 


4 


_ 


86 


Ludlow 






7,855 


1 


1 


21 


_ 


27 


— 


_ 


_ 


_ 


- 


3 


- 


87 


Rockland . 






7,692 






4 


_ 


3 


_ 


_ 


_ 


1 


_ 


3 


— 


88 


Reading 






7,639 


1 


_ 


2 


— 


7 


_ 


— 


_ 


— 


_ 


2 


_ 


89 


Fairhaven . 






7,611 


_ 


_ 


28 


_ 


21 


4 


1 


- 


_ 


_ 


- 


- 


90 


Montague . 






7,596 


1 


1 


2 


_ 


61 


8 


_ 


_ 


1 


_ 


1 


- 


91 


Marblehead 






7,235 


1 


— 


9 


— 


4 


— 


— 


— 


_ 


_ 


7 


_ 


92 


Maynard . 






7,185 




- 




- 


35 


2 


_ 


_ 


_ 


_ 


3 


- 


93 


Needham . 






7,160 


_ 


_ 


12 


_ 


2 


_ 


_ 


_ 


- 


- 


3 


- 


94 


Grafton 






7,088 


1 


— 


— 


_ 


1 


— 


_ 


_ 


_ 


_ 


6 


_ 


95 


Whitman . 






7,030 




_ 


22 


_ 


■ 8 


_ 


_ 


_ 


_ 


_ 


4 


_ 


96 


Dartmouth 






6,860 


— 


_ 


9 


._ 


14 


1 


_ 


_ 


— 


_ 


_ 


_ 


97 


Stoughton . 






6,828 


- 


_ 


1 


_ 


48 


2 


_ 


_ 


4 


_ 


2 


_ 


98 


Lexington . 






6,606 


_ 


_ 


19 


- 


2 


_ 


- 


_ 


7 


- 


4 


- 


99 


Franklin 






6,515 


_ 


— 


18 


_ 


11 


— 


_ 


_ 


1 


_ 


2 


- 


100 


Mansfield . 






6,408 


1 


1 


32 


_ 


_ 


_ 


_ 


_ 


1 


- 


8 


- 


toi 


Concord 






6,392 


— 




15 


— 


5 


-_ 


2 


_ 


5 


— 


53 


_ 


102 


North Andover 






6,362 


1 


— 


21 


— 


18 


2 


_ 


_ 


_ 


_ 


_ 


1 


103 


Great Barrington 






6,216 




- 


29 


- 


2 




- 


- 


1 


- 


14 


- 





No. 34.] DIVISION OF COMMUNICABLE DISEASES. 225 



lo the Public Health, 1921 — Continued. 



11 


101 


7 


13 


40A 


8 


38 


31, 


37, 


32-36E 


1 


9 






















37A 


37B 










Influ- 
enza. 


Lobar 
Pneu- 
monia. 


Measles. 


Mumps. 


■ Oph- 
thalmia 
Neona- 
torum. 


Searlet 
Fever. 


Syphi- 
lis. 


Tuber- 
culosis, 
Pulmo- 
nary. 


Tuber- 
culosis, 
Other 
Forms. 


Ty- 
phoid 
Fever. 


Whoop- 
ing 
Cough. 






DC 




CO 




CQ 




m 




03 




M 




oi 




03 




03 




03 




M 


d 


03 


J= 


m 


s: 


m 


.c 


« 




03 


X! 


fn 


X 


03 


JS 


m 


.c 


03 


j5 


03 


j3 


03 


-C 


O 
CO 


03 


O 
03 


c3 


^ 






rt 


0) 


S 




03 


% 


"S 




•s 


». 


"S 




c3 




9 




03 


U 


cS 


il> 


d 


4) 


(a 


a 


01 




o 


ce 


a 


c3 


in 


c3 


(U 




Si 


73 


O 




u 


Q 


O 


C 


o 


P 


u 


a 


O 





o 


Q 


O 


Q 


o 


P 


o 


P 


o 


P 


o 


P 


3 


_ 


_ 


10 


8 


5 


_ 


5 


_ 


3 




5 


_ 


2 


_ 


15 


41 


_ 


3 


1 


_ 


10 


_ 


44 


- 


1 


10 


8 


27 


- 


30 


- 


17 


- 


45 


- 


3 


- 


14 


12 


3 


1 


4 


1 


1 


- 


45 


1 


1 


14 


14 


343 


1 


2 


- 


- 


- 


22 


- 


5 


1 


25 


5 


4 


2 


5 


3 


35 


1 


46 


- 


- 


10 


4 


278 


4 


5 


— 


- 


- 


55 


- 


5 


- 


49 


28 


2 


2 


5 


- 


12 


1 


47 


1 


2 


38 


9 


39 


1 


- 


- 


2 


- 


81 


- 


_ 


- 


16 


10 


2 


2 


1 


- 


5 


- 


48 


- 


1 


11 


7 


34 


1 


4 


- 


2 


- 


127 


- 


8 


- 


13 


4 


1 


- 


7 


1 


- 


- 


49 


5 


- 


23 


8 


42 


- 


9 


- 


- 


_ 


31 


- 


9 


_ 


11 


9 


2 


- 


2 


1 


9 


- 


50 


- 


- 


7 


5 


19 


- 


35 


- 


2 


- 


45 


2 


5 


- 


12 


3 


1 


- 


8 


1 


15 


1 


51 


- 


- 


10 


4 


15 


- 


29 


- 


2 


- 


113 


1 


1 


_ 


27 


11 


5 


2 


3 


1 


45 


- 


52 


1 


- 


7 


14 


33 


- 


2 


- 


1 


- 


42 


2 


5 


1 


11 


5 


3 


2 


1 


- 


14 


- 


53 


- 


2 


8 


7 


270 


1 


- 


- 


- 


- 


19 


- 


4 


1 


29 


12 


2 


1 


2 


- 


1 


- 


54 


- 


1 


24 


5 


140 


1 


2 


- 


6 


- 


48 


- 


1 


- 


13 


5 


3 


3 


3 


1 


1 


- 


55 


- 


- 


15 


4 


103 


2 


4 


- 


2 


- 


43 


4 


1 


- 


13 


6 


1 


- 


1 


- 


9 


1 


56 


5 


- 


14 


4 


17 


- 


176 


- 


12 


- 


4 


_ 


1 




14 


5 


5 


1 


3 


^ 


- 


- 


57 


- 


1 


6 


8 


64 


- 


2 


- 


2 


- 


15 


- 


- 




21 


11 


3 


2 


14 


2 


3 


- 


58 


- 


- 


19 


4 


65 


- 


97 


- 


2 


_ 


11 


1 


_ 




27 


4 


1 


2 


- 




39 


- 


59 


2 


- 


22 


7 


87 


1 


1 


- 


- 


- 


50 


1 


1 




14 


9 


5 


4 


3 


- 


6 


- 


60 


1 


- 


5 


5 


12 


1 


3 


_ 


- 


_ 


177 


2 


4 


_ 


23 


3 


3 


5 


3 


1 


20 


2 


61 


1 


- 


30 


12 


67 


2 


- 


- 


1 


- 


26 


- 


2 


- 


13 


14 


3 


4 


5 


- 


4 


- 


62 


- 


2 


9 


4 


1 


- 


3 


- 


- 


- 


66 


- 


2 


- 


34 


10 


- 


- 


27 


2 


- 


- 


63 


- 


- 


27 


6 


7 


- 


1 


_ 


1 


- 


12 


_ 


- 


_ 


21 


8 


1 


1 


_ 


- 


1 


- 


64 


1 


- 


8 


4 


16 


- 


35 


- 


1 


- 


14 


- 


- 




11 


3 


1 


_ 


- 


- 


93 


1 


65 


- 


1 


9 


6 


24 


- 


39 


_ 


_ 


_ 


31 


_ 


30 


2 


41 


26 


2 


3 


2 


_ 


1 


1 


66 


-62 


2 


6 


2 


151 


- 


46 


- 


- 


- 


37 


- 


1 


1 


10 


4 


2 


1 


3 


- 


22 


3 


67 


- 


- 


7 


4 


23 


- 


4 


- 


- 


- 


48 


1 


2 




9 


42 


- 


1 


1 


1 


5 


- 


68 


- 


1 


1 


2 


96 


1 


2 


- 


- 


- 


39 


_ 


4 


- 


10 


3 


- 


- 


2 


- 


12 


- 


69 


1 


- 


1 


4 


7 


- 


11 


- 


- 


- 


10 


- 


2 


- 


6 


4 


- 


- 


- 


- 


12 


- 


70 


1 


1 


3 


4 


47 


1 


2 


- 


- 


- 


17 


_ 


2 


1 


6 


4 


1 


2 


2 


1 


24 


- 


71 


- 


- 


15 


3 


3 


- 


24 


- 


- 


- 


18 


- 


3 


- 


11 


6 


- 


- 


- 


- 


1 


1 


72 


- 


3 


3 


5 


6 


- 


1 


- 


1 


- 


14 


2 


1 


_ 


13 


3 


_ 


1 


5 


1 


- 


- 


73 


~ 


— 


3 


2 


17 


— 


9 


— 


1 


— 


9 


- 


3 


- 


11 


7 


- 


— 


3 


1 


— 


5 


74 


■63 


18 


167 


13S 


22S1 


7 


500 


- 


48 


- 


585 


11 


152 


10 


g89 


181 


43 


35 


51 


S 


590 


7 


75 


- 


7 


5 


4 


16 


__ 


7 


_ 


_ 


_ 


6 


_ 


2 


_ 


3 


3 


1 


2 


1 


_ 


3 


_ 


76 


5 


- 


10 


2 


160 


- 


18 


- 


- 


- 


14 


- 


1 


- 


5 


2 


1 


- 


1 


- 


32 


- 


77 


- 


1 


1 


4 


10 


1 


1 


- 


- 


_ 


7 


_ 


4 


3 


10 


3 


_ 


2 


- 


2 


- 


- 


78 


1 


- 


6 


3 


9 


- 


30 


- 


1 


- 


5 


- 


1 


- 


14 


7 


1 


- 


1 


- 


95 


1 


79 


- 


1 


2 


- 


354 


1 


5 


- 


1 


- 


39 


1 


1 


- 


9 


3 


- 


1 


6 


1 


2 


- 


80 


1 


- 


3 


2 


- 


- 


27 


- 


2 


- 


20 


_ 


2 


_ 


5 


2 


- 


_ 


- 


- 


- 


- 


81 


— 


- 




6 


1 


- 


- 


- 


1 


- 


6 


1 


- 


- 


4 


4 


- 


2 


1 


- 


- 




82 


— 


- 


11 


3 


2 


- 


59 


- 


- 


- 


13 


_ 


58 


3 


23 


15 


1 


1 


2 


- 


51 


- 


83 


1 


- 




5 


184 


- 


- 


- 


- 


- 


10 


- 


4 


- 


6 


3 


- 


- 


2 


- 


7 


_ 


84 


— 


- 




1 


1 


- 


- 


- 


2 


_ 


3 


_ 




_ 


7 


6 


_ 


_ 


2 


- 


- 


- 


85 


— 


- 




1 


1 


- 


1 


- 


5 


- 


29 


2 


1 


- 


12 


4 


1 


- 


- 


- 


4 


- 


86 


- 


- 


5 


3 


2 


- 


- 


- 


1 


- 


- 


- 


1 


- 


10 


7 


1 


1 


- 


- 


3 


- 


87 


— 


- 


- 


1 


5 


- 


- 


- 


- 


- 


22 


- 


- 


- 


4 


5 


- 


1 


1 


- 


- 


- 


88 


— 


- 


3 


2 


2 


- 


33 


- 


6 


_ 


28 


2 


_ 


_ 


14 


3 


1 


1 


3 


- 


16 


1 


89 


— 


- 


7 


5 


75 


- 


- 


- 


2 


- 


3 


- 


2 


_ 


5 


1 


- 


1 


3 


- 


- 


- 


90 


- 


- 


3 


6 


1 


- 


4 


- 


1 


- 


21 


- 


- 


- 


4 


2 


- 


- 


1 


- 


- 


- 


91 


— 


- 


- 


1 


- 


- 


- 


- 


- 


- 


1 


- 


- 


- 


7 


6 


2 


- 


1 


1 


- 


- 


92 


1 


2 


8 


8 


8 


- 


- 


- 


- 


_ 


11 


_ 


_ 


_ 


1 


2 


1 


2 


_ 


- 


43 


- 


93 


- 


- 


- 


3 


2 


- 


- 


- 


- 


- 


- 


_ 


_ 


_ 


7 


14 


1 


1 


- 


- 


- 


- 


94 


- 


- 


2 


- 


3 


- 


11 


- 


- 


- 


15 


- 


1 


- 


7 


1 


2 


2 


4 


1 


23 


- 


95 


- 


- 


8 


- 


1 


- 


5 


- 


2 


- 


13 


_ 


_ 


_ 


6 


3 


2 


1 


2 


1 


21 


1 


96 


- 


- 


- 


2 


10 


- 


5 


- 


1 


- 


14 


- 


- 


- 


11 


3 


- 


1 


- 


- 


- 


- 


97 


- 


- 


1 


3 


74 


- 


5 


- 


2 


_ 


6 


_ 


1 


_ 


10 


5 


1 


1 


- 


- 


57 


1 


98 


1 


1 


5 


4 


6 


- 


1 


- 


- 


- 


6 


- 


2 


- 


4 


2 


- 


- 


- 


- 


22 


- 


99 


- 


- 


7 


2 


153 


- 


8 


- 


1 


- 


9 


_ 


1 


_ 


4 


_ 


_ 


_ 


1 


_ 


3 


- 


100 


33 


- 


14 


7 


184 


_ 


3 


_ 


2 


_ 


7 


_ 


12 


_ 


8 


2 


_ 


_ 


_ 


_ 


_ 


- 


101 


- 


- 


5 


2 


4 


- 


3 


- 


- 


_ 


29 


_ 


_ 


_ 


3 


4 


_ 


1 


1 


- 


7 


- 


102 


2 


1 


9 


2 


205 


— 


3 


— 


— 


— 


61 


- 


- 


- 


1 


2 


- 


- 


2 


— 


21 


— 


103 



226 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Cases and Deaths from Diseases Dangerous 









22 


25A 


10 


24 


25B 


40 






Popu- 
lation 


An- 
terior 
Polio- 


Chicken 


Diph- 


Ep. 
Cere- 
bro- 


Ger- 
man 


Gonor- 






esti- 


Pox. 


theria. 


spinal 


Mea- 


rhea. 




Cities and Towns grouped 
IN Order of Population. 


mated 

as of 

July 1, 


mye- 
litis. 






Menin- 
gitis. 


sles. 
































o 

z 




1921. 




tn 




oi 




en 




m 




rjl 




(a 






CQ 


X 


02 


j3 


(n 


J3 


OQ 


J3 


^ 


A 


09 


jq 


o 

a 






s 
s 


Si 






i 






03 
Si 


1 








3 






o 


Q 


o 


Q 


o 


Q 


o 


Q 


U 


Q 


o 


Q 


104 


Ipswich 


6,179 






5 




11 












4 




105 


Wellesley . 






6,156 


- 


_ 


74 


_ 


39 


_ 


_ 


_ 


13 


_ 


3 


_ 


106 


Canton 






6,047 


- 


- 


40 


_ 


13 


2 


_ 


_ 


4 


_ 


4 


_ 


107 


Spencer 






5,910 


- 


- 


14 


- 


3 


- 


1 


- 


- 


- 


2 


- 


108 


Winchendon 






5,903 


_ 


_ 


13 


_ 


46 


2 


_ 


_ 


_ 


_ 


_ 


_ 


109 


Chelmsford 






5,840 


_ 


_ 


6 


_ 


11 


1 


_ 


_ 


_ 


_ 


1 


_ 


110 


Abington . 






5,832 


- 


- 




- 


3 


- 


- 


- 


- 


- 




_ 


111 


Millbury . 






5,766 


- 


- 


35 


- 


17 


1 


- 


- 


- 


- 


2 


- 


112 


Westborough 






5,746 


- 


_ 


20 


_ 


13 


_ 


- 


- 


1 


_ 


5 


_ 


113 


Hingham . 






5,711 


- 


_ 


50 


- 


17 


- 


_ 


_ 


10 


- 


3 


_ 


114 


Dracut 






5,677 


- 


- 


37 


- 


6 


- 


1 


- 


- 


- 


- 


- 


115 


South Hadley . 






5,637 


1 


_ 


22 


_ 


9 


1 


_ 


_ 


1 


_ 


1 


_ 


116 


Amherst 






5,548 


_ 


- 


3 


_ 


7 


_ 


_ 


- 


4 


_ 


_ 


_ 


117 


Uxbridge . 






5,5.30 


- 


- 


11 


- 


7 


1 


_ 


- 


- 


- 


2 


- 


118 


VValpole 






5,432 


1 


1 


45 


- 


4 


- 


2 


- 


4 


- 


6 


- 


119 


Orange 






5,397 


- 


- 


- 


- 


7 


- 




- 


- 


- 


2 


- 


120 


Agawam 






5,170 


- 


_ 


_ 


- 


2 


_ 


_ 


- 


- 


- 


2 


- 


121 


Easton 






5,034 


- 


— 


43 


- 


3 


1 


- 


- 


- 


- 


- 


- 


122 


Towns, 2,500-5,000. 


174,761 


8 


9 


195 


1 


2'^3 


IS 


8 


1 


5 


_ 


61 


- 


123 


Barnstable .... 


4,786 


1 


1 


8 


_ 


_ 


_ 


_ 


_ 


_ 




10 


_ 


124 


Monson 






4,770 


- 


- 


2 


- 


- 


- 


- 


- 


- 


- 


- 


- 


125 


Randolph . 






4,763 


- 


- 


- 


- 


3 


- 


- 


- 


- 


- 


3 


- 


126 


Foxborough 






4,256 


- 


- 


17 


- 


3 


- 


- 


- 


1 


- 


5 


- 


127 


Provincetown 






4,231 


- 


- 


17 


1 


- 


- 


- 


- 


- 


- 


2 


- 


128 


Tewksbury 






4,193 


- 


- 


3 


- 


2 


- 


- 


1 


- 


- 


- 


- 


129 


Wareham . 






4,175 


- 


- 


- 


- 


18 


1 


- 


- 


- 


- 


2 


- 


130 


Auburn 






4,083 


- 


_ 


_ 


- 


2 


_ 


_ 


_ 


- 


- 


- 


- 


131 


Templeton 






4,000 


- 


- 


6 


- 


- 


- 


- 


- 


- 


- 


2 


- 


132 


Shrewsbury 






3,996 


- 


- 


- 




1 


- 


- 


- 


- 


- 


- 


- 


133 


Lee 






3,960 


- 


- 


- 




2 


- 


1 


- 


- 


- 


- 


- 


134 


Oxford 






3,928 


- 


- 


12 


- 


10 


1 


- 


- 


1 


- 


- 


- 


135 


Blackstone 






3,860 


- 


- 


- 


- 


34 


3 


1 


- 


- 


- 


- 


- 


136 


Billerica 






3,772 


_ 


_ 


_ 




9 


1 


_ 


_ 


_ 


_ 


1 


- 


137 


Leicester . 






3,734 


- 


- 


2 




_ 


_ 


- 


- 


- 


- 


- 


- 


138 


Rockport . 






3,728 


- 


- 


5 


- 


- 


- 


- 


- 




- 


1 


- 


139 


Dalton 






3,719 


2 


- 


3 


- 


1 


- 


1 


- 


- 


- 


2 


- 


140 


Williamstown 






3,620 


_ 


- 


4 


_ 


9 


~ 


- 


- 


- 


_ 


- 


- 


141 


Medfield . 






3,579 


- 


- 


1 


- 


3 




- 


- 


- 


- 


3 


- 


142 


Somerset . 






3,565 




_ 


1 


_ 


2 


_ 


_ 


_ 


_ 


_ 


1 


- 


143 


Dudley 






3,489 




_ 


4 


_ 


3 


2 


_ 


_ 


_ 


_ 


- 


- 


144 


East Bridgewater 






3,422 


- 


- 


- 


- 


8 


_ 


1 


-. 


- 


- 


1 


- 


145 


Falmouth . 






3,368 


- 


- 


17 


- 


4 


1 


- 


- 


1 


- 


2 


- 


146 


Barre . 






3,320 


_ 


_ 


2 


_ 


1 


_ 


_ 


_ 


- 


- 


- 


- 


147 


Aciishnet . 






3,292 


- 


- 


5 


- 


18 


1 


- 


- 


- 


- 


- 


- 


148 


Westford . 






3,273 


2 


_ 


11 


_ 


2 


1 


_ 


_ 


_ 


_ 


_ 


- 


149 


Holbrook . 






3,228 


1 


_ 


_ 


_ 


1 


- 


1 


_ 


_ 


_ 


1 


- 


150 


Warren 






3,214 


_ 


- 


- 


_ 


1 


- 


- 


- 


- 


- 


1 


- 


151 


Ayer . 






3,138 


1 


1 


- 


- 


3 


- 


- 




- 


- 


1 


- 


152 


Holden 






3,114 


- 


- 


5 


- 


4 


- 


- 




- 


- 


6 


_ 


153 


Westport . 






3,069 


- 


- 


6 


- 


12 


1 


- 


_ 


- 


- 


- 




154 


Harvard 






3,001 


- 


- 


- 


- 


- 


- 


- 




- 


- 


- 


- 


155 


Medway 






2,991 


- 


- 


- 


- 


11 


3 


- 




- 


- 


3 


- 


156 
157 


West Bridgewater 
Seekonk 






2,961 
2,939 


- 


- 


- 


- 


1 


- 


2 


- 


— 


— 


— 


— 


158 


Wrentham . 






2,932 


_ 


_ 


15 


_ 


- 


- 


- 


_ 


- 


- 


3 


- 


159 


Hardwick . 






2,924 


_ 


- 


1 


- 


- 


- 


- 


- 


2 


- 


- 


- 


160 
161 


Longmeadow 
Wilbraham 






2,882 
2,861 


— 


~~ 


1 


— 


4 
1 


— 


— 


— 


— 


— 


: 


— 


162 


Deerfield . 






2,823 


- 


- 


5 


- 


5 


1 


- 


- 


- 


- 


- 


- 


163 


Hadley 






2,821 


~ 


~ 


1 


~ 


6 


1 


~ 


~ 


~" 


~ 


1 


— 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



227 



to the Public Health, 1921 — Continued. 



11 


101 


7 


13 


40A 




8 


38 


31, 37, 


32-3SE 


1 


9 






















37A, 37B 










Influ- 
enza. 


Lobar 
Pneur 
monia. 


Measles. 


Mumps. 


Oph- 
thalmia 
Neona- 
torum. 


Scarlet 
Fever. 


Syphi- 
lis. 


Tuber- 
culosis, 
Pulmo- 
nary. 


Tuber- 
culosis, 
Other 
Forms. 


Ty- 
phoid 
Fever. 


Whoop- 
ing 
Cough. 






00 




i 




GQ 




CC 




03 




lb 




K 




03 




CO 




a: 




03 


d 
a) 


i 




s 




i 






c3 


05 


j3 


tn 


X 
tj 


(0 

01 


J3 

o3 


oj 


C3 


S 


J3 


i 


a 




..J 
03 




0; 


a 


s. 




0> 


03 


O 




0) 




c 


03 


o 




U 




o 


c3 


9. 


a 


S 


u 


Q 


O 


0. 


O 


G 


o 


Q 


'^ 


O 


o 


Q 


o 


p 


d 





O 


p 


o 


p 


O 


P 


HH 


_ 


_ 




1 


2 












37 


1 


2 




9 


2 


2 


2 


6 




1 




104 


12 


— 


6 


3 


139 


1 


46 


- 


8 


- 


26 


- 


_ 


1 


6 


6 


2 


1 


1 


_ 


16 


_ 


105 


- 


- 


1 


3 


12 


- 


93 


- 


- 


- 


8 


2 


1 


1 


7 


10 


20 


2 


1 


- 


34 


_ 


106 


- 


- 


2 


2 


2 


- 


3 


- 


- 


- 


1 


1 


_ 


_ 


2 


6 


_ 


_ 


1 


_ 


4 


_ 


107 


3 


- 


1 


1 


179 


2 


- 


- 


- 


- 


40 


- 


- 


- 


2 


1 


- 


- 


- 


- 


40 


- 


108 


- 


2 


- 


3 


25 


- 


9 


- 


- 


- 


3 


_ 


_ 


_ 


2 


3 


_ 


_ 


1 


_ 


_ 


_ 


109 


- 


- 


1 


1 


- 


- 


- 


- 


- 


- 


13 


- 


1 


- 


6 


2 


_ 


_ 


_ 


- 


- 


_ 


110 


1 


- 


6 


3 


17 


- 


5 


- 


3 


_ 


5 


_ 


— 


_ 


1 


4 


1 


1 


— 


_ 


47 


1 


111 


- 


- 


3 


8 


2 


- 


28 


- 


- 


- 


9 


- 


48 


2 


7 


10 


_ 


_ 


2 


_ 


- 


- 


112 


1 


- 


5 

1 
4 


1 
2 
3 


166 


- 


1 


- 


1 


- 


6 
1 

1 


- 


3 


- 


3 
5 

5 


3 
2 
2 


1 


1 
2 


- 


- 


1 


- 


113 

11/1 


1 


_ 


91 


_ 


12 


_ 


1 


_ 


I 


I 


I 


I 


I 


I 


1 


I 


114 
115 


- 


1 


3 


1 


79 


- 


7 


- 


4 


- 


7 


_ 


_ 


_ 


7 


— 


_ 


1 


_ 


_ 


21 


2 


116 


- 


1 


1 


3 


- 


- 


- 


- 


1 


- 


4 


- 


1 


_ 


4 


2 


_ 


_ 


2 


1 


- 


_ 


117 


- 


1 


6 


4 


8 


- 


18 


- 


_ 


- 


9 


_ 


1 


_ 


9 


4 


1 


4 


2 


1 


7 


_ 


118 


- 


- 


- 


4 

1 
6 


48 


2 


2 


- 


- 


- 


3 
9 
5 


- 


1 


- 


3 
1 
6 


2 
5 
3 


- 


- 


- 


- 


- 


- 


119 

1 oa 


- 


- 


8 


38 


- 


47 


- 


- 


- 


1 


- 


- 


- 


- 


- 


- 


8 


- 


121 


62 


13 


88 


89 


1079 


7 


ers 


- 


3 


- 


37g 


5 


2^ 


8 


188 


135 


10 


S7 


53 


6 


434 


11 


122 


- 


2 


9 


7 


207 


_ 


_ 


_ 


1 


_ 


7 


_ 


_ 


_ 


12 


4 


_ 


_ 


1 


_ 


22 


1 


123 


- 


- 


1 


3 


118 


- 


- 


- 


- 


- 


15 


_ 


7 


_ 


8 


7 


_ 


_ 


1 


_ 


_ 


_ 


124 


- 


- 


- 


1 


- 


- 


- 


- 


- 


- 


1 


- 


_ 


- 


6 


2 


_ 


- 


3 


- 


- 


- 


125 


1 


- 


5 


1 


21 


1 


- 


- 


_ 


- 


5 


_ 


3 


_ 


8 


4 


1 


1 


_ 


_ 


1 


_ 


126 


- 


- 


- 


2 


2 


- 


1 


- 


- 


- 


3 


- 


_ 


- 


10 


3 


2 


_ 


1 


- 


116 


1 


127 


- 


- 


1 


1 


30 


- 


- 


- 


_ 


- 


1 


_ 


_ 


_ 


2 


3 


_ 


_ 


1 


3 


_ 


_ 


128 


"- 


~ 


4 


1 
1 


10 


— 


2 


— 


- 


- 


2 
2 


- 


- 


1 


■12 


5 


1 


- 


1 


- 


13 


1 


129 
130 


50 


3 


2 


- 


10 


- 


- 


- 


- 


- 


7 


1 


_ 


_ 


2 


3 


_ 


_ 


4 


_ 


- 


- 


131 


- 


- 


- 


- 


5 


- 


2 


_ 


_ 


_ 


7 


_ 


_ 


_ 


_ 


2 


_ 


_ 


_ 


_ 


3 


2 


132 


- 


1 


- 


5 


12 


- 


- 


- 


- 


- 


27 


_ 


_ 


_ 


9 


3 


_ 


2 


_ 


_ 


4 


- 


133 


- 


- 


2 


- 


22 


- 


84 


- 


- 


- 


39 


1 


_ 


_ 


5 


1 


_ 


1 


- 


- 


- 


- 


134 


- 


- 


1 


6 


- 


1 


- 


_ 


- 


- 


4 


_ 


_ 


_ 


_ 


2 


_ 


_ 


_ 


_ 


_ 


1 


135 


- 


1 


5 


3 


16 


- 


1 


_ 


_ 


_ 


2 


_ 


_ 


_ 


8 


5 


2 


1 


1 


_ 


4 


1 


136 


- 


- 


- 


2 


32 


- 


- 


- 


_ 


_ 


7 


1 


_ 


_ 


1 


5 


_ 


2 


_ 


_ 


_ 


- 


137 


- 


- 


- 


1 


9 


- 


3 


- 


- 


- 


1 


_ 


_ 


_ 


3 


3 


_ 


_ 


1 


- 


- 


- 


138 


- 


- 


- 


- 


3 


- 


- 


- 


- 


- 


8 


- 


- 


- 


_ 


3 


- 


1 


1 


- 


- 


- 


139 


- 


1 


2 


5 


50 


- 


2 


- 


- 


- 


71 


_ 


_ 


_ 


5 


1 


_ 


2 


1 


- 


_ 


- 


140 


- 


- 


12 


7 


4 


- 


18 


- 


_ 


- 


13 


_ 


_ 


3 


20 


21 


_ 


5 




_ 


1 


_ 


141 


- 


- 


2 


3 


- 


- 


- 


- 


- 


- 


5 


_ 


_ 


_ 


4 


2 


_ 


_ 


1 


_ 


2 


2 


142 


_ 


— 


1 


3 


1 


1 


84 


- 


- 


- 


7 


- 


1 


- 


1 
3 


2 
8 


1 


- 




- 


- 


- 


143 
144 


- 


- 


- 


1 


9 


- 


6 


- 


- 


- 


1 


- 


1 


1 


7 


1 


1 


1 


- 


- 


36 


1 


145 


- 


1 


- 


- 


6 


- 


- 


- 


_ 


- 


5 


- 


_ 


_ 


5 


5 


_ 


_ 


_ 


_ 


25 


- 


146 


- 


- 


- 


- 


- 


- 


6 


- 


1 


- 


2 


1 


- 


- 


1 


_ 


_ 


- 


- 


- 


4 


- 


147 


- 


- 


3 


1 


71 


1 


2 


- 


- 


- 


11 


_ 


_ 


_ 


2 


4 


_ 


_ 


_ 


1 


69 


1 


148 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


2 


- 


1 


_ 


2 


2 


- 


- 


1 


- 


- 


- 


149 


- 


- 


- 


- 


65 


1 


- 


- 


- 


- 


4 


_ 


_ 


_ 


9 


6 


_ 


1 


_ 


_ 


1 


- 


150 


1 


- 


1 


3 


78 


- 


_ 


_ 


_ 


_ 


5 


_ 


1 


_ 




1 


_ 




_ 


_ 


6 


_ 


151 


- 


- 


3 


- 


30 


- 


- 


- 


- 


- 


9 


_ 


3 


1 


1 


_ 


1 


2 


6 


2 


1 


- 


152. 


- 


- 


- 


- 


9 


- 


1 


- 


- 


- 


4 


- 


_ 


_ 


1 


1 


_ 


1 


1 


- 


22 


- 


153 


- 


- 


- 


- 


7 


- 


2 


- 


- 


- 


- 


_ 


_ 


_ 


_ 


1 


_ 


_ 


_ 


_ 


9 


- 


154 


- 


- 


- 


3 


8 


- 


- 


_ 


_ 


_ 


1 


_ 


_ 


_ 


3 


1 


_ 


_ 


1 


_ 


9 


_ 


155 


- 


- 


1 


- 


- 


- 


- 


- 


_ 


_ 


1 


1 


_ 


1 


1 


1 


_ 


_ 


1 


_ 


5 


- 


156 


- 


- 


- 


3 


3 


1 


- 


- 


- 


- 


1 


- 


- 


1 


4 


2 


- 


- 


- 


- 


- 


- 


157 


- 


- 


8 


3 


2 


- 


- 


- 


- 


- 


16 


_ 


_ 


_ 


6 


6 


1 


_ 


_ 


_ 


2 


- 


158 


- 


1 


- 


3 


1 


- 


- 


- 


- 


- 


1 


- 


- 


- 


5 


1 


- 


1 


_ 


- 


- 


- 


159 


- 


- 


1 


1 


3 


- 


1 


- 


- 


- 


11 


- 


- 


- 


1 


- 


- 


- 


- 


- 


- 


- 


160 


— 


— 


— 


_ 


— 


_ 


_ 


_ 


_ 


_ 


1 


_ 


_ 


_ 


_ 


1 


_ 


1 


_ 


_ 


_ 


_ 


161 


- 


- 


1 


2 


3 


_ 


21 


_ 


_ 


_ 


1 


_ 


_ 


_ 


2 


2 


_ 


2 


_ 


_ 


_ 


_ 


162 


"" 


— 


" 


1 


27 


— 


I 


— 


— 


— 


11 


- 


- 


- 


3 


1 


- 


- 


- 


- 


19 


— 


163- 



■228 



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, 

1921. 



22 

An- 
terior 
Polio- 
mye- 
litis. 



Q 



25A 



Chicken 
Pox. 



O 



10 



Diph- 
theria. 



C3 
O 



24 

Ep. 
Cere- 
bro- 
spinal 
Menin 
gitis. 



25B 

Ger- 
man 
Mea- 
sles. 



40 



Gonor- 
rhea. 



O 



=3 



Hopedale . 

Groveland 

Holliston . 

Nantucket 

Wilmington 

Hatfield 

Dighton 

Cohasset 

Hanover 

Lenox 

North Brookfield 



Towns under 2,500. 



Sutton 

Scituate 

Bourne 

East Longmeado 

Ivingston . 

Sharon 

Lancaster . 

Ashland 

Pepperell . 

Manchester 

Norton 

Millville . 

Swansea 

Shirley 

Weston 

Hopkinton 

Merrimac . 

Douglas 

Avon . 

Acton 

Bellingham 

Groton 

Belchertown 

Rehoboth 

Ashburnham 

Georgetown 

Hanson 

Charlton . 

Wayland 

Southborough 

Williamsburg 

Northfield . 

Chatham . 

Harwich 

Northborough 

Stockbridge 

West Boylston 

Salisbury 

Rutland 

Raynham 

Lunenburg 

Hull . 

Upton 

Sturbridge 

Hamilton 

Colrain 

Sherborn 

Townsend 



2,813 
2,736 
2,681 
2,680 
2,660 
2,657 
2,598 
2,588 
2,547 
2,517 
2,504 



307,250 

2,499 

2,494 

2,485 

2,482 

2,481 

2,467 

2,422 

2,376 

2,351 

2,315 

2,307 

2,292 

2,264 

2,263 

2,263 

2,231 

2,196 

2,181 

2,179 

2,165 

2,149 

2,139 

2,057 

2,014 

1,997 

1,987 

1,946 

1,926 

1,904 

1,819 

1,787 

1,773 

1,759 

1,741 

1,739 

1,721 

1,720 

1,696 

1,695 

1,659 

1,642 

1,607 

1,585 

1,559 

1,553 

1,537 

1,515 

1,500 



1 

12 

5 

4 



318 

1 
1 
5 



1 
17 

2 
50 

4 
38 

2 



15 
4 
1 



5 

16 

3 



1 

3 

11 

5 
3 
2 



S5S 

5 

2 

31 

2 



1 

3 

11 



25 
5 



2 
20 



3 

26 
5 



14 



59 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



229- 



to the Public Health, 1921 



Continued. 



11 


101 


■3 




13 


40A 


8 


38 


31, 37, 


32-36E 


1 


9 


























37A, 37B 










Influ- 
enza. 


Lobar 
Pneu- 
monia. 


Measles. 


Mumps. 


Oph- 
thalmia 

Neona- 
torum. 


Scarlet 
Fever. 


Syphi- 
lis. 


Tuber- 
culosis, 
Pulmo- 
nary. 


Tuber- 
culosis, 
Other 
Forms. 


Ty- 
phoid 
Fever. 


Whoop- 

iiis; 
Cough. 


i 


tit 

u 






p 




03 

V. 


6 


en 

a 

P 


6 


P 


oi 




t 

6 


CO 

.a 

■s 
p 


1 


5 


er* 

6 


tn 

J3 
+^ 

ai 

P 


CO 

s 

03 
O 


0) 

p 


o 


.a 
P 


3 




1 




3 


4 




18 








2 








2 


2 






1 




1 




164 


_ 


- 


7 


1 


6 


- 


17 


- 


- 


- 


5 


- 


- 


- 


2 


2 


- 


_ 


_ 


_ 


7 


_ 


165 


- 


1 


1 


1 


61 


1 


- 


- 


- 


- 


- 


- 


2 


- 


- 


- 


- 


- 


- 


- 


- 


_ 


166 


- 


- 


1 


2 


2 


- 


- 


- 


- 


- 


- 


- 


- 


- 


3 


- 


- 


- 


2 


- 


23 


_ 


167 


_ 


- 


- 


- 


3 


- 


~ 


- 


- 


- 


2 


- 


- 


- 


- 


1 


- 


- 


1 


- 


_ 


_ 


168 


_ 


_ 


4 


1 


24 


- 




_ 


- 


- 


10 


- 


- 


- 


2 


1 


_ 


- 


- 


— 


— 


_ 


169 


_ 


- 


1 


2 


- 


- 


- 


- 


- 


- 


6 


- 


1 


- 


3 


- 


- 


1 


- 


_ 


6 


— 


170 


- 


- 


4 


- 


3 


- 


- 


- 


- 


- 


12 


- 


1 


- 


1 


- 


- 


- 


- 


- 


4 


- 


171 


_ 


- 


3 


3 


- 


- 


- 


- 


- 


- 


1 


- 


- 


- 


- 


2 


- 


- 


_ 


_ 


_ 


_ 


172 


- 


1 


- 


- 


101 


- 


- 


- 


- 


- 


8 


- 


1 


- 


2 


- 


- 


1 


- 


- 


19 


_ 


173 


— 


- 




3 


1 


— 


— 


— 


- 


~ 


5 


~ 


~ 


~ 


1 


2 


— 


1 


2 


- 


- 


- 


174 


B5 


10 


8S 


H 


1382 


13 


i90 


- 


6 


- 


il7 


IS 


13 


4 


SOS 


3^8 


10 


15 


u 


3 


536 


13 


175 


_ 


_ 


3 


— 


39 


2 


8 


_ 


_ 


_ 


1 


1 


— 


— 


— 


_ 


— 


— 


1 


_ 


_ 


_ 


176 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


1 


- 


2 


- 


2 


2 


- 


- 


1 


_ 


_ 


_ 


177 


1 


1 


9 


3 


3 


_ 


4 


_ 


- 


- 


2 


- 


1 


- 


7 


9 


- 


- 


— 


— 


3 


1 


178 


- 


- 


2 


1 


1 


- 


- 


- 


- 


- 


4 


- 


- 


- 


8 


4 


- 


- 


- 


- 


- 


- 


179 


— 


— 


— 


~ 


— 


— 


— 


— 


— 


— 


14 


— 


— 


— 


2 


— 


1 


— 


— 


— 


— 


— 


180 


5 


- 


- 


2 


8 


- 


4 


_ 


- 


- 


18 


- 


2 


- 


9 


5 


- 


- 


1 


_ 


63 


_ 


181 


3 


- 


1 


_ 


15 




- 


- 


- 


- 


6 


- 


- 


- 


1 


- 


- 


- 


- 


- 


_ 


- 


182 


- 


1 


1 


- 


11 


- 


6 


- 


- 


- 


2 


- 


- 


- 


3 


- 


- 


- 


1 


- 


3 


- 


183 


- 


- 


- 


4 


134 


2 


2 


- 


- 


- 


9 


1 


- 


- 


1 


2 


- 


- 


_ 


_ 


- 


1 


184 


1 


- 


- 


1 


1 


- 


- 


- 


- 


- 


2 


- 


1 


- 


1 


3 


- 


- 


- 


- 


- 


- 185 


- 


- 


- 


1 


2 


- 


2 


- 


1 


- 


3 


- 


- 


- 


3 
2 
1 


1 


- 


- 


- 


- 


- 


- 186 

_ 1 OT 


3 


_ 


7 


1 


_ 

7 


_ 


_ 


_ 


_ 


_ 


5 


1 


_ 


_ 


_ 


_ 


_ 


1 


_ 


3 


1 


10/ 

188 


- 


- 


3 


- 


7 


- 


- 


- 


- 


- 


40 


- 


1 


- 


2 


- 


1 


1 


- 


- 


9 


_ 


189 


1 


- 


9 


1 


2 


- 


2 


- 


- 


- 


2 


- 


- 


- 


- 


- 


- 


- 


- 


- 


8 


- 


190 


- 


- 


- 


1 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 


2 


3 


- 


- 


- 


- 


_ 


_ 


191 


- 


- 


- 


- 


2 


- 


1 


- 


- 


- 


- 


- 


1 


- 


- 


- 


- 


- 


1 


- 


5 


_ 


192 


- 


- 


- 


1 


20 


1 


2 


- 


- 


- 


1 


- 


- 


- 


1 


1 


- 


- 


_ 


- 


_ 


_ 


193 


- 


- 


- 


- 


20 


- 


121 


- 


- 


- 


- 


- 


- 


- 


8 


2 


- 


- 


1 


- 


61 


- 


194 


- 


- 


- 


6 


10 


- 


5 


- 


- 


- 


- 


- 


- 


- 


2 

1 

11 


- 


1 
1 


- 


- 


- 


1 


- 


195 
196 
197 


_ 


_ 


_ 


_ 


13 


_ 


_ 


_ 


_ 


_ 


2 


_ 


_ 


_ 


_ 


1 


_ 


_ 


2 


_ 


- 


- 


- 


- 


15 


- 


3 


- 


- 


- 


- 


- 


- 


- 


5 


- 


- 


- 


1 


- 


6 


- 


198 


8 


1 


1 


2 


8 


_ 


- 


_ 


- 


- 


- 


- 


- 




2 


1 


_ 


- 


_ 


_ 


1 


_ 


199 


4 


- 


2 


2 


1 


- 


1 


- 


- 


- 


2 


- 


- 


1 


1 


1 


- 


- 


11 


- 


1 


- 


200 


- 


- 


- 


- 


1 


- 


- 


- 


- 


- 


3 


- 


- 


- 


1 


1 


- 


- 


- 


- 


- 


- 


201 


- 


1 


- 


2 


6 

1 


- 


- 


- 


- 


- 


2 
2 

2 


- 


1 


- 


16 


37 


- 


- 


- 


- 


4 
4 


- 


202 
203 
204 


_ 


_ 


1 


1 


1 


_ 


_ 


_ 


_ 


_ 


_ 


_ 


2 


1 


_ 


_ 


2 


_ 


_ 


- 


- 


- 


- 


1 


- 


- 


- 


- 


- 


6 


3 


- 


- 


2 


1 


- 


- 


- 


- 


- 


- 


205 


- 


- 


1 


1 


18 


- 


- 


- 


- 


- 


22 


- 


- 


- 


3 


2 


- 


- 


- 


- 


_ 


_ 


206 


- 


1 


- 


1 


5 


- 


4 


- 


- 


- 


10 


- 


- 


- 


1 


- 


- 


- 


- 


- 


- 


- 


207 
208 
209 


4 


_ 


_ 


42 


_ 


1 


_ 


1 


_ 


_ 


1 


_ 


2 


1 


_ 


_ 


1 


_ 


5 


1 


1 


- 


- 


1 


2 


- 


- 


- 


- 




2 


- 


- 


- 


- 


- 


- 


- 




- 


- 


- 


210 


•- 


- 


2 


- 


20 


- 


1 


- 


- 


- 


6 


- 


- 


- 


1 


- 


- 


- 


- 


- 


8 


- 


211 


- 


- 


- 


- 


46 


- 


52 


- 


1 


— 


8 
1 


1 


- 


- 


1 


2 


- 


- 


1 


- 


- 


- 


212 
213 


- 


- 


- 


- 


- 


- 


- 


- 


— 


- 


- 


- 


- 


- 


3 


70 
2 


- 


- 


- 


- 


- 


1 


214 
215 


- 


- 


1 


- 


82 


- 


76 


- 


- 


- 


1 


- 


- 


- 


- 


1 


- 


- 


- 


_ 


- 


- 


216 


5 


- 


4 


1 


- 


- 


3 


- 


- 


- 


- 


- 


- 


- 


2 


- 


- 


- 


- 


- 


11 


- 


217 


- 


~ 


- 


1 


1 


- 


- 


- 


- 


- 


- 


- 


- 


- 


- 




- 


1 


1 


- 


18 


_ 


218 


1 




- 


1 


3 
2 


- 


2 


- 


- 


- 


7 


- 


- 


- 


1 
3 


- 


- 


- 


- 


- 


- 


- 


219 
220 
221 


_ 


_ 


_ 


1 


_ 


_ 


_ 


_ 


4 


_ 


_ 


_ 


~ 


_ 


_ 


_ 


_ 


2 


_ 


- 


- 


- 


1 


28 


1 


1 


- 


- 


- 


9 


1 


- 


1 


- 


5 


- 


- 


3 


_ 


- 


1 


222 


1 


1 


1 


— 


1 


— 


32 


— 


_ 


- 


2 


— 


- 


— 


3 


1 


— 


— 


— 


— 


48 


— 


223- 



230 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Cases and Deaths from Diseases Dangerous 



Cities and Towns grouped 
IN Order op Popdlation. 



Millis . 

Freetown . 

West Newbury 

Cheshire . 

Dennis 

Sandwich . 

Duxbury 

Huntington 

Shelburne . 

Essex . 

Lakeville . 

Buckland . 

Brookfield . 

Pembroke . 

Bedford 

Plainville . 

Erving 

Westwood . 

Sheffield . 

Nahant 

Littleton 

Sunderland 

Chester 

North Reading 

Norwell 

Russell 

West Brookfield 

Sterling 

Marshfield . 

Whately . 

Westminster 

Tisbury 

Mattapoisett 

Marion 

Newbiu-y . 

Lynnfield . 

Rowley 

Yarmouth . 

Edgartown 

Middleton . 

Clarksburg 

Southwick 

Norfolk 

Wenham 

Sudbury 

Stow 

Tyngsborough 

Lanesborough 

Hubbardston 

Rochester . 

Hinsdale 

New Marlborough 

West Stockbridge 

Oak Bluffs 

Mendon 

Orleans 

Lincoln 

Burlington 

Berkley 

East Brookfield 

Conway 

Berlin 

Gill . 



Popu- 
lation 

esti- 
mated 

as of 
July 1, 

1921. 



1,499 
1,491 
1,480 
1,458 
1,446 
1,445 
1,437 
1,425 
1,421 
1,415 
1,397 
1,390 
1,366 
1,364 
1,361 
1,352 
1,335 
1,330 
1,300 
1,297 
1,292 
1,292 
1,289 
1,284 
1,280 
1,279 
1,279 
1,274 
1,270 
1,270 
1,264 
1,260 
1,253 
1,225 
1,213 
1,182 
1,177 
1,171 
1,163 
1,159 
1,143 
1,140 
1,125 
1,097 
1,094 
1,093 
1,068 
1,043 
1,033 
1,011. 
1,005 
1,004 
989 
984 
970 
964 
958 
927 
920 
900 
880 
869 
857 



22 

An- 
terior 
Polio- 
mye- 
litis. 



25A 



Chicken 
Pox. 



03 

o 



2 

1 

13 

3 

1 



10 



Diph- 
theria. 



C8 



24 

Ep. 
Cere- 
bro- 
spinal 
Menin- 
gitis. 



25B 

Ger- 
man 
Mea- 
sles. 



40 



Gonor- 
rhea. 



03 

o 



S3 



10 



2 
2 
4 
15 
3 
1 
1 
4 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



231 



to the Public Health, 1921 — Continued. 



n 

Influ- 
enza. 


101 

Lobar 
Pneu- 
monia. 


7 

Measles. 


13 

Mumps. 


40A 

Oph- 
thalmia 
Neona- 
torum. 


8 

Scarlet 
Fever. 


38 

Syphi- 
lis. 


31, 37, 
37A, 37B 

Tuber- 
culosis, 
Pulmo- 
nary. 


32-36E 

Tuber- 
culosis, 
Other 
Forms. 


1 

Ty- 
phoid 
Fever. 


9 

Whoop- 
ing 
Cough. 




6 


CO 


en 

d 


P 


03 


a 


i 
6 




6 


o 

G 




05 

<u 




oi 

6 


Q 


O 


P 


03 

6 




m 


03 

P 


s 
6 


03 

ci 
a) 

P 


6 

c 

3 


1 
1 

3 

1 

1 
2 
2 

1 

1 
1 


1 
1 

1 


3 

2 

2 

1 
2 

1 

1 

1 
1 

1 
2 

2 
2 

1 
1 

4 

1 


1 
2 
2 
2 
2 
2 
1 
2 

1 

1 

1 
1 

1 
1 
1 

1 

3 

_ 
1 
1 

1 

i 

1 

1 
3 

1 


1 

2 

7 
20 
10 
90 

1 

1 

1 
7 

56 

27 
4 
5 

35 

7 

32 
3 
2 
4 

2 

1 

6 

27 

1 

60 

31 

4 

15 

37 

2 
6 

1 

1 

4 


1 

_ 

1 


1 

1 

12 

34 

13 
6 

1 

1 

3 

1 

1 
2 

1 

1 
1 
2 
1 

2 
2 

4 




1 

1 


_ 
- 


3 

1 

8 
1 
6 

3 

7 
7 
1 
1 
2 
2 

1 
2 

4 

2 

10 

1 
1 

1 

3 
3 

7 
4 
2 
1 
3 
1 
7 

1 

1 
3 
1 
3 

1 

I 

2 

1 
3 

~ 

6 

16 

4 

3 
5 

2 


1 

1 

1 
1 


1 
_ 


1 
1 


1 

4 
2 
2 
1 
1 
5 

22 

2 

2 
2 

2 

2 

1 

3 
2 

1 
3 

2 

1 

1 
2 

5 


3 
2 

2 

80 

1 

2 
2 

36 

3 

1 
2 

1 

1 
1 
1 
2 

19 

1 

1 

1 

1 
2 

3 

1 


1 
1 

1 
1 

1 


1 

2 
1 

1 
1 

1 
1 

1 


1 

1 
1 

2 
4 

1 

1 
1 

1 


1 
1 


1 

14 
11 

1 

1 

4 

3 

1 

26 
2 
1 

1 
45 

2l 

43 

3 
6 

7 


_ 

2 

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 



232 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Cases and Deaths from Diseases Dangerous 





Cities axd Towns grouped 
IN Order of Population. 


Popu- 
lation 
esti- 
mated 
as of 
July 1, 
1921. 


22 

An- 
terior 
Polio- 
mye- 
litis. 


25A 

Chicken 
Pox. 


10 

Diph- 
theria. 


24 

Ed, 
Cere- 
bro- 
spinal 
Menin- 
gitis. 


25B 

Ger- 
man 
Mea- 
sles. 


40 

Gonor- 
rhea. 


6 




O 


CQ 

C3 
O 

Q 


GO 

6 


CO 

a 

Q 


6 


(3 




CO 

P 


03 

d 




1 


CO 

Q 


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 


AshBeld 

Dover 

Topsfield 

Ashby 

Royalston 

Boylston 

Well fleet 

Enfield 

Southampt( 

Granby 

Bernardstoi 

Charlemont 

Brimfield 

Bolton 

Leverett 

Brewster 

Princeton 

Carver 

Granville 

Petersham 

Hampden 

Becket 

Dana . 

Richmond 

Boxford 

Halifax 

Truro 

Pelham 

Paxton 

New Salem 

Oakham 

Carlisle 

Hancock 

Wales 

Cummingtc 

Blandford 

Plympton 

Sandisfield 

Windsor 

Savoy 

Chesterfielc 

Eastham 

Egremont 

Greenwich 

Hawley 

New Brainf 

Dunstable 

Phillipston 

Worthingto 

Otis . 

Wendell 

Leyden 

Plainfield 

West Tisbu 

Heath 

Rowe 

Boxborougl 

Warwick 

Middlefield 

Westhampt 

Monterey 

Florida 

Tyringham 


3n 
1 

)n 

ree 
n 

ry 

1 

on 








830 
825 
814 
807 
806 
797 
792 
785 
771 
764 
763 
755 
729 
689 
668 
658 
645 
636 
615 
615 
609 
580 
563 
560 
549 
539 
520 
504 
495 
476 
462 
454 
449 
445 
435 
434 
428 
427 
412 
409 
404 
394 
391 
390 
378 
376 
350 
343 
343 
336 
333 
326 
319 
315 
307 
304 
289 
280 
266 
266 
258 
258 
248 


1 

1 
1 


1 


2 

2 

15 

6 
4 

1 
1 


- 


5 
2 

2 
5 
3 

3 

1 

3 
2 

5 

1 
2 


1 


1 

_ 

1 


1 

1 


7 
2 


- 


1 

1 
1 

1 

1 

_ 

1 
1 

_ 


- 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



2.33 



to the Public Health, 1921 - 


- Continued. 
























11 

Influ- 
enza. 


101 

Lobar 
Pneu- 
monia. 


7 

Measles. 


13 

Mumps 


40A 

Oph- 
thalmia 
Neona- 
torum. 


8 

Scarlet 
Fever. 


38 

Syphi- 
lis. 


31,37, 
37A, 37B 

Tuber- 
culosis, 
Pulmo- 
nary. 


32-36E 

Tuber- 
culosis, 
Other 
Forms. 


1 

Ty- 
phoid 
Fever. 


9 

Whoop- 
ing 
Cough. 




1 


Q 


6 


03 


6 


CO 

o 

Q 


6 


•4-> 


a 
O 


in 

m 
Q 


J 


-C 
o 

p 


i 


P 


03 

6 


P 


cc 

6 


!0 

p 


J 


to 

-a 

1 

p 


O 




6 

3 


_ 

3 


1 


1 
1 

1 

1 

1 
1 


2 

1 
1 

1 
1 

2 

1 

1 
2 

1 
1 

1 
2 

1 
1 


14 

25 
3 

24 
4 
7 
1 
2 

5 

4 

1 

9 

12 
96 
18 

4 

1 
1 

3 

1 

14 
37 


2 

1 
1 


_ 
1 

1 

4 

27 

_ 

7 
11 

3 

1 
1 


- 


1 

_ 


~ 


3 

12 

1 

12 
2 

1 
4 

4 

1 

1 

1 

_ 

2 

1 
7 

1 
1 


_ 


1 
1 

_ 


_ 


1 
1 

1 

1 

1 
1 

2 

1 
1 

4 
4 


2 

1 

1 

1 

1 
1 
2 

1 

1 
1 

1 
2 

1 


1 


1 

1 
1 


1 

1 

1 

1 


1 


4 
3 

10 

2 
9 

6 

1 

9 

1 

1 

12 

2 


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 

211 

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 



234 



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, 

1921. 


22 

An- 
terior 
Polio- 
mye- 
litis. 


25A 

Chicken 
Pox. 


10 

Diph- 
theria. 


24 

Ep. 
Cere- 
bro- 
spinal 

Menin- 
gitis. 


25B 

Ger- 
man 
Mea- 
sles. 


40 

Gonor- 
rhea. 


6 
o 
3 


6 


.a 

03 
O 




05 

O 

6 






Q 


i 

6 




6 


to 

-a 

Q 


a 


P 


350 
351 
352 
353 
354 
355 
356 
357 
358 
359 
360 
361 
362 
363 
364 
365 

366 

367 


Alford 

Mash pee 

Montgomer 

Washington 

Shutesbury 

Chilmark 

Prescott 

Goshen 

Tolland 

Holland 

Gay Head 

Monroe 

Peru . 

Gosnold 

New Ashfo 

Mount Was 

Camp Dev 

State Infi 


y 

rd 
hingt 

ens 

RMAR 


on 

y, T 


EWKSBURY 


241 

236 
229 
229 
227 
225 
216 
203 
190 
151 
135 
134 
134 
124 
124 
66 


- 


- 


1 

19 


- 


1 

15 


2 


2 




- 


- 


35 
28 


- 



In addition to the above there 
occurred 2 cases of actinomy- 
cosis, with 1 death : — 

Boston 

Cambridge .... 



6 cases of anthrax: — 
Danvers 
Deerfield 
Haverhill . 
Lynn . 
Wayland 
Worcester . 



118 cases of dog bite (requiring 
antirabic treatment): — 
Arlington . 
Billerica 
Boston 
Braintree . 
Bridgewater 
Brookline . 
Charlton 
Chelmsford 
Dighton 
Everett 
Fall River . 
Framingham 
Freetown . 
Granby 
Hingham . 
Holbrook . 
Holyoke 
Lawrence . 
Lexington . 
Lowell 
Lynn . 
Natick 
New Bedford 
Newton 



Cases. 
1 
1 



1 
2 

8 
1 
1 
4 
1 
6 
1 
2 

16 
1 
1 
1 
1 
1 
2 

12 
2 

24 
5 
1 
1 
1 



Deaths. 



North Adams 
North Attleborough 
Pittsfield . 
Plainville . 
Somerville . 
South Hadley 
Springfield . 
Swansea 
Taunton 
Webster 
Weymouth . 
Winthrop . 
Woburn 
Worcester . 
Wrentham . 



25 cases of dysentery, 
deaths: — 
Adams 
Ayer . 
Bellingham 
Beverly 
Boston 
Braintree 
Cambridge 
Clinton 
Concord 
Danvers 
Everett 
Fall River 
Framingham 
Great Barrington 
Hardwick 
Haverhill 
Holden 
Holyoke 
Ipswich 
Maiden 
Marshfield 



ith 23 



Cases. Deaths. 
2 



1 
2 

1 
1 



1 
1 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



235 



to the Public Health, 1921 - 


- Concluded. 
























11 

Influ- 
enza. 


101 

Lobar 
Pneu- 
monia. 


7 

Measles. 


13 

Mumps. 


40A 

Oph- 
thalmia! 
Neona- 
torum. 


8 

Scarlet 
Fever. 


38 

Syphi- 
lis. 


31, 37. 
37A. 37B 

Tuber- 
culosis, 
Pulmo- 
nary. 


32-36E 

Tuber- 
culosis, 
Other 
Forms. 


1 

Ty- 
phoid 
Fever. 


9 

Whoop- 
ing 
Cough. 




U 


Q 


i 


Q 


i 


a> 
P 




o 

n 




g 

Q 




cn 

Q 


03 

ll> 


CQ 

03 


6 




8 


03 

C3 
o 

p 


1 


CO 


6 


4) 
P 


d 


36 


- 


1 

22 


1 
1 

i 

8 


4 

1 

5 
9 


- 


7 
4 

3 


- 


- 


- 


11 

4 


- 


2 
7 


14 


70 


85 


4 


2 


5 


1 


19 


- 


350 
351 

352 
353 
354 
355 
356 
357 
358 
359 
360 
361 
362 
363 
364 
365 

366 

367 



Medford 
North Adams 
Oxford 
Plainfield . 
South bridge 
Sutton 
Warren 
Watertown . 
Woburn 
Worcester . 



117 cases of encephalitis le- 
thargica, with 74 deaths: — 
Adams 
Arlington 
Attleboro 
Bedford 
Belmont 
Beverly 
Boston 
Braintree 
Brockton 
Brookline 
Cambridge 
Chelsea 
Chicopee 
Dan vers 
Douglas 
Dudley 
Easthampton 
Everett 
Fall River 
Fitchburg 
Framingham 
Gloucester 
Greenwich 
Haverhill 
Holyoke 
Lawrence 



ases. 


Deaths. 










- 


1 


Lowell .... 


- 


1 


Ludlow 








- 


1 


Lynn . 








5 


- 


Marlborough 








- 


1 


Melrose 








- 


1 


Mendon 








1 


_ 


Milford 








- 


1 


Millbury 








- 


1 


Milton 








1 


3 


Newbury . 
Newburyport 
Newton 
North Adams 








1 


1 


Northampton 








1 


- 


Norwood 








- 


1 


Peabody 








1 


1 


Quincy 








1 


- 


Salem 








1 


1 


Somerset 








40 


29 


Somerville . 








1 


- 


Springfield . 








— 


2 


Swampscott 








2 


2 


Wakefield . 








2 


_ 


Waltham . 








1 


1 


Watertown . 








1 


_ 


Webster 








1 


1 


Weymouth . 








1 


- 


Winchendon 








1 


- 


Winthrep . 








1 


- 


Worcester . 








3 


1 




2 


2 




1 


1 


1 case of hookworm : — 


- 


1 


Boston 


1 
3 


1 




_ 


1 case of leprosy, with 1 


3 


1 


death; — 


2 


3 


Boston 




, 


, 



Cases. Deaths. 
2 2 



236 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



49 cases of malaria, with 2 






37 cases of smallpox: 


— 




Cases. 


Deaths 


deaths: — Cases. 


Deaths. 


Boston 


6 


- 


Boston 18 


- 


Gloucester . 








2 


_ 


Brockton . 








2 


- 


j\Ialden 








3 


_ 


Chelsea 








4 


- 


Methuen 








12 


- 


Dedham 








6 


- 


Salem 








7 


_ 


Douglas 








1 


- 


Tisbury 








1 


_ 


Dover 








1 


- 


Worcester . 








6 


- 


Fall River . 








3 


- 






Fitchburg . 








1 


- 






Framingbam 








1 


- 


39 cases of tetanus, with 25 




Holyoke 








1 


- 


deaths : — 




Methuen 








1 


- 


Barnstable 1 


1 


Milford 








2 


- 


Beverly 








1 


1 


Newton 








1 


- 


Boston 








9 


6 


Northampton . 








1 


1 


Brockton . 








1 


1 


Northbridge 








2 


- 


Brookline . 








- 


1 


Taunton 








1 


- 


Cambridge 








2 


- 


Westport 








- 


1 


Chelsea 








1 


- 


Winthrop . 








1 


- 


Clinton 








1 


1 


Worcester . 








2 


- 


Dennis 








1 


- 








Fall River . 








2 


2 


14 cases of pellagra, wil 


,h 14 




Fitchburg . 








2 


2 


deaths: — 






Haverhill . 








1 


1 


Boston .... 


5 


4 


Leominster 








1 


1 


Brockton 






1 


- 


Lowell 








1 


- 


Danvers 






5 


4 


Lynn . 








1 


1 


Northampton 






1 


3 


New Bedford 








V 2 


1 


Salem 






- 


1 


North Adams 








1 


I 


Waltham 






2 


1 


Oak Bluffs . 








- 


1 


Winchester . 






_ 


1 


Peabody 








1 








Pittsfield . 








3 


3 


1 case of rabies, with 3 deaths: — 




Salem 








2 


_ 


Boston 1 


1 


Shirley 








1 


_ 


LawTence 


2 


Springfield . 
Taunton 








1 

1 


1 


140 cases of septic sore throat, 




Winchester . 








1 


_ 


with 42 deaths : — 




Worcester . 








1 


- 


Arlington 1 


- 






Ayer . 








1 


- 






Belmont 








1 


- 


97 cases of trachoma: — 




Berlin 








- 


1 


Arlington 1 


_ 


Boston 








56 


10 


Boston 








42 


_ 


Braintree . 








1 


- 


Braintree . 








2 


_ 


Bridgewater 








1 


1 


Brockton 








1 


_ 


Brockton . 








2 


1 


Cambridge 








3 


_ 


Brookline . 








1 


- 


Chelsea 








4 


- 


Cambridge 








7 


- 


Everett 








1 


_ 


Chieopee . 








2 


- 


Fall River . 








1 


_ 


Clinton 








; 1 


- 


Fitchburg . 








3 


- 


Dracut 








- 


1 


Haverhill . 








1 


- 


Easthampton 








. 


1 


Holliston 








1 


- 


Fairhaven . 








1 


1 


Lancaster . 








1 


- ■ 


Fall River . 








2 


1 


LauTence . 








2 


- 


Fitchburg . 








'. 1 


_ 


Lowell 








o 


_ 


Framingham 








- 


1 


Lynn . 








; 4 


_ 


Haverhill . 








1 


- 


Medford 








2 


- 


Holyoke 








- 


2 


Methuen 








1 


- 


LawTcnce . 








4 


1 


Noedham . 








1 


- 


Leominster 








2 


1 


Newton 








1 


_ 


Lowell 








7 


6 


Northbridge 








1 


_ 


Lynn . 








3 


2 


Norwood 








1 


_ 


Maiden 








1 


1 


Plymouth . 








1 


_ 


Mansfield . 








1 


- 


Somerville . 








5 


- 


Methuen 








6 


_ 


Springfield . 








1 


_ 


Middleborough 








1 


- 


Taunton 








1 


_ 


New Bedford 








4 


- 


Wakefield . 








1 


- 


Newburyport 








7 


4 


Watertown . 








2 


- 


Newton 








3 


1 


West Springfield 








1 


- 


North Adams 








- 


1 


Whitman 








1 


- 


Peabody 








1 


_ 


Worcester . 








8 


_ 


Pittsfield . 








- 


1 






Saugus 








2 


- 






Somerset 








'. 1 


- 


10 cases of trichinosis, with 1 




Somerville . 








3 


- 


death : — 




Springfield . 








2 


1 


Boston 1 


- 


Stoughton 








2 


- 


Maynard 


. 






1 


- 


Sutton 








1 


- 


Somerville . 








1 


- 


Taunton 








1 


1 


Winchester . 








6 


- 


Wakefield . 








2 


_ 


Worcester . 








1 


1 


Watertown . 








\ 2 


- 






West Springfield 








'. 1 


- 






Westford 








1 


- 


2 cases of typhus fever, with 1 




Westport 








1 


- 


death : — 




Winthrop . 








1 


- 


Boston 1 


- 


Worcester . 








1 


1 


Gloucester . 


. 




. 


1 


1 



No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



237 



Cases and Deaths, with Case and Death Rates, per 100,000 Population 
FOR All Reportable Diseases during the Year 1921. 



Disease. 



Cases. 



Deaths. 



Case 
Rate. 



Death 
Rate. 



Fatality 
Rate. 



Actinomycosis .... 
Anterior poliomyelitis 

Anthrax 

Chicken pox .... 
Diphtheria .... 

Dog bite 

Dysentery .... 
Encephalitis lethargica i . 
Epidemic cerebrospinal meningitis 
German measles 
Gonorrhea .... 
Hookworm .... 

Influenza 

Leprosy 

Malaria 

Measles 

Mumps 

Ophthalmia neonatorum 2 
Pellagra ...... 

Pneumonia, lobar . . . , 

Rabies 

Scarlet fever . . . . , 
Septic sore throat . . . , 

Smallpox 

Syphilis 

Tetanus 

Trachoma 

Trichinosis 

Tuberculosis, pulmonary 
Tuberculosis, other forms 

Typhoid fever 

Typhus fever 

Whooping cough . . . , 
Totals 



2 

233 

6 

8,324 

9,100 

118 

25 

117 

164 

649 

5,563 

1 

735 

1 

49 

17,827 

3,952 

1,573 

14 

4,080 

1 

8,331 

140 

37 

2,497 

39 

97 

10 

6,168 

827 

917 

2 

5,703 



1 

47 



603 

23 
74 
58 



155 
1 
2 

174 
6 

14 

1,818 

3 

189 

42 

198 
25 

1 

3,304 

551 

121 

1 

197 



77,302 



7,621 



.1 

6.0 

.2 

213.3 

233.2 

3.0 

.6 

3.0 

4.2 

16.6 

142.5 

18.8 

1.3 

456.8 

101.3 

40.3 

.4 

104.5 

213.5 

3.6 

.9 

64.0 

1.0 

2.5 

.3 

158.0 

21.2 

23.6 

.1 

146.1 



1,980.7 



1.2 

.2 
15.5 

.6 
1.9 
1.5 



4.0 

.1 

4.4 
.2 

.4 
46.6 

.1 
4.8 
1.1 

5.1 
.6 



84.7 

14.1 

3.1 

5.0 



195.3 



50.0 
20.2 

.1 

6.6 

92.0 
63.2 
35.4 



21.1 

100.0 

4.1- 

1.0 

.2 

100.0 
44.6 

300.0 

2.3 

30.0 

7.9 
64.1 

10.0 
53.6 
66.6 
13.2 
50.0 
3.5 



9.9 



I Made reportable March 1, 1921. 



2 Includes suppurative conjunctivitis. 



238 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 






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No. 34.] DIVISION OF COMMUNICABLE DISEASES. 



239 



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Division of Biologic Laboratories 



Benjamin White, Ph.D., Director 

William A. Hinton, M.D., Assistant Director 

Robert N. Nye, M.D., Assistant Director 



[241] 



Eepoet of Division of Biologic Laboratories. 



Antitoxin and Vaccine Laboratory. 

The activities of this laboratory may be best discussed under the 
following headings: — 

1. Production and distribution. 

2. Improvements: 

(a) In methods and production. 
(6) In plant and equipment. 

3. Expenses. 

4. Personnel. 

5. Educational activities. 

6. Rdsum6. 

1. Production and Distributio7i. 

The accompanying table shows the amounts of the various biologic 
products distributed during the fiscal years 1920 and 1921. 



Product. 


1920. 


1921. 


1. Diphtheria antitoxin: 

Distributed (1,000 unit doses) 

2. Antimeningococcic serum : 

Distributed fdoses) 

3. Antipneumococcic serum : 

Distributed (doses) 

4. Smallpox vaccine: 

Distributed Ccapillary tube.s) 

5. Typhoid-paratyphoid vaccine: 

Distributed (doses) 

6. Schick outfits: 

Distributed (doses) 

7. Diphtheria toxin for Schick test: 

Distributed tcubic centimeters in bulk) 

8. Diphtheria toxin-antitoxin mixture: 

Distributed (doses) 

9. Normal serum: 

Distributed (cubic centimeters) 


218,227 

3,585 

444 

189,064 

49,191 

6,300 



3,614 




261,024 

3,444 

649 

197,733 

55,804 

54,750' 

32 

9,414 

9,788 



One outfit equals 50 doses. 



244 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

(a) Diphtheria Antitoxin. — From this table it is to be seen that 
the distribution of diphtheria antitoxin exceeds the amounts of any 
previous year. This unprecedented demand has been met from the 
reserve stocks mentioned in last year's report. 

(6) Antimeningococcic Serum. — The amount of this product dis- 
tributed remains approximately the same as last year. 

(c) Antipneumococcic Serum. — There was approximately a 46 per 
cent increase in the amount of this product distributed. 

(d) Vaccine Virus. — This item shows a 5 per cent increase. 

(e) Bacterial Vaccine made from Typhoid and Paratyphoid A and 
B Bacilli. — There was a 12 per cent increase in the distribution of 
this product. 

(/) Schick Outfits. — There were 1,095 outfits distributed in 1921 
against 63 outfits in 1920. This great increase may be considered as 
a direct result of the active campaign carried on by the State Depart- 
ment of Public Health during the year. 

(g) Diphtheria Toxin-antitoxin Mixture. — The 160 per cent increase 
in the distribution of diphtheria toxin-antitoxin mixture is most 
gratifying. Each month shows a progressive increase in the number 
of doses distributed and there is every reason to expect that this pro- 
gressive increase will continue for some time to come. Every lot dis- 
tributed has met every requirement of the United States Hygienic 
Laboratory, and in addition has been safeguarded by duplicate tests. 

2. Improvements. 

(a) The various methods of making the different biologic products 
have been refined, and the potency, sterility and safety tests have been 
amplified in excess of the government requirements. Further improve- 
ments in the packages and in the pamphlets accompanying the 
products are under way. 

Owing to the fact that the success in producing more potent toxin 
has resulted in a higher degree of immunity in the horses and to the • 
higher degree of efficiency developed in the concentration process, the 
potency of the diphtheria antitoxin shows a marked increase, and it is 
now possible to put out a much more concentrated antitoxin. 

(6) The physical condition of the laboratory has been greatly im- 
proved by the painting of four rooms and the basement, by the addi- 
tion of new apparatus, which greatly facilitates the work, and par- 
ticularly by the installatio;i of an incubator room. Although this 
incubator room cost approximately $1,300 to construct and install, its 
operation has resulted in a marked reduction in electric current bills; 



No. 34.] DIVISION OF BIOLOGIC LABORATORIES. 245 

it takes the place of four other incubators and provides sufficient in- 
cubating space to accommodate any future expansion of the work. 
On account of its dependability, the lots of diphtheria toxin prepared 
since its installation show a greater uniformity and higher degree of 
potency than formerly. 

3. Expenses. 

A table showing the comparative amounts spent for personal services 
and expenses in 1920 and 1921 follows: — 



1920. 



1921. 



Personal ser^'^ce 
Expenses 
Total 



?23,094 16 
23,742 37 



S46,836 53 



$28,610 41 
24,500 46 



$53,110 87 



The increase in appropriation has been necessary to put the labora- 
tory in better physical condition, to supply much needed apparatus, 
to meet the increased production, and for the salaries of added as- 
sistants. Further increase, as already requested in budget estimate for 
1922, will be necessary if this laboratory is to meet the demands made 
upon it by the physicians of the Commonwealth. 

The laboratory has been fortunate in having horses presented and 
has, to a large extent, been spared the necessity of purchasing animals 
for serum production. 

4. Personnel. 

The former assistant director resigned in October, 1921, and the 
position has been filled by the appointment of Dr. Robert N. Nye. 
The director feels that on account of the training, experience and the 
scientific and personal qualifications of Dr. Nye the Department is to 
be congratulated upon this appointment. 

During the past year two assistant bacteriologists Grade II, one 
laboratory assistant Grade I, one laborer, female, and one laborer, 
male, have been added to the staff. These additions have been made 
necessary partly by Federal requirements and partly on account of the 
increased activities of the laboratory due to the greatly increased de- 
mand for its products. With the appointment of Mr. Bemis, it will 
now be possible to concentrate practically all the diphtheria antitoxin 
produced in this laboratory. With the appointment of Miss Harris, 
the amplification of control tests on biologic products has been made 
possible, and through the appointment of the two laborers the cleanli- 
ness of the laboratory and stable has been markedly increased. 



246 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



5. Educational Activities. 

This laboratory has continued, to a greatly increased extent, its 
function as a place of instruction for physicians, medical and other 
college students, nurses and the general public in the preparation and 
use of biologic products and their application in preventive medicine. 
During the year 12 demonstrations have been given to a total of 526 
people. The results of this educational work are shown by the interest 
aroused not only in private physicians, but in officials of various insti- 
tutions, which has been manifested in their adoption and increased use 
of biologic products. In addition to this phase of the work, the 
director has also addressed medical, college and lay organizations on 
the achievements of preventive medicine and on the use of biologic 
products. 

The greatest educational activity of this Division has been in the 
campaign to introduce and extend the use of the Schick test and 
diphtheria toxin-antitoxin mixture for the prevention of diphtheria. 
Clinics, demonstrations and lectures have been given before medical 
societies, before the Massachusetts Association of Boards of Health 
and before meetings arranged by boards of health, and popular talks 
have been given before school children, teachers and parents. Nearly 
everywhere this campaign has been met with eagerness and with the 
active co-operation of health officers, physicians and school officials. 
One phase or another of this work has been carried on in the following 
towns, and largely as a result of this work clinics have been established 
in all these towns, either by the board of health or the school board, 
and the use of the Schick test has been supplemented by the use of 
toxin-antitoxin mixture by practicing physicians in these localities. 



Cities and Towns in which the Schick Test has been deynonstrated. 

Lynn. Waltham. 

Newton. ' Wellesley. 

North Reading. Winchendon. 

SOMERVILLE. 



Cambridge. 
Fall River. 
Foxborough. 
Hingham. 
Lawrence. 



Worcester. 



On account of the importance of this work, it is intended to devote 
much time to its continuation during the coming year. 

The laboratories of the Division have served to a greater extent as 
places of instruction to students and public health workers. During 
the past year students from the Harvard Medical School and foreign 
students, fellows of the International Health Board, have acted as 



No. 



34.] 



DIVISION OF BIOLOGIC LABORATORIES. 



24; 



voluntary assistants in the laboratory. It is hoped that the labora- 
tories may further serve as teaching centers for health workers in the 
public health field. 

6. Resume. 

The greatly increased distribution of biologic products is undoubtedly 
due to the educative campaign carried out by the Department and by 
the hearty interest and co-operation shown by the various local boards 
of health, institutions and practicing physicians throughout the State. 
The Director desires to record here his deep appreciation of the 
courtesy and co-operation extended to him by these various agencies 
and individuals. 

Acknowledgment should also be made of the faithful and conscien- 
tious services rendered by the majority of the employees of this labora- 
tory during the year, demanded of them by the labor resulting from 
the increased production. 

The increased distribution of products has taxed both the personnel 
and the capacity of the present laboratory to the utmost, and should 
this increase progress still further, it will be necessary to provide 
larger accommodations for this work. 



Wassermann Laboratory. 

The general character of the work and the number of personnel of 
the Wassermann Laboratory have not changed during the past year. 
There has been, however, a noteworthy increase in the number of tests, 
as indicated by the following table: — 





1916. 


1917. 


1918. 


1919. 


1920. 1921. 


Wassermann tests 

Gonococcvis fixation tests 

Lange's colloidal gold tests 

Diagnostic examinations for the Divi- 
sion of Animal Industry: 
(0) Complement fixation tests for 
glanders. 

(b) Examinations for rabies 

(c) Pathologic and bacteriologic ex- 

aminations. 


25,497 

985 
47 
10 


28,524 

1,330 

67 

3 


27,534 

646 
61 
45 


31,485 
222 

122 
84 

79 


36,953 
1,726 

221 

166 

64 


42,679 
1,703 

82 

125 

277 
50 




26,539 


29,924 


28,236 


31,992 


39,130 


44,916 



It is to be noted from this table that the total number of tests for 
each succeeding year has shown an increase except for 1918. This was 
undoubtedly due to the pandemic of influenza which largely occupied 
the attention of medical men. 



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

Lange's colloidal gold test was added because of insistent requests 
from the State-approved venereal clinics to furnish a more complete 
examination of spinal fluid for the "discharge cases" of treated 
syphilis and the diagnosis of neurosyphilis. 

The increase in the number of Wassermann tests (15| per cent) with 
the present personnel has been possible only by a high degree of 
efficiency on the part of the individual workers. This is likewise true 
of the diagnostic tests for rabies, which show an increase of 67 per 
cent. These two classes of examinations constitute approximately 90 
per cent of the laboratory's work. 

The requests for complement fixation tests for glanders have de- 
creased owing to the slight prevalence of this disease. The peak of 
the crest reached during 1917 was due, undoubtedly, to the fact that 
thousands of mules and horses were brought into the State by the 
United States Army. 

In addition to the above, a statistical investigation has been carried 
on in connection with 10,431 cases of pregnancy, which were consecu- 
tive admissions to four large institutions, and it therefore represents 
an analysis of the incidence of syphilis among married women. Three 
and three-quarters per cent gave a positive reaction and 3^ per cent a 
doubtful reaction, leaving 93 per cent showing no evidence of syphilis 
as indicated by the Wassermann test. There was a variation in the 
age groups, the incidence of positive reactions being shghtly larger in 
the younger than in the older women. A marked difference was noted 
in the incidence of positive reactions (syphilis) among the various 
racial groups, showing as low as 0.9 per cent among Greeks and 33 per 
cent among negroes A detailed account of this investigation is being 
prepared for publication in one of the current medical journals. 



Division of Hygiene 



Merrill E. Champion, M.D., Director 
Mary R. Lakeman, M.D., Assistant Director 



[249] 



Report of Division of Hygiene. 



The work of the Division of Hygiene has not extended into any 
particularly new fields during 1921, but has represented a measured 
and healthy progress along paths which have been gradually cleared 
during the past few years. Extension of our work is now made diffi- 
cult by lack of money and personnel, to say nothing of lack of actual 
office space. 

Geneeal Survey. 

It may not be amiss to recapitulate the various activities of the 
Division of Hygiene. Broadly speaking, they are educational in 
character. Child hygiene occupies first place both in time and money 
expended. The attempt is made, however, to touch the whole field of 
personal hygiene, bearing down on adult as well as child hygiene. 
The preventable noncommunicable diseases come within the scope of 
the Division. Nevertheless, owing to the fact that heart disease and 
kidney disease are comparatively recent acquisitions, even to a limited 
degree, of the field of preventive medicine, little has been done by our 
Department to cope with these serious affections which so often cut 
off the individual at or near the time of his greatest productivity. 
Heart disease in children seems to offer a most promising field, but the 
unsolved problems of infant and maternal mortality and morbidity 
present such a challenge to a health department that, for the time 
being, others must be in the nature of luxuries beyond the purse of the 
impecunious official agency. 

An Exception to the Rule — Cancer. 

One exception to this rule should be recorded. For several years 
now S3,000 have been spent annually through the Division of Hygiene 
to aid in the control of cancer. The problem of cancer is not entirely 
or even mainly one of public health. The dissemination of informa- 
tion as to methods of preventing death from cancer is clearly a health 
department function; so is the furnishing of diagnostic service. With 
the actual treatment of cancer, the municipality or State should not 



252 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

interfere. The Division of Hygiene has scrupulously observed this 
distinction in its work. 

With this general description of the work of the Division of Hygiene, 
it is in order to discuss more in detail the various phases of the active 
work carried on by the Division with special reference to the work of 
the past year. First in point of time comes our health exhibit and 
health weeks. 

Health Exhibit and Health Weeks. 

Health exhibits represent an early development of health educa- 
tional work; health weeks are comparatively new. It is undoubtedly 
true, however, that the indiscriminate use of "weeks" of all kinds has 
seriously lessened their influence for good. The true purpose of a 
health week ought to be to focus public opinion and interest upon some 
phase of municipal or private health activity which is not being 
sufficiently stressed. The purpose back of the health exhibit or health 
week should be a serious one and not merely a desire to entertain or 
even to "take a shot in the dark." The objective ought to be clearly 
seen and ought to be worth the effort involved in arranging the 
activities of the "week." If the town is lacking in school nurses, the 
whole effort of the health week ought to be the getting of more nurses. 
This involves getting as many as possible of the townspeople talking 
and thinking school nurse. This cannot be done unless all the local 
agencies which normally touch on some phase of health work are 
sharing in making a "go" of the enterprise. 

Advisory Committee on Health Weeks. 

To aid in this effort, the State Department of Public Health, 
through its Division of Hygiene, formed during 1921 an Advisory 
Committee on Health Weeks, including representatives of all State 
organizations with health committees who might, through their local 
affiliations, aid in local health weeks. Whenever a group in some town 
begins to plan for a health week and asks the assistance of the State 
Department of Public Health, a meeting is called of the Advisory 
Committee on Health Weeks, to which are invited the local people 
who are to have the health week activities in charge. At this meeting 
plans are formulated for aiding the local agencies in every way possible. 
This plan has now been in operation long enough to demonstrate its 
value. 



No. 34.] DIVISION OF HYGIENE. 253 



Exhibit at Health Weeks and Health Daijs. 

Boston (five times). 

Brockton. 

Chester. 

East Longnieadow. 

Huntington. 

Lawrence. 

Maiden. 

Medford. 

Montague. 

New Bedford. 



Newton. 

Northampton. 

North Attleborough. 

Revere. 

Russell. 

Springfield. 

Templeton. 

Warren. 

Weymouth. 

Williamsburg. 



Follow-up Work. 

Valuable as all effort of this sort undoubtedly is, it is essential to 
success that the incentive to endeavor furnished by a health week or 
an exhibit be reinforced and made permanent through follow-up work 
on the part of the local agencies originally interested in starting the 
health week. To carry on the example used above, if the given town 
needs more school nurses and the health week stressed their importance 
and got people thinking about the need of school nurses, then the re- 
sult ought to be municipal action and the acquisition of more nurses; 
otherwise, the enthusiasm aroused will soon evaporate and the health 
week will have been a failure. 



Work at Agricultural Fairs. 

Our work at the agricultural fairs, where we have a tent and 
exhibit, has been of value and was continued during the past year. 
A special cottage has been assigned for our use for the past two years 
at the Eastern States Exposition at Springfield where, literally speak- 
ing, throngs have viewed our exhibit. It goes without saying that 
very many retain no lasting impression under circumstances like these, 
but many others do. 

Agricultural Fairs visited by Exhibits. 



Barnstable. 
Charlemont. 
Great Barrington. 



Northampton. 
Springfield. 



254 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Nutritional Activities. 

The real importance of food in its relationship to health is becoming 
more and more recognized. It is a matter of satisfaction to know that 
the Massachusetts Department of Public Health recognized this early 
and took steps to place nutritional work on a par with other health 
activities. It is the duty of our health instructor in foods to advise 
communities or groups of persons in a community as to the need of 
nutrition classes, school lunches, and so forth, and to help them get 
started. It is our duty to serve as a clearing house for information on 
the subject of nutrition, and to this end we have been accumulating 
information as to what communities and States have been doing. 



Pamphlets, Lantern Slides and Lectures. 

Since we have only the one worker in nutrition, we have to extend 
her influence in other ways than by word of mouth if we are to cover 
the field adequately. Written material has its place as a supplement 
to the spoken word. During the past year several of our nutrition 
bulletins have been revised and, in addition, the following new pam- 
phlets have been issued: — 

Diet for the Mother. 

Diet for the Breast Fed Baby. 

Diet for the Bottle Fed Baby. 

Three sets of Diet Cards for Children under Two Years Old. 

Suggestions for Diet in Cases of Constipation. 

Vitamines or Accessory Food Factors. 

Food in its Relation to Weight and Health. 

The A, B, C of Eating. 

Our set of lantern slides for children, entitled "The Foodway to 
Health," has been revised and a new set for adults has been completed 
recently, as well as a set of slides on "The School Lunch." These 
stereopticon slides have met with an instant response and have ap- 
parently filled a genuine need. 

Lectures by our health instructor in foods, prominently stressed in 
earlier years, have become more difficult to arrange owing to the press 
of office work. In other words, the demand now greatly exceeds the 
supply. During 1921, however, the health instructor in foods gave 31 
lectures in various parts of the State. In addition to these, she con- 
ducted a course in dietetics for the nurses in training at the State 
sanatorium for tuberculosis at Rutland. 



No. 34.] 



DIVISION OF HYGIENE. 



255 



Lectures were given during the year on the following subjects: — 



Food and its Relationship tc 


) 


Social Hygiene .... 


19 


Health .... 


125 


Personal Hygiene .... 


19 


Mouth Hygiene . 


106 


Public Health and School Nurs- 




Venereal Diseases 


64 


ing 


14 


Public Health 


52 


State Department of Public 




Child Hygiene and Child Wel- 




Health 


14 


fare 


47 


Preventable Diseases . 


11 


Schick Test .... 


40 


School Hygiene .... 


10 


Communicable Diseases 


38 


Health Legislation 


6 


Maternity Benefits 


30 


Preventive Pediatrics . 


4 


Sanitation .... 


30 


Wear and Tear Diseases of Adult 




Vital Statistics 


29 


Life 


1 


Tuberculosis .... 


26 


Rural Hygiene .... 


1 


Health Laws Administration 


25 






Industrial Nursing 


22 


Total 


733 



A table of lectures, by months, follows: 



Month. 



Lectures. 



Number 
present. 



1920. 
December ..... 

1921. 

Janu.ary 

February 

March 

April 

May 

June 

July 

August 

September 

October 

November 

Totals 



55 



733 



4,467 



90 


7,313 


93 


9,321 


107 


9,555 


128 


18,602 


102 


9,172 


52 


6,631 


4 


225 


4 


88 


6 


479 


47 


2,301 


42 


4,691 



72,845 



During the fiscal year ending Nov. 30, 1921, lectures were given in 
the following cities and towns: — 



256 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Adams 3 

Alford 3 

Arlington 6 

Ashburnham 1 

Ashfield 1 

Athol ...... 1 

Attlebobo 1 

Auburn 2 

Avon 1 

Ayer ...... 1 

Barnstable 5 

Belchertown 1 

Belmont 1 

Beverly 1 

Billerica 1 

BlacJistone 1 

Boston 213 

Bourne 1 

Braintree 2 

Brockton 13 

Brookline 5 

Buckland 1 

Cambridge 19 

Charlemont 1 

Chelsea 3 

Cheshire 1 

Chester 1 

Cohasset 1 

Dedham 1 

Dennis 1 

Dighton 1 

Dracut 11 

Dudley 1 

East Bridgewater .... 1 

Egremont 2 

Everett 2 

Fall River 12 

Falmouth 2 

FiTCHBURG 4 

Foxborough 2 

Framingham 10 



Gloucester . 








1 


Grafton . 








3 


Granby . 








1 


Great Barrington 








7 


Greenfield 








11 


Hadley . 








2 


Hampden 








1 


Haverhill . 








15 


Heath 








1 


Hingham 








3 


Ho L YOKE 








10 


Hudson . 








1 


Hull . . 








1 


Huntington . 








2 


Lakeville 








1 


Lancaster 








1 


Lawrence 








12 


Lee . 








1 


Leicester 








3 


Leominster . 








2 


Leverett 








3 


Longmeadow 








1 


Lowell . 








15 


Lynn 








5 


Malden 








11 


Manchester . 








1 


Mansfield 








2 


Marblehead . 








2 


Marlborough 








1 


Medford 








3 


Melrose 








9 


Milford . 








1 


Milton . 








1 


Montague 








1 


Mount Washington 






2 


Natick . 






1 


New Bedford 






9 


New Marlborough 






7 


Newburyport 






5 


Newton 






13 


North Adams 






11 


North Attleboroug 


h 






2 



No. 34.] 



DIVISION OF HYGIENE. 



257 



North Brookfield 




. 


, 


1 


Southwick 


1 


Northampton . . . . 14 


Springfield . 


. 15 


Norton 2 


Stockbridge . 


. . 3 




Swampscott . 


1 


Oxford 1 








Taunton 


8 


PiTTSFIELD 8 


Templeton 


5 


Plymouth 3 


Tewksbury . 


1 


Princeton 1 


Topsfield 


1 


Provincetown .... 1 








Wakefield . . . 


. . 8 




Waltham 


6 


<^UINCY 10 


Wareham 


. . 2 




Warren .... 


5 


Randolph 2 


Watertown . 


7 


Reading 1 


Webster .... 


1 


Revere 7 


Wellesley 


. . 2 


Richmond 1 


Wellfleet . . . 


1 


Rockland 1 


West Newbury 


. . 3 


Russell 2 


Westfield . 


10 


Rutland 7 


Westford 


1 




Westminster . 


5 


Salem 5 


Weymouth 


4 


Sandwich 










1 


Whitman 


1 


Saugus . 










4 


Williamsburg 


1 


Scituate . 










2 


Wilmington . 


2 


Seekonk . 












Winchendon . 


1 


Shelburne 












Winchester . 


. . 5 


Shirley . 












Winthrop 


. . 2 


Shrewsbury 












WOBURN 


2 


Shutesbury 












Worcester . 


. . 13 


SOMERVILLB 
















South Hadley 










Total . 


. 733 


Southborough 














Southbridge 












Outside of State . 


4 



Mouth Hygiene. 

This important phase of hygiene has been receiving an increasing 
amount of recognition in recent years. The health instructor in 
mouth hygiene in the Division of Hygiene, like the health instructor 
in foods, has for her function the interpretation of the subject to 
municipalities and private agencies carrying on, or wishing to carry on, 
this type of work. There is much more involved in this than merely 
giving information as to how to start a dental clinic and as to its cost. 



258 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

It is also the duty of the Department of Public Health to place before 
those seeking advice the relative importance of the various kinds of 
public health activity and what may be expected in the way of results 
from the expenditure of a given sum of money. Not infrequently a 
community wishes to make its debut into public health work by 
establishing a dental clinic. It is, of course, the community's privilege 
to do this if it sees fit. Such an action, however, does not show good 
sense, since unquestionably a public health nurse is generally conceded 
to be the most logical first step in getting public health work started. 
Then the question of dental hygienist versus regular dental clinic has 
to be considered carefully before a decision is reached. 

Assistance of this sort seems to be the most worth-while service 
the Division of Hygiene can offer communities. In addition to this, 
however, we have developed a lecture service, an attractive set of 
stereopticon slides, pamphlets on mouth hygiene subjects, and are 
circulating moving pictures on mouth h\'giene. 

Investigative Work. 

It is highly necessary that investigative work be carried on by 
State health departments. It is only by the constant accumulation 
of information from all over the State and constant analysis of such 
information that a true perspective is maintained. A constant attempt 
must be made to measure results of various procedures and to modify 
these procedures in accordance with the information obtained. 

An excellent example of what I mean by this is offered by the 
problem of maternal and infant hygiene. We know that a certain 
number of mothers die every year from causes related to pregnancy 
and childbirth. We know that the infant mortality under one month 
of age is from 40 to 50 or more per cent of the total infant mortality 
under one year. Nevertheless, there is a very great deal yet which 
puzzles us with regard to the maternal and infant mortality. We do 
not know why it is that in spite of improvements in medical, nursing 
and hospital care our maternal mortality in this State is apparently 
on the increase. W^e do not know why it is that in spite of a gradual 
reduction in the total infant mortality the early infant mortality re- 
mains practically stationary. Problems like these can be solved only 
by constant investigation and study. It is the duty of a Division 
charged with the responsibility of child hygiene activities to contribute 
to such study. Hitherto, because of lack of money and personnel, we 
have fallen far short of what we should like to do. 



No. 34.] DIVISION OF HYGIENE. 259 



Child Hygiene Clinics. 

Reference has been made elsewhere to the strictly advisory nature 
of the work of the Division of Hygiene. That this as a general State 
health policy is sound, is attested by the numerous health activities 
now being carried on by the majority of our 355 cities and towns. 
The policy of the Department in regard to child hygiene clinics is in 
nowise in conflict with that just stated. The pediatrician of the Di- 
vision of Hygiene, as part of her duties, stimulates the establishment 
of child hygiene clinics throughout the State. A visit to the com- 
munity is made on the invitation of some responsible agency — prefer- 
ably the board of health — and a well-baby or well-child clinic con- 
ducted in a schoolhouse, the town hall, or some other central building. 
No treatment of any kind is given. 

This clinic is merely for the purpose of demonstrating a need and a 
method of meeting this need. Children found defective are referred 
to their family physician. If the town has a public health nurse, she 
is given the names of those needing treatment in order that through 
sympathetic interpretation of the findings of the clinic physician the 
family may have the child's defects remedied. Parents and physicians 
are always invited to these clinics. 

Once the demonstration has been made, the Division feels that its 
duty has been fulfilled for the time being. The responsibility for 
carrying on the work now rests with the town itself. Our services are 
always at their disposal, however, to assist and encourage but not to 
supplant. 

It is only fair to say that this type of work is slow and uphill and 
results are not always immediately apparent. It has resulted, never- 
theless, in the accumulation of a great deal of valuable data with re- 
gard to the health of the rural child. 

Other Activities. 

The Division of Hygiene, in addition to the duties already referred 
to, has charge of the departmental library, edits the Department's 
bimonthly bulletin, "The Commonhealth," also the "Manual of Laws 
relating to Public Health" and the annual report. 

" The Commonhealth." 

The yearly six issues of "The Commonhealth" are now divided 
evenly between numbers of general interest and numbers dealing with 
special subjects. Its circulation is comparatively limited, — about 



260 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

11,000 copies, — but no attempt has been made to get a very wide 
popular circulation. It seems wiser at the present time to Hmit its 
circulation to professional people of all kinds and to those of the 
general public who show sufficient interest to write in to ask to be 
placed upon the mailing list. Such people will probably pass along to 
other groups information they obtain from "The Commonhealth." 
During the year 1921 special issues of 'The Commonhealth" dealt 
with a study of open-air schools in Massachusetts, with a midwife 
investigation, with communicable diseases, and with cancer, the latter 
issue brought out at the time of the National Cancer Week. 

Lectures to Training Schools for A^urscs. 

The service which we have been offering to training schools for 
nurses has been continued only in part during the past year. We still 
feel that it is highly desirable that the pupils in every training school 
for nurses in the State should have a certain number of lectures upon 
the public health subjects. The difficulty is to offer this service in a 
fashion convenient both to those who are to receive it and to those 
who are to give it. It has proved to be considerable of a burden upon 
the Department to furnish this lecture service to so many hospitals. 
Another year it probably will be necessary to offer a short course of 
lectures upon public health at certain central points to which the 
superintendents of the various training schools will be invited and 
urged to send their pupils. Those who will not be able to make use of 
the service one year will be able to get it before they graduate. It is 
difficult for hospital superintendents to allow their nurses to leave the 
hospitals for any great length of time owing to the difficulty they 
experience in maintaining their staif at full strength. None the less, 
it seems that if such brief absence is the only way whereby the nurses 
can get these public health lectures, hospital superintendents should 
make the necessary effort to accomplish this purpose. 

Boston Health League. 

A most interesting experiment is being tried in Boston looking 
towards the co-ordination of all the agencies carrying on public health 
work within the limits of the city. This organization of agencies has 
taken the name of the Boston Health League and has picked East 
Boston as the place where concentrated effort may be put forth with 
the hope that work accomplished in this section of Boston will serve 
as an example of what can be done throughout the whole city. The 



No. 34.] DIVISION OF HYGIENE. 261 

Division of Hygiene has been much interested in furthering this work 
especially so far as it is likely to improve the standard of child hygiene. 
The director of the Division has served as secretary of the council of 
the Boston Health League. 

Courses for Continuation School Teachers at Hyannis. 

At the request of the director of the Division of Vocational Educa- 
tion of the Department of Education, the Division of Hygiene co- 
operated to the extent of giving a short course in the essentials of 
hygiene for continuation school teachers. This gave the director and 
assistant director of the Division a valuable opportunity to come in 
contact with a large proportion of the continuation school teachers of 
the State. Through them the Division was able to reach a very much 
wider public than could possibly be reached through the unaided 
efforts of one or two individuals. Incidentally, it served as a demon- 
stration of the sort of interdepartmental co-operation which should be 
a matter of regular occurrence in the State service. 

Parent- Teacher Association. 

It is becoming more and more clearly evident that the Parent- 
Teacher Association is one of the most useful agencies for the dissemi- 
nation of knowledge with regard to child hygiene. The members of 
this association, from the very nature of their work, are interested in 
the health of the child and are anxious to further all measures which 
will improve it. During the past year the director of the Division 
had the pleasant privilege of addressing a number of local Parent- 
Teacher Associations, basing his discussion upon a questionnaire which 
had been sent out in advance. This questionnaire, when fully filled 
out, represented a considerable degree of investigation on the part of 
local Parent-Teacher Association members into the health conditions 
of their community. This type of work can be extended indefinitely 
to great advantage. 

Mental Hygiene. 

The subject of mental hygiene is coming prominently to the front 
at the present time. Many are beginning to feel that it is a most im- 
portant phase of hygiene in general, although, unquestionably, we 
know less about it than we do about other aspects of hygiene. There 
seems to be considerable reason to believe that if the Division of 
Hygiene is to fulfill its whole duty, it should have at least one worker 



262 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

who deals solely with the subject of mental hygiene. It is to be hoped 
that in the near future it will be possible to obtain an appropriation 
for this purpose. 

Relative Importmice of the Different Activities of the Division of Hygiene. 

It is a matter of considerable difficulty to apportion values to the 
different phases of activity as carried on by a State department. It is 
even more difficult to compare such relative values with those which 
would obtain in a municipality. Certain types of work as, for example, 
health education through health weeks, exhibits, moving pictures, etc., 
are peculiarly suited to a State department as distinguished from a 
municipal department of health. Such activities are extremely im- 
portant and yet are relatively expensive if carried on on too small a 
scale. 

Lecture work is difficult for the average local health department and 
may well be a large function of a State advisory body. There is no 
question, so far as the State Division of Hygiene is concerned, that 
work directed toward the improvement of the hygiene of mothers and 
infants has been greatly neglected hitherto. None the less, the Di- 
vision of Hygiene in this State is expending at the present time ap- 
proximately more than one-third of its appropriation upon this type 
of activity. 

Another branch of its work which, unquestionably, is dealing with 
fundamental things is that of nutrition. It is unfortunate that this 
particular line of activity has not been extended more rapidly. At the 
present time there is great need in several directions, notably in that 
of classes in nutrition for expectant mothers and for others who are 
interested and who might serve as local leaders in this work. The 
problem of extending a knowledge of nutrition is perhaps more diffi- 
cult because of the paucity of concrete ways in which local groups 
can act. The school lunch and the nutrition class represent almost the 
only types of activity which can be carried on in groups. 

In the case of mouth hygiene, on the other hand, the dental clinic 
serves as a definite objective for those who, through the expenditure 
of municipal or private funds, wish to carry on some dental work. 
One rather unfortunate result of this has been that, because of the 
very definiteness of the dental clinic, towns have been prone to place 
this type of work before other kinds which, while not necessarily more 
important, should come first in point of time. An example of this 
would be public health nursing of all kinds. Furthermore, owing to 
the popular appeal of the dental clinic it would seem as if a step had 



No. 34.] DIVISION OF HYGIENE. 263 

been taken too far in advance with regard to the establishment of 
dental clinics without due regard to the fundamental problems of poor 
relief. This same thing is, of course, true of many well-baby and other 
clinics carried on by municipalities. An extended discussion of this 
would be out of place here, but it is pertinent to the subject to say 
that there is a great need at the present time for clear thinking upon 
the subject of furnishing free medical care on the part of municipalities, 
and in medical care must be included dental care. 



New Needs. 

Any discussion of new needs should be backed by a clear perception 
of State policy with regard to assistance to local communities. It has 
been the policy of the Division of Hygiene to do little or no detailed 
work but to serve merely as a leader in the field of hygiene, assisting 
the communities but not doing their work for them. For this reason 
the Division will never need a large field force. Certain types of 
assistance, however, already referred to in part, will always be neces- 
sary and will extend in scope naturally from year to year for some 
time to come. Beginning with 1915 the work of the Division for some 
time was largely that of reaching individual groups of the public. 
Gradually, as this work was extended, an increasing amount of time 
had to be given to office consultation with those who were in a position 
to start new lines of local activity to be paid for by municipal or 
private funds. With the growth of this type of consultation work 
there came the necessary curtailment of work in the field. There is no 
question that the consultation work is of the highest importance, of 
greater importance, in fact, than much of the individual field work. 
None the less, it seems a pity that more field work cannot be done, 
especially along the line of investigations into local conditions. In 
fact, the latter is absolutely essential if sound advice is to be given 
through the office. For this reason it is much to be hoped that at 
least one more worker be obtained in the field of nutrition and another 
in mouth hygiene. 

Another promising field which ought to be worked more intensively 
by the Division of Hygiene is that of school nursing. Now that a 
compulsory school nursing law has been passed, we shall probably see 
many new nurses employed by municipalities and many of these 
nurses will be inexperienced. It would be of advantage if the Division 
of Hygiene had a nurse experienced in school nursing who could be at 
the service of the school nurses of the State for advice and assistance. 

It is confidently hoped that the coming year will see regional con- 



264 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

ferences for school nurses, physicians and school superintendents held 
under the joint auspices of the Department of Public Health and the 
Department of Education to discuss the subject of school hygiene in 
general and the medical supervision of school children in particular. 

So far as infant and maternal hygiene is concerned, if Massachusetts 
is to do her full duty to the mothers and babies of the State, a con- 
siderable expenditure must be made in the near future in three di- 
rections: first, to spread our informational service with regard to the 
hygiene and needs of the mother and her child; secondly, to carry on 
a continuous investigation into the causes of maternal and infant 
mortality with a view to devising measures to combat such maternal 
and infant mortality and morbidity; thirdly, to establish a larger 
number of public health nurses who may serve constantly in the field 
to investigate local child welfare conditions and upon the basis of the 
investigations to advise communities as to ways of bettering the con- 
ditions under which both the city and rural mothers and babies live 
and die. This latter type of work was carried on with great success 
during the war by eight child welfare nurses attached to the Division 
of Hygiene. 

hifant Mortality with Reference to Future Work. 
The infant mortality for 1921, of the State as a whole and of the 
individual municipalities, can merely be foreshadowed at the time of 
writing this report. These figures are available only late in the year 
owing to the slowness with which the birth returns come into the office 
of the Registrar of Vital Statistics from the 355 cities and towns of the 
State. This renders the results of historical rather than of news value. 
The fault, if fault there be, does not rest with the Registrar of Vital 
Statistics,' who has been very anxious to get the facts at the earliest 
possible moment. 

Infant Mortality) during 1921. 
Basing our estimate on figures published by the Federal Census 
Bureau there seems to have been an unprecedented drop in infant 
mortality over all this country during 1921. Of the 51 cities included 
in the Federal report, 7 are in Massachusetts. The foUowmg are the 
decreases in infant mortality of these cities for 1921 over that for 1920, 
more complete reports will probably lower the rate somewhat further 
still- Boston, a decrease in rate of 25 per 1,000; Cambridge, 29; Fall 
River 18; Lowell, 45; New Bedford, 23; Springfield, 17; Worcester, 8. 



No. 34.] DIVISION OF HYGIExXE. 265 



Lack of Knowledge of Causes. 

Such changes as these are startling in nature and emphasize strongly 
how much we have yet to learn about the causes of infant mortality. 
The first reaction of enthusiastic child welfare workers will be, natu- 
rally, that at last their devoted work is showing results. Further 
thought, however, will serve to dampen this over-enthusiasm. It is 
manifestly impossible to expect to see such sudden results produced 
over all the country as a result of work of varying degrees of efficiency. 
Indubitably there is some factor operating to influence infant mortality 
in a way not yet fully understood. 



Future Lines of Attack. 

The knowledge we do possess, however, leads to the conviction that 
we must reach that part of the infant mortality which occurs within 
the first month of life if we are to see a reduction in the total rate to 
correspond to that of recent years. That fraction of the infant mor- 
tality rate which occurs during the first month of life is pretty con- 
sistently 40 per cent or more of the total rate. In certain places it is 
over 70 per cent. Yet nowhere in the world has there been as yet any 
noteworthy reduction in the early infant mortality. Such a reduction 
has been accomplished in parts of certain cities, but we have yet to see 
a State-wide demonstration. Such a demonstration is long overdue. 



Division of Tuberculosis (Sanatoria) 



Sumner H. Remick, M.D., Director 



[2671 



Eeport of Division of Tuberculosis (Sanatoria). 



I have the honor to submit the annual report of the Division of 
Tuberculosis for the year ending Nov. 30, 1921. 

This annual report, on account of the sudden death of Dr. William 
J. Gallivan, the former director, must be inadequately presented for 
I find it impossible, having been connected with the Division for so 
short a period, to give a comprehensive analysis of the work of the 
year 1921. 

All who knew the late Dr. Gallivan mourn his loss, as a personal 
one; the tuberculosis workers and sufferers throughout the State feel 
deeply his passing from the work he had been so interested in; the 
Division of Tuberculosis, to which he had bent his great energies as 
director from its inauguration as a division of the State Department 
of Public Health, misses his genial smile, his courage, his leadership. 

The four sanatoria under this Division, Rutland, Westfield, North 
Reading and Lakeville, have had a successful year and have provided 
a total of 375,535 days of treatment for 2,363 patients. The general 
policy of administration has been changed in three points: first, to 
limit the residence of patients to a period of two years in any one in- 
stitution; second, to reserve Westfield for children; third, to admit 
the early and favorable cases of tuberculosis not only to Rutland but 
all the State sanatoria. 

The first point has been successfully carried out at Westfield and 
Rutland, and at the present time all patients having a residence of 
over two years at North Reading are being transferred to other in- 
stitutions as fast as opportunity permits. The same method will be 
carried out at Lakeville, now that we have sufficient bed capacity in 
the county and municipal hospitals for the care of unfavorable or 
advanced cases of tuberculosis. 

For several years tuberculous children, requiring institutional treat- 
ment, have been segregated at Westfield in a separate children's build- 
ing. The demand for beds has increased so rapidly that children have 
often had to wait months before being admitted. Realizing the im- 
portance of this phase of the tuberculosis problem, and the disaster 
a few months' waiting for treatment can mean to the child, the De- 
partment decided to change the policy as above stated in point two. 



270 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

viz., to eliminate the adults at Westfield as fast as possible, and to 
reserve this sanatorium for the use of children from four to sixteen 
years of age. So far has this plan been carried out that at the present 
time we have at Westfield only forty-two adults and two hundred 
and twenty-five children. I believe this plan a very important step 
in the campaign against tuberculosis, and am happy to say it has been 
received by official and unofficial agencies throughout the State with 
enthusiastic approval. 

"When Rutland was opened in 1898 the policy of the sanatorium was 
to treat only early and favorable cases of tuberculosis. But as the 
years passed the original policy had to be modified. Because of the 
great need of the advanced type and the lack of hospitals which could 
care for these cases, the State tried to reserve one sanatorium for the 
early cases, namely Rutland, and provide hospital treatment, without 
being properly equipped to do so, for the large number of needy cases 
of the advanced type. At present the situation is changing, and with 
the opening of the county and municipal institutions, the State De- 
partment is able to return to its original policy. With the increased 
bed capacity for the unfavorable or advanced type, it is important 
that early cases be admitted not only to Rutland, as formerly, but to 
all the State sanatoria. 

The dispensary act, passed in 1911, requires every city or town of 
over 10,000 population to establish and maintain a dispensary for the 
diagnosis of pulmonary tuberculosis. There are now fifty-six estab- 
lished dispensaries under the supervision of the State Department of 
Public Health. It is impossible at the present time to state the 
amount of work accomplished during the past year, but my impres- 
sions are that the work, with a few exceptions, is unsatisfactory, and 
that a large number of the cities and towns are complying with the 
letter of the law only, and are not trying to develop the work to its 
maximum eflaciency. I feel that there are many causes for this, and 
believe that the subject needs careful consideration at once, for these 
dispensaries are one of the most important agencies we have in the 
State for discovering early tuberculosis and supervising those who 
suffer from it. 

The consultation clinics, established in sixteen cities in the Com- 
monwealth in 1920, have not been utilized by the physicians as much 
as anticipated. This, I believe, is not because the general practitioner 
does not desire this service or that he does not realize its value to him, 
but more from the fact that he has forgotten that such a service exists. 
This clinic gives any physician in the State an opportunity to have 
any suspected case examined, free of charge, by members of the staffs 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 271 

of the State sanatoria. Every effort will be made during the coming 
year to acquaint the physician with this service, and if found practica- 
ble to extend the clinics to other centers. 

Eight hundred and ninety-five patients were referred to the consulta- 
tion clinics, and were classified as follows: — 

Pulmonary tuberculosis (active) 438 

Pulmonary tuberculosis (inactive) 55 

Further observation 255 

Nontuberculous 147 

A large per cent of the 438 active cases desired sanatorium treat- 
ment, and were hospitalized at once in either State, county or munici- 
pal hospitals. 

Expert medical examination service for small towns under 10,000 
population where no provisions are made for a regular dispensary has 
been a problem for a number of years. The Massachusetts Tuber- 
culosis League, recognizing this weak point in our system, rendered a 
distinct service to the Commonwealth by working up clinics in the 
rural communities and appealing to this Division for the assistance of 
the sanatoria staffs to make the examinations. This service was 
gladly given and every effort will be made in the future to co-operate 
with the League in this work. During the past year clinics have been 
held in twelve towns and 225 cases have been examined, the great 
majority of those examined being children. These clinics have brought 
to light the fact that tuberculosis and malnutrition in children show a 
very close relationship. "Watch out for the undernourished child" 
may well be our watchword to-day. Eighteen of the 225 examined 
were definitely tuberculous; 103 were held for further observation; 
104 were considered nontuberculous. 

If we are to get a clear picture of the results of our work, the 
supervision and follow-up work of this Department are readily seen to 
be of vital importance and well repay the expense entailed. The 
Department requires an original history card on every reported case, 
and files that card with this Division. That in the past six years 
23,000 cards have been filed is a convincing argument. These cases 
are all under the direct supervision of the local boards of health, who 
report yearly on every case to the State Department. The Division, 
through its seven District Health Officers and their nursing assistants, 
follows up every case discharged from our four sanatoria. On these 
cases a report is made to the Division every six months. 

Last year with the desire to stimulate interest in "follow-up" work, 
and to create better co-operation among public health nurses, the 



272 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Division organized an association in each of the territorial assignments 
of the District Health Officers, seven in number. Two conferences 
were held, — the first at Rutland State Sanatorium, the second at 
Lakeville State Sanatorium, — with marked success. The work of the 
nurse is invaluable in public health work, and we feel that the in- 
spiration gained by the individual nurse at such conferences enables 
her to give better service to the community, and fills a great need in 
her life and work. 

Essex County Tuberculosis Sanatorium at Middleton was opened 
last June, with a bed capacity of 104 which will be increased to 175 
beds. With the completion of the remaining two county hospitals, as 
required by law, and the necessary addition to a few local and county 
hospitals, adequate hospitalization will be provided for all needing in- 
stitutional treatment in the Commonwealth. 

The tuberculosis sanatoria, both State, county and municipal, 
should, in the future, serve as educational centers, first for the patient, 
and second for the public; and should be equipped to carry on the 
clinical work of their hospital area. 

The campaign against tuberculosis has been going on for over 
twenty-five years and is showing splendid progress as seen by the 
steady decline in the death rate. In Massachusetts in 1900 the death 
rate was 185.3 per 100,000; in 1910, 133; in 1915, 113; in 1920, 
96.7; in 1921, 84.6, the lowest in the history of the State, and a record 
of which we are indeed proud. 

This is a great fight, and we have made great strides, "but the end 
is not yet." Let us not relax our efforts until the victory is assured. 



LAKEVILLE STATE SANATORIUM. 

Resident Officers. 



StTMNER COOLIDGE, M.D. 

MtNOT W. Gale, M.D. 



Mrs. Mary M. Coakley . 
Mrs. Harriet M. Gassett 
Robert A. Kennedy 
Thomas Francis Mahoney 



Superintendent. 

Assistant Superintendent. 

Assistant Physician. 

Steward. 

Head Matron. 

Chief Engineer. 

Head Farmer. 



REPORT OF THE SUPERINTENDENT. 

To Eugene R. Kelley, M.D., Commmioner, Department of Public Health, 

State House, Boston, Mass. 

I have the honor to submit the twelfth annual report of the Lakeville State 
Sanatorium for the year ending Nov. 30, 1921. 

During the year there has been expended $202,236.43 for maintenance, a 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 273 

gross weekly per capita cost of $16.42, and $29,716.63 from the appropriation 
authorized by chapters 153 and 203, Resolves of 1919 and 1921. The details 
of these disbursements are contained in the report of the treasurer. 

There has been collected from miscellaneous sources $44,099.76 (the total 
of all collections). Deducting this amount from the gross maintenance expense 
leaves a net expense of $158,136.67, and a net weekly per capita cost of $12.84. 

There has been collected from private funds $228.56; from charitable in- 
stitutions $4,585.92; from cities and towns $28,461.55; from the United States 
Veterans Bureau $9,925.91. Seventy cases were supported wholty or in part 
from private funds; 334 by cities and towns; 48 wholly by the State; 47 by the 
United States Veterans Bureau. 

There were 251 patients in the sanatorium at the beginning of the year and 
238 at the close. The largest number present at one time was 257 and the 
smallest 211. The daily average number of patients was 236.9150. There were 
•380 cases admitted during the j^ear, — ■ 7 incipient, 190 moderately advanced, 
157 advanced, 25 unclassified and 1 not examined. There were 292 cases ad- 
mitted from cities and towns under 25,000 population. The average age of 
patients admitted was thirty-two. Including deaths, there were 393 discharged, 
and the average duration of residence was seven months and nine days. Of 
those discharged, 183 gained 2,747 pounds, an average gain of 15 pounds per 
person. Of the discharges there were 8 apparently arrested cases, 12 less than 
last year; 18 quiescent, 2 more than last year; 152 improved and 79 unim- 
proved. There were 48 patients not considered, the duration of treatment 
being less than one month. There were 85 deaths, 46 less than last year. 
There were 2 discharged nontuberculous. There were 86,474 hospital days of 
treatm.ent, 1,803 more than last year. 

The following table shows the classification on the application blank and 
our classification on admission : — 





Classification 

on Appli- 
cation Blank. 


Our Classifica- 
tion 
on Admission. 


Incipient 


41 




7 


Moderately advanced 


263 




186 


Advanced 


66 




149 


Unclassified 


10 




37 


Not examined 


- 




1 


Totals 


380 


380 



Medical Report. 

The medical work of the year has been handicapped by changes and vacancies 
in the medical staff. Dr. Frederick Moore resigned on July 14, 1921, to accept 
a position with the Pubhc Health Service, and the vacancy thus caused was 
filled on July 13, 1921, by the appointment of Dr. Earl F. Ryan. After a stay 



274 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



of three months he resigned to accept a more lucrative position on Oct. 3, 1921, 
since which time it has not been possible to secure a suitable candidate for the 
vacancy. 

The remedial procedures of former years were continued throughout the 
year. Our confidence in heliotherapy has been confirmed by another year of 
experience in its use. The only new feature of our treatment was the intro- 
duction of the Alpine lamp, which it is believed supplements heliotherapy by its 
application on cloudy days or at night when direct sunlight is not available. 

Clinics. 

Consultation clinics were attended by members of the Lakeville State 
Sanatorium staff throughout the year in Fall River, Brockton, Taunton and 
Plymouth. The number of patients examined at these clinics is as follows: — 



Nontuber- 
culous. 






Tubercu- 
losis. 



Suspicious 
Tuber- 
culosis. 



Totals. 



Fall River 
Brockton 
Taunton 
Plymouth 
Totals 



10 



2 

7 

12 



21 



Dentistry. 

There being no dentist on the sanatorium staff, the imperative dentistry has 
been done by arrangement with one of the Middleborough dentists. A large 
number of patients who have been able to finance their own dentistry have 
seen fit to patronize this same dentist. Others have been given leaves of absence 
so that they might have their dentistry done at home. We have usually found 
boards of health quite willing to finance the dentistry of town cases, including 
repair work and artificial teeth. 

Farm. 

The farming operations at the sanatorium showed a substantial financial 
profit. The development of the tuberculosis free herd is progressing satisfac- 
torily, there being now forty young animals that have passed the tuberculin 
test. Since the development of a segregated herd was undertaken the main- 
tenance of so large a number of nonproducing animals has reduced the usual 
dairy profit, and is hkely to continue to do so for two years more, after which 
it is hoped that the old herd can be entirely eliminated and replaced by the 
clean herd. 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 275 



Improvements. 

The completion of the dairy barn and the new storehouse, both of which 
were sorely needed for many years, has been successfully accomplished during 
the year, and should very much increase efficiency in handling those two 
departments. 

A graphoscope moving-picture machine has been installed in the chapel and 
has been greatly enjoj'ed bj^ the patients since it has been in operation. 

A new house telephone system has been purchased to replace the old worn-out 
system which has been in use since the institution opened. 

A new boiler feed pump has been installed in the power plant, bringing the 
boiler room equipment up to a condition of efficiency. 



Recommendations. 

There is urgent need of an addition to the chapel, plans for which have been 
made, to include an adequate laboratory and space for the installation of an 
X-ray equipment. Our present chapel is not large enough for the audiences 
which it is expected to hold. For this work an appropriation of $9,500 is 
requested. 

There should also be undertaken an extension of the source of water supply 
for the sanatorium as well as of the pumping equipment and storage capacity. 
A duplicate pumping unit and a 30,000-gallon tank have been requested for two 
years, and until they are installed the institution vaay at any time be without 
a water supply if the single pumping unit now in operation should break down. 
Estimates have been submitted for the duplicate pumping unit and the 30,000- 
gallon tank, of $2,500 and $6,000 respectively, but a considerable sum must be 
added to this to develop an additional supply of water at the source. 

I would also recommend the purchase of property adjacent to the sanatorium 
containing houses suitable for homes for sanatorium employees. Two such prop- 
erties are now in the market, the purchase of one of which, that of Mr. Clarence 
A. Holmes on Bridge Street, is requested this coming year, to cost $3,500. The 
property on the southerly side of the sanatorium, on Main Street, belonging to 
Mr. Charles Spooner, should also be acquired. It contains two habitable houses, 
one of which is so close to the sanatorium property that its inmates have at 
times been rather offensive to the institution administration. The lack of proper 
quarters for married physicians is the sole cause of our inability to find a 
physician for the position of second assistant. The Holmes' house on Bridge 
Street is conveniently located and in every way a suitable home for a member 
of the medical staff. 

There is also serious need of a dormitory for male employees who may be 
maintained at the institution. At present these employees are scattered in many 
buildings, including the upper story of the women's ward, and as all available 
rooms are full all the time we are not able to employ a larger number of this 
class of men for the reason that we have no rooms to accommodate them. A 
considerable sum might be saved in the wages of day laborers if we had accom- 



276 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



modations for a larger number of monthly men with maintenance. I recom- 
mend the erection of a new building with rooms for twenty-five or thirty male 
employees. 

Acknowledgments. 

I again take pleasure in acknowledging the helpful co-operation of the 

Catholic, Protestant and Jewish clergymen who have served us during the year. 

The untiring loyalty and zeal of the assistant superintendent, who has done 

the work of two physicians during many weeks of the year, deserves special 

recognition. 

The same is true of the several heads of departments who by their hearty 
co-operation have greatly assisted in the administration of sanatorium affairs 
during the year. 

Numerous gifts of books, flowers and entertainment by friends of the institu- 
tion are gratefully acknowledged. 

Respectfully submitted, 

Sumner Coolidge, 

Superintendent. 

Valuation. 



Land. 



Grounds (50 acres) 

Lawns and buildings, 48 acres. 

Roads, 2 acres. 
Woodland (10 acres) 
Mowing (44 acres) 
Tillage (.51 acres) . . . . 

Tillage, 3U acres. 

Garden, 19^ acres. 
Orchard (8 acres) . . . . 

Pasture (13 acres) 
Waste and miscellaneous (33 acres) 

Rough pasture, 20 acres. 

Meadow swamp land, 12 acres. 

Sewer beds. 

New coal trestle, 1 acre. 

Sewerage system . 



Institution buildings 
Farm, stable and grounds 
Miscellaneous 



Buildings. 



),289 17 



535 


70 


2,130 


37 


4,391 


81 


611 


65 


696 41 


1,582 


27 



- $19,237 38 
4,572 00 



$129,894 50 
34,142 87 
91,410 10 



$23,809 38 



255,447 47 



Total ^279,256 85 

Present value of all personal property as per inventory of Dec. 1, 1921 . 120,089 85 



Grand total ^399.346 70 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 277 



SPECIAL REPORT. 

The following special report is prepared in accordance with a resolution of 
the National Conference of Charities and Corrections adopted May 15, 1906: — 



Population. 





Males. 


Females. 


Totals. 


Number received during the year 

Number passing out during year 

Number at end of fiscal year in the institution . 

Daily average attendance (number of inmates actually 

present) during the year. 
Average number of employees and officers during the year 


253 
261 
159 
155.36 


127 
132 

79 

81.54 


380 

393 

238 

236.915 

110 



Expenditures. 
Current expenditures: 

1. Salaries and wages 

2. Clothing 

3. Subsistence ..... 

4. Ordinary repairs .... 

5. Office, domestic and outdoor expenses 

Extraordinary expenses: 

1. Permanent improvements to existing buildings 

Grand total ..... 



$91,907 49 

5 74 

27,317 22 

7,233 22 

76,772 76 



$202,236 43 

29,716 63 

$231,953 06 



Summary of Current Expenses. 

Total expenditure ....... 

Deducting extraordinary expenses ..... 



Deducting amount of sales 



. $231,953 06 
29,716 63 

$202,236 43 
651 50 

$201,584 93 



Dividing this amount by the daily average number of patients — 237 — gives a cost 
for the year of $850.81, equivalent to an average weekly net cost of $16.36. 



278 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



STATISTICAL TABLES. 
Table 1. — Admissions and Discharges. 



Males. 



Females. 



Number of patients admitted Dec. 1, 1920, to Nov. 30, 1921, 

inclusive. 
Number of patients discharged Dec. 1, 1920, to Nov. 30, 1921, 

inclusive. 
Number of deaths (included in preceding item) . 

Number remaining in sanatorium Nov. 30, 1921 . 

Daily average number of bed patients Dec. 1, 1920, to Nov. 

30, 1921. 
Daily average number of patients 



253 
261 

61 
159 

48 
155 



127 
132 
24 
79 
43 
82 



Totals. 



380 
393 

85 
238 

91 
237 





Table 2. 


— Civil Condition of Patients admitted. 






Males. 


Females. 


Totals. 


Married . 






125 


63 


188 


Single 






117 


47 


164 


Widowed 






8 


12 


20 


Divorced 






3 


5 


8 


Totals 


253 


127 


380 



14 to 20 years . 
20 to 30 years . 
30 to 40 years . 
40 to 50 years . 
Over 50 years 
Totals 



Table 3. — ■ Ages of Patients admitted. 



Males. 



16 
92 
64 
59 

22 



253 



Females. 



12 
67 
28 
13 

7 



127 



Totals. 



28 

159 

92 

72 
29 



380 



Average age, 32 years. 



No. 34,1 DIVISION OF TUBERCULOSIS (SANATORIA). 279 



Table 4. — Nativity and Parentage of Patients admitted. 






Males. 


Females. 


Totals. 




Places of Nativity. 


a 
.2 


i 


2 

.s 

o 


a 


2 


o 


a 
.Si 

oi 

0-, 


2 


2 

J3 
1 


United States: 




















Massachusetts . 


90 


20 


20 


54 


15 


10 


144 


35 


30 


Other New England States 


12 


10 


9 


7 


7 


5 


19 


17 


14 


Other States . 


13 


8 


n 


6 


6 


6 


19 


14 


17 


Total native 


115 


38 


40 


67 


28 


21 


182 


66 


61 


Other countries : 




















Africa .... 


1 


1 


1 


- 


- 


- 


1 


1 


1 


Austria-Hungary 


2 


3 


3 


1 


1 


1 


3 


4 


4 


Azores .... 


1 


2 


2 


- 


- 


- 


1 


2 


2 


Armenia .... 


1 


1 


1 


2 


2 


2 


3 


3 


3 


Bohemia .... 


1 


1 


1 


- 


1 


1 


1 





2 


Canada .... 


18 


34 


28 


18 


28 


26 


36 


62 


54 


Cape Breton Island 


1 


2 


1 


- 


- 


- 


1 


2 


1 


Cape Verde Islands 


4 


4 


4 


- 


- 


- 


4 


4 


4 


England . 




12 


13 


11 


3 


3 


8 


15 


16 


19 


Europe 




1 


1 


1 


- 


- 


- 


1 


1 


1 


Finland . 




3 


3 


3 


1 


1 


1 


4 


4 


4 


France 




- 


- 


- 


- 


1 


1 


- 


1 


1 


Germany . 




- 


1 


1 


3 


4 


4 


3 


5 


5 


Greece 




8 


8 


8 


3 


3 


3 


11 


11 


11 


Ireland 




16 


57 


65 


7 


19 


21 


23 


76 


86 


Italy 




19 


20 


20 


8 


13 


14 


27 


33 


34 


Lithuania 




- 


- 


- 


2 


1 


2 


2 


1 


2 


Newfoundland 




4 


4 


4 


1 


2 


2 


5 


6 


6 


Norway . 




- 


1 


1 


1 


1 


1 


1 


2 


2 


Roumania 




- 


1 


- 


- 


- 


- 


- 


1 


— 


Russia 




24 


28 


28 


4 


7 


6 


28 


35 


34 


Poland . 




9 


9 


9 


3 


6 


6 


12 


15 


15 


Portugal . 




4 


6 


6 


1 


1 


1 


5 


7 


7 


Scotland . 




6 


8 


8 


1 


3 


3 


7 


11 


11 


Sweden . 




1 


3 


2 


1 


2 


2 


2 


5 


4 


Syria 




2 


2 


2 


- 


- 


- 


2 


2 


2 


Wales 




- 


- 


1 


- 


- 


- 


- 


- 


1 


Total foreign 


138 


213 


2U 


60 


99 


105 


198 


312 


316 


Unknown 




- 


2 


2 


- 


- 


1 


- 


2 


3 


Grand totals 


253 


253 


253 


127 


127 


127 


380 


380 


380 



Patients native born, 47.8947 per cent; patients foreign born, 52.1053 per cent. 



280 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 5. — Residence of Patients admitted. 



Place. 

Adams 

Arlington 

Athol 

Attleboro 

Bedford . 

Belmont . 

Boston 

Braintree 

Brockton . 

Cambridge 

Carver 

Chelsea . 

Chicopee . 

Clinton . 

Concord . 

Dracut 

Edgartown 

Everett . 

Fall River 

Foxborough 

Frammgham . 

Gardner . 

Gloucester 

Hardwick 

Haverhill 

Hawley . 

Hingham 

Holyoke . 

Hopedale 

Lakeville . 

Lawrence 

Leominster 

Lexington 

Lowell 

Ludlow 

Lynn 

Maiden 

Marlborough . 



Number. 



2 
3 
1 
2 
1 
1 
146 
2 
2 
6 
1 
8 
1 
1 
4 
2 
1 
5 

35 
1 
3 
1 
2 
2 
1 
1 
1 
1 
1 
2 

1 

2 

1 
3 
1 

6 

19 

3 



Place. 



Number. 



Medford . 
Melrose 
Methuen . 
Middleborough 
Milford 
Natick 
Needham 
New Bedford . 
Newburyport . 
Newton . 
Northbridge . 
Norwood . 
Oxford . 
Pawtucket, R. I. 
Quincy 
Salem 
Saugus 
Seekonk . 
Sherborn . 
Somerset . 
Somerville 
Southbridge 
Springfield 
Stoneham 
LTpton 
Uxbridge . 
Wakefield 
Walpole . 
Waltham . 
Wareham . 
Watertown 
Westport . 
Westwood 
Winthrop 
VVoburn . 
Worcester 
Total 



1 
4 
1 
1 
3 
2 
1 

24 
1 
9 
3 
2 
1 
1 
5 
2 
2 
1 
1 
1 

12 
2 



380 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 281 



Table 6. — Occupations of Patients admitted. 



Males. 



Attendant 

Auto repairer . 

Baker 

Barber . 

Bartender 

Blacksmith 

Bookbinder . 

Bookkeeper . 

Book sewer 

Bottler . 

Boxmaker 

Brass buffer . 

Bricklayer 

Brushmaker . 

Candy factory 

Carpenter 

Carpet factory 

Chairmaker . 

Chambermaid 

Chauffeur 

Checker, creamery 

Chef 

Child's nurse . 

Clerk . 

Clothing salesman . 

Conductor 

Confectionery factory 

Cook 

Coremaker 

Cotton mill . 

Cream filler . 

Creamery manager 

Curtain cutter 

Domestic 

Dealer, fruit . 

Dealer, provisions . 

Electrician 



12 
1 
1 

17 
1 
1 
1 

7 
1 
5 

1 
1 

2 
1 

2 



Females. 



Totals. 



2 
1 

4 
■ 2 
1 
3 
1 
2 
? 
I 
2 
1 
1 
1 
1 
8 
2 
1 
2 

12 
1 
1 
3 

20 
1 
1 
1 
8 
1 

11 
1 
1 
L 
1 
2 
1 
2 



282 



DEPARTMENT OF PUBI>IC HEALTH. [Pub. Doc. 



Table 6. — Occupations of Patients admitted — Continued. 



Males. 



Females. Totals 



Factory worker 
Fireman . 
Forelady in mill 
Garage man . 
Gardener 
Gasoline merchant 
Generator operator 
Greenhouse . 
Hatter . 
Housekeeper . 
Housewife 
Ironworker 
Janitor . 
Laborer . 
Leather store . 
Letter carrier . 
Linotypist 
Longshoreman 
Machine operators 
Machinist 
Marine engineer 
Mason 

Meat cutter . 

Mechanic 

Merchant 

Metal factory . 

Mill operatives 

Milliner . 

Musician 

News agent . 

Night watchman 

None 

Nun 

Optician 

Packer . 

Painter . 

Paper mill 



3 
3 
22 
1 
1 
1 
2 

2 

10 
1 
3 
1 
3 
1 
2 
4 

1 
1 

1 
1 



1 
14 

53 



14 
53 

3 

3 
22 

1 

1 

1 

2 

2 

10 
1 
3 
1 
3 
1 
2 
5 
1 
1 
1 
1 
2 
1 
1 
1 

,4 
2 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 283 



Table 6. — Occupations of Patients admitted — Continued. 



Males. 



Females. 



Parish visitor 

Peddler . 

Photographer 

Plasterer 

Plumber 

Porter 

Portrait artist 

Poultryman . 

Printer . 

Real estate collector 

Restaurant manager 

Rubber factory 

Salesman 

Saleswoman . 

Sawmill . 

Seaman . 

Seamstress 

Ship fitter 
Shipping clerk 
Shoe repairer . 
Shoe shop 
Silversmith 
Social worker . 
Stage performer 
Stamp girl 
Steamfitter 
Stenographer . 
Stitcher, shoe factory 
Stone cutter . 
Storekeeper 
Student . 
Tailor shop 
Tannery 
Teacher 
Teamster 

Telephone operator 
Tinsmith 



2 
1 
1 
1 
1 
1 
1 
1 
1 
1 
3 
9 

1 
3 

1 
3 
1 
2 
1 



Totals. 



- 


3 


3 


3 


6 


- 


1 


- 


3 


2 





1 


1 


- 


1 


1 


2 


_ 



1 

2 

1 

1 

1 

1 

1 

1 

1 

1 

1 

6 

9 

1 

1 

3 

3 

1 

3 

1 

2 

1 

1 

1 

1 

1 

3 

6 

6 

1 

5 
11 

1 

2 
2 
3 
3 



284 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 6. — Occupations of Patients admitted — Concluded. 



Males. 



Females. Totals 



Tool checker . 
Trucking 
Upholsterer . 
Vulcanizer 
Waiter 
Waitress . 
Watchmaker . 
Weaver . 
Wholesale dealer 
Wool handler . 
Woolen mill 
Totals 



1 
3 
1 

1 

7 

1 
3 
1 
1 
1 



253 



127 



Table 7. — Condition on Admission. 



Males. 



Females. 



Totals. 



Incipient 

Moderately advanced 
Advanced 
Not cla.ssified 
Nontuberculous . 
Not examined 
Totals . 



2 

133 

99 

18 



253 



5 

57 
58 

7 



127 



7 
190 
157 

25 



380 



Table 8. — Condition on Discharge. 



Males. 



Females. 



Totals. 



Apparently arrested 
Quiescent 
Improved 
Unimproved 
Died . . . . 
Not considered 
Nontuberculous . 
Nonactive tuberculosis 
Totals . 



2 
13 
99 
51 
61 
33 
1 
1 



261 



6 
5 
53 
28 
24 
15 
1 



132 



18 

152 

79 

85 

48 

2 

1 



1 
3 
1 
1 
7 
2 
1 
5 
1 
1 
2 



380 



Percentage. 



1.8421 
50.0000 
41.3158 

6.5790 
.2632 



393 



Percentage. 



2.04 

4.58 

38.68 

20.10 

21.63 

12.21 

.51 

.25 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 285 



Table 9. — Deaths. 



Duration 


OF Disease. 






Males. 


Females. 


Totals. 


Length of Residence 
AT Sanatorium. 




Males. 


Females. 


Totals. 


Under 1 month 


- 


- 


- 


9 


4 


13 


1 to 2 months 












1 


- 


1 


9 


3 


12 


2 to 3 months 












- 


- 


- 


7 


3 


10 


3 to 4 months 












- 


- 


- 


5 


1 


6 


4 to 5 months 












2 


1 


3 


5 


_ 


5 


5 to 6 months 












1 


1 


2 


_ 


2 


2 


6 to 7 months 












5 


1 


6 


2 


O 


5 


7 to 8 months 












3 


1 


4 


2 


2 


4 


8 to 9 months 












3 


- 


3 


3 


1 


4 


9 to 10 months 












3 


- 


3 


2 


_ 


2 


10 to 11 months 












- 


3 


3 


3 


1 


4 


11 to 12 months 












4 


1 


5 


1 


1 


2 


12 to 18 months 












12 


4 


IG 


3 


1 


4 


18 to 24 months 












2 


3 


5 


2 


2 


4 


Over 2 years . 












23 


9 


32 


8 


_ 


8 


Unknown 












2 


- 


2 


- 


- 


- 


Totals 


61 


24 


85 


61 


24 


85 



Table 10. — Cause of Deaths. 





Males. 


Females. 


Totals. 


Phthisis pulmonalis 


61 


24 


85 


Totals 


61 


24 


85 



286 



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, 1921 : — 



Cash Account. 
Balance Dec. 1, 1920 $4,501 68 

Receipts. 
Income. 

Board of inmates: 

Private $4,585 92 

Reimbursements, insane, War Risk Insurance 9,925 91 

Cities and towns 28,461 55 

Reimbursements, charitable .... 228 56 

$43,201 94 

« 

Personal services: 

Reimbursement from Board of Retirement . . . . 15 25 

Sales: 

Travel, transportation and ofl&ce expenses . $18 26 

Clothing and materials 9 00 

Furnishings and household supplies . . 20 28 

Medical and general care 5 00 

Farm: 

Cows and calves .... $247 00 

Pigs and hogs 80 00 

Grease 215 15 

Roosters 4 50 

Sundries 52 31 

598 96 

651 50 

Miscellaneous: 

Interest on bank balances 231 07 

44,099 76 

Other receipts: 

Refunds of previous year 6 00 

Receipts from Treasury of Comm,onwealth. 

Maintenance appropriations: 

Balance of 1920 $7,796 89 

Advance money (amount on hand November 30) . . 10,000 00 

Approved schedules of 1921 186,448 35 

204,245 24 

Special appropriations 29,356 76 

Total $282,209 44 



No. 34.] DIVISION OF TUBERCUI.OSIS (SANATORIA). 287 



Payments. 
To treasury of Commonwealth: 

Institution income $44,099 76 

Refunds, account of maintenance 71 07 

Returned drum, account of 1920 6 00 

$44,176 83 



Maintenance appropriations: 

Balance of schedules of previous year $12,298 57 

Eleven months' schedules, 1921 . . . $186,448 35 

Less returned 71 07 

186,377 28 

November advances 8,303 15 



206,979 00 



Special appropriations : 

Approved schedules $29,356 76 

November advances 359 87 



29,716 63 



Balance, Nov. 30, 1921: 

In bank $1,059 49 

In office 277 49 



1,336 98 



Total $282,209 44 



Maintenajstce. 

Balance from previous year, brought forward $275 18 

Appropriation, current year 209,130 00 



Total $209,405 18 

Expenses (as analyzed below) 202,236 43 

I 

Balance reverting to treasury of Commonwealth $7,168 75 

Analysis of Expenses. 
Personal services: 

Sumner Coolidge, M.D., superintendent .... $3,900 00 

Medical 3,429 20 

Administration 5,640 00 

Kitchen and dining-room service 6,775 78 

Domestic 16,204 16 

Ward service (male) 6,358 87 

Ward service (female) 5,571 19 

Engineering department 7,665 35 

Repairs 4,879 13 

Farm 28,850 12 

Stable, garage and grounds 2,633 69 

$91,907 49 



Amount carried forward $91,907 49 



288 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Amount brought forward $91,907 49 

Religious instruction: 

Catholic $600 00 

Hebrew 225 10 

Protestant 450 00 

Other 13 00 

• 1,288 10 

Travel, transportation and office expenses: 

Advertising $17 25 

Postage 130 51 

Printing and binding 244 87 

Stationery and office supplies 848 30 

Telephone and telegraph 327 25 

Travel 1,101 70 

Freight 19 58 

2,689 46 

Food: 

Flour $2,775 20 

Cereals, rice, meal, etc 1,136 37 

Bread, crackers, etc 121 18 

Peas and beans (canned and dried) 193 38 

Macaroni and spaghetti 59 57 

Potatoes 128 00 

Meat 9,421 83 

Fish (fresh, cured and canned) 2,104 71 

Butter 4,680 01 

Butterine, etc 105 60 

Cheese 149 51 

Coffee 321 68 

Tea 53 60 

Cocoa 53 97 

Milk (condensed, evaporated, etc.) 40 00 

Eggs (fresh) 1,239 38 

Sugar (cane) 2,027 62 

Fruit (fresh) 280 45 

Fruit (dried and preserved) 373 92 

Lard and substitutes 115 20 

Molasses and syrups 74 62 

Vegetables (fresh) 42 96 

Seasonings and condiments 489 98 

Yeast, baking powder, etc 146 12 

Sundry foods 64 04 

Freight 1,118 42 

27,317 22 

Clothing and materials: 

Clothing (outer) 5 74 

Furnishings and household supplies: 

Beds, bedding, etc $665 74 

Carpets, rugs, etc 322 20 

Crockery, glassware, cutlery, etc 534 62 

Dry goods and smallwares 164 75 

Electric lamps 386 63 

Amounts carried forward $2,073 94 $125,281 95 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 289 

Amounts brought forward $2,073 94 $125,281 95 

Furnishings and household supplies — Concluded. 

Fire hose and extinguishers 57 03 

Furniture, upholstery, etc. 1,071 67 

Kitchen and household wares 2,185 73 

Laundry supplies and materials 856 16 

Lavatory supplies and disinfectants 659 32 

Table linen, paper napkins, towels, etc 484 72 

Sundries 52 94 

Freight 158 71 

7,600 22 

Medical and general care: 

Books, periodicals, etc $45 40 

Entertainments, games, etc 897 03 

Funeral expenses 249 00 

Ice and refrigeration 184 43 

Laboratory supplies and apparatus 96 29 

Medicines (supplies and apparatus) 2,043 20 

Medical attendance (extra) 46 00 

Sputum cups, etc 997 57 

Tobacco, pipes, matches 10 25 

Freight 39 36 

4,608 53 

Heat, light and power: 

Coal (bituminous) $9,481 84 

Freight and cartage 8,173 10 

Coal (anthracite) 1,245 11 

Freight and cartage 485 13 

Oil 335 63 

Operating supplies for boilers and engines .... 399 78 

Sundries 148 43 

Freight 31 83 

20,300 85 



Farm: 

Bedding materials $333 26 

Blacksmithing and supplies 359 00 

Carriages, wagons and repairs 124 47 

Dairy equipment and supplies 587 08 

Fencing materials 136 81 

Fertilizers 2,763 68 

Grain, etc 17,281 05 

Hay 915 73 

Harnesses and repairs 49 96 

Cows 109 00 

Other live stock 1,188 00 

Labor (not on pay roll) 339 30 

Rent 115 00 

Road work and materials 312 91 

Spraying materials 283 62 

Stable and barn supplies 273 62 

Tools, implements, machines, etc 1,807 72 

Amounts carried forward $26,980 21 $182,697 82 



290 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Amounts brought forward $26,980 21 $182,697 82 

Farm — Concluded. 

Trees, vines, seeds, etc 1,127 37 

Veterinary services, supplies, etc 318 00 

Sundries 468 48 

Freight 1,678 68 

30,572 74 

Garage, stable and grounds: 

Motor vehicles $1,550 00 

Automobile repairs and supplies 3,184 81 

Fertilizers 238 77 

Road work and materials 326 31 

Spraying materials 27 00 

Tools, implements, machines, etc 95 88 

Trees, vines, seeds, etc 142 84 

Freight 110 23 

5,675 84 

Repairs, ordinary: 

Brick $46 88 

Cement, lime crushed stone, etc 413 00 

Electrical work and supplies 687 68 

Hardware, iron, steel, etc. 722 92 

Labor (not on pay roll) 281 62 

Lumber, etc. (including finished products) .... 1,407 33 

Paint, oil, glass, etc 796 54 

Plumbing and supplies 334 94 

Roofing and materials 457 32 

Steam fittings and supplies 821 89 

Tents, awnings,' etc 380 86 

Tools, machines, etc 247 23 

Boilers, repairs 191 47 

Dynamos, repairs 37 91 

Engines, repairs 149 47 

Sundries 97 49 

Freight 158 67 

7,233 22 

Repairs and renewals: 

Moving picture machine ' . •- • $1,149 97 

House telephone system 1,387 10 

Boiler feed pump 499 95 

3,037 02 

Total expenses for maintenance $202,236 43 

Special Appropriations. 

Balance Dec. 1, 1920 $12,155 18 

Appropriations for current year 18,000 00 

Total $30,155 18 

Expended during the year (see statement below) . . . $29,356 76 

Reverting to treasury of Commonwealth 96 

29,357 72 

Balance Nov. 30, 1921, carried to next year $797 46 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 291 



Object. 


Act or Resolve. 


Whole 
Amount. 


Expended 

during 
Fiscal Year. 


Total 

Expended 

to Date. 


Balance 

at End of 

Year. 


Generator unit 

Purchase of house and land, 

J. Letcher estate. 
Shelter for young stock 

Storehouse .... 

Cow barn addition 


Chap. 629, 1920 . 
Chap. 153, 1919 . 
Chap. 629, 1920 . 
Chap. 203, 1921 . 
Chap. 203, 1921 . 


$9,005 00 
2,500 00 
2,500 00 

10,000 00 
8,000 00 


58,850 81 

2,500 00 

803 41 

9,960 58 

7,241 96 


$9,004 11 
2,500 00 
2,499 93 
9,960 58 
7,241 96 


$0.89* 

.07* 
39 42 
758 04 




S32,005 00 


$29,356 76 


$31,206 58 


$798 42 



* Balance reverting to treasury of the Commonwealth . . $0 96 

Balance carried to next year 797 46 

Total as above 8798 42 

RESOtTHCES AND LIABILITIES. 

Resources. 

Cash on hand $1,336 98 

November cash vouchers (paid from advance money) : 

Account of maintenance $8,303 15 

Account of special appropriations . . . 359 87 

8,663 02 

Due from treasury of Commonwealth from available appropriation, account 
of November, 1921, schedule 



$10,000 00 
5,859 15 



Liabilities. 



Outstanding schedules of current year: 
Schedule of November bills 



$15,859 15 
$15,859 15 



Per Capita. 

During the year the average number of inmates has been 236.915. 

Total cost for maintenance, $202,236.43. 

Equal to a weekly per capita cost of $16.4162. 

Receipt from sales, $651.50. 

Equal to a weekly per capita of $0.05288. 

All other institution receipts, $43,448.26. 

Equal to a weekly per capita of $3.5267. 

Net weekly per capita cost $12.8367. 



Respectfully submitted, 

Sumner Coolidge, 

Treasurer. 



Examined and found correct as compared with the records in the office of the Auditor 

of the Commonwealth. 

Alonzo B. Cook, 

Auditor. 



292 



DEPARTMENT OE 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. 
James F. McLaughlin, M.D. 
David Zacks, M.D. . 
William J. O'Connor, D.M.D. 
Delta E. Nardi 
Cora A. Phillips 
Olin C. Blaisdell 
Walter C. Brown 
Joseph A. Carroll 



Superintendent. 

Assistant Superintendent. 

Physician. 

Physician. 

Physician. 

Physician. 

Dentist. 

Superintendent of Nurses. 

Head Matron. 

Steward. 

Chief Engineer. 

Farmer. 



REPORT OF THE SUPERINTENDENT. 

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

State House, Boston, Mass. 

I have the honor to submit the twenty-fifth annual report of the Rutland 
State Sanatorium for the year ending Nov. 30, 1921. 

During the year there has been expended $312,281.20 for maintenance, a gross 
weekly per capita cost of $17.3406. There has been expended from the special 
appropriation authorized by chapter 55, Resolves of 1918, $853.42. The details 
of these disbursements are contained in the report of the treasurer. 

There has been collected from miscellaneous sources (the total of all collec- 
tions) $58,926.53. Deducting this amount from the gross maintenance expense 
leaves a net expense of $253,354.67, and a net weekly per capita cost of $14.0682. 
There has been collected from private funds $12,667.37; from cities and towns 
$39,880.32; from the United States Veterans Bureau $4,940.38. One hundred 
and twenty-eight cases were supported wholly or in part from private funds; 
213 by cities and towns; 58 wholly by the State; 23 by the United States 
Veterans Bureau. 

There were 356 patients in the sanatorium at the beginning of the year, and 
364 at the close. The largest number present at one time was 371 and 
the smallest 304. The daily average number of patients was 346.32. There were 
483 cases admitted during the year, — 118 mcipient, 174 moderately advanced, 
165 advanced and 26 unclassified. There were 338 cases admitted from cities 
and towns of over 25,000 population, and 145 from cities and towns under 25,000 
population. The average age of patients admitted was twenty-nine .years. In- 
cluding deaths, there were 475 patients discharged, and the average duration 
of residence was seven months and twenty-one days. Of those discharged, 345 
gained 4,647^ pounds, an average gain of 13.47 pounds per person. Of the 
discharges there were 14 arrested cases, 11 less than last year; 26 apparently 
arrested, 8 less than last year; 215 quiescent, 28 more than last year; 75 im- 
proved and 46 unimproved. There were 45 patients not considered, the dura- 



No. 34.1 DIVISION OF TUBERCULOSIS (SANATORIA). 293 

tion of treatment being less than one month. There were 51 deaths, 11 less than 
last year. There were 3 discharged nontuberculous. There were 126,407 hos- 
pital days of treatment, 365 more than last year. 

The following table shows the classification on the application blank and our 
classification on admission : — 



Classification 

on Appli- 
cation Blank. 



Our Classifica- 
tion 
on Admission. 



Per Cent. 



Incipient 

Moderately advanced 
Advanced 
Unclassified . 
Totals 



278 

186 

11 

8 



483 



118 

174 

165 

26 



483 



24.4 

36.0 

34.0 

5.6 



Medical Report. 

There were two vacancies on the staff at the beginning of the year occasioned 
by resignations Sept. 12 and Oct. 15, 1920, noted in last year's report. The 
following appointments were made to fill these vacancies : — 

Dr. James F. McLaughlin, a graduate of Tufts Medical School, of the Spring- 
field Hospital and of the Evangeline Booth Maternity Hospital, was appointed 
assistant physician Jan. 1, 1921. 

Dr. David Zacks, a graduate of Tufts Medical School, of the Boston City 
Hospital and of the Evangeline Booth Maternity Hospital, was appointed 
assistant physician on Aug. 15, 1921. 

In view of the length of time these positions were vacant it may not be out of 
place to mention again the difficulty of securing well-trained and competent 
physicians. Such men are not looking to the institutions for a career. Institu- 
tional work is rarely entered with the idea of making it a permanent calling; 
rather it is taken up primarily as a means to an end. With the accumulation of 
experience and a replenished pocketbook the young physician enters other fields 
where he may obtain greater rewards for his efforts. A mechanic's wage and 
one room do not appeal to the live man who has spent twenty years in prepara- 
tion for a career. Constant changes in a medical staff are discouraging and 
demoralizing and standards cannot be maintained, to say nothing of progress. 
It is either the enthusiast desirous of further experience before taking up the 
practice of medicine or the one who has failed to make good and anticipates an 
easy existence who is attracted to a State institution. There should be an oppor- 
tunity in the State institutions for a strictly medical career, with a reward for 
ability and experience sufficient to attract and to hold in the ser\4ce the best 
that are coming from the medical schools. 

Mrs. Doris L. Davidson, a graduate of Smith College and more recently 
technician at the Worcester City Hospital, was appointed assistant bacteriolo- 
gist to take charge of the laboratory Aug. 8, 1921. 



294 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Treatment has been carried along essentially the same lines as in previous 
years except that we are prescribing more rest in bed for a group of patients 
previously treated as chair cases. These patients are not given absolute rest 
treatment but are allowed toilet and bathroom privileges, meals at the bedside 
and the libertj^ of visiting about the ward in the evening. We believe that pro- 
longing the period of bed treatment for this group lays a foundation for a more 
rapid arrest or inactivity of the disease than undertaking to secure sufficient 
relaxation with the patient dressed and supposedly taking chair treatment as 
prescribed. A few patients will co-operate beyond criticism if allowed clothes, 
but the majority feel too well to appreciate the significance of their trouble or 
the importance of rest, and it is practically impossible for the nurse to check 
accurately those disposed to regulate their own activities. Acute and active 
cases, as in the past, are given more intensive treatment and are not allowed the 
privileges granted the other group. All new admissions are automatically treated 
as bed cases for two weeks. The dail}^ rest period observed by all patients has 
been increased from one hour to two hours. 

It should not be lost sight of that the increased number of bed cases adds 
materially to the work of the laundry, nursing, housekeeping and kitchen 
departments. 

Our experience has been similar to that of the Westfield Sanatorium, that 
more harm is done by overeating than by undereating, as a result of which, 
lunches are being prescribed less and less as time goes on. 

The increase in weights this year has been quite remarkable. The average 
gain of those who gained is 2 pounds more than the average gain of the previous 
three years, and the average loss in weight of those who have lost is 3j\ pounds 
less for the same period. It is a question whether to attribute these gains to 
the omission in part of the lunches, to the increased bed treatment, or to both. 
The fact that 24.4 per cent of the admissions were classified as incipient as against 
32.6 per cent incipient last year is suggestive so far as figures go that these modi- 
fications of the treatment may have some bearing. 

There is a routine examination of sputum and urine and a specimen of blood 
drawn for the Wassermann test immediately after admission. The sputa of those 
cases found positive for tuberculosis are then examined once a month; all nega- 
tive cases twice monthly. A special effort has been made this year to confirm 
diagnoses by demonstrating the tubercle bacillus. Persistently negative cases 
have been examined by the antiformin method or a daily sputum examination 
has been made for a period of two weeks or longer. Animal inoculations have 
been made in a few instances. There are, however, 15.7 per cent negative cases 
or 84. .3 per cent positive cases. 

The following examinations have been made : — 



Urine ..... 
Sputum .... 

Blood counts .... 
Blood smears 

Examinations for pneumococcus 
Smears from eyes, throat, etc. . 
Blood drawn for Wassermann test 



691 

5,320 

20 

1 

2 

5 

462 



No. 34.1 DIVISION OF TUBERCULOSIS (SANATORIA). 295 



Routine dental examination is made of all admissions. 
is a simimary of the dentistry done during the year : — 

Office visits and treatments 

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 



The followina; table 



1,552 

130 

268 

91 

132 

141 

41 

406 

10 

148 

60 

71 

3 

73 

5 

82 

16 

91 

112 

6 



A sterilizer and motor-driven dental engine have been added to the 
equipment. 

The staff meets three times a week, — Monday morning for the consideration 
particularly of administrative questions, and Tuesday and Friday mornings for 
a clinical conference. All new patients are presented by the physicians, together 
with the case histories, laboratory reports and X-ray plates. The patient is 
examined and classified and prognosis and treatment discussed. Patients ready 
for discharge are similarly seen at these conferences. The staff meetings and 
clinical conferences have developed a co-operative spirit and teamwork which 
has been most gratifying. 

Clinics. 

The consultation clinics inaugurated by the Department last year have been 
held monthly at Worcester, Fitchburg, Clinton and Gardner. I believe this 
service is an advance in the campaign against tuberculosis and that as time goes 
on its value will become more generally recognized. Certainly the call for this 
service justifies its continuation for another year at least. 

The day of the monthly clinic is more or less lost sight of by the busy prac- 
titioner ; consequently, the number of cases referred is in a large measure due to 
the activity of the local nurse. I believe the attention of physicians should be 
called more frequently to this service until such time as it may become more 
firmly established and generally knowoi. The clinics as now conducted are more 
or less unsatisfactory from the \'iewpoint of the consultant, inasmuch as we are 
frequently seeing cases in which a diagnosis is practically impossible from a 
single examination and oftentimes doubtful after several examinations. There 
are occasional cases in which a diagnosis can be made only after a careful study 



296 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



and investigation, involving the X-ray, the laboratory and clinical observation, 
all of which facilities are available in the sanatorium. A large proportion of 
these obscure cases might be satisfactorily cleared up were it possible to admit 
them at once to the sanatorium for a lunited period of observation and study. 
Proof positive of tuberculosis is the presence of the tubercle bacillus in the 
sputum, yet it is the established practice to admit to the sanatorium on physical 
findings, symptoms and the assumption of an existing tuberculosis rather than 
to wait for a positive sputum. As our admitting wards are essentially observa- 
tion wards for the cases regularly admitted but not necessarily correctly diag- 
nosed, it would appear to be a logical step to admit at once to these wards for 
observation the doubtful cases discovered at the clinic. If the patient is found 
to be nontuberculous, he need not be labeled as such; no harm has been done 
and he may be relieved of the depressing thought that he is a consumptive. On 
the other hand, valuable time may be saved in starting the proper treatment 
which in early cases particularly is of vital importance. 

The following statistics cover a period of fifteen months since the consultation 
service was estabUshed : — 



Number of patients examined . 

Diagnosis: 

Tuberculosis .... 

Nontuberculous .... 

Observation .... 

Number of physicians referring cases . 
Number of cases brought in by nurse 

Number of patients examined once 
Number of patients examined twice . 
Number of patients examined three times 
Number of patients examined four times 
Number of patients examined five times 



296 

127 

56 

113 

71 
4 

296 

29 

10 

1 

1 



There were 24 cases admitted to this sanatorium following examinations at 

the clinics. 

The following examinations were made at the sanatorium covering a period 

of twelve months : — 

Ex-patients examined ........... 57 

Patients referred by outside physicians ........ 35 

Patients examined at own request ......... 27 

Total 119 

Diagnosis: 

Tuberculosis ............ 99 

Nontuberculous .....••••••• 1^ 

Observation .....••■••••' 

Total .119 

Number of physicians referring cases ......... 31 



No. 34.] DIVISION OF TUBERCLTLOSIS (SANATORIA). 297 

Number of ex-patients examined once ........ 57 

Number of ex-patients examined twice ........ 7 

Number of ex-patients examined three times ....... 2 

There were 21 cases admitted to this sanatorium following examinations. 

It will be noted that 102 physicians have referred cases either to the clinics 
or to the sanatorium for examination, and that as a result of the clinics and the 
examinations at the sanatorium 45 cases favorable for improvement or arrest 
have been admitted. These facts indicate the possibilities of the consultation 
service. 

Training School. 
There are 25 nurses in training, — 5 probationers, 7 juniors and 13 seniors. 
Seven nurses have received four months' training at the Milford General Hos- 
pital, which constitutes a part of the prescribed course. The following have been 
awarded diplomas : — 

Caroline Thompson White. 

Margaret Mary McKay. 

Mary Blanche Boucher. 

Mary Latina Musante. 

Florence Isabelle Grady. 

The training school offers an exceptional opportunity for the ex-patient to 
obtain a profession while at the same time living under ideal conditions and in a 
sense continuing treatment. There is a broad field for graduates of this school 
either in public health work or in sanatorium service, and the demand for our 
graduates far exceeds the supply. 

Our nurses are recruited for the most part from the ranks of the patients. 
They enter the school with a point of view somewhat different than that of one 
who has never experienced the life of the patient. With this background I have 
felt that the true spirit of nursing is developed as an outstanding feature of the 
school and that the course given is an exemplification of practical vocational 
training. 

The prescribed course for a registered nurse is given by the superintendent of 
nurses and the medical staff. The course in dietetics was given by Mrs. Alzira 
Sandwall of the Department of Public Health. Instruction in mental diseases 
was given by Dr. Michael J. O'Meara of Worcester. 

Farm. 
The stone wall south of the Bartlett Farm and the wall in the field on Central 
Tree Road have been removed, in addition to considerable grubbing to make 
this land suitable for cultivation. The chestnut timber has been cut and is to 
be sawed for use about the institution. A tractor, power sprayer and other less 
expensive items of machinery have been added to the farm equipment. 

Improvements. 
Outside painting, including metal roofs, has been done over the entire institu- 
tion, in addition to considerable work in the wards. All brickwork has been 
repointed. Outside stucco work and inside plastering have been repaired or 



298 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

replaced. Work on the gravel roofs started in October has progressed slowly 
because of weather conditions. Repairs to the metal roofs have been completed. 
About 1 mile of road and driveway has been resurfaced. Shortly before the 
close of the year the coal pocket collapsed, at the same time breaking away the 
northeast corner of the power house. Repairs requiring considerable brickwork, 
cement and steel girders are under way. 

Recommendations . 

Plans and specifications have been submitted for a building to provide quarters 
for forty-two employees now sleeping in dormitories adjacent to the wards and 
sharing toilets, lavatories and locker rooms with the patients. This condition 
is deplorable, to say the least, and results in overcrowding and more or less 
friction between patients .and employees. Desirable nontuberculous employees 
will not tolerate such accommodations, which the ex-patient, equally entitled to 
the privacy of a single room, is compelled to accept by reason of his misfortune. 
At the present time there is no place patients may go, with the exception of the 
lavatories and toilets, where heat is provided. The lack of such facilities is a 
hardship particularly during the winter months. The removal of these em- 
ployees from the dormitories will relieve the overcrowding, increase the capacity 
of the institution and afford much needed space for the use of patients. Esti- 
mates have been submitted that the building can be erected for $67,000, and I 
recommend an appropriation of that amount. I recommend that $10,000 be 
appropriated for steel lockers to replace the present wooden lockers which are 
obsolete and unsanitary, and that $4,000 be appropriated for the erection of a 
garage to provide space for motor equipment now housed in the horse barn. 

Since the trestle at Muschopauge was condemned, the delivery of coal has 
become a serious problem inasmuch as there is not space at the siding in Jeffer- 
son to store over six cars without rehandling. This is expensive and incon- 
venient; the expense of shoveling alone practically offsetting the price which 
may be obtained for immediate delivery or large shipments. Furthermore, 
because of inadequate storage, it is necessary to haul coal at the most inoppor- 
tune times, seriously interfering ^vith other work, whereas with sufficient storage 
space it would be hauled at our convenience and at less expense. I beheve the 
Jefferson trestle either should be extended or a new trestle built on the site of 
the old one at Muschopauge. A new trestle at Muschopauge would appear to 
be a better proposition than an extension to the one at Jefferson. The siding 
at Jefferson is approximately 3 miles from the boiler house and the coal pocket 
several feet under water in the spring; the siding at Muschopauge is 1^ miles 
away and the site above water. Notwithstanding the advantage of the State 
road to Jefferson, the difference in the length of the haul adds materially to the 
cost of coal in the bunker; a pair of horses can make five trips to Muschopauge 
as against three trips to Jefferson. I recommend that plans and estimates be 
obtained for this construction. 

News of the death of Dr. William J. Gallivan, Director of the Division of 
Tuberculosis, came as a shock to all on the morning he had planned to visit the 
sanatorium for a week end. During the time he had been officially connected 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 299 

with the sanatorium he had won the respect and love of all with whom he was 
associated. He had a warm, personal interest in every one; a word of encour- 
agement and good cheer accompanied his visits to the wards. Prominent for 
many years in health and tuberculosis work, with a broad vision of the future, 
the Commonwealth loses a most conscientious worker in the interests of better 
health. To me his counsel and optunism were invaluable and his loss a per- 
sonal one. 

The members of the staff, nurses and employees have rendered a year of 
faitMul service and merit your approval. 

Deeply appreciating your interest and confidence during the year, I am 

Respectfully, 

Ernest B. Emerson, 

Superintendent. 



VALUATION. 

Land. 

Grounds (51.107 acres)- $17,979 20 

Lawns and buildings, 41.107 acres. 

Roads, 10 acres. * 

Woodland (77.21 acres) 2,683 65 

Mowing (56.05 acres) 5,605 00 

TiUage (58.52 acres) 6,646 74 

TUlage, 42.32 acres. 

Garden, 16.20 acres. 

Orchard (1.64 acres) 328 00 

Pasture (93.05 acres) 2,933 85 

Waste and miscellaneous (26.65 acres) . . 1,369 50 

Rough pasture, 1.95 acres. 

Meadow swamp land, 18.22 acres. 

Sewer beds, 5.98 acres. 

New coal trestle, .50 acre. 

$37,545 94 

Sewerage system 15,508 32 

$53,054 26 

Buildings. 

Institution buildings $493,312 69 

Farm, stable and grounds 25,375 00 

Miscellaneous 30,295 75 

548,983 44 

Total ' . ■ $602,037 70 

Present value of all personal property as per inventory of Dec. 1, 1921 . . 103,585 61 

Grand total $705,623 31 



300 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



SPECIAL REPORT. 

The following special report is prepared in accordance with a resolution of the 
National Conference of Charities and Corrections, adopted May 15, 1906: — 

Population . 





Males. 


Females. 


Totals. 


Number received during the year 


262 


221 


483 


Number passing out of the institution during the year 


265 


210 


475 


Number at end of fiscal year in the institution . 


180 


184 


364 


Daily average attendance (number of inmates actually 

present) during the year. 
Average number of employees and officers during the year 


174.50 
118.40 


171.82 
65.90 


346.32 
184.30 



Ex'penditures 
Current expenditures: 

1. Salaries and wages 

2. Clothing 

3. Subsistence .... 

4. Ordinary repairs .... 
6. Office, domestic and outdoor expenses 



$133,195 45 

241 52 

78,421 92 

8,542 35 

91,879 96 



$312,281 20 



Extraordinary expenses: 

1. Permanent improvements to existing buildings 

Grand total ...... 



853 42 



$313,134 62 



Summary of Current Expenses. 



Total expenditure 

Deducting extraordinary expenses 



Deducting amount of sales 



$313,134 62 
853 42 

$312,281 20 
600 25 

$311,680 95 



Dividing this amount by the daily average number of patients — 346.32 — gives a 
cost for the year of $899.97, equivalent to an average weekly net cost of $17.3073. 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 301 



STATISTICAL TABLES. 

Table 1. — Admissions and Discharges. 





Males. 


Females. 


Totals. 


Patients in sanatorium Nov. 30, 1921 


182 


174 


356 


Patients admitted Dec. 1, 1920, to Nov. 30, 1921 . 


262 


221 


483 


Patients discharged Dec. 1, 1920, to Nov. 30, 1921 


265 


210 


475 


Patients remaining in sanatorium Nov. 30, 1921 . 


180 


184 


364 


Daily average number of patients 


174.50 


171.82 


346.32 


Deaths (included in number discharged) .... 


26 


25 


51 



Table 2. — Civil Condition of Patients admitted. 





Males. 


Females. 


Totals. 


Single 


139 


119 


258 


Married 


112 


94 


206 


Widowed 


10 


7 


17 


Divorced 


1 


1 


2 


Totals 


262 


221 


483 



Table 3. — Age of Patients admitted. 





Males. 


Females. 


Totals. 


Percentage. 


14 to 20 years 


49 


45 


94 


19 


20 to 30 years 


100 


103 


203 


42 


30 to 40 years 


71 


54 


125 


26 


40 to 50 years 


32 


15 


47 


10 


Over 50 years 


10 


4 


14 


3 


Totals 


262 


221 


483 


- 


Average age 


30.32 


27.94 


29.23 


- 



302 



DEPARTMENT OF PUBIJC HEALTH. [Pub. Doc. 



Table 4 


. — N 


ativity 


and Parentage of Patients admitted. 






Males. 


Females. 


Totals. 


Places of Nativity. 


i 


03 
fa 


O 

o 


-.J 

a 
.2 


.2 

fa 


2 
o 


_s 

cS 
fa 


£ 

fa 


o 


United States: 




















Massachusetts . 


158 


48 


44 


118 


36 


40 


276 


84 


84 


Other New England States 


15 


16 


16 


21 


16 


15 


36 


32 


31 


Other States . 


13 


13 


13 


9 


6 


6 


22 


19 


19 


Total native 


186 


77 


73 


148 


58 


61 


334 


135 


134 


Other countries (24) 


76 


182 


186 


73 


159 


154 


149 


341 


340 


Unknown 


- 


3 


3 


- 


4 


6 


- 


7 


9 


Grand totals 


262 


262 


262 


221 


221 


221 


483 


483 


483 







Table 5 


— Residence of Patients admitted. 






Place. 


Number. 


Place. 


Number. 


Adams 


6 


Gardner 


8 


Andover . 










1 


Gloucester 










1 


Arlington 










2 


Grafton . 










1 


Ashland . 










1 


Hardwick 










1 


Athol 










1 


Haverhill 










8 


Barre 










1 


Hingham 










2 


Beverly . 










1 


Holden . 










4 


Boston 










178 


Holyoke . 










4 


Brockton . 










3 


Hopkinton 










1 


Cambridge 










19 


Hudson . 










2 


Chelsea . 










7 


Ipswich . 










2 


Chicopee . 










1 


Lawrence 










4 


Clinton . 










4 


Leicester . 










2 


Danvers . 










2 


Leominster 










5 


Dedham . 










1 


Lexington 










3 


Douglas . 










1 


Lowell 












Everett . 










2 


Ludlow . 












Fall River 










5 


Lynn 










12 


Falmouth 










1 


Maiden . 












Fitchburg 










4 


Mansfield 












Framingham 










9 


Marlborough 










13 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 303 



Table 5. — Residence of Patients admitted — Concluded. 



Place. 

Maynard . 

Medford . . . 

Medway . 

Melrose . 

Methuen . 

Milford . 

Millville . 

Milton 

Nahant . 

Natick 

New Bedford . 

Newburyport . 

Newton . 

North Adams . 

Northborough 

Northbridge . 

Norwood . 

Peabody . 

Pittsfield . 

Plymouth 

Quincy . 

Revere 

Rutland . 

Salem 

Saugus 

Sharon 



Number. 



Place. 



Number. 



Shelbiu-ne 
Sherborn . 
Somerville 
Southbridge 
Springfield 
Sudbury . 
Sutton 
Templeton 
Tewksbury 
Upton 
Uxbridge . 
Wakefield 
Walpole . 
Waltham . 
Watertown 
Webster . 
West Boylston 
West Springfield 
Westborough 
Weymouth 
Winchendon 
Winthrop 
Woburn . 
Worcester 
Total 



1 
1 
7 
2 

13 
1 
1 
3 
1 
1 
2 
1 
2 

3 
1 
1 
1 
1 
2 
1 
2 

2 

3 

29 



483 



304 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 6. — Occupations of Patients admitted. 





Males. 


Females. 


Totals. 


Accountant 


1 


_ 


1 


Advertising agent 


1 


- 


1 


Attendant 


1 


- 


1 


Baker 


1 


_ 


1 


Barber 


3 


_ 


3 


Boiler tender 


1 


_ 


1 


Bookbinder 


- 


1 


1 


Bookkeeper 


- 


3 


3 


Brakeman 


2 


- 


2 


Bundle girl 


- 


1 


1 


Candy maker 


2 


- 


2 


Carpenter 


5 


- 


5 


Chairmaker 


1 


- 


1 


Chambermaid 


- 


2 


2 


Chauffeur 


7 


- 


7 


Clerk 


21 


11 


32 


Collector 


- 


2 


2 


Conductor, Elevated Railroad 


1 


- 


1 


Conductor, street railway 


3 


- 


3 


Cook 


2 


- 


2 


Cook, helper 


1 


- 


1 


Cutter, clothing 


1 


- 


1 


Cutter, meat 


1 


- 


1 


Cutter, shoe 


1 


- 


1 


Cutter, stone 


1 


- 


1 


Designer 


- 


1 


1 


Draftsman 


4 


- 


4 


Dressmaker 


- 


1 


1 


Dyeworker 


1 


- 


1 


Electrician 


4 


- 


4 


Electrician, helper 


1 


- 


1 


Elevator operator 


2 


1 


3 


Engineer, electrical 


1 


- 


1 


Engineer, mechanical 


1 


- 


1 


Engineer, stationary 


3 


- 


3 


Errand boy 


1 


- 


1 


Expressman 


1 


- 


1 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 305 



Table 6. — Occupations of Patients admitted — Continued. 





Males. 


Females. 


Totals. 


Factory 


18 


36 


54 


Farmer 


1 


1 


2 


Fireman 


2 


- 


2 


Gate tender 


1 


- 


1 


Governess 


- 


1 


1 


Hatter 


1 


- 


1 


Housekeeper 


- 


3 


3 


Housewife 


- 


85 


85 


Housework 


- 


18 


18 


Illustrator 


1 


- 


1 




1 


- 


1 


Insurance adjuster 


1 


- 


1 




1 


- 


1 


Janitor 


1 


- 


1 




1 


- 


1 


Laborer 


18 


- 


18 




- 


2 


2 


Leather worker 


3 


- 


3 




1 


- 


1 


Machinist 


23 


- 


23 




- 


1 


1 


Mason 


1 


- 


1 




2 


- 


2 


Mechanic, auto 


3 


- 


3 




3 


- 


3 


Molder 


1 


- 


1 




1 


- 


1 


No occupation 


4 


12 


16 




- 


2 


2 


Nurse, trained 


- 


6 


6 


Nursemaid 


- 


1 


1 


Optical workman 


1 


- 


1 


Orderly 


3 


- 


3 


Painter 


6 


- 


6 




1 


- 


1 


Peddler 


1 


- 


1 




1 


- 


1 



306 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 6. — Occupations of Patients admitted — Concluded. 



Males. 



Females. 



Totals. 



Plumber 

Pool room proprietor 

Pressman 

Printer . 

Produce dealer 

Repairer, car . 

Repairer, shoe 

Repairer, telephone 

Sailor 

Salespeople 

Seamstress 

Secretary 

Shipbuilder . 

Shipper . 

Shoeworker . 

Singer, professional 

Stage manager 

Stenographer . 

Student . 

Tailor . 

Teacher . 

Teamster 

Telephone operator 

Telephone supervisor 

Tinsmith 

Toolmaker 

Trainman, passenger 

Typist . 

Upholsterer . 

Waiter 

Watchman 

Weaver . 

Wireworker 
Totals 



2 
20 

1 
1 

2 
9 
1 
1 

11 

2 



262 



221 



2 

1 

1 

7 

1 

1 

1 

1 

2 
27 

2 

1 
1 

2 
9 
1 
1 
7 

17 
2 
2 
4 
2 
1 
1 
4 
1 
2 
1 
4 
1 
2 
2 



483 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 307 



Table 7. • — Condition on Admission. 



Males. 



Females. 



Totals. 



Percentage. 



Incipient 

Moderately advanced 
Far advanced 
Unclassified . 
Totals . 



64 
89 
98 
11 



54 
85 
67 
15 



118 

174 

165 

26 



262 



221 



483 



24.43 

36.03 

34.16 

5.38 



Table 8. • — Condition on Discharge. 



Males. 



Females. 



Totals. 



Percentage. 



Arrested 

Apparently arrested 
Quiescent 
Improved 
Unimproved 
Died . 

Nontuberculous . 
Not considered 
Totals . 



3 

7 

122 

42 

29 

26 

2 
34 



265 



11 
19 
93 
33 
17 
25 
1 
11 



14 
26 
215 
75 
46 
51 
3 
45 



no 



475 



2.95 

5.48 
45,26 
15.77 

9.69 

10.74 

.63 

9.48 



Table 9. — Deaths 















Males. 


Females. 


Totals. 


Length of Residence 
AT Sanatoriom. 


DtJR.^TION OF iJISE.\SE. 
















Males. 


Females. 


Totals. 


Under 1 month 


- 


- 


- 


- 


1 


1 


1 to 2 months 












- 


- 


- 


4 


7 


11 


2 to 3 months 












- 


- 


- 


- 


- 


- 


3 to 4 months 












- 


- 


- 


2 


1 


3 


4 to 5 months 












- 


- 


- 


3 


2 


5 


5 to 6 months 












- 


1 


1 


4 


2 


6 


6 to 7 months 












- 


- 


- 


2 


1 


3 


7 to 8 months 












- 


- 


- 


1 


2 


3 


8 to 9 months 












1 


1 


2 


2 


2 


4 


9 to 10 months 












- 


1 


1 


1 


3 


4 


10 to 12 months 












2 


2 


4 


3 


- 


3 . 


12 to 18 months 












7 


5 


12 


4 


3 


7 


18 to 24 months 












2 


5 


7 


- 


1 


1 


Over 2 years . 












14 


10 


24 


- 


- 


- 


Totals 


26 


25 


51 


26 


25 


51 



308 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 10. — Cause of Deaths. 



Males. 


Females. 


Totals. 


Pulmonary tuberculosis 

Acute endocarditis 


26 


24 
1 


50 
1 


Totals 


26 


25 


51 



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, 1921 : — 

Ca.'^h Account. 
Balance Dec. 1, 1920 $11,486 19 

Receipts. 
Incotne. 
Board of inmates: 

Private $12,667 37 

Cities and towns. War Risk .... 44,820 70 

$57,488 07 

Personal services: 

Reimbursement from Board of Retirement . . . . 115 72 

Sales: 

Food $273 45 

Clothing and materials 38 

Furnishings and household supplies . . 40 95 

Medical and general care 121 39 

Heat, light and power 8 61 

Farm: 

Cows and calves .... $43 00 

Pigs and hogs 40 00 

Hides 7 33 

Sundries 59 55 

149 88 

Garage, stable and grounds .... 5 59 

600 25 

Miscellaneous: 

Interest on bank balances .... $548 13 

Sundries 174 36 

722 49 

58,926 53 

Other receipts: 

Refunds of previous year 133 69 

Amount carried forward $70,546 41 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 309 

Amount brought forward $70,546 41 

Receipts from Treasury of Commonwealth. 
Maintenance appropriations: 

Balance of 1920 $10,090 42 

Advanced money (amount on hand November 30) . . 20,000 00 

Approved schedules of 1921 288,135 33 

318,225 75 



Special appropriations 853 42 



Total $389,625 58 

Payments. 
To treasury of Commonwealth : 

Institution income $58,926 53 

Refunds, account of maintenance 6 70 

Refunds of previous year 133 69 

$59,066 92 



Maintenance appropriations: 

Balance of schedules of previous year $21,576 61 

Eleven months' schedules, 1921 . . . $288,135 33 

Less returned 670 

288,128 63 

November advances 9,979 16 



319,684 40 

Special appropriations: 

Approved schedules 853 42 

Balance, Nov. 30, 1921: 

In bank $5,123 61 

In office 4,897 23 



10,020 84 



Total ^ $389,625 58 



Maintenance. 

Balance from previous year, brought forward $2,447 46 

Appropriation, current year, $344,300 plus $6.70 (refunds current year) . 344,306 70 



Total $346,754 16 

Expenses (as analyzed below) 312,281 20 



Balance reverting to treasury of Commonwealth $34,472 96 

Analysis of Expenses. 
Personal services: 

Ernest B. Emerson, superintendent $3,900 00 

Medical 8,131 92 

Administration 9,571 98 

Kitchen and dining-room service 12,477 38 

Domestic 30,589 77 



Amount carried forward $64,671 05 



310 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Amount brought forward $64,671 05 

Personal services — Concluded. 

Ward service (male) 13,115 33 

Ward service (female) 16,543 58 

Engineering department 12,617 45 

Repairs 6,014 21 

Farm 14,005 47 

Stable, garage and grounds 6,227 06 

$133,194 15 

Religious instruction: 

Catholic • $600 00 

Hebrew 600 00 

Protestant 600 00 

Other 50 00 

1,850 00 

Travel, transportation and office expenses: 

Advertising $22 06 

Postage 267 00 

Printing and binding 315 72 

Stationery and office supplies 1,150 37 

Telephone and telegraph 1,145 10 

Travel 608 04 

Freight 21 09 

3,529 38 

Food: 

Flour > $2,974 70 

Cereals, rice, meal, etc 1,702 86 

Bread, crackers, etc 103 31 

Peas and beans (canned and dried) ..... 195 41 

Macaroni and spaghetti 123 54 

Potatoes 1.664 90 

Meat 27,843 49 

Fish (fresh, cured and canned) 2,080 03 

Butter 5,706 13 

Butterine, etc ^ ^\ 

Chee.se 152 53 

Coffee 822 02 

Tea 154 96 

Cocoa 61 33 

Whole milk 11,325 66 

Milk (condensed, evaporated, etc.) 206 73 

Eggs (fresh) 7,003 43 

Sugar (cane) 2,376 33 

Sugar (maple, etc.) 68 54 

Fruit (fresh) 1,810 23 

Fruit (dried and preserved) 4,025 74 

Molasses and syrups 123 92 

Vegetables (fresh) 1,594 00 

Vegetables (canned and dried) 4,147 12 

Seasonings and condiments 1,177 22 

Yeast, baking powder, etc 169 06 

Sundry foods 1 65 

Freight 793 77 

78,418 42 

Amount carried forward $216,991 95 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 311 

Amount brought forward $216,991 95 

Clothing and materials: 

Boots, shoes and rubbers $135 00 

Clothing (outer) 105 69 

Freight 83 

241 52 

Furnishings and household supplies: 

Beds, bedding, etc. $2,587 72 

Carpets, rugs, etc 19 50 

Crockery, glassware, cutlery, etc 1,294 21 

Dry goods and smallwares 152 36 

Electric lamps 245 12 

Fire hose and extinguishers 37 03 

Furniture, upholstery, etc. 279 81 

Kitchen and household wares 1,690 10 

Laundry supplies and materials 534 01 

Lavatory supplies and disinfectants 1,305 82 

Table linen, paper napkins, towels, etc 674 87 

Freight 176 59 

8,997 14 

Medical and general care: 

Books, periodicals, etc $144 48 

Entertainments, games, etc 276 42 

Gratuities 12 34 

Ice and refrigeration 193 84 

Laboratory supplies and apparatus 1,397 29 

Medicines (supplies and apparatus) 4,195 83 

Medical attendance (extra) 57 00 

Sputum cups, etc 1,357 97 

Tobacco, pipes, matches 21 74 

Water 2,182 60 

Freight 78 67 

9,918 18 

Heat, light and power: 

Coal (bituminous) $16,269 13 

Freight and cartage 20,494 90 

Coal (anthracite) 1,360 47 

Freight and cartage 930 01 

Charcoal 100 00 

Electricity 120 00 

Oil 1,163 80 

Operating supplies for boilers and engines .... 412 35 

Rent of coal trestle 6 66 

Freight 27 98 

40,885 30 

Farm: 

Bedding materials $523 35 

Blacksmithing and supplies 378 47 

Carriages, wagons and repairs 973 26 

Dairy equipment and supplies 328 95 

Fencing materials 185 39 

Fertilizers 1,377 55 

Grain, etc 6,415 11 

Amounts carried forward $10,182 08 $277,034 09 



312 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Amounts brought forward $10,182 08 $277,034 09 

Farm — Concluded. 

Harnesses and repairs 244 07 

Horses 190 00 

Cows 375 00 

Other live stock 710 83 

Labor (not on pay roll) 107 00 

Spraying materials 45 87 

Stable and barn supplies 81 02 

Tools, implements, machines, etc 3,889 04 

Trees, vines, seeds, etc 518 19 

Veterinary ser\'ices, supplies, etc 506 72 

Hennery supplies and pasturing 153 70 

Freight 225 32 



Garage, stable and grounds: 

Automobile repairs and supplies $2,770 85 

Bedding and materials 30 71 

Blacksmithing and supplies 74 72 

Carriages, wagons and repairs 204 17 

Grain ■. 131 12 

Harnesses and repairs 104 80 

Labor (not on pay roll) 16 00 

Road work and materials 27 50 

Spraying materials 8 45 

Stable supplies 33 97 

Tools, implements, machines, etc , . . 391 00 

Trees, vines, seeds, etc 24 63 

Freight 4 00 



Repairs, ordinary: 

Cement, lime, crushed stone, etc $902 01 

Electrical work and supplies 802 72 

Hardware, iron, steel, etc. 349 82 

Labor (not on pay roll) 51 21 

Lumber, etc. (including finished products) . . . . 819 67 

Paint, oil, glass, etc 2,659 30 

Plumbing and supplies 460 74 

Roofing and materials 28 53 

Steam fittings and supplies 436 99 

Tents, awnings, etc 226 88 

Tools, machines, etc 884 63 

Boilers, repairs 337 80 

Dynamos, repairs 8 04 

Engines, repairs 43 20 

Labor, not on pay roll 406 00 

Freight 122 91 



Repairs and renewals: 

Scales for weighing coal $759 50 

Plumbing 229 19 

Roofing 3,894 79 

Steam fitting 384 10 



17,228 84 



3,821 92 



8,540 45 



Amounts carried forward $5,267 58 $306,625 30 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 313 

Amounts brought forward $5,267 58 $306,625 30 

Repairs and renewals — Concluded. 

Painting 192 33 

Boilers 42 GO 

Lumber 147 29 

5.649 20 

Total expenses for maintenance $312,274 50 

Special Appropriations. 

Balance Dec. 1, 1920 $1,094 26 

Expended during the year (see statement below) . . . $853 42 

Reverting to treasury of Commonwealth 240 84 

$1,094 2 6 

Balance Nov. 30, 1921, carried to next year - 



Object. 


Act or Resolve. 


Whole 
Amount. 


Expended 

during 
Fiscal Year. 


Total 

Expended 

to Date. 


Balance 

at End of 

Year. 


Kitchen, service and store- 
house building. 


Chap. 55, 1918 . 


$55,000 00 


S853 42 


$54,759 16 


$240 84 • 


^.v ■■, ' . 


$55,000 00 


$853 42 


$54,759 16 


$240 84 



* Balance reverting to treasxiry of the Commonwealth. 

Resources and Liabilities, 

Resources. 

Cash on hand $10,020 84 

November cash vouchers (paid from advance money), account 

of maintenance 9,979 16 



Due from treasury of Commonwealth from available appropriation, account 
of November, 1921, schedule 



$20,000 00 

4,145 87 
$24,145 87 



Liabilities. 
Outstanding schedules of current year: 

Schedule of November bills $24,145 87 



Per Capita. 

During the year the average number of inmates has been 346.32. 

Total cost for maintenance, $312,274.50. 

Equal to a weekly per capita cost of $17.3402. 

Receipt from sales, $600.25. 

Equal to a weekly per capita of $0.0333. 

All other institution receipts, $58,326.28. 

Equal to a weekly per capita of $3.2387. 

Net weekly per capita cost, $14.0682. 

Respectfully submitted, 

Leon A. Alley, 

7'reasurer. 

Examined and found correct as compared with the records in the office of the Auditor 
of the Commonwealth. 

Alonzo B. Cook, 

Auditor. 



314 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



WESTFIELD STATE SANATORIUM. 

Resident Officers. 



Henry D. Chadwick, M 
Roy Morgan, M.D. 
Heman B. Chase . 
Russell H. Bethell 
Emily B. Morgan . 
Benjamin J. Sandiford 
Robert J. Goldberg 



D. 



Superintendent. 

Assistant Superintendent. 

Physician. 

Dentist. 

Superintendent of Nurses and Matron, 

Chief Engineer. 

Farmer. 



REPORT OF THE SUPERINTENDENT. 

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

State House, Boston. 

I have the honor to submit the twelfth annual report of the Westfield State 
Sanatorium for the year ending Nov. 30, 1921. 

During the year there has been expended $190,027 for maintenance, a gross 
weekly per capita cost of $13,896, and $5,237.11 from the appropriations au- 
thorized by chapter 225, Resolves of 1920, and chapter 203, Resolves of 1921. 
The details of these disbursements are contained in the report of the treasurer. 

There has been collected from miscellaneous sources $48,039.10. Deducting 
this amount from the gross maintenance expense leaves a net expense of 
$141,987.90, and a net weekly per capita cost of $10,383. There has been col- 
lected from private funds $4,930.12; from cities and towns $36,112.99; from 
the United States Veterans Bureau $3,721.69. Fiftj^-six cases were supported 
wholly or in part from private funds; 318 by cities and to\\Tis; 83 wholly by the 
State; 5 by the United States Veterans Bureau; 25 by the Department of Public 
Welfare; in 51 the status was undetermined. 

There were 266 patients in the sanatorium at the beginning of the year and 
273 at the close. The largest number present at one time was 276 and the 
smallest 250. The daily average number of patients was 262.98. There were 
309 cases admitted during the year, — 83 incipient, 141 moderately advanced, 
82 advanced and 3 nontuberculous. There were 167 cases admitted from cities 
and towns of over 25,000 population, and 142 from cities and towns under 25,000 
population. The average age of patients admitted was 21.05 years. Including 
deaths, there were 303 discharges, and the average duration of residence was 
eleven months and ten days. Of those discharged, 211 gained 2,322 pounds, an 
average gain of 11 pounds per person. Of the discharges there were 160 appar- 
ently arrested, 24 more than last year; 21 quiescent, 31 less than last year; 25 
improved and 42 unimproved. There were 14 patients not considered, the 
duration of treatment being less than one month. There were 38 deaths, 3 less 
than last year. There were 3 discharged nontuberculous. There were 95,987 
hospital days of treatment, 1,828 less than last year. 

The following table shows the classification on the application blank and our 
classification on admission : — 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 315 



Incipient . 

Moderately advanced 
Advanced 
Unclassified 
Nontuberculous 
Totals 



Classification 

on Appli- 
cation Blank. 



Our Classifica- 
tion 
on Admission. 




Medical Report. 

"We have found heliotherapy of great advantage in cases of superficial tuber- 
culous lesions, such as lupus, scrofula derma, suppurating adenitis and sinuses 
from diseased bones and joints. The sun's rays are used on the exposed part when 
weather conditions warrant, and on cold and cloudy days the Quartz lamp is 
found to be an effective substitute. We have used bed rest treatment more than 
ever before and are getting better results. 

The X-ray equipment has been of inestimable value to the medical staff to 
supplement the first physical examination, and to study conditions that arise 
as the result of complications and artificial pneumothorax treatment. In the 
study of the thoracic conditions of children, the X-ray is indispensable for accu- 
rate diagnosis. 

I have written two papers the past year. Both have been published in the 
"American Review of Tuberculosis," — "Malnutrition and its Relation to 
Tuberculosis" and "The Child's Place in the Tuberculosis Program." In addi- 
tion to this I have given addresses on "Childhood Tuberculosis and Nutrition" 
in Westfield, Marlborough, Cambridge, Worcester, Northampton and Boston. 
In May I served on a joint committee of the National Tuberculosis Association 
and the American Association to define Rules of Discipline and Treatment of 
War Risk Insurance Beneficiaries. The report of this committee was accepted 
and has been i3ut into practice. 

Clinics. 

Consultation clinics have been held each month in Springfield, Holyoke, 
Pittsfield and Adams. Those in Holyoke and Adams have been well attended 
and seemed to be appreciated by the local plwsicians, who frequently accom- 
pany their patients to the dispensary where the examinations are made. The 
physicians of Pittsfield have been slower to make use of the clinic. During the 
past four months of the year, however, several of the leading doctors have sent 
in patients, and this indication of interest on their part makes the prospect en- 
couraging for a more successful clinic there in the future. I think the reason 
we have had so few patients at the Springfield clinic is the proximity of the 
sanatorium to that city. The physicians find it more convenient to direct their 
patients to come to the sanatorium on any day of the week than to wait for the 



316 



DEPARTMENT OF PUBIJC HEALTH. [Pub. Doc. 



second Wednesday of the month to see us at the dispensary. Although but 10 
patients were seen at the consultation clinics, 42 Springfield patients came to 
the sanatorium for examination during the year. Most of them were advised 
to do so by their physicians, to whom we reported the results of our findings. 

The total number of patients examined at the consultation clinics was as 
follows : — 



Holyoke 
Adams . 
Springfield 
Pittsfield 
Totals 



Positive. 



30 

26 

3 

8 



67 



Further Ex- 
amination. 



7 

16 
3 
1 



27 



Negative. 



17 



Totals. 



42 
47 
12 
10 



111 



Examination clinics have been continued during the year in co-operation with 
the Hampden County Tuberculosis Association. These have been arranged 
by the public health nurses in the employ of the association. They have been 
well plamied and the positive and suspicious cases found at these clinics have 
been followed up by the nurses to see that suitable treatment was instituted. 
These clinics have been held in Ludlow, West Springfield, Palmer, East Long- 
meadow, Three Rivers, Southwick and Brimfield, 13 clinics altogether. Two 
hundred and twenty-five patients were examined; 18 were found to be positive, 
and 103 had suspicious signs and are being kept under observation. These are 
all small towTis without dispensaries, and the physicians and the people have 
seemed to welcome this service. It is a plan that should be extended to all the 
rural communities so that we may complete the chain of systematic tuberculosis 
work and make it State wide. The sanatoria, both State and county, should 
serve as centers for this clinical work in their adjacent territory. Its purpose is 
not to compete with existing dispensaries, but to supplement them in the small 
towns and isolated villages. The intensive work done in recent years in the 
cities has resulted in bringing down the death rate from tuberculosis close to the 
rural level and bids fair to go below it. The change in the rural tuberculosis 
death rate as compared with the urban has declined but little. We have reason 
to assume that this is because the small towTis have been neglected in the past 
by the tuberculosis crusade. The Berkshire County Tuberculosis Association 
arranged two clinics this last year,— one at Williamstown, where we examined 
20 patients, and the other at Lee, where we examined 24. The board of 
health of Chicopee invited us to hold a clinic at their dispensary last spring, 
and 18 patients appeared for examination. 

Sanatorium out-patient work has increased in a very satisfactory way. In 
1920 we examined 118 out-patients. This year we have examined 185, — 110 
males and 75 females. Of these, 70 were active tuberculous cases, 26 quiescent, 
69 negative and 20 suspicious. It was found desirable as an aid in diagnosis to 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 317 

take an X-ray film of the chest in 71 of these cases. We have therefore been 
called upon to make a diagnosis in 296 cases, including out-patients and those 
who appeared at the consultation clinics. This number is within 13 of as many 
as were admitted to the sanatorium. Including the out-patients, those ex- 
amined at the consultation clinics, at the examination clinics, and at the board 
of health clinics, we have examined a total of 583 patients for diagnosis of chest 
conditions. 

Dentistry. 

All the new patients are examined ^vithin a few days after admission. All the 
children are re-examined within four months. As a matter of interest the 
younger patients were asked whether or not they were in the habit of using a 
toothbrush at home and their answers were as follows : — 



Ages. 


BOTS. 


Girls. 


Number. 


Per Cent. 


Answer. 


Number. 


Per Cent. 


Answer. 


4 to 13 years 

13 to 17 years .... 


45 
38 


42 
48 


Yes 

Yes 


40 
30 


75 
75 


Yes 

Yes 



The teaching of oral hygiene and providing needed dental work is a very 
important factor in the care of sanatorium patients. Undoubtedly such treat- 
ment hastens recovery in many cases. 

The following is a summary of Dr. Bethell's work during the year. The total 
number of operations is one-third more than the preceding year. 



Number of patients examined 
Number of canal dressings 
Number of prophylaxis . 
Number of extractions 
Number of amalgam fillings 
Number of cement fillings 
Number of pulp cappings 
Number of pulp treatments 
Number of devitalizations 
Number of temporary stoppings 
Number of X-rays . 
Number of irrigations 



Total number of operations 



367 

96 

660 

429 

450 

515 

160 

87 

35 

141 

46 

63 



3,049 



Children. 

In September we began to carry out your policy of making more beds avail- 
able for children. About 30 adult patients were transferred to other sanatoria 
and municipal hospitals. On the date of this report we had but 66 patients over 
sixteen years of age out of a population of 272. This rearrangement has been 
brought about without serious objection. There is, however, some difficulty 
in administration in the men's ward because the young boys and men have to 



318 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

use the same locker room. This leads to some friction and also the men patients 
cause some disturbance by teasing the boys and stirring up trouble among them. 
Minor details of construction, such as rearrangement of locker room and plumb- 
ing, will have to be made to accommodate the young boys. If the present plan 
of using one-half of the ward for adults and the other half for boys is to be con- 
tinued, it will be necessary to construct an additional locker and toilet room. 
A plan for such addition, with estimated cost, has been submitted for your 
consideration. I would recommend, however, that no more men be admitted 
to Westfield, and in that event no additional construction will be necessary as 
we can continue to get along as we are until all the men here are transferred or 
discharged. 

For the next year we have asked for two additional employees, — one more 
attendant for the boys and another handicraft teacher. The children require 
more supervision than the adults but less actual skilled nursing. It means more 
employees of the attendant class but fewer trained nurses will be necessar}^ 

We have had the advantage of weekly visits of two teachers of handicraft 
work from the Junior Achievement Bureau of Springfield during the past two 
months. They have taught the boys and girls who are confined to the wards 
to3'- making and millinery. This supplements the craft work done by the reg- 
ular teachers. The additional teacher to be employed next year will continue 
this work and we will be fortunate, indeed, if we can also have the benefit of 
the instruction that has been furnished without charge by Director Martin of 
the Achievement League and his assistant, Miss Garrison. 

We have recently secured permission to organize a troop of Girl Scouts among 
our patients. This organization will, I am sure, be of great service in providing 
the girls with many interesting things to do and they will learn much that will 
be useful in later life. 

Sanatorium School. 

The attendance has averaged 134, with a total enroUment of 378. This will 
be increased next year because we are using more beds for children. I think, 
however, that we will be able to accommodate the additional children by placing 
more desks in the classrooms. 

Much work has been done in the craft shop. The production of baskets has 
increased and these have met with a ready sale; $599.83 work of baskets has 
been sold besides many given to the patients, who get one for each three that 
they make. Other patients, who become proficient in basket making are paid 
15 cents an hour. In such cases their product goes into stock and is sold. The 
receipts from sales has been sufficient to buy nearly all the raw materials. Easter 
and Christmas cards were designed and printed by the school children. These 
were sold to the value of $76.39. 

The children are carefully graded and the school work is kept up to the stand- 
ard of the public schools. Although the children only attend a half-day session, 
they are able in most instances to keep up with their home classes in all, of the 
fundamental requirements. When they are discharged well a year or two later, 
they do not lose a grade on account of absence. 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 



319 



Average Daily Attendance 



Grade I 
Grade II 
Grade III 
Grade IV 
Grade V 
Grade VI 
Grade VII 
Grade VIII 
Domestic science 
Manual training . 



12.21 
14.88 
12.46 
20.69 
15.54 
11.82 
14.32 
9.73 
7.06 
15. 78 



Total 134.49 

Farm. 

We have raised more garden truck and field crops this year than ever before. 
We have spent but S54.94 for green vegetables and $497.55 for potatoes. All 
other fresh vegetables used on our table have been produced on the farm. 

The dairy has supplied all the milk used in the institution, a total of 156,964 
quarts, at a cost, including pasteurization, of 9.4 cents a quart. 

There have been 13,075 pounds of pork produced and consumed on our table. 
The advisability of establishing a poultry plant should be seriously considered 
another year. 

Improvements. 

We have extended a 4-inch water main to the school buildmg, farmhouse and 
barns and installed three hydrants for fire protection. 

The locker room at the men's ward has been enlarged and improved and two 
private rooms have been added to the infirmary section of the ward. 

A tunnel has been constructed to connect the men's ward with the children's 
ward. Now all the water and steam pipes connecting the children's ward, which 
have been underground, can be placed in the tunnel where they will be accessible 
for repairs, and the steam pipes can be kept properly insulated. 

A new 12-ton ammonia compressor and new steam engine for pumping water 
has been added to our power house equipment. 

There have been 25.6 acres of pasture and woodland added to the sanatorium 
property by purchase. The o^-nership of this property -nill give us an attractive 
area for the patients to enjoy and a portion of it will furnish much needed pasture. 



Recoaimendations, 

A tunnel should be built to connect the school building with the power house; 
then all our main buildings \\\\\ be connected by passages through which the 
steam and water pipes vnW run and be easy of access at all times. 

One small area of excellent tillage land is needed to complete the farm property. 
It is about 6 acres in area and is very desirable because it can be used to great 
advantage with our adjoining field. An appropriation of $1,890 was obtained 



320 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

two years ago to purchase this lot, but the owner changed his mind and refused 
to sell and the money reverted to the treasury. This sum should be again appro- 
priated and an act passed allowing the taking of this property by right of eminent 
domain. 

Acknowledgments. 

The CathoHc, Protestant and Jewish chaplains have continued mthout 
change in personnel to hold religious services each Sunday. The personal 
relations which they establish mth the individual patients by week-day visits 
aids materially in keeping the men and women cheerful and contented and gives 
them courage to continue treatment. 

We have received many gifts of magazines, books, toys and games for the 
children from several indi\4duals, from Troops of Girl Scouts, from Sunday- 
school classes and the Children of the American Revolution. These donations 
have been of great help to us in providing presents for the cliildren at Christ- 
mas. Much reading matter was also furnished throughout the year. 

The annual bazaar, which has become an established feature of the Westfield 
Sanatorium activities, was even more successful in a financial way than in former 
years. This event is entered into by the patients and employees with great 
enthusiasm. Fifty or more of the well-known residents of Westfield came up 
for the cafeteria supper which is held on the lawn; $732.28 was cleared and this 
sum goes to pro^^de entertainment for the patients. It was later decided to 
expend $350 of it for the construction of a swimming pool, which was completed 
in September. This was too late for use last season, but will give great pleasure 
to the patients and emploj^ees in the summers to come. It is a distinct asset 
and will prevent the boys from running away to swdm in the more dangerous 
river where they cannot be supervised. 

Employees. 

There have been no changes among the physicians, dentist, office force, heads 
of any department or head nurses during the year. I feel that I have been 
particularly fortunate in this respect and it has resulted in a very efficient or- 
ganization. For their loyal support and co-operation I ^-ish to express my most 

grateful appreciation. 

Henry D. CHADW^CK, 

Superintendent. 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 



321 



VALUATION. 

Land. 

Grounds (25.8 acres) $5,100 00 

Lawns and buildings, 25.8 acres. 

Roads. 

Woodland (97.6 acres) 4,764 00 

Mowing (2.6 acres) 195 00 

THlage (53 acres) 3,925 00 

Tillage, 48 acres. 

Garden, 5 acres. 

Orchard (2 acres) 400 00 

Pasture (13.1 acres) 747 00 

Waste and miscellaneous (12.6 acres) . . 690 50 

Rough pasture, 7.6 acres. 

Meadow swamp land. 
Sewer beds, 4 acres. 

New coal trestle, 1 acre. 

$15,821 50 

Sewerage system 12,928 80 

$28,750 30 

Buildings. 

Institution buildings . $161,836 29 

Farm, stable and grounds 17,070 00 

Miscellaneous 46,921 97 

225,828 26 

Total $254,578 56 

Present value of all personal property as per inventory of Dec. 1, 1921 . . 94,781 29 

Grand total $349,359 85 



SPECIAL REPORT. 

The following special report is prepared in accordance Tvath a resolution of the 
National Conference of Charities and Corrections, adopted May 15, 1906 : — 



Population . 





Males. 


Females. 


Totals. 


Number received during the year 


158 


151 


309 


Number passing out of the institution during the year 


144 


159 


303 


Number at end of fiscal year in the institution . 


142 


126 


268 


Daily average attendance (number of inmates actually 

present) during the year. 
Average number of employees and officers during the year 


133.53 
66 


129.45 
44 


262.98 
110 



322 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Expenditures 
Current expenditures: 

1. Salaries and wages 

2. Clothing ..... 

3. Subsistence .... 

4. Ordinary repairs .... 

5. Office, domestic and outdoor expenses 

Extraordinary expenses : 

1. Permanent improvements to existing buildings 

Grand total ...... 



$87,617 86 

761 53 

33,173 35 

9,936 08 

58,538 18 



$190,027 00 
8,343 76 

$198,370 76 



Summary of Current Expet^ses. 



Total expenditure 

Deducting extraordinary expenses 



Deducting amount of sales 



$198,370 76 
8,343 76 

$190,027 00 
424|83 

$189,602 17 



Dividing this amount by the daily average number of patients — 262.98 — gives a 
cost for the year of $720.89, equivalent to an average weekly net cost of •513.87. 



STATISTICAL TABLES. 
Table 1. — Admissions and Discharges. 





Males. 


Females. 


Totals. • 


Number of patients admitted Dec. 1, 1920, to Nov. 30, 1921, 

inclusive. 
Number of patients discharged Dec. 1, 1920, to Nov. 30, 1921, 

inclusive. 
Number of deaths (including those in previous item) . 


158 

144 

18 


151 
159 

20 


309 
303 

38 


Nimiber in sanatorium Dec. 1, 1920 .' . 


131 


135 


266 


Number remaining Nov. 30, 1921 


144 


128 


272 





Table 2. 


— Civil Condition of Patients admitted. 






Males. 


Females. 


Totals. 


Married . 


• ■ ■ 




29 


17 


46 


Single 


. 




125 


132 


267 


Widowed 


• 




4 


2 


6 


Totals 

r 


158 


151 


309 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 323 



Table 3. — Ages of Patients admitted. 



Males. 



Females. 



Totals. 



1 to 13 years . 
13 to 20 years , 
21 to 30 years , 
31 to 40 years 
41 to 50 years . 
51 to 60 years 
Over 60 years 
Totals 



70 
35 
18 
18 
15 
2 



158 



60 

60 

16 

6 

7 



151 



130 
95 
34 
24 
22 
4 



309 



Table 4. — Nativity and Parentage of Patients admitted. 





Males. 


Females. 


Totals. 


Places of Nativity. 


a 
1 




2 

.s 

o 


i 

a 
.2 




2 

.a 
o 


i 

a 

(2 


2 


2 

a 

.a 
t 


United States: 




















Massachusetts . 


106 


32 


35 


106 


32 


26 


212 


64 


60 


Other New England States 


15 


11 


6 


9 


4 


8 


24 


15 


15 


Other States . 


7 


9 


9 


5 


11 


16 


12 


20 


25 


Total native 


128 


52 


50 


120 


47 


50 


248 


99 


100 


Other countries: 




















Austria .... 


2 


2 


3 


1 


3 


2 


3 


5 


5 


Azores .... 


- 


- 


- 


- 


1 


1 


- 


1 


1 


Canada .... 


8 


24 


21 


7 


24 


26 


15 


48 


47 


Brazil .... 


- 


- 


- 


1 


- 


- 




- 


- 


Denmark 


- 


- 


- 


1 


1 


1 




1 


1 


England .... 


- 


3 


2 


1 


6 


3 




9 


5 


Finland .... 


1 


1 


1 


- 


- 


- 




1 


1 


France .... 


- 


1 


1 


1 


1 


3 




2 


4 


Germany .... 


1 


2 


2 


- 


- 


- 




2 


2 


Greece .... 


- 


1 


1 


4 


4 


4 




5 


5 


Ireland .... 


- 


18 


25 


2 


9 


15 




27 


40 


Italy .... 


2 


9 


11 


1 


11 


10 




20 


21 


Lithuania 


- 


3 


3 


1 


3 


3 




6 


6 


Peru .... 


- 


- 


- 


- 


- 


1 


- 


- 


1 


Poland .... 


2 


4 


4 


1 


6 


7 


3 


10 


11 



324 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 4. — Nativity and Parentage of Patients admitted — Concluded. 







Males. 


Females. 


Totals. 


Places of Nativity. 


i 

a 
1 


03 


2 

.s 

o 


d 
.2 

03 


CO 

03 
fa 


o 


CO 

d 
.2 


2 


2 

.s 

o 


Portugal . 
Russia . ' . 
Scotland . 
Sweden . 
Switzerland 
Turkey . 




1 
3 
2 
2 

1 


6 
2 
5 

1 


1 

6 
2 
6 

1 


1 
1 

1 


1 

3 
4 

1 

1 


1 
5 
1 

1 


2 
3 
3 

2 

2 


1 
9 
6 
5 
1 
2 


2 

11 

3 

6 

2 


Total foreign 
Unknown 


25 
5 


82 
24 


90 
18 


24 

7 


79 
25 


84 
17 


49 
12 


161 

49 


174 
35 


Grand totals 


158 


158 


158 


151 


151 


151 


309 


309 


309 



Table 5. — Residence of Patients admitted. 




No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 325 



Table 5. — Residence of Patients admitted — Concluded. 




Place. 


Number. 


Place. 


Number. 


Newton 


1 


Springfield 


37 


North Adams 

• 


6 


State minor wards .... 


4 


Northampton 


6 


Taunton 


2 


Northfield 


1 


Wakefield 


1 


Norwood 


1 


Waltham 


1 


Oxford 


1 


Ware 


1 


Pahner 


6 


Warren 


2 


Pittsfield 


7 


Watertown 


1 


Plymouth 


3 


Webster 


2 


Quincy 


4 


West Springfield .... 


4 




2 


Westfield 


11 


Salem 


1 


Wilbraham 


1 


Shelburne 


1 


Williamstown 


1 


Somerville 


5 


Winchester 


2 


Southbridge 


2 


Woburn 


1 


Southwick 


1 
1 


Worcester 

Total 


8 


Spencer 


309 



Table 6. — Occtipation of Patients admitted. 





Males. 


Females. 


Totals. 


Armory inspector 


1 


- 




At home 


- 


4 




Bank clerk 


1 






Battery repairer 


1 


- 




Bindery factory hand 


- 


1 




Blacksmith 


1 


- 




Blank book store 


- 


1 




Bleacher 


1 


- 




Bookbinder 


- 


1 




Bookkeeper 


- 


1 




Car service man 


1 


- 




Carriage factory hand 


1 


- 




Celluloid factory hand 


- 


1 




Chemist 


1 


- 




Chocolate dipper 


- 


1 


J 



326 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 6. — Occupation of Patients admitted — Continued. 



Males. 



Clerk 

Companion . . . . . 
Corset maker .... 
Cotton mill hand ... 
Crane man .... 
Cutlery inspector . 
Diet kitchenmaid 
Draftsman .... 
Electric motorman 
Electrician .... 
Engineer (motor) . 
Factory shipper 
Farm hand .... 

Farmer 

Fish peddler .... 
Foreman pump factory 
Freight house worker 
Grocery clerk 
Hospital attendant 
Housewife .... 
Houseworker .... 

Laborer 

Laundress .... 
Machinist .... 

Maid 

Match factory hand 

Meat cutter .... 

Mill worker .... 

No occupation (under five years) 

Nurse 

Office clerk .... 

Orderly 

Painter 

Paper mill hand 

Paymaster .... 

Printer ..... 

Railroad worker 



Females. 



1 

12 
3 



Totals. 



1 
1 

2 
3 
1 
1 
1 
1 
1 
2 

1 
1 

2 

1 
1 
1 
1 
1 
1 
12 
3 
3 
1 
7 
1 
1 
1 
1 
6 
2 
2 
2 
2 
3 
1 
1 
1 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 327 



Table 6. 


— Occupation of Patients admitted — 


Concluded 






Males. 


Females. 


Totals. 


Rubber factory hand . 




_ 


1 


1 


Saleaman 




3 


- 


3 


Saw shop hand 




- 


1 




School .... 




96 


101 


197 


Searchlight plant . 




- 


1 




Shipping clerk 




1 


- 




Shoemaker 




1 


- 




Social worker . 




- 


1 




Stenographer . 




- 


1 




Stock room clerk . 




1 


- 




Street railroad inspector 


• 


1 


- 




Tailor .... 




1 


- 




Textile weaver 




1 


- 




Tool maker . 




1 


- 




Toothbrush factory hand 




- 


1 




Waitress .... 




- 


2 


^ I 


Wire mill hand 




1 


- 




Yarn mill hand 




- 


1 




Totals 


158 


151 


309 


1 



Table 7. — Condition on Admission. 





Adults. 


Children under Six- 
teen Years of Age. 




Males. 


Fe- 
males. 


Totals. 


Per- 
centage. 


Males. 


Fe- 
males. 


Totals. 


Per- 
centage. 


Incipient 

Moderately advanced . 

Far advanced .... 

Unclassified 

Nontuberculous .... 


4 
13 
41 

1 


2 

24 
25 


6 

37 
66 

1 


1.94 
11.97 
21.36 

.33 


44 

49 

5 

1 


33 

55 
11 

1 


77 

104 

16 

2 


24.59 

33.98 

5.18 

.65 


Totals 


59 


51 


110 


35.60 


99 


100 


199 


64.40 



328 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 





Table 8. - 


- Condition on Discharge. 










ADUI.T8. 


Per- 
centage. 


Children under Six- 
teen Years of Age. 


Per- 




Males. 


Fe- 
males. 


Totals. 


Males. 


Fe- 
males. 


Totals. 


centage. 


Apparently arrested 


9 


20 


29 


9.57 


65 


66 


131 


43.23 


Quiescent 






3 


13 


16 


5.28 


1 


4 


5 


1.65 


Improved 






9 


6 


15 


4.95 


5 


5 


10 


3.33 


Unimproved . 






20 


13 


33 


10.89 


4 


5 


9 . 


2.97 


Died . 






16 


15 


31 


10.23 


3 


4 


7 


2.31 


Nontuberculous . 






1 




1 


.33 


1 


1 


2 


.66 


Not considered 






5 


5 


10 


3.33 


2 


2 


4 


1.32 


Totals 


63 


72 


135 


44.58 


81 


87 


168 


55.47 



Table 9. — Deaths. 



Duration of Disease. 


Males. 


Females. 


Totals. 


Length op Residence 
AT Sanatorium. 








Males. 

1 


Females. 


Totals. 


Under 1 month 










- 


- 


- 


1 


2 


3 


1 to 2 months 












- 


- 


- 


3 


- 


3 


2 to 3 months 












- 


- 


- 


1 


2 


3 


3 to 4 months 












- 


- 


- 


- 




1 


4 to 5 months 












- 




1 


3 




7 


5 to 6 months 












2 




3 


1 




2 


6 to 7 months 












- 




- 


1 




2 


7 to 8 months 












- 




1 


- 




2 


8 to 9 months 












- 




- 


1 




2 


9 to 10 months 












1 




2 


- 




1 


10 to 12 months 












- 




1 


3 


- 


3 


12 to 18 months 












2 




5 


2 


2 


4 


18 to 24 months 












2 




6 


1 


- 


1 


Over 2 years . 












12 


' 


19 


2 


o 


4 


Totals 


19 


19 


38 


19 


19 


38 

3 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 329 



Table 10. — Cause of Death. 





Males. 


Females. 


Totals. 


Tuberculosis of the lungs 

Tuberculosis of lungs and bowels 

Tuberculosis of larynx and lungs 

Tuberculosis of lungs and kidney 

Tuberculosis of lungs and meningitis 

Tuberculosis of lungs and peritonitis 


10 

7 

1 
1 


14 

2 

1 
1 
1 

~ 


24 
2 
8 
1 
2 
1 


Totals 

J 


19 


19 


38 



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, 1921 : — 



Cash Account. 
Balance Dec. 1, 1920 $240 21 

Receipts. 
Income. 

Board of inmates: 

Private $8,651 81 

Reimbursements, cities and towns . . . 38,725 68 

$47,377 49 

Persona] services: 

Reimbursement from Board of Retirement .... 19 49 

Sales: 

Food $103 65 

Medical and general care 16 50 

Farm: 

Cows and calves .... $136 00 

Pigs and hogs 13 50 

Vegetables 17 25 

Sundries 77 93 

244 68 

Use of auto 60 00 

424 83 

Miscellaneous: 

Interest on bank balances 217 29 

48,039 10 

Amount carried forward $48,279 31 



330 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Amount brought forward $48,279 31 

Receipts from Treasury of Commonwealth. 
Maintenance appropriations: 

Balance of 1920 $9,419 73 

Advance money (amount on hand November 30) . . 10,000 00 
Approved schedules of 1921 177,185 88 

196,605 61 

Special appropriations 8,343 76 

Total $253,228 68 

Payments. 

To treasury of Commonwealth, institution income $48,039 10 

Maintenance appropriations: 

Balance of schedules of previous year $9,659 94 

Eleven months' schedules, 1921 177,185 88 

November advances 8,487 59 

195,333 41 

Special appropriations: 

Approved schedules 8,343 76 

Balance, Nov. 30, 1921: 

In bank ^971 53 

In office • 540 88 

1,512 41 

-Pq^^I $253,228 68 

Maintenance. 

Appropriation, current year $190,050 00 

Expenses (as analyzed below) 190,027 00 

Balance reverting to treasury of Commonwealth $23 00 

* 

Analysis of Expenses. 

Personal services: 

Henry D. Chadwick, superintendent $3,900 00 

Medical 5-010 00 

Administration 4,049 09 

Kitchen and dining-room service 10,170 92 

Domestic 10,662 63 

Ward service (male) 7,653 46 

Ward service (female) 7,882 86 

Industrial and educational department 3,875 30 

Engineering department 9,696 34 

Repairs 2,834 33 

Farm 19,358 64 

Stable, garage and grounds • ' ^,524 29 ^^^^^^^ ^^ 

Religious instruction: 

Catholic ^600 00 

Hebrew 249 60 

— — !!i^ 1,214 60 

Amount carried forward $88,832 46 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 331 

Amount brought forward $88,832 46 

Travel, transportation and office expenses: 

Advertising $12 62 

Postage Ill 23 

Stationery and office supplies 933 69 

Telephone and telegraph 704 09 

Travel 504 66 

Freight 12 49 

2,278 78 

Food: 

Flour $1,706 84 

Cereals, rice, meal, etc 1,168 19 

Bread, crackers, etc 145 85 

Peas and beans (canned and dried) 593 12 

Macaroni and spaghetti 83 49 

Potatoes 497 55 

Meat 12,041 83 

Fish (fresh, cured and canned) 1,285 40 

Butter 2,986 53 

Butterine, etc 326 85 

Peanut butter 8 55 

Cheese 82 81 

Cofifee 399 10 

Tea 71 77 

Cocoa 26 16 

Milk (condensed, evaporated, etc.) 159 38 

Eggs (fresh) 5,096 47 

Egg powders, etc 255 16 

Sugar (cane) 1,607 16 

Fruit (fresh) . •. 661 28 

Fruit (dried and preserved) 1,605 09 

Lard and substitutes 680 40 

Molasses and syrups 126 43 

Vegetables (fresh) 53 94 

Vegetables (canned and dried) 547 49 

Seasonings and condiments 466 96 

Yeast, baking powder, etc. 151 67 

Sundry foods 205 59 

Freight 132 29 

33,173 35 

Clothing and materials: 

Boots, shoes and rubbers $86 80 

Clothing (outer) 356 93 

Clothing (under) 102 77 

Dry goods for clothing 208 66 

Hats and caps 1 87 

Socks and smallwares 4 50 

761 53 

Furnishings and household supplies: 

Beds, bedding, etc $2,740 86 

Carpets, rugs, etc 22 75 

Crockery, glassware, cutlery, etc 703 52 

Dry goods and smallwares 481 59 

Electric lamps 135 21 



Amounts carried forward $4,083 93 $125,046 12 



332 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Amounts brought forward $4,083 93 $125.046 12 

Furnishings and household supplies — Concluded. 

Fire hose and extinguishers ° "" 

Furniture, upholstery, etc 282 16 

Kitchen and household wares 1-095 55 

Laundry supplies and materials 1-551 93 

Lavatory supplies and disinfectants 1-896 22 

Table linen, paper napkins, towels, etc 424 97 

-'-^' ^ o,.oa6o 

Medical and general care: 

Books, periodicals, etc $43 26 

Entertainments, games, etc 87 39 

Funeral expenses 

1 ^S Q7 

Ice and refrigeration ^^° ^' 

Laboratory supplies and apparatus 682 71 

Manual training supphes 119 76 

Medicines (suppHes and apparatus) 1.309 65 

Medical attendance (extra) "* 00 

School books and supplies 175 77 

Sputum cups, etc '^^q oc 

Tobacco, pipes, matches 3 25 

^-^^* ^ 2,817 92 

Heat, light and power: 

Coal (bituminous) ^11-445 07 

Freight and cartage 9,068 84 

Coal (anthracite) 361 10 

Freight and cartage 212 52 

Qjj 339 73 

Operating supplies for boilers and engines .... 379 02 

^''^^^' ^ 21,828 90 

Bedding materials . ^^^0 76 

Blacksmithing and supplies jl 

Carriages, wagons and repairs 64 75 

Dairy equipment and supplies 171 66 

Fencing materials 1^® ^^ 

FertUizers JfAl 

Grain, etc ^'^^^ 22 

Hay 2.894 79 

• 27 O'l 

Harnesses and repairs 

rr; ::::;::::•■ •■ ZZ 

other Uve stock ^^O 00 

T> 4. ... 65 00 

Kent .„.,„ 

Spraying materials ;|^ 

Stable and barn supplies • • 187 01 

Tools, implements, machines, etc 323 52 

Trees, vines, seeds, etc 269 38 

Veterinary services, supplies, etc 232 32 

■V ■ U4- ... 1.407 10 

^'^'^^^ 13,596 95 



Amount carried 



forward $172,69149 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 333 

Amount brought forward $172,691 49 

Garage, stable and grounds: 

Motor vehicles $1,420 00 

Automobile repairs and supplies 2,342 94 

Spraying materials 17 75 

Trees, vines, seeds, etc 121 86 

Freight 79 

3,093 34 

Repairs, ordinary: 

Cement, lime, crushed stone, etc $701 57 

Electrical work and supplies 779 24 

Hardware, iron, steel, etc. 551 37 

Labor (not on pay roll) 1,294 98 

Lumber, etc. (including finished products) .... 733 16 

Paint, oil, glass, etc 1,408 43 

Plumbing and supplies 1,332 87 

Roofing and materials 49 30 

Steam fittings and supplies 1,221 48 

Tents, awnings, etc 132 35 

Tools, machines, etc 1,138 58 

Boilers, repairs 142 22 

Engines, repairs 160 21 

Freight 290 32 

9,936 08 

Repairs and renewals: 

Ammonia compressor $1,000 00 

Tunnel, E Ward to C Ward 1,050 00 

Shingling roofs and repairing rooms 1,134 95 

Repairs on sanatorium side track 311 14 

3,496 09 

Total expenses for maintenance $190,027 00 

Special Appropriations. 

Balance Dec. 1, 1920 $7,127 11 

Appropriations for current year 3,200 00 

Total $10,327 11 

Expended during the year (see statement below) 8,343 76 

Balance Nov. 30, 1921, carried to next year $1,983 35 



Object. 


Act or Resolve. 


Whole Expended 
^°-t- FistT^far. 


Total 

Expended 

to Date. 


Balance 

at End of 

Year. 


Purchase of land 

Remodeling farmhouse and 

dormitory. 
Remodeling barn . 

Installing engine and gener- 
ator. 
Purchase of land 

Fire protection 


Chap. 225, 1920 . 
Chap. 225, 1920 . 
Chap. 225, 1920 . 
Chap. 225, 1920 . 
Chap. 203, 1921 . 
Chap. 203, 1921 . 


?1,890 00 
10,000 00 
5,700 00 
6,500 00 
2,000 00 
1.200 00 


$11 77 

37 24 

5,188 10 

1,910 00 

1,196 65 


$10,000 00 
5,700 00 
6,500 00 
1,910 00 

1,196 65 


$1,890 00* 

90 00* 
3 35* 




$27,290 00 


$8,343 76 


$25,306 65 


$1,983 35 



* Balance reverting to treasury of the Commonwealth. 



334 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Resoubces and Liabilities. 

Resources. 

Cash on hand $1,512 41 

November cash vouchers (paid from advance money), ac- 
count of maintenance 8,487 59 

$10,000 00 

Due from treasury of Commonwealth from available appropriation account 

of November, 1921, schedule 2,841 12 

$12,841 12 
Liahilities. 
Outstanding schedules of current year: 

Schedule of November bills $12,841 12 

PfiR Capita. 
During the year the average number of inmates has been 262.98. 
Total cost for maintenance, $190,027.00. 
Equal to a weekly per capita cost oi $13.8959. 
Receipt from sales, $424.83. 
Equal to a weekly per capita of $0.0310. 
All other institution receipts, $47,614.37. 
Equal to a weekly per capita of $3.4818. 
Net weekly per capita cost $10.3831. 

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. 

Alonzo B. Cook, 

Auditor. 

NORTH READING STATE SANATORIUM. 

Resident Officers. 

Carl C. MacCorison, M.D Superintendent. 

Earle C. Willoughby, M.D Assistant Superintendent. 

Joseph W. Reddy, M.D Physician. 

Samuel Randall Dentist. 

Kathryn V. Daily, R.N Superintendent of Nurses. 

MiRA B. Ross Head Matron. 

J. Ellis Doucette Steward. 

Daniel J. Scott • Chief Engineer. 

Edward Leary Farmer. 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 335 



REPORT OF THE SUPERINTENDENT. 

To Eugene R. Kelley, Commissioner, Department of Public Health, State House, 

Boston. 

I have the honor to submit the thirteenth annual report of the North Reading 
State Sanatorium for the year ending Nov. 30, 1921. 

During the year there has been expended $1.56,642.11 for maintenance, a gross 
weekly per capita cost of .^16.4925, and .$7,789.55 from the appropriation author- 
ized by chapter 20.3, Resolves of 1921. The details of these disbursements are 
contained in the report of the treasurer. 

.There has been collected from miscellaneous sources .$32,568.51 (the total of 
all collections). Deducting this amount from the gross maintenance expense 
leaves a net expense of $155,976.54, and a net weekly per capita cost of $16.4226. 
There has been collected from private funds $4,461.68; from cities and towns 
$22,125.67; from the United States Veterans' Bureau $5,315.59. Seventy-seven 
cases were supported wholly or in part from private funds; 209 by cities and 
towns; 77 wholly by the State; 3 by the United States Veterans' Bureau. 

There were 186 patients in the sanatorium at the beginning of the year and 
201 at the close. The largest number present at one time was 203 and the 
smallest 156. The daily average number of patients was 182.65. There were 
220 cases admitted during the year, — 2 incipient, 104 moderately advanced, 
111 advanced and 3 unclassified. There were 181 cases admitted from cities 
and towns of over 25,000 population, and 39 from cities and towns under 25,000 
population. The average age of patients admitted was 32.13. Including deaths, 
there were 205 discharged, and the average duration of residence was nineteen 
months and seven days. Of those discharged, 103 gained 1,374 pounds, an 
average gain of 13.31 pounds per person. Of the discharges there were 8 arrested 
cases, 5 more than last j^ear; 4 apparently arrested, 10 less than last year; 17 
quiescent, 15 less than last year; 78 improved and 36 unimproved. There were 
21 patients not considered, the duration of treatment being less than one month. 
There were 39 deaths, 8 less than last year. There were 2 discharged non- 
tuberculous. There were 66,667 hospital days of treatment, 2,252 less than last 
year. 

The following table shows the classification on the application blank and our 
classification on admission: — 



Classification 

on Appli- 
cation Blank. 



Our Classifica- 
tion 
on Admission. 



Incipient ..... 
Moderately advanced 
Incipient, moderately advanced 
Advanced .... 

Unclassified .... 
Totals .... 




220 



2 
104 

111 
3 



220 



336 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Consultation clinics have been held monthly during the past year at Haver- 
hill, Lowell, Lawrence and Woburn. We feel very strongly that the medical 
profession in this district has failed to avail itself to the fullest extent of the 
opportunities placed at its disposal. The clinic at Woburn has been very poorly 
attended, and we believe if this clinic is discontinued and one estabhshed in 
Stoneham, it would serve a much larger area, inasmuch as Stoneham is within a 
short distance of Woburn, Reading, Wakefield, Melrose and Winchester. The 
following table will show the extent of the work accompHshed : ■ — 



Number of 

Clinics held 

during 

the Year. 



Number of 

Cases referred 

to Clinic. 



Number 

of Physicians 

referring 

Cases. 



Haverhill 
Lowell . 
Lav/rence 
Woburn 
Totals 



15 
15 
14 
15 



59 



37 

17 
69 
20 



143 



29 



In addition to the above, 15 physicians practicing in the smaller towns within 
a radius of 5 to 15 miles from North Reading referred 30 cases direct to the 
sanatorium, thus making a total at the end of the year of 173 cases. Of the 173 
cases examined, 65 were classified as active pulmonary tuberculosis, 29 as in- 
active, 1 as nontuberculous and 78 as suspects. 

On February 16, 1921, Dr. Samuel Randall of Boston was appointed dentist 
at the sanatorium. Although the dental clinic has been in existence but a short 
time, the results obtained have been most gratifjdng. At the beginning we 
found it difficult to get the patients to accept dental service, but as tune went 
on the majority requested to be treated. 

At present a routine examination is made of the teeth of all patients ad- 
mitted. The following table will show what has been accomplished: — 



bridges and crowns 



Total number of patients examined 

Prophylaxis 

Extractions 

Pyorrhea 

Removal of defective 

Vulcanite plates 

Gold inlays reset 

Synthetic fillings 

Cement fillings 

Silver fillings . 

Gold fUlings . 

Repairing plates 

Porcelain crowns 

Gold crowns 

Bridges . 



372 

233 

165 

6 

11 

18 

4 

58 

14 

24 

8 

6 

2 

5 

4 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 337 

On March 24 3 men in the Prison Camp and 3 employees reported at the 
infirmary, complaining of sore throat. Cultures were taken and examined for 
Klebs-Loeffler bacUlus. One prisoner gave positive culture for K.L., although 
the patients did not show the clinical symptoms of diphtheria. A few days later 
all these throats gave positive cultures for hemolytic streptococcus. Immediately 
following the laboratory report on these cases, practically all patients and em- 
ployees were given a dose of diphtheria antitoxin, and those who were showing 
symptoms, such as sore throat, fever, etc., were given from 5,000 to 15,000 units 
of antitoxin. 

The sanatorium was under a strict quarantine for fourteen days, and no 
patients were admitted to the institution between March 26 and May 10. During 
the epidemic 35 cases gave a positive culture of hemolytic streptococcus. In 
addition to the above, 5 cases showed throat symptoms but negative culture for 
hemolytic streptococcus. Cultures made from smears taken from the throats 
of 2 patients and 5 employees gave positive culture for hemolytic streptococcus, 
but at no time did the suspects complain of sore throat or show symptoms. 

Sixteen employees sent to us during the epidemic were cultured on arri\'ing 
at the sanatorium. Three of this group gave cultures of hemolytic strepto- 
coccus, but at no time complained of sore throat or showed symptoms. 

Of the 281 cases receiving diphtheria antitoxin, 44 developed urticaria, 16 
developed both urticaria and joint symptoms, and 41 complained of arthritic 
pains. Four of this latter group developed very severe arthritis lasting about 
six months in one case, and about three weeks in the others. 

Of the 220 cases admitted to the hospital during the j'ear, 190 were subjected 
to a Wassermann test. One hundred of this number were reported negative and 
11 positive. 

The productii'ity of the farm during the past year has been rather disap- 
pointing. The severe frosts of May completely uiped out the possibility of 
apple and strawberry crops. The drouth lasting up to the first of July markedly 
interfered with the germination of seed and the early development of plants, and 
the heavy rains of July and August ruined many of the crops. 

The cottage for the engineer and steward was completed in February. A new 
washing machine has been installed in the laundry. The water tanks and towers 
have been painted and repaired. About 500 feet of surface drainage have been 
installed, and rather extensive repairs made on the buildings, plumbing, heating 
and electrical systems. Work has been started on the fire protective system. 

The overcrowded condition of our sick ward has not been reheved, and during 
the past three months 50 per cent of all the admissions in the female unit were 
bed cases. If a new hospital building is not to be considered, I feel very strongly 
that new lockers and toilet room facilities should be installed in our present 
wards, that new locker and toilet room facilities on each pavihon in the female 
unit and on the two pavihons in the male unit be constructed, and that the 
fronts of these buUdings be glazed in and heat installed in the sleeping quar- 
ters. With this arrangement we could much better care for the fever cases 
which are being sent to us. It is estimated that $60,952 will be necessary for 
this improvement. 

The steam mains which run in the conduits from the power plant to the 



338 



DEPARTIVIENT OF PUBLIC HEALTH. [Pub. Doc. 



various buildings are evidently in poor condition. Green grass grows over these 
conduits throughout the winter. It is estimated that it will cost $8,658 to prop- 
erly cover the steam mains. 

The sleeping quarters for male employees are altogether inadequate. Many 
of the employees are quartered in the old farmhouse, and it is necessary for men 
who sleep in the upper rooms to pass through a sleeping room on the lower floor 
occupied by three employees. A small dormitory to accommodate twelve em- 
plo3^ees could be added to this building at an approximate cost of $14,800. 

We are handicapped in our work by the lack of an X-ray outfit. We estimate 
that an up-to-date machine can be installed for the sum of $5,000. 

Services by the Protestant, Jewish and Catholic chaplains have been held 
each week. 

On behalf of the patients I wish to express appreciation of gifts of books, 
flowers, magazines, entertainments, etc. We are especially grateful to D. W. 
Griffith for the use of his film, "Way Do\vn East. " 

I feel very much indebted to the heads of the departments and employees for 
their faithful and efficient work during the year. 

I appreciate your support during the past year and also the assistance ren- 
dered by your Department during the recent septic throat epidemic. 

Respectfully submitted, 

Carl C. MacCorison, 

Siqierintendeyit. 
VALUATION. 



Land. 



Grounds (11.76 acres) 

Lawns and buildings, 11.01 acres. 

Roads, 76 acres. 
Woodland (28.99 acres) 
Mowing (16.60 acres) 
Tillage (7.30 acres) . 

Tillage, 1.50 acres. 

Garden, 5.80 acres. 
Orchard (2.64 acres) . 
Pasture (2.09 acres) . 
Waste and miscellaneous (37.28 acres) 

Rough pasture, 6.53 acres. 

Meadow swamp, 30 acres. 

Sewer beds. 

New coal trestle, .75 acre. 

Sewerage system 



Institution buildings . 
Farm, stable and grounds 
Miscellaneous 



Buildings. 



.?566 48 



1,155 


60 


803 


96 


351 


64 


127 


17 


100 


67 


1,795 


78 





$4,901 30 
5,692 93 


$135,188 68 
15,285 00 
64,605 09 


$10,594 23 
215,078 77 



Total 



$225,673 00 



Present value of all personal property as per inventory of Dec. 1, 1921 . 90,895 01 

Grand total $316,568 01 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 



SPECIAL REPORT. 

The following special report is prepared in accordance with a resolution of 
the National Conference of Charities and Corrections, adopted May 15, 1906: — 



Population. 





Males. 


Females. 


Totals. 


Number received during the year 


104 


116 


220 


Number passing out of the institution during the year 


95 


110 


205 


Number at end of fiscal year in the institution . 


113 


88 


201 


Daily average attendance (number of inmates actually 

present) during the year. 
Average number of employees and officers during the year 


103.715 
47.604 


78.93 
32.925 


182.65 
80.529 



Expenditures 
Current expenditures: 

1. Salaries and wages 

2. Clothing 

3. Subsistence .... 

4. Ordinary repairs 

5. Office, domestic and outdoor expenses 



$67,925 29 

217 76 

61,317 02 

3,295 06 

18,671 49 



S151,426 62 



Extraordinary expenses: 

1. Permanent improvements to existing buildings 

Grand total ...... 



5,220 16 



$156,646 78 



Summary of Current Expenses. 
Total expenditure ....... 

Deducting extraordinary expenses .... 



Deducting amount of sales 



$156,646 78 
5,220 16 

$151,426 62 
665 57 

$150,761 05 



Dividing this amount by the daily average number of patients — 182.65 — gives a cost 
for the year of $825.4095, equivalent to an average weekly net cost of $15,873. 



340 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



STATISTICAL TABLES. 
Table 1. — Admissions and Discharges. 





Males. 


Females. 


Totals. 


Patients in the sanatorium Nov. 30, 1920 .... 

Patients admitted from Dec. 1, 1920, to Nov. 30, 1921, in- 
clusive. 

Patients discharged from Dec. 1, 1920, to Nov. 30, 1921, in- 
clusive. 

Patients remaining in sanatorium Nov. 30, 1921 . 

Daily average number of patients 

Deaths (included in nmnber discharged) . . . 


104 
104 

95 
113 
103.71 

22 


82 
116 
110 

88 

78.93 

17 


186 
220 
205 
201 
182.65 
39 



Table 2. — Civil Condition of Patients admitted. 



Single 
Married . 
Widowed 
Divorced 
Totals 
1 I 



Males. 



Females. 



40 
57 

7 



104 



52 

58 

6 



116 



Totals. 



92 

115 

13 



220 



Table 3. — Age of Patients admitted. 



14 to 20 years 
20 to 30 years 
30 to 40 years 
40 to 50 years 
Over 50 years 
Totals . 
Average age 



Males. 



5 

29 

32 

29 

9 



104 
35.36 



Females. 



13 
60 
28 
12 
3 



116 

29.23 



Totals. 



18 
89 
60 
41 
12 



Percentages. 



220 
32.13 



8.18 
40.46 
27.27 
18.64 

5.45 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 341 





Table 4. — Nativity and Parentage of Patients admitted. 






Males. 


Fem.vles. 


Totals. 


Places of Nativity. 


a 

t 


(2 


03 

o 


a 
.S 




S 

O 


i 

a 
ft 


2 

..J 

(2^ 


o 


United States: 




















Massachusetts . 


47 


15 


17 


57 


15 


21 


104 


30 


38 


Other New England State 


s 2 


3 


3 


7 


3 


3 


9 


6 


6 


Other States . 




10 


6 


3 


4 


12 


6 


14 


18 


9 


Total native 


59 


24 


23 


68 


30 


30 


127 


54 


53 


Other countries: 






















Armenia . 




- 


- 


- 


1 


1 


1 


1 


1 


1 


Belgium . 




- 


- 


- 


- 


1 


1 


- 


1 


1 


Bohemia . 




1 


1 


1 


- 


- 


- 


1 


1 


1 


Canada . 




15 


19 


18 


21 


30 


31 


36 


49 


49 


Denmark 




- 


- 


- 


1 


1 


1 


1 


1 


1 


East Indies 




- 


- 


- 


- 


1 


- 


- 


1 


- 


England . 




9 


9 


11 


3 


3 


2 


12 


12 


13 


France 






- 


1 


1 


- 


- 


- 


- 


1 


1 


Germany 






- 


2 


1 


1 


3 


3 


1 


5 


4 


Greece 








1 


1 


- 


- 


- 


1 


1 


1 


Ireland 








29 


30 


10 


23 


26 


16 


52 


56 


Italy 








2 


2 


G 


9 


9 


7 


11 


11 


Poland 








2 


2 


1 


- 


- 


3 


2 


2 


Russia 








8 


8 


3 


8 


8 


10 


16 


16 


Scotland 








1 


2 


- 


1 


1 


1 


2 


3 


Sweden 








2 


1 


1 


3 


2 


1 


5 


3 


Syria 








1 


1 


- 


- 


- 


1 


1 


1 


Turkey 








1 


1 


- 


- 


- 


1 


1 


1 


Total foreign 


45 


79 


80 


48 


84 


85 


93 


163 


165 


Unknown 




- 


1 


1 


- 


2 


1 


- 


3 


2 


Grand 


totals 


45 


80 


81 


48 


86 


86 


93 


166 


167 



342 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 5. — Residence of Patients admitted. 



Place. 


Number. 


Pl.^ce. 


Number. 


Andover 

Amesbury 

Arlington 

Beverly 

Billerica 

Boston 

Brockton 

Brookline 

Cambridge 

Canton 

Chelsea 

Danvers 

Dracut 

Everett 

Fitchburg 

Framingham 

Gardner 

Gloucester 

Haverhill 


1 
2 
1 
1 
1 
106 
2 
1 
3 
1 
2 
2 
2 

10 
1 
1 
1 
2 
2 

13 
5 


Lynn 

Maiden 

Medford 

Melrose 

Methuen 

Newton 

Peabody 

Pittsfield 

Reading 

Revere 

Somerville 

Southborough 

Townsend 

Wakefield 

Waltham 

Waverley 

Winchester 

Woburn 

Worcester 

Total 


5 
11 
4 
2 
3 
4 
2 
1 
2 
1 
12 
1 
2 
3 
1 
2 
1 
1 
2 


Lawrence 

Lowell 


220 



Table 6. — Occwpation of Patients admitted. 



Males. 



Females. 



Totals. 



Actor 

At home 

Attendant 

Barber . 

Bookkeeper 

Brass worker 

Carpenter 

Chauffeur 

Chef 

Chemist . 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 343 



Table 6. — Ocmpation of Patients admitted — Continued. 



Males. 



Females. 



Clergyman 
Clerk . 
Cooper . 
Dressmaker . 
Electrical worker 
Electrician 
Factory foreman 
Factory worker 
Fisherman 
Housekeei)er . 
Housewife 
Junk dealer . 
Laborer . 
Longshoreman 
Machinist 
Metal polisher 
Metal worker 
Mill operative 
Milliner . 
Motorman 
Nurse 
Nursemaid 
Painter . 
Parish visitor 
Pharmacist 
Piano maker . 
Pipe organ voicer 
Police officer . 
Porter 
Printer . 
Pupil nurse 
Railroad worker 
Sailor 
Salesman 
Shipper . 
Shoe cutter 
Stenographer . 



11 

20 

42 



2 


- 


5 


- 


1 


- 


4 


- 


5 


2 


- 


1 


1 


- 


- 


3 


- 


1 



Totals. 



1 

12 
1 
4 
1 
I 
1 

15 
1 

20 

42 

9 



344 



DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



Table 6. — Occtipation of Patients admitted — Concluded. 





Males. 


Females. 


Totals. 


steward 


'1 


- 


1 


Student 


2 


3 


5 


Tailor 


3 


- 


3 


Teacher 




3 


3 


Telephone operator 


- 


3 


3 


Telephone repairman 


4 


- 


4 


Theatreman 


1 


- 


1 


Tool maker 


1 


- 


1 


Truckman 


5 


- 


5 


Waiter 


4 


- 


4 




104 


116 


220 



Table 7. — Condition on Admission. 





Males. 


Females. 


Totals. 


Percentage. 


Incipient , . 


1 


1 


2 


.91 


Moderately advanced 


51 


53 


104 


47.27 


Far advanced 


50 


61 


111 


50.45 


Unclassified 


2 


1 


3 


1.37 


Totals 


104 


116 


220 


100.00 



Table 8. — Condition on Discharge. 





Males. 


Females. 


Totals. 


Percentage. 


Arrested 


7 


1 


8 


3.92 


Apparently arrested 


1 


3 


4 


1.95 


Quiescent 


11 


6 


17 


8.29 


Improved 


27 


51 


78 


38.04 


Unimproved 


17 


19 


36 


17.56 


Died 


22 


17 


39 


19.02 


Nontuberculous 


2 


- 


2 


.98 


Not considered 


8 


13 


21 


10.24 


Totals 


95 


110 


205 


100.00 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 345 



Table 9. — Deaths. 



Duration of Disease. 


Males. 


Females. 


Totals. 


Length of Residence 
AT Sanatorium. 




Males. 


Females. 


Totals. 


Under 1 month 


- 


1 


1 


3 


- 


3 


1 to 2 months 


- 


- 


- 


2 


- 


2 


2 to 3 months 


- 


- 


- 


1 


1 


2 


3 to 4 months 


- 


- 


- 


1 


2 


3 


4 to 5 months 


- 


- 


- 


1 


- 


1 


5 to 6 months 


- 


1 


1 


- 


- 


- 


6 to 7 months 


- 


- 


- 


1 


- 


1 


7 to 8 months 


1 


- 


1 


- 


- 


- 


8 to 9 months 


1 


- 


1 


1 


3 


4 


9 to 10 months 


- 


1 


1 


- 


1 


1 


10 to 12 months 


1 


1 


2 


- 


4 


4 


12 to 18 months 


1 


1 


2 


2 


4 


6 


18 to 24 months 


2 





4 


- 


- 


- 


Over 2 years 


16 


10 


26 


10 


2 


12 


Totals 


22 


17 


39 


22 


17 


39 





Table 10. 


— Cause 


/ Death. 








Males. 


Females. 


Totals. 


Tuberculosis of lungs 
Chronic endocarditis 


. 


• ■ * 


21 

1 


17 


38 

1 


Totals 


22 


17 


39 



346 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, 1921 : — 

Cash Account. 
Balance Dec. 1, 1920 $1,159 45 

Income. Receipts. 

Board of inmates: 

Private $9,777 27 

Cities and towns 22,125 67 

131,902 94 

Personal services: 

Reimbursement from Board of Retirement .... 41 36 

Sales: 

Food $97 64 

Clothing and materials 16 22 

Furnishings and household supplies . . 28 77 

Heat, light and power 60 65 

Farm: 

Ice $7 75 

Vegetables 85 

Sundries 212 23 

220 83 

Garage, stable and grounds .... 28 75 

452 86 

Miscellaneous: 

Interest on bank balances . . . . $169 47 

Sundries 43 24 

212 71 

32,609 87 

Other receipts: 

Refunds of previous year ^'^ 

Receipts from Treasury of Commonwealth. 
Maintenance appropriations: 

Balance of 1920 $16,972 00 

Advance money (amount on hand November 30) . . 10,000 00 

Approved schedules of 1921 139,779 04 

^^ 166,751 04 

Special appropriations 14,675 97 

Total $215,202 04 

Payments. 
To treasury of Commonwealth: 

Institution income $32,609 87 

Refunds, account of maintenance 26 50 

Refunds of previous year 5 71 

$32,642 08 



Amount cam 



led forward $32,642 OS 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 347 



Amount brought forward $32,642 08 

Maintenance appropriations: 

Balance of schedules of previous year $18,261 36 

Eleven months' schedules, 1921 . . , $139,779 04 
Less returned 265 50 



139,752 54 

November advances 7,283 09 



Special appropriations: 

Approved schedules $14,675 97 

Less advances, last year's report . . . 129 91 



$14,546 06 



165,296 99 



November advances 441 36 



Balance, Nov. 30, 1921: 

In bank $1,780 82 

In office 494 73 



14,987 42 



2,275 55 



Total $215,202 04 



Maintenance. 

Balance from previous year, brought forward $3,513 24 

Appropriation, current year 167,750 00 



Total $171,263 24 

Expenses (as analyzed below) 156,646 78 



Balance reverting to treasury of Commonwealth $14,616 46 

Analysis of Expenses. 
Personal services: 

Carl C. MacCorison, superintendent $3,900 00 

Medical 4,534 41 

Administration 5,907 39 

Kitchen and dining-room service 8,383 76 

Domestic 11,622 92 

Ward service (male) 7,500 79 

Ward service (female) 6,994 67 

Engineering department 7,434 53 

Repairs 3,525 66 

Farm 5,088 38 

Stable, garage and grounds 3,032 78 

$67,925 29 



Religious instruction: 

Catholic $600 00 

Hebrew 500 00 

Protestant 500 00 



1,600 00 



Amount carried forward $69,525 29 



348 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Amount brought forward $69,525 29 

Travel, transportation and office expenses: 

Advertising $11 05 

Postage 192 44 

Printing and binding 295 67 

Stationery and office supplies 614 37 

Telephone and telegraph 314 56 

Travel 442 00 

Freight 18 93 

1,889 02 

Food: 

Flour $1,670 88 

Cereals, rice, meal, etc . . . 621 90 

Bread, crackers, etc 73 66 

Peas and beans (canned and dried) 23 25 

Macaroni and spaghetti 70 84 

Potatoes 1.076 11 

Meat 11.743 26 

Fish (fresh, cured and canned) 1,758 02 

Butter 2,354 44 

Butterine, etc 145 50 

Cheese 84 68 

Coffee 373 52 

Tea 169 56 

Cocoa 8 72 

Whole mUk 12,984 65 

Eggs (fresh) . 3,136 86 

Sugar (cane) 1,303 31 

Fruit (fresh) 709 46 

Fruit (dried and preserved) 2,287 25 

Lard and substitutes 205 25 

Molasses and syrups 51 03 

Vegetables (fresh) 406 44 

Vegetables (canned and dried) 695 10 

Seasonings and condiments 413 19 

Yeast, baking powder, etc 206 50 

Sundry foods 424 33 

Freight 848 89 

43,846 60 

Clothing and materials: 

Boots, shoes and rubbers $125 55 

Clothing (outer) 49 08 

Clothing (under) 7 50 

Hats and caps 12 15 

Socks and smallwares 2112 

Freight 2 36 

217 76 

Furnishings and household supplies: 

Beds, bedding, etc $1,296 79 

Carpets, rugs, etc 202 73 

Crockery, glassware, cutlery, etc 590 18 

Dry goods and smallwares 200 94 

Electric lamps 210 05 

Fire hose and extinguishers 29 79 



Amounts carried forward $2,530 48 $115,478 67 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA). 349 



Amounts brought forward $2,530 48 $115,478 67 

Furnishings and household supplies — Concluded. 

Furniture, upholstery, etc. . . . . . . . 208 40 

Kitchen and household wares 1,877 32 

Laundry supplies and materials 383 28 

Lavatory supplies and disinfectants 463 66 

Table linen, paper napkins, towels, etc 377 90 

Sundries 21 60 

Freight 107 93 

5,970 57 

Medical and general care: 

Books, periodicals, etc $66 73 

Entertainments, games, etc 617 56 

Funeral expenses 30 00 

Ice and refrigeration 136 64 

Laboratory supplies and apparatus 110 08 

Medicines (supplies and apparatus) 1,768 24 

Medical attendance (extra) 338 60 

Sputum cups, etc 488 30 

Tobacco, pipes, matches 64 62 

Sundries 1 00 

Freight 125 64 

3,747 41 

Heat, light and power: 

Coal (bituminous) $5,206 45 

Freight and cartage 6,652 04 

Coal (anthracite) . . . . • 821 31 

Freight and cartage 618 60 

Gas 35 75 

OU 125 09 

Operating supplies for boilers and engines . . . . 250 67 

Freight 13 10 

13,723 01 

Farm: 

Bedding materials . $130 00 

Blacksmithing and supplies 61 39 

Carriages, wagons and repairs 54 84 

Dairy equipment and supplies ■ 6 27 

Fencing materials 41 44 

Fertilizers 773 31 

Grain, etc 2,543 41 

Hay 178 42 

Harnesses and repairs 13 10 

Horses 250 00 

Other live stock 332 20 

Labor (not on pay roll) . 1,742 00 

Road work and materials 274 14 

Spraying materials 39 49 

Stable and barn supplies 34 82 

Tools, implements, machines, etc 194 12 

Trees, vines, seeds, etc 97 10 

Veterinary services, supplies, etc 107 23 

Sundries 19 59 

Freight 128 15 

7,021 02 

Amount carried forward $145,940 68 



350 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Amount brought forward $145,940 68 

Garage, stable and grounds: 

Automobile repairs and supplies $1,.352 47 

Bedding and materials 21 00 

Blacksmi thing and supplies 16 41 

Carriages, wagons and repairs 36 23 

Fertilizers 37 60 

Grain 234 75 

Harnesses and repairs 2 20 

Labor (not on pay roll) 24 25 

Rent 133 25 

Road work and materials 100 20 

Spraying materials 14 60 

Stable supplies 4 00 

Tools, implements, machines, etc 63 90 

Trees, vines, seeds, etc 45 91 

Sundries 44 50 

Freight ' 69 95 

2,191 12 

Repairs, ordinary: 

Cement, lime, crushed stone, etc $103 65 

Electrical work and supplies 467 55 

Hardware, iron, steel, etc. . 425 11 

Lumber, etc. (including finished products) .... 226 26 

Paint, oil, glass, etc 597 63 

Plumbing and supplies 359 99 

Roofing and materials 19 99 

Steam fittings and suppUes 262 07 

Tents, awnings, etc _. . . 185 56 

Tools, machines, etc 151 74 

Boilers, repairs . 65 65 

Dynamos, repairs 6 07 

Engines, repairs 314 11 

Sundries 20 59 

Freight 94 18 

3,290 15 

Repairs and renewals: 

Repairing dynamo $616 90 

Repairing tank and tower 434 11 

Partitioning two rooms 217 24 

Henrici washer 1,964 25 

Veranda repairs 147 69 

Recovering pipe 349 82 

Surface drainage 562 95 

Work in patients' dining room 139 27 

Plumbing 398 45 

Relocation of water heater 389 48 

6,220 16 

Total expenses for maintenance $156,642 11 



No. 34.] DIVISION OF TUBERCULOSIS (SANATORIA.) 351 



Special Appropriations. 

Balance Dec. 1, 1920 

Appropriations for current year 

Total 

Expended during the year (see statement below) 
Reverting to treasury of Commonwealth .... 

Balance Nov. 30, 1921, carried to next year 



$14,675 97 
2 29 



$6,888 71 
28.000 00 

$34,888 71 



14,678 26 
$20,210 45 



Object. 


Act or Resolve. 


Whole 
Amount. 


Expended 

during 
Fiscal Year. 


Total 

Expended 

to Date. 


Balance 

at End of 

Year. 


Cottage for engineer and 

steward. 
Fire protective system 


Chaps. 225, 629, 1920 
Chap. 203, 1921 . 


$16,500 00 
28,000 00 


$6,886 42 
7,789 55 


$16,497 71 
7,789 55 


$2 29* 
20,210 45 


r— ■■ 


$44,500 00 


$14,675 97 


$24,287 26 


$20,212 74 
1 



* Balance reverting to treasury of the Commonwealth . . $2 29 

Balance carried to next year 20,210 45 

Total as above $20,212 74 

Resources and Liabilities. 

Resources. 

Cash on hand $2,275 65 

November cash vouchers (paid from advance money) : 

Account of maintenance $7,283 09 

Account of special appropriations . . . 441 36 

7,724 45 



$10,000 00 

Due from treasury of Commonwealth from available appropriation account 

November, 1921, schedule 6,889 57 

$16,889 57 
Liabilities. 
Outstanding schedules of current year: 

Schedule of November bills $16,889 57 



Per Capita. 

During the year the average number of inmates has been 182.65. , 

Total cost for maintenance, $156,642.11. 

Equal to a weekly per capita cost of $16.4929. 

Receipt from sales, $452.86. 

Equal to a weekly per capita of $0.0476. 

All other institution receipts, $32,157.01. 

Equal to a weekly per capita of $3.3857. 

Net weekly per capita cost, $13.1072. 

Respectfully submitted, 

Gael 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. 



Repoet of the Boaed of State Examinees 

OF Plumbees 



Charles J. O'Brien, Chairman 



[3531 



Report of the State Examinees of Plumbers. 



Information concerning Examinations for Plumbers, shoiving the Place arid Date 
of Exaynination and Number examined, together ivith the Results of the Ex- 
amination, etc. 



Examinations. 



Examined. 



Pa.ssed. 



Refused. 



Boston, Dec. 4, 1920 . 
Lowell, Dec. 18, 1920 . 
Boston, Dec. 31, 1920 . 
Pittsfield, Jan. 15, 1921 
Boston, Feb. 5, 1G21 . 
Springfield, Feb. 19, 1921 
Boston, Mar. 5, 1921 
Fall River, Mar. 19, 1921 
Boston, April 2, 1921 . 
Worcester, April 16, 1921 
Boston, May 7, 1921 
Lowell, May 21, 1921 . 
Boston, June 4, 1921 . 
Pittsfield, June 18, 1921 
Boston, July 2, 1921 . 
Boston, July 16, 1921 . 
Boston, Sept. 3, 1921 . 
Springfield, Sept. 17, 1921 
Boston, Oct. 1, 1921 
Fall River, Oct. 15, 1921 
Boston, Nov. 5, 1921 . 
Worcester, Nov. 19, 1921 
Totals . 



77 
31 
51 
20 

101 
53 

102 
40 
93 
49 
98 
50 
90 
25 
91 
45 
91 
45 
91 
38 
65 
38 



12 
11 
11 

5 

24 
20 
24 
12 
19 
25 
19 
12 
18 

5 
13 

3 
19 
10 
19 
11 
16 
10 



1,385 



318 



65 

20 

40 

15 

77 

33 

78 

28 

74 

24 

79 

38 

72 

21 

78 

42 

78 

35 

72 

27' 

49 



1,067 









Masters. 


Journeymen. 


Total. 


Licenses granted on account of examination, Dec. 1, 

1920, to Dec. 1, 1921. 
Probationary licenses issued during year . 


121 


190 

8 


310 


L . , . ^ 



356 



DErARTMENT OF PUBLIC HEALTH. [Pub. Doc. 



REGISTRATION'S. 



Journeymen. 



December, 1020 
January, 1921 
February, 1921 
March, 1921 . 
April, 1921 
May, 1921 
June, 1921 
July, 1921 
August, 1921 . 
September, 1921 
October, 1921 . 
November, 1921 
Totals 




Meetings 48 



Examinations ....... 21 



Fees received. 



1,385 examination fees, at 80.50 . . . . 
133 master plumber licenses issued, at $2 . 
198 journeymen plumber licen.ses is.sued, at $0.50. 
1,794 master plumber renewals at $0.50 
4,060 journeymen plumber renewals, at SO. 50 

213 back fees, at $0.50 

Total 

Interest during May, 1921 



Paid to the 
Treasurer of 
the Common- 
wealth. 



$692 50 

266 00 

99 00 

897 00 

2,030 00 

106 50 



$4,091 00 
1 51 



No. 34.] 



EXAMINERS OF PLmiBERS. 



357 



For carrying out the Provisions of the Act relative to the Examiners of Plumbers. 

Salaries $3,500 00 

Travel 741 79 

Express 48 61 

Printing 152 48 

Postage 50 88 

Books and stationery 99 19 

Telephone and lighting 106 83 

Plumbers' materials 6 00 

Extra services 68 90 

Cleaning 28 75 

Miscellaneous 22 42 

Total $4,815 77 

Summary of Registrations. 





Masters. 


Journeymen. 


Certificate holders (individuals) 

Licenses, year ending May 1, 1921 (individuals) 


463' 
1,956 = 


462 
3,146 


Totals 


2,419 


3,608 



1 Holding journeymen also, 312. 



2 Holding journeymen also, 1,728. 



Number of last master license issued up to Aug. 1, 1921 ....... 2,970 

Number of last journeyman license issued up to Aug. 1, 1921 6,757 



Masters . 



Deceased Plumbers reported to Examiners. 
. 10 I Journeymen 



Repoet of Drainage Board 



Leslie R. Smith, Secretary 



[359] 



Eeport of Deainage Board. 



The Drainage Board, as authorized in chapter 252 of the General 
Laws, is comprised "of one member designated by the Department of 
Public Health and one member designated by the Department of 
Agriculture." 

The Drainage Board of 1921 comprises Mr. Warren C. Jewett of 
Worcester, chairman, who represents the Department of Public Health, 
and Leslie R. Smith of Hadley, secretary, representing the Depart- 
ment of Agriculture. During the year 1921 the Board has received 
and acted upon three petitions from landowners in as many different 
areas, who have asked help of the Board in organizing a drainage dis- 
trict as authorized in chapter 252 of the General Laws. 

Green Harbor District. 

The first petition was from certain landowners residing in the town 
of Marshfield, who asked for aid in organizing a drainage district to be 
known as the Green Harbor Drainage District. After viewing the 
area personally, the Board proceeded to appoint a local drainage com- 
mission as provided in chapter 252. Further action was delayed be- 
cause of the fact that the local landowners have not decided as to 
which course to pursue in order to adequately drain the area which 
contains approximately 1,300 acres. 

Salisbury Drainage District. 

A petition was received from certain landowners in the town of 
Salisbury for the aid of the Board in forming the Salisbury Drainage 
District. The Board was favorably impressed with the project, which 
would improve approximately 1,100 acres of land situated directly 
back of Salisbury Beach. The Board has appointed a local drainage 
commission, and the project is held up awaiting an amendment to 
chapter 252 of the General Laws. It developed that the logical place 
for dikes and tidewater gates necessary to carry out the project is 
situated over the Hne in the State of New Hampshire. 



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



Weweantic River Drainage District. 

A petition was received from certain landowners in the town of 
Carver asking aid in forming the Weweantic River Drainage District. 
The Board viewed the area and found that this area contained nearly 
3,000 acres of cranberry bog dependent on the Weweantic River for 
drainage. 

The local drainage commission was appointed and the county com- 
missioners of Plymouth County have voted to finance the district to 
the extent of S10,000, and the work of clearing out the Weweantic 
River is about to begin. 

Herring River Project. 

Upon request of certain landowners in the town of Wellfleet, the 
Drainage Board visited the area in that town drained by the Herring 
River. This is a case where considerable State money has been ex- 
pended in building a good dike with the necessary tide gates, and 
where the main river above the dike has grown full of wild rice, grass 
and flag in such a way as to almost completely clog the stream. The 
Board has not as yet received a petition from the owners of land in 
this district. 



Nova Scotia Trip. 

June 23, 1921, Commissioner of Agriculture Dr. Arthur W. Gilbert, 
Prof. Sidney B. Haskell, Director of the Experiment Station at the 
Massachusetts Agricultural College, together with Messrs. Jewett and 
Smith of the Drainage Board, went to Nova Scotia to study the great 
salt marsh areas, some of which have been drained for more than one 
hundred years. The party was shown the Great Canard Marsh and 
the Wellington Dike, the Wickwire Marsh, the extensive marsh areas 
around Grand Pre, also the various marshes around Nappan. The 
party was able to learn of the successes and failures of these extensive 
drainage projects. One important feature impressed itself upon all 
members of the party and that was the absolute necessity of State 
supervision over any drainage district. Local drains must be kept 
clear and the areas must be properly fed and cultivated in order to 
warrant the expenditure of public funds. 

The cost of the work of the Drainage Board for the year was 
$970.20; the appropriation was $1,000, leaving a balance unexpended 
of $29.80. 



Papers written in 1921 and Pamphlets 

ISSUED 



1363] 



PAPEES WEITTEN in 1921 AND PAMPHLETS ISSUED. 



Papers written by Members of the State Department of Public Health 

DURING THE YeAR 1921. 

Division of Administration. 

Eugene R. Kelly, M.D., Commissioner of PubUc Health. 

"The Modern Public Health Movement." The Commonhealth, Novem- 
ber-December, 1921. The Nation's Health, May, 1922. 

"The Public Health Activities of Prof. William T. Sedgwick." Boston 
Medical and Surgical Journal, July 21, 1921. 

Division of Communicable Diseases. 
Bernard W. Carey, M.D. 

" Diphtheria Control." Journal of American Medical Association, Aug. 27, 
1921. Reprinted in "The Medical Officer," London, Eng. 

Jonathan E, Henry, M.D., C.P.H. 

"A Brief Statistical Study of Recent Experience -wath Measles and Whoop- 
ing Cough in Massachusetts." American Journal of Public Health, 
April, 1921. 

"Experience in Massachusetts and a Few Other Places with Smallpox and 
Vaccination." Boston Medical and Surgical Journal, iVug. 25, 1921. 

Lyman Asa Jones, M.D. 

"Methods wliich may be employed in the Control of Communicable Dis- 
eases." The Commonhealth, July-August, 1921. 

Charles E. Simpson, M.D. 

"Septic Sore Throat from the Viewpoint of a Field Worker." The Com- 
monhealth, July- August, 1921, 

George T. O'Donnell, M.D. 

"Scarlet Fever." The Commonhealth, July-August, 1921. 

Charles W. Milliken, M.D. 

"Routine Immunizations for the Prevention of Institutional Infections." 
The Commonhealth, July-August, 1921. 

Francis A. Finnegan, M.D. 

"Pubhc Health Notations." The Commonhealth, July-August, 1921. 



366 DEPARTMENT OF PUBLIC HEALTH. [Pub. Doc. 

Harold E. Miner, M.D. 

"Communicable Diseases in Schools." The Commonhealth, July- August, 
1921. 

Oscar A. Dudley, M.D. 

"The Problem of Communicable Disease Control in Strictly Rural Com- 
munities." The Commonhealth, July- August, 1921. 

Howard A. Streeter, M.D. . 

"Progress of the Massachusetts Campaign for the Control of Venereal 
Diseases." The Commonhealth, July-August, 1921. 

Edith A. Beckler, S.B. 

"Notes from the Bacteriological Laboratory." The Commonhealth, July- 
August, 1921. 

Angeline D. Hamblen, A.B. 

"Proportionate Mortality, Ages 1 to 14, Massachusetts, 1915-19." The 
Commonhealth, March-April, 1921. 

CeciUa Lemner, R.N. 

"What the Public Health Nurse can do for the Mother." The Com- 
monhealth, May- June, 1921. 

Division of Sanitary Engineering. 

X. H. Goodnough, C.E. 

"Rainfall in New England." Journal of the New England Water Works 
Association, June, 1921. 

Division of Food and Drugs. 

Hermann C. Lythgoe, S.B. 

"The Application of the Theory of Probability to the Interpretation of 
Milk Analyses." Journal of the Association of Official Agricultural 
Chemists, Aug. 15, 1921. 

Division of Biologic Laboratories. 
Benjamin White. 

" The Schick Test and Immunization with Diphtheria Toxin-Antitoxin." 
Boston Med. and Surg. Jour., Vol. 184, p. 241, March 10, 1921. 

Division of Hygiene. 

Merrill E. Champion, M.D., C.P.H. 

"The Maternity Benefit Movement in Massachusetts." The Survey, 
March 12, 1921. 

"Summary of Public Health Legislation." The Commonhealth, May- 
June, 1921. 

"The Organization of State Divisions of Child Hygiene with Especial 
Reference to the Budget." Transactions of American Child Hygiene 
Association, 1921. 



No. 34.] PAPERS AND PAMPHLETS ISSUED. 367 

Harriet L. Wedgwood, R.N. 

"Report on Open-Air Schools in Massachusetts." The Commonhealth, 
January-February, 1 92 1 . 

Hazel Wedgwood, R.N. 

"Midwifery in Massachusetts." The Commonhealth, March-April, 1921. 

Alzira Wentworth Sandwall, S.B. 

"The A, B, C of Eating." Home Beautiful Exposition Magazine, April, 

1921. The Commonhealth, May- June, 1921. 
" Vitamines or Accessory Food Factors." The Commonhealth, May- June, 

1921. 
"Food and its Relation to Weight and Health." The Commonhealth, 

September-October, 1921. 

Division of Tuberculosis {Sanatoria) . 

Henry D. Chadwick, M.D. 

"Malnutrition and its Relation to Tuberculosis." The American Review 

of Tuberculosis. 
"The Child's Place in the Tuberculosis Program." The American Review 

of Tuberculosis. 

Pamphlets issued by the Massachusetts Department of Public Health. 

Cancer: Facts which every Adult should know. 13 pp. 

Diphtheria Bulletin. (Leaflet.) 

The Occurrence of Infantile Paralysis in Massachusetts in 1908. 26 pp. 

Infantile Paralysis in Massachusetts in 1909. 105 pp. 

Infantile Paralysis in Massachusetts, 1907-1912. 151 pp. 

Infantile Paralysis: Committee Report, State and Provincial Boards of Health. 

1917. 8 pp. 
The 1916 Epidemic of PoliomyeUtis. 53 pp. 
Influenza Bulletin. (Leaflet.) 
The Venereal Diseases. 5 pp. 
The Abatement of Nuisances. 7 pp. 
Fly Danger. 21 pp. 

Posture and its Relation to Health. 4 pp. 
A Health Creed for Massachusetts Boys and Girls. (Card.) 
Health Habits. (Card.) 

The Importance of Mouth Cleanliness. (Leaflet.) 
The Home Care of the Mouth. (Card.) 
Do You Know That — (Leaflet, mouth hygiene.) 
The Baby and You. 39 pp. 

Care of the Child in Hot Weather. (Booklet.) 7 pp. 
Diet No. 1. The Breast Fed Baby. 

Diet No. 2. The Bottle Fed Baby (from Birth to Ten Months) . (Leaflet.) 
Diet No. 3. Diet for Child from Ten Months to Eighteen Months. (Leaflet.) 



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

Diet No. 4. Diet for Child from Eighteen Months to Two Years. (Leaflet.) 

Food for Children from Two to Six Years Old. 15 pp. 

Food for the Child. 7 pp. 

Food Ways to Health. (Card.) 

Food: What it is and what it does. 10 pp. 

Food and the Calorie. 7 pp. 

Tissue-forming Foods. 8 pp. 

Fats and their Value in the Diet. 8 pp. 

The Importance of Minerals in the Diet. 4 pp. 

Simple Facts about Digestion. 7 pp. 

Carbohydrate Foods. 8 pp. 

How Cooking affects Digestibility of Foods. 5 pp. 

The School Lunch. 19 pp. 

Food for Working Women in Boston. 1917. 213 pp. 

List of Illustrated Lectures and Moving Pictures on Health Topics. 5 pp. 

Suggested List of Books on Hygiene for the Town Library. 11 pp. 

Diet for the Mother. 

The A B C of Eating. 

Vitamines as Accessory Food Factors. 

Food and its Relation to Weight and Health. 



INDEX 



[3691 



INDEX. 



Aberjona River: 

Condition of . . . 

Examination of . 
Abington, water supply 
Accord Pond, analysis of water 
Actinomycosis .... 
Activated sludge 
Acton, water supply 
Adams, water supply . 
Administration, Division of . 

Appropriations and expenditures of 

Papers written by members of 
Advisory committee on health weeks 
Aeration, purification of sewage by 
Agricultural fairs visited with exhibit 
Amesbury, water supply 
Amethyst Brook reservoirs, analysis of water 
Amherst, water supply 
Andover, water supply 
Anterior poliomyelitis . . . 9,27,30,212,222,224,226 

Anthrax 

Antimeningococcic serum 
Antipneumococcic serum 
Antitoxin and vaccine laboratory 
Appropriations and expenditures for year ended Nov. 30, 1921 
Arsphenamine 

Appropriation for manufacture and distribution of 

Manufacture 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 
Assabet River: 

Condition of . . . 

Examination of . 
Assawompsett Pond, analysis of water 
Athol, water supply 
Attleboro, water supply 
Auburn, water supply . 
Austin Brook Reservoir, analysis of water 



PAGE 

97 
57 
75 
77 
30, 212, 234, 237, 238 

120 

80 

75,80 

24 

41 

365 

34, 252 
120 
253 

80 
75 
75 
75 

228, 230, 232, 234, 237, 238 
30, 213, 234, 237, 238 
243, 244 
243, 244 

35, 243 
41 
39 
45 

157 
78 
75 
76 
75 
80 
75 
78 
78 

97 
. 57 
79 
75 
80 
80 
76 



372 



INDEX. 



Avon, water supply 
Ayer, water supply 

Bacterial vaccine 

Bacteriological Laboratory, work of 

Bakeries ..... 

Bakery inspections 

Barnstable, water supply 

Barre, water supply 

Basin Pond Brook, analysis of water 

Bassett Brook, analysis of water . 

Beaman Reservoir, analysis of water 

Bear Hole Brook: 

Analysis of water . 

Analysis of filtered 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 

Papers written by members of 

Report of . 

Antitoxin and Vaccine Laboratory 
Wassermann Laboratory 
Biologic products 

Distributed .... 

Produced and distributed 

Sale of, surplus 
Birch Reservoir, analysis of water 
Black Brook, analysis of water 
Blackstone River: 

Condition of . . . 

Examination of . 
Blandford, water supply 
Bondsville (Palmer), water supply 
Boston Health League 
Bottomly Reservoir, analysis of water 
Braintree, water supply 
Breed's Reservoir, analysis of water 
Bridgewater, water supply . 
Brockton, water supply 
Brookline, water supply 
Bubonic plague .... 

Prevention and control of 
Bubonic plague, investigation, appropriation and expenditures 
Buckman Brook Reservoir, analysis of water 
Buckmaster Pond, analysis of water 
Buttery Brook Reservoir, analysis of water 

Cady Brook, analysis of water 

Cambridge, water supply 

Cancer .... 

Canton, water supply . 

Cape Pond, analysis of water 

Cases and deaths from diseases dangerous to the public health 



for 



PAGE 

80 
80 

244 
31, 205 
155 
38 
80 
75 
77 
75 
78 

79 

79 

75 

80 

75 

80 

35 

43 

366 

241 

243 

247 

36 

207 

243 

37 

77 

79 

97 

58- 

75 

83 

260 
80 
80 
77 
81 
75 
81 

203 
31 
48 
75 
78 
79 

76 

75, 76 

22, 251 

81 

79 
219 



INDEX. 



373 



PAGE 

Cases and deaths, with case and death rates, per 100,000 population for all report- 
able diseases during the year 1921 . . . . . . 237 

Cerebrospinal meningitis .......... 30 

Charles River: 

Analysis of filtered water ......... 78 

Condition of .......... . 97 

Examination of .......... . 53 

Chelmsford, water supply .......... 81 

Chelmsford (North), water supply ........ 81 

Cheshire, water supply .......... 76 

Chester, water supply ........... 76 

Chestnut Hill Reservoir, analysis of water ....... 75 

Chicken pox 30, 213, 222, 224, 226, 228, 230, 232, 234, 237, 238 

Chicopee, water supply .......... 76 

Chicopee (Fairview), water supply ........ 81 

Chicopee River: 

Condition of ........... 98 

Examination of .......... . 53 

Child hygiene clinics ........... 259 

Clinics: 

Consultation, for tuberculosis ........ 33, 270 

Examination, for tuberculosis ........ 33, 271 

Clinton, water supply ........... 76 

Codding Brook reservoirs, analysis of water ....... 77 

Cohasset, water supply .......... 81 

Cold Brook Reservoir, analysis of water ....... 77 

Cold storage ............ 154 

Cold-storage statistics ........... 174 

Collinsville (Dracut), water supply ........ 81 

Color, removal of, from water ......... 131 

Colrain (Griswoldville) , water supply ........ 76 

Commissioner of public health, report of ...... . 6 

Administration, Division of ........ . 24 

Appropriations and expenditures of, for the year ended Nov. 30, 1921 . 41 

Biologic Laboratories, Division of ....... . 35 

Antitoxin and Vaccine Laboratory ....... 35 

Wassermann Laboratory ......... 38 

Communicable Diseases, Division of ...... . 27 

Disease prevalence ........... 8 

Food and Drugs, Division of ........ . 38 

Hygiene, Division of ......... . 34 

Hygiene, problems of . . . . . . . . . . 18, 20 

Institutions ............ 12 

Legislative recommendations ......... 24 

Maternity benefits .......... 18 

Oil-refining industry problems ........ 14 

Personnel, retaining of, efficient ........ 8 

Plague problems ........... 14 

Plumbing report ........... 17 

Recapitulation ........... 50 

Sanitary Engineering, Division of ....... . 25 

Tuberculosis, Di\dsion of ........ . 32 

Venereal diseases ........... 11 

Water and Sewage Laboratories, Division of ..... . 26 

Water supply problems ......... 18 

Commonhealth ............ 259 



374 



INDEX. 



Communicable Diseases, Division of 

Appropriations and expenditures of 
Papers written by members of 
Report of . 

Bacteriological Laboratory, work of 

Bubonic plague 

Cases and deaths from diseases dangerous to the public health 

Cases and deaths, with case and death rate, per 100,000 population 
all reportable diseases . 

Diphtheria and the Schick test . 

District health officers, work of . 

Dog bite ..... 

Encephalitis lethargica 

Epidemiologist, report of . 

Incidence of communicable diseases by months 

Measles ..... 

Nursing assistants, work of 

Penikese hospital 

Personnel, changes in .1 

Pneumonia, lobar 

Quarantine regulations 

Scarlet fever .... 

Schick test .... 

Smallpox ..... 

Tuberculosis .... 

Typhoid fever .... 

Venereal diseases, subdivision of . 
Concord and Sudbury rivers, examination of 
Concord, water supply 
Concord River, condition of 
Connecticut River: 

Condition of .... 

Examination of . 
Contact filters, operation of . 
Cook Allen Reservoir, analysis of water 
Cooley Brook (Chicopee), analysis of water 
Cooley Brook (Longmeadow), analysis of water 
Courses for continuation school teachers 
Coweeset River, condition of 
Crystal Lake (Gardner), analysis of water 
Crystal Lake (Haverhill) , analysis of water 
Crystal Lake (Wakefield), analysis of water 



Dalton, water supply . 
Danvers, water supply 
Dedham, water supply 
Deerfield, water supply 
Deerfield River: 

Condition of 

Examination of 
Dental hygiene . 
Diagnostic outfits distributed 
Dike's Brook Reservoir, analysis of water 
Diphtheria . . 9, 28, 29, 30, 197, 212, 213, 222, 224. 226, 

Diphtheria antitoxin . 
Diphtheria toxin for Schick test 



228, 230, 232, 234 



for 



PAGE 

27 
42 
365 
193 
205 
203 
219 

237 
197 
204 
201 
202 
211 
238 
202 
205 
210 
205 
200 
203 
202 
197 
202 
200 
199 
208 
58 
76 
98 

98 

59 

124 

78 

76 

77 

261 

101 

76 

77 

79 

76 
76 
81 
81 

98 

59 

21 

207 

76 

237, 238 

243, 244 

243 



INDEX. 



375 



Diphtheria toxin-antitoxin . 
Disease prevalence 
Dispensaries inspected 
Dispensaries, tuberculosis 
District health officers, work of 
Doane Pond, analysis of water 

Dog bite 28 

Douglas, water supply 

Dow's Brook Reservoir, analysis of water 

Dracut, water supply . 

Dracut (Collinsville), water supply 

Drainage Board, report of 

Green Harbor district 

Herring River project . 

Nova Scotia trip . 

Salisbury drainage district 

Weweantic River drainage district . 
Drug samples examined, summary of 
Drugs, examination of samples of . 
Dry Brook, analysis of water 
Dudley, water supply .... 
Duxbury, water supply 
Dysentery ...... 

East Brookfield, water supply 

Easthampton, water supply . 

East Mountain Reservoir, analysis of water 

Easton (North Easton), water supply 

Edgartown, water supply 

Educational activities of Division of Biologic Laboratories 

Egremont (South), water supply . 

Egypt Brook Reservoir, analysis of water 

Elder's Pond, analysis of water 

Encephalitis lethargica 

Epidemic cerebrospinal meningitis . 214, 222 

Epidemiologist, report of, for 1921 

Exhibit 

Expenses of the biologic laboratories 

Fairhaven, water supply 

Fairview (Chicopee), water supply 

Fall Brook Reservoir, analysis of water 

Fall River, water supply 

Falmouth, water supply 

Falulah Brook, analysis of water . 

Farnham Reservoir, analysis of water 

Filters: 

Contact, operation of 

Intermittent sand, operated with untreated sewage 

Lawrence, city 

Trickling, operation of . 
Filtration of water as polluted as Merrimack River 
Fitchburg, water supply 
Flow of streams .... 
Follow-up work on health weeks . 
Fomer Reservoir, analysis of water 



30, 201, 21 



2, 213, 234 



29, 30, 202, 211, 214, 235, 
224, 226, 228, 230, 232, 234, 



PAGE 

243, 244 
8 
205 
270 
32, 204 
78 
237, 238 
81 
77 
81 
81 
359 
361 
362 
362 
361 
362 
172 
152 
75 
81 
81 
30, 214, 234, 237. 238 



81 

81 

76 

81 

81 

37, 246 

76 

76 

79 

237, 238 

237, 238 

211 

20 

245 



water below Lawrence 



81 
81 
77 
76 
76 
76 
79 

122 
125 
136 
122 
135 

76 

53,88 

253 

77 



376 



INDEX. 



Food and Drugs, Division of 

Appropriations and expenditures of 
Papers written by members of 
Report of . 

Arsphenamine, manufacture of 

Bakeries .... 

Cold storage 

Cold-storage statistics 

Drug samples examined, summary of 

Drugs, examination of samples of 

Food samples examined, summary of 

Foods other than milk, examination of samples of 

Liquor, examination of samples of 

Liquor samples examined, summary of 

Milk, examination of samples of . 

Milk samples examined, summary of 

Prosecution for violations of food and drug laws 

Prosecutions, list of . 

Slaughtering 
Food samples examined, summary of 
Foods other than milk, examination of samples of 
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 . • • 

Examination of . 
Fresh Pond, analysis of water 
Fulling Mill Pond, analysis of water 

Gallivan, William J. . 

Gardner, water supply 

Gates Pond, analysis of water 

German measles . . . • • 30, 215, 222, 224 

Glanders .... 

Glen Brook reservoirs, analysis of water 

Gloucester, water supply 

Gonorrhea 30, 215, 222, 224 

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 Harbor district (drainage) . 

Green River, analysis of water 

Griswoldville (Colrain) , water supply 



226 



226 



228, 



228, 



230, 



230, 232, 234 



;,234 



PAGE 
38 

45 

366 

141 

157 

155 

154 

174 

172 

152 

171 

146 

153 

172 

146 

170 

144 

158 

156 

171 

146 

81 

79 

81 

75 

81 

75 

99 
59 

76 

77 

5 

76 
77 

237, 238 

215 

76 

76 

237, 238 
76 
81 
81 
78 
76 
76 
78 
79 
79 
78 
79 
76 
361 
76 
76 



INDEX. 



377 



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 

Hatfield, water supply 

Hathaway Brook, analysis of water 

Haverhill, water supply 

Hawkes Reservoir, analysis of water 

Haynes Reservoir, analysis of water 

Health exhibits . 

Health weeks 

Advisory committee on . 
Follow-up work on 
Herring River project (drainage) 
Hicks Spring, analysis of water 
Hingham, water supply 
Hinsdale, water supply 
Hobbs Brook Reservoirs, analysis of water 
Holden reservoirs, analysis of water 
Holliston, water supply 
Holyoke, water supply 
Hookworm .... 

Hoosick River: 

Condition of . . . 

Examination of . 
Hopkinton, water supply 
Hopkinton Reservoir, analysis of water 
Horn Pond (Chester), analysis of water 
Hospitals, jails, houses of correction and dispensaries, inspection of 
Hospitals inspected ..... 
Housatonic (Great Barrington), water supply 
Housatonic River: 
Condition of 
Examination of 
Hudson, water supply . 
Huntington, water supply 
Hygiene, Division of . 

Appropriations and expenditures of 
Papers written by members of 
Report of . 

Activities of, importance of, relative 

Advisory committee . 

Agricultural fairs 

Boston Health League 

Cancer ..... 

Child hygiene clinics . 

Commonhealth .... 

Courses for continuation school teachers 

Follow-up work 

General survey . 

Health exhibit . 

Infant mortality 



PAGE 

81 
81 

76 
75 

76 
76 
79 
77 
78 
77 
77 
77 
252 
252 
252 
252 
362 
82 
77, 81 
77 
75 
80 
81 
77 
30, 215, 235, 237, 238 



99 
59 
81 
75 
76 
31 
205 
76 

99 

59 

77 

77,82 

34 

41 

366 

249 

262 

252 

253 

260 

251 

259 

259 

261 

253 

251 

252 

264 



378 



INDEX. 



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

Investigative work .... 
Lectures to training schools for nurses . 
Maternal mortality ..... 
Mental hygiene . . . . • 

Mouth hygiene ....•• 
New needs of . • • • • • 

Nutritional activities of ... • 

Pamphlets, lantern slides and lectures . 
Parent-teacher associations 

Hygiene, problems of . 

Improvements in the Biologic Laboratory 
Incidence of commvmicable diseases by months, 1921 
Infant mortality ...•••• 

Influenza 30, 212, 215, 223. 225 

Inland waters, care of . . . • • • 

Difficulties of pro^dding water and sewerage facilities 

Objectionable conditions due to lack of sewerage 

Public water supplies, sanitary protection of . 

Rainfall and flow of streams 

Rivers, examination of . 

Sewage disposal systems 

Sewer outlets discharging into the sea, examination of 

Water supplies 

Water supplies, examination of 
Institutions . . • • 

Intermittent sand filters operated with untreated sewage 
Ipswich, water supply . 
Ipsv?ich River, analysis of water . 

Jails, lock-ups, etc., inspected 
Johnson's Pond, analysis of water 
Jonathan Pond, analysis of water . 

Kendall Reservoir, analysis of water 
Kenoza Lake, analysis of water 
Kent Reservoir, analysis of water 
Kingston, water supply 
Kitchen Brook, analysis of water 

Lake Averic, analysis of water 
Lake Cochituate, analysis of water 
Lake Pleasant, analysis of water 
Lake Saltonstall, analysis of water 
Lakeville State Sanatorium 
Special report 
Statistical tables . 
Superintendent, report of 

Acknowledgments 

Clinics 

Dentistry . 

Farm 

Improvements 

Medical report 

Recommendations 



227, 229, 231, 233, 235 
in certain districts 



PAGE 

258 
260 
264 
261 
257 
263 
254 
254 
261 
18,20 

244 

238 

258, 264 

237, 238 

51 

53 

56 

54 

53 

57 

55 

55 

51 

54 

12 

125 

77 

79 

205 

77 
79 

80 
77 
80 
82 
76 

79 

75 

78 

77 

272 

277 

278 

272 

276 

274 

274 

274 

275 

273 

275 



INDEX. 



379 



Lakeville State Sanatorium — Concluded 

Treasurer, report of . . . 

Valuation ..... 

Lake Williams, analysis of water . 
Lantern slides ..... 

Laurel Lake, analysis of water 
Lawrence, city filters .... 

Lawrence, filtration of water as polluted as Merrimack River 

Lawrence, water supply 

Leaping Well Reservoir, analysis of water 

Lectures ...... 

Lectures to training schools for nurses . 
Lee, water supply .... 

Legislative recommendations 

Leicester, water supply 

Leicester (Cherry Valley and Rochdale Water District) , water 

Leicester Reservoir, analysis of water 

Lenox, water supply ..... 

Leominster, water supply .... 

Leprosy 

Lincoln, water supply ..... 
Liquor, examination of samples of 
Liquor samples analyzed .... 
Little Quittacas Pond, analysis of water 
Little South Pond, analysis of water 
Littleton, water supply .... 

Longham Reservoir, analysis of water . 
Longmeadow, water supply .... 
Long Pond (Falmouth), analysis of water 
Long Pond (Great Barrington), analysis of water 
Lowell, water supply . 
Lynn, water supply 



Malaria .... 

Manchester, water supply 

Manhan River, condition of 

Mann Reservoir, analysis of water 

Mansfield, water supply 

Marblehead, water supply . 

Marion, water supply . 

Marlborough, water supply . 

Marshfield, water supply 

Maternal mortality 

Maternity benefits 

Mattapoisett, water supply . 

Maynard, water supply 

McClellan Reservoir, analysis of water 

Measles . . .29, 30, 202, 212, 215, 223, 225, 

Mechanical filtration of Merrimack River water 

Medfield, water supply .... 

Medway, water supply .... 

Meetinghouse Pond, analysis of water . 
Mental hygiene ...... 

Merrimac, water supply .... 

Merrimack River: 

Analysis of filtered water 

Condition of ..... 



water 



supply 



belt 



30, 215 



235, 



30, 215, 



227, 229, 231, 233, 235 



PAGE 

286 

276 
78 

254 
77 

136 

135 
77 
79 

254 
34, 260 
77 
24 
82 
82 
80 
77 
77 
237, 238 
77 

153 
38 
78 
79 
82 
79 
77 
76 
76 
82 
77 



236, 237, 238 
78, 82 
98 
80 
82 
82 
82 
78 
82 

258 
18 
82 
78 
76 
237, 238 

127 

82 

82 

76 

22, 261 



82 

77 
99 



380 



INDEX. 



Meri'imack River — Concluded. 

Examination of 

Flow of . . . 

Merrimack River water, mechanical filtration of 
Methuen, water supply 
Metropolitan Water District, water supply 
Middleborough, water supply 

Middle Reservoir (Northampton), analysis of water 
Middleton Pond, analysis of water 
Midwife question .... 

Milford, water supply .... 
Miiham Brook Reservoir, analysis of water 
Milk, examination of samples of . 
Milk samples examined, summary of 
Mill Brook, analysis of water 
Millburj', water supply 
Millers River: 

Condition of .... 

Examination of . 
Millis, water supply .... 
Mill River, condition of . . . 

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 30, 215, 223, 225 

Muschopauge Lake, analysis of water 

Nagog Pond, analysis of water 
Nantucket, water supply 
Nashua River: 

Condition of 

Examination of 

Flow of . . . 

Rainfall on drainage area 
Natick, water supply . 
Naukeag Lake, analysis of water 
Needham, water supply 
Neponset River: 

Appropriations and expenditures regarding 

Condition of 

Examination of 

Protection of the public health in the valley of 
New Bedford, water supply . 
Newburyport, water supply . 
Newton, water supply . 
Normal serum (Schick test) . 
North Adams, water supply 
Northampton, water supply 
North Andover, water supply 
North Attleborough, water supply 
Northborough, water supply 



227, 



229,231,233,235 



PAGE 

59 

93 

127 

82 
75 
82 
78 
76 
22 
78 
78 
146 
170 
78 
82 

99 

60 

82 

, 98 

77 
82 
78 
79 
77 
76 
78 
262 
79 
, 237, 238 
79 

76 

78, 82 

100 
60 

91, 95, 96 
92 
82 
75 
82 

49 

100 

60 

62, 74 

78 

71, 78 

82 

243 

78 

, 78 

78 

82 

78 



io,, 



INDEX. 



381 



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 . 

Special report 

Statistical tables . 

Superintendent, report of 

Treasurer, report of 

Valuation .... 
North River Cin Peabody and Salem), examination 
North River, condition of 
North Watuppa Lake, analysis of water 
Norton, water supply . 
Norwood, water supply 
Notch Brook Reservoir, analysis of water 
Nova Scotia trip of Drainage Board 
Noxious trades, nuisances from 
Nuisances from noxious trades 
Nursing assistants, work of . 
Nutrition .... 
Nutrition work . 
Nutritional activities . 

Oak Bluffs, water supply 

Oil refineries ..... 

Investigations of complaints regarding 
Oil-refining industry problems 
Onset (Wareham), water supply 
Ophthalmia neonatorum 
Orange, water supply . 
Oxford, water supply . 



of 



30, 215, 223, 225, 227, 229, 231, 2 



PAGE 

78 

78 

81 

81 

78 

78- 

334 

339 

340 

.335 

346 

338 

60 

100 

76 

82 

78, 82 

78 

362 

73 

73 

205 

262 

20 

254 



83 
62 
25 
14 
79 

.33,2.35,237,2.39 
78 
83 



Palmer, water supply ......... 

Palmer (Bonds\Tlle) , water supply ...... 

Pamplilets ........... 

Pamphlets issued by the Massachusetts Department of Public Health 

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

year 1921 

Parent-Teacher Association ...... 

Peabody, water supply ...... 

Pellagra 30, 217, 236 

Penikese Hospital ....... 

Appropriation and expenditures for 
Penikese Island ........ 

Pentucket Lake, analysis of water .... 

Pepperell, water supply ...... 

Personnel (Biologic Laboratories) ..... 

Personnel, changes in, in Division of Communicable Diseases 
Personnel, retaining of, efficient ..... 

Phillipston Reservoir, analysis of water .... 

Pittsfield, water supply ...... 

Plague problems ........ 



78 

83 

254 

367 

365 
261 

78 

237, 239 

31,210 

49 

12 

77 

83 

245 

32, 205 

& 

75 

78, 79 

14 



382 



INDEX. 



Plumbers, State Examiners of, appropriation and expenditures of 

Report of the Board of . 
Plumbing report .... 
Plymouth, water supply 

Pneumonia, lobar . . .30, 200, 217, 223, 225, 227, 

Prosecutions by the Department of Public Health for violat 

drug laws ..... 
Prosecutions for violations of food and drug laws 
Prosecutions, list of . 
Provincetown, water supply 
Public Health CouncU, report of . 
Public health nursing service 
Public water supplies, sanitary protection of 

Quarantine regulations 



Rabies ..... 
Rainfall: 

In Massachusetts . 
On Nashua River drainage area 
On Sudbury River drainage area 
Rainfall and flow of streams 
Randolph, water supply 
Reading, water supply 
Recapitulation 
Removal of color from water 
Rivers, examination of 
Rockport, water supply 
Round table conferences 
Running Gutter Brook Reservoir, analy 
Russell, water supply . 
Rutland State Sanatorium . 
Special report 
Statistical tables . 
Superintendent, report of 
Clinics 
Farm 

Improvements . 
Medical report . 
Recommendations 
Training school 
Treasurer, report of 
Valuation 
Rutland, water supply 



229 2 
ions 



31, 2.33, 235, 
of food and 



Sacket Brook, analysis of water 
Salem, water supply . 
Salisbury, water supply 
Salisbury drainage district . 
Salisbury Plain River, condition of 
Sanatoria, tuberculosis 
Sandy Pond, analysis of water 
Sanitary Engineering, Division of 

Papers written by members of 

Report of . 
Scarlet fever . . 29,30,202, 



sis of 



water 



P.^GE 

48 

353 

17 

79 

237,239 

40 
144 
158 

83 
3 

22 

54 

203 



30, 236, 237, 239 



87 

92 

89 

53 

79 

83 

50 

131 

57, 96 

79 

22 

77 

79 

292 

300 

301 

292 

295 

297 

297 

293 

298 

297 

308 

299 

79 



79 
79 
83 
361 
101 
12, 269 
77 
25 
366 
67 
212, 217, 223, 225, 227, 229, 231, 233, 235, 237, 239 



INDEX. 



383 



Schick clinics 

Schick outfits 

Schick test 

School hygiene . 

Scituate, water supply 

Scott Reservoir, analysis of water 

Seaport cities and toAOTis, survey of, for diseased rats 

Sedgwick, William T. . 

Septic sore throat 

Septic tanks, operation of 

Serum distributed 

Seven Mile River, condition of 

Sewage : 

Character of the, used at the Lawrence Experiment Station 

Intermittent sand filters operated with untreated 

Purification of, by aeration 
Sewage disposal systems 
Sewage disposal works, examination of 
Sewer outlets, examination of 

Sewer outlets discharging into the sea, examination of 
Sewerage, objectionable conditions due to lack of 
Sewerage facilities, difficulties of providing, in certain districts 
Sharon, water supply .... 

Shaw Pond, analysis of water 
Sheffield, water supply 
Shelburne (Shelburne Falls), water supply 
Shirley, water supply .... 

Shrewsbury, water supply 
Silver Lake, analysis of water 
Slaughtering ..... 

Slow sand filtration of water treated ^-ith aluminum sulphate 
Smallpox ...... 

Smallpox vaccine distributed 

Snake Brook Reservoir, analysis of water 

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 

Stockbridge, water supply 

Stony Brook Reservoir, analysis of water 

Stoughton, water supply 

Streams, flow of . 

Sudbury Reservoir, analysis of water 

Sudbury River: 

Condition of .... 

Flow of .... . 

Rainfall on drainage area 
Sudbury (and Concord) rivers, examination of 
Suntaug Lake, analysis of water 
Supplement 

Survey, general, of work of Division of Hygiene 
Swan Pond, analysis of water 
Syphilis 30, 218, 223, 225, 227, 229, 231 



30, 217, 236 



28, 30, 202, 211, 217, 236 



PAGE 
28 

243, 244 

197 

22 

83 

76 

31 

4 

237, 239 

118 

243 

98 

116 

125 

120 

55 

102 

72 

55 

72 

70 

83 

79 

83 

79 

83 

83 

75 

156 

130 

, 237, 239 

243 

79 

79 

76 

79, 83 

79 

75 

79 

78 

79 

75 

79 

88 

75 



98 
88, 95, 96 
89 
58 
78 
65 
251 
76 
, 233, 235, 237, 239 



384 



INDEX. 



Taunton, water supply 
Taunton River: 

Condition of .... 

Examination of . 
Tetanus ..•••• 
Thunder Brook, analysis of water 
Tillotston Brook Reservoir, analysis of water 
Trachoma ..•••• 
Trichinosis . . . • • 

Trickling filters, operation of 
Tuberculosis . . . • • 

Nonpulmonary . . . • 

Other forms . • • 30,201,218,223 

Pulmonary . . • 29,30,200,218,223, 

Tuberculosis sanatoria 
Tuberculosis (sanatoria), Division of 
Appropriation and expenditures of 
Papers written by members of 
Report of . 

Lake\alle State Sanatorium: 
Special report 
Statistical tables 
Superintendent, report of 
Treasurer, report of 
Valuation 
North Reading State Sanatorium 
Special report 
Statistical tables 
Superintendent, report of 
Treasurer, report of 
Valuation 
Rutland State Sanatorium: 
Special report 
Statistical tables 
Superintendent, report of 
Treasurer, report of 
Valuation 
Westfield State Sanatorium: 
Special report 
Statistical tables 
Superintendent, report of 
Treasurer, report of 
Valuation 
Typhoid fever . 8, 27, 29, 30, 199, 211, 218, 223 
Typhoid-paratyphoid vaccine 
Typhus fever . . . • 



PAGE 

. . . 79 

101 

61 

30, 21S, 236, 237, 239 

76 

79 

30, 218, 2.36, 239 

30, 218, 236, 237, 239 

122 

10 

211 

;, 225, 227, 229, 231, 233, 2.35, 237, 239 

225, 227, 229, 231, 233, 235, 237, 239 

12, 33 

32 

47 

367 

267 

277 
278 
272 
286 
276 

339 
340 
335 
346 
338 

300 
301 
292 
308 
299 

321 
322 
314 
329 
321 
225, 227, 229, 231, 233, 235, 237, 239 

243 
30, 236, 237, 239 



Uxbridge, water supply 



83 



Vaccine virus . . • " • 

Venereal disease statistics 
Venereal diseases 
Venereal diseases, subdivision of: 

Appropriation and expenditures of 

Work of . . 



244 

209 

11 

43 

30, 208 



INDEX. 



385 



sulphate 



ing, in certain districts 



Wachusett Lake, analysis of water 

Wachusett Reservoirs, analysis 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 

Ware River, condition of 

Wareham, water supply 

Wareham (Onset), water supply . 

Wassermann Laboratory 

Water: 

Consumption of, in cities and towns 

Filtration of, as polluted as Merrimack River water below Lawrence 

Removal of color from 

Slow sand filtration of, treated with aluminum 
Water and Sewage Laboratories, Division of 

Report of . 
Water and sewerage facilities, difficulties of providi 
Water supplies .... 

Analyses of ground-water sources 

Analyses of surface-water sources 

Examination of . 

Examination of, public . 

Sanitary protection of public 
Water supply investigation, special 
Water supply statistics 

Water supply and sewage disposal, appropriations and expenditures for 
Water supply and sewerage, report regarding 
Water supply needs and resources 

Investigation of . 
Water supply problems 
Wayland, water supply 
Webster, water supply 
Wellesley, water supply 
Wenham Lake, analysis of water 
Westborough, water supply . 
West Brookfield, water supply 
Westfield, water supply 

Westfield Little River, analysis of filtered water 
Westfield State Sanatorium: 

Special report 

Statistical tables . 

Superintendent, report of 
Acknowledgments 
Children . 
Clinics 
Dentistry . 
Employees 
Farm 

Improvements 
Medical report 
Recommendations 
Sanatorium school 



PAGE 

76 
75 
79 
77 
76 
83 
83 
78 
83 
98 
83 
79 
38, 247 

84 
135 
131 
130 
26 
113 
70 
51 
80 
75 
54 
74 
71 
74 
84 
46 
51 
63 
26 
18 
79 
83 
83 
79 
83 
83 
79 
79 

321 
322 
314 
320 
317 
315 
317 
320 
319 
319 
315 
319 
318 



386 



INDEX. 



Westfield State Sanatorium — Concluded. 
Treasurer, report of 
Valuation .... 

Westford, water supply 

West Groton (Groton) , water supply 

Weston, water supply . 

Weston Reservoir, analysis of water 

West Springfield, water supply 

Weweantic River, drainage district 

Weymouth, water supply 

White Pond, analysis of water 

White Reservoir, analysis of water 

Whiting Street Reservoir, analysis of water 



Whooping cough 

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 



29, 30, 212, 219, 223, 225 



227, 



229, 231, 233, 235 



PAGE 

329 
321 
83 
81 
83 
75 
79 
362 
79 
78 
77 
77 
237, 239 
79 
79 
83 
79, 80 
76 
83 
80 
83 
83 
77 



T> I . T-|, 



BOSTON UNIVERSITY 




r\r\—7r-r\ 



8059