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PRESENTED BY 







ClIAFTEK V. 



Of the LlHRAKl. 



The Library Committee shall divide the books and other 
articles belonging to the Library into three classes, namely: 
(a) those winch are not to be removed from the building; (b) 
those which may be taken from the halls only by written 
permission of three members of the committee, who shall 
take a receipt for the same and be responsible for their safe 
return : (c) those which may circulate under the following 
rules. 

Members shall be entitled to take from the library one 
folio, or two quarto volumes, or four volumes of any lesser 
fold, with the plates belonging to the same, upon having 
them recorded bythe Librarian. or Assistant Librarian, and 
promising to make good any damage they sustain. Avhile in 
their possession, and to replace the same if lost, or pay the 
sum fixed by the Library Committee. 

No person shall lend any book belonging to the Institute, 
excepting to a member, under a penalty of one dollar for 
everv such offence. 

The Library Committee may allow members to take more 
than the allotted number of books upon a written applica- 
tion- and may also permit other persons than members to 
use the Library, under such conditions as they may impose. 
No person shall detain any book longer tlian four weeks 
from the time of its being taken from the Library, if notified 
that the same is wanted by another member, under a penalty 
of five cents perdav, and no volume shall be retained longer 
than three months at one time under the same penalty. 

The Librarian shall have power by order of the Library 
Committee to call in any volume after it has been retained 
by a mem tier for ten days. 

On or before the first Wednesday in May. all books shall 
be returned to the Library, and a penalty of five cents per 
day shall lie imposed for each volume detained. 

Labels designating the class to which each book belongs 
shall be placed upon its cover. 

No book shall be allowed to circulate until one month after 
its reception. 



PUBLIC DOCUMENT No. 37. 



Second Annual Report 



STATE BOARD OF HEALTH 



MASSACHUSETTS 



Januaky, 1871. 



BOSTON : 

WRIGHT & POTTER, STATE PRINTERS, 
79 Milk Street (corner of Federal). 

1871. 






MEMBERS OF THE BOARD. 



H. I. BOWDITCH of Boston, Chairman. 

R. T. DAVIS of Fall River. 

P. EMORY ALDRICH of Worcester. 

W. C. CHAPIN of Lawrence. 

WARREN SAWYER of Boston. 

RICHARD FROTHINGHAM of Charlestown. 

GEORGE DERBY of Boston, Secretat-y. 



CONTENTS 



Page. 

1. General Keport of the Board, ... .... 2 

2. Expenses of the Board in 1870, 18 

3. Report of the Secretary, 19 

4. Poisoning by Lead-pipe used for the Conveyance of Drinking- 

water, 21 

5. Trichina Disease in Massachusetts, 45 

6. Health of Towns, 51 

7. Charbon in Massachusetts, 85 

8. The Causes of Typhoid Fever, 109 

9. Homes for the Poor — Convalescent Homes — The Sewage Ques- 

tion, 181 

10. Correspondence concerning the Effects of Intoxicating Drinks, 245 

11. Analysis of the Mortality of the City of Boston in 1870, . . 349 

12. The Ventilation of School-houses, 369 

13. Mystic Pond and its Sources of Supply, 385 

14. Air and its Impurities, 395 

15. Health of Minors Employed in Factories, 409 

16. Use of Milk from Cows affected with " Foot and Mouth Dis- 

ease," 425 



ALPHABETICAL INDEX. 



Page. 

Air and its impurities, .* 15, 396 

" of Boston, 399 

" of Cambridge, 404 

" of Schools in Boston, 400 

" of Halls, &c, in Boston, 402 

" Letter from Mr. Stodder concerning, 406 

Aphtha Epizootica, Description of, 427 

Allen's Buildings in London, Description of, 208 

Alcoholic drinks, Report on, 11 

" " Circulars concerning, 246, 256 

" " Correspondence concerning, from Massachusetts, 246 
and from foreign countries, as follows : 

Ancona, 257 

Athens, 257 

Alexandria, 320 

Basle, 360 

Beirut, " 310 

Berlin, 264 

Berne, 261 

Bremen, 264 

Ceylon, 311 

Cape Haytien, 321 

Cadiz, 267 

Cologne, 274 

Constantinople, 265 

Copenhagen, 268 

Darien, 346 

Dublin, 278 

Edinburgh, 336 

Elsinore, 280 

Fayal, 289 

Florence, 286 

Frankfort-on-the-Main, 282 

Funchal, 309 

Japan, 316,341 



viii ALPHABETICAL INDEX. 

Page. 

' Leipsic, 291 

Lima, 327 

Liverpool, 292 

London, 295 

Malta, 296 

Manchester, 297 

Nicaragua, 323 

Odessa, 300 

Para, 328 

Pernanibuco, 329 

Rotterdam, • 340 

Sandwich Islands, 341 

San Juan del Sur, 331 

St. Croix, 324 

TenerhYe, 302 

Toronto, 325 

Trinidad de Cuba, 326 

Trieste, 331 

Utrecht, 344 

Vienna, 303 

Zanzibar, 321 

Zurich, 308 

Bacteria in blood, 94 

Bowditch, Letter of Dr. H. I., 182 

Brighton, Nuisances in, 3 

" " Foot and mouth disease "in, 428 

Breton farm in England, 240 

Boston, Consultiug physicians of, 56 

Tenement-houses of, 5, 59 

Neglect of health authorities of, 56 

Letter to aldermen of, 5 

Mortality of, 13, 349 

Typhoid fever in, „ 123 

Health districts of, 350 

Tabular analysis of mortality in, 354 

Death-rate of, in 1870, 365 

Distribution of disease in, 366 

Convalescent homes, 229 

Courts', Miss, buildings in London, 199 

Charbon, or malignant vesicle, 9, 86 

" Symptoms in man, S7 

" " in animals, ........ 89 

" Morbid changes iu, U0 



ALPHABETICAL INDEX. ix 

Page. 

Charbon, Specific virus in, 91 

" Methods and sources of infection, 97 

' " Value of disinfectants in, 104 

Cochituate water, Analysis of, 35 

" " Action on lead-pipe, 35 

Drainage, Letter concerning, in Concord, 64 

Dwelling Company, Improved Industrial, 201 

Dwellings of London poor, Improvement of, 193 

Earth-closet, 235 

Expenses of the Board, 17, 18 

" Foot and mouth disease " of cattle, ... . . 4, 426 

« " " " " Inoculation with, . . . 430 

« " " " Conclusions concerning, . . . 432 

Factory operatives, Health of, 16, 410 

Haskins, Dr. A. L., Examination of tenement-houses, ... 219 

Homes for the people, 10, 217 

Hill, Miss Octavia, 212 

Hill, Mr. H. B., Examinations of air, 404 

Health of towns, 8,51 

" of minors in factories, 16, 410 

Irrigation of land, . . 241 

Jarrow Building Company, 210 

Lead, Poisoning by, 8, 21 

Lead-poison, Letters from towns concerning, 22 

Lead-pipe water, Influence of, 40 

Lead in water, Poisonous amounts of, 42 

Lead-poison, Susceptibility to, 42 

Lead-pipe, Substitutes for, 43 

Lead-pipe protected by certain salts, 33 

Lead acted on by water — Bibliography, 38 

Laws, English, concerning lodging-houses, 243 

Model house and common tenement-house compared, . . . 218 

Mystic Pond water, 15,386 

" " Chemical report, concerning 387 

" " Conclusions regarding, 390 

Martin, Report of A. C, on ventilation of school-houses, . . 369 

Manufacturers, Reports from, 412 

2 



x ALPHABETICAL INDEX. 

. Page. 

Mortality among minors in factories, 16, 420 

" " " " Eemarks on, . . . . 422 

" of the City of Boston 13, 349 

Milk from diseased cows, 4, 426 

Meat, Need of inspection of, 3 

" from diseased cattle, 432 

Morin's experiments with ventilation, 379 

Nichols, Report of Professor W. R., concerning lead, ... 32 

" . " " " concerning Mystic water, . 387 

Nichols, Report of Dr. A. H., on Charbon, 86 

" " " " on " foot and mouth disease," . . 426 

Pearson, Mr. A. H., Examinations of air, 399 

Peabody Buildings, London, 194 

Poor, Organized work among the, ....... 212 

Report, General, of Board, 2 

" of Secretary, 19 

Smallpox in Massachusetts, 6 

" in Ireland, 7 

Sewing-machines, 16 

School-houses, Ventilation of, 14,369 

Sanderson's, Dr., investigations, 91 

Smith, Dr. R. Angus, on air, 398, 405 

Stodder, Letter from Mr., ; . 406 

Sewage question, 233 

Sewers of London, 238 

Tenement-houses in London and Boston, night inspection of, . 183 

Tenement-house and model lodging-house compared, . . . 218 

Tenement-houses of Boston, 5, 59 

Trichina disease, . 8, 46 

" " Signs of, 47 

" " in Lowell and Saxonville, 48 

" " Prevention of, . ' 50 

Towns, Health of, . . 8,52 

" Reports from, concerning disease and its causes, . . 54 

" Reports from, concerning lead, 23, 32 

" Reports from, concerning typhoid, 119 

" Reports from, concerning alcoholic drinks 246 

Typhoid fever, 9, 110 

" " Registration of deaths from, Ill 

" " Opinion of correspondents concerning, . . . Ill, 118 



ALPHABETICAL INDEX. 



XI 



Page. 

Typhoid fever, circular concerning, 112 

Dr. Pettenkofer on, 112, 175 

114 

119 

123 

118 

129 

161 

163 

165 

169 

. 171,176 

. 171, 179 

. 143,172 

173 

174 

. . 174 

178 

178 



Table of deaths from, .... 
Keports from towns, concerning, 

in Boston, 

a disease of country rather than town, 
Keport of a case of, . 
among the Shakers, .... 
Dr. Nathan Smith on, .... 
Modes of propagation of, . 
Tracing the causes of, ... 

springing from the soil, 

Dr. Rush on, 

in Martha's Vineyard, 

on clay subsoil, 

Dr. James Jackson on, 
and intermittents, .... 
and decomposition, .... 
Prevention of, 



Ventilation of school-houses, 

" explained, .... 
" Amount of air needed for, 
" Theory of efficient, . 
" explanation of plans for, . 
" General Morin's plans for, 



14,369 
370 
373 
376 
381 
379 



Waterlow Buildings in London, 204 

Water of various cities compared, 393 

Walpole, Charbon in, 86, 99 



ERRATA. 

In Typhoid table, pages 114 and 115 : 
Opposite Adams, for 7,475, read 747. 

" Pall River, for 17,451, read 17,481. 

" Montgomery, for 853, read 353 ; for 948, read 392. 



Commottfoualil] of lUssatJusdis. 



Boston, Jan. 21, 1871. 
Hon. Horace H. Coolidge, President of the Senate of Massachusetts : 

Sir, — I have the honor to present to the Legislature the 
Second Annual Report of the Massachusetts State Board of 
Health. 

Very respectfully, 

Your obedient servant, 

GEORGE DERBY, 

Secretary of the State Board of Health. 



STATE BOARD OP HEALTH. [Jan. 



GENERAL REPORT OF THE BOARD. 



To the Honorable the Senate and the House of Representatives 
of Massachusetts : 

The State Board of Health, in presenting to the General 
Court its Second Annual Report, desires to acknowledge the 
courtesy and cordial reception it has met with from the civil 
authorities, and from the local boards of health of the towns 
of the Commonwealth. At the suggestion of this Board,* cor- 
respondents have been appointed by the authorities in various 
towns. These correspondents form an efficient body of aids. 
Their letters and other labors, some of which will be presented 
in this Report, have already added immensely to the power for 
really good sanitary work, which, through the liberality of the" 
legislature, the Board has enjoyed. It is our hope that this corre- 

* The following circular was sent to every town in January, 1870: — 

[circular.] 
To the Board of Health of the oj 

Gentlemen, — The State Board of Health is desirous of establishing such communica- 
tion with every city and town in Massachusetts that they may be able to investigate the 
causes of disease and death. They believe such causes to be often obscure when exam- 
ined in detail, but that when grouped and classified in large numbers they sometimes re- 
veal the existence of influences which have an important bearing upon public health, and 
the prevention of disease. 

They would like to have a medical correspondent in every town, to whom they could 
apply for local information — some physician possessing your confidence, and who would 
be willing for the public good, to report to us facts relating to disease occurring within 
your jurisdiction. 

Will you have the kindness to send us the name of some one physician, upon whose 
information we may rely, and who will be willing to perform the service to which we have 
referred? 

In behalf of the State Board of Health, 

Very respectfully yours, 

George Derby, 
Secretary State Board of Health. 



1871.] PUBLIC DOCUMENT— No. 37. 3 

spondence and these labors will annually become more valuable 
contributions to scientific medicine and, at the same time, that 
they will tend to give more knowledge of sanitary matters to 
every citizen who wishes to educate his family to perfect health. 

Legislative Results op Last Year's Labors. 

Among the most agreeable results of the labors of the Board 
last year was the passage, by the legislature, of an Act of incor- 
poration to enable certain persons to build an abattoir at 
Brighton. The same Act imposed upon the Board very impor- 
tant duties in reference to the building itself and to the estab- 
lishment of sanitary rules upon which it was to be subsequently 
managed. "We hailed this Act as one destined to bring great 
benefit to the comfort, health, and, we may add, to the wealth 
of Brighton. We regret to say that, as yet, no practical result 
has come from the Act, owing, as we have good reason for be- 
lieving, to the persistent opposition of the butchers of that town. 
The Board desires to bring the subject again earnestly before 
the legislature and whole community, as well as before the 
citizens of Brighton. 

We are informed that indictments are now pending against 
three or four slaughter-houses in Brighton as nuisances to the 
immediate neighborhood. 

We may also remark that the building of an abattoir, with 
its thorough sanitary rules, is quite as important to the commu- 
nity at large, consumers of the meat slaughtered at Brighton, 
as to the inhabitants of that town. The Commissioners on Cat- 
tle have already ordered that no cattle shall be carried from 
Brighton. Many affected with the " foot and mouth disease " 
are liable to be slaughtered at private establishments, in differ- 
ent parts of the State and the meat then sent to the consum- 
ers, and eaten. This cannot be prevented until proper inspec- 
tion before the killing of the animals can be enforced, as is now 
done in all the regularly constituted abattoirs of Europe. 

In order to aid still further a true appreciation of the impor- 
tance of this subject, we recommend the perusal of two reports 
presented this year, viz.: that upon the " Health of Towns" 
and that upon " Typhoid Fever in Massachusetts." In these 
reports, besides an immense mass of evidence going to prove the 
deleterious results arising from the decomposition of animal 



4 STATE BOARD OF HEALTH. [Jan. 

refuse, some of our correspondents allude especially to the bad 
effects caused by proximity to slaughter-houses. 

The Foot and Mouth Disease in Cattle. — Its Effects on 

Man. 

This subject, save in its immediate relation to man, has been 
examined by another board (Commissioners on the Cattle Dis- 
ease), and efficient action has been taken thereupon. The dis- 
ease has been prevalent for some time in New England. Every 
one naturally feels desirous of knowing what, if any, would be 
the effects of the use of milk from diseased cows, or from the 
eating of flesh of diseased cattle. The Board has had no oppor- 
tunity to thoroughly investigate this subject in this State, 
although attention has been given to it during the past few 
weeks. Meanwhile we feel that it may be well to give a brief 
abstract of the results of English investigations. 

It appears that, in consequence of the extensive prevalence 
of the disease, during the autumn of 1869, in various parts of 
England, the Privy Council determined to make a special ex- 
amination of the question as to " the effects produced on the 
human subject by the use of milk derived from animals suffer- 
ing " from this disease. 

Dr. Thorne, the special investigator, visited at least thirteen 
towns, some of which had large populations. The evidence 
was conflicting, but Dr. Thorne feels justified in making the fol- 
lowing inferences * as the conclusion at which he arrives : — 

" I. That disease appears sometimes to have been produced in 
the human subject when the milk of cows suffering from foot and 
mouth disease has been freely used without being boiled. There is 
no evidence to show whether this affection is of a specific nature 
or not, but it seems to consist in a derangement of the alimentary 
canal, accompanied by febrile disturbance, the • presence of vesicles 
on the mucous membrane of the mouth and tongue, which having 
ruptured, leave superficial ulcerations and, at times, a herpetic erup- 
tion (small water blisters) about the exterior of the lips. 

• " II. That in a very large number of cases the milk of cows un- 
doubtedly affected has been used without producing any noticeable 
effects. This absence of results may, though only to an inconsider- 

* Twelfth Report of Med. Officer, Privy Council, p. 298. 



1871.] PUBLIC DOCUMENT— No. 37. 5 

able extent, have been dne to the smallness of the consumption and 
the boiling of the milk." 

Mr. Simon, chief medical officer of the Council, in summing 
up the results, thinks that " dilution of the milk and mere 
lapse of time may have to be taken into account, and that milk 
which after dilution or after some hours' delay does not infect 
might have infected if taken neat or fresh." He is " clearly of 
the opinion that the milk of cows affected with the disease 
ought not to be unrestrictedly sold for human consumption." 

While admitting that the disease as seen in man or animals 
is rarely, if ever, fatal, we deem it needful and proper to warn 
our citizens from using such milk, particularly for the food of 
young children. 

In regard to the use of flesh of slaughtered diseased cattle, 
we must say that undoubtedly large quantities of it have been 
eaten in London and its vicinity, and there has been, according 
to Dr. Thorne, " no instance of any disease having been re- 
ported to him as resulting from the use of such meat." This 
statement is very different from asserting that disease never 
occurs ; and we think that the fact that meat has been taken 
from diseased cattle should be of itself enough to condemn it. 
No meat should ever be allowed to leave the shambles in any 
part of this State without thorough inspection and permission 
for sale being given by a properly qualified person. 

Overcrowding of Tenement Houses, and Want of Clean 
Streets, &c, in Boston. 
In the month of July the Secretary of the Board called the 
attention of the members to the dangers liable to happen in 
Boston, from overcrowding in tenement houses, and from a 
want of cleanliness in alleys and streets. By a vote of the 
Board, the following letter was sent to the proper authorities : — 

(copy.) 
To the Board of Aldermen, Health Commissioners of the City of Boston : 

The State Board of Health desire, respectfully, to call the atten- 
tion of the health authorities of the city of Boston to the fact that 
the owners and keepers of tenement and lodging houses are not 
complying with the provisions of an Act of the legislature of 1868, 
chap. 281, General Statutes of Massachusetts. A large proportion 



6 STATE BOARD OF HEALTH. [Jan. 

of the unfortunate poor are crowded into buildings 'whose construc- 
tion sets at defiance the laws of health, whose yards and privies are 
filthy in the extreme, and whose general condition is such as to 
render them liable at any time to become centres from which pesti- 
lence may extend in every direction. 

Very respectfully, your obedient servant, 

(Signed) George Derby, M. D., 

Secretary of the State Board of Health. 
Boston, July 11, 1870. 

A reference to the report by the Secretary upon the health of 
the city of Boston will show the influence of this letter. It 
seems to have been small indeed. 

Smallpox in Massachusetts. 

The certainty and commonly perfect innocuousness of vaccina- 
tion have been established by the experience of nearly a century 
of its use. Overwhelming evidence has been presented recently 
by Mr. Simon (Twelfth Report of English Privy Council) 
that the fears of vaccination occasionally contaminating the sys- 
tem are really not well founded. There must be many now 
alive who have heard at least of the horrible results of small- 
pox ravages before Jenner lived. With all these well-known 
facts before us, it seems strange that any town could allow the 
pest to grow rampant as it has been recently allowed to become 
at Holyoke in this State. For over two months this loathsome 
disease has been spreading in that town, and now (Dec. 25th) 
infests every part of it. The Secretary has visited Holyoke and 
had an interview with the selectmen and physicians. At his 
suggestion, a thorough districting of the town was made, and 
every arm is to have its vaccine safeguard placed upon it. No 
amount of disinfectants can cope with this dire disease. 

The only way to thoroughly drive it from the United States is 
by a national law, as in England, requiring every parent to duly 
register his child after having been duly vaccinated. Meanwhile 
the laws of our State in regard to unvaccinated children not 
being allowed to go to school, and other laws relative to infec- 
tious diseases must have been grossly neglected in Holyoke to 
have such an unhappy result as has taken place at that town, 
viz. : up to Dec. 31st one hundred and sixty-seven (167) cases of 



1871.] PUBLIC DOCUMENT— No. 37. 7 

smallpox have occurred, of which thirty-six (36) or about one- 
quarter proved fatal. There are doubtless many survivors also 
who have been disfigured for life by the disease. In connection 
with this statement, the Board draws attention to the fact that 
several of our correspondents (see Report on Health of 
Towns) allude to the indifference and neglect of the people in 
regard to vaccination as being quite general, and fraught with 
great danger to the people when the seed shall fall among 
them. 

In the Massachusetts Registration Report for 1868, we find 
the following on vaccination : — 

"In Jreland vaccination was made compulsory in 1863. Since 
that period the Irish Poor Law Commissioners have carried out 
the provisions of law and the whole population has been vac- 
cinated. The results are seen in the following figures, from which 
it appears that the Irish physicians have banished the smallpox 
from their island as Saint Patrick is said to have banished the 
snakes. Whereas, in the periods 1830-40, 1840-50 and 1850-60, 
the respective annual average mortalities had been 5,800, 3,827 and 
1,272, in the years 1864, 1865, 1866, 1867, 1868, they were 854, 
347, 187, 20 and 19, respectively. In the first half ot 1869 the 
whole number was three. The deaths from smallpox in Ireland 
since 1866 have been so few that it is fair to suppose the cases have 
been generally imported from abroad. The population being about 
five and a half millions, we should have, if equally well protected, 
about four deaths a year in Massachusetts." 

Special Investigations made under Direction of the Board 
during the present year. 

The questions especially investigated either by individual 
members of the Board or by agents appointed by them are 
twelve in number. Some are of a more popular character and 
intended to diffuse information on sanitary matters among the 
people, while others are interesting to physicians chiefly. Most, 
if not all of them, however, contain more or less of the popular 
and also of the scientific element, and as such are commended 
not only to the notice of the legislature, but to that of every 
adult inhabitant in the State. 

The following brief analysis is offered of these various 
papers : — 



8 STATE BOARD OF HEALTH. [Jan. 

Poisoning- by Lead. 

By the Secretary, assisted by Prof. William Ripley Nichols, of the Massachusetts Institute 
of Technology, and by various Correspondents. 

In this paper will be found correspondence from physicians 
in different towns of the State relative to their personal ex- 
periences. The essay is equally valuable to the student for the 
scientific thoroughness with which Professor Nichols has per- 
formed his part of the work, and to the citizen for the warnings 
it gives in regard to the employment of lead pipe for the con- 
duction of water that is to be used for drinking or culinary 
purposes. It also presents facts regarding the danger incur- 
red by those who drink cider or other acid drinks from faucets 
fastened with lead ; and other analogous facts tending to show 
the evil effects of cosmetics containing salts of lead. 

Trichiniasis in Massachusetts. 

By the Secretary. 

The paper on this disease, which is caused by eating raw 
pork, or pork but partially cooked, is a frightful warning to the 
community. It should be carefully read by every parent when 
providing food for his family ; and the essential point of it, viz., 
the necessity of thoroughly cooking lean pork before placing it 
on the table, should be known and duly appreciated by every 
cook in the land. 

Health of Towns. 

Arranged by the Secretary, aided by our Correspondents. 

This document, prepared from returns made by correspon- 
dents, contains facts and deductions therefrom. Among the 
returns specially noticeable may be named the influence of 
residence on river banks, near swamps, pigsties or foul privies ; 
details of wretched tenement houses (Boston) and stringent 
criticisms thereupon. In Brookline we see proof that the rich 
are more liable than the poor to some diseases ; and at Concord 
we have the evil influence of irregular flowing of lands by mill- 
dam corporations, and an admirable example of wise sanitary 
precautions used by a correspondent. At Hinsdale, the bad effects 
of overcrowding are found ; and at Hadley, the influence of 
too many shade-trees. In Northborough we have allusions to 
the effect of wet soil on the prevalence of consumption. One 
town has its threatening of future pestilence unless better 



1871.] PUBLIC DOCUMENT— No. 37. 9 

drainage be brought about by the citizens or by an active board 
of health. Suggestions in regard to infectiousness of consump- 
tion we have from Rockport. At Taunton our correspondent 
has opinions on the influence of a want of sunlight on the 
homestead. A gross neglect of vaccination is apparent in 
various towns, as Billerica, Holyoke,* Worcester, &c. The 
straw business as a cause of consumption appears at Upton. 
These are only a few of the variety of questions brought up by 
our correspondents. It is well for every one to look at his own 
town, and see if any nuisances exist there and afterwards do 
whatever can be done to remove any evil existing. The Board 
hopes eventually to have similar returns from all the towns. 
The continuation of such annual reports will tend to enlighten 
the public mind on all sanitary matters. 

Charbon, or Malignant Vesicle, in Massachusetts. 

By Arthur H. Nichols, M. D., of Boston. 

This paper contains a resume of the latest views on the idea 
of contagion. These views, though still in debate, are impor- 
tant as presenting one of the actual phases of thought on the 
all-important, but very profound questions involved in the 
terms " infection " and " contagion." While recommending 
therefore the paper to the consideration of our scientific inves- 
tigators of disease, the Board feels that the practical suggestions 
made in regard to the necessity of cleanliness and of free ven- 
tilation are of equal value to the practical manufacturer and 
laborer. The suggestions also with regard to the free use of 
carbolic acid as a disinfectant should be known by all engaged 
in working on hair at Walpole and other towns, and they are 
worthy of serious consideration by every physician who is called 
to treat a case of charbon. 

Typhoid Fever in Massachusetts. 

By the Secretary, aided by our Correspondents. 

This contribution to the etiology of typhoid fever made by 
various correspondents throughout the State, with the summary 
of inferences that can be drawn from the letters made by the 
Secretary of our Board is worthy of attention by every house- 
holder. Pittsfield, knowing too well the truth of two of the 

* See also special remarks on smallpox at Holyoke. 
2 



10 STATE BOARD OF HEALTH. [Jan. 

inferences, viz., that fetid smells and impure water can alike 
produce typhoid fever of a most virulent type, has now its able 
and efficient board of health that foresees the evils threatened, 
and by determined action or timely warning arrests trouble. 
The State Board of Health feels that it cannot give any better 
advice than that every town should have an equally active 
board of health, and every inhabitant should read carefully 
the various letters, and, after doing so, should make his or her 
own inferences as to the condition and wants of his or her own 
town. The paper is also submitted to scientific investigators 
in the belief that, at least, it adds somewhat to our knowledge 
of the causes of this destructive disease. 

Homes for the People. 

The Chairman of the Board, having been obliged to reside 
during the past six months in London, availed himself of the 
opportunity thus offered of studying the homes of the poor of 
that metropolis and of learning what is now doing by public 
and by private philanthropy and capital in the matter of pro- 
viding better homes for the people. 

His letter to the Board presents the results of his investiga- 
tions in reference to this most worthy object. The Board 
commend to the attention of the citizens the practical workings 
of the Peabody, Coutts and Waterlow buildings in fostering 
habits of cleanliness, temperance and self-respect among the 
people. To the last-named company, as proving that capital 
can combine with philanthropy, and each reap abundant 
harvests, the Board would especially call attention. Never 
was there a fairer chance or a greater necessity for similar 
operations than now exist in Boston. 

The other subjects of Convalescent Homes in the country for 
broken-down but not really diseased persons, the matter of the 
use, waste and danger arising from Sewage, the Board deem 
worth the careful consideration of all. 

The walks with the police in London and Boston, in their 
terrible and disgusting revelations, are solemn warnings, and, 
although perhaps to some minds, may seem ill-adapted for a 
report from a State Board of Health, are nevertheless entirely 
in accordance with the principles laid down in our first Report, 
as those upon which the Board was determined to act, viz. : 



1871.] PUBLIC DOCUMENT— No. 37. 11 

that " nothing which pertains to Humanity in its widest sense 
will this Board deem foreign to its aims." 

Alcoholic Drinks. Their use and abuse. 

With information derived from correspondence throughout the loorld. 

The law establishing the Board requires it " to examine into 
and report what in their best judgment is the effect of intoxi- 
cating liquors as a beverage upon the industry, prosperity, 
happiness, health and lives of the citizens of the State. Also 
what additional legislation, if any is necessary in the premises." 

These inquiries the Board deem of the highest importance. 
For years they have been the sources of violent language, or of 
party zeal alike in the privacy of home life, and upon the polit- 
ical arena. For years public sentiment in the Commonwealth 
has fluctuated between the extremes of action and of reaction 
on this matter. Meanwhile it seems certain that, while 
throughout the State there is less drunkenness than formerly, 
it never was more rampant than now in Boston and some of the 
larger cities. This habit the Board believe to be infinitely 
deleterious " to the prosperity, happiness, health and lives of the 
citizens." The records of our courts, and the knowledge which 
every one has of its effects in the private family assure us of 
this fact. The evil is enormous. How to remedy it is the 
difficulty. 

In the hope of being able to lift the question of the use and 
abuse of intoxicating agencies above the region of partisanship 
and to enable the people of the Commonwealth to know how, 
more or less generally, human nature tends, the world over, 
to use and at the same time to fall into the vice of immoderate 
indulgence in intoxicating drinks, a circular was sent to the 
American Ministers at foreign courts, and to the Consuls of all 
the principal ports on the globe. It was designedly made as 
brief as possible — because we hoped thereby to get a greater 
number of responses than a more elaborate programme would 
have obtained. The Board presents the correspondence from 
Europe, Asia, Africa, North and South America, the isles of the 
Pacific, as well as from the State at large in the hope that the 
effort has not been in vain. From representatives of the United 
States in foreign countries we inquired what are the kinds of 
intoxicating drinks used, and what amount of crime do they 



12 STATE BOARD OF HEALTH. [Jan. 

produce. These two questions it was unnecessary to put to our 
medical correspondents in Massachusetts who are more especially 
cognizant of the effects upon public health. Every member of 
this Board, and indeed every citizen knows that intoxicating 
drinks are the direct cause of a very large proportion of all the 
crime which is committed among us. 

The foreign correspondence is not yet wholly finished. 
Letters have arrived within the past few days. It will therefore 
be impossible thoroughly to analyze the whole in all their 
various bearings. We hope to do this at a future time. 
Meanwhile certain general inferences we think can be drawn 
from this correspondence. 

First. — Wherever we go, we observe that man finds some 
drink to use as a stimulus. Some nations use immoderately 
the more fiery, more potent liquors, and the results are in- 
finitely more disastrous than are noticed among other nations 
using a milder beverage. 

Second. — It would seem that the Northern nations of Europe, 
more especially the inhabitants of the British Isles and their 
descendants in America, tend to use immoderately these more 
violent liquors. The more Southern nations, except in the 
Southern States of this republic, use either milder articles 
altogether, or if perchance the stronger ones are drank, smaller 
glasses and fewer of them are taken. 

Drunkenness is far less common among Southern than among 
Northern nations, but when it occurs is regarded with extreme 
aversion. It degrades its victims, in public estimation, in a far 
greater degree. 

Third. — A curious physiological effect seems hinted at by 
some of our correspondents, viz. : that among Northern nations 
the vice of drunkenness is much more frequently the cause of 
violence and crime than in more Southern climes. In the 
North, men seem to become savage, wild and boisterous. The 
drunkard in the North beats his wife, and stabs his friend, or 
breaks into his neighbor's house under the influence of liquor. 
In the South he reels home rather happy in his insanity, and 
without any strong tendency to violence, or theft, or murder. 
We may add as a fact also that in this climate the Northern 
European cannot drink with impunity even that amount of 
alcohol he has all his life used in Europe. 



1871.] PUBLIC DOCUMENT— No. 37. 13 

Fourth. — It would seem from the correspondence that the 
practice of using stimulants is universal, and if unrestrained 
brings misery and death not only to him who indulges but often 
also to the community in which he lives. 

If these conclusions are fairly deducible from such information 
as we have been able to collect from every part of the world, 
the question arises, what can we do to keep this universal ten- 
dency within proper bounds in Massachusetts ? 

The subject is, in some form, before the legislatures of all 
the States, and is everywhere recognized as one of difficulty. 
Men equally earnest in their desire to reach the evil differ in 
opinion as to the best means to be used. This Board can sug- 
gest no specific remedy : they have no sources of information 
which can give them any peculiar advantage in proposing the 
modification of existing statutes. The details of law are not 
within their proper province, but they do most earnestly desire 
and recommend that the legislature may devise some plan by 
which dram-shops, or tippling-houses may be summarily sup- 
pressed throughout the State. 

Recognizing also that the love of strong drink becomes at 
times a real disease, and as such controls its victims as 
completely as insanity can ever do, this Board earnestly urges 
upon the legislature the establishment of inebriate asylums, to 
be held as insane asylums are now established and held, under 
State guardianship, in various parts of the Commonwealth. 

Mortality of the City of Boston. 

Prepared by the Secretary, assisted by Frank W. Draper, M. D., of Boston. 

This paper is presented in the conviction that from it may 
be deduced inferences of great importance to the future health 
not only of the city but of that of the State at large. The 
Board hopes that similar " health districting" of the various 
towns in the Commonwealth will be undertaken by the local 
boards of health. No more valuable work could be inaugur- 
ated. If such investigations were carried on thoroughly and 
conscientiously by every nation in all their various townships, 
we should, in ten years, know more certainly about many 
causes of disease than the medical profession has been able by 
its own unaided efforts to arrive at during the centuries of its 
existence. The deductions made by our Secretary from the 



14 STATE BOARD OF HEALTH. [Jan. 

tables of Dr. Draper are few compared with what may possibly 
be drawn from them, but although few, they unmistakably 
point to the fearful neglect of the city authorities of Boston in 
reference to the sanitary condition of the metropolis; and the 
terrible penalty for this neglect is daily and hourly paid at the 
present time by the sacrifice of human life. 

The remarks of the Secretary on the fact that houses are 
now allowed by the city authorities to be built on land in a cer- 
tain portion of the city that must be eventually raised at an enor- 
mous expense, the Board submits with deference to the tax- 
payers of Boston as worthy of their especial notice, in order 
that the evil may be promptly checked. Unless this be done, a 
deteriorated sanitary condition of the inhabitants of the dis- 
trict will be the inevitable result. 

Ventilation of School-Houses. 

By A. C. Martin, Architect, of Boston. 

This paper is based upon scientific principles relating to ven- 
tilation, and presents plans for carrying out the design in a 
practical way. 

In most of our school-houses the object seems to be to get 
heat enough at any rate, and if ventilation is considered at all 
it is regarded as of secondary importance. Our school-houses 
are charged with carbonic acid gas and animal effluvia which 
undermine the health of both teachers and scholars. The 
removal of such deleterious influences is surely greatly to be 
desired. 

We deem it important to remind those who have charge of 
the warming and ventilation of schools that it is no easy or 
simple matter, in our variable climate, to maintain a uniform 
temperature, and at the same time renew the air with such 
frequency as health requires. No methods of warming and 
ventilating the two and three story school-houses which it is 
now customary to build in our large towns, can be reasonably 
expected to be otherwise than expensive, and whatever they may 
be, they need the constant care of intelligent persons to insure 
their proper working. 

The plans of Mr. Martin are believed to meet the necessities 
of the case. 



1871.] PUBLIC DOCUMENT— No. 37. 15 

Mystic Pond Water. 

By the Secretary, assisted by Prof. Wm. Ripley Nichols, Massachusetts Institute of Tech- 
nology. 

The Board commends this paper to the notice of the scientist 
as well as to that of the citizen. It shows how a pollution which, 
at first sight, it would seem must necessarily cause contamina- 
tion to the drinking water of several towns is rendered hy the 
alchemy of nature, at present at least, comparatively harmless. 
At the same time it forewarns us of what must certainly occur 
if we allow the present impurities of Mystic Pond to be in- 
creased, by new and more numerous nuisances in the form of 
the refuse of tanneries, &c, being thrown into it. For a still 
further reason, the Board urges removal even of the present 
small nuisance, because the very filth, which tends to contami- 
nate, might be saved and used for beneficial purposes, whereas 
it is now lost and at the cost, perhaps, of human health and 
life. For it is undoubtedly true that the very refuse which 
may tend to contaminate the drinking water of the citizens of 
Charlestown and of other populous places, might be used as a 
fertilizer by the farmer, or perchance in some operations in the 
various manufactories of the State. 

Air and some of its Impurities. 

By the Secretary, assisted by Messrs. A. H. Pearson, H. B. Hill, and Charles Stodder. 

This article comprises a contribution to our accurate know- 
ledge, of the amounts of carbonic acid gas contained in various 
open places in the cities of Boston and Cambridge, compared 
with what is found in our schools, churches, halls, theatres, 
&c. It is a record of carefully conducted experiments, and 
will, we hope, commend itself to American and European in- 
vestigators on the subject. It is interesting also to every one, 
even though he be not occupied with the scientific view of the 
matter, to observe how this deleterious gas collects in all badly 
ventilated places. 

The letter from Mr. Stodder is a truthful statement of the 
views of an experienced microscopist, upon the difficulties con- 
nected with microscopic investigations relative to the " germ " 
theory of disease. Although it seems to teach us but little 
on that subject, it does us substantial service when it tends to 



16 STATE BOARD OF HEALTH. [Jan. 

check the exuberant imaginations of many about " organic 
germs," of which we have heard so much the past year. 

The practical suggestion also of the possibility of preventing 
the dust, of iron and steel filings, from flying about the air of 
machine shops, and thereby saving life by means of magnets, 
is worthy of the attention of master-machinists who desire to 
promote the well-being of their operatives. 

Health of Minors Employed in Manufactories of Cotton, 
Woollen, Silk, Flax and Jute. 

By the Secretary, assisted by Frank W. Draper, M. D., of Boston. 

This report is from the nature of the case imperfect. The 
difficulty in procuring the required information has been great. 
From many factories it has been found impossible to get 
returns. For this reason the subject cannot be said to be 
completely examined, and its great importance demands still 
further investigation. 

Meanwhile it is gratifying to the Board to find that with these 
imperfect returns, there is no suggestion of the existence of 
greater mortality or sickness, among the operatives than in the 
State at large. 

In reading this report the Board feels the great importance 
of the question, now much debated in Europe, as to the regis- 
tration of disease. If every corporation in the State were 
obliged by law, under a penalty for non-performance of the 
duty, to make annual returns of the number of days lost by 
their employes by reason of sickness, and if all hospitals and 
dispensaries were required to give similar information, a great 
deal might be learned important to the future health of our 
citizens. 

Saving Machines. 
Early in the year the Board took measures for careful inves- 
tigation, as to the truth or otherwise, of the statement widely 
circulated, that constant labor by women on sewing machines 
moved by foot-power, was undermining health, and was produc- 
tive of various complaints peculiar to women. They engaged 
a physician of experience and skill, and having a wide practice 
among the operatives of one of the cities of the State to report 
upon the subject. The importance of the matter is understood 



1871.] PUBLIC DOCUMENT— No. 3T. 17 

by the Board, and they regret to say that only within the past 
few days has the gentleman found himself unable to perform 
the services agreed upon. At present, owing to lack of the 
time necessary to make a complete examination, it is impossi- 
ble to do more than to promise information on this subject as 
soon as it may be obtained, and, if deemed of sufficient impor- 
tance, some publication may be made before our next annual 
report. 

Expenses of the Board. 

It will be seen by the following statement of accounts that 
our Board has expended $2,288.35, which is less than half of 
the sum which the legislature appropriated for our use in 1870. 

We trust that the same liberality and the same generous con- 
fidence in the intentions of the Board will be continued in 
1871. It is always necessary to have some reserved fund for 
extra work which may suddenly occur. 

The Secretary has already in behalf of the Board asked for 
an appropriation equal to the sum granted last year. If this 
be allowed, we shall promptly enter upon new tasks and with 
renewed zeal ; in full confidence that all money expended by 
us will in the end be amply repaid to the State. 

All which is respectfully submitted. 

HENRY I. BOWDITCH, 
P. EMORY ALDRICH, 
WARREN SAWYER, 
GEORGE DERBY, 
WM. C. CHAPIN, 
RICHARD FROTHINGHAM, 
R. T. DAVIS, 
Members of the Massachusetts State Board of Health. 

Boston, January 18, 1871. 



18 



STATE BOARD OF HEALTH. 



[Jan. 



EXPENSES OF STATE BOARD OF HEALTH-1870. 



Postages and stationery, . 
Travelling expenses of Secretary, 
Express charges and soldier messengers, 
Printing, ..... 

Personal expenses of members while engaged in the 
duties of the Board, 

Paid for special investigations, — 

Concerning Air, .... 

Water, .... 

Charbon, 

Ventilation of school-houses, 

Mortality of Boston, 

Typhoid fever, 

Health of factory operatives, 
Furniture and philosophical apparatus, 
Copying, translating, &c, 
Miscellaneous, .... 



1429,28 
57 59 
57 60 

100 86 

148 29 



271 


66 


200 


00 


125 


00 


125 


00 


255 


00 


103 


50 


30 


00 


98 


92 


210 


90 


74 


75 



£,288 35 



1871.] PUBLIC DOCUMENT— No. 87. 19 



REPORT OF THE SECRETARY. 



To the State Board of Health. 

Gentlemen : — I have occasion to add but little to the record 
of the year's work which is presented in the accompanying re- 
ports. 

An extensive correspondence has been kept up with all parts 
of the State, and many visits have been made to the different 
towns, for the purpose of consultation with the local boards of 
health. 

I have lectured on subjects connected with public health in 
Amherst, Springfield, Boston, Worcester, Charlestown, Salem 
and Lowell. It gives me pleasure to assure you that every- 
where I have met with evidence of the great interest which is 
felt in the operations of our Board by the selectmen of towns, 
members of the medical profession, and by the people generally. 

Physicians are the natural guardians of public health. They 
know better than any other class in the community that many 
diseases are avoidable — that it is easier to keep well than to 
get well — that prevention is better than cure. These convic- 
tions have led them to co-operate most heartily in the inquiries 
undertaken by our Board. Two hundred physicians, in as 
many different towns, have contributed information on the spe- 
cial subjects investigated in the following pages. Many of these 
gentlemen are of eminence in their profession, and their prac- 
tice and observation may be said to extend over nearly the 
whole territory of Massachusetts. In many instances the 
smaller towns have no resident physician. In the letters of 
our correspondents, as arranged for publication, I have sepa- 
rated the various topics, that each subject standing by itself 
might be the better understood. 



20 STATE BOARD OF HEALTH. [Jan.'71. 

The report of deaths from all prevalent diseases in the largest 
cities and towns, has been published every Wednesday during 
the year in the Boston Morning "Journal." I desire to express 
my thanks to the clerks and registrars who have aided me in 
collecting this information. 

Yery respectfully, your obedient servant, 

GEORGE DERBY, 

Secretary of the State Board of Health. 
Boston, January 18, 1871. 



POISONING BY LEAD PIPE 



USED FOR THE 



CONVEYANCE OF DRINKING WATER. 



22 STATE BOARD OF HEALTH. [Jan. 



POISONING BY LEAD PIPE. 



One of the questions addressed to our correspondents, in the 
circular of April 8, 1870, was as follows : 

" Have any cases of lead colic or lead paralysis occurred in 
your town or district, in which you have been able to trace the 
origin of the disease to water-pipes ? " 

The replies are from one hundred and seventy correspon- 
dents, in as many different places, and are as follows : 

Yes, 41 

No, 101 

Doubt expressed, 20 

No lead used in the town, ... 8 

It is stated that in certain towns lead pipe is only used to 
convey water from springs, and that, when allowed to flow con- 
tinually without plugs or stop-cocks, no harm has been known 
to follow. 

The negative replies are very brief, and may be construed as 
meaning generally that no bad effects have been observed, 
rather than that, in the opinion of the writers, none may occur 
from the contact of drinking water and metallic lead. 

The affirmative replies are direct and positive, and are usu- 
ally accompanied by evidence. They occasionally refer to other 
accidental modes of poisoning by lead, as by hair-dyes, which 
are almost universally composed of acetate of lead and sulphur 
in various proportions ; also by cider and vinegar drawn 
through lead faucets. 

Information relating to this general subject is given in the 
following extracts from letters of our correspondents : — 



1871.] PUBLIC DOCUMENT— No. 87. 23 

Ashland. — Three cases of lead poisoning through water-pipes are 
reported. Two, which occurred eighteen months ago, were in the 
same family : a father, aged sixty, and his daughter, aged twenty- 
four. The latter was the first affected, and her case for a consider- 
able time was obscure. " She had no colic from first to last, but a 
series of indefinite ailments for which three of us physicians could 
assign no satisfactory cause ; anceniia, pain in epigastrium, with 
nausea and vomiting, neuralgia occasionally in limbs and chest ; 
bowels not constipated. Gastric ulcer, or carcinoma, were sus- 
pected. Lead poison was thought of, but there being no blue line 
on the gums, and no paralysis, the idea was given up. About the 
fifth month amaurosis occurred ; but we groped in the dark three 
weeks longer. At this time her father was attacked with severe 
colic, and as the bowels were constipated, I examined the gums 
and found a well-marked blue line." The mystery was solved. 
The drinking water was brought into the house through fifty feet of 
lead pipe from a well in the stable. The daughter subsequently 
had wrist-drop. On removal of the cause, and with appropriate 
remedies, both father and daughter completely recovered. 

The third case was in January, 1870. A French Canadian, aged 
thirty, exhibited the characteristic signs of lead poison, colic of 
great severity, constipation, blue line of the gums. The cause of 
these symptoms was found in the drinking water, which was brought 
into the house from a well, through forty feet of lead pipe. This 
water had also to flow through a box in the cellar, as large as a 
water pail, which was lined with lead. On removal of these causes, 
and with appropriate remedies, this case also recovered. 

Amherst. — Two cases are reported ; one of them having all the 
characteristic signs, — colic, constipation, partial paralysis, lead 
jaundice, blue line of gums. Analysis of drinking water in both 
cases yielded confirmatory evidence of the presence of lead, and 
both cases recovered on removal of cause. 

" The water of our wells and springs in this neighborhood, espec- 
ially in gravelly soil, is characterized by the presence, in large 
amount, of carbonic acid, and an almost absolute absence of sul- 
phates." 

Abington. — Our correspondent reports a case of lead paralysis, 
caused by drinking water conveyed four rods through lead pipe. 
Now under treatment. 

Athol. — N o cases have come under the immediate observation of 
our correspondent ; but three cases in one family occurred in the 



24 STATE BOARD OF HEALTH. [Jan. 

town two or three years ago, in which the disease was directly 
traced to lead water-pipes. In one of the cases there was partial 
paralysis. 

Andover. — Lead water-pipes are very generally used, but no 
cases of colic or paralysis have resulted from it. In some instances, 
injury to health from their use was suspected. The pipes are often 
found much oxidized. 

AttleborougJi. — In one instance, repeated attacks of abdominal 
pain ceased to recur after the removal of lead pipe from the well. 
In another, where the general health was undermined, with paraly- 
sis of the extensors of both arms, recovery commenced after the 
use of water conveyed through lead pipe was discontinued. 

Barre. — Case of a middle-aged man, long sick and treated for 
rheumatism ; finally there was partial paralysis of both wrists and 
ankles. He used water conveyed through lead pipe. Removal of 
the pipe, which was found to be very much corroded, and in some 
places nearly perforated, was followed by gradual, though incom- 
plete recovery. He subsequently died suddenly, and, as reported, 
from pleurisy. 

Brimfield. — One case reported with unmistakable signs of lead 
poisoning. Advised giving up use of water conveyed through lead 
pipe, but the man persisted in using it ; and, finally, died uncon- 
vinced. A large proportion of people in this town use lead pipe for 
conveying water and do not suffer from it. 

Bridgewater. — A case is reported of a boy eight years old, who 
had epileptiform convulsions, gradual decline, partial loss of 
speech and power of motion. The cause was not suspected for 
a long time, but when at last discovered and the lead pipe removed 
from the well, the boy completely recovered. 

Nearly all lead pipes are now removed from wells in this vicinity. 

Blachstone. — " I have been able, I think, to trace several cases of 
lead paralysis to the use of some of the hair preparations now in 
use. Cannot say that I have been able to trace it to water drawn 
through lead pipe." 

Concord. — Our correspondent has met with no cases of lead 
disease from water pipes for some years past, but furnishes a report 



1871.] PUBLIC DOCUMENT— No. 37. 25 

of several which occurred in his practice in 1853, and expresses his 
opinion that similar instances of lead poison occur more frequently 
than is generally supposed, the cause being unrecognized. In the 
cases referred to, four persons were afflicted with lead disease, and 
brought near to death by drinking water conveyed through lead. 
The water was found to be charged with salts of iron from a 
meadow in which existed a bed of iron ore, and through its action 
upon the pipes, soluble salts of lead were produced in abundance. 
Removal of the pipe was followed by recovery of health. 

F/rving. — " The only cases of poisoning from lead pipe which I 
have observed here were caused by drinking cider drawn through 
a lead syphon which was allowed to remain in the barrel." 

Essex. — One case reported. A man about fifty years of age was 
subject to attacks of epigastric pain and neuralgia. Cause not sus- 
pected until the extensor muscles of the arm became paralyzed. It 
was then found that he was drinking water conveyed twelve or fif- 
teen rods through lead pipe. This being discontinued he gradually 
recovered. 

Fitchburg. — A good many cases of lead disease, supposed to be 
from the use of lead water-pipes, occurred from ten to eighteen years 
ago, but none recently. The use of lead water-pipes is not wholly 
abandoned, but medical and popular discussion of the subject has 
greatly diminished their use, and very generally induced more cau- 
tion. 

FramingJiam. — Nearly all the members of one family have suf- 
fered from the various forms of lead disease, traced directly to the 
influence of water conveyed through lead pipe. 

Gloucester. — " I have met with some three or four cases of dis- 
ease occasioned by drinking water drawn through lead pipe. The 
symptoms, at first, were generally colic and constipation. This has 
been followed by partial paralysis. 

" In one case the patient was the only one affected out of a large 
number who used the water. He had paralysis of the extremities, 
persisting for two months. That the lead poisoning was due to the 
pipe seems to me evident from the fact that a recurrence of the 
primary symptoms supervened upon resuming the use of the water 
drawn through the lead pipe, which speedily subsided on discon- 
tinuing its use." 

4 



26 STATE BOARD OF HEALTH. [Jan. 

Grroton. — Several cases of lead poison from water are remem- 
bered. In one, the case was treated for three years unsuccessfully, 
the cause not being recognized. Recovery followed rapidly on 
removal of lead pipe used for conveyance of water thirty rods. 

JHubbardston. — " I have seen, during my practice in this town, 
two cases of partial paralysis which I believe to be due to the pres- 
ence of lead in the system ; and I am confident they occurred from 
the excessive and continued use of hair-coloring and hair-dressing 
preparations containing lead in solution. Both cases recovered on 
discontinuing their use." 

Holyoke. — "In 1867 and 1868 a case was under my observation 
of gastric and intestinal derangement, with impaired use of the 
forearms and hands, which I suspected came from using water 
drawn through lead pipe. The service pipe was changed and the 
case was discharged cured some weeks afterwards." 

Hyde Park. — A number of cases of suspected lead poisoning 
have been seen to improve after the removal of lead pipe from con- 
tact with drinking water. 

Leverett. — Several cases have occurred. One of a lady who suf- 
fered for two years from partial paralysis of arms, and other equally 
marked signs of lead poison, and recovered her health after the 
removal of forty rods of lead pipe through which drinking water 
was conveyed. Another of a very similar kind, but in a different 
locality, with colic, great debility and finally " drop-wrist," from 
which recovery was speedy on removal of the lead pipe. Our cor- 
respondent has also met with cases of lead poison from the use of 
hair-dyes composed of sugar of lead and sulphur. 

Our correspondent expresses the most decided opinions on the 
general subject of lead poison through water-pipes and hair-dyes, 
and believes that very large numbers of persons are unconsciously 
undermining their health through minute doses of lead administered 
in this way. 

Monson. — One well marked case of lead poison in an excessive 
water drinker who got his supply through one hundred rods of lead 
pipe with very little fall. Lead water-pipe in very general use, but 
the above case the only one in which harm has been known to 
result from it. A fatal case of lead disease reported from the use 
of cider drawn from the barrel through a lead faucet. 



1871.] PUBLIC DOCUMENT— No. 37. 27 

North Andover. — A case of lead disease reported by our corre- 
spondent, from the use of a chain-pump, about which lead was used 
to prevent the water leaking down the chain. 

North Adams. — In the course of twenty-five years' practice, 
some cases are recalled of illness supposed to be caused by water 
conveyed through lead pipe. 

Northampton. — " The following cases of lead poisoning from the 
use of water drawn through leaden pipes are brought to the notice 
of your Board, as a matter peculiarly pertaining to the public 
health. The neighborhood in which the suffering family reside is 
very generally using water drawn through lead pipes, and is not 
disposed to accept the theory of poisoning from this source. The 
family of Mr. H., consisting of himself, wife, daughter and son-in- 
law, reside in Westhampton. Mr. H. removed to the farm he now 
occupies, seven years ago. Mrs. H. has lived on the place many 
years with her daughter ; and the son-in-law, Mr. E., joined the 
family in November, 1868. Mr. H., aged fifty-seven years, had 
always enjoyed good health until the spring of 1869. Early in 
May he found himself losing flesh and strength, tormented contin- 
ually with an unpleasant constriction and pinching in the abdomen 
and with pains in the extremities, not following the course of any 
of the large nerve trunks. June 19, he had an attack of colic so 
severe as to require the attention of his family physician. These 
attacks were repeated many times, and accompanied with obstinate 
constipation and nausea for many days. The abdomen was uni- 
formly and considerably depressed and the blue fine on the edge of 
the gums well marked. 

" Mrs. H., aged fifty-seven, with good general health heretofore, 
had similar symptoms. Mr. E., the son-in-law, was still more 
severely afflicted, being extremely emaciated and feeble. His gen- 
eral appearance was like that of one suffering from malignant 
disease, and without the blue line and the family history to aid me 
in the diagnosis, I should have expected to find a cancerous devel- 
opment somewhere. The source of all this trouble was near at 
hand. The water which the family used was drawn from a well in 
the cellar through a one and a half inch pipe, extending from the 
bottom of the well to the sink in the kitchen, about forty feet. This 
same arrangement had been in use in this house for twenty-four 
years. The well was walled up with brick, fed from a spring at the 
bottom, and the water stood generally about six feet deep. The 
lead pipe passed through the wall above the surface of the water 



28 STATE BOARD OP HEALTH. [Jan. 

then down to within six inches of the bottom of the well. The 
water in this well, as in the neighborhood generally, percolates 
through a gravel subsoil and is called soft. The surface of the 
pipe inside and out was coated with a carbonate of lead, and in 
several places the pipe was much eroded. The water was analyzed 
by the professor of chemistry at the Agricultural College, Amherst, 
and reported by him to give evidence of holding lead in solution, 
with an unusual quantity of free carbonic acid. These cases all 
recovered completely on removal of the cause of their illness and 
with appropriate treatment. 

" This question may be pertinent. How does it happen that this 
water has been used by one member of the family (Mrs. H.) for 
twenty-four years without evidence of poisoning, and then all the 
family suffer about the same time ? I have only one explanation 
to offer, which may or may not be correct. The wooden cover had 
become decayed and portions of it had fallen into the well. The 
decomposing wood had supplied the excess of carbonic acid gas 
necessary to act upon the leaden pipe." 

Norihborough. — " I can recall eight cases of lead colic where the 
unmistakable cause was drinking water pumped through lead pipe ; 
three cases from water from an aqueduct, two cases from water 
drawn from a well with a bucket made from a whitelead keg, and 
one case caused by drinking cider drawn through a lead faucet." 

Pepperell. — "I have now under treatment several cases of partial 
paralysis, caused, I have no doubt, by the use of water taken 
through lead pipe. The most prominent symptoms are these: 
mental depression ; paralysis more or less complete of the extensor 
muscles of the forearm, with dropping of the wrists ; inconvenience 
in walking over uneven surfaces, there being inability to extend 
the foot to avoid accidents ; distinct blue line along the margin of 
the gums. 

" In no instance had these persons come in contact with any form 
of lead in an unusual manner, except by lead pipe being used to 
convey water for domestic use. These cases are peculiarly inter- 
esting to me, witnessing, as I do, the effects upon different 
members of the same family." 

Rutland. — " Lead pipes for pumps and aqueducts are in universal 
use. No instance of lead colic or paralysis has occurred to my 
knowledge in the last twenty years. " 



1871.] PUBLIC DOCUMENT— No. 37. 29 

Sherborn. — " I remember but one case in which poisoning from 
lead water-pipe was suspected. There was temporary paralysis of 
the extensor muscles of the arm and the blue line on the gums. 
The patient was a boy and made a good recovery after treatment 
and the removal of the lead pipe. No other member of his family 
was affected. Lead pipe for the conveyance of water is very 
generally used here." 

Shelburne. — " I have known four cases of lead colic, two of them 
complicated with paralysis. Three recovered and one died. All 
of these persons used water from lead pipes." 

Sterling. — " I am convinced that the universal use of lead pipe 
for water conduits has had a prejudicial effect on the health of the 
people of this town in years past and evidences of lead poisoning 
are apparent in some patients now under my treatment." 

Sudbury. — In forty years' observation no cases of lead colic or 
lead paralysis have been seen which could be directly traced to 
water pipes, but our correspondent believes lead to be an unsafe 
metal to be used for the conveyance of water, and is recommending 
its removal and the substitution of other materials free from the 
suspicion of danger. 

Taunton. — A few cases of paralysis from the absorption of lead, 
supposed to come from lead pipes and cisterns, have been observed. 

TewJcsbury. — A case is reported of lead poisoning from long con- 
tinued use of a hair-dye containing sugar of lead. 

Uxbridge. — No case of lead poisoning from water pipes known to 
have occurred in Uxbridge, but in a neighboring town two cases 
were recently seen by our correspondent. Water was brought 
from a well through lead pipe, and produced in one instance lead 
colic and in the other " drop-wrist " before the cause was discov- 
ered. The water treated with sulphuretted hydrogen showed the 
presence of lead in abundance. 

Upton. — One case reported by our correspondent as distinctly 
traceable to lead-pipe water. Other cases of colic and partial par- 
alysis have occurred in which this cause was suspected but not 
proved. 



30 STATE BOARD OP HEALTH. [Jan. 

Ware. — A case of neuralgia in which lead disease from water 
pipes is suspected, now under observation. Our correspondent in 
Ware reports a case of lead disease, although not from water pipes, 
which is curious and instructive. 

" An old gentleman, a farmer, had colic, constipation and finally 
drop-wrist. It took me a long time to find out from whence the 
lead which had evidently caused these symptoms could possibly be 
obtained, as the water was from an old oaken bucket and no paint 
was used about the house or on any of the cooking utensils. But I 
made every inquiry and at last discovered that the old man was 
fond of vinegar and water, sweetened, for a drink ; and thinking it 
nicer freshly drawn, was in the habit of going to his barrel and 
drawing a little into his glass through a lead faucet ! 

" This source of danger in his case came very near being an 
unsolved mystery, but happily it was at last made manifest." 

Watertoicn and Helmont. — Lead disease occasionally seen and 
almost without exception in the form of colic. Several cases 
reported. A middle-aged man, a shoemaker, lived with his wife 
for three years in a house supplied with water through lead pipe. 
He had no family. The wife, with more active habits, never 
showed distinctive signs of lead poison, but was never quite well. 
The husband had lead colic of the most violent and obstinate 
character. Another case was of a little girl who was constantly 
drinking from the faucet which supplied the basin in her mother's 
chamber. The lining of the tank from which the water was drawn 
was found to be oxidized. 

In a second letter our correspondent says : " I think I stated that 
I had seen the effects of lead poisoning manifested almost invariably 
in the form of colic. I now recall a single exception, which was the 
case of a lady who suffered from a neuralgic affection of the limbs, 
especially the arms, which were lame, painful and weak. The 
water she had been in the habit of drinking was found to contain 
a large proportion of lead. The use of lead-water was discontinued 
and the symptoms eventually disappeared. 

" One case more of susj)ected lead affection, that of a woman who 
was teased and annoyed for a long period by abdominal pains, not 
severe and sharp like those of ordinary colic but dull and wearing. 
I believed the cause of this trouble to be the use of water which 
came from a painted roof. She recovered perfectly." 

Wakefield. — Two families affected; both entirely recovered on 



1871.] PUBLIC DOCUMENT— No. 37. 81 

removal of the lead pipe. In one of these cases there was paralysis 
of the extensor muscles of both hands. 

Webster. — "There have been several cases of colic and a few- 
cases of paralysis in this vicinity, directly traceable to the use of 
water drawn through lead pipe. A case of lead paralysis caused by 
drinking cider drawn through a lead faucet was also under my 
observation a few years ago." 

Wcdtham. — Several cases of lead poisoning from water pipes 
occuiTed in this town in the practice of the late Dr. Horatio Adams, 
and were published by him in the Transactions of the American 
Medical Association, Vol. 5. Our correspondent has recently seen 
a case which was caused by water drawn through lead pipe from a 
brick cemented cistern. 

Westminster. — Two cases of lead palsy traced to the use of water 
drawn through lead pipe. Extensor muscles affected. One was 
relieved by omitting the water ; the other was incredulous as to the 
cause of his trouble, and has been permanently injured. He has 
had " wrist-drop " for several years. 

West Boylston. — Some cases of lead disease from water-pipes 
have been seen, but they are not common. People are beginning 
to understand that water confined in lead pipes is dangerous, and 
are more careful than formerly. - Our correspondent has seen par- 
alysis, colic, a blue streak around the gums, costiveness and extreme 
emaciation caused by drinking water that had been stagnant in lead 
pipes. 

Wilbraham. — One case of facial paralysis observed which was 
supposed to be due to the use of hair-dyes. 

Worcester. — No cases of lead poisoning from water pipes observed 
since the introduction of " city water." Before its introduction 
many cases of colic and partial paralysis were seen, apparently due 
to lead pipe in wells. On removal of the suspected cause the 
symptoms disappeared. 

Wrentham. — " Instances have occurred where I think I have 
been able to trace the origin of disease to lead water-pipes. There 
is a hilly section where a dozen families are supplied with water 
from an excellent spring, a fourth of a mile above them. It is 
brought through lead pipe. These houses are also supplied with 



32 STATE BOARD OF HEALTH. [Jan. 

good wells. I think I am correct in saying that every one who 
uses the water conveyed through the lead pipe for any time is in- 
jured by it. The complaints are varied ; generally abdominal pain 
and neuralgia. Lately I have in a measure dissuaded the people 
from its use. The flow is not constant ; it only moves as it is drawn 
upon." 

In addition to this information directly from the towns, there 
are many similar cases reported in the " Boston Medical and 
Surgical Journal " as having occurred in Massachusetts during 
the past fifteen years. They are of the same general character 
as those already given, and it is therefore unnecessary to repro- 
duce them. They may be found in Vol. L1Y. p. 21 ; Vol. LV. 
p. 428 ; Vol. LVI. p. 422 ; Vol. LVII. p. 368 ; Vol. LIX. p. 
99 ; Vol. LXI. p. 480 ; Vol. LXXVI. p. 37. 

The Transactions of the American Medical Association, Vol. 
V., also contains a report on the subject, with many interesting 
cases occurring in the neighborhood of Boston, by the late Dr. 
Horatio Adams of Waltham. 

The special action of the water of Lake Cochituate (Boston 
water) on lead pipe, and the amount of lead it is capable of dis- 
solving under various circumstances, have been investigated, 
by request of the State Board of Health, by Mr. Wm. Ripley 
Nichols, Assistant Professor of General Chemistry in the Massa- 
chusetts Institute of Technology, who presents the following 

REPORT: 
George Derby, M. D., Secretary of Mass. State Board of Health : 

Dear Sir, — At your request I have made a number of deter- 
minations of the amount of lead contained in Cochituate water 
under the ordinary circumstances of its use ; and in this connection 
I would present the following statement with regard to the action 
of water on lead in general : — 

Perfectly pure water, in the absence of air, has no action on 
metallic lead ; if, however, lead be immersed in rain water or in 
ordinary distilled water there is almost immediate action, and if, 
after the lapse of a few minutes, the liquid be agitated, there will 
be seen an abundance of white scales of the hydrated oxy-carbon- 
ate of lead. This violent action seems to be due, in considerable 
measure, to salts of nitrous acid, especially nitrite of ammonium, 
always present in such water, and to be effected by the formation 



1871.] PUBLIC DOCUMENT— No. 37. 33 

of some nitrous compound of lead which is more soluble in water 
than the oxy-carbonate, into which it is almost immediately con- 
verted by the carbonic acid of the air or by that which is dissolved 
in the water. In all waters also, hard and soft, there appears to be 
formed at first an oxide, (or hydrate,) and this also is more soluble 
than the oxy-carbonate ; if lead be partially submerged in water, 
there will always be found on it, after some days, at the surface 
of the liquid, yellowish white crystals of hydrate of lead, along with 
the crystals of the oxy-carbonate. The bluish gray coating which 
forms on the surface of lead exposed to a moist atmosphere is a 
practically insoluble suboxide. 

It may be asserted that in all natural waters lead suffers cor- 
rosion to a greater or less extent. All the conditions upon which 
this action depends are not accurately known, so that we cannot 
say a priori whether a given water will act slightly or violently on 
the metal with which it may come in contact ; moreover, there is 
considerable diversity of opinion as to the effect, in this regard, of 
the presence of various individual salts ; still, it seems to be very 
generally agreed that the influence of sulphates, phosphates and car- 
bonates is protective, not only because the presence of these salts 
lessens the power of the water to dissolve oxygen and carbonic acid 
from the air, but also on account of the formation of a coating of 
lead compounds, which coating is but very slightly soluble itself, 
and at the same time prevents the direct contact of the water and 
the metal. 

In regard to the solubility of the various salts of lead : one part 
of the sulphate requires 20,000 parts of cold water for its solution 
(Fresenius) ; the carbonate requires 50,000 parts of water (Frese- 
nius) ; the oxy-carbonate is but very slightly soluble (Yorke), while 
the phosphate is altogether insoluble (Mitscherlich, Fresenius). 
The solubility of the carbonate and oxy-carbonate is so slight, that 
it is ordinarily stated that water contaminated with lead from lead- 
pipes or tanks may be rendered harmless by standing for a certain 
length of time exposed to the carbonic acid of the air, and Faraday 
proposed (Rep. Chim. App., I., 498,) the addition of powdered 
chalk to water collected from a lead-covered roof, asserting that the 
lead was thus entirely precipitated and the water made potable. 
With regard to the other salts of lead, the suboxide is absolutely 
insoluble (Horsford and others), the hydrated oxide is soluble in 
7,000 (Bonsdorff) or 10,000 to 12,000 (Yorke) parts of water, while 
the chloride and nitrate are much more soluble, the chloride dissolv- 
ing in 135 parts of cold water (at 12.5°C, Bischof), and the nitrate 
in about three parts of water at the ordinary temperature. 
5 



34 STATE BOARD OF HEALTH. [Jan. 

The greatest amount of protection seems to be afforded by the 
presence of carbonate of lime held dissolved by an excess of car- 
bonic acid, a coating of carbonates of lime and lead being formed 
in such case ; yet some observers assert that a large excess of car- 
bonic acid exercises a solvent action on carbonate of lead (see Miller's 
Inorganic Chemistry, under Lead). Other observers deny this fact 
(see Noad.— Chem. Soc. Jour. IV., 1852, pp. 20-26). The influence 
of nitrates and chlorides is felt to be pernicious ; organic matters, 
which under certain circumstances cause corrosion of the metal, as 
they contribute to the formation of a difficultly penetrable coating, 
are to be classed with the protective agents. 

In the distribution of water through lead-pipes, there are other 
circumstances which exert more or less influence on the action of 
the water on these pipes. The corrosion is recognized to be more 
considerable where the pipe has been sharply bent, where other 
metals, as in the case of solder-joints and stop-cocks of metal or 
alloy, come in contact with the lead, and where the water is trans- 
mitted through the pipes at an elevated temperature. In regard to 
the action of iron-rust coming from the mains, authorities differ ; 
Horsford distinctly states (Proc. Am. Acad., II., 64,) that hydrated 
peroxide of iron in water is not reduced by lead, and consequently 
that we "may infer the freedom from corrosion of leaden pipes con- 
nected with iron mains, as far as the reduction of the pulverulent 
peroxide of iron may influence it ; " Hayes, on the other hand, as- 
serts that the ochreous deposit from the iron mains assists in the 
corrosion. It is a question whether there may not be a certain 
galvanic action between the iron-rust and the lead, or even between 
the coating of lead compounds and the lead itself; it is, moreover, 
well-known that if a bit of mortar or plastering falls into a lead- 
lined tank, or is carried into a lead-pipe, there is rapid corrosion in 
its immediate vicinity, — so that the influence of carbonates may not 
be altogether for good. 

When the introduction of Cochituate water into Boston was 
under discussion, Professor Horsford of Cambridge made a series of 
experiments with regard to the action of the Cochituate, as well as 
of other waters, upon lead (see Boston City Documents, 1848, Nos. 
18 and 32; also Proc. Amer. Acad., II., p. 64). He concluded that 
lead pipes could be used with safety for its transmission, and that 
the coating formed would be to such an extent insoluble and im- 
penetrable, that after a certain time the action of the water would 
be practically nothing. These experiments in the laboratory have 
a certain value, yet too much importance must not be given to 
them, performed, as they are, with small quantities of water and 



1871.] PUBLIC DOCUMENT— No. 37. 35 

with a limited amount of metallic surface, and with the relative 
amounts of the two so different from those that are brought together 
in actual practice. Indeed, experience has shown that some waters, 
which in the laboratory seemed to corrode lead but slightly, really 
act very violently on the pipes through which they are conveyed. 

With regard to the action of the Cochituate water on lead, we 
should infer from the small quantity of chlorides and nitrates, and 
from the proportionally large quantity of carbonates,* that this 
action would not be very considerable, and we are now in a position 
to determine from the actual experience of so many years how 
much it really amounts to. I have tested many samples taken from 
the pipes under various conditions, and have never failed to find 
indications of the presence of lead. The following quantitative 
determinations were made : — 

No. 1. — Water dipped from the upper part of Cochituate Lake in a glass 
jar, August 31st, 1870.— 1,000 c. c. of this water failed to give indications of 
the presence of lead. 

No. 2. — Water from one of the drinking-fountains on Boston Common, 
July 20th.— 100,000 parts of this water contained 0.0415 parts metallic lead, 
equivalent to 0.0242 grains to the U. S. gallon of 231 cubic inches. 

No. 3. — Water from private residence, No. 137 Walnut Avenue, July 
19th. — The water is delivered through a hundred feet or more of tin-lined 
pipe, and then through 10 or 12 feet of lead pipe. The pipes have been in 

* Professor Siliiman's analysis of the water was as follows: No. I. being from the part 
of the lake from which the aqueduct starts; No. II. from the other, the upper, end of the 
lake. 

I. II. 

Chloride of Sodium, 0323 .2540 

Chloride of Potassium, 0380 

Chloride of Calcium, 0308 

Chloride of Magnesium, .0764 

Sulphate of Magnesia, 1020 

Sulphate of Soda, _ .0843 

Sulphate of Alumina, _ .0146 

Alumina, j080G 

Sulphate of Lime and Silica, _ .5700 

Phosphate of Alumina, - .1700 

Carbonate of Magnesia, 0630 .2560 

Carbonate of Lime, 2380 .3860 

Silica, 0300 

Carbonate of Soda, equivalent to nitrates and crenates, and loss, . . .5295 .4757 

1.2200 2.2106 

Carbonic Acid, average cubic inches to gallon, 10.719 4.549 

(See Water Commissioners' Report, Boston, 1845.) 

I find that the water as drawn from the pipes in the laboratory of the Institute contains 
0.217 grains of chlorine to the United States gallon, and a mere trace of nitrates. 



36 STATE BOARD OF HEALTH. [Jan. 

use some six months. — 100,000 parts of the water contained 0.0342 parts me- 
tallic lead equivalent to 0.0290 grains to the gallon. 

No 4. — Water from hot water pipes of same dwelling-house as No. 3, 
July 21st. This water passes through 40 additional feet of lead pipe, through 
a lead-lined tank and through an ordinary copper boiler. — 100,000 parts of 
this water gave 0.191 parts metallic lead, equivalent to 0.112 grains to the 
gallon. 

No. 5. — Water from the Chemical Laboratory of the Massachusetts Insti- 
tute of Technology, drawn June 25th, early in r the morning, after standing 
some 14 hours in the lead pipe which is about 150 feet long and has been in 
use several years. — 100,000 parts of this water contained 0.098 parts metallic 
lead, equivalent to 0.057 grains to the gallon. 

No. 6. — Water from the same pipes as No. 5, after running out enough to 
clear the pipes. — 100,000 parts of this water gave 0.0307 parts metallic lead, 
equivalent to 0.0179 grains to the gallon. 

No. 7. — Water from private residence, No. 8 Sawyer Street, Sept. 20th. 
The water had been let into the pipes only four days previously, and, at the 
time the sample was taken, had remained in the pipes for three or four hours. 
The pipe (lead) is some fifty feet in length. — 100,000 parts of this water gave 
0.073 parts metallic lead, equivalent to 0.0427 grains to the gallon. 

No. 8. — Water from private residence, Kendall Street, Sept. 26th. This 
water was let into the pipes some four months since, and none had ever 
been drawn previous to this time. — 100,000 parts of this water gave 0.0937 
parts metallic lead, equivalent to 0.0547 grains to the gallon. 

I would also record the following determinations.* 

No. 9 — MYSTrc Water from private residence, No. 12 Adams Street, 
Charlestown, 1\ o'clock A. M., Sept. 6th. There are about 50 feet of lead pipe 
which have been in use for 2\ or 3 years. Very little water had been drawn 
since July 1st. — 100,000 parts of the water gave 0.120 parts metallic lead, 
equivalent to 0.0695 grains to the gallon. 

No. 10. — Mystic Water from Kidder's Chemical Works, Charlestown. 
Drawn 7 A. M. Sept. 6th, after remaining 13 or 14 hours in the pipes. Con- 
siderable quantities of water are used, and the pipe, 200 feet in length, has 
been in use four or five months. — 100,000 parts of this water gave 0.120 parts 
metallic lead, equivalent to 0.0695 grains to the gallon. 

* In all cases the lead was weighed as sulphate. Two liters of the water were evapor- 
ated to fifty c. c, with previous addition of nitric acid, and filtered. The incinerated filter 
was treated with nitric acid, the excess of acid driven off, the residue taken up with 
water and the solution filtered through a minute filter into the mass of liquid to be tested!. 
Sulphuretted hydrogen was now passed through the liquid which was allowed to be only 
slightly acid, the precipitated sulphide of lead was collected on a filter, moistened with 
nitric acid, treated with a drop of dilute sulphuric acid and subsequently ignited cau- 
tiously with the filter. To avoid error from reduction to metallic lead, a second treatment 
with nitric acid and dilute sulphuric acid took place, followed by ignition with proper 
precautions. 



1871.] PUBLIC DOCUMENT— No. 37. 37 

In view of the foregoing quantitative determinations (Nos. 1 to 8) 
and of a number of qualitative tests, from conversation with men of 
experience engaged in the plumbing business, and from personal 
examination of various samples of lead pipes which have been in 
actual service, I feel justified in asserting: — 

(1.) That Cochituate water which has passed through lead pipes 
is never absolutely free from lead. 

(2.) That when the water is first introduced into the pipes, there 
is more action on the pipes, as far as contamination of the water is 
concerned, than subsequently, but that after a few days' service the 
quantity of lead in the water is practically very small. 

(3.) That there is always more lead in the water after it has 
stood for some hours in the pipes than when it is allowed to flow 
freely. 

(4.) That when the water passes through a lead-lined tank it will 
be likely to contain in solution or suspension a more considerable 
quantity of lead salts, from the fact that the lead is corroded more 
rapidly on the sides of the tank at the surface of the water. More- 
over, in such tanks there is generally a considerable extent of sur- 
face of contact between solder and the lead. 

(5.) That in the introduction of water into the pipes, the first ef- 
fect is the tarnishing of the brightness of the lead due to the for- 
mation of oxide or suboxide ; that there begins to form, almost im- 
mediately, a coating consisting on the outside of a brown and, at 
first, rather loose deposit (the color of which is not due to iron-rust 
as is ordinarily supposed, but to organic matter), and underneath 
of a white deposit composed mainly of carbonate of lead ; that this 
coating increases with time in firmness and also in thickness, but 
that the rate of increase is so slow that practically the pipes used 
for conveying cold water, do not wear out and become unservice- 
able except from some accidental circumstance, as the freezing of 
the water, or, as is often the case where the pipes are laid under 
ground, from corrosion from the outside or from a cause immediate- 
ly to be mentioned. That, however, the pipes even under ordinary 
conditions would eventually wear out, I have no doubt, as there 
seems to be no limit to the action. I have indeed a specimen of a 
pipe which, being in contact with cold water only, for a period of 
fifteen years, was so corroded in the vicinity of a solder -joint as to 
be eaten through, and along the pipe there is a thick coating con- 
sisting almost entirely of carbonate of lead (with organic matter, 
a little carbonate and sulphate of lime and a trace of oxide of iron) 
which has penetrated the pipe in some places to the depth of 1-15 
of an inch and more. There is one other circumstance contribut- 



38 STATE BOARD OF HEALTH. {Jan. 

ing to the wear of cold-water pipes which is not to be overlooked. 
The water is delivered in many cases under such a pressure that 
the pipes tend continually to expand. The effect of this is often to 
strain the pipes so as to form longitudinal seams or grooves of greater 
or less length and the corrosion taking place under such favoring 
circumstances more rapidly, sometimes extends through the pipe, 
which is thus rendered unserviceable by a combination of chemical 
and mechanical action. 

(6.) That pipes used to convey hot water are corroded more or 
less rapidly, a deposit similar to that in the cold-water pipes being 
formed, and the corrosion manifesting itself most decidedly in the 
vicinity of the solder points, and where the pipe is sharply bent. 
Whether the iron-rust, coming from the water-backs in which the 
water is heated, contributes to produce this effect, I am not pre- 
pared to say. The disarrangement of the particles of the lead and 
the change in its mechanical structure, brought about by the alter- 
nate and unequal contractions and expansions to which it is sub- 
jected, must present more favorable opportunity for the corrosive 
action due simply to the passage of the water through the pipes. 

In connection with this report, I would present a list of the 
" literature of the subject," which, although not pretending to com- 
pleteness, may be of service to any one interested in the matter. 

Vitruvius. — De Architectural Liber VIII., Cap. 6. De ductionibus 
aquarum. Ed. Schneider. Lipsise, 1807. Vol. I, p. 227. 

Galen. — De Compositione Medicamentoruin secundum Locos. Ed. Kiihn. 
Lipsije, 1826. Vol. XII. 

Lambe. — Researches into the Properties of Spring Water. 1803. 

Guyton-Morveau.— Ann. de Chim. LXXI. (1809), p. 197. 

Scudamore. — Analysis of Water of Tunbridge Wells. 1816. 

Thomson. — Appendix to preceding ; also Edinburgh Med. and Surg. Jour. 
XII., p. 495. 

Beck. — Elements of Medical Jurisprudence. Albany, 1823. Vol. II., 
p 315. 

Bostock. — Report of the Commissioners appointed to inquire into the State 
of the Supply of Water in the Metropolis. London, 1828. 

Yeats. — Hints on a mode of procuring soft water at Tunbridge. Jour, of 
Science. XIV., p. 352. 

Comte de Milly. — Rosier. Obs. sur la Phys. XIII., p. 145. 

Wall— Trans. Lond. Coll. Phys. II., p. 400. 

Hall— Pogg. Ann. XIV, p. 145. 

Yorke.— Phil. Mag. (3) V. (1834), pp. 81-95. Also, Pogg. Ann. 
XXXIII. (1834) pp. 110-112. 

Sitbold.— Pharm. Centr.-Bl. 1835, p. 831. Also Buch. Rep III , pp. 155-179. 



1871.] PUBLIC DOCUMENT— No. 37. 39 

Bonsdorf.— Pharm. Centr.-Bl. 1836. p. 520. Also Pogg. Ann. 
XXXII., p. 573 ; Buch. Rep. V., pp. 55-59. 

Nevius. — Pharm. Journ. Trans. X., 595. 

Merat — De la Colique Metallique. 

Phillips.— Report from the Select Committee of the House of Lords to in- 
quire into the Supply of Water for the Metropolis. London. 1840. 

Christison.— Trans. Roy. Soc. Edinb., XV., 2 (1842) p. 271. 

Treatise on Poisons. 1st Amer. Ed. from 4th Edinb. Philadelphia, 

1845. 

Dispensatory. Phila. 1848. 

Dana, S. L. — Report of Joint Special Committee, &c. Lowell, 1842 ; 
also an appendix to his Translation of Tanquerel on Lead Diseases. Lowell, 
1848. 

Morson.— Pharmaceutical Journ. II., (1842) p. 355. 

Pareira — Treatise on Food and Diet. London, 1843. 

Elements of Materia Medica and Therapeutics. 3d Edition, 

London, 1849. 

Phillips — Chem. Gaz. 1845. 

Silliman.— Report and Analysis of the Waters, with " Report of Water 
Commissioners." Boston (1845). 

Yorke.— Phil. Mag. XXVIII, (1846) pp. 17-20. 

Report of Consulting Physicians on the Action of Cochituate Water upon 
Mineral Substances. City Document No. 18, Boston, 1848; containing a 
report by A. A. Hayes, M. D., also Prof. Horsford's partial reports, 1, 2 and 3. 

Report of Water Commissioners on the Material best adapted for the Dis- 
tribution Water-Pipes. City Document No. 32. Boston, 1848, containing 
Prof. Horsford's Reports. 

Horrford— Boston City Documents 1848, Nos 18 and 32 ; Proc. Amer. 
Acad. II, p 64; Chem. Gaz. VII.; pp 295-298. 

Hays. — Boston City Document No. 18, 1848. 

Taylor— On Poisons. London, 1848. Guy's Hospital Reports. VI. 

Jackson — Essay on Lead Pipes used as Conduits for drinking-water, con- 
trasted with pure block-tin pipes. New York, 1852. 

Buckler— Amer. Jour. Sci. (2) XIV., (1852) p. 267. 

Graham.— Chemical Report on the Supply of Water to the Metropolis. 
Jour. Chem. Soc. IV., (1852) p. 401. 

N ad —Jour. Chem. Soc. IV, (1852) pp. 20-26. 

Smith.— Jour. Chem. Soc. IV., (1852) pp. 123-133. 

Eisner.— Chem-tech. Mitth. 1854-1856, p. 24. 

Medlock. — On the Action of certain Waters on Lead. Rec. of Pharm. 
and Therap of Gen. Apoth. Comp. London, 1857, part 2, p. 33. 

Phil. Mag. XIV , p 202; also Jour, de Pharm (3) XXXIII., p. 

237 ; Journ. Prac. Chem. LXXII., p. 277 ; Dingler's Poly tech. Jour. CXLIV., 
p. 284 ; Arch. ph. nat. XXXVI , p. 354. 

Die Wasserleilung Berlins 1857. 
Sicherer —Dingler's Polytech. Jour. CXLIV , p. 284. 
Lindsay— Edinb. New Phil. Jour. IX., (1859) p. 245. Abstr. in Br. 
Assoc. Rep. 1858. 



40 STATE BOARD OF HEALTH. [Jan. 

Faraday. — Rep. Chim. Appl. I., p. 498. 

Langloise. — Journ. de Pharm. (4) I., p. 99. 

Stefanelli— Zeitschr. Ch. u. Pharm. 1860. 

Nichols, J. R — Boston Med. and Surg. Jour. LXIII., p. 149. 

Calvert.— Chem. News. IV, (1861) p. 172 ; also Dingler's Polytech. Jour. 
CLXIL, (1861) p. 220. 

Ludwig. — Die natiirlichen Wasser. 1862. 

Silliman. — Report on Mystic Pond. Charlestown. 1862. 

Kersting. — Riga Water Supply. Dingler's Polytech. Jour. CXLIX.,p. 183. 

Varrentrapp — Mitth. f. den Gewerbeverein d. Herzogtlnuns Braunschweig. 
1864. p. 27. Also Dingler's Polytech. Jour. CLXXV., p. 286. 

Petlenkofer — Baier. Kunst u. Gewerbebl. 1864. p. 682 ; also Dingler's 
Polytech. jour. CLXXV., p. 283. 

Stalman.— Dingler's Polytech. Jour. CLXXX. (1S66) p. 366; also 
Zeitsch. f. Ch. 1866, p. 416. 

Report of the Joint Special Committee on a Supply of Water for the City 
of Lowell. Lowell, 1869, p. 74. 

Kirkwood. — Collection of Reports and Opinions of Chemists in regard to 
the use of Lead Pipe for Service Pipes. New York, 1859. ovo. 

Consult also — 

Amer. Jour Sci XXXIV., (1838) p. 25; XLVL, (1844) p. 398; 
XXXII., (1861) p 115. 

Miller's Elements of Inorganic Chemistry ; 4th Edition, (London) p. 714. 

Brande. — Dictionary of Materia Medica and Practical Pharmacy. 

Wood and Bache.—XJ. S. Dispensatory. 13th Ed. Phila., 1870. 

Graham, Otto.— Lehrbuch. 1863. II., 3, p. 311. 

£o/%.— Handbuch d. chem. Technologie, 1802. Vol. I., p. 95. 

Graham. — Elements of Chemistry. 

Brande and Taylor. — Chemistry, — and various other text-books and treatises 
on Chemistry. 

Respectfully submitted, 

(Signed) Wm. Ripley Nichols. 

Mass. Institute of Technology, ) 
Boston, Oct. 20, 1870. ( 

From the evidence presented in the preceding pages, it seems 
reasonable to believe that the use of lead pipe for the convey- 
ance of drinking water is always attended with a certain degree 
of danger, because such water always contains lead ; and that 
this danger varies in degree with the character of the water 
conveyed and the susceptibility to lead poison of those who 
drink it. 

The chemist can say that water containing air (or natural 
water) always acts upon lead ; but he cannot say that a certain 
kind of water will, under all circumstances, take up and convey 



1871.] PUBLIC DOCUMENT— No. 37. 41 

in solution, only a certain proportion of lead. The physician 
finds it equally impossible to say that a certain proportion of 
lead in water will hurt no one. 

From these two shifting elements of difficulty come all the 
doubt and obscurity which have made the influence of lead-pipe- 
water a disputed question. 

How much lead can we habitually take without injury ? No 
one would voluntarily add it in ever so small amount to the 
water of the spring, well, or lake which supplies his drink, yet 
thousands and even hundreds of thousands of people in Massa- 
chusetts do constantly receive it in very minute amounts with- 
out manifest injury. 

No well authenticated instance of lead poisoning from the 
Boston water has come to our knowledge, although lead pipe 
is almost universally used for its distribution. The same state- 
ment may be made as regards Charlestown and Worcester, and 
is doubtless true of other large cities and towns supplied by 
water works from lakes of great purity. We may conclude 
from experience and observation that the character of the water 
in these cities is such as to dissolve lead in so small amounts as 
to be generally harmless, — and we use the word " generally " 
advisedly, because although paralysis, and wrist-drop, and the 
most distinctive signs of saturation with lead have not been 
observed, it does not therefore follow that minor obscure ail- 
ments, particularly of the nervous system, have not been aggra- 
vated or even caused by this subtle poison. There are a great 
many cases of neuralgia, of (so-called) rheumatism, and of dys- 
pepsia, whose causes are unknown. 

When we see that Professor Nichols finds one-ninth of a 
grain of lead to the United States gallon (equal to one-eighth of 
a grain English gallon), in the hot-water pipes of a private 
house in Boston, and remember the possibility of such water 
being habitually used for cooking purposes, it is well to be cau- 
tious in giving it a good character under all circumstances.* 

But if the lake water of the cities mentioned, is generally 
incapable of dissolving a dangerous proportion of lead, it is 

* A case of lead poisoning recently occurred in the city of New York, which was 
traced to the use of Croton water (whose character has been thought safe), drawn from 
the hot-water pipes after standing in them all night. In this water " cracked wheat " 
was soaked ever}' morning, preparatory to boiling. 

6 



42 STATE BOARD OP HEALTH. [Jan. 

equally certain that the water of springs and of wells is very 
often ready to dissolve an amount which will produce danger- 
ous disease. 

The chemical evidence already presented shows that it is so 
difficult as to be practically impossible to say, even when we 
know the constituents of the water, whether it will dissolve 
dangerous amounts of lead until it has been actually tried by 
domestic use and for considerable periods of time. 

It is well that we should have some idea of what have been 
found to be dangerous amounts of lead for habitual use. 

Dr. Angus Smith says that one-fortieth of a grain per gallon 
will affect some persons, while one-tenth of a grain may be re- 
quired for others. Dr. Parkes, a high English authority, thinks 
that any quantity exceeding one-twentieth of a grain per gallon 
must be regarded as unsafe. These opinions are also held by 
Professor Graham, Dr. Taylor and other equally known chem- 
ists and physicians. Dr. Adams, of Waltham, reports a case of 
poisoning in which only one-hundredth of a grain per gallon 
was found in the water. In the celebrated case of the poison- 
ing of the family of Louis Philippe by drinking water which 
had been stored in a lead tank, the amount of lead was seven- 
tenths of a grain per gallon. This quantity affected thirty-four 
per cent, of those who drank it. 

The susceptibility of individuals to the action of poisons, 
whether metallic or non-metallic, is known to differ exceedingly. 
Many persons pass half their lives in ignorance of their own 
peculiarity in this respect, and then have revealed to them by 
some lucky accident that what to their neighbors has been 
harmless, has been to them for a long term of years the source 
of great discomfort or illness. In our reports from the towns 
it is evident that in numerous cases water containing lead in 
solution has been insidiously undermining the strength of 
people who never suspected the cause until some one of their 
family, still more susceptible to this peculiar poison, developed 
the signs of advanced lead disease. The minor degrees of ill- 
ness from minute doses of lead must have been unrecognized 
in a great number of cases where no physician was consulted, 
and where, even if he had been, lie might readily have failed 
to trace them to the use of water conveyed very likely in the 



1871.] PUBLIC DOCUMENT— No. 37. 43 

same way as that which he had himself used without any visi- 
ble harm. 

The only safe practice with water which has not been tested 
with lead pipe by long experience, is to use some other material 
than lead for its conveyance. 

The only reason (and it is an excellent one as far as it goes), 
why lead pipe is so generally used for the distribution of water, 
is that it is cheap and convenient. Many substitutes have been 
proposed. Iron naturally suggests itself first, and, on the score 
of health, is quite free from objection, as minute doses of iron 
rust are harmless. One difficulty with iron is found in adapt- 
ing it to the circuitous passages which domestic convenience 
requires it to traverse in our houses ; another is found in the 
obstruction of the pipes by rusting. For conducting water from 
a spring in a direct line to the dwelling, it may be regarded, in 
spite of this latter objection, as practicable, cheap and safe. 
It has been said that the iron rust might render it unfit for 
washing white clothes, but this objection seems rather fanciful 
than real, as in all city houses supplied with hot water it is 
carried through an iron water-back behind the range, besides 
passing through miles of iron mains, without discoloration. 

For use in wells or for conducting water from springs, tubes 
of wood have been proved by long experience to be generally 
good and wholesome. It ha& been thought that water contain- 
ing sulphate of lime sometimes acquired a flavor of sulphu- 
retted hydrogen from its passage through decaying wood. It is 
certainly a perishable material, but so is lead, and the latter by 
dangerous corrosion. We are inclined to believe that, generally, 
wood will last longer than lead. 

To obviate the inconvenience and obstruction caused by 
rusting, the (so-called) " galvanized iron " is often used. This 
is prepared by passing iron pipes, cleaned by dilute acid, 
through a bath of molten zinc* It is claimed that the whole 
character of the metal is thus changed, and the zinc does 
actually seem to soak in, in certain cases. But the quality of 

* It has been said that zinc (as well as lead) may impart a poisonous quality to water 
conducted through it. This is not proved, nor is it very probable. The question is 
discussed by Dr. Winsor, of Winchester, in the Boston Med. and Surg. Journal, Jan. 5, 
1871, and the conclusion reached that although carbonate of zinc may be found in water 
conveyed through galvanized iron pipes it is no more harmful than carbonate of iron. 



44 STATE BOARD OF HEALTH. [Jan. 71. 

the product varies, so that often the coating of zinc is only 
superficial, and sometimes the interior of the pipe is not com- 
pletely covered. There can be no doubt that this zinc covering 
preserves the iron from rusting for a certain time, varying with 
the quality of the pipe.* 

Gutta-percha pipes are sometimes used in wells and would 
seem to be excellent for this purpose, but it is questionable 
whether they will bear the pressure of the water-works of 
Boston. 

Pure block-tin pipes are excellent on the score of health, as 
the oxide of tin is insoluble, but they are rather expensive for 
general use.f 

Quite recently much use has been made of lead pipe lined 
with tin. This material is sufficiently flexible to be carried any- 
where, and is not expensive. It has been longer used in Eng- 
land than in this country, and is there highly commended and 
on good authority. Nevertheless, it would seem difficult, if not 
impossible, to entirely prevent in this way contact between lead 
and water, and when it does take place, the corrosive action 
would be rather hastened by the presence of the other metal. 
Time alone can prove the value of lead lined with tin, and it is 
yet new.:j: 

The same may be said of the seamless brass tubing now 
being introduced, to save the expense of repairs, in a good 
many places. For drinking water it must be looked upon with 
suspicion. 

Glass tubes, and iron lined with glass have sometimes been 
used, and seem to answer every condition required by health ; 
but, as in so many other things, health, convenience and econ- 
omy cannot in this way be combined. 

* See Mallet, in report of British Association for 1840. 

t Block-tin pipes are rapidly corroded underground, and should be protected in some 
way from the action of the soil when used under such circumstances. 

$ Since the above was written we hear on good authority of some tin-lined lead pipe 
being removed after being in use two years at Roxbury Highlands, and found perfectly 
uninjured and even bright on its internal surface. 



TRICHINA DISEASE IN MASSACHUSETTS. 



46 STATE BOARD OF HEALTH. [Jan. 



TRICHINA DISEASE IN MASSACHUSETTS. 



There have been two recognized outbreaks of this preventable 
disease in 1870 ; one in Saxonville, and the other in Lowell. 

The discovery of this strange and terrible cause of sickness 
and death is an excellent illustration of the progress of science, 
of the use of the microscope, and of exact and careful observa- 
tion. Here is a disease which we have every reason to believe 
has existed among men as long as they have eaten pork, which 
has killed or made sick thousands upon thousands of people, 
and yet whose nature and whose cause no man suspected until 
within a very few years. The first glimmer of light concerning 
it was perceived in 1832, but since 1860 it stands clearly re- 
vealed through the labors of physicians and microscopists all 
over the world, so that to day it is one of the diseases most com- 
pletely understood. Its history, its causes as occurring in man, 
and the means of avoiding it are now plain and intelligible. 
Trichinous pork is the flesh of a pig containing, imbedded in its 
substance, very minute living worms of a peculiar kind, invis- 
ible to the naked eye, each coiled up in a snug little oval cap- 
sule. The pig having this parasite in its muscles may be, and 
often is at the time of killing in apparent health. He may have 
been well cared for, and there may be absolutely nothing in his 
condition or in his surroundings to excite the least suspicion. 
This was true of the Tewksbury pig which caused such suffering 
to the family at Lowell in the present year. Yet whoever eats 
the smallest morsel of the lean meat of the animal without first 
killing the parasite, becomes surely affected with one of the 
most painful and terrible, although fortunately not one of the 
most fatal of diseases. 

The parasites on being swallowed by man are quickly freed 
from their capsular envelope, multiply with immense rapidity, 



1871.] PUBLIC DOCUMENT— No. 37. 47 

and in three or four days the intestine swarms with the young 
trichinae or flesh worms. They then set out on their travels, 
piercing the walls of the intestine, and boring their way through 
all intervening tissues, they proceed to establish themselves in 
the muscles (the red flesh) of the whole body. No muscles, 
except those of involuntary motion, escape their presence. 

It is as if myriads of needles were being thrust through the 
flesh of the unhappy subject. The great muscles of the extrem- 
ities and of the trunk of the body, the little muscles concerned 
in turning the eye, all, big and little, are invaded by these 
worms. The whole body is alive with them. Their number is 
so great that a minute fragment of flesh placed under the micro- 
scope reveals scores of them pushing their way through the 
muscular fibres. 

Finally, in the course of about four weeks if the patient sur- 
vives the suffering and the disturbance of vital functions, the 
worms all find the home they have sought, the promised land of 
the red voluntary muscle, and there they coil themselves up, 
become encysted or encapsuled, as originally found in the flesh 
of the pig, are dormant, comparatively harmless, and in the 
course of years die, and are changed into a chalky material 
which remains ever after in the muscle, weakening its structure 
somewhat, but apparently doing no great subsequent harm. 
In this condition they are "not very infrequently observed in 
the bodies of those who have died from other diseases. 

The writer has now in his possession a piece of dried flesh 
taken from a dissecting-room subject many years ago, and which 
has the appearance of being finely dusted with a grayish powder. 
On microscopic examination each of these minute points is seen 
to be a trichinous capsule converted into a cretaceous material. 

The symptoms of trichina disease ordinarily observed are as 
follows : — 

1st. — Feverishness, loss of appetite and of strength. Sudden 
swelling of the face, particularly about the eyelids, but without 
pain ; copious perspirations. 

2d. — Swelling of the muscles all over the body ; every 
movement is now attended with severe pain ; the muscles are 
also sensitive when touched. 

3d. — Contraction of the flexor muscles of the legs, arms, and 
trunk, so that the patient lies drawn up, and upon his side ; 



48 STATE BOARD OF HEALTH. [Jan. 

swelling of a dropsical character, affecting the feet, legs, thighs 
and trunk. This order of signs marks the disease, and occurs 
in no other. There is usually diarrhoea, but not always. The 
prostration and febrile action bear a certain resemblance to 
typhoid fever, with which trichina disease has no doubt been 
confounded in previous generations before the flesh worm was 
seen. 

The cases occurring in Massachusetts during the past year 
were under the care of Dr. G. S. Eddy of Saxonville, and 
Dr. Joel Spalding of Lowell, and we are indebted to these 
gentlemen for the following details. The Lowell cases were 
also seen by the writer on the 9th of April. 

A family in Saxonville consisting of six persons partook of a 
dinner of fried fresh pork on the 8th of February, 1870. It 
was the only fresh pork used in the family during three months, 
with one exception. A portion of the meat was underdone, and 
the member of the family who ate the red and imperfectly 
cooked pork suffered most. Three escaped entirely, and three 
were affected on or about the 15th of February with the follow- 
ing symptoms. 

Very marked lameness, soreness and stiffness of the volun- 
tary muscles, more especially those of the calf of the leg. This 
muscular pain was the first sign in all these cases, and the most 
distinctive sign throughout. All three, however, had swelling 
of the face and of the feet. 

The youngest, a boy of fourteen, after an illness of four weeks, 
during a portion of which period he had diarrhoea, entirely 
recovered. 

His sister, two years older, was more seriously affected. For 
ten weeks she was confined to her bed, most of the time unable 
to lift hand or foot, and the lightest touch causing excessive pain. 
During this time there was no diarrhoea, and no marked in- 
crease of temperture, but an extremely rapid and weak pulse. 
Appetite voracious. No gastric disturbance. On the 16th 
of May she was just able to move about the house with muscles 
impaired, but daily improving. 

The case of the eldest, a young man of 19, assumed about the 
third week, the general appearance of typhoid fever. Extreme 
depression, abdominal tenderness, diarrhoea, bleeding from the 
nose, pulse 150, finally, coma and death on the 12th of March. 



1871.] PUBLIC DOCUMENT— No. 37. 49 

Portions of muscle taken after death from the arm, thigh and 
calf of the leg proved to be swarming with living trichinae. 

No portion of the pork could be obtained for examination, nor 
could any history of the pig be got from the butcher who sold 
it. He was somewhat incensed by the subsequent small demand 
for fresh pork in the neighborhood, and declined giving any 
information. 

The trichina disease was communicated to a family in Lowell 
in February and March, 1870, through a smoked ham from a pig 
raised by a Tewksbury farmer. It was one of an apparently 
reputable litter, had been well kept, and exhibited no sign of 
disease during its life. The ham and some of the salted mid- 
dlings from this pig were delivered to the family in Lowell on 
or about January 20th. 

The family consisted of father, mother and six children. 

The two youngest children ate none of it. The father ate 
some of it slightly cooked, and the rest of the family ate it raw, 
cut in thin slices like smoked beef. 

It seems to have been used as a sort of relish, eaten with 
bread, and portions of it remained in existence and were exam- 
ined under the microscope as late as April 1st. The infection 
was thus received in small portions and at considerable inter- 
vals by different members of the family, except in the case of a 
girl of sixteen who had been absent and returned home on the 
3d of March. 

The first signs observed in all these cases except one, were 
those of an ordinary cold. Weakness, loss of appetite, shiver- 
ing, and irritation about the air-passages. 

The daughter declared that her first indication of illness was 
swelling about the eyes. In a few days muscular pains suc- 
ceeded in all the cases. 

Then stiffness and contraction of the muscles, swelling of the 
feet and of various parts of the body. In all there was great 
prostration of strength, and a rapid pulse. There was diarrhoea 
in three of the six cases. 

On the 9th of April all were able to be on their feet except a 
boy of 11, who laid on his side with the body bent, arms and 
legs strongly flexed, complaining of great pain on being touched, 
with a rapid pulse and an expression of great suffering. He 

7 



50 STATE BOARD OF HEALTH. [Jan. '71. 

was quite unable to extend his body or extremities, but had a 
voracious appetite, and subsequently recovered entirely. 

The daughter of 16 had the complexion and facial expression 
of Bright's disease, and walked across the room stiffly, without 
being able to touch her heels to the ground, like a person under 
the influence of strychnia. She was improving daily. 

The fragments of ham which were sought for by Dr. Spalding 
early in his attendance on these singular cases, and which for- 
tunately remained, were found to be filled with living trichinae. 

The salt pork from the same pig was also crowded with them 
in perfect form and shape, each curled up in its little cyst, but 
probably killed by the pickle. 

The prevention of this pork flesh-worm disease is entirely 
within our power, and depends upon the following well ascer- 
tained facts. Although the vitality of the trichina is maintained 
for years in the muscle of either man or pig, ready to become 
active and to reproduce its like on being transferred to the in- 
testine of another animal, its life is completely destroyed by 
thorough cooking. A temperature of 150 to 160 degrees 
Fahrenheit is fatal to it. 

Pickling may and probably does render the pork harmless. 

Smoking (except at a very high temperature) certainly does 
not, as we see in the Lowell cases and many similar ones in 
different parts of the world. In some parts of Germany, where 
much uncooked pork is eaten in the form of sausages and ham, 
there are government inspectors to examine with the microscope 
portions of every pig offered for sale. This of course would be 
quite impracticable with us, and is indeed unnecessary anywhere 
if people will understand the all-important fact that uncooked 
pork muscle, that is to say the lean portion, (for trichinae are 
not harbored in the fat) can never be eaten with safety. It 
should not only be cooked, but fresh pork, whether spare-rib or 
sausage, should be cooked so thoroughly that all redness has 
disappeared from it, and smoked pork should be boiled at least 
two or three hours. If a temperature of 160 degrees has 
reached the interior portions we may eat it without fear of 
trichina disease. 



HEALTH OF TOWNS. 



52 STATE BOARD OF HEALTH. [Jan. 



HEALTH OF TOWNS. 



Replies of Correspondents to Inquiries Concerning the Probable 
Cause of such Diseases as are Specially Prevalent in Massa- 
chusetts. 

In our Circular of April 8, 1870, the following questions 
were asked : — 

1st. Is there any disease, or are there any diseases which seem to 
be specially prevalent in your town, or in the region in which you 
practise ? 

2d. If so, will you do us the favor to state what they are ? 

3d. Can you account for this special prevalence, and is it, in your 
opinion, removable in any degree ? 

These questions will be seen „to cover an immense field. 
They were proposed in order that some general idea might be 
formed of the extent and value of the materials at our com- 
mand, and in the belief that a comparison of the replies would 
furnish a guide for more direct inquiries in all parts of the 
State, as well as for the study of the causes of local disease in 
the various towns. 

These expectations have been fulfilled. Although a very 
large majority of the answers received have been mere nega- 
tions, there is a valuable remainder in which will be found facts 
of the greatest interest, and many speculations and sugges- 
tions founded upon daily observation, sometimes extending over 
a very long term of years. 

Physicians, as a class, are not communicative. They neither 
talk nor write much. In the smaller towns they but rarely 
have opportunity of communicating freely with each other, and 
except in the occasional meetings of the District Medical Socie- 
ties, or in consultation, each goes his own way. Even in the 



1871.] PUBLIC DOCUMENT— No. 37. 53 

larger towns and cities where physicians are numerous, although, 
as everywhere in the civilized world, the knowledge of each is 
the common property of the profession, there is but little talk 
upon the causes of disease. 

But if physicians say little and print almost nothing on these 
obscure subjects, it is certain that they think a great deal. In 
the course of his long and weary rides about the country, the 
Doctor ponders and speculates upon the causes of what it is the 
business of his life to contend with. 

Why does that particular farm-house have fever or dysentery 
among its occupants every year in a certain month ? 

How is it that three or four different families who have lived 
in a certain house within my recollection have become con- 
sumptive ? 

Why does a certain hill, or ledge, or swamp, or clay bottom 
prove fatal to three times as many of its inhabitants as another 
locality within a mile of it ? 

Do as many people die of consumption now as thirty years 
ago when I began practice ? 

How has the temperance reform affected public health ? 

What change has taken place in the health of the people in 
this town since they left off going to sea and took to shoe- 
making ? 

Such questions are suggested by daily experience, but have 
not often been answered in printed publications, or in any form 
through which other practitioners or the general public could 
use the knowledge thus gained for the general good of the 
community. Such information has for the most part been lost 
by the death of those who collected it. 

The following extracts from letters received from physicians, 
chosen by the selectmen of towns in every part of the State, 
will show how deep is the interest which they feel in the study 
of the causes of disease ; and we doubt not will give the medi- 
cal profession still stronger claims than ever before to be 
regarded as the natural guardians of the public health. 

The .whole number of replies received to the Circular before 
referred to is one hundred and seventy-one. Of this number, 
one hundred and twenty say that no disease is specially preva- 
lent in the town or region of their practice. Fifty-one designate 



••• 
1 



54 



STATE BOARD OF HEALTH. 



[Jan. 



either a special disease or a class of diseases as specially preva- 
lent, and they are thus divided : — 



Respiratory organs, . 
Consumption, . 
Typhoid fever, . 
Disease of nervous system, 


20 

15 

9 

2 


Croup and pneumonia, 
Dysentery,. 

Functional diseases of uterus, 
machines, . 


1 

1 

caused by use of sewing 
1 


Cerebro-spinal meningitis, . 
Rheumatism, . 


1 

1 



Acushnet. — Consumption and typhoid fever are the most prevalent 
diseases, and seem to be influenced by easterly and southerly winds 
blowing across the Cape, and by a great deal of swampy land and 
stagnant water. 

Amesbury. — " Lung diseases prevalent. The town, or rather its 
most thickly settled portion, is located about seven miles from the 
seacoast. To the west and northwest hills rise, leaving the village 
in a hollow, through which flows Powow River. We have strong 
east and northeast winds. A large portion of the Irish live in ten- 
ement houses built along the bank of the river, and but little raised 
above the high-tide level. In some localities and houses I think I 
have been right in attributing the frequent throat and lung difficul- 
ties to dampness of the house or part of the house occupied by the 
family." 

Attleborough. — " Consumption is of frequent occurrence, but 
perhaps not disproportionately to other diseases. In every case of 
consumption seen during fifteen years I have found that ancestors 
in the direct or collateral line have died from it. I have met with 
some marked instances of arrested phthisis where the physical signs 
indicated the first stage of the disease. These cases have seemed 
to testify to the correctness of Niemeyer's theory. The disease 
has, under my observation, occurred in several instances twice or 
three times in the same house. In one case, where three persons 
have died within five years, the house, though large, open and well- 
exposed to air and light, is on a ridge between two swamps, neither 
of which is more than two or three hundred feet distant. I have 



1871.] PUBLIC DOCUMENT— No. 37. 55 

also learned that before my acquaintance, one or more cases of con- 
sumption occurred in the same house. In another place where 
there have been three deaths from this disease within my knowl- 
edge and another previously, the house is surrounded on three sides 
by low lands and on the east there is a high hill. The town is well 
elevated, but there is much undrained land and prevalent surface 
water." 

Ashland. — Occupation of the inhabitants, boot-making, chiefly ; 
the usual number of mechanics of other classes and a few farmers. 
The main village, on a level plain at the confluence of two streams 
and surrounded by hills. The soil is a sandy loam, with a yellow 
subsoil resting on a bed of gravel. The whole plain is full of water 
in the spring, but the natural drainage is excellent. From the low- 
ness of this plain a stranger would suppose that Ashland must be 
an unhealthy town, but our correspondent thinks it above the aver- 
age in respect of health. (For further remarks concerning the 
diseases prevalent here at certain times and places, see under the 
head of typhoid fever.) 

Athol. — Air of lower village affected injuriously by stagnant 
water. 

Brimfield. — " Pigsties and privies are the chief abominations of 
country dwellings, and will, in my opinion, continue to be a great 
cause of disease until the people are educated on this point. If 
they were properly attended to, there would be less sickness. I 
have in several instances directed the removal of piggeries which 
had been built close up to the dwelling." 

Boston. — Our reply to the question concerning diseases specially 
prevalent may be found in another part of the present volume, 
under the head of "Analysis of the Mortality of the City of 
Boston." This information applies to the year 1870 alone. For a 
series of years the answer in general terms would be that the 
diseases most prevalent are those of infancy, and that they are 
dependent chiefly upon the impurity of air and of food. 

Boston is blessed with an abundant supply of pure * water for 
rich and poor, and for this we cannot be too thankful. Vaccination 
has also been, for many years past, provided gratuitously for all 
who would avail themselves of it, and this, combined with the rule 

* The qualifying statement should be added that lead, in minute amounts, is always 
found in the water when lead pipe is used for its conveyance. 



56 STATE BOARD OF HEALTH. [Jan. 

that all children before entering the public schools shall produce 
evidence of vaccination, has kept small-pox under control. An 
insj)ection of milk is made by public authority, and with the best 
results. Public bathing-houses during the summer months have 
been established, and have proved of great value. All these are 
important provisions for public health, but they are only exceptions 
to the general rule of indifference to the general subject. 

Boston has grown to be a great and crowded city, needing to avail 
itself of all the aid which modern science can furnish to prevent 
the origin and spread of disease, while its (so-called) health depart- 
ment is almost exclusively occupied in the direction of the city 
stables, and of the men and horses and carts connected with those 
establishments, and is seemingly without a care beyond the routine 
of scavenging, which is conducted on the same plan as when 
Boston was a town. When nuisances have grown to be unbearable 
by those exposed to their influence, and after repeated " complaints " 
have been made, an effort is made to suppress them ; but there is no 
spirit of prevention, or of anticipation, and no sign of an intelli- 
gent appreciation of the consequences of sanitary neglect. 

The legislature has provided laws framed to meet all our needs 
but they are not executed. 

The deficiencies of the public service in these respects are set 
forth in the following document, which was presented to the Board 
of Aldermen in April, 1870, by the physicians who then accepted 
what they regarded as the responsible office of " Consulting Physi- 
cians of the City of Boston." 

CITY OF BOSTON. 

To the Mayor and Aldermen, Health Commissioners of the City of Boston. 

The undersigned have recently received the honor of appointment as Con- 
sulting Physicians of the City of Boston. 

Being desirous to understand at the outset the exact nature of our duties, 
application was made to the City Solicitor. 

From that officer we learn that we are required to watch over the public 
health, and give timely warning of danger from any form of preventable dis- 
ease, and that, failing to do this, we should not comply with the intention of 
the ordinance requiring our services. 

This grave responsibility we accept, and in accordance with its obligations 
beg leave respectfully to make the following statements. 

The death-rate of Boston has been for some years past so high as to excite 
the attention of the medical profession. 

With natural advantages for drainage and ventilation equalled by very few 
cities in the world, and with an abundant supply of pure water, there is still 



1871.] PUBLIC DOCUMENT— No. 37. 57 

an average annual mortality of between twenty-four and twenty-five to the 
thousand of population. 

During the past ten years the chance of living has been not quite as good 
in our City of Boston, almost surrounded by the sea, with a population of 
200,000, as in London, on the Thames, with a population of 3,000,000. 

The greater vital depression caused by want and misery in that most vast 
of modern cities seems to have been more than counteracted by the careful 
protection of public health 

Comparing the mortality of Boston with that of other parts of the State, the 
indications are also very unfavorable. 

Half of the people of Massachusetts live in districts where the annual mor- 
tality does not exceed seventeen or eighteen to the thousand. 

In 1868, the last year of which the records are published, four hundred and 
eighty-seven deaths from cholera infantum occurred in Suffolk county, while 
in an equal population outside of city limits the number was less than one 
hundred. The mortality from all bowel diseases of children is in similar pro- 
portion in Boston and in the country. 

There are causes for this excessive mortality, and it is our duty to try to 
discover what they are, and if possible to point the way for their removal. 

Among the first requirements for public health in a crowded city are sew- 
erage and pavement, — such sewers as will cause all the foul liquids to flow 
away by force of gravity, and such pavement as will prevent all soakage into 
the soil. 

To obtain these in perfection is a work of time, of great cost, and of the 
highest engineering skill ; we cannot hope to have them changed except by 
slow degrees, and by such processes as have for many years been going on in 
Boston with public approval. 

But there are other means of protecting public health easily reached, and 
whose benefits might be at once enjoyed by the citizens, to which we would 
invite your attention, as we deem them to be of great importance. 

Our streets are not clean. It is perhaps unfortunate for sanitary progress 
in Boston that comparison in this respect with New York is so readily made. 
We return from that city congratulating ourselves on the superior cleanliness 
of Boston streets, which no one can question, but sometimes forgetting that 
the standard of comparison is a very low one. 

The Metropolitan Board of Health of the city of New York have already 
accomplished a sanitary work from which other great cities may learn many 
useful lessons. 

They have reformed the tenement-houses, suppressed dangerous epidemics, 
cleaned and disinfected the vaults, and removed or regulated all offensive 
trades ; but the streets have been always entirely beyond their control, and 
the Board of Health are not in the least degree responsible for their condition. 
Street-cleaning in New York is a corporation job. 

There can be no doubt that, in so far as the streets are concerned, New 
York is the most filthy great city in the civilized world. Our standard of 
comparison should be the streets of the great cities of Europe, which are as 
8 



58 STATE BOARD OP HEALTH. [Jan. 

much cleaner than the streets of Boston, as ours are cleaner than those of 
New York, 

The dirt of the streets of Boston is made up, in great part, of the excre- 
ment of horses. This is allowed to accumulate, being alternately dried by the 
sun and air and soaked by the rains and watering carts, until it forms a foul 
and dangerous compost, tending directly, through the air with which it is in 
contact, to the production of disease. The interests of public health require 
that it be removed with much greater frequency than is now practised. We 
are of opinion that, during the summer and early autumn, every street in the 
city should be cleaned once in twenty-four hours, and the great thoroughfares 
by night. 

There are, in all parts of Boston, filthy back-yards, alleys and passage- 
ways, broken-down and overflowing vaults, and, in the older portions, disused 
wells and cisterns, which are receptacles for dirt. All these nuisances should 
be reformed. 

Offensive trades, like fat-melting and bone-boiling, are carried on in open 
vats in the midst of a crowded population. They should be compelled to use 
methods, tried and approved in New York, by which the sickening vapors 
may be entirely consumed. The authority to control these trades is given by 
statute. 

House-offal, or swill, is allowed to become putrid before removal from the 
houses of the citizens. The offal is a source of profit, being kept by special 
ordinance free from mixture with ashes, which would tend to prevent its be- 
coming offensive ; but this enforced division of refuse material makes it the 
more obligatory upon the city authorities to take the dangerous portion away 
before it undergoes decomposition. 

In our opinion public health requires that house-offal should be removed, 
in summer and early autumn, every day from every house. 

Our tenement-houses are in a condition discreditable to a civilized commu- 
nity. It is only necessary to visit Friend Street Court, or the " Crystal Pal- 
ace, " in Lincoln Street, for any citizen to see under what desperate circum- 
stances the occupants of these and hundreds of other similar houses are com- 
pelled to live. Their rents are enormous, and their condition calls for the 
relief which the legislature of 1868 intended to afford them through the Tene- 
ment-House Law. 

This law has been a dead letter, but the interests of public health require 
that it be enforced without delay. 

It is now no one's duty to inspect the fresh provisions offered for sale in 
Boston, while the law provides for the destruction of all which are unsound, 
and of all meat of any calf killed when less than four weeks old. We believe 
that public health requires the enforcement of these laws, and we would 
respectfully suggest that a systematic inspection of meats, fish, vegetables and 
fruits be made by city authority in a manner similar to the inspection of milk, 
which has proved to be so useful. 

We think that all the reforms to which we have referred are practicable. 
They concern every citizen, whether he may chance to live in a good 
home, with apparently wholesome surroundings, or in the most wretched ten- 



1871.] PUBLIC DOCUMENT— No. 37. 59 

ement-house ; for no one can escape the general influence of the sanitary 
condition of the city in which he dwells. 

These reforms would require an outlay of money, but we believe they 
would prove to be good investments, and that a true economy demands them. 

The money value of human life to a community is real. A destructive 
epidemic is expensive. Moreover, a clean and unquestionably healthy city, 
such as Boston might be made, would have attractions for permanent residents 
and transient visitors which could not fail to favorably affect its commercial 
interests. 

It might also well be an object of pride with every citizen to furnish in 
Boston an example of public cleanliness and public health which other 
American cities would imitate. 

Very respectfully, your obedient servants, 

HENRY BARTLETT, 
GEORGE DERBY, 
JAMES C. WHITE, 
WILLIAM READ, 
P. P. INGALLS, 

Consulting Physicians of the City of Boston. 
Boston, April 14, 1870. 

As the season approached when cholera infantum and the bowel 
diseases of children were certain to commit great havoc in and 
around the filthy localities in which Boston abounds, the State 
Board of Health called the attention of the city authorities to their 
unwarrantable neglect of a law of the State in a letter which may 
be found in the general report of the Board. 

These remonstrances have produced no visible effect. Instead 
of improvement there has rather been a progressive deterioration 
during the past year ; a gradual lowering of the standard of municipal 
cleanliness, such as has been going on for many years through the 
growth of population, and the inertia of the health department fixed 
in its old traditions. 

The streets are still very dirty, the alleys and passage-ways and 
back-yards often filthy, the vaults still broken and overflowing, the 
air of crowded neighborhoods made sickening by bone-boiling and 
fat-melting. 

House-offal is still a nuisance in all parts of the city by being 
kept until putrid during the warm season. 

Unsound provisions, both meat and vegetables, are freely sold, 
and, as it is nobody's business to enforce the law on this subject, it 
is a dead letter. 

The tenement-houses of Boston, the houses in which the most 
impoverished and unhappy portion of our fellow-citizens are crowded 



60 STATE BOARD OF HEALTH. [Jan. 

together, are a disgrace to our civilization. Through their squalor 
and wretchedness they foster crime as well as disease. Moral and 
physical health must equally suffer under their shadow. 

The rent extorted from their unfortunate tenants, often through 
middle-men who have great rapacity and little feeling, is far larger 
in proportion to what they get in return than is paid by the pros- 
perous. A single room, fifteen feet by ten, sunless and damp, un- 
furnished and entirely out of repair, brings $1.25 to $1.50 a week, 
or the interest of $1,000. Two rooms, fairly above ground, but 
equally squalid in all other respects, bring double this sum. All 
such premises are at the present time crowded to overflowing at 
the above rates. Often twenty families may be found using the 
same privy, filthy and repulsive in condition. Nowhere in these 
houses can the slightest evidence be seen to-day of the existence of 
a law of the State passed in 1868 for their regulation, and whose 
execution is vested exclusively in the Board of Health of the city 
of Boston. 

Lest the above statements concerning the dwellings of the very 
poor should be regarded as exaggerations, the following list is 
given of places visited by the Secretary of the State Board of Health 
in November and December, 1870, and which justify the descrip- 
tion : — 

Note. — Where numbers are not given, reference is intended to the general 
character of houses in the street or court. 

Stone's Yard, 100 Cross Street. 

105 and 107 Cross Street. 

Young's Court, rear of 124 North Street. 

Mechanic Court. 

Blind Alley, rear 209 North Street. 

Land's Court. 

Rear of 324 North Street. 

Stone's Alley, Stillman Street. 

Cook's Court, rear 390 Commercial Street. 

Holden Court, rear 398 Commercial Street. 

Commercial Court. 

Basements in Pond Street Place. 

Institute Avenue. 

Basement of No. 8 Morton Place. 

Crystal Palace, Lincoln Street. 

Utica Street. 

Cove Place. 

Shaving Street. 

Rear of 147 Kneeland Street. 

128 Kneeland Street. 



1871.] PUBLIC DOCUMENT— No. 37. 61 

Cove Street. 

Rear 298 Federal Street, extending around to Shaving Street. 

137 Beach Street. 

Federal Place, rear of 235 Federal Street. 

Belmont Barracks, Broad Street. 

116 Broad Street. 

Wharf Street. 

Rear of 155 and 157 Federal Street. 

Holden Place. 

62 and 72 Joy Street. 

Stanhope Place. 

Rear of 42 and 44 Phillips Street. 

Southac Place. 

Wilberforce Place. 

Lee Place. 

Lindall Alley. 

Adams Place. 

Barton Street (57 and 59) and Short Napier Street. 

Parts of Billerica and Nashua Streets. 

28 and 30 Lancaster Street. 

126 Merrimack Street. 

Alley leading from 132 Merrimack Street. 

Parts of South Margin Street. 

Rear of 67 Pitts Street. 

Rear of 71 and 75 Pitts Street. 

Yard and privies of 91 Merrimack Street. 

47 and 53 Portland Street. 

Alden Court. 

Doherty Court, East Boston. 

Rear of 107 Everett Street. 

Second Street, (S. Boston,) south side, from Athens Street to No. 49. 

Green's Alley. 

Dungarvin Block. 

Boston Wharf. 

Athens Street from Second to A. 

Slate House, corner Third and B. 

Dewarson's Block, Silver Street, corner of C. 

Silver Street, between B and C. 

Buckley's Block. 

Old Colony Block. 

Parts of Ontario Street. 

Parts of Rochester Street. 

In evidence of the want of prevision of nuisances, of the complete 
neglect of their formative stage, when they might be prevented, of 
the indifference which permits their establishment, or of the ignor- 
ance which fails to see in advance the results to which they must 



62 STATE BOARD OF HEALTH. [Jan. 

certainly lead, we would call attention to a hotel or lodging-house 
of seventy rooms at 44 Portland Street, built in 1870. At least, 
half of the whole number of bed-rooms have no windows, and are 
on both sides of long passage-ways only four feet wide. The rooms 
are in dimensions about ten feet by eight, and are absolutely dark, 
so that you cannot see the opposite wall without lighting the gas, 
and have their only supply of air through the narrow passage-way 
into which the doors lead. All this, of course, is in direct violation 
of the Tenement-House Law of 1868. 

BlacJcstone. — " The diseases most prevalent are those of the lungs 
and inflammations of the mucous membranes generally. The mor- 
tality among our foreign population is large, more particularly 
among children. Very much sickness can be traced to a want of 
proper sewerage and the neglect of cleanliness and ventilation." 

Barnstable. — Pulmonary affections very common, accounted for, 
in part, by exposed position of the town, moist atmosphere, fogs, 
cold winds from the sea. 

Billerica. — "Vaccination and re-vaccination have been grossly 
neglected in this town, and if smallpox were to break out to-day, 
not more than five per cent, of the inhabitants would be suitably 
protected by vaccination." 

Barre. — Locality favored with great natural sanitary advantages. 
No disease more likely to prevail here in the future than smallpox, 
when once imported. People are very negligent about vaccination. 

BrooMine. — Our correspondent informs us that there are in 
Brookline three or four filthy localities occupied by foreigners, and 
where the houses are crowded with people who pay no regard to 
cleanliness ; their slops and refuse are for the most part thrown 
upon the ground — their pigsties are offensive. In contrast with 
all this, we know that the greater portion of the people of 
Brookline enjoy all the comforts of fife, and there is, perhaps, no 
town in the State where so large a number are in possession of all 
which may be supposed to promote health and long life — beautiful 
estates are to be found throughout its territory. Our correspondent 
finds, as between these two classes of inhabitants, quite as much 
sickness among the rich as among the poor — quite as large a pro- 
portion of illness among the Americans as among the Irish. He 



1871.] PUBLIC DOCUMENT— No. 37. 63 

writes as follows : " I have concluded, in considering the compara- 
tive amounts of sickness among those who have comfortable houses 
and those who live in crowded quarters, that the habit of living out 
of doors day and evening in the summei, which prevails among the 
latter class, acts as a preventive of disease * The gross amount of 
deaths in the poorer class is not an indication of the comparative 
amount of sickness with that class, but only a proof that, owing to 
a want of good nursing and good care, a larger number of fatal 
cases occur than among the wealthier classes. With regard to our 
epidemics of scarlet fever, I have noticed that they are at times 
confined to the population in the poorer neighborhoods and at other 
times to the wealthier class, thus agreeing with the idea that the 
disease does not, as commonly expressed, ' come in the air,' but is 
conveyed by contagion. For instance, this autumn the inhabitants of 
Pearl Place and of Fairmount, two locations occupied by the labor- 
ing class, the one on the marsb, the other a mile away, high and 
well ventilated, both suffered with scarlet fever of a malignant type, 
and causing many deaths, while there were only one or two cases 
in other parts of the town." (See further remarks under the head 
of Typhoid.) 

Berkley. — Bronchial diseases seem to be most prevalent. Their 
cause obscure. Soil rather low and wet, not very pervious to 
water. A good deal of easterly wind. 

Concord. — " Cases of consumption, of rheumatism and neuralgia 
are of frequent occurrence. The Concord River is a very sluggish 
stream, having less than three feet fall in twenty miles. There are 
extensive wet meadows on its borders, subject to be overflowed two 
to four times a year, and to remain saturated with water several 
weeks at each overflow. Early after the settlement of the country, 
permission was given to build a dam over this stream at North 
Billerica. Near the close of the last century this dam was raised 
to facilitate the operations of the Middlesex Canal, and since then 
the meadows have been growing worse, and remain saturated a 
longer time. Some twenty years ago, the old mill and dam passed 
into the hands of a manufacturing company which has raised the dam 
still more, and aggravated the difficulty. There is upon the borders 
of these meadows, for twenty miles or more, a damp, chilly atmos- 
phere for considerable portions of the year, which may be supposed 
to account for many cases of consumption and rheumatism. We 

* In the absence of weather-strips, double-windows, and furnaces, do they not also get 
more fresh air in winter? — Sec'y. 



64 STATE BOARD OF HEALTH. [Jan. 

once got an Act of the legislature requiring the reduction of the 
dam, but the manufacturing interests of the State combined and 
repealed the Act the next year, and thus several hundred thousand 
dollars worth of property has been destroyed, and probably many 
lives lost, and much suffering endured to save two or three men the 
difference in the cost of running their works by water or by steam." 

(From a non-medical correspondent comes the following.) " This 
excellent old town has been settled two hundred and thirty-five 
years, and in point of education and general civilization may fairly 
be claimed to be the equal of any town in the State. It is a quiet, 
agricultural town with no such press of business as to prevent the 
citizens from taking the best care of themselves, and no such multi- 
tude of children that they may not be taken proper care of. Indeed, 
in one school district where there was formerly a large school, of 
late there have been too few children to form a quorum, and the 
school has been discontinued. 

"The houses are nearly all old, and have been occupied for a half 
century or more. We see therefore that there has been time 
enough to get things into comfortable order, and I do not know 
why we may not fairly presume that Concord, as to its provisions 
for drainage and ventilation, is as well provided as most other 
towns. Now for the facts. A High School was finished for occu- 
pation about a year ago, at a cost of twelve thousand dollars and 
more, under the direction of a committee of some of our best 
citizens, and there is not yet the slightest pretence of any venti- 
lation, except by opening the windows. 

" When the matter was discussed at our recent town meeting, the 
only reason given for not providing ventilation for that school-house 
was that, of the nine other school-houses in town, none of them had 
any better means of ventilation, and that it was very expensive to 
ventilate, any way. The town however voted to begin their ven- 
tilation of school-houses at once with the new building. 

" The absences from schools in Concord from illness have been, 
during the past winter, very great, and I have no doubt that want 
of ventilation was the cause of much sickness and loss of progress 
in the classes. So much for ventilation. 

"Now as to drainage. To-day (April 21, 1870), probably one-half 
and more of the houses between the railway station and the Sol- 
diers' monument, comprising the most substantial and compact part 
of the village for half a mile on the two principal streets, and two 
or three cross streets, have the bottom of their cellars covered with 
water to vai'ious depths, from a few inches to two feet. There is 
no pretence of any drainage to these cellars. The plain fills with 



1871.] PUBLIC DOCUMENT— No. 37. 65 

water in the spring, and it rises in the cellars. The old casks, and 
Uibs, and planks, and vegetables, and dead rats and other nameless 
horrors, float and soak and exhale their aromas. 

" The furnace fires are drowned, and the oldest inhabitants are 
very much surprised, as they have been for a century or two, at the 
wetness of the season. 

"When I bought my house three years ago, I drained it with 
tiles 240 feet across the road, at a cost of less than $25, and it is now 
perfectly dry. It had been occupied seventy-five years, with a foot 
or two of water in the cellar once in two or three years during the 
spring." 

Chicopee. — Our correspondent sends a drawing, showing the posi- 
tion of the town and the central village, with reference to the rivers 
which bound it on two sides. On the other sides are hills abound- 
ing in springs. Both the air and soil are unusually damp. He 
says : " From the location of the town, the dampness of the soil, 
the many springs running to the rivers, it might be expected that 
diseases of the lungs and throat would be prevalent, and especially 
consumption ; but, after careful investigations and many inquiries, 
I find that these diseases are no more rife in Chicopee than on the 
highlands which stretch away on one side to the Berkshire hills, and 
on the other to those of Worcester county." Water is conveyed 
to the central village from neighboring springs, and is of great 
purity. 

Coleraine. — "I think that erysipelatous diseases and fevers of the 
typhoidal type prevail in this region, and in the western part of the 
State generally, more than they do farther east. I think I have 
also observed a periodical element in various diseases which I refer 
to malarial influences. I cannot fully account for the prevalence 
of zymotic diseases, but I believe that increased knowledge of the 
conditions of health, and greater cleanliness in the neighborhood of 
farm buildings, with land drainage, will help much to prevent these 
diseases. 

" The mill-ponds near our factory villages, I think render the air 
foul in times of drought." 

Dennis. — Soil quite different on the two sides of the Cape at this 
point ; on the south side, sandy ; on the north side a stiff clay sub- 
soil. There are several diseases which present different appearances, 
as our correspondent believes, from this circumstance. Scarlet 
fever is one of them, and is more fatal on the north side. Lung 
9 



G6 STATE BOARD OF HEALTH. [Jan. 

fever prevails on the north side. Tobacco is doing much to shorten 
life. " There is another thing which should receive your attention. 
It is the intermarriage of relations. In this locality the effect is 
truly dreadful. There are, I think, more than fifty children of 
cousins who are either straight-out idiots or feeble-minded." 

Dudley. — "Lung diseases are most prevalent here; pneumonia, 
pleurisy, bronchitis. I think that cases of consumption are rather 
more frequent than in adjoining towns. I cannot account for it un- 
less it is from the wet soil. The subsoil is clay. Location, high 
and exposed to winds." 

Essex. — Diseases of the air-passages ; also, in a less degree, rheu- 
matism. " There is but little doubt in my own mind that the 
prevalence of these diseases is dependent on the chilly, damp east 
winds which continue here a considerable portion of the year." 
Soil, clayey and rather impervious to water. 

Fitchburg.— Purity of water supply from wells becoming ques- 
tionable, from the increase of population. A reliance on the surface 
water not regarded as safe in the future. Wells and springs 
becoming gradually less pure. 

The opinion is expressed that consumption is not less frequent 
now than formerly, and that the apparent diminution is due to more 
careful registration. 

Falmouth. — Pulmonary affections very common, and the most 
probable cause found in heavy fogs and cold winds. 

Fall River. — Consumption, catarrh, dyspepsia and nervous dis- 
eases are prevalent. The first two are due, in a certain degree, to 
the localities. The town is exposed to cold, damp fogs, and has a 
large body of fresh water on the east, and Narragansett Bay on the 
south-west. Soil wet and impervious to water. Consumption is 
very prevalent among the foreign population, who have not the 
slightest knowledge of hygienic laws, who live in a crowded condi- 
tion in the midst of filth of all kinds, and sleep in poorly ventilated 
rooms. These conditions are perhaps even more conducive to con- 
sumption than the location of the city. 

Groveland. — No prevalent disease since dysentery in 1866. 
Gloucester. — " The atmosphere in spring and summer is sometimes 



1871.] PUBLIC DOCUMENT— No. 37. 67 

rendered exceedingly offensive by emanations from decaying fish, 
either thrown into the harbor or spread upon land as manure. 

" I am not aware that any disease has been engendered by this 
contamination of the atmosphere, or that those prevalent at such 
seasons have been peculiarly aggravated." 

Groton. — Influenza has been very prevalent from atmospheric 
changes A prominent cause of consumption is the want of ventila- 
tion in houses, As soon as cold weather comes people shut up their 
houses as tight as possible, and then, with stoves, heat them to such 
a degree that they become very sensitive to cold on going out of 
doors. 

Hanson. — " The region in which I practise is considered healthy 
and not subject to any special disease. There are, however, small 
localities where it might be expected that health would be affected ; 
and indeed I think it is. Here fevers are more serious; scarlet 
fever is attended with more ulceration of the throat ; common in- 
flammation of the throat is more apt to pass to ulceration, and ill- 
turns are more frequent. These localities are low and wet, being 
near cedar swamps and marshes, and sometimes foggy This cause 
affecting health cannot be removed, but only mitigated by proper 
care and management." 

Hinsdale. — " Scarlet fever has been very prevalent and fatal in 
this town during the past year, and has been confined almost ex- 
clusively to the foreign residents, operatives in the mills. Why the 
disease should be restricted to this class of our population I cannot 
explain, unless it be from their crowded tenements and less cleanly 
habits." 

Hingham. — Consumption a very dbmmon disease but not to be 
regarded as specially prevalent. " I do not notice that this disease 
appears with greater frequency near the harbor, which is a flat at 
low tide, or along a slow-flowing stream which runs through a low 
marsh, on the borders of which a portion of the town is built for 
over a mile, than in what is known as South Hingham, which lies 
on an elevated and well-drained plain." 

Holmes' Hole. — Bronchial affections very common in winter and 
spring. The winters are open, with rain instead of snow, and a 
humid atmosphere. Much exposed to winds from north-east, east, 
and south-east. 



68 STATE BOARD OF HEALTH. [Jan. 

Hadley. — Cerebrospinal meningitis has been frequently observed 
here. The cause entirely unknown. " The type of all disease is 
low, the nervous system showing great depression from apparently 
trivial influences. After ordinary colds, pleurisies, pneumonia, 
erysipelas, etc., there will be great depression, feebleness, sighing, 
tendency to nausea, etc. 

" Six or seven years ago we had diphtheria very severely, and 
since have had more or less of it, but in a milder form. I know of 
no special agency in producing the tendency described." The soil 
not wet except during freshets. The air apparently pure. The 
houses much shaded. 

Hudson. — " "We have not been free from scarlet fever since the 
autumn of 1866. The site of the village is low, but with a dry and 
pervious soil. In the hot season the purity of the air is somewhat 
affected by decaying vegetation in surrounding ponds." 

Hubbardston. — Our correspondent reports thirty persons living 
in this town who are over eighty years of age, including one aged 
ninety, two aged ninety-one, and one aged ninety-six. Population 
in 1865, 1,546. 

Leominster. — No diseases specially prevalent during our corre- 
spondent's practice of thirty-two years. He believes that consump- 
tion is less destructive than it was a quarter of a century ago, and 
thinks it accounted for by improved methods of treatment, and by 
better sanitary regulations in families arising from greater intelli- 
gence concerning the causes of disease. 

Lunenburg. — Our corrrespondent at Fitchburg sends us the fol- 
lowing letter on the 31st December, 1870: "In the south-east 
corner of Lunenburg there is a%eservoir pond covering about 1,000 
acres, from which several mills are supplied in Shirley Village. Last 
summer and fall this pond was drawn unusually low, — never so low 
before. The pond is shallow, and a great amount of vegetable mat- 
ter must have been exposed to the sun by this unusual drainage. 
Scarlet fever of a malignant type has prevailed on the borders of 
this pond and in Shirley Village, some three miles below, for several 
months past. I think, in a very sparse population, six deaths have 
occurred, and from those cases which I saw in consultation I think 
they died early from blood-poison, and not from anginose or local 
trouble. It has occurred to me that possibly a local influence, from 
decaying vegetation in that old drained reservoir, may have pre- 



1871.] 



PUBLIC DOCUMENT— No. 37. 



69 



pared the ' nidus ' in these patients for an intense and malignant 
development of the specific germ of scarlatina. Or is it possible 
that the unknown ' entity ' which produces scarlet fever may have 
a spontaneous generation in wet, decaying vegetable matter under 
the influence of a hot sun ? " 

Lexington. — " Situation quite high ; soil generally dry. Thei - e 
is little or no stagnant water in the warm season. The air is pure 
except in so far as it is affected by four or five piggeries of some 
size, supported by slaughter-house offal and city swill." 

Lenox. — Houses much shaded. 

Lowell. — See remarks under the head of " Typhoid Fever." 

Littleton. — Reference is made to slaughter-houses existing in the 
town which render the air of their neighborhood foul from decom- 
posing animal matter. 

Lynn. — Our correspondent, representing the opinions of the City 
Medical Society, replies that functional diseases of the uterus are of 
very common occurrence, and that this special prevalence is due to 
the use of sewing machines, run by foot-power. 

We are also furnished with some interesting facts, reduced to 
tabular form, and designed to show the comparative healthfulness 
of two great divisions of the city, one of high land, the other of low 
land. The population of these sections in 1870 is obtained from the 
United States census in advance of publication. The comparison 
has been made by Dr. J. O. Webster, under the direction of the 
Lynn Medical Society. 

Table I. 

Showing the number of Deaths from the Diseases specified, in the City of Lynn 
for the years 1865-69, inclusive, east of the line of Washington Street, ex- 
cluding all doubtful cases. 

HIGHER SECTION OF THE CITY. 



YEARS. 


Consumption. 


Typhoid 
Fever. 


Dysentery. 


Cholera 
Infantum. 


1865, 

1866, 

1867, 

1868, 

1869, 


44 
37 
41 

48 
46 


14 
12 

7 
3 
9 


17 
13 

4 


9 

13 
16 
13 

18 


Totals, 


216 


45 


34 


69 



70 



STATE BOARD OF HEALTH. 



[Jan. 



Table II. 

Showing the Deaths, as above, west of the line of Washington Street. 



LOWER SECTION OF THE CITY. 



TEAKS. 


Consumption. 


Typhoid 
Fever. 


Dysentery. 


Cholera 
Infantum. 


1865, 

1866, 

1867, 

1868, 

1869, 


44 
50 
43 
43 
54 


28 

13 

3 

15 
11 


9 
9 
2 
2 
1 


13 
10 
8 
17 
14 


Totals, 


234 


70 


23 


02 



Population of the north-east or highland section, — 

1865, 11,731 

1870, 16,710 

Population of the south-west or lowland section, — 

1865, 9,016 

1870, 11,521 



Mean population of the north-east section, 
Mean population of the south-west section, 



14,220 

10,268 



In 1865, the deaths from consumption were, in the north-east sec- 
tion 3.75 in 1,000 of population ; in the south-west section 4.86 in 
1,000. In the same year the deaths from typhoid were, — in the 
north-east section 1.19 in 1,000 ; in the south-west section 3.10 in 
1,000. 

The average annual mortality in the five years 1865-1869, inclu- 
sive, from consumption was, in the north-east or highland section 
3.03 in 1,000 of mean population ; in the south -west or lowland 
section 4.55 in 1,000. 

Same years, from typhoid fever in north-east or highland section, 
0.63 in 1,000; in south-west or lowland section, 1.36 in 1,000. 

The percentages of dysentery are very nearly alike in the two sec- 
tions, while cholera infantum shows only a slight preponderance on 
the side of the south-west or lowland section. 

Middleton. — The town is hilly and of generally uneven surface, 
but there are long tracks of meadow on which grows a coarse grass. 
These meadows are sometimes covered with water, and are always 



1871.] PUBLIC DOCUMENT— No. 37. 71 

wet. The banks of the Ipswich River are also frequently overflowed. 
There are no unhealthy exhalations from these meadows, river- 
banks, nor from the ponds. Soil loamy and gravelly. There are 
now living in this town forty persons between the ages of 70 and 
92. Population in 1865, 922. 

Nahant. — Our correspondent reports a severe epidemic of whoop- 
ing-cough during the summer of 1870, but no diseases specially 
prevalent in a series of years. 

Nantucket. — Neuralgia, rheumatism, catarrh and lung affections 
the most common ailments, and influenced apparently by cold and 
dampness in the winter and spring. Not removable. 

Northborough. — "No diseases especially prevalent. During the 
past twenty years dysentery and scarlet fever have twice prevailed 
extensively, with a large number of fatal cases. I think we have very 
few cases of consumption, but there are two families, one in the 
west and the other in the south part of the town, where nearly all 
the members have been affected with this disease. Both houses are 
in certain respects alike, both are situated very low, and fronting a 
large expanse of low meadow land, which causes them to be very 
damp during most seasons of the year. This, it seems to me is the 
cause of the disease. I have a case in Boylston similarly situated, 
and in which I find the same cause." 

North Adams. — Typhoid fever very common in the autumn. 
Tubercular diseases always, though less prevalent than formerly. 
Mountains and valleys seem equally exposed to both diseases. The 
town lies in a valley with mountains on the east and west sides ; 
consequently there is less sunlight than in most places. Morning 
fogs were formerly very common, but of late years are rare. The 
cause of this change is unknown. 

Newton Corner. — " No disease specially prevalent. Village com- 
posed almost entirely of well-to-do or wealthy people, who live in 
houses quite well ventilated, with plenty of room about them now. 
The matter of drainage will soon demand attention. Surface water 
is carried off quickly by brooks running into Charles River. 

" Where there are water-closets no cess-pools are provided and 
the drainage is into the ground. In some parts of this village there 
is complaint of wet cellars at certain seasons. I have not, in such 
cases, noticed any more disease than in other and drier parts of the 



72 STATE BOARD OF HEALTH. [Jan. 

town. Perhaps there is not so good a state of health, that is all. 
No standing water in any part of the village. Subsoil gravelly, or 
sand and clay." 

Newton Centre. — " The only disease which has a marked preval- 
ence is dysentery, and that is almost exclusively confined to a re- 
gion south-west of this village bordering on an extensive peat 
swamp, and drained by a sluggish creek. A fatal epidemic of diph- 
theria prevailed in this same region six years ago." 

New Salem and North Prescott.— Consumption is prevalent. In 
some measure it seems to be developed by working on palmleaf, an 
occupation which gives employment to a large number of females 
in this vicinity. In trimming the leaf there is much fine dust. 
Those who braid are constantly wetting the hat so that the leaf will 
not break ; their fingers are, in this way, exposed to cold. These 
occupations are favorable to the development of consumption on 
account of sedentary habits and in-door life, as well as from ex- 
posure to dust, and to cold and wet hands. Other causes are found 
in the character of the soil which is rather a heavy loam, very stony, 
rather impervious to water, and with swamps in many localities. A 
large proportion of cases of consumption met with have been on 
high ground. Drainage of the soil is much to be desired. 

Orleans.— Consumption prevalent ; also typhoid fever. Soil gen- 
erally dry and sandy, but few swamps or marshes (except salt 
marshes), but a great number of ponds of pure water with no na- 
tural outlet. Township nearly destitute of timber and much ex- 
posed to winds. 

Provincetown. — Rheumatism a disease specially prevalent in this 
town, both inflammatory and chronic ; affecting children as well as 
adults, women as well as men. 

Plymouth. — " In the south part of the town, along the basin of a 
small river flowing into the sea, consumption is frequent. The soil 
is in this basin low and wet." 

Pittsfield. — Houses too much shaded. [See under head of 
" Typhoid."] 

Bandolph. — Consumption is less fatal, and probably less frequent, 
in the past few years than previously, and is not now regarded as 



1871.] PUBLIC DOCUMENT— No. 37. 73 

specially prevalent. " It has not been observed by a majority of the 
physicians practising here that this disease affects preferably any 
particular districts. Nevertheless, it is the experience of one 
gentleman that in his neighborhood, swampy tracts of land have 
furnished more cases than dry, exposed upland." 

Reading. — Consumption very prevalent. Our correspondent 
says : " I cannot account for this prevalence except from dampness, 
and this is only partially removable. Much of the land is low, level 
and wet, and much of the higher land is retentive of moisture. In 
spring many cellars are partially filled with water for a considerable 
time." 

Rockport. — Our correspondent furnishes the following sketch of 
the climatic peculiarities of Cape Ann, and the diseases of that 
section of the State, derived from observation extending through 
thirty-three years of practice. 

" The surface of Cape Ann, on the north-east extremity of which 
I am located, is mostly elevated and dry, rising on all sides towards 
the centre more or less abruptly, and varying from one to two hun- 
dred feet in height. It is thickly studded with boulders which were 
once part and parcel of the underlying granite, and which probably, 
as successive portions formed the coast, have been thrown up by 
the waves, and, along with the gravel and the sand, the products of 
their attrition and disintegration, constitute the greater part of the 
soil. There are portious of the Cape where, for acres, these bould- 
ers lie so close to each other that a man cannot thrust his foot 
to the "earth between them, or a sheep, with nose ever so much 
sharpened, crop the herbage that ventures to spring up among 
them. 

" There is comparatively little low, wet or boggy land, and from 
the character of the soil, there is little mud in wet weather, and, if 
allowance is made for the vast amount of teaming from the granite 
quarries, there is little dust in dry weather. 

" Near the centre of the Cape is a clear and deep pond, between 
two and three miles in circumference, which furnishes a bountiful 
supply of ice in winter, and from which issue two fine brooklets 
running to the ocean, one across the north-western, and the other 
through the eastern part, passing through the centre of the village 
of Rockport. 

" Springs of pure water are not unfrequent, though most of the 
water used for drinking and for culinary purposes is obtained from 
10 



74 STATE BOARD OF HEALTH. [Jan. 

wells. From whatever source, it is probably as free from impuri- 
ties as in any part of the State. 

" On the whole, when the materials of which the Cape is com- 
posed are considered, so little adapted to harbor the causes of 
disease, the diversified yet elevated landscape, and the thorough 
washings of the surface and stirrings of the air which the storms 
compel us to submit to, it must be regarded as most favorable in a 
sanitary point of view, in so far as these causes operate. 

" The climate of Cape Ann may be said to be a little exaggeration 
of the climate of the New England coast generally. The Cape 
itself, being an island rather than a cape, is exposed to the full 
influence of the sea-breezes in all directions, and the summer's heat 
and winter's cold are tempered by them accordingly. A difference 
of five degrees I have often noticed between the extremes of cold 
reported at Worcester and by our thermometer. On the hottest 
day of the present season it reached ninety-four degrees. I believe 
it never rises above that point here, or falls lower than seven degrees 
below zero. 

" As the water warms less rapidly that the land, in the early part 
of the season, and cools more slowly in the latter part, we are 
subject to damp and chilly winds from the ocean in the spring and 
early summer months, engendering a good proportion of rheumatic 
and catarrhal affections ; while from July to December, we are 
repaid by the tempering of the extremes of heat and cold which 
render this Cape a pleasant abode for the invilid and pleasure- 
seeker. One striking effect of the tempering of the sea-air is the 
fact that in winter it often rains here, when a few miles inland it is 
snowing, and, as a consequence, there is good sleighing in the neigh- 
boring towns, when the Cape is bare. 

" Another peculiarity, though from a different cause, is that in 
summer the showers seem to be ' balky.' A large area of the 
centre of the Cape is elevated, denuded of trees, and therefore, in 
the warm season, hot and dry. The heated air arising from this 
surface prevents the condensation of vapor above it, and in a dry 
season we are often tantalized with the prospect of a shower which 
has already refreshed our more fortunate neighbors, Essex and Man- 
chester, the cloud rising and splitting just over our heads and 
passing over Massachusetts Bay on one side and Ipswich Bay on 
the other, and distributing its treasures where they are not 
wanted. Similar effects are observed at Cape Cod. I have been 
told by residents of that cape that it is no uncommon thing to wit- 
ness a shower arise, and swing round the circle, replenishing the 
ocean on both sides with fresh water before a drop falls on the 
parched sand. 



1871.] PUBLIC DOCUMENT— No. 37. 75 

" The only disease that has been thought to be specially prevalent 
here is consumption, and it has been the fashion to attribute it to 
the prevalence of east winds. That in the spring and early 
summer months this cause, by producing catarrhal affections, may 
occasionally hurry on, in the predisposed, the disease in question, 
may be admitted, but a very large proportion of the cases I have 
witnessed here have been hereditary, or due to a predisposition 
generated in families by unfavorable hygienic influences, such as 
confinement in closed, small rooms, sedentary habits, intermarriages, 
neglected or mismanaged skin diseases, (a cause more fruitful than 
is usually supposed,) and an innutritious diet. Seldom has this 
disease entered a family without a number falling victims one after 
another of those who are usually most in contact with the sick, 
until large families have sometimes, from this cause, become nearly 
extinct. There is no doubt in my mind of the infectious nature of 
this disease, and, consequently, that there would be a great diminu- 
tion of the mortality could those constitutionally predisposed be 
separated from the sick. An important fact bearing on the question 
of the influence of the sea-winds, and which seems to me decisive 
that they are made the scape-goat for violation of hygienic and 
social laws, is that while our best lands lie on the most easterly and 
exposed parts of the Cape, and our farmers are out in all weathers, 
not an instance has occurred of a farmer dying in consumption 
during my residence here, while repeated instances have occurred 
where the sons of farmers have left their father's employment, and 
becoming students, or entering into mercantile pursuits have fallen 
in the prime of life victims to this disease. Nor is this exemption 
confined to the period of one generation. Our oldest citizens 
inform me that they have no recollection of a farmer dying in 
consumption. 

" The east wind bloweth where it listeth, and we cannot regulate 
the dampness thereof. If it is a cause it is an irremediable one ; 
but if it is the chief cause here, it is a little remarkable that those 
most exposed to it should suffer least from the disease. 

" With regard to other diseases, my experience has furnished 
nothing to lead me to think that they differ in character from those 
of the New England towns generally, especially of the towns on 
the coast." 

[Remarks on typhoid fever and cognate diseases may be found 
under that division of our correspondence.] 

Mehoboth. — Pulmonary affections most prevalent. The acute 
forms of these diseases occur during the breaking up of winter. 



76 STATE BOARD OF HEALTH. [Jan. 

Consumption generally hereditary. The soil where it prevails is 
wet, impervious to water, and low in situation. Air rendered 
impure by stagnant water in large swamps. People persist in 
living in the worst parts of their houses, and where the sun does 
not come, and thereby do injury to their health. 

Stow. — " In the lower portion of Assabet Village there were last 
autumn a good many cases of typhoid fever, and they were confined 
to that portion of the village which is built upon a meadow which 
has once been cut over for its peat, and left to fill up again. The 
builders have two modes of preparing their foundations for building 
upon this old peat flat. One is to dig out the mud for three or four 
feet and fill up with sand or gravel, on which they build their 
houses. The other is to drive spiles into the mud ten or twelve feet, 
and cover them over with stones and sand. They dig their w T ells 
in the mud-hole and use the water for drink and for culinary pur- 
poses. But this is not the whole story. They build their privies 
and pig-pens near their houses, and their sink drains add to the 
accumulated filth which is all mixed up with the water they 
use. 

" From this swamp there is no proper drain. Right opposite this 
bog-hole is a pond belonging to the paper-mill, which is often drawn 
off during the night, exposing a surface covered with decaying 
vegetable matter, the odor from which is much complained of by 
those living near. Draining the swamp, which can be done without 
great cost, would contribute much to the health of the people who 
live upon or near it." 

Southampton. — " Diseases of the respiratory organs are common 
in winter, and of the digestive organs in summer ; and they both 
depend more upon the season than the locality." 

South Hadley. — Diseases of the nervous system are much more 
prevalent during the past six or seven years than formerly, appear- 
ing to affect all ages. The cause is entirely unknown. No unfavor- 
able conditions of earth or air discoverable. 

[See Hadley for similar observations.] 

Stoughton. — Our correspondent has practised in the town for 
forty years. He says : " Travelling westerly from the centre of 
this place, two miles, on a street where there are perhaps two hun- 
dred persons, I find the oldest of them is seventy. Going the 
same distance in the opposite direction there are about the same 



1871.] PUBLIC DOCUMENT— No. 37. 77 

number of people, but I find three couples all over eighty, and 
three widowers aged from eighty-one to eighty-five. I know of no 
essential differences in the situation, except that the land where the 
older persons live is considerably higher, and I should judge more 
pervious to water." 

Stochbridge. — " In all this immediate vicinity, except on the hills 
which almost encircle us, there is a vast deal of moisture arising 
from the close proximity of the river, with abundant low grounds 
and frequent overflowings, on the south side, while to the north 
lies a flat marshy meadow at the foot of the hills. 

" From these surroundings one would look for rampant consump- 
tion, if imbued with the doctrines of Dr. Bowditch on this subject, 
but while that scourge was at large among us years ago, we now 
see comparatively little of it, though catarrhal troubles are not 
infrequent. While our settlement is on very level ground, it is 
nevertheless a sort of knoll, with a porous, sandy soil,* through 
winch water readily permeates to the meadows about us. The 
meadows on the north, I have thought, might be drained, and 
certainly should be, if possible. 

" If any one characteristic of disease has shown itself more than 
another within the range of my practice, it has been a tendency to 
functional disturbance of the liver and of the digestive system, 
usually classed as biliousness. Some of these troubles I have been 
inclined to attribute to the great heat maintained in the dwellings. 
I have often found some of the foregoing difficulties almost incurable 
until I could induce the parties to keep a thermometer in their 
rooms and regulate them to a more temperate heat. Our streets 
and houses used to be very densely shaded, so that one could 
scarcely see some of the dwellings from the street. By incessant 
cryings out this state of things has been very essentially modified, 
and the people seem to be waking up to the possible utility of a 
little sunshine." 

Somerville. — " This town has been represented as favorable to 
the development of consumption, but after a residence here of fif- 
teen years, I do not find it to be so. On the contrary, I find less of 
this disease in proportion to the population than in Truro, Mass., 
which is dry and sandy, and where I practised medicine twenty 
years. 

" Of our foreign population I will only say, that if there is any 

* A noteworthy fact with reference to the relations existing between " soil moisture " 
and consumption. — Sec'y. 



78 STATE BOARD OF HEALTH. [Jan. 

bog-hole, they will get as nearly into it as possible, and they seem 
to thrive in the mud. 

" Tobacco is doing much to undermine the constitutions of the 
people." 

Shrewsbury. — Pulmonary diseases prevalent, and this owing to 
the general characteristics of the district : soil wet ; tolerably per- 
vious to water ; great exposure to north and east winds. 

Sutton. — Tubercular disease most prevalent. " My own opinion 
is that, in certain instances, it depends upon the character of the 
soil, and, in others, to proximity to streams and ponds, removable 
perhaps, partially, by extensive drainage. The situation is generally 
elevated and hilly, but the soil is for the most part heavy, impervi- 
ous, or only partially pervious, to water; springy and wet quite 
late in the season ; retains moisture on or near the surface a long 
time after rainfall. 

" A small portion of the town has a soil differing very much from 
this ; sandy, pervious, low or lying along the borders of streams or 
ponds. Very few wet meadows or swamps. Several ponds of 
clear water. Frequent fogs in the valleys and near streams." 

Salem. — Consumption very prevalent, and due, in the opinion of 
our correspondent, to three causes, chiefly ; 1st, the character of 
the soil ; 2d, want of proper drainage ; 3d, exposure to harsh 
winds. 

" The soil in this city is, on one side, upon the surface a clay 
loam with a subsoil of damp, heavy clay, which is nearly impervi- 
ous to water ; on the other side, loam with a subsoil of sand very 
pervious to water. The city is bounded on three sides by tide wa- 
ter, and much exposed to harsh east winds. In one locality, where 
consumption is often met with, the ground is high and the soil grav- 
elly ; but on one side of this rising ground is a pond, the water of 
which during the summer becomes very stagnant, its emanations 
necessarily poisoning the air in the neighborhood. A portion of 
the city is made land, which was formerly a marsh. It seems to 
me that a thorough system of drainage would, in a measure, remove 
the unhealthy character of the soil ; but the exposed position, the 
easterly winds, and the dampness which must necessarily arise 
from water on three sides, must always, I think, render this district 
the favorite seat of consumption." 

Stoneham. — " Scarlet fever the only disease which seems to be 



1871.] PUBLIC DOCUMENT— No. 37. 79 

prevalent. For the past fifteen months it has been present. Cases 
of an extra severe type have occurred in well-to-do families as fre- 
quently as in those of the poor. Principal sanitary deficiency of 
the town is want of drainage. There are two tanneries. In the 
warm weather, the open drain connected with these establishments 
gives off very offensive gases. This drain is, in fact, the common 
sewer for a great part of the town, and many privies empty into it. 
It should be arched and covered over with earth." 

[The Secretary can testify to the foul state of the ditch above re- 
ferred to. Its condition has been the subject of fruitless litigation. 
It is certainly the duty of the town authorities to remove this nui- 
sance before it occasions an outbreak of unmanageable disease.] 

" In some boarding-houses in this town, six or eight persons 
occirpy a small bedroom, and it is quite common to find four in one 
room, say thirteen by fourteen feet." 

Taunton. — " Diseases of the respiratory organs have been unusu- 
ally prevalent during the past winter and spring. The late autumn 
and early winter were comparatively mild, and were followed by a 
sudden change to cold and wet weather, which severely affected 
children and aged people. Many of our hale old men died in a 
very few days of congestion of the lungs; and many consumptives, 
who had been getting along tolerably, became exhausted and died. 

" Tubercular affections are constantly under the care of our phy- 
sicians. 

" Taunton lies in a basin encircled by hills from one to three 
hundred feet high. This ridge is complete, excej)t where the river 
causes a break. The Taunton River is tidal, emptying into Mount 
Hope Bay, seventeen miles below. Dense fogs roll up from the 
sea at times, and are retained in this basin, alternating with east- 
erly winds. The land is swampy, and the drainage very imperfect. 
The city is built on the banks of the river, and when the tide is 
out the surface of the water is not more than four or five feet below 
the adjoining land. All the houses are built with cellars six or 
seven feet below the surface of the land. These cellars have from 
six to eighteen inches of water in them for a considererable part of 
the spring. The houses are heated in many instances with fur- 
naces to a temperature of 70 to 74 degrees. 

" When east winds set in, a constant flow of damp air, alternat- 
ing with heated currents, pervades the buildings. Catarrhal affec- 
tions are very frequent ; rheumatism, chlorosis and anaemia appear 
among those who are compelled to remain within doors. 

" It is a prevalent custom to keep the window-blinds constantly 



80 STATE BOARD OF HEALTH. [Jan. 

closed, thereby excluding sunlight. The furniture and closets are 
damp in wet weather, and when the season of fogs sets in, constant 
care is required to keep clothes from mildew." 

Truro. — Consumption prevalent. " I think this is owing to the 
east winds and fogs from the ocean, and also somewhat to the mode 
of living, as there is hut little fresh meat used here." 

Topsfield. — Consumption prevalent. Special cause found in wet 
soil, which may be improved in some degree by drainage The 
soil of the hills, as well as that of the lowlands, is wet. 

Air has been rendered putrid by the emanations from slaughter 
houses which have existed many years in and near the village. 

Tisbury, — " Influenza has been recently very prevalent, affecting 
all ages. Rheumatism, both acute and chronic, is a common disease, 
and doubtless owing to cold and damp, and the occupation of the 
people. Of chronic diseases, dyspepsia is the most universal ; nearly 
every other person you meet suffers from indigestion in some form. 
The causes are chiefly the mode of cooking, and irregularity in 
eating. The frying-pan is in universal requisition. Still I believe 
that the sudden changes of temperature, to which we are subject, 
produce their effect on the digestive organs. We have a large pro- 
portion of ' nervous people,' so called, especially in the upper or 
western part of the island." 

West Newbury. — " The soil a clayey loam, impervious in a great 
degree to moisture. As the hills have been shorn of their natural 
growth, the intervening swamps have become suitable for cultiva- 
tion, but are still wet and cold, until the surface water has run off 
or evaporated. There are very few cellars in town that have not 
water in them during the wet season, and they are almost always 
damp. I have heard many complain this spring of having a foot or 
more of water in their cellars. The consequence is that consump- 
tion in its various forms finds many victims. In the westerly part 
of the town is a swamp two miles long and half a mile wide which 
produces wood, or, if cleared, an inferior grass. By ditching it and 
clearing out an old and useless dam, the whole district would be 
rendered more healthy. The condition of the town, as regards both 
health and prosperity, would be improved by thorough drainage. 

" Air is rendered foul in the neighborhood of comb-shops, from 
the pith of the horns of slaughtered cattle. This is taken out and 



1871.] PUBLIC DOCUMENT— No. 37. 81 

put in piles, making an almost intolerable odor, and constituting a 
nuisance which ought to be abated. " 

Wakefield. — Two severe epidemics of dysentery have occurred in 
the past six years, coming on when the surrounding bogs were 
dried up. Soil usually very wet. Cellars have more or less water 
in them nearly all the time. Houses are damp, — much mould ob- 
served in them. Both epidemics of dysentery were preceded by an 
epidemic of scarlet fever. 

West JBoylston. — Typhoid fever rather prevalent and has been 
for more than twenty years. Cause not obvious. A river town 
with interval lands ascending to beautiful hills. Most of the wood 
cut off. Soil pervious in some parts, impervious in others ; some- 
what springy. Interval lands not well drained. Drainage, much 
neglected. 

Westborough. — " Situation of village low as in a basin, shut off 
from winds, with dry soil and subsoil of quicksand. Typhoid fever 
and consumption much more rare than on the exposed hills around 
us where the ground is wet from a clay subsoil." 

West Roxbury. — Believed to be a more favorable place for con- 
sumptives to live in than many others. The deaths occurring from 
consumption are, in great part, of persons who have- come here to 
live, after being attacked with the disease. 

West Stockbridge. — "Pneumonia and bronchitis are quite preva- 
lent. I attribute this to the occupation of the people more than 
co anything else. The mining of iron ore is the chief business. 
The miners work underground in wet and damp places ; they come 
to the surface in a state of perspiration and are thus subject to sud- 
den changes of atmosphere. This district, like all of Berkshire 
County, is mountainous. The village is situated in a valley with 
a mill-pond in its midst, which in summer is often quite low and 
from which arises offensive effluvia from decaying vegetable matter ; 
yet all the epidemics that I have witnessed here have originated 
and been most severe on the high ground. These epidemics have 
been dysentery, diphtheria and measles. " 

Winthrop. — See remarks under the head of Typhoid Fever. 

Wrentham. — This region seems to be remarkably conducive to 
11 



82 STATE BOARD OF HEALTH. [Jan. 

health ; elevated, well-drained, good water. Excellent natural 
sanitary advantages ; of course, some minor artificial nuisances 
exist ; little attention is paid to the condition of cellars ; drains and 
privies are often in too close proximity to wells, giving rise to dys- 
entery and typhoid. 

Wellfleet. — Affections of the lungs prevalent. The general cause 
is found in locality. Exposure to cold, damp, east winds. Con- 
sumption is more prevalent in the valleys that run across the Cape, 
and on damp soil. 

Weymouth. — Diseases of respiratory organs prevalent ; due in 
great part to location of village ; exposed to east and north-east 
winds. Soil clayey and moist. 

" Bone factory does not tend to purify the air. " 

Walpole. — Our correspondent "refers to the cases of " charhon" or 
" malignant vesicle," which have occurred in Walpole and which are 
separately described in another part of this volume. 

Worcester. — ISTo disease is found to specially prevail during a 
series of years. The proportion of consumption is large, as it is 
everywhere. Smallpox and varioloid have recently been very 
prevalent, but the epidemic has now subsided as vaccination has 
been general. Large numbers of persons at all ages were found to 
be unprotected by vaccination. The opinion is expressed by our 
special correspondent that greater power to enforce vaccination and, 
in case of need, to remove cases to a smallpox hospital should be 
given to local boards of health. 

The subject of drainage is receiving much attention in Worces- 
ter. Through the heart of the city runs a brook which is now 
being enclosed by a covered stone wall, to be used as the main 
sewer. A complete system of sewers is in process of building ; the 
outlet will be the Blackstone River. 

Waltham. — Consumption more prevalent than in some of the 
neighboring agricultural towns, but not more so than in manufac- 
turing towns generally. Waltham is situated in a basin drained 
through its centre by Charles River. Soil generally light and 
porous. 

It is worthy of observation that although the people living in the 
immediate vicinity of the manufactory of sulphuric acid in this 
town are, during every damp day, constantly subjected to an at- 



1871.] PUBLIC DOCUMENT— No. 3T. 83 

mosphere sufficiently charged with sulphurous acid gas to he very- 
irritating to the air-2>assages of a person first coming into it, neither 
they nor the people engaged in the manufactory are apparently in 
any way permanently affected by it. 

Westhampton. — Regarded as an exceedingly healthy town. Soil 
loose and stony. Good elevation. Very hilly. Excellent drain- 
age. Our correspondent is informed that scarlet fever, although 
often present, has been for eighty years past non-malignant, and his 
observation in recent years confirms it. 

Upton. — Lung diseases prevalent. Soil rather dry on the low 
lands and springy on the high lands. Not, on the whole, wet. 

" A very large proportion of the women work on straw goods at 
their homes. From January to June, which is the busy season, 
they often work immoderately. I have theorized that this has been 
one strong predisposing cause of consumption ; 1st, by overtaxing 
the strength ; 2d, by the dust and fumes from the braid (much of 
which has been treated with sulphur and oxalic acid), irritating the 
sensitive throats, exciting cough and opening a road to disease," 



CHARBON IN MASSACHUSETTS, 



AKTHUK H. NICHOLS, M.D., of Boston. 



86 STATE BOARD OF HEALTH. [Jan. 



ON THE OCCURRENCE OE CHARBON, OR MALIGNANT 
VESICLE, IN MASSACHUSETTS. 



In comparing the maladies which affect mankind with those 
to which the lower animals are subject, we cannot fail to be 
impressed with the fact, that it is with the greatest difficulty 
that contagious diseases can be transmitted from the former to 
the latter, and even when the attempt is apparently successful, 
the symptoms invariably assume so mild a type as to be scarcely 
recognizable. Thus, the material containing the poisonous 
element of smallpox, scarlet fever, measles or syphilis has been 
repeatedly introduced into the blood of cattle, horses, sheep, 
dogs and rabbits, in the majority of cases without any visible 
result, and in no instance producing serious symptoms. 

Man, on the other hand, by no means possesses the same im- 
munity with regard to the diseases of inferior animals, for some 
of the most virulent and fatal affections to which we are sub- 
ject, such as hydrophobia and glanders, are derived from dogs, 
horses and cattle, and when once thoroughly established, in a 
large proportion of cases, in spite of all treatment, terminate 
unfavorably. 

In the year 1853, there first appeared in the town of Wal- 
pole, in this State, a most singular disease, which was recog- 
nized by the attending physician as Charbon, or malignant 
vesicle, a malady known from remote antiquity as prevailing 
among animals, but observed among mankind only within a 
comparatively recent period.* 

* A pustular eruption, accompanied with some local inflammation, and caused by the 
inoculation of putrid animal matter, is not uncommon among men employed in discharg- 
ing vessels laden with hides. 

This affection, which resembles an ordinary dissection wound, is sometimes ascribed to 
the action of some of the chemical substances employed in curing the hides, or to the 
bite of an insect which is thought to have been brought with them from South America. 

In these cases the poison is as a rule quickly eliminated without "producing any serious 
results, and differs essentially in its character and effects from that of Charbon, with 
which it may possibly be confounded. 



1871.] PUBLIC DOCUMENT— No. 37. 87 

The same disease has since revisited the same locality at 
irregular intervals, until, at length, during a period of seven- 
teen years, twenty-six cases have come under observation, a 
very able report of which was given by Dr. Silas E. Stone at 
the last meeting of the Massachusetts Medical Society. 

The object of the present paper is to review briefly the symp- 
toms of the disease and the different theories of contagion, and, 
at the same time, enumerate the prophylactic measures which 
have been proposed to arrest its course and avert its recurrence. 

This affection has of late attracted no little attention in 
Europe, where, in certain countries, and particularly in por- 
tions of Prance and Germany, it prevails extensively as an 
epidemic, whereas, in the United States, it is none the less 
interesting from the extreme rarity of its occurrence. 

Different writers give very discordant accounts of the symp- 
toms and morbid anatomy of charbon, so that it is difficult to 
frame an unexceptionable description of the disease. The 
fluctuations of opinion which have at various times prevailed 
on this subject are indeed remarkable ; so that, even now, 
many standard authorities fail to distinguish the different forms 
which the disease is capable of assuming. 

Recent researches, however, have materially diminished the 
uncertainty connected with the matter, and it is now estab- 
lished that the poison of charbon, like that of scarlatina and 
syphilis, may manifest itself in a variety of ways, sometimes 
causing external lesions in the skin, at other times attacking 
the spleen, liver, lungs, or intestines, in all cases, however, 
accompanied by severe constitutional disturbance. The identity 
of the different forms has been demonstrated by the fact that 
the poison of each is respectively capable of producing the 
others. 

I. — Symptoms. 

Charbon is the result of a specific poison introduced into the 
body, and characterized by different symptoms, according to 
the method by which the virus enters the circulation. If im- 
planted on some uncovered part, there is noticed, after a period 
of latency or incubation varying from a few hours to several 
days, a minute red spot or papule, not unlike a flea-bite. 

This point now becomes the seat of a small vesicle which 



88 STATE BOARD OP HEALTH. [Jan. 

soon bursts and dries np, and is afterwards surrounded by- 
other similar concentric vesicles, at first separate, but subse- 
quently confluent, and all running the same course. 

Meanwhile, under and around the base of the original pa- 
pule appears a well-defined layer of thick, hardened tissue, 
involving the thickness of the skin and compared to a disk of 
sole-leather, which creaks when cut with a knife, presenting 
almost as much resistance as cartilage. The cut surfaces have 
the appearance of ordinary fibrous tissue, mottled with black 
pigment. At the same time a peculiar gangrenous inflamma- 
tion, not unlike erysipelas, arises from the point originally 
affected, and spreads in all directions with the greatest rapidity. 
Later, the inflamed tissue becomes firmer and darker, and loses 
all vitality, so that it may be pressed or even pricked without 
the patient being aware of it ; the neighboring lymphatic 
glands become enlarged, delirium sets in, and death ensues 
with the usual symptoms of blood-poisoning. The duration of 
this variety of the disease varies from one to several days. 

In favorable cases, the course of the inflammation is sud- 
denly arrested ; a vivid red circle appears around the gangre- 
nous portion ; the patient feels an agreeable warmth and 
returning pulsation in the affected part, and the dead tissue is 
finally separated from the living, in the form of a brown loz- 
enge, leaving behind a suppurating surface of various extent in 
different cases. [Aitken, Virchow, Smith, Stone.] In rare 
cases, two or more vesicles have been noticed upon different 
parts of the same individual. 

In another variety of the disease the external manifestations 
may be confined to a mere erysipelatous-like inflammation, 
without any vesicle (malignant oedema), while, in a third class 
of cases, death may ensue without gangrene, vesicle, oedema, 
or other external symptom whatsoever, which serves in a mea- 
sure to mask the nature of the malady. 

It must be confessed, the anomalous forms which charbon 
often assumes, and more especially the absence of all external 
lesions, render, at times, the diagnosis of the disease difficult 
if not impossible. 

Virchow * states that he has not unfrequently met with cases 

* Virchow ueber Milzbrand. Handbuch der speciellen Pathologie und Therapie. 
Erlangerj, 1855. II. Band, 1 Abth. 



1871.] PUBLIC DOCUMENT— No. 37. 89 

where suspicious vesicles were present on the neck and face, 
and where death quickly ensued, which would undoubtedly 
have been considered instances of charbon, had they occurred 
in a district where this malady was prevalent. 

II — Symptoms in Animals. 

In animals, as in man, there is not much constitutional dis- 
turbance at the beginning of the disease. The premonitory 
symptoms, according to Virchow, are loss of appetite, a stiff 
gait especially marked in the hind legs, a dejected look, trem- 
bling of the limbs and body, and a weak pulse. These symptoms 
become greatly intensified upon the appearance of the vesicles, 
which may occur in a few hours or not for several days. The 
pulse then increases in frequency, the temperature is raised and 
the respiration hurried. With the complete formation of the 
vesicle, the crisis of the disease is usually reached, and the 
unfavorable symptoms either abate, while the vesicle shrinks 
and disappears with the diminution of the fever, or, in other 
cases, a sort of gangrene attacks the affected part and death 
rapidly ensues. In other forms of this affection, as in man, 
death may be sudden and unaccompanied by vesicles, swelling, 
or other local manifestation. 

In the so-called Apoplexia Carbunculosa, for instance, the 
strongest animals of a herd, while feeding, or at work, are 
at times attacked with dyspnoea, trembling, cramps and 
bloody discharges from mouth and nose, and succumb, 
either at once or in the course of the day. In other cases, the 
malady seems to bear a close resemblance to hydrophobia. 
Here the animals snap, bite, run and finally fall into a kind of 
fit, which may be followed by partial paralysis, and results 
fatally in one or two days. 

It has been considered by some that the virulence of the at- 
tack depends upon the appearance of the vesicles. Garreau, 
for example who inclines to this theory, reports that of 118 cat- 
tle affected with charbon, 112, in which no external manifesta- 
tions were noticed, died, whereas six upon which vescicles were 
formed, recovered. In horses, as in man, there seldom arises 
more than one collection of vesicles, but in cattle, several are 
frequently found upon spots remote from each other. 

It has been noticed that, as in the cattle-plague, the poison 

12 



90 STATE BOARD OF HEALTH. [Jan. 

varies greatly in intensity at different times, as is indicated by 
the marked difference in the severity of the symptoms. It is 
remarkable, moreover, that, as in the former disease, not the 
feeble, but rather the stout, well-nourished beasts are selected 
as the victims. 

While the progress of the disease is generally arrested by a 
very low degree of temperature, a warm, moist atmosphere is 
thought to be favorable to its advance. 

III. — Of the Moebid Changes in the Tissues and Inter- 
nal Organs. 

These are almost identical in man and in animals. The prin- 
cipal seat of the disease appears to be the blood, for the changes 
in this fluid are uniformly the same. It is found to be darker 
and thicker than in health, sometimes having almost the color 
and consistence of tar, and being filled with minute parasitic 
growths known as bacteria. The spleen has also been found in 
most cases to be the seat of serious changes, forming the chief 
reservoir of the poison as in intermittent or typhoid fever. 
This organ is enlarged, and distended with dark-colored blood, 
while its substance is softened and at times almost fluid; and 
such is the constancy with which these changes are found that 
in France the name " sang- du rate " has been given to the dis- 
ease. The liver, lungs, kidneys and veins are all found to be 
distended and gorged with blood. In the venous system, this 
distension is best marked in the vessels of the subcutaneous 
tissue, intestines and lymphatic glands, while in all these local- 
ities ecchymosed patches are found, extending, in the case of 
the subcutaneous tissue, deep down between the muscles. 

In the thoracic and abdominal cavities of animals, has been 
noticed a peculiar yellow, serous-like fluid which at times be- 
comes almost gelatiniform, and which has been proved to be in- 
tensely virulent when introduced into the bodies of other ani- 
mals. In man, however, while the changes in the lymphatic 
glands, and especially those in the immediate vicinity of the 
vesicles, is more frequent than in the cases of animals, the 
spleen and liver are less commonly affected, while the serous 
effusion in the thoracic and abdominal cavities is rare. 

With regard to the situation of the vesicles, it is to be observed 
that the parts of the body which are usually uncovered (as the 



1871.] PUBLIC DOCUMENT— No. 37. 91 

face, neck, chest, arms, head, and, in certain trades, the feet), 
are almost exclusively affected. The disease, it is true, some- 
times appears in other situations, but always under such cir- 
cumstances that the apparent exceptions only confirm this fact. 
Thus, it is reported that a butcher, in slaughtering a diseased 
animal, placed a soiled knife between his teeth, and the malady 
appeared in the mouth. Again, the blood of a slaughtered 
beast trickled down the back of a man who was carrying it, 
and the disease broke out in the parts with which the blood 
had come in contact. 

IV. — Theoretical Considerations as to the Nature op the 
Morbid Poison or Contagidm in Charbon. 

The nature and origin of specific virus or contagium in char- 
bon, as well as in other contagious diseases, has of late attracted 
the attention of several eminent observers, and although this 
whole problem is still involved in considerable obscurity, yet 
many of the physical properties of the poisonous principle have 
been demonstrated by careful experiments, the results of which 
there is reason to believe, will pave the way for additional and 
more practical conclusions. 

The following summary of the facts and observations regard- 
ing the contagious principle, and the nature of the contagious 
process appears in a recent report* of Dr. Burdon Sanderson 
on the " Intimate Pathology of Contagion." It serves to give 
an idea how great advance has been made in this important 
field, and thus has a direct bearing upon our subject. 

There are different liquids, existing in the diseased body, and 
characteristic of the various contagious affections, which, being 
introduced into the healthy body, have the property of repro- 
ducing the disease. It was with some of these infecting liquids 
that the experiments referred to were made, and vaccine lymph, 
being the most familiar, is selected as an example. 

Dr. Lionel S. Beale first called attention, in the year 1864, to 
the existence in vaccine matter, of certain minute particles, 
transparent and of spheroidal form. These he regarded as liv- 
ing or germinal matter, and advanced the theory that they 
might contain the contagious principle. The same bodies were 
also recognized independently, about the same time, by Professor 

* Twelth Annual Report of the Medical Officer of the Privy Council. 



92 STATE BOARD OF HEALTH. [Jan. 

Chauveau* of Lyons, who carried the investigation still further, 
and demonstrated conclusively that the activity of the vaccine 
matter is contained exclusively in these particles. M. Chau- 
veau starting with these elements of vaccine lymph, viz., the 
recently discovered particles, the larger bodies, known as leu- 
cocytes, and the serum which holds them in suspension, proved, 

First, — that the leucocytes when separated from the serum 
by simply allowing them to subside are absolutely inactive when 
employed for inoculation. 

Second, — all the soluble elements of the lymph were next 
separated (by the so-called method of diffusion), and it was 
shown by repeated experiments on children and animals, that 
the soluble constituents, like the leucocytes, produce no result. 

Third, — that the minute particles above described are insolu- 
ble, and that moreover the activity of the vaccine lymph de- 
pends entirely upon their presence. 

These experiments were subsequently completely verified by 
Dr. Sanderson, and disprove the previously accepted theory, 
namely, that because vaccine matter is transparent, and more- 
over is most active when most transparent, that therefore the 
contagious principle must be soluble. 

The elements of the contagious liquid of sheep-pox were 
examined in the same manner, and with equally satisfactory 
results. In this malady, it appeared that the infecting liquid 
is much more concentrated than in the case of smallpox, as 
illustrated by the fact that while in the former affection the 
liquid can be diluted with only ten times as much water without 
losing its activity, in the latter, three hundred times its weight 
of water may be added, without impairing its infecting quality. 

If in the above cases the dilution is carried to a still greater 
degree, the chances of a successful inoculation are proportion- 
ately diminished, or, in other words, the greater the quantity 
of water added, the greater the chances of failure ; but what- 
ever the degree of dilution, the effect produced (provided any 
effect is produced), is invariably the same. These effects of 
dilution afford the strongest evidence that the contagious prin- 
ciple is composed of separate particles, and moreover does not 
possess the physical properties of a vapor, for no other hypothe- 

* Determination experimentale dis e^ments qui constituent le principe de la s^'rosit^ 
vaccinale virulente. Comptes Rendues, LXVIII., 1808, p. 289. 



1871.] PUBLIC DOCUMENT— No. 37. 93 

sis can be framed which tallies with the combination of phe- 
nomena here presented. 

The assumption that the infecting virus is volatile, inasmuch 
as its effects are exercised at a considerable distance from its 
source, is then no longer tenable. 

As to the specific gravity of the above particles, we are justi- 
fied in inferring, that it must be the same as the fluid in which 
they are suspended, inasmuch as there is little or no disposition 
on their part to subside, so that however long the fluid contain- 
ing the virus is allowed to stand the superficial layers remain as 
active as those beneath. 

Another and more difficult problem is whether the particles 
of contagium owe their specific power to the fact that they are 
organized, and possess in themselves vitality, or whether their 
qualities are to be ascribed to their chemical composition. This 
question is purely a speculative one, and as yet involved in very 
great doubt. 

Dr. Sanderson maintains that the phenomena of contagion, 
as manifested by the multiplication of the particles in the body 
is totally unlike any chemical change with which we are famil 
iar. On the other hand if we assume the contagious princi- 
ple to be a living, organic ferment, having the power of multi- 
plication when deposited in living tissues, and that its simple 
transference will therefore be the exciting cause of the disease, 
then most of the phenomena to be accounted for may be ex- 
plained in a very satisfactory manner. It is not necessary to 
assume that the blood-poisoning is the immediate result of the 
multiplication of the virus cells. On the contrary, from what 
is known with regard to the familiar ferment, yeast, it would 
seem more probable that this poisoning is the result of some 
chemical change in the constituents of the blood, caused by the 
growth of these cells within it. In yeast, for instance, we 
know that as the cells multiply, they absorb sugar, and secrete 
alcohol and carbonic acid, and it is not unreasonable to infer 
that, in a similar manner, the virus cells are nourished by ex- 
tracting some substance from the blood and secreting in turn 
another substance, the presence of which has the effect of a 
blood poison. 

There is every reason to hope that the experimental study of 
the various forms and metamorphoses of the organic substances 



94 STATE BOARD OF HEALTH. [Jan. 

found in contagious matter, and the chemical changes which 
take place in them may in the end throw much additional light 
on the process of infection. In this connection may be men- 
tioned the researches of Davaine and Hallier, who believe that 
certain organic forms known as bacteria and microzomes found 
in the contagious fluid, and which, when transferred to the 
blood of healthy from that of diseased animals, have the power 
of reproducing the disease, are identical with the contagious 
particles. M. Davaine claims to have proved, by experiments 
similar to those of M. Chauveau with vaccine lymph, that the 
poisonous element of charbon resides exclusively in these bac- 
teria, and that when they are eliminated from the blood, the 
latter no longer retains its poisonous power. These organic 
forms (bacteria) are described by Hallier as consisting of cells 
either spheroidal or of the form of a short cylinder, and en- 
dowed with a peculiar progressive oscillatory movement. It 
has been demonstrated by Dr. Edward Schwarz* of Vienna 
that these cells are formed under certain conditions from still 
smaller organisms known as micrococci (microzymes) or micro- 
spores which have the appearance of minute round cells, filled 
with a transparent liquid and containing several nuclei. They 
differ in no respect from those spores or germs deposited in cer- 
tain states of the atmosphere upon the moist surfaces of bread, 
vegetables and the like. It should not be overlooked, however, 
that these different parasitic growths have been found in the 
body in health, and they moreover accompany nearly every 
disease characterized by blood-poisoning. 

Thus, bacteria are found in the blood in hydrophobia, glan- 
ders, syphilis and snake poisoning ; micrococci abound in the 
blood in recurrent fever, and are still more numerous in scarlet 
fever ; they are contained in the pustules of smallpox and 
cow-pox ; also in the sputa in case of measles, and the alvine 
liquid of dysentery. As no specific difference exists in the 
appearance of these organic growths in the various diseases it is 
not pretended that the different contagia can be distinguished 
from each other. Inasmuch, however, as it has been noticed 
that under certain circumstances, the metamorphoses they un- 
dergo are essentially different, it is therefore claimed by Hallier 
that a distinction may be eventually found upon the different 

* Wiener Med. Zeitung, April 3, 1870. 



1871.] PUBLIC DOCUMENT— No. 37. 95 

forms to which they gradually unfold. If this distinction can 
be demonstrated, it will, of course, indicate that a most inti- 
mate relation exists between the germs, and the different dis- 
eases in which they are found. 

Other eminent observers, on the other hand, claim that no 
great importance should be attached to the presence of these 
organic growths in the blood, because, as has already been 
noticed, they are found in the body in health as well as in disease, 
and though multiplied greatly in certain diseases, they are 
really but harmless concomitants of the disease, acting as 
poisonous agents only by serving as rafts for transferring the 
morbid material. They maintain that these so-called germs, 
whatever may be their origin, remain passive or latent in the 
healthy body, but when, in certain morbid conditions, the blood 
and other fluids become diseased, they find therein an appro- 
priate pabulum, by absorbing which they are nourished and 
multiplied just as, in the forests, certain vegetable fungi flour- 
ish only upon the trunks of dead and decaying trees and 
plants. 

This view is thus forcibly expressed in a recent work* by Mr. 
Lionel S. Beale : — 

" In various cases in which certain fungi do actually invade our 
tissues, the evidence of change in these last having occurred prior 
to the development of the fungi is sometimes so distinct, that, so 
far from the fungus attacking a healthy structure, and damaging it, 
the structure itself had deteriorated and changed or had undergone 
morbid derangement ere it was invaded. 

" By decay it would appear that it had become converted into 
material adapted for the nutrition of the fungi, the growth of which 
had been effectually resisted as long as the tissues remained 
healthy. If this be so, the fungi cannot be regarded as the cause 
of the disease, any more than the vultures which devour the 
carcass of a dead man can be looked upon as the cause of his 
death." 

None the less weighty are the objections urged by Dr. Rich- 
ardson of London in a recent address. 

" The germ theory fails altogether to account for the immunity 
from recurrence of the communicable diseases, such as scarlet fever 
* Disease Germs. L. S. Beale. London, 1870. 



96 STATE BOARD OF HEALTH. [Jan. 

and smallpox, by virtue of a previous attack. Why cannot persis- 
tent organisms, which ever reproduce themselves in suitable soil, 
reoccupy the same soil, and live and reproduce there again ? Can 
they not enter the body a second time ? Or, entering it cannot they 
re-assert their activity ? Can a man be charged with germs of small- 
pox or scarlet fever and remain unaffected by them? Again, if 
germs, capable of independent multiplication, are the cause of the 
diseases, why should there be recovery at all when once the body 
becomes jnfected ? If the theory were true, then the body infected 
with organisms which, so long as they find a soil, are reproducible, 
should have no chance of recovery ; for what is to prevent the 
continuance of the process of reproduction ? But the facts are, 
that the majority of persons suffering from communicable diseases 
recover." 

From the above quotations it will be seen that neither the vi- 
tal nor the chemical or physical theory of the origin of com- 
municable diseases is as yet satisfactorily demonstrated. Nor 
can either of these thories be accepted or rejected till additional 
investigations have increased our knowledge of the exact origin 
of microzymes. The problems to be solved are thus stated by 
Dr. Sanderson : — 

" Do microzymes naturally exist as particles of living tissue, and 
thus take part not only in morbid processes, but in the performance 
of the normal functions, or are they originally morbid and imported 
into the body from without, being derived from the tissues or or- 
gans of other infected individuals, or produced by the transforma- 
tion of the contents of the reproductive cells of the parasitic fungi 
nhabiting the higher plants ? / 

" (a.) Is it true that the destructive parasites which inhabit the 
tissues of many of our common plants produce microzymes by a 
normal process of development ? 

" (b.) Are such microzymes respectively endowed with destruc- 
tive morbific properties ? 

" (c.) Is it true that microzymes take part in any of the normal 
chemical functions, especially those which relate to the transforma- 
tion of the albuminous compounds ? 

" (d.) Can they arise de novo in living tissues in mere conse- 
quence of impaired activity of nutrition ? " 

Meanwhile it must be acknowledged that there are very 



1871.] PUBLIC DOCUMENT— No. 3T. 97 

strong grounds for inferring that the virus of charbon, like that 
of vaccine lymph and cow-pox, consists of minute organic mat- 
ter of unknown origin which, under certain conditions, instead 
of undergoing chemical decomposition, is capable of preserving 
its activity outside the body and of being transferred as solid 
particles from place to place ; but, having been introduced into 
the blood, becomes developed and multiplied, and thus causes 
the characteristic symptoms. 

This hypothesis, if accepted, is sufficient to enable us to ex- 
plain how the disease may be communicated, and how, by the 
aid of certain chemical compounds, contagious matter may be 
neutralized or destroyed. 

V. — Methods and Sources of Infection. 

While most writers have considered that in animals charbon 
may originate spontaneously, like intermittent fever in man, 
from miasmatic emanations, yet it has been established by re- 
peated observations, that the districts in which the disease pre- 
vails as a epizootic, have not been characterized by any marked 
peculiarity either of climate or soil. On the contrary, it has 
been known to break out spontaneously in the most elevated 
regions as well as in marshy districts ; in cultivated as well as 
in uncultivated tracts ; in barns as well as in the open air. 

M. Davaine, who has had unequalled facilities for investigat- 
ing this disease in France, has undertaken to demonstrate that 
flies prove the chief source of the contagion, by sucking the 
blood of an infected animal and thence conveying the poison to 
others. Those insects, especially, which are armed with pierc- 
ing probosces, seem qualified for transferring the poison in this 
way, but it is also possible that the wings and feet of ordinary 
flies may serve as rafts to convey the poisonous matter to the 
bodies of both animals and men. 

But whatever may be the facts regarding the origin of the 
disease in animals, the great mass of testimony goes to prove 
that, in our race, the poison is exotic, being derived invariably 
from some of the lower animals, and the affection is most viru- 
lent when communicated by direct inoculation from horses and 
cattle, either during their life or shortly after their death. As 
the poison adhering to the various tissues of the animal is by 
no means destroyed when dried, or macerated in water, it is 
13 



98 STATE BOARD OF HEALTH. [Jan. 

not surprising that the persons most commonly affected with 
the disease are those whose occupation brings them in frequent 
contact with animals or animal remains, such, for example, as 
butchers, tanners, drovers, herdsmen, soap-boilers, manufac- 
turers of glue, and workers in wool and horse-hair. 

It is not essential that the poison should be deposited in a 
wound or on an excoriated surface, for experience has shown 
that a drop of blood or serum from a diseased animal, placed 
upon the skin, may in a short time cause the formation of a 
vesicle and the attendant symptoms. 

Nothing can indicate more clearly the possible modes of in- 
fection than the report of the cases occurring in the practice of 
Dr. A. H. Smith* at Las Cruces, New Mexico: — 

" Two men were engaged in skinning an animal which had died 
of the distemper. One of them had a pimple on the face which he 
had scratched with his nails till it bled. The other had received a 
scratch from a thorn in passing through the chaparral. The day 
was extremely warm, and the men frequently wiped the perspira- 
tion from their faces with their hands, covered, as they were, with 
the fluids from th^animal. In a few hours vesicles were developed 
upon the abraded surfaces in both individuals." # * * * " One 
case, occurring in the hand, made its appearance immediately after 
handling a number of dry hides." * * * * " In another in- 
stance, the source of infection was a goat which, having the symp- 
toms of the distemper, was killed, and the flesh eaten by the family. 
Although several persons ate the meat, that one alone was affected 
who prepared it for the table." 

Equally instructive are the cases reported by Dr. Pennock, 
occurring in Philadelphia. Here, one man, while engaged in 
skinning a cow that had died a few hours before, was bitten on 
the thumb by a mosquito. He scratched the bitten spot with 
the bloody fingers of the other hand, and four days afterward a 
vesicle was observed on this spot. Another man received a 
slight wound on his left hand while handling the same cow, 
and four days afterward a vesicle appeared on the spot of the 
incision. 

Instances like these might be multiplied indefinitely, but the 
above are sufficient to illustrate how all objects which have 

* Amer. Journal of Med. Sciences, Vol. LIII. 



1871.] PUBLIC DOCUMENT— No. 37. 99 

been in contact with the blood, hair or carcasses of diseased 
animals may be the means of communicating the disease to 
others. 

They will also explain those singular cases recorded by Hil- 
debrandt, in which dogs ate with impunity the flesh of animals 
which had died of charbon, but communicated the disease, by 
biting, to cattle and horses. 

The question as to whether the flesh of animals that have 
died of charbon can be eaten with impunity has been discussed 
at length by those who have given this subject their attention. 
While numerous instances are on record in which the carcasses 
of diseased animals have been served to soldiers and others, in 
large quantities, without producing any bad results, exceptional 
cases are related by Pournier and Amnion,* where death quickly 
followed after eating such meat, although evidence is here want- 
ing to show that this meat was thoroughly cooked. 

Another not less interesting problem is whether charbon is 
transmissible from one human being to another, or whether the 
poison is exhausted in man, and here again the testimony of 
authorities is somewhat discordant. Thomassinf relates a case 
where a woman contracted the disease from direct contact with 
her husband, and similar instances are quoted by FournierJ 
and Stone, § while Heilbach |[ reports an instance where the 
malady was apparently communicated by a child to its mother. 

It will be admitted, however, that these instances are of 
so very rare occurrence as to justify the conclusion that the 
danger of contagion from this source must be exceedingly small. 

YI. — Observations on the Epidemic at Walpole. 
» If we turn now to the consideration of the disease as it has 
prevailed at Walpole it will appear that in August, 1853, a 
workman in a certain factory was taken suddenly ill, and died 
two days after, a well-marked characteristic vesicle having in 
the meanwhile appeared. 

No other similar case is known to have occurred until April, 
1861, when another man expired after an illness of twenty-four 

* Unterricht iiber den Milzbrand, Amnion, p. 60. 

t Thomassin. Diss, sur le charb. Malin., p. 31. 

\ Fournier. Observ. et Exper. sur le charb., Malin., p. 9. 

§ Stone. Publications of the Mass. Med. Society, Vol. III., p. 84. 

|| Heilbach, Diss. Inaug. de carb. malig. Berol., p. 16. 



100 



STATE BOARD OF HEALTH. 



[Jan. 



hours, having obscure symptoms of blood-poisoning, but with- 
out the appearance of any vesicle. Two months later, this was 
followed by another case, accompanied by a vesicle upon the neck. 

These scattering cases attracted at that time but little atten- 
tion, and the disease seems to have stopped here, without recur- 
rence to any process of disinfection. 

In March, 1866, another operative died, manifesting unmis- 
takable symptoms of charbon, and from that time till July, 
1869, the malady seems to have lurked about this same factory, 
indicating its presence at pretty regular intervals. During this 
period seven or eight cases have occurred each year, the average 
number of operatives employed being about eighty. 

The following table (taken from the report of Dr. Stone) 
will indicate the total number of cases that have been observed 
up to the present time,* the particular varieties of the malady 
and the results : — 



Malignant Vesicle, , 
Internal Lesions, 
Malignant (Edema, 
Total, 



14 



10 
2 



12 



15 

10 
1 



26 



The annexed list shows the seat of the vesicles, which were 
invariably upon an exposed part : — 

Neck, 6 

Face, 5 

Shoulder, 1 

Nose, 1 

Scalp, 1 

Arm, 1 

The malignant character of the malady will be appreciated 
when it is observed that of the fatal cases, five succumbed 
within twenty-four hours of the attack, in none of which, by the 
way, were any vesicles formed. If, now, we attempt to seek 

* November, 1870. 



1871.] PUBLIC DOCUMENT— No. 37. 101 

the source of the contagion in these instances, we shall be at 
once struck by the fact that of the above twenty-six patients, 
twenty-four were employed in manufacturing curled hair. Of 
the other two, one was a carpenter who, a short time previous 
to his attack, had worked about the buildings connected with 
the factory, and the other was seized shortly after having 
nursed her husband who had been ill with the same malady. 
The fact that no other similar cases are known to have occurred 
in the town or in the State, and that in these the symptoms 
were nearly all unmistakable, lead to the conviction that the 
materies morbi was here introduced into the town through the 
medium of the hair employed in the factory. 

This hair is sheared from the necks and tails of living wild 
horses, and is imported in bales, for the most part from Buenos 
Ayres, a small portion only being brought from Europe. 

At the factory it is taken from the bales, picked apart by 
hand and sorted according to the quality and color, and then 
passed through a picking machine which separates the indi- 
vidual hairs and removes all foreign substances. It is next 
spun into ropes, boiled and finally dried in a heated compart- 
ment, by which the curl is set, and the ropes are now coiled and 
forwarded to the warehouse. During all these processes, the 
hands of the operatives are brought constantly in contact with 
the hair, while in the vicinity of the picking machine, the air is 
loaded with minute particles of dried animal matter, so that 
there is every facility for absorbing the poison by both contact 
and inhalation. There is a decided difference in the qualities 
of the hair imported, some specimens being quite clean, while 
others are often matted together with dirt and putrid animal 
matter. 

Portions of this animal matter have been repeatedly intro- 
duced into the bodies of rabbits without producing any charac- 
teristic effects, and there are therefore no sufficient grounds for 
the belief that any of this unclean hair was charged with the 
virus of charbon, and the nature of the poison must, in the 
present state of our knowledge, render it impossible to distin- 
guish hair that is thus infected from that of sound animals 
unless recourse is had to actual inoculations. 

For a long while it was found difficult to convince many that 
the disease was in any way connected with the hair, and the 



102 STATE BOARD OF HEALTH. [Jan. 

rarity of its occurrence, compared with the number of those 
exposed, was urged as an objection to this theory. To this, the 
obvious reply is, that the immunity of those who escape merely 
shows the susceptibility of the human race to contract the dis- 
ease is small, and serves to illustrate one of the well-known 
laws of morbid poisons, viz. : " that many individuals are un- 
susceptible of their influence in the absence, at least, of pecu- 
liar predisposing causes." In hydrophobia, for instance, ac- 
cording to Hunter and Vaughan, only one out of twenty or 
thirty bitten by mad dogs contract the disease. 

There are other and larger factories in New York, Philadel- 
phia and Baltimore all of which obtain their supplies of hair 
from the very same sources. 

When a cargo of hair arrives at New York, it is at once dis- 
tributed among these different factories, and it has therefore 
been urged that it is somewhat remarkable, that, if large quan- 
tities of diseased hair were imported, all of it should have found 
its way to Walpole, and it is certain that the most careful in- 
quiry has failed to discover a single instance of the disease or 
anything resembling it, in any other factory. Merchants em- 
ployed in importing the hair in vessels to this country assert 
that no cases of the disease have ever occurred, to their knowl- 
edge, while, at the place of export in South America, persons 
have been known to be engaged for years in constantly hand- 
ling the hair, without being aware of any bad effects therefrom. 
It must be remembered, however, that it is by no means neces- 
sary to assume that any very large amount of diseased hair has 
been imported, to account for the Walpole manifestations. We 
have already seen that the materies morbi, when dried may re- 
tain its activity for an indefinite period. Now throwing aside 
the three cases that occurred in 1851-1853, if we have reason 
to think that the hair of one affected animal was introduced 
into the factory at the beginning of the year 1866, it will be 
possible to account for the cases which have occurred since that 
time. We have only to suppose the morbific matter attached 
to the hair of one diseased horse to have entered the buildings 
at that time, and to have been scattered about the walls and 
floors by the process of manufacture ; that it was afterwards 
stirred up from time to time and conveyed by means of the 



1871.] PUBLIC DOCUMENT— No. 37. 103 

hands or through the medium of the air to some portion of the 
body of an operative, and thus to have inoculated the disease. 

This view will appear more plausible when it is considered 
that during this period, no efficient means were taken to disin- 
fect the buildings, and that since a thorough disinfecting proc- 
ess was adopted, but one mild case of the disease has taken 
place, although a period of sixteen months has now elapsed. 

As has been previously mentioned charbon is very seldom 
met with in the United States, so that there are but few instan- 
ces on record where it has prevailed to any extent. 

In the autumn of 1834, an epizootic of this nature broke out 
among cattle in and around Philadelphia, and the poison was 
communicated to several persons who had been engaged in 
skinning the dead bodies of these animals. Four of these cases, 
which occurred in the practice of Dr. C. W. Pennock were re- 
ported at length in the Amer. Jour. Med. Sciences.* 

The same distemper appeared among cattle in the vicinity of 
Las Cruces, New Mexico, in the summer of 1865, and here, 
again, was communicated to quite a number of individuals, the 
mode of infection being in many instances demonstrated be- 
yond a doubt. A very clear account of these cases, by Dr. A. 
H. Smith, will be found in the same journal. f 

Dr. A. L. Pierson of Salem, states that the malady occurred 
formerly in that city every few years, generally among men en- 
gaged in unloading hides from vessels, or among curriers and 
tanners. He gives a brief account of five of these cases in one 
of the numbers of the Boston Medical and Surgical Journal 
for 1852,$ one of which is here given : — 

"On the 29th of October, 1850, I visited an Irishman of previous 
good health and temperate habits, with a sore on the chin, looking 
like an abrasion with a margin of vesication. He had left off his 
work as a journeyman currier the day before, on account of feeling 
unwell. The margin of the sore was very hard, purple and hot. 
The tumefaction and induration of cellular membrane rapidly ex- 
tended, without the least abatement, during the five following days. 
The whole front of the neck became turgid, the eyes nearly closed, 
the cheeks and parotid glands distended, and at the period of death 
it had reached the clavicles. No suppuration evinced itself in any 
part of the swelling. The pulse grew fearfully rapid, the respira- 

* Vol. XIX., p. 13, 1836. f Vol. XXXIV., p 481, 1867. } Vol. XL VII., p. 75. 



104 STATE BOARD OF HEALTH. [Jan. 

tion hurried, the heat of the skin was intense, the mind wandered 
on the last three days, and death took place on the fifth day of my 
attendance." 

Some of the other cases reported by this gentleman would, I 
am inclined to think, be more properly included under the 
head of malignant carbuncle, a totally different affection. 

Although other establishments in this country have fortu- 
nately not been visited with this malady, similar factories in 
Europe have not enjoyed the same immunity. Trousseau* 
narrates that in two French factories for working up horse-hair 
imported from South America, in which from six to eight hands 
were, on the average, employed, there were twenty deaths from 
charbon in the course of ten years. 

In Chelius' System of Surgery ,f a brief allusion is made to 
two similar cases occurring among operatives in a horse-hair 
manufactory. 

VII. — On the Value and Application of Disinfectants or 

Antiseptics. 

We have already learned from the experiments of Beale, 
Hallier, Sanderson and Davaine what (for the present at least) 
may be assumed as the nature and properties of the poisonous 
element in charbon, and we are now the better prepared to con- 
sider the more practical part of the inquiry, viz. : whether the 
agents known as disinfectants and antiseptics really exert a 
decided and powerful action upon organic matter and vital 
phenomena. 

This question is discussed by R. Angus Smith, F. R. S. and 
William Crookes, F. R. S., in their very elaborate and exhaus- 
tive report^ on the cattle plague in England, giving the results 
of a series of careful experiments to demonstrate the compara- 
tive value of different disinfecting and antiseptic agents, such 
as chlorine, ozone, sulphurous acid and the tar acids. 

The term " disinfectants " is meant to apply to those sub- 
stances, which neutralize or destroy animal poisons by oxidation 
or some similar action. One of the most active and common 
disinfectants is heat. Clothing, wool, hair and similar sub- 

* Gaz. Medic. 1847. Feb. No. 4. 

t Vol. I, p. 69. 

X Report from Commissioners; Cattle Plague. Vol. XXII, p. 187, London, 1866. 



1871.] PUBLIC DOCUMENT— No. 37. 105 

stances placed in boiling water half an hour become thoroughly 
disinfected, inasmuch as the vitality of all organic cells must 
in this way be destroyed. 

" Antiseptics " include those agents which prevent chemical 
change by destroying the tendency to putrefy or ferment. Such 
is the action of carbolic acid in preserving meat.* 

These experiments were made upon skins, hides, meat, yeast, 
air and infected matter, and some of the most decisive are here 
quoted. 

" I. A few drops of carbolic acid, added to a half a pint of 
sugar syrup and yeast in full action immediately put a stop to fer- 
mentation. 

" II. Fresh brewers' yeast was washed with a solution of one per 
cent, of carbolic acid and then with water. Its power of inducing 
fermentation in solution of sugar was entirely destroyed, although 
no perceptible change in the appearance of the yeast-cells could be 
detected under the microscope. The experiment was repeated 
several times, and always with the same result, although when the 
yeast was simply washed in water, it readily induced fermentation." 

The above experiments prove conclusively that carbolic acid 
has a special action on the fermentation induced by organic 
matter; it not only arrests it instantly when in progress, but it 
prevents the development of futu/e fermentation. 

From still other experiments, it is demonstrated that carbolic 
acid acts, not as sulphurous acid is thought to do, by retarding 
oxidation through its affinity for oxygen, nor, on the other hand, 
does it possess the power of coagulating albumen. It must, 
therefore, be admitted that it attacks the vitality of organic 
substances in some manner which as yet remains unexplained. 

The following illustrates the action of this subtance (carbolic 
acid) on organic life. 

" III. Cheese mites were immersed in water where they lay for 
several hours. A few drops of a solution of carbolic acid, contain- 
ing one per cent, killed them instantly. 

" IV. An aqueous solution of carbolic acid was added to water 
in which a small fish was swimming; it proved fatal in a few 
minutes. 

* Antiseptics have been called also by Dr. Angus Smith " colytics " from k<oUw, I 
arrest. 

14 



106 STATE BOARD OP HEALTH. [Jan. 

" V. A very minute quantity of a weak solution of carbolic acid 
was added under the microscope to water containing various infu- 
soria, such as bacteria, vibrious amoebcea, etc. 

" The acid proved instantly fatal, arresting the movement of the 
animalcules at once. These animalcules are the almost invariable 
accompaniments of putrefactive fermentation. 

" The above experiment has been tried with putrid blood, sour 
paste and decayed cheese, and in every instance, the destruction of 
vitality and the arrest of putrefaction have been simultaneous. 

" VI. Caterpillars, beetles, crickets, fleas, moths and gnats were 
covered with a glass, the inside of which was smeared with carbolic 
acid. The vapor proved quickly fatal. 

" It is also recorded by Dr. Lemaire that the vapor of carbolic 
acid will kill flies, ants and their eggs, lice, bugs, ticks, acari, and 
mosquitos and other insects of this size. 

"VII. French experimentalists have repeatedly tested the in- 
fluence on vaccine lymph of carbolic acid. They have employed 
lymph both pure, and mixed with a trace of carbolic acid. The 
vaccination with pure lymph was followed by tbe usual results, but 
in no instance was any effect produced by the lymph containing 
carbolic acid." 

The following experiment tends to show a similarity between 
the action of vaccinal virus and that of the cattle plague. 

The air from a close, highly infected shed, containing animals 
in the last stage of the disease, was drawn through glass tubes 
containing tufts of cotton wool, in the expectation that some of 
the virus cells supposed to be floating about in the air would 
be arrested by the wool. One piece of the infected wool was 
then exposed for half an hour to the vapor of carbolic acid. 
Two apparently healthy calves were then selected, and an in- 
cision being made beneath the skin, these pieces of wool were 
respectively inserted in each. The animal thus inoculated with 
the infected wool, which had been exposed to carbolic acid, re- 
mained perfectly well, but the other animal took the disease 
and died in a few days.* 

"VIII. Experiments made upon farms in regions where the 
cattle plague was raging have afforded complete proof of carbolic 
disinfection. In some instances, the cattle upon properly disinfected 

* As the plague was raging in the vicinity, it is possible that the calf which died did 
take the disease from the wool. — W. C. 



1871.] PUBLIC DOCUMENT— No. 37. 107 

farms have remained perfectly healthy, although whole herds were 
attacked and swept off upon farms a few hundred feet distant, 
which were not disinfected. 

" In other instances, where the plague had appeared upon a farm, 
and the premises were subsequently disinfected, the disease seems 
to have been suddenly arrested. It appeared, moreover, that when 
a plague did enter a disinfected shed, it lost, in a great measure, its 
virulence, and was deprived of its infectious character. In one in- 
stance, forty-five disinfected animals were turned out to grass, and 
at the same time removed from the protecting influence of carbolic 
acid. "Within a few days, the plague attacked and killed the whole 
of them." 

After many practical trials, and a full consideration of the 
relative merits of the principal disinfectants, Mr. Crookes has 
concluded that, — 

" Chlorine and ozone have the power of converting animal 
poisons into simple and innocuous substances by their property of 
oxidation. That the tar acids neither accelerate nor interrupt oxi- 
dization, but they act most powerfully in arresting all kinds of 
fermentative and putrefactive changes, and annihilate with the 
greatest certainty all the lower forms of animal life." 

"That the most powerful, and at the same time most simple, 
process of disinfection, applicable to living beings, as well as build- 
ings, is to employ the tar acids,* as constant aeriform and liquid 
disinfectants." 

The positive and satisfactory nature of these results indicates 
very clearly the importance of resorting at once to energetic 
measures of disinfection, whenever there is reason to suppose 
that any infected hair exists in a factory, like that at Walpole. 
These measures may be briefly summarized as follows : 
I. All suspected hair should be thoroughly disinfected, 
either by boiling for one-half hour, or by wetting with a solution 
of carbolic acid in proportions of two ounces to one gallon of 
water. 

*The tar acids are. known as carbolic and cresylic acids. Of these, carbolic acid, the 
most familiar, is a white crystalline solid, prepared from coal or wood tar, which becomes 
liquid when a small quantity, (5 per cent.) of water is added. 

Pitch and other substances of which these acids form the active principle, have been 
employed from the most remote times as antiseptics, having been used by Egyptians in 
embalming mummies. 



108 STATE BOARD OF HEALTH. [Jan.'U. 

The former process is the one which has thus far been adopted 
by the proprietors of the Walpole factory, from the belief that 
it would be more efficacious. It has been found, however, that 
boiling the hair extracts a large proportion of the animal oil 
contained in it, thereby destroying its elasticity, rendering it 
more difficult to pick and spin, and causing considerable dim- 
inution in the weight. 

It remains, therefore, to be decided whether on the whole, 
the application of the acid is not less expensive, and equally 
efficacious, since the weight of hair is not diminished by its 
use, nor its quality impaired. Furthermore, as the hair is 
invariably boiled in the latter stages of its manufacture, all 
odor left by the acid must thereby be removed. 

II. The rooms to which the hair has been admitted should 
be thoroughly disinfected. The roofs and walls should be 
washed with lime. The floor and woodwork should be washed 
with water containing soda, and then sprinkled with a solution 
of carbolic acid. The clothing, boots and shoes of the opera- 
tives also demand attention, as the seeds of the disease may 
have attached themselves to some of these articles. 

III. Those who are obliged to handle hair suspected of 
being infected should previously anoint their hands with a mix- 
ture of carbolic acid and lard, in the proportion of one drachm 
to the ounce.* 

In the above observations no allusion has been made to the 
value of different remedies or modes of treatment, from the 
conviction that much more important results are to be obtained 
by the attempt to arrive at correct views of the nature and 
causes of the malady, and by anticipating its effects rather than 
by seeking to cure or mitigate them. It is gratifying to be 
able to report that the prophylactic measures carried out at 
Walpole have thus far been attended with satisfactory results. 
These results are confirmatory of the views of those who have 
paid most attention to sanitary questions, and afford proof that 
the labors of these men have been of very great advantage 
to mankind. 

* A supply of this ointment is kept in constant readiness in the different apartments 
at the Walpole factory. 



THE CAUSES 



TYPHOID FEVER IN MASSACHUSETTS. 



110 STATE BOARD OF HEALTH. [Jan. 



AN INQUIRY INTO THE CAUSES OF TYPHOID FEVER, 
AS IT OCCURS IN MASSACHUSETTS. 



It may be stated in round numbers that one person out of 
every thousand in Massachusetts, between the ages of five and 
seventy, dies yearly from typhoid fever. Excluding the ex- 
tremes of youth and age within these limits, the proportion 
would be much larger. Reckoning the mortality at one in ten 
of those attacked, it seems very certain that more than one per 
cent, of the able-bodied adult population is rendered helpless 
every year from this disease, and for a period often extending 
through many months. Add to this the loss of time on the 
part of nurses and attendants, and it will be seen that the 
bread-winning efficiency of the people is impaired in a way 
which might be expressed in dollars, and it would certainly 
amount to a very large sum, — how large we do not pretend to 
estimate. Neither can we place in definite form the misery 
which the killing and wounding, from this cause, of so many 
persons in the prime of life, brings upon their kindred. The 
object of the present inquiry is to find out, if we can, whether 
all this loss and wretchedness is inevitable. If it shall appear 
that it is, either in whole or in part, avoidable, the information 
will be of value. The question is a difficult one and may not 
be completely answered at once, but by the collection of such 
evidence as now exists among us, we shall be brought nearer to 
its final solution. 

We first seek to know where typhoid fever prevails ; to learn 
something of its distribution ; to compare different localities in 
a general way, and to find out in what towns or what class of 
towns it is most frequently present. Here we need a careful 
registration of sickness, but this is not to be had as yet, either 
in Massachusetts or in any other country. The time is coming 
when in some form or other it will be demanded and obtained. 



1871.] PUBLIC DOCUMENT— No. 37. Ill 

The best we can now do is to estimate the prevalence of this 
disease, as of all others, by the official report of deaths. An 
epidemic of typhoid may have a fatality in certain years and 
under certain circumstances of season or place, which may vary 
from one in three to one in twenty ; but taking a series of years 
this element of error diminishes in force. 

The disease may be called by a wrong name in the returns 
from the towns. This is certainly possible in some cases, but 
typhoid fever has very marked characters, and before death 
occurs, its nature can hardly fail to be recognized. No disease, 
except perhaps consumption, or the eruptive fevers, is less liable 
to be mistaken for others. 

We do not wish to overstate the value of registration returns 
of the causes of death. They are certainly liable to error, but 
after much examination we believe them to be made with great 
care by trustworthy and intelligent men. The system of regis- 
tration has now been in use in Massachusetts for thirty years, 
and has been constantly improving. 

The information with regard to deaths from typhoid fever 
received through registration, is to be taken as the opinions of 
the town-clerks, based usually on the certificates of medical 
attendants, and, in their default, upon the declaration of sur- 
viving friends, and in rare cases upon common report. 

The deaths from typhoid liave always been classed with 
deaths from infantile fever, which latter term is vague and 
unsatisfactory. To eliminate this source of error, the death 
records of every town at the office of the State secretary have 
been searched for the ten years 1859-1868 inclusive, and the 
result is given in a table, showing the total and comparative 
mortality from typhoid fever, during this period, in persons 
over five years of age, in all parts of Massachusetts. 

Another kind of evidence available in this inquiry, is that 
presented in the opinions of our correspondents all over the 
State, concerning the relation of cause and effect in typhoid 
fever as they have watched it. These opinions are full of inter- 
est and value. Discordant they surely are, and must necessa- 
rily be on a question of such obscure nature. Each judges from 
his own point of view, influenced by the varying circumstances 
of locality, opportunity, faith in the possibility of discovering 
causes, the character of his own mind. 



112 STATE BOARD OP HEALTH. [Jan. 

And let no one imagine that, because physicians disagree, it 
is to their discredit as observers. How often do the twelve 
men of a jury entirely agree, even when direct visible proof is 
presented to them ? How many engineers, or underwriters, or 
carpenters would entirely agree as to the causes of injury in a 
bridge, or a vessel, or a house, seeing only the destructive 
effects ? 

Yet the physician, in looking for the causes of disease in that 
most complex of all machines, the human body, is as yet but 
groping in the dimmest twilight. A century or two ago it 
might -even have been thought irreverent to pry into these 
secrets of nature, and even yet there lingers in some minds a 
doubt as to the propriety of asking why we are sick. 

The remote and essential causes of the phenomena which the 
physician witnesses in typhoid fever, are as yet almost completely 
hid from his eyes. He can only associate conditions of the 
most various sort with their apparent effects, and by a long 
series of such observations, be prepared to state his convictions 
concerning them. 

It may be said of the questions addressed to our correspond- 
ents that they indicate preconceived opinions, that they are lead- 
ing questions. To a certain extent this is true, and it could 
hardly be avoided. To bring out definite replies it was neces- 
sary to ask definite questions, but the evidence which we have 
received has been arranged to support no theory, but to establish 
truth. Whoever could present facts carefully observed, or pro- 
fessional opinions based upon general experience, has been wel- 
comed in this inquiry, and his testimony is presented in the 
following pages. 

The circular of May 1st, 1870, had two special objects : — 1st. 
To obtain all information possible concerning the agency of filth 
in causing typhoid fever, either through the medium of air or of 
drinking-water ; and 2d, to discover, if possible, whether the 
same relation exists between the height of subsoil water and 
epidemics of typhoid in Massachusetts as has been recently 
found at Munich in Bavaria. 

Dr. Max Pettenkofer of Munich, a chemist and philosopher of 
world-wide repute, has made known of late, chiefly through the 
pages of the" Zeitschrift fur Biologie," some views of the nature 
of cholera and typhoid fever, which are of singular interest. 



1871.] PUBLIC DOCUMENT— No. 37. 113 

His observations upon the first disease do not now concern us, 
but they led directly to the extension of the same ideas to the 
enteric fever of Munich, which may be regarded as identical 
with our typhoid. The subject has been still further elaborated, 
and at great length, by Dr. Buhl of Munich, and other followers 
of Pettenkofer. They contend, and, in so far as Munich is con- 
cerned, they demonstrate that epidemics of enteric fever stand in 
a fixed relation to certain obscure and as yet inexplicable changes 
in the soil, which changes are signalized by the fluctuations in 
the height of ground-water. The years of greatest mortality 
from enteric fever have been the years of lowest water-level ; the 
years of least mortality, of highest water-level ; and the varia- 
tions between these extremes of mortality have coincided with 
the comparative depth at whicb/water is found in the soil. 

These observations have been made during the past fifteen 
years ; and within that period the degree of danger from typhoid 
fever has been correctly indicated by the depth of water in the 
wells. Upon these and similar observations elsewhere in Ger- 
many, Dr. Pettenkofer and his followers have founded an hypoth- 
esis that the causes of typhoid are to be found in the soil, not in 
the water of the soil, which is regarded simply as an index, like 
the face of a clock, recording changes going on behind it ; and 
that the fever-seed or germ is the result of" organic processes " 
taking place in the earth, and communicated to man through the 
medium of air. What these changes are, or in what the fever- 
germs consist, are unexplained. 

These views have met with great opposition, and particularly 
in England, where belief in the contamination of drinking-water 
by animal excrement is very generally accepted as the chief 
cause of typhoid. The facts reported by Pettenkofer have been 
interpreted in England to mean that in a season of drought foul 
matters are retained in the loose soil, and that the area of drain- 
age for each well is greatly increased by the subsidence of the 
ground-water level. In certain English towns the water level 
was permanently reduced by artificial drainage, while pure water 
was brought in from springs and streams for the use of the in- 
habitants, with a marked reduction in the mortality from typhoid. 

Another and similar cause for fever is found by English 
writers in the washing of soluble filth from the loose soil into the 
wells by the first rain-fall after a drought. 

15 



114 



STATE BOARD OF HEALTH. 



[Jan. 



Pettenkofer and his school do not deny the general importance 
of having drinking-water free from taint, but think that the art- 
ificial drainage of the English towns signifies no more in contra- 
diction of the Munich experience as regards typhoid fever than 
the movement of the face of a clock by human hands would in- 
fluence the rotation of the earth. Setting the soil-clock at typhoid 
will not cause the disease. Not until the soil is " typhoid-ripe " 
will that form of fever appear. Filth will foster and increase its 
virulence, but will not originate it. Pettenkofer believes that air 
coming from the soil (and not water) is the common vehicle of 
the typhoid poison, and he urges upon all who seek to know the 
causes of this disease to study the soil and the changes of char- 
acter which it undergoes, not merely on the surface but at all 
depths above that at which water fills its pores. 



Table of Deaths of Persons above five Years of age from Typhoid 
Fever in Massachusetts during Ten Years, 1859 to 1868, inclu- 



sive. 





a 


9 

H 


o c a 




a 


9 
H 






a 


a 


szr? 




a 


_a 


Y A"~~ n 


Counties and 


o 




OS 


Counties and 


© 




to & a; . 


Towns. 


a l<5 

3 9 


2 *- 




Towns. 


o 18 

3 9 


1 I 


cog >n 




P- X 
Pi 


P 


"■ 5 5 " 




- -/J 




^ £ 2 <» 


Barnstable County. 








Berkshire — Con. 








Barnstable, . 


4,928 


34 


1,449 


Lenox, 


1,660 


22 


754 


Brewster, 


1,456 


8 


1,857 


Monterey, . 


737 


15 


491 


Chatham, 


2,624 


16 


1,640 


Mt. Washington, 


237 


1 


2,370 


Dennis, 


3,592 


43 


835 


New Ash ford, 


178 


1 


1,780 


Eastham, 


757 


8 


946 


N. Marlborough, 


1,649 


31 


532 


Falmouth, . 


2,283 


31 


736 


Otis, . 


956 


23 


416 


Harwich, 


3,540 


57 


621 


Peru, . 


494 


6 


823 


Orleans, . . 


1,585 


17 


932 


Pittstield, . 


9,676 


93 


1,040 


Provincetown, 


3,472 


18 


1,929 


Richmond, . 


944 


20 


472 


Sandwich, . 


4,158 


31 


1,341 


Sandisfield, 


1,411 


26 


542 


Truro, 


1,447 


9 


1,608 


Savoy, 


866 


22 


394 


Well fleet, . 


2,296 


15 


1,530 


Sheffield, . 


2,459 


69 


356 


Yarmouth, . 


2,472 


26 


951 


Stockbridge, 


1,967 


28 


702 










Tvringham, 


650 


9 


722 


Berkshire County. 








Washington, 


859 


9 


954 


Adams, 


8,298 


111 


7,475 


W. Stockbridge, 


1,620 


23 


704 


Alford, . 


461 


3 


1,537 


Williamstown, . 


2,555 


23 


1,110 


Becket, 


1,393 


16 


870 


Windsor, . 


753 


5 


1,506 


Cheshire, 


1,650 


11 


1,500 










Clarksburg, . 


530 


4 


1,325 


Bristol County. 








Dalton, 


1,137 


22 


517 


Acushnet, . 


1,251 


14 


893 


Egremont, . 


928 


6 


1,547 


Attleborough, 


6,200 


57 


1,087 


Florida, 


1,173 


14 


837 


Berkley, 


847 


9 


941 


Great Barrington, 


3,920 


36 


1,089 


Dartmouth, 


3,435 


29 


1,184 


Hancock, 


937 


7 


1,339 


Dighton, 


1.813 


11 


1,648 


Hinsdale, 


1,517 


16 


948 


Easton, 


3,076 


30 


1,025 


Lanesborough, 


1,294 


4 


3,235 


Fairhaven, . 


2,547 


24 


1,061 


Lee, 


4,035 


65 


621 


Fall River, . 


17,451 


136 


1,286 



1871.] 



PUBLIC DOCUMENT— No. 37. 



115 



Table of Deaths of Persons — Continued. 





c 


O 

H 






a 


9 


~ o 


Counties and 


S . 


a 




Counties "and 


a 


C 


dJSS 


Towns. 


in 

o H 


22 *- 


<s> 2 ° • 

s? £ «£ 


Towns. 


is 




6C§ >.J3 




Ph 


G 


< 




Ph 


<- 




Bristol — Con. 








Franklin — Con. 








Freetown, . 


1,485 


9 


1.650 


Coleraine, . 


1,726 


23 


750 


Mansfield, . 


2,130 


15 


1,420 


Conway, 




1,538 


21 


732 


New Bedford, 


20,853 


162 


1,287 


Deerfield, 




3,038 


40 


759 


Norton, 


1,709 


23 


743 


Erving, 




576 


8 


720 


Raynham, . 


1,868 


18 


1,038 


Gill, . 




635 


5 


1,270 


Rehoboth, . 


1,843 


18 


1,024 


Greenfield, 




3,211 


56 


573 


Seekonk, 


928 


3 


3,093 


Hawley, 




687 


6 


1,145 


Somerset, 


1,789 


13 


1,376 


Heath, 




642 


4 


1,605 


Swanzey, 


1,336 


14 


953 


Leverett, 




914 


19 


481 


Taunton, 


16,005 


98 


1,633 


Leyden, 




592 


5 


1,184 


Westport, . 


2,799 


33 


848 


Monroe, 
Montague, 




191 
1,574 


2 

21 


955 
750 


Dukes County. 








New Salem 




1,116 


18 


620 


Chilmark, . 


548 


3 


1,827 


Northfield, 




1,660 


26 


639 


Edgartown, . 


1,846 


11 


1,678 


Orange, 




1,909 


24 


795 


Gosnold, 


108 


_ 


- 


Rowe, 




563 


6 


938 


Tisbury, 


1,696 


34 


499 


Shelburne, 




1,654 


20 


827 










Shutesbury, 


788 


8 


985 


Essex County. 








Sunderland, 


861 


8 


1,076 


Amesbury, . 


4,181 


28 


1,493 


Warwick, . 


901 


15 


601 


Andover, 


5,314 


56 


949 


Wendell, . 


603 


10 


603 


Beverly, 


5,942 


68 


874 


VVhateley, . 


1,012 


18 


562 


Boxford, 


868 


12 


723 










Bradford, 


1,566 


15 


1,044 


Hampden County. 








Danvers, 


5,144 


46 


1,118 


Agawam, . 


1,664 


18 


925 


Essex, . 


1,630 


22 


735 


Blandford, . 


1,087 


25 


435 


Georgetown, 


1,926 


30 


642 


Brimfield, . 


1,316 


13 


1,012 


Gloucester, . 


11,937 


94 


1,270 


Chester, 


1,266 


11 


1,151 


Groveland, . 


1,619 


22 


736 


Chicopee, . 


7,577 


59 


1,284 


Hamilton, . 


799 


6 


1,332 


Granville, . 


1,367 


30 


456 


Haverhill, . 


10,740 


49 


2,192 


Holland, . 


368 


6 


613 


Ipswich, 


3,311 


23 


1,440 


Holyoke, . 


5,648 


38 


1,486 


Lawrence, . 


21,698 


181 


1,199 


Longmeadow, 


1,480 


12 


1,233 


Lynn, . 


20,747 


188 


1,104 


Ludlow, 


1,232 


23 


536 


Lynnfield, . 


725 


5 


1,450 


Montgomery, 


853 


9 


948 


Manchester, 


1,643 


26 


632 


Palmer, 


3,080 


32 


962 


Marblehead, 


7,308 


52 


1,405 


Russell, 


618 


12 


516 


Methuen, 


2,576 


15 


1,717 


Southwick, 


1,155 


19 


607 


Middleton, . 


922 


10 


922 


Springfield, 


22,035 


213 


1,034 


Nahant, 


313 


2 


1,565 


Tolland, 


511 


7 


730 


Newbury, . 


1,362 


23 


592 


Wales, 


696 


11 


632 


Newburyport, 


12,976 


64 


2,027 


Westfield, . 


5,634 


89 


633 


North Andover, . 


2,622 


33 


795 


West Springfield, 


2,100 


22 


954 


Peabody, 


6,051 


27 


2,241 


Wilbraham, 


2,111 


42 


503 


Rock port, 


3,367 


26 


1,295 










Rowley, 


1,191 


15 


794 


Hampshire County. 








Salem, 


21,189 


126 


1,682 


Amherst, 


3,415 


33 


1,035 


Salisbury, . 


3,609 


29 


1,244 


Belchertown, 


2,636 


31 


850 


Saugus, 


2,006 


11 


1,824 


Chesterfield, 


801 


8 


1,001 


Swampscott, 


1,535 


7 


2,193 


Cummington, 


980 


12 


817 


Topsfield, . 


1,212 


16 


757 


Easthampton, 


2,869 


37 


775 


Wenham, 


918 


8 


1,147 


Enfield, 


997 


19 


525 


West Newbury, . 


2,087 


22 


949 


Goshen, 


411 


2 


2,055 










Granby, 


908 


13 


698 


Franklin County. 








Greenwich, 


648 


9 


720 


Ashfield, 


1,221 


12 


1,017 


Hadley, 


2,246 


21 


1.070 


Bernardston, 


902 


15 


601 


Hatfield, . 


1,405 


15 


937 


Buckland, . 


1,922 


26 


739 


Huntington, 


1,163 


16 


726 


Charlemont, 


994 


9 


1,104 


Middlefield, 


727 


6 


1,216 



116 



STATE BOARD OF HEALTH. 



[Jan. 



Table of Deaths of Persons — Continued. 



Counties and 
Towns. 






Hampshire — Con 
Northampton, 
Pelham, 
Plainfield, . 
Prescott, 
South Hadley, 
Southampton, 
Ware, . 
Westhampton, 
Williamsburg, 
Worthington, 

Middlesex County 

Acton, . 

Arlington, 

Ashby, 

Ashland, 

Bedford, 

Belmont, 

Billerica, 

Boxborough 

Brighton, 

Burlington, 

Cambridge, 

Carlisle, 

Charlestown 

Chelmsford, 

Concord, 

Dracut, 

Dunstable, 

Framingham 

Groton, 

Holliston, 

Hopkinton, 

Hudson,* 

Lexington, 

Lincoln, 

Littleton, 

Lowell, 

Maiden, 

Marlborough 

Medford, 

Melrose, 

Natick, 

Newton, 

North Readin 

Pepperell, 

Reading, 

Sherborn, 

Shirley, 

Somerville, 

Stoneham, 

Stow, . 

Sudbury, 

Townsend, 

Tyngsborough, 

Wakefield, 

Waltham, 

Watertown, 



7,925 

737 

579 

596 

2,099 

1,216 

3,374 

636 

1,976 

925 



1,660 
2,760 
1,080 
1,702 

820 
1,279 
1,808 

454 
3,854 

594 
29,112 

642 

26,399 

2,291 

2,232 

1,905 

533 
4,665 
3,176 
3,125 
4,132 

2,220 

711 

967 

30,990 

6,840 

7,164 

4,839 

2,865 

5,208 

8,975 

987 

1,709 

2,436 

1,049 

1,217 

9,353 

3,298 

1,537 

1,703 

2,042 

578 

3.244 

6.896 

3,779 



5 5 
2 H 



14 
13 
20 
23 
13 

2 
11 

1 
19 

5 
134 

5 

154 

19 

12 

18 

2 
36 
28 
26 
26 
12 
13 

3 

9 
191 
55 
45 
24 
12 
46 
59 
13 
23 
18 
10 
12 
40 
29 
18 
17 
30 

5 
19 
56 
19 



911 

931 

482 

1,987 

1,000 

450 

733 

1,272 

732 

617 



1,186 
2,123 
540 
740 
631 
6,395 
1,644 
4,540 
2,028 
1,188 
2,173 
1,284 
1,714 
1,206 
1,860 
1,058 
2,665 
1,296 
1,134 
1,202 
1,589 

1,708 
2,370 
1,074 
1,623 
1,244 
1,592 
2,016 
2,388 
1,132 
1,521 

759 

743 
1,355 
1,049 
1,014 
2,338 
1,137 

854 
1,002 

681 
1,156 
1,707 
1,231 
1988 



Counties and 
Towns. 



Middlesex — Con 

Wayland, . 

Westford, . 

Weston, 

Wilmington, 

Winchester, 

Woburn, 



Nantucket, 

Norfolk County, 
Bellingham, 
Braintree, 
Brookline, 
Canton, 
Coh asset, 
Dedham, 
Dorchester, 
Dover, 
Foxborougb 
Franklin, 
Hyde Park 
Medfield, 
Med way, 
Milton, 
Needham, 
Quincy, 
Randolph, 
Roxbury, \ 
Sharon, 
Stoughton, 
Walpole, 
West Roxbury, 
Weymouth, 
Wrentham, 

Plymouth County 
Abington, . 
Carver, 
Duxbury, . 
E. Bridgewater, 
Halifax, 
Hanover, . 
Hanson, 
Hingham, . 
Hull, . 
Kingston, . 
Lakeville, . 
Marion, 
Marshfield, . 
Mattapoisett, 
Middleborough, 
N. Bridgewater, 
Pembroke, . 
Pl3"inouth, . 
Plympton, . 
Rochester, . 
Scituate, 






1,137 


7 


1,568 


26 


1,231 


8 


850 


10 


1,968 


4 


6,999 


58 


4,748 


33 


1,240 


7 


3,725 


23 


5,262 


18 


3,318 


13 


2,048 


23 


7,195 


52 


10,717 


53 


616 


2 


2,778 


38 


2,510 


22 


_ 


2 


1,012 


8 


3,219 


30 


2,770 


27 


2,793 


22 


6,718 


41 


5,734 


37 


28,426 


167 


1,393 


12 


4,855 


45 


2,018 


10 


6,912 


20 


7,975 


41 


3,072 


22 


8,576 


53 


1,059 


18 


2.384 


20 


2,976 


34 


722 


15 


1,545 


15 


1.196 


20 


4,176 


15 


260 


- 


1,626 


13 


1,110 


15 


960 


19 


1,809 


11 


1,451 


19 


4,565 


49 


6,332 


46 


1,489 


26 


6,068 


41 


924 


18 


1,156 


13 


2,269 


15 



* Three years only. 



t One year only. 



t Nine years only. 



1871.] 



PUBLIC DOCUMENT— No. 37. 



117 



Table of Deaths of Persons — Concluded. 





- 


O 
H 


r- — O 




c 




V > 3 


Counties and 


a 

o 


a 


£15+3 


Counties and 


a 
o 


O 




Towns. 


« >9 

"3 S 


1 a 




Towns. 


a IS 

"3 » 


1 1 


"§ ^3 




a. GO 


« Z 


•^ £ cs v 




o. 1 




£ £11 




P-i 


g* 


5 c.«^ 




£ H 


P* 


>p.£Q 


Plymouth — Con . 








Worcester — Con. 








South Scituate, . 


1,635 


17 


962 


Leominster, 


3,313 


21 


1,577 


Wareham, . 


2,798 


24 


1,166 


Lunenburg, 


1,167 


12 


972 


W. Bridge water, . 


1,825 


12 


1,521 


Mendon, 


1,207 


8 


1,508 










Milford, . 


9,108 


64 


1,423 


Svffolk Couufy. 








Willbury, . 


3,780 


29 


1,304 


Boston, (9 years,) 


192,318 


949 


2,026 


New Braintree, . 


752 


9 


835 


Boston and Rox- 








Northborough, . 


1,623 


10 


1,623 


bury, (1868,) . | 220,744 


122 


1,809 


Northbridge, 


2,642 


16 


1,651 


Chelsea, 


14,403 


86 


1,675 


N. Brookfield, . 


2,514 


27 


931 


North Chelsea, 


858 


1 


8,580 


Oakham, . 


925 


14 


661 


Winthrop, . 


633 


3 


2,110 


Oxford, 


2,713 


22 


1,233 










Paxton, 


626 


13 


482 


Worcester County. 








Petersham, . 


1,428 


20 


714 


Ashburnham, 


2,153 


29 


742 


Phillipston, 


725 


16 


453 


Athol, . 


2,814 


30 


938 


Princeton, . 


1,239 


15 


826 


Auburn, 




959 


16 


599 


Rovalston, . 


1,441 


37 


390 


Barre, . 




2,856 


37 


772 


Rutland, . 


1,011 


9 


1,123 


Berlin, . 




1,061 


20 


530 


Shrewsbury, * . 


1,570 


20 


785 


Blackstone, 




4,857 


32 


1,518 


Southborough, . 


1,750 


13 


1,345 


Bolton, 




1,502 


31 


485 


Southbridge, 


4,131 


47 


879 


Boylston, 




792 


5 


1,584 


Spencer, 


3,024 


30 


1,008 


Brook field, 




2,101 


21 


1,000 


Sterling, 


1,668 


16 


1,042 


Charlton, 




1,925 


18 


1,069 


Sturbridge, 


1,993 


16 


1.246 


Clinton, 




4,021 


27 


1,489 


Sutton, 


2,363 


30 


787 


Dana, . 




789 


'7 


1,127 


Templeton, 


2,390 


36 


664 


Douglas, 




2,155 


17 


1,267 


Upton, 


2,018 


17 


1,175 


Dudley, 




2,076 


41 


506 


Uxbridge, . 


2,838 


11 


2,580 


Fitchburg, 




8,118 


86 


944 


Warren, 


2.180 


26 


838 


Gardner, 




2,553 


20 


1,276 


Webster, 


3,608 


62 


582 


Grafton, 




3,961 


58 


683 


Westborough, . 


3.141 


29 


1,083 


Hardwick, 




1,967 


9 


2,185" 


West Boylston, . 


2,294 


30 


765 


Harvard, 




1,355 


7 


1,936 


West Brookfield, 


1,549 


31 


500 


Holden, 




1,846 


11 


1,678 


Westminster, 


1,639 


26 


630 


Hubbardstoc 


, 


1.546 


31 


499 


Winchendon, 


2,801 


26 


1,077 


Lancaster, 




1,752 


21 


834 


Worcester, . 


30,055 


254 


1,183 


Leicester, 




2,527 


15 


1,685 











The first thing which strikes us on looking over this table is the 
apparently greater mortality from typhoid in the small towns. 
How great this difference is will appear from the following compar- 
ison : — 



118 



STATE BOARD OF HEALTH. 



[Jan. 



Table showing relative mortality for Ten Years from Typhoid 
Fever in persons above five years of age, in the larger and smaller 
Cities and Towns. 







Total 


Av'geNo. 


Av'ge No. 




Population 




Of persons 


of Deaths 




1865 




living each 


each year to 




(AU Ages.) 


Typhoid in 


year to one 


1,000 Per- 




Ten Tears. 


Death. 


sons living. 


One hundred and forty-seven (147) 










cities and towns of more than 










2,000 inhabitants * . 


1,044,294 


7,888 


1,323.90 


0.755 


One hundred and eighty-four (184) 










towns of less than 2,000 inhab- 










itants,! 


213,468 


2,539 


840.75 


1.189 



There can be no doubt that typhoid in Massachusetts, is a 
disease of scattered communities rather than of crowded towns, 
of rural rather than of urban districts. In spite of the smaller 
mortality from all causes, typhoid is more destructive in the 
farming towns than in the manufacturing towns and the large 
cities. This is an important fact in the study of the causes of 
the disease, and one which we shall have occasion again to refer. 

Our circular of May 1st relating to typhoid fever asked four 
questions. Replies have been received from one hundred and 
sixty-three (163) towns. The replies are tabulated under each 
question. 

1. Have you observed a difference in the prevalence of this 
disease between houses supplied with water from wells about the 
premises, and houses supplied with water conveyed from springs 
or from ponds of unquestionable purity ? 



Replies. 

Yes, 

No difference has been remarked, 
Whole supply of town from wells, 
Indefinite, .... 



23 
71 
18 
51 



2. Can you inform us whether, at times when typhoid pre- 
vailed, the water of the wells was rising or falling, and whether 
it was higher or lower than the average for the year ? 



* Not including Monson and Bridgewater (State Almshouses), Hyde Park and Hudson, 
t Not including Tewksbury (State Almshouse). 



1871.] PUBLIC DOCUMENT— No. 37. 119 

(If your attention has not been given to the height of subsoil 
water as marked by the wells, will you have the kindness to note 
it in future epidemics, and let us know the result ?) 



Replies. 




Rising after being very low, 


11 


Falling, 


16 


Very low, . 


36 


Have not observed, 


. 100 



3. Have you observed any connection between typhoid fever 
and foul soil, whether from privies, pigsties, manure heaps, or 
similar collections of decomposing matter lying on the ground ? 

Replies. 

Yes, 79 

No, 45 

Doubtful, 39 

4. Have you observed any connection between typhoid fever 
and putrid air, whether from rotting vegetables in cellars, bad 
drains, unventilated living or sleeping rooms, or from any other 
cause ? 

Replies. 

Yes, . . . " . . . 90 

No, 36 

Doubtful, 37 

Ten towns report that typhoid fever is a disease almost un- 
known among them, and for this reason they can give no infor- 
mation. 

The following are the replies on this interesting subject in the 
form of opinions based on professional experience, from our cor- 
respondents in the various towns. 

Andover. " Something more than twenty years ago there ap- 
peared in one of the English .medical journals an article written 
with much ability, the object of which was to show that the defec- 
tive sewerage of London was the cause of a large amount of sick- 
ness. Statistics were given running through a series of years, 
showing that the mortality from bowel complaints and fevers had 



120 STATE BOARD OF HEALTH. [Jan. 

been uniformly inversely to the amount of rainfall to wash out the 
sewers, particularly during the hot months. The statistics were of 

this kind. In the month of from the 20th to the 30th there 

was no rain sufficient to wash out the sewers, and the mortality 
from these diseases was constantly increasing. On the 30th, a 
heavy rain, followed by a diminution of the mortality ; but, as no 
more rain fell for the next twelve days, the mortality again increased 
till another rain, and so on. 

" Some sixteen years ago I was mentioning this to a very intelli- 
gent and observing man and an old resident, who stated that the 
same had always been true in this town. My observation since 
that time has convinced me that he was entirely correct. The 
English writer's conclusions with regard to defective sewerage I 
cannot regard as proven. The statistics only go to show that the 
mortality from these diseases is inversely to the amount of rainfall. 
The less rain, the more typhoid fevers and other cognate diseases 
I apprehend is the rule or law the world over, not only in the cities 
but in the country also. But the fevers thus caused may not be 
developed until after more rain and the water in the wells is again 
rising. I believe that the law is not confined entirely to the sum- 
mer season, and to fevers and bowel complaints, but is of more 
general application to nearly all (especially acute) diseases, and to 
all seasons of the year. Rain is undoubtedly the great purifier of 
the atmosphere from the causes of disease." 

Our correspondent, in a subsequent letter states that from per- 
sonal experience and observation in Siam he finds confirmation of 
the views above expressed. 

Attleborough. " In localities where typhoid fever prevails, foul 
soil or foul air, under conditions corresponding to questions three 
and four, have almost always been detected. Still, I have seen 
some very striking instances of immunity from typhoid in positions 
where the pythogenic influences were conspicuous, and where the 
assumed fever producing elements must have existed in a concen- 
trated form. In view of these exceptions, I have been compelled 
to think that there must be a preparatory receptivity in order to 
make the exciting influences noxious." 

Amherst. " Typhoid fever is a common disease here. * * I have 
now in mind a house where, at one time, fever seemed endemic. 
The cause was found in decaying vegetables and filth in the cellar. 
These being removed, the disease disappeared." 



1871.] PUBLIC DOCUMENT— No. 37. 121 

Ashland. " The most unhealthy part of our village is not on the 
plain but is a street extending along the south side of a hill. Dur- 
ing the past two years there have been cases of typhoid fever on 
this street quite out of proportion to the number of inhabitants. 
Two years ago this location was a piece of woodland. It was 
cleared, and ten tenement houses erected on it for the accommoda- 
tion of twenty families. Soil, a gravelly loam resting on a gravelly 
subsoil and very rocky. The land is springy, and water stands in 
the cellars of these houses five or six months in the year. No pig- 
sties ; and privies five rods distant from the houses. Water from 
wells. From the land having been so recently cleared, there is 
much decaying vegetable matter on the ground and in the soil. 
The structural ventilation of these houses not more deficient than 
other houses of the village, but as there are no shade-trees, and the 
houses stand on the south side of the hill, and all the roofs are flat 
and covered with a black composition absorbing much heat, the air 
of the sleeping rooms in summer was exceedingly hot. We may 
say that the ventilation of the houses was virtually poor. 

" We may consider the practical facts presented in this connec- 
tion to be these : That quantities of decomposing matter, whether 
from pigsties, privies, vegetables in cellars, or decomposing leaves of 
newly cleared land, combined with dampness and deficient ventila- 
tion may be among the causes of typhoid fever ; bearing in mind 
that the disease is propagated by contagion. Another thought 
worthy of notice is the question of the influence of the mind as a 
predisposing cause. All the inmates of these houses were strangers 
in town ; families imported by the factory company from different 
parts of the country. Strangers in a strange land, away from all 
the sympathies of friends and neighbors, subject to all the emotions 
of home-sickness, depressed by the uncertainties of new undertakings, 
and constantly undergoing the fatigues of toil." 

Athol. " Typhoid fever has not prevailed to any great extent 
during the past eight years. Most of the cases have occurred in a 
certain part of Athol proper. In this locality the land is very high, 
the soil cold, thin and marshy; no running water, no drainage. 
There is no known impurity in the well water. Connection has 
been traced in this locality between typhoid and foul soil and air. 

" On the other hand, cases have occurred in various localities 
where no connection seemed to exist with these causes." 

Ashburnham. Last autumn there were some thirty cases of 
typhoid in town ; no cause recognized. Water mostly from springs. 
16 



122 STATE BOARD OF HEALTH. [Jan. 

Beverly. — Our correspondent reports ten cases of typhoid of a 
very severe type, occurring in ©ne family, in November, 1865. The 
house stands near the ocean, but on a hill seventy feet above high- 
water mark. The hill slopes in every direction from the house, and 
is mostly rock. The house is built on rock, is large and airy. The 
cause of the fever was found in the following circumstances : — The 
privy was only about eight feet from the house and exceedingly 
foul. The sink spout ran into a hogshead, and the odor from this 
and the ground immediately about it was intensely putrid. Two 
families occupied the other end of the building, and no cases of 
fever occurred among them. About seventy persons acted as 
watchers and attendants upon the sick family, and not one took the 
disease. The weather before this outbreak of fever had been very 
wet, and, just previous, very hot and dry. 

Berkley. — "There is one house where typhoid fever has been 
more prevalent than in any other in the town. Its situation is as 
follows : Soil dry, gravelly and sandy ; on the south is a course 
of swamps with water sometimes a little stagnant ; on the north is 
a deep pond-hole with some vegetation growing in it, quite near the 
house, and surrounded with hills on the north-east, north and 
north-west. When in the fall of the year the wind blows for some 
time from the north-east, over the woody hill and across the pond- 
hole, I expect typhoid fever in that house, and I have not often been 
mistaken. I have observed this for the past twenty-six years." 

Brookline. — Our correspondent gives the result of his observa- 
tions during twenty years of practice in this town. He writes as 
follows : — " By consulting the town records I find that during the 
ten years, 1860-1869 inclusive, there were but twenty deaths from 
typhoid fever. Of this number fifteen were in the class who live in 
well-built comfortable homes, and five in the crowded homes of 
the poorer and laboring classes. I have been unable to obtain the 
relative numbers of these two classes of our population, yet my ex- 
perience has been that the poorer class has not been so liable 
to typhoid fever as the wealthier portion of the community. 

" The larger proportion of typhoid cases which have been under 
my care in the fall of the year must be referred to epidemics or 
atmospheric influences existing in other towns where the subjects 
of the disease had been visiting. One fatal instance this autumn 
commenced ten days after the patient returned from Conway, N. H. 
Four individuals in one family had very severe typhoid, one at 
Nahant, and three after returning thence to Brookline. And 



1871.] PUBLIC DOCUMENT— No. 37. 123 

so with nearly all the cases I remember during the past six years. 
Although I believe in the necessity of careful drainage, I must say 
that I have never had cases that I could attribute to bad drainage, 
but many that I could trace to decaying vegetables -in cellars. 

" I have always supposed that moisture and heavy fogs had a great 
deal to do with the existence of typhoid fever, as it has been the 
scourge of towns in the vicinity of rivers and brooks, and where 
large extents of meadow land were uncovered by the heat and evap- 
orations of summer. 

"In 1846 or 1847 a serious and malignant epidemic of typhoid- 
dysentery raged on Bradlee's Hill, and in the houses in the vicinity 
of the reservoir, then in process of construction, in a locality which 
in other years had been healthy. At that time, I attributed the 
epidemic to the turning over and exposure to the air of the meadow 
mud filled with decaying roots and other vegetation. Something 
of the same kind occurred in Brighton, on breaking ground for the 
Brighton reservoir, but owing to the smaller number of houses in 
the neighborhood the epidemic was less noticeable. 

" It is the custom in Brookline at this season to cover the grass 
and garden-beds around the houses with manure, often taken from 
the pigsty, filling the air with an intolerable stench. To be sure the 
frost soon checks decomposition, and the rains wash out the odor, 
yet we might expect this practice would excite disease, but I have 
not noticed any such result." 

Boston. — The answer to the first question of the circular of May 
1st, requires a comparison to be made, as regards typhoid fever, 
between the Boston of a quarter of a century ago, and the Boston 
of to-day. Previous to 1848 the water supply of the inhabitants 
was to a very limited extent from Jamaica Pond, but in by far the 
larger portions from wells. These wells were very numerous ; 
almost as much so as the privy vaults with which they were in close 
proximity. After an extensive fire, such as frequently occurred at 
that time, the foul character of the soil drained by these wells was 
very evident. The water nevertheless was, although "hard," gener- 
ally clear and sparkling, as is not unusual with water containing a 
large proportion of nitrates, the result of decomposition. 

The water of Lake Cochituate was brought into Boston in the 
autumn of 1848, and was very soon received by the whole popula- 
tion. The wells were abandoned and filled up, or now only exist 
as receptacles for dirt and rubbish. 

We have endeavored in various ways to ascertain the relative 



124 STATE BOARD OF HEALTH. [Jan. 

frequency and severity of typhoid fever before and since the intro- 
duction of the unquestionably pure water of Lake Cochituate. 

The following table gives the number of deaths for each year 
from 1846 to 1867, reported as from typhoid or typhus. Previous 
to 1846 no record was made.* We have therefore only the three 
years 1846, 1847 and 1848 to compare in statistical form with the 
nineteen subsequent years. Moreover, the year 1847 was marked 
by the importation of a great number of cases of true typhus, 
known here as " ship-fever," occurring among the immigrants arriv- 
ing at this port. 

It is unnecessary that the distinction made by physicians during 
the past thirty years between typhus and typhoid, should be 
enlarged upon in this connection, but it is important to remember 
that the two diseases were confounded by every one before that 
period, and that true typhus, although occasionally originating here, 
is a rare disease, while typhoid is exceedingly common. For our 
present purpose, with the exception of the ship fever of 1847, the 
two forms of fever may be regarded as one. Our oldest physicians 
(while recognizing the differences, which have been perfectly defined) 
still speak of typhoid as typhus, and we wish to be understood as 
classing together these two nearly related forms of continued fever. 

With this explanation, the following table may be taken as a 
close approximation to the truth with regard to mortality from 
typhoid fever in Boston : — 

♦Since the above was written we have seen an old record of deaths and their causes in 
Boston for nearly every year, from 1825 to 1846, which is preserved at the office of the City 
Registrar. Although this record is too imperfect for use in statistical form, it seems right 
to say that it gives the impression that while typhoid fever was somewhat more fatal, and 
therefore probably of more frequent occurrence, in those years than at the present time, 
it would be wrong to suppose that the death-rates, which prevailed in 1847 and 1848 
were the rule previous to the introduction of pure water. Those were exceptional years 
in so far as we can discover, and the great mortality from fever was due in part at least 
to the importation of foreigners who brought disease with them. 



1871.] 



PUBLIC DOCUMENT— No. 37. 



125 



Table of Deaths from Typhoid and Typhus Fever in Boston, 

1846-1867. 









(Previous 


to the 


Annexation of Roxbury.) 




TEAR. 


Typhoid. 


Typhus. 


Totals 


1846, 




133* 


133 


1847, 














- 


666*f 


666 


1848, 














- 


288* 


288 


1849, 














30|| 


119 


149 


1850, 














43 


61 


104 


1851, 














82 


88 


170 


1852, 














66 


46 


110 


1853, 














67 


44 


111 


1854, 














64 


38 


102 


1855, 














78 


12 


90 


1856, 














70 


6 


76 


1857, 














83 


3 


86 


1858, 














73 


o 


75 


1859, 














85$ 


- 


85 


1860, 














- 


110§ 


110 


1861, 














- 


96§ 


96 


1862, 














74$ 


- 


74 


1863, 














130$ 


- 


130 


1864, 














107 


10 


117 


1865, 














125 


12 


137 


1866, 














93 


8 


101 


1867, 














88 


3 


91 



* Reported in First Annual Report of Registrar (1849), taken from previous records. 

t Includes 366 deaths from ship-fever at Deer Island, City Poor-House and House of 
Industry. 

% Typhoid and typhus together. 

|| Note to Annual State Registration Report for 1849: — "This county (Suffolk) was 
never complete till 1849, the city of Boston never having complied with the law prior to 
that time." 

§ Taken from State Registration Reports for 1860 and 1861, no municipal report of the 
Registrar having been made in those years. The figures for these two years include all 
of Suffolk County, and also include " cases of infantile fever classed with those of typhoid, 
relapsing and other continued fevers under one name — typhus." 



126 



STATE BOARD OF HEALTH. 



[Jan. 



Table of Deaths from Typhoid Fever in Boston, compared with a 
fixed number of the living in each year. 



Population. 



Deaths to 
10,000 living. 



1846, 

1847, 
1848, 
1849, 
1850, 
1851, 
1852, 
1853, 
1854, 
1855, 
1856, 
1857, 
1858, 
1859, 
1860, 
1861, 
1862, 
1863, 
1864, 
1865, 
1866, 
1867, 



116,865 
122,346 
127,827 
133,308 
138,788 
142,693 
146,598 
150,503 
154,408 
158,313 
162,218 
166,123 
170,028 
173,934 
• 177,840 
180,735 
183,630 
186,526 
189,422 
192,318 
195,214 
198,110 



11.4 
24.5 
22.5 
112 
7.5 
11.9 
7.5 
7.4 
6.6 
5.7 
4.7 
5.2 
4.4 
4.9 
6.2 
5.3 
4.0 
69 
6.2 
7.1 
5.2 
4.6 



An examination of these tables shows that typhoid fever is less 
fatal now than when the registration of the causes of death was 
commenced, and it shows a very marked diminution in the number 
of deaths in the years following an abundant supply of pure water. 
This may be attributed not only to the improved character of the 
drinking-water used by the people, but also to the constant flushing 
of the drains and sewers, by which much material which had pre- 
viously been retained there in a state of putrescence, particularly 
during seasons without rain, was washed into the sea. 

But the statistical evidence is not all which goes to prove the 
effect of Cochituate water on typhoid fever in Boston. 

Inquiry has been made of our oldest physicians for their opinions 
on this point, based upon professional experience. Their testimony 
is almost unanimously to the effect that since the period when pure 
water was introduced, typhoid fever has been less frequent and less 
severe. The following extracts from the reply of a gentleman whose 
professional experience extends over a period of fifty-five years will 
be read with interest : — 



1871.] PUBLIC DOCUMENT— No. 37. 127 

" I have noticed since the time when Cochituate water was introduced that 
typhoid fever has been les9 frequent in proportion to the population, and gen- 
erally mitigated in its character. ******* At the early part 
of my professional life, fever of a severe type was quite common, much more 
so than it was a few years later, and the cases were of a more serious charac- 
ter than at any subsequent period. ***** Cases of what is now 
distinctly recognized as ' typhus ' were not then uncommon ; they are now 
comparatively rare. Mild cases of ' typhoid ' fever, such as have of late 
been most common, do not readily arise to the remembrance of the prac- 
titioner of that early time. ***** From the period referred to 
down to the time of the introduction of Cochituate water, fevers had still been 
gradually lessening in frequency and severity. It has been noticed that since 
the introduction of pure water the diminution of typhoid fever, both in fre- 
quency and virulence, has been still more marked." 

How much of this improvement is due to better drinking-water, 
and how much to the better drains and sewers, how much to the 
free supply of water to wash away impurities, how much to the 
more rational treatment of fevers, our correspondent thinks may 
not be determined ; but, 

" Taking into view the fact that fevers have become comparatively less 
frequent, and much mitigated in severity since the introduction of pure water, 
the inference is just that much of the benefit derived is due to this cause." 

With regard to the second inquiry of the typhoid circular, we are 
unable to answer with precision. Wells being disused in Boston, 
the height of water in the soiL is not as readily ascertained as in 
the country. 

The extension of land over the sea which has been going on in 
Boston for many years has been attended with a contest between the 
waters of the land and the waters of the sea for possession of the 
subsoil, a contest in which fresh water speedily triumphs. Soon 
after the filling is made the water is salt, then brackish, and, in a 
few months, fresh. 

This has been the case wherever the filling has been made with 
porous material. The pressure of rain-water received upon the sur- 
face of the new-made land, combined with that flowing down from 
more elevated points, is evidently greater than the pressure of the 
water of the ocean, so that we meet even now on the gravel-filled 
territory south and west of the Public Garden with fresh water 
below the level of the tide, just as is described by our correspon- 
dents of Cape Cod and Martha's Vineyard. 

The reply to be made to the third and fourth questions of the cir- 
cular of May 1st, must be that in Boston the ordinary collections 
of filth found in crowded localities, in dirty houses, in foul privies 



128 STATE BOARD OF HEALTH. [Jan. 

and stables and streets and alleys, — the combination of all those im- 
purities which make Boston stink in the month of August, does 
not especially invite epidemics of fever. The city is more free from 
typhoid than the country. We have to pay the penalty (and a 
heavy one it is) in other forms of disease, but not in this. 

A very considerable number of the cases of typhoid treated in 
Boston during the autumn originate in the country and at seaside 
places where families from the city have passed the summer. 

We cannot assume to fully explain the comparative exemption ot 
Boston from typhoid, but there are some things in this connection 
which, whether they are causes or coincidences, it is well to re- 
member. 

The drinking-water is, beyond all question, free from contamina- 
tion by putrefying material. The soil is well covered by pavement, 
or by macadamized streets, or thoroughly packed gravel, and is not 
often disturbed to any great extent. 

People do not live in large numbers on the ground floor ; a very 
great majority sleep in rooms twenty feet at least above the ground. 
Cellars are very seldom used for the storage of vegetables. Pig- 
sties are unknown. Drains and sewers receive the liquid slops of 
the kitchen and convey them to the sea. Liquid filth is not often 
poured upon the ground. 

The older parts of Boston are more filthy from overflowing, 
neglected and broken privy-vaults, than any country place can 
possibly be ; but they do not contaminate the drinking-water. 

The influence of obstructed drains and of emanations from un- 
trapped sinks and water-closets is as evident in Boston as elsewhere. 
In Kearsarge Avenue, Boston Highlands, is a block of three brick 
houses, built seven years ago. They are situated on the slope of a 
hill, with good natural facilities for drainage. The neighborhood is 
an excellent one. In these three houses there occurred in the 
autumn of 1868 eleven cases of typhoid fever; and in the adjacent 
houses, whose rear came against the block, there were two cases. 

Of the thirteen cases, two were fatal. One of the attending phy- 
sicians states that at his suggestion the common sewer of the block, 
which was laid along the rear of the houses and into which the 
drains of the houses emptied, was examined. It was found to be 
effectually obstructed by a mass of rubbish, including crockery, tin- 
ware and ashes, so that the fluids accumulating above this plug had 
over-flowed, saturating the ground beneath the houses and infecting 
also in some degree the soil beneath the adjacent block. The 
workmen engaged in taking up the drain and repairing it were 
nauseated and were obliged to desist at intervals from their work. 



1871.] PUBLIC DOCUMENT— No. 37. 129 

The physician stated further that the typhoid epidemic in that 
neighborhood subsided soon after the nuisance was abated. 

The following history of a single case of typhoid fever has been 
furnished for publication at our request, by an eminent practitioner. 
Although not referring directly to the special object of this inquiry, 
it throws so strong a reflected light upon the causes of disease, and 
is itself so striking an example of the value of hygienic treatment, 
that we cannot doubt the propriety of reporting it in this connec- 
tion : — 

" A young and apparently vigorous man, between twenty and thirty years 
of age, a butcher by trade, was attacked with typhoid fever in the autumn of 
a few years ago. I saw him soon after the fever commenced, and attended 
him through the whole of it. He was a bachelor and occupied a good sized 
chamber in the second story of a house in Pleasant Street. The chamber was 
lighted by two windows, and furnished with an open fire-place in a chimney. 

" The fever was a mild but unmistakable typhoid, which developed itself 
normally. The patient had a daily febrile exacerbation, a hot skin, thirst, a 
slight diarrhoea, rose-spots and the like. There were no violent symptoms, 
and consequently no indications for active treatment. In fact I saw no 
reason for the exhibition of drugs, and therefore gave none. His skin was 
bathed two or three times a day with tepid water. A slight wood fire, just 
enough to insure ventilation, was kept in the chimney of his chamber, and 
one of the windows raised a little. He was allowed to drink as much water 
as he chose, iced or not according to his taste. In like manner the covering 
of his body was regulated by his sensations ; when hot he had only a sheet 
over him, at other times he required a light blanket. 

" As soon as the fever was sufficiently developed to render its character 
clear I advised his landlady to inform his family, who resided at a distance 
from the city in Vermont or New Hampshire I think, of his illness, and to 
add that he was not dangerously ill. 

" Directly the news reached his family a maiden aunt and sister were 
despatched to the city to take care of him. Alarmed by the name, typhoid 
fever, they hurried to Boston and reached his quarters one forenoon, just after 
I had made my customary visit. My patient was in the condition described 
above, comfortably sick, with a pulse of about eighty and without delirium. 
They were frightened and astonished to find their relative, who was sick with 
typhoid fever, so poorly cared for. Guided by their theory of the proper 
treatment of fever, they proceeded without informing me to reform matters. 

" They pinned a blanket over each window so as to exclude the light, and 
closed the open window so as to shut out the noise of the street. A fire- 
board, or chimney-board I believe it is called, which had been removed from 
the fire-place was replaced, -and an ' air-tight ' stove, in which a fire was 
built, was substituted for the open fire. In order to make him sweat he was 
packed in two or three blankets, and the diaphoretic process encouraged by 
copious libations of herb tea. The fact that no medicines were given they 
regarded as an unpardonable neglect on the part of the attending physician, 

17 



130 STATE BOARD OF HEALTH. [Jan. 

but until they saw me were content to make up for this neglect by giving the 
hot teas just referred to. 

" When I reached the house on the next day for the purpose of visiting 
my patient I was met at the door by the landlady who informed me that he 
was much worse. She gave me no hint, however, of the transformation in 
his surroundings that had taken place. I went up stairs and was surprised 
beyond measure at the change. I found a dark room, filled with a hot and 
foul atmosphere. The odor was of that offensive sort that the chambers of 
the sick are too often charged with. But the greatest change was in the sick 
man whom I had left so comfortable the day before. He was wrapped in 
blankets, his skin was dry and very hot, his tongue dry, his lip cracked, his 
eye wild, his pulse one hundred and twenty, and he was so restless and de- 
lirious that it was all his attendants could do to keep him in bed. 

" The maiden aunt approached me and introduced herself and niece. She 
• said she came to nurse her nephew, and had found him with open windows, 
exposed to noise and currents of air, drinking cold water as freely as he 
chose, and taking no medicine. These evils she had endeavored to remedy, 
but in spite of all her efforts he had grown rapidly worse. She said this 
with such downright honesty and sincere simplicity that I could not be pro- 
voked with her. I asked her to step into an adjoining room, and told her 
that unless everything about her nephew was arranged just as it was before 
she came, I should take no further care of him. As she hesitated a moment, 
I added, ' he will probably die left as he is, and it is for you to take the re- 
sponsibility of following your own course or mine.' We returned to the sick- 
chamber. I remained and saw her with trembling hands and doubtful looks 
remove the blankets from the windows and from the bed. The air-tight stove 
and the chimney-board were taken away. A fire was built in the chimney 
and a window opened. I gave the sick man a tumbler of water, which he 
drank as if he were quenching an internal fire. All this they bore in silence, 
but when I called for a large tub, and made preparations for a bath, they 
remonstrated. A bath, and particularly a cold bath, would kill him. 

" Remonstrances were unavailing, and they were compelled to acquiesce. 
My patient got a cool affusion by pouring water all over him. He was then 
put to bed, lightly covered, and soon went to sleep. By night his condition 
had considerably improved, and on the next day, twenty-four hours later, his 
fever assumed its previous mild type. His pulse was about eighty, and his 
head tolerably clear. He made a satisfactory convalescence. His relatives 
returned home in due time, and if they are alive I hope they are the apos- 
tles of a rational treatment of typhoid fever." 

Brimfield. — An experience of twenty years has satisfied our 
correspondent that the most prolific sources of typhoid fever are 
found in the conditions mentioned in the third and fourth questions. 
" Many and many a time " he has traced such connections. 

" We have every year a few cases of typhoid fever, and in nearly 
every family where it has occurred in the past three or four years, 
I have thought it originated from decaying vegetable matter." 



1871.] PUBLIC DOCUMENT— No. 37. 131 

Bridgewater. — " Whenever I have had several cases of typhoid 
fever in one house or neighborhood I have usually found what I 
considered the cause ; either a wet cellar with decaying vegetables, 
or a sink-drain running into a pool near the house for the purpose 
of making compost." 

Brewster. — " Typhoid fever has in some instances seemed to be 
caused by bad drains, but in my opinion by far the most fruitful 
cause has been the emanations from low, wet, swampy grounds, and 
fresh-water ponds, of which the bottoms were partially exposed 
from evaporation in dry seasons." 

Cambridge. — " I have not been able in the cases of typhoid 
fever I have seen to trace any connection between this disease and 
impurity of water, of soil or of air. I have seen the disease alike 
in the dwellings of the rich and of the poor, of the clean and of 
the filthy, in wet and in dry places. The only endemic of typhoid 
fever whieh we have ever had occurred some twenty years ago, and 
the cases were almost exclusively on the comparatively high land 
between Cambridgeport and Old Cambridge, in families provided 
with the comforts and, a large part of them, with the luxuries of 
life, in houses comparatively well ventilated, and containing nothing 
so far as could be discovered, to render the air impure." 

Chatham. — "This town is situated at the heel of the Cape on a 
peninsula almost devoid of trees, and is almost continually swept 
by the wind. We have very few cases of typhoid, and those of a 
mild type. The disease is much more prevalent in East Harwich 
where my practice extends. That locality is well wooded, and 
there is much more fresh water. While practising in Wareham 
(head of Buzzard's Bay), I noticed the same peculiarity, which 
strikes me as being more than a coincidence. Most of the typhoid 
cases were in the adjoining town of Carver, which is interior, and 
where there is much fresh water and low meadow land ; Wareham 
being unlike it in these respects." 

Conway. — " According to my observation, putrid air from decay- 
ing vegetable matter and foul sink-drains, with poorly ventilated 
sleeping room, constitute the most frequent cause of typhoid 
fever." 

Chester. — " Typhoid fever prevailed here constantly in 1858 and. 
1859 without regard to water or weather." 



132 STATE BOARD OF HEALTH. [Jan. 

Concord. — " In two epidemics of typhoid, soil in the immediate 
vicinity of the cases was broken for the first time, and exposed to 
a hot and dry air in a season of drought. In one instance, in 
making a railroad a knoll was cut through and the dry, gravelly 
soil was carried forward to fill a depression by the side of a street 
occupied by several good houses. The work was done in the 
winter and spring. The subsequent autumn was dry and hot and 
the springs very low ; fever occurred in nearly every house — from 
two to five cases. 

" In another instance extensive stone quarries had been laid 
open, and large quantities of earth exposed for the first time. The 
wells were very low so that it was difficult to obtain water. In 
August, September and October following, many of the workmen, 
mostly stout men from the country, were affected with severe 
typhoid. I had ten cases at one time, some lasting six weeks, but 
all recovered." 

Coleraine. — " I have failed in most cases, but not always, to ob- 
serve the connection referred to in question 3. 

" With regard to question 4, negligence in these respects, is 
common among the rural population ; but often the most negligent 
families seem to escape. Still I have often found such carelessness 
in infected families. I think the bottoms of mill-ponds in times of 
drought are fertile sources of typhoid fever." 

[Note.— See also " Health of Towns."] 

Dartmouth. — "My experience is that typhoid fever prevails in 
its most malignant form in low, damp places, where rooms are but 
poorly ventilated, where cellars are overflowed, where drains are 
bad, and where decaying animal and vegetable matter is found in 
and around the building." 

Dennis. — "In eighteen years' practice I have met with many 
cases of typhoid. They have generally been imported. For 
instance, a father, who is master of a vessel, comes home with 
typhoid fever, and there is a pretty good chance for it to go through 
the family, let the subsoil water be high or low. 

" In a neighboring town I have seen well marked instances of 
typhoid caused by partially draining a swamp. 

" Our people every year put fish under corn-hills, and it makes a 
most dreadful fetor for about ten days, but no disease results there- 
from to my knowledge." 



1871.] PUBLIC DOCUMENT— No. 37. 133 

Dudley. — Oar correspondent has observed an apparent connec- 
tion between wet cellars and the habit of sleeping on the ground 
floor, and the origin of typhoid fever. 

Erving. — "Last August three persons in one house died of 
typhoid fever. The cause seemed to be a pool of stagnant water 
and decaying vegetable matter within thirty feet of the house." 

Essex. — Typhoid fever was prevalent here in the summer and 
autumn of 1869, but no cause could be distinctly traced. 

Fall River. — " In the autumn of 1867, about forty cases of typhoid 
fever occurred in one locality where a large number of houses had 
been recently built, and filled with French Canadians as soon as 
completed. The water was from wells just dug. Every form of 
filth was thrown on the ground, and left exposed. This locality is 
now well sewered and is as free from disease as any part of Fall 
River. 

" The following year a large number of cases of fever occurred 
in another neighborhood. Here also the houses and wells were 
new. An examination of the premises showed that the pipe lead- 
ing to vaults containing refuse matter and filth of all kinds, was so 
arranged as to allow the foul air to escape directly into the houses. 
These pipes were properly trapped, and no cases of typhoid have 
since occurred. 

"In both years referred to (1867 and 1868) the typhoid fever in 
town was confined almost wholly to new comers, to the French 
recently from Canada." 

Franklin. — "We have but little typhoid fever. What seems 
strange to me is the fact that I see so many places where the sink 
water is deposited at the back door, and no apparent evil results 
follow. On the other hand I have had cases in families where the 
surroundings seemed conducive to health. I remember one instance 
six or eight years ago in which three families, comprising about 
sixteen persons were affected. Of this number twelve had the 
fever. The fathers of these families were brothers and lived quite 
near each other. I could discover no local causes. Those who 
were in the sick-rooms during the night took the fever, while a 
man-nurse, who remained only during the day, escaped. It was 
cold weather, but the nurse kept the windows open while he was 
in the house. These families had been previously well, and have 
continued well ever since, living in the same houses and with the 
same eurroun diners." 



134 STATE BOARD OF HEALTH. [Jan. 

Fitchburg. — "Water from wells in the valley occupied by this 
town is believed to be deteriorating from the increase of population, 
but no connection with typhoid is remarked by our correspondent. 
"An epidemic of typho-bilious fever occurred in 1865 when our 
wells were very low and continued till the November rains of that 
year." Soil, very variable in different localities, — some clay bot- 
toms, some gravel, a good deal of rock, very little alluvial soil. 
" The Nashua River makes a serpentine course of ten or eleven 
miles in crossing the town which is six miles wide. My experience 
of thirty-two years in this region leads me to believe that we have 
more of typhoid fever on the high land or on the summits between 
the water-sheds, than in valleys or low lands." 

Great Barrington. — " Whenever called to a case of typhoid 
fever, I have been able to trace the origin to some local cause in 
every instance." The above opinion is the result of twenty years' 
practice. Our correspondent is very decided in the expression ol 
his opinion that foul soil and air and water are the causes of typhoid 
fever. 

Grafton. — Our correspondent finds no difference as regards the 
causes of fever between the water of springs or wells and other 
sources, provided the water be of good quality, but remarks, what 
others have also observed, that patients suffering from typhoid 
often manifest a singular longing for the water of springs or wells 
in the vicinity of a former residence. 

" I have noticed that a connection between typhoid fever and 
foul soil seems to exist ; occurring more generally and assuming a 
more grave and malignant type under these "circumstances, some- 
times seizing a whole family, or even many families in a neighbor- 
hood, until the cause was abated. Many cases, not only of typhoid, 
but of dysentery (the latter, perhaps, especially,) have originated 
in foul soil and putrid air within the range of my practice." 

Gloucester. — " I have always found typhoid fever most prevalent 
and malignant where the air has been rendered impure from the 
causes enumerated in the fourth question of the typhoid circular." 
[See also " Health of Towns."] 

Hartley. — " Some twenty years ago I attended upon a family 
consisting of a father, mother and nine children. The mother and 
eight children had typhoid fever. After the first case of fever, 
four of the children, who showed no signs of illness, were placed in 



1871.] PUBLIC DOCUMENT— No. 37. 135 

as many different families, three of them being at a distance of 
two or more miles from their home. They, however, exhibited 
signs of the disease as soon as those remaining at home. As to 
the cause, — there was a slaughter-house at the distance of one- 
third of a mile from the house. The proprietor had spread the ac- 
cumulation of his hog-yard with the butchers' offal upon a low, wet 
piece of ground lying between his buildings and the house of his 
neighbor. Whenever the north-west wind blew, the stench was 
perceptible to all in the vicinity. I noticed it many times in riding 
by. I have always believed that the fever must be attributed to 
the influences proceeding from the manured field above mentioned. 

" Thirty years ago, a clergyman built a house in this town, with 
a fine cellar extending under all portions of it. He dug a well 
under the L portion. The well was not covered, and consequently 
the floors of all the lower story were kept damp by evaporation. 
The sink-pipe ran down near the pump into a wooden spout, which 
passed under ground to a closed box, situated about fifteen feet 
from the cellar wall. The foul air from the box and drain had no 
means of escape, excepting through the drain back into the cellar. 
The cellar was also used for the storage of whatever vegetables 
were used in the family. The windows of the cellar were never 
taken out. There was no escape for the moisture and foul air, ex- 
cept by permeating the floors. Water stood in drops upon all the 
timbers and boards. 

" After a few months' residence in the house, the minister's wife 
died, of fever so far as I can - learn. He soon married again, and 
within one year of the death of the first wife, the second died from, 
as I understand, the same disease. His children were also sick. 
He lived in the house about two years. The next occupant was a 

man named B . His wife was desperately sick. A physician 

then took the house. He married, and his wife died of the fever. 
Another physician was the next occupant, and he, within a few 
months, came near dying of erysipelas. All this while matters had 
remained as before described, with reference to ventilation. A 
school teacher then rented the house, and tore up the closed box, 
but did not cover the well. This was about eight years after the 
building of the house. The sickness and fatality were so marked, 
that the property became unsalable. When last sold, every sort 
of prediction was made as to the risk of occupancy, but by a 
thorough attention to sanitary conditions, no such risks have been 
encountered. 

" For the following circumstances, I take popular statements as 
the only evidence available. In North Hadley is an extensive mill- 



136 STATE BOARD OF HEALTS. [Jan. 

pond. About thirty years ago the water was drained off to make 
repah-s during the summer. It had islands and many shallow 
places, on which there was a rank vegetable growth. There was 
consequently much decaying material from the exposure. Typhoid 
fever swept through the village, causing great mortality. No one 
here has ever questioned the fact that the draining of the pond was 
the cause. 

" It is a fact, that within forty or fifty years, many ponds have 
been permanently dried up in the roads, and instead of there being 
a frog-pond in every farm-yard, there are now almost none. The 
drainage is greatly improved, land better cultivated, and sanitary 
laws better understood and acted upon. 

"In those days the 'fall fever,' as it was called (really typhoid), 
was the di-ead of the people. One fall is spoken of in which there 
were twenty-two deaths from this cause, in an area of territory oc- 
cupied probably by not more than twelve hundred people. Dys- 
entery of a very fatal type was also a very common disease. Ty- 
phoid fever is now comparatively rare." 

■Holyohe. — "In the fall of 1869 cases of typhoid were quite num- 
erous, but the disease prevailed in a greater or less degree through 
this entire valley, and could be traced to no special cause or causes. 
This year (1870) only three cases have come under my own obser- 
vation. They were persons of exemplary habits, lived in the most 
healthy parts of the town, remote from each other, and I confess 
myself at a loss to know why they should have been ill at all." 

Harwich. — In this town the condition of some seventy-five to a 
hundred acres of territory lying south of and in close proximity to 
the principal village, has been the subject of much discussion. It 
was formerly covered with water to a depth of several feet, and 
known as " Grassy Pond." Of late it has been almost completely 
drained during a part of the year, for the cultivation of cranberries, 
to which use about one-third of it is now devoted, the remaining 
two-thirds being covered with rank grass. A ditch and many 
holes remain, partially filled with water. [This place was visited 
by the Secretary July 25th, 1870, at the request of the selectmen of 
Harwich.] 

Our correspondent says of this place and its effects on those 
dwelling on its borders : "I have always freely expressed my 
opinion with regard to the cause of the sickness in the neighbor- 
hood of ' Grassy Pond.' It is due to the decomposition of vege- 
table and animal matter. My attention was called to it some ten 



1871.] PUBLIC DOCUMENT— No. 37. 137 

or fifteen years ago, when the cranberry culture commenced, and 
when the pond was partially drained. Since that time sickness 
has, on the whole, increased in this vicinity, though not in every 
year. In 1863, there were about forty cases of typhoid dysentery 
within one mile of the pond, on the northerly side, including in 
the area, I should judge, not more than thirty or forty families. 
At that time not a case of the kind occurred in any other section 
of the town." 

Another physician of the town has given similar testimony. 

Huntington. — Our correspondent states that typhoid fever is a 
very frequent disease, and is decided in the expression of his opinion 
that it may very commonly be traced to some local foulness as the 
cause. " In the winter of 1868 I attended six cases of typhoid in 
one house, on high and dry ground with good cellar and good water. 
I found no privy. The family for two years had made use of the 
vacant lot in the rear of the house. No other cause for the disease 
was found ; this seemed sufficient." 

In a subsequent letter it is stated that " persons coming here from 
other places have seemed most sure to have the fever, unless pro- 
tected by a previous attack ; from this I judge that there is some 
local cause operating here. Our village is low. Two large streams 
(the south and west branches of the Westfield River) pass through 
it. The fever, however, seems equally prevalent on the hills for 
miles around as in the valley. The autumn and winter of 1868 gave 
me fifty cases, about equally divided between the villages, and the 
country five miles around. I have usually found, on close investi- 
gation, some immediate and direct local cause on or about the prem- 
ises. Our cellars are many of them damp, sinks foul, and the people 
blind to the importance of these things. In 1867, in one house 
where there were nine cases of severe fever, a drainage from a wet- 
sink, into which all the slops were thrown, had established itself 
to the well from which the water for drinking and cooking was 
obtained. In nearly every case some local cause was ascertained, 
in some instances apparently slight. ' 

Hingham. — Typhoid fever is a disease of very rare occurrence in 
this town. 

Hudson. — "We had a great number of cases of typhoid fever and 
typhoid dysentery six years ago, caused, as I suppose, by the decay- 
ing vegetable matter from a pond in the village, which was drawn 
off for the purpose of repairing a dam. 
18 



138 STATE BOARD OP HEALTH. [Jan. 

""Wherever I have seen typhoid fever in ill-ventilated rooms, or 
where the surroundings were foul, the fever has been of a low type, 
and has proved more fatal." 

Hanson. — " I have found typhoid fever to be more prevalent in 
low, wet and foggy locations, and have sometimes been suspicious 
of the influence of foul cellars." 

Hyde Park. — " Typhoid fever, a disease of common occurrence. 
Have found foul privies on the premises, where repeated and fatal 
cases of typhoid have occurred, but have not always so found them. 
Do not think connection can be traced with other causes mentioned 
in third question." 

Kingston. — " We have but little typhoid fever. No epidemic for 
twenty years. I had five cases in one neighborhood last year in 
houses supplied with spring-water. Also two other cases in a house 
with a wet cellar and near a mill-pond, which had been drawn off." 

Lenox. — " Nearly every case of typhoid in my practice can be 
traced to foul privies, decaying vegetable matter, obstructed drains, 
or wells below the level of cess-pools, privies, or manure heaps." 

Leominster. — "Typhoid was prevalent in the fall of 1869, but 
except in four families the cases were isolated, scattered over differ- 
ent parts of the town, and without known or suspected cause. In 
the first of the excepted families there were five cases in a family of 
eight. In the second, four miles from the first, there were four cases 
in a family of six. In the third, far removed from either of the 
others, there were seven cases in a family of ten. All three of these 
families were farmers ; the water used was derived from open wells 
at some distance from the houses, with no possibility of anything 
running into them, as the ground around the wells was higher than 
the surrounding surface, and far removed from any contaminating 
cause existing upon the top of the ground, such as privies, drains, 
manure-heaps, &c. The water in the wells was rising, and remained 
higher than usual on account of the heavy and then recent rains. 
The houses of these three families were all on elevated ground, with 
no wet or swampy ground in their vicinity. The fourth family con- 
sisted of boarders, forty-one in number, operatives in a woollen mill. 
Twenty-two were within a few days seized with typhoid fever. The 
cause of the disease in this instance was apparent. The drain of 
the sink had found access to the well. A new well was dug and no 



1871.] PUBLIC DOCUMENT— No. 37. 139 

more cases occurred. For the last thirty years I have observed that 
typhoid fever prevailed here most extensively in those years in 
which the summer was dry, followed by a wet autumn." 

Leverett. — Typhoid fever is an annual epidemic in the village, 
which is built on the banks of a rapid stream, having five dams sup- 
plying power to as many mills. The cause of so much fever in the 
village is not, in the opinion of our correspondent, stagnant water, 
but more probably a cider-mill, where the pomace from the apples is 
heaped up yearly and left to ferment, so that in the hot season, with 
a west wind, the odor can be perceived throughout the village. 
There is now a great mass of this pomace which has been accumu- 
lating for years. There is a good deal of fever in this section of 
country, but more in the village than in all the rest of the town. 

" An epidemic of typhoid occurred here some time since from the 
flowing of a meadow, and then draining it. After it was drawn off 
every family living around the pond had typhoid fever. I have 
observed that if one member of a family is attacked some of the 
others are almost sure to be if the rooms are small and ill-ventilated. 
Among the causes of typhoid which I have observed, may be men- 
tioned, slops thrown on the ground, putrescent puddles from sinks 
under the window, rotting vegetables in cellars. Typhoid is often 
caused by decaying vegetation, ceasing after a hard frost. I have 
had cases occur after digging muck in swamps, and working around 
ponds that were drying up. 

"Two years ago three boys went in swimming in a foul pond of 
water. In just two weeks afterwards they were all taken down with 
severe typhoid fever." 

Littleton. — " I have observed that typhoid fever has assumed a 
graver type when the cases have been near a slaughter-house. It 
seemed to be aggravated by the impure air arising from the decom- 
posing animal matter." 

Lawrence. — " Many cases of typhoid fever occur in overcrowded 
and ill-ventilated sleeping-rooms, as well as from all the causes men- 
tioned in the fourth question." 

Lowell. — " In reply to your questions concerning typhoid fever, 
I would say that no opportunity is afforded in this city for observ- 
ing the difference in the prevalence of the disease between houses 
supplied with water from wells and those supplied from springs or 
ponds. All our water is from wells. This water, in the thickly 



140 STATE BOARD OF HEALTH. [Jan. 

settled localities, is highly charged with impurities. The worst ex- 
ample is a well on the corner of Lowell and Dummer Streets, which 
is exposed to the washings of streets, and the drainage of vaults 
and sewers, filtered through a few feet of earth. A gallon of this 
water contains fifty-two grains of inorganic and twenty-five grains 
of organic residue, but in spite of this impurity it is not unpleasant 
to the taste, and is used Dy at least one hundred families. "Works 
are now being constructed to supply the city with pure water. 

" During the year 1869 there were thirty-four deaths from ty- 
phoid fever in Lowell ; a greater number than in any year since 
1857. With a view of answering your inquiries, I have looked up 
the recorded residences of the deceased, and found, contrary to my 
expectation, that this disease was less fatal in the filthy than in the 
well-ordered districts, as will be seen by the following statement : 

Number of deaths in worst localities, . . .5 

of deaths in localities somewhat better, . 5 

of deaths in well ordered sections, . . 24 

" In Lowell, Winter, Williams and Middle Streets, regarded as the 
filthiest in the city, there were no fatal cases. If one may deduce 
any conclusion from the mortality in Lowell in a single year, it 
would appear that though filth, putrid air and impure water are 
active agents in causing scrofulous, tubercular and bowel diseases, 
they have but little if any effect to cause typhoid fever. 

" The greatest mortality from this disease is in August and Octo- 
ber. The greatest number of deaths occurred between the ages of 
twenty and thirty, Recent residents seem to be most susceptible 
to attacks of typhoid fever. I have in mind instances where it 
seemed to extend itself by contagion." 

In a subsequent letter, our Lowell correspondent says : " You re- 
quest me to give the population of the districts referred to in which 
the number of deaths from typhoid fever differed so greatly. It is 
difficult to estimate the number of persons living in these localities. 
Some streets are wholly good, bad, or indifferent in a sanitary point 
of view, while others may have two or even three of these condi- 
tions in different parts of their extent. 

" The only convenient way that suggests itself to me is to divide 
the population into nationalities. Lowell has a population of about 
forty-two thousand. The Irish and those of Irish parentage num- 
ber fifteen thousand strong, and there are three thousand French 
Canadians. The Americans and a small number of English, Scotch 



1871.] PUBLIC DOCUMENT— No. 37. 141 

and English Canadians constitute the remaining twenty-four 
thousand. 

" Now the Irish and French Canadians, as a rule, crowd into the 
bad and indifferent localities, and almost wholly disregard hygienic 
laws. The Americans, on the other hand, as a rule, live in the well 
ordered sections and observe hygienic laws, but notwithstanding 
this, and also the fact that the mortality from all diseases for the 
year was forty-three more among the former than the latter, we 
find, what appears to me singular, that the mortality from typhoid 
fever among the Irish and French Canadians was only seven (five 
in the bad and two in the indifferent localities), while among the 
Americans it was twenty-seven (twenty-four in the good and three 
in the indifferent districts)." 

In addition, we have the following history of typhoid in Lowell 
in 1870 :— 

" In reply to yours of the 6th ultimo requesting me to give the 
mortality in this city from typhoid fever during the year 1870 to 
the first of December, observing the same order regarding locality 
and nationality as that adopted in a communication respecting the 
same disease in 1869, I would say that I find the whole number of 
deaths from the disease to be 31 ; of this number 16 were in good, 
4 in bad and 11 in indifferent localities or sections of the city. 
Among the American population (including the few English, Scotch 
and English Canadians) there were 15 deaths ; 11 in good and 4 in 
indifferent locations. Among the Irish and French Canadian popu- 
lation and those of Irish and 'French Canadian parentage there 
were 16 deaths ; 5 in good, 4 in bad, and 7 in indifferent locations. 
During the year 1870, to the first of December, there have been 
879 deaths from all diseases and causes. Of this number 356 
occurred among the American and 523 occurred among the Irish 
and French Canadian population, an excess among the latter over 
the former of 167 deaths. By the above statement it will be seen 
that typhoid fever has caused 4.21 per cent, of the deaths among 
the Americans and only 3.06 per cent, of the deaths among the 
Irish and French Canadians. Or to state it in another way, typhoid 
fever caused one death in every 23 deaths among the American and 
only one in 32 deaths among the Irish and French Canadian 
population." 

Lexington. — " I had eight or ten cases of typhoid fever in 1865 
in a circle twenty rods in diameter. I noticed that within this area 
sinks disgorged their filth on the surface of the ground close to the 
houses, the privies had no vaults, the excrement lying on the sur- 



142 STATE BOARD OF HEALTH. [Jan. 

face of the ground ; a pigsty was an invariable appendage to each 
house or shanty, and often the house formed one side of the sty ; 
the weather was unusually warm, and the stench horrid. At the 
same time a large piggery from twenty to forty rods distant was 
daily replenished and enriched by loads of slaughter-house offal. 
The air from it at times was almost insupportable. Sleeping and 
other rooms were small and badly ventilated." 

Zieyden. — Typhoid fever a rather prevalent disease. Our corre- 
spondent regards it as due to a specific poison in the atmosphere at 
certain seasons of the year, " coming we know whence," rather than 
to sanitary neglect. He has, however, frequently observed the dis- 
ease to prevail where animal and vegetable matter was in a state of 
putrefaction, as near foul privies or over damp cellars holding decay- 
ing vegetables. 

"In one family six persons had typhoid fever and three died. In 
this instance the privy was found to communicate with the well." 

" The soil of the town, is, on the whole, rather dry than wet ; 
surface uneven, and much exposed to north-west winds. Typhoid 
prevails more on the low than on the high ground." 

Marshfield. — Our correspondent at Bridgewater writes as follows 
concerning a malignant form of fever which he witnessed at South 
Marshfield in 1842, and of which he thinks no account has ever 
been published : — 

"In the spring or early part of the summer of 1842, Daniel Web- 
ster, who lived three miles from South Marshfield had a large sur- 
face of ground, in the vicinity of his homestead, covered with fish 
(some hundreds of cart-loads of menhaden), which were left to de- 
compose during the warm weather. I was living in Hanover at 
that time, but was frequently called to the neighborhood in ques- 
tion. South Marshfield is in a hollow, bounded on the north-west, 
west and south-west by hills covered with forests which extend back 
several miles. In going from Hanover I passed through this forest 
and emerged from it on a high hill overlooking the village. From 
this hill I noticed a most offensive stench which continued several 
weeks. There was no unusual sickness in Mr. Webster's neighbor- 
hood, but in South Marshfield a very malignant form of typhoid 
fever began to prevail about the middle of July. Some of those 
attacked died in forty-eight hours without reaction. Many of those 
who lived a week had gangrenous spots, which sometimes became 
sloughing ulcers an inch in depth. A few recovered under the 



1871.] PUBLIC DOCUMENT— No. 37. 143 

influence of tonics and stimulants in very large amounts, but they 
made slow progress to health. 

" In the latter part of August there prevailed a malignant form of 
erysipelas, with rapid and extensive sloughing of the skin." 

Our correspondent has no doubt that these diseases, appearing as 
they did to leeward (by prevailing wind) of the great accumulation 
of putrid fish, were due to this cause. 

Martha's Vineyard. — Our information from this quarter is of an 
interesting character. The following remarks are from a medical 
man, a former resident of the island: "The eastern end of the 
island is sandy, chiefly drift. There are very few wells, and the 
people, in general, drink rain-water from cisterns. At the western 
end the land is high and hilly, and the water used is mostly from 
wells." [The division of these sections is indicated in a pen-and-ink 
sketch enclosed by our correspondent by a line running nearly north 
and south through the middle of the township of Tisbury. The 
island of Martha's Vineyard is thus divided into two parts of about 
equal area.] " It is my opinion, gained from several years' resi- 
dence, that cases of typhoid fever are as ten west of the line to one 
east of it." 

Our regular correspondent at Holmes' Hole writes as follows: 
" There is, without doubt, some influence or other which regulates 
the prevalence of typhoid fever upon this island, resulting in an 
almost complete absence of the disease in the eastern end, and con- 
fining it to the hilly part in the north and west. This latter region 
is almost all of it in the town of Chilmark. Now the population of 
Chilmark is to the rest of the county as one to four,* yet there is 
said, by the physicians who practise there, to be more typhoid 
there than in all the rest of the county. In the village of Holmes' 
Hole an epidemic of typhoid and dysentery occurred seven years 
ago, and all the fatal cases were on the same side of the same street. 
From all that I can learn, the conditions of the case are these : all 
the wells in the eastern part of the island are on the level of the sea. 
Those near the water's edge ebb and flow with the tide. In those 
further back this phenomenon is not observed, yet in these it is 
necessary to dig down to the sea-level in order to obtain water. As 
the land rises it is difficult to obtain water from the deep wells. 
This leads to the discontinuance of their use, especially in Holmes' 
Hole, where cisterns for rain-water are substituted. In Chilmark, 
the hilly region, spring water and well-water are almost universally 
used. The wells are on a higher level than the sea, caused no 

* One to six, according to Census of 1865. — Sec'y. 



144 STATE BOARD OF HEALTH. [Jan. 

doubt by the clayey substratum which forms basins for the col- 
lection of the water. On the side of the street referred to in 
Holmes' Hole, where typhoid and dysentery prevailed, every fatal 
case was in houses supplied with wells. No cases, fatal or other- 
wise, occurred in houses provided with cisterns, the water of which 
was used for drinking purposes. The only case of typhoid I have 
known since I have been in practice in this village was imported." 

Our correspondent in West Tisbury practises also in Chilmark, 
the adjoining town, and may speak for the western end of the 
island. He says : " Probably more cases of typhoid occur in the 
town of Chilmark than in all the rest of the county." [This fully 
confirms the opinion above given by a former resident of the 
island.] "I have imputed this to the character of the subsoil, 
which is clay, retaining the moisture, and also to the greater fertility 
of the soil. Typhoid is comparatively rare in the eastern part of the 
island, where the soil is light and sandy and the vegetation sparse. 

" In several instances I have known typhoid to follow the taking 
down and repairing of old houses while the family still lived in a 
part of them ; but in a majority of cases I have been unable to 
assign any cause. The inhabitants in the region of my practice use 
either well or spring water, — generally the former. Occasionally a 
family will use cistern water in winter. I have never observed any 
connection between typhoid and foul air from decaying animal 
matter, as fish spread on the land for manure, but I have thought 
the disease prevailed more extensively where vegetation grew 
luxuriantly and where large amounts were left on the ground, in 
the fall, to decay." 

[The condition of the camp-grounds at Martha's Vineyai-d in the 
summer of 1869 was such as would lead an observer to predict that 
sooner or later they would be visited by pestilence. They certainly 
violate the plainest teachings of hygienic common sense. The 
buildings are so close together that ventilation is obstructed ; they 
have no drainage ; there is no adequate provision for the removal 
of refuse ; the privies and wells are everywhere in close proximity, 
and most of the houses are so shaded by trees that direct sunlight 
can hardly ever reach them. — Secretary.] 

Mendon. — Our correspondent, who has practised in this town 
during the past forty-four year's, reports that during that period he 
has not met, in the usual circle of his visits, with more than (by 
estimation) one hundred cases of typhoid fever. " Many years ago, 
during the autumn, all the members of a family, six in number, had 
typhoid fever, mostly of a mild type. Three or four other families, 



1871.] PUBLIC DOCUMENT— No. 37. 145 

within sixty feet of the first, did not have a single case. The family 
in which the cases occurred was remarkably neat, and from garret 
to cellar everything, in a sanitary point of view, was well cared for. 
In the autumn of 1836, while the only physician in Milford was 
sick, I had the care of some thirty cases of typhoid in that town. 
I attributed its prevalence at that time to the fact that a large, 
shallow pond which had for a long time been covered with water 
was, during that year, bare. The Milford cases were all confined 
to the valley in which the pond was located, and no cases occurred 
beyond the summit level on each side of it, east and west (the 
stream running south)." 

Medway. — " There is a large swamp near the centre of the town, 
but the land around it is generally somewhat elevated, and but few 
people live near its level ; those who do I think are more subject to 
fevers. "We have had no general epidemic of typhoid since 1839. 
At that time the most severe and fatal cases were observed to be in 
houses with bad drainage and exposed to the influence of decaying 
animal and vegetable matter." 

Montague. — " Typhoid fever occurs where the surface water has 
drained off or dried up, leaving vegetable matter, which at other 
times is covered, exposed to sun and air. My observation leads me 
to believe there is a close connection between this disease and foul 
soil and putrid air. It prevails more in the lowlands about swamps 
and stagnant water than in the "upland." 

Middleton. — Thirty years' practice. Typhoid a rare disease. 
When it has appeared, it has been by single cases, without any ap- 
parent cause. If the greatest care was not given to ventilation, it 
has spread by contagion. 

New Marlborough. — "I have no doubt that foul soil from privies 
and pigsties is often connected with the development of typhoid 
fever, although I have not met with such cases. I have observed in- 
stances in which I thought the disease was due to rotting vege- 
tables in cellars, and to old cisterns with stagnant water, and I 
make it a point when I have cases of typhoid to look out for these 
causes of impurity, and to remove them when they exist." 

Newburyport. — "Water supplied from neighborhood wells. A 
pump on the highway affords water for twenty or thirty families. 
Some old estates have wells on the premises. No connection 
19 



146 STATE BOARD OF HEALTH. [Jan. 

observed between this water supply and fever. During the war, 
have seen typhoid originate in camps from unventilated quarters 
and decomposing vegetable matter." 

Nantucket. — Our correspondent recalls two cases of typhoid in 
one house some years ago which were apparently caused by a mass 
of turnips which had been left in the cellar and forgotten until their 
presence was made known by the smell of decomposition. 

Northbridge. — The disease not a common one here ; but the old 
village of Northbridge Centre, situated upon a hill, is thought to 
have comparatively more cases than the factory village, situated on 
a stream and in a valley. 

Newton Centre. — Typhoid is rare here. "In ten years I have 
seen not more than twelve cases, and two-thirds of these occurred 
among the theological students, on the top of a very high hill, where 
the subsoil is tough marl / the other four were at the base of the 
same hill, where the soil was swampy and the house-sills decayed. 
Improvement in two of these cases was very marked after removal 
to higher and drier land ; two other cases were fatal. The village 
lies on a plateau, one hundred and fifty feet above Charles River ; 
has most excellent surface drainage, and is underlaid with an un- 
fathomed bed of loose gravel.' 1 '' 

Orleans. — " Typhoid fever was first known in this town and 
vicinity in the spring and summer of 1837. It was then epidemic 
and severe, and pervaded the whole town. I could never trace the 
cause to bad drinking-water, decomposing matter aboiit the prem- 
ises, bad ventilation or any local filthiness ; but in my opinion, the 
atmosphere of the whole place had become contaminated, tainted, 
poisoned by the noxious exhalations from low, marshy grounds sur- 
rounding the numerous inlets from the sea (forming ponds of mingled 
fresh and salt water of greater or less extent) with which this town 
is sadly cut up. Typhoid fever has stuck to us ever since 1837 in 
the summer and autumn, but most prevalent and most severe in dry 
seasons. The towns on the south side of the Cape were compara- 
tively exempt from fever at the time it first appeared in Orleans, and 
for several subsequent years ; but of late, sporadic cases are quite 
common. The town of Chatham is geographically very like the 
town of Orleans, but there are counteracting climatic influences." 

Oxford. — Opinions based upon a practice of forty years. 

Our correspondent says : " I have very frequently observed a 



1871.] PUBLIC DOCUMENT— No. 37. 147 

marked connection between typhoid fever and exhalations from 
privies, cess-pools, pigsties, foul cellars, &c. These, together with 
filthy and unventilated places of living and sleeping, have appeared 
to me to be the cause of typhoid fever in a great majority of cases. 
So firm is my belief of this that when I meet with a case of this 
fever not readily traceable to some of these causes, I infer that the 
truth has not been told me, or that my perceptive faculties have 
been at fault." 

Pittsfield. — Has good reason to believe in the production of 
typhoid fever by local causes. In the summer of 1864 this disease 
appeared among the pupils of the Maplewood Institute. Among 
seventy-seven young ladies occupying the premises, fifty-one were 
attacked, and thirteen died. Three servants also died. A thorough 
investigation of the causes of this pestilence was made by three pro- 
fessors of the Berkshire Medical College, whose report was pub- 
lished. The water used at the school was brought by an aqueduct 
from hills outside the town, and was of unquestionable purity. 
During a few days in July this water gave out, and the supply was 
from a well in the neighborhood used by several families, none of 
whom suffered from illness. There seems to have been no well on 
the premises. The committee were of opinion that water had noth- 
ing to do with the disease. A few rods from the school was a barn, 
whose yard was a basin holding foul water, in which swine wal- 
lowed, emitting an offensive odor. The kitchen drain discharged 
its contents on the surface of theground. The vaults of the privies 
were shallow, filled to overflowing, and emitted an odor very offen- 
sive, and at times pervading the whole building. The grounds were 
excessively shaded by trees, and the sleeping-rooms were so shaded 
by piazzas and vines that the direct rays of the sun could not reach 
them. These were the causes of the fever. At the same period 
there was no unusual sickness in Pittsfield, and since the removal of 
the causes above described, the Maplewood Institute has been 
exempt. 

In December, 1835, typhoid fever appeared in Pittsfield in a 
family of about forty persons, a boarding-school for boys. The 
head of the school and four boys died. Eight or ten other cases 
recovered. The surrounding community was healthy. In this 
family the water used was from a well under the wash-room. The 
drain from the wash-room was obstructed, and the foul water found 
its way under the floor and into the shallow well. The well was 
closed, and the family supplied with water from another source, and 
the fever subsided. 



148 STATE BOARD OF HEALTH. [Jan. 

The published report of the board of health of the town of Pitts- 
field for the last year shows the most intelligent interest in the pre- 
vention of disease, and the citizens of that town may be congratu- 
lated on having such faithful guardians of the public health in the 
gentlemen who constitute the board. 

Since the above was written, our venerable correspondent at Pitts- 
field has been removed by death. The town authorities have 
promptly appointed a successor, who writes to us concerning 
typhoid in 1870. " A case of typhoid fever under my care in Sep- 
tember appeared to be caused as follows : The man was engaged in 
laying drain-tiles in a meadow, with two others. They all drank 
while at work from an old well in the meadow, supplied only by 
meadow water. This case of fever was severe, but recovery fol- 
lowed. It so happened that the other two men engaged in the same 
work, both came to me, one a few days before, and the other a few 
days after the case of fever occurred, with violent headache, general 
pains, and nausea. Both immediately recovered after a vigorous 
catharsis, followed with quinine ; but I attributed their symptoms 
to the poison of the meadow well. 

" Another physician of Pittsfield reported to the Medical Society 
in September two cases of typhoid occurring in the immediate 
neighborhood of an overflowing and very foul cesspool from an 
hotel. The same physician also reported in August a case of 
typhoid in a very old house, under which a cellar was being dug, 
disturbing a great quantity of rotten timber. 

" Another physician of Pittsfield, had three cases of typhoid in 
July, in a house built upon a meadow, through which, and near the 
house, flows a sluggish brook, which receives all the sewage of the 
town. This house is also surrounded on three sides by stagnant 
ditches, foul with sewage. Most of my own cases have been of 
obscure origin." 

Our correspondent states that typhoid has been unusually infre- 
quent in Pittsfield during the past summer, and adds: "I am quite 
sure, and it is the general impression here, that our comparative 
freedom from fevers during the past summer, has been largely due 
to the activity of the town board of health, in causing the imme- 
diate removal of every removable nuisance or source of sickness. 
Our board of health has now acquired so established a character 
that our ' notices ' have been immediately complied with. In only 
two cases has it been necessary to remove a nuisance and collect 
charges of the owner." 

Promncetovm. — "In a practice here of more than thirty years, 



1871.] PUBLIC DOCUMENT— No. 37. 149 

typhoid has been a rare disease ; never epidemic. I have had spor- 
adic cases which were aggravated by ill-ventilated rooms. 

" Our wells rise and fall with the tide at all seasons, and afford 
very pure water." 

The following letter was received from Provincetown in Decem- 
ber, 1870, in reply to a question whether putrid fish had ever been 
known to cause typhoid fever in that town : — " I came to Province- 
town in December, 1839. During that year typhoid fever (as it 
was called) had prevailed epidemically, and was very mortal. It 
had subsided so that I did not see any of the cases. During the 
winter much was said about the offal of fish, left on the shores un- 
buried, as the cause of the fever of the preceding season. At the 
town meeting in February, a very efficient man was chosen as 
health officer, who kept the shores clear the following year, and there 
were but few cases of typhoid. The shores have been kept clean 
from that time to the present, and typhoid has diminished. For 
fifteen years past typhoid fever has been almost unknown among us. 
Now and then a sporadic case occurs ; whether this is owing to our 
keeping the shores clean, or to the inhabitants taking better care of 
themselves, the fact is that typhoid is so rare with us that we do not 
look for it unless it is imported, while Truro, Wellfleet, Eastham, 
Orleans, Chatham, are not so exempt. We shall keep our shores 
free from filth for general convenience, and if by so doing we keep 
off disease, we are by so much the gainers. We have swamps 
which have been in a great degree converted into cranberry bogs, 
by being filled up with sand, and this I think, has had some influence 
in making this a healthy spot. I should say that in the towns above 
referred to, typhoid fever cannot be referred to decaying fish left on 
the shore, for they are not exposed to this danger as we are. I still 
believe that decaying vegetable matter and impure water have 
more to do with the production of typhoid." 

Pembroke. — " Some of the most severe and fatal epidemics of 
typhoid dysentery I have seen occurred in very dry seasons, in the 
vicinity of large ponds, or low marshy places usually overflowed, 
but then exposed by prolonged drought." 

Hoice. — Our correspondent has had an experience of thirty-eight 
years' practice of medicine in this town, and answers our first and 
third questions in the negative. 

Typhoid has seldom originated here, but has often been imported. 
" In one instance we had an endemic fever, arising from the flow- 
ing of an artificial pond. It did not seem to be pure typhoid, so I 



150 STATE BOARD OF HEALTH. [Jan. 

called it the ' pond-fever.' All the cases recovered. Some years 
ago a case of typhoid was imported into the neighboring town of 
Monroe, from a region where fever was prevalent. It was com- 
municated to the attendants and visitors, and was of a severe type, 
causing many deaths. It was a strictly contagious disease. 

" On another occasion, in a high and healthy part of the town, a 
family of four persons came down with the fever. They were neat 
and tidy people, but I always thought in this case there must have 
been some impurity about the premises. All recovered." 

Randolph. — " Typhoid usually occurs among us from August to 
November inclusive. Occasional cases occur during an open win- 
ter, or in the following spring. Its time of prevalence generally 
coincides with the season of low water, but it ceases for the most 
part with the coming of dry, cool weather, whether the autumn 
rains have been heavy or light." 

Rutland. — " Although I have uniformly tried to discover the con- 
nection between cases of typhoid fever and its alleged causes, my 
experience has been negative rather than positive. There are sev- 
eral neighborhoods in the region of my practice the atmosphere of 
which in the warm season is often rendered very offensive by the 
offal and pigsties of slaughter-houses, and the draining off of two 
or three large reservoir ponds used for the storage of water for fac- 
tories. This has been especially true this season, but typhoid fever 
has never prevailed in these localities more than in others; and 
never at those particular times and places when and where they 
would naturally be predicted. 

"For many years after my first residence in this town (1839), 
probably a dozen, I never saw a case of typhoid fever on the sum- 
mit of the hill on which the centre village is located, unless it was 
imported. A very few since that time have originated there. The 
hill is of about eleven hundred feet elevation above tide-water, and 
has no wet subsoil. In digging wells which are the only supply for 
water, a ledge is always encountered, at a depth of eight, ten or 
twelve feet. The base of this hill has not had the same immunity 
from this disease. About a mile to the north of this hill is another 
of about the same height, on the summit of which there have been, 
until within a few years, two families. In both of these houses 
typhoid fever used to be of very frequent occurrence. In one of 
them, which was burned down six or eight years ago, it was rare 
that a hired man or a female domestic escaped the disease the first 
autumn. I never could quite satisfactorily explain the prevalence 



1871.] PUBLIC DOCUMENT— No. 37. 151 

of typhoid on one of these hills, and the comparative immunity of 
the other, unless it was because one was wet soil and the other dry." 

Mockport. — " Although dysentery and typhoid fever are seldom 
absent during the latter part of summer and the fall, they have only 
ouce presented a sufficient number of cases to warrant being called 
1 epidemic' 

" While the typhoid epidemic was prevailing there appeared to be 
nothing unusual in the state of the atmosphere ; but during the epi- 
demic of dysentery, the weather was unusually hot and dry, many 
of the wells were dry, and rain was withheld until far into October. 
In neither instance could the disease be traced directly to any de- 
composition of animal or vegetable matter, but in both seemed to 
spread from communication with the sick. Within a few years, 
however, I have noted cases of typhoid which seemed to be con- 
nected, in one instance with vegetable, and in another with animal 
decomposition. In December, 1868, I was called to see two cases 
of typhoid in a room underneath which was stored a large quantity 
of turnips and cabbages which were rotting, and the odor from 
which was extremely unpleasant. Soon after two other cases 
occurred in another family in the room immediately over the first, 
while in the opposite end of the house, also occupied by two fami- 
lies, but not directly over the vegetables, no case occurred. There 
was but one other case in the neighborhood about that time, and 
that was in the house adjoining. During the hot and dry weather 
in the latter part of the summer of 1869, some fifteen cases occurred 
in quick succession in tenement houses owned by the ' Rockport 
Granite Company.' Most of them were under my care. These 
houses were situated on a high and broad ledge, with very little soil 
on its surface,* to absorb the semi-liquid contents of a half dozen 
privies and pig-pens which flowed out over its north-east declina- 
tion towards the sea. The stench was almost intolerable. On my 
representing to the clerk of the company the possible effect of such 
a state of things, the premises were freely strewed with quicklime, 
and subsequently covered with dry coal ashes. The adoption of 
this modification of the dry earth system was soon after followed 
by copious rains, which washed the surface of the ledge and carried 
into the sea much of the filth which had accumulated during the 
summer. No new cases occurred, and I am led to believe the 
means used, along with the atmospheric changes prevented the 
spread of a serious disease." 

* Compare with remarks of Worcester correspondent on "ledges." — Sec'y. 



152 STATE BOARD OF HEALTH. [Jan. 

Reading. — " Three years ago there prevailed here an epidemic of 
typhoid dysentery, beginning- in the middle of August, and lasting 
about six weeks. There were eighteen deaths. One, a young girl, 
was living in a high, dry, healthy spot, a half mile from the rest. 
All the others were in or near a circumscribed locality, low, level, 
wet; the ditches full and overflowing, the wells also, and some of 
the latter I know were offensive. The season was unusually wet. 
The rest of the town, and the adjoining towns were remarkably 
healthy." 

Rochester. — "Forty years ago typhoid prevailed extensively in 
this town. I was then in practice, but I cannot from memory 
throw any light on the causes. A few years since I knew a whole 
family sick of typhus from a very foul cellar. One died." 

Sutton. — In illustration of the effects of drinking-water made 
foul by decomposing organic matter, the following instructive facts 
are related by our correspondent : — 

" A large house in this village is supplied with water from a well 
in the front yard, three rods from the house. Connected with the 
house is a barn without cellar, some three rods from the well. In 
December, 1868, a trench three or four feet deep was dug from the 
well to a point near the middle of the barn, where a pump was set 
and a pipe connecting it with the well was laid in the trench ; after 
which the earth, which was in large frozen chunks, was filled back 
into the trench. In the house was kept a boarding-school for boys, 
of whom there were ten or twelve. Three little girls were also 
there, aged twelve, eight, and three years, belonging to the family 
of the owner of the house ; there were therefore fourteen or fifteen 
children who drank from the well. The oldest boy was seventeen 
or eighteen years old, while the others were of ages from ten to 
thirteen. 

" Everything went well until after the thaws in February and 
March, 1869, when the water had a decided taste and smell of 
stable-manure. March 26th, one of the boys, thirteen years old, 
was seized with typhoid fever ; another, twelve years old, on the 
31st of March ; another, eleven years old, April 2d ; another, ten 
years old, April 4th, and another, twelve years old, April 9th. 
April 20th, one of the little girls (eight years old) was seized. 
Each of these six children (all of whom finally recovered) drank 
water with their meals from the well in the yard. Some of the 
older boys drank coffee in the morning and tea at night. The man- 
ner in which these children were attacked, and the fact that this 



1871.] PUBLIC DOCUMENT— No. 37. 153 

house had been free from typhoid fever for many years, and the 
water heretofore known to be very pure and wholesome, leads me 
to the conclusion that the use of the water thus impregnated was 
the cause of the disease occurring where and just at the time it did. 
My theory is that while the ground, manure, &c, under the barn, 
were frozen, the water was all right ; but when it thawed, and the 
previously frozen filth leached through the soft and loose earth 
along the track of the pipe into the well, the effect of the poison 
was felt most perceptibly by those who used the polluted water 
most freely, while those who used it less freely escaped entirely." 

Salem. — "In one season, typhoid fever prevailed extensively 
along the banks of the North River, but of late years it has shown 
no more preference for that locality than for other parts of the city. 
Cases seem to be quite equally distributed about the city, without 
regard to soil or water supply, whether from wells or aqueduct. 

" It has been a matter of surprise that the old mill-pond has not 
been a more fruitful source of disease than it has hitherto been, as 
its surface is covered, during the hot season, with decaying vege- 
table matter." 

Somerset. — Our correspondent thinks that the influences of 
marshes, and not those referred to in questions 3 and 4, are con- 
cerned in the cause of typhoid fever. 

Shelburne. — Our correspondent reports twenty cases of typhoid, 
of a severe type, which occurred in 1868, in a little hamlet of eight 
houses at the confluence of the North and Deerfield Rivers. With 
one exception these houses were clean, of rather recent construc- 
tion, and free from any discoverable cause for the disease. 

Shirley. — "I give you the history of typhoid fever as it has 
occurred in a certain house in this town ; not as throwing light on 
the questions you have submitted, but from the regularity of the 
intervals being very peculiar. 

" 1st. In 1818, when four deaths occurred. 

" 2d. In 1836, three cases and one death. 

" 3d. In 1856, six cases and three deaths. 

" On neither of these occasions was the disease specially prevalent 
in this vicinity. The house is in a valley on a small, sluggish 
stream, a tributary of the Nashua River. No other local cause was 
ever recognized. The commencement of the disease each year was 
in August." 

20 



154 STATE BOARD OF HEALTH. [Jan. 

Somerville. — The most severe epidemic known here in fifteen 
years occurred in July and August, in a section of the town sloping 
to the south, with decidedly dry soil and with good well-water. 
" I regard bad air as one of the principal causes of this disease. 
The most unhealthy condition we ever experience is to live in a 
house with a wet and imperfectiy drained basement. Large and 
well-ventilated sleeping-rooms are indispensable to health, and 
equally so for the recovery of the sick." 

Shrewsbury. — " I have observed for some years an apparent con- 
nection between foul soil (and consequently air) and typhoid fever. 
I have often believed a vile sink-drain, or rather sink-pool, to be 
the cause ; also, butchers' slaughter-yards, the foul effluvia from 
which have seemed to favor typhoid and dysentery of a low grade." 

Spencer. — "Have observed instances where typhoid fever seemed 
to be directly caused by foul air from pigsties and privies. Five 
cases at an isolated farm-house, in 1867, apparently due to the foul 
air from a pigsty. The disease more prevalent in houses supplied 
with water from wells." 

Stockbridge. — " A few years since there were several tanneries 
on the river just above us, from which tons of filth were cast into 
the stream to be borne away or scattered over the low lands, as 
chance or flood might direct. The result was a dreadful stench 
and a prevalence of typhoid fever, causing numerous deaths. The 
tanneries were finally removed, and water introduced from a neigh- 
boring hill through iron pipes ; and, with a purer air and delightful 
water, typhoid fever has almost become unknown. Nearly all the 
people used wells formerly, while we now have a fine reservoir." 

Stow. — [See remarks on diseases most prevalent in towns.] 

Southampton. — " Have observed typhoid fever to prevail with 
great severity in a neighborhood where a mill-pond had been drawn 
off, leaving the debris at its bottom exposed to a hot sun, gener- 
ating putrid air." 

Stoneham. — " I think there is a connection, and an intimate one 
too, between typhoid fever and foul soil. Several cases could be 
distinctly traced to this source, in the form of filthy privies and 
pigsties." 

Springfield. — " In three-fourths of the cases of typhoid fever 



1871.] PUBLIC DOCUMENT— No. 37. 155 

coming under my observation, in this city, during the past eight 
years, foul soil from privies or defective drains was present, and in, 
I should say, one-third of the cases impure privies were on the 
premises. Most of my cases of typhoid have been found in ill- 
ventilated apartments and overcrowded tenement-houses. In a 
large number, I could trace the cause directly to impure air from 
decomposing animal matter. In several families where it prevailed 
the cellar was inundated with sink-drain water. 

" Since the more general introduction of water from springs, by 
the Springfield Aqueduct Company, there has been a diminution 
in deaths from typhoid. Of late the drainage has also been better. 
There has been no epidemic of typhoid during the eight years of 
my observation ; but the cases have been sporadic, springing up 
here and there wherever some focus of infection has seemed to be 
produced by decomposition." 

Sunderland. — "Typhoid fever has only once prevailed here as an 
epidemic during the past twenty years. It was then (1851) as I 
doubt not, due to imperfect drainage. The season was very dry 
and hot. I then called the attention of the town to what I regarded 
as the cause. The drains were opened and have since been kept 
open." 

Our correspondent in reply to the third question of the typhoid 
circular says : " In several instances, the connection has been of 
such a natixre as not to admit of a reasonable doubt. In one case 
a whole family was down from the influence of a neglected cistern." 

Sterling. — Our correspondent reports that typhoid has prevailed 
in this town and vicinity to an alarming extent during some past 
seasons but not within the period of his own observations. 

Swampscott. — Three cases of typhoid are reported as occurring 
at about the same time, and among the crew of the same schooner. 
They had been exposed on board to the emanations from a quantity 
of putrid clams which were very offensive. 

Taunton. — "The disease has been observed to be prolonged 
and convalescence made tedious when sinks and cess-pools and cel- 
lars were neglected. 

"It is not unusual to meet with cases of typhoid in boarding- 
houses of unskilled laborers. In such cases I have sometimes found 
them in an attic room with three beds, two men for each bed, one 
window in the room and the upper sash fixed." 



156 STATE BOARD OF HEALTH. [Jan. 

Truro. — " There has been a good deal of typhoid fever here the 
last year, and I have observed that nearly all the cases have been 
around a low, marshy meadow over which the tide used to ebb and 
flow, but from which the salt water has been excluded of late by a 
dike built about a year ago." 

Teioksbury. — Our correspondent states that some years ago, 
while he was in charge of the Monson State Almshouse, typhoid 
broke out in a detached building occupied by idiotic and epileptic 
patients, and was arrested by clearing it out, and having it 
thoroughly cleansed. Typhoid rare in Tewksbury, either inside or 
outside the State Almshouse. 

Upton. — " I think I have observed a connection between typhoid 
symptoms in fever and other diseases, and foul air and soil from 
want of proper drainage, unventilated sleeping-rooms, and decom- 
posing substances in and about the houses; and where these condi- 
tions of impurity were most obvious typhoid was most severe." 

Uxbridge. — Several cases in one house apparently proceeding 
from filth spread upon the ground from a sink-drain. No new cases 
after removal of cause. 

Webster. — Our correspondent believes that putrid air about 
houses is a prolific cause of typhoid. " During an epidemic of 
typhoid fever in 1864 I met with about forty cases in three tene- 
ment houses. The houses were one story, with basement tene- 
ments, and cellars only in the rear of the basement. All the fever 
cases occurred in the upper tenements during the summer and 
autumn. Not a case occurred in the basements until late in winter, 
and then only two or three mild cases. I attributed this to the ex- 
halations from the cellars and sink-drains having free access to the 
rooms above, but not to the rooms below." 

Ware. — Our correspondent has not been able to plainly trace the 
origin of fever, in the cases under his observation, to the causes 
enumerated in questions 3 and 4, except in a young man who had 
typhoid after cleaning a dirty cellar. While engaged in the work 
he complained of its making him feel sick, and two weeks after 
came down with severe typhoid fever. 

Instances of apparent contagion from one case to another have 
been observed. 



1871.] PUBLIC DOCUMENT— No. 37. 157 

Westfield. — " Have had a great many cases which could be di- 
rectly traced to decaying vegetable matter coupled with moisture, 
in cellars and about houses." 

"Warren. — " In two instances have thought there was a connec- 
tion between the disease as it appeared and ill-ventilated cellars." 

Winthrop. — One section of this town is, from some cause entirely 
unknown, very subject to typhoid fever. In one house, built ten or 
twelve years ago, there have been at diffei-ent times fourteen cases. 
Local causes have been often sought for but never found. The 
situation of this portion of the town is high, and very much ex- 
posed to wind. The soil is rather springy and cellars often damp. 

Wrentham. — Typhoid fever not by any means a prevailing dis- 
ease. Twelve cases under observation of our correspondent last 
September. " In each place where it occurred, the water used by 
the family was of questionable purity, privies or sink-drains being 
very near the well. In one instance a direct communication be- 
tween an obstructed sink-drain and the well was shown to exist." 
Our correspondent has met with no case of typhoid in families sup- 
plied with water from springs or ponds ; and in a subsequent letter 
informs us that he can recollect twenty-four families so supplied ; 
and that there are doubtless others. In some of these families, 
water is obtained by dipping directly from the spring. 

" Little attention is paid to -the condition of cellars. Drains and 
privies are often too near wells. Hence typhoid and dysentery." 

West Boylston. — [See remarks on diseases most prevalent in 
towns.] 

Westborough. — Our correspondent believes that he has often seen 
a connection between typhoid fever and foul soil and air, but limits 
the connection to cases in which the decomposing matter was under 
cover, as from cellars, or from drains which had become obstructed 
and thus thrown their contents back to the cellar or under the 
dwelling. He is also suspicious of the influence of shade-trees in 
close proximity to the house. 

West JSfexcbury. — "We have had no epidemics of typhoid or ty- 
phus for the past ten years, — a few cases arising from local causes. 
We have had, however, two epidemics of dysentery, ascribable to 
local exciting causes in connection with continued hot, dry weather. 
These causes were bad sink-drainage, filthy cess-pools and slaughter- 



158 STATE BOARD OP HEALTH. [Jan. 

houses not properly disinfected, the waste being matter thrown into 
pig-pens to be partially eaten by pigs, and the rest to become decom- 
posed, and render the air impuz-e and noxious for quite a distance 
from them." 

Wales. — " In years past have observed the connection between 
typhoid fever and foul soil and putrid air from dirty cellars and un- 
ventilated sleeping-rooms." 

Watertown. — " In connection with inquiries 3 and 4, I will say 
that in all instances in which I have seen a succession of cases of 
typhoid fever in one house or in a small locality, I have diligently 
searched for some local cause of contamination, but have never, 
with a single exception, been able to discover any satisfactory one." 

The " Boston Medical and Surgical Journal " for February 4, 1869, 
gives a history of some cases of fever originating in Watertown, 
which are doubtless the exception to which our correspondent re- 
fers. Five members of a family were successively attacked with 
typhoid fever in the autumn of 1868. A foul smell had been per- 
ceived soon after the first case occurred, and the drain was taken 
up and examined, but nothing wrong was discovered. Some weeks 
later, a more careful search being made, it was found that an open- 
ing existed between the drain and an air-box which conveyed 
air from without to a chamber behind the kitchen range, and 
thence to the bath-room and other parts of the house. A third 
search being made still later in the season, another opening was 
discovered beneath the wash-room floor. The workman who took 
up the floor was so overpowered by the effluvia that he had to be 
assisted to the outer air. 

Winchester. — "I had last fall two fatal cases of typhoid in the 
same house, where the water came from a cistern exposed to con- 
tamination from a leaky sink-drain. At the same time the vault 
was overflowing, though not in a position to make it probable that 
its wash affected the cistern. They died of distinct blood-poison- 
ing, but the other members of this family were not attacked with 
typhoid, although one was threatened with it. 

" There is a tenement house in this town occupied by seven or 
eight Irish families, where for the past three years the sink-drains 
emptied into the cellar, whither also the wash of the privy worked 
after every rain. The well is in this cellar. Now I have known 
but one case of typhoid in that house. There have been several 
cases of diphtheria, two or three of which were fatal. I have made 



1871.] PUBLIC DOCUMENT— No. 37. 159 

various efforts to get the drains in this house put in order, but can 
effect nothing. It amazes me that there is not more severe sickness 
there, but it stands at a distance from any other house, and the 
children live out of doors, while awake." 

Walpole. — " Typhoid fever not often met with. There is, how- 
ever, one house in which it has occurred, in 1856 and 1858. It is 
situated on the north side and at the foot of a high hill, and is sur- 
rounded from the south to the north-west by low, swampy land. 

" Some years ago, an epidemic of typhoid and dysentery occurred 
among the residents near a mill-pond which had been drained for 
the purpose of making repairs. Typhoid has more frequently oc- 
curred in the south part of this town (where there is low, damp 
land bordering a stream), than in any other part." 

Waltham. — " A brook in this town flows about six months of 
the year ; at other times there is only a ditch of stagnant water. 
It is just back of an Irish settlement. Typhoid usually commences 
here, and is more prevalent and more severe than in any other part 
of the town." 

Williamstown. — Our correspondent reports an outbreak of ty- 
phoid of a severe type in August, 1868, in tenement houses on the 
grounds of the Williamstown Manufacturing Company. These 
houses (eighteen in all) are in two rows, placed back to back, with 
a space of thirty-three paces between them. In this street or pas- 
sage, common to them all, are placed the privies ; there is also a 
gutter which makes pretence of carrying away the water, but fails 
of doing it. Close by the front of the row, facing south, is a well ; 
at this well washing was done, and when the sickness broke out 
the water was falling. The well had a pump and a platform about 
six feet square. At one side the water had worn a hole, and it is 
probable that the foul water from washing was drained from this 
hole into the well. 

" About twenty cases of fever, with several deaths, occurred in 
the tenement houses using this particular well, and it was in the 
section of the tenement houses, of both rows before referred to, 
nearest this well that the outbreak occurred. Typhoid fever did 
not exist in other parts of the village at the time." 

Westminster. — " A large proportion of the cases of typhoid 
fever observed here, have occurred in persons living in the val- 
leys, or in persons who have been at work in low lands, getting 



160 STATE BOARD OF HEALTH. [Jan. 

swamp hay. There are several places in the town where the land 
is flowed early in the season, and then the water drained off' to 
allow a crop of grass to grow. I have attributed typhoid and dys- 
entery, in part at least, to the exhalations arising from these places." 
" Typhoid-dysentery prevailed last year in a particular locality. 
Five houses containing ten adults and fifteen children were affected, 
and not an individual escaped the influence in a greater or less 
degree. The cause was evidently the exposure to the sun's rays 
of the bottom of the pond. The prevailing winds were from the 
pond to the houses in question ; houses still nearer the pond, but 
to windward of it, escaped entirely. After rain had fallen to fill 
the pond again the sickness disappeared." 

Wilbraham. — " We have had an epidemic of typhoid among a 
few families living within a third of a mile of each other on the 
same road. Only one, or at most two in each family escaped its 
influence. The soil is wet, retaining water a long time ; somewhat 
elevated, yet near the highway is a swamp, from which arises quite 
a stream of water. At one of the houses I learned that the sink- 
drain was broken, and that an unpleasant odor arose from it. From 
others the sink water was allowed to flow over the surface of the 
ground. The families are all in good circumstances, not exposed 
to want, or given to luxuries." 

"West Roxbury. — Typhoid fever rarely seen. In cases which 
have occurred, no satisfactory cause could be discovered. 

Worcester. — Our correspondent has collected the opinions of 
several leading practitioners in his city. 

One says : " Typhoid is a comparatively rare disease among us. 
It has occui'red, however, in all parts of the city ; quite as often in 
high, airy, well-ventilated houses, as the reverse. I have never 
been able satisfactorily to trace the disease to any particular cause." 

Another expresses essentially the same views, and adds : " I 
have often remarked the strong predisposition to the disease in 
certain families." 

Another says : " The worst cases have been on high ground, and 
under apparently the best hygienic influences." 

Another believes that foul soil and foul air are causes of typhoid. 

Another says : " When I first came to Worcester there was a 
row of privies in Maple Street, which drained into the wells near 
by, and typhoid fever raged until the use of the water was discon- 
tinued. I have found more of the disease on hills where, under 



1871.] PUBLIC DOCUMENT— No. 37. 161 

the soil, was a ledge. My opinion always has been that, in such 
places, the water became retained in cavities in the rocks under the 
soil, and was the cause of the disease." 

Another says : " I think we have had less typhoid in Worcester 
since the introduction of ' city water.' When the disease raged 
so fearfully in Auburn a few years since, the wells were dry and 
the ponds very low. I thought that perhaps there might have 
been miasma from the ponds as a cause, but those living around 
those ponds were free from the disease. It occurred almost entire- 
ly on the hills. I have always thought that its increase was from 
contagion." 

Yarmouth. — Our correspondent regards true " dothinenteritis " as 
one of the exanthemata or eruptive fevers ; not influenced by the 
conditions enumerated in questions 3 and 4. 

Shaker Communities. 

We have endeavored in various ways to obtain definite in- 
formation concerning typhoid fever among the Shakers in Mas- 
sachusetts. Their habits of extreme neatness render them in 
this respect an exceptional people, and their experience, if it 
could be obtained, would be of great value. Our efforts have 
been only partially successful. The following is all we have 
been able to gather from reliable sources. 

The Lebanon Community (just over the State line) numbers 
400, of whom one-fourth are under eighteen, and there are none 
under five years of age. During the past year two cases of ty- 
phoid have occurred among them ; one of these is said to have 
been contracted elsewhere. Twelve years ago, a woman em- 
ployed in the dairy died from a violent form of typhoid, at a 
time when the dairy drain was obstructed. Since that time the 
drainage has been made very perfect, and fevers have been in- 
frequent. The Shaker village is more elevated than the village 
of Lebanon, where typhoid is frequent. Epidemics of fever 
have sometimes visited the Shakers, having been severe in 
former years when drainage was bad. Epidemics of typhoid in 
the Shaker village, and in the village of Lebanon, have never 
been known to coexist ; but sometimes when it has subsided in 
the one, it has immediately broken out in the other. 

The Hancock Community numbers 150, of whom 25 are 
under eighteen, and none under 5 years of age. Their phy- 

21 



162 



STATE BOARD OF HEALTH. 



[Jan. 



sician has been connected with the community for 43 years, and 
states that he has no recollection of a case of typhoid fever 
among them, although bilious and gastric fevers are not uncom- 
mon. [Physicians will see from this statement that it is a 
question of diagnosis.] He also states that since the partial 
drainage of Richmond Pond, which is less than a mile from the 
Shaker village, sickness in their community has increased. 

It will be evident from all this, that the statements which have 
been sometimes made by tourists and sensational writers, that 
typhoid is an unknown disease among the Shakers, are incorrect. 

Such is the evidence we have been able to collect concerning 
the causes of typhoid fever in Massachusetts. - The more diffi- 
cult task still remains of endeavouring to draw from it some 
consistent and reasonable conclusions. Let us try to find some 
continuous thread of probability, if not of proof, by following 
which a clearer idea of the relation of cause and effect may be 
finally reached. 

There are some essential facts which do not appear in the 
evidence presented. First, as regards the season in which 
typhoid prevails. 

The registration of deaths shows that it is a disease most rife 
in the months of autumn and early winter, but that no season 
is exempt. The observations of physicians would show that, 
when prevailing epidemically, it is found to begin usually in the 
months of autumn, and to continue till December, but rarely 
later. Individual cases (sporadic) are met with in every 
month. 

During the five years 1865-1869, deaths are distributed 
among the months in the following order : — 



Deaths from typhoid fever in Massachusetts arranged by months. 
Five years, 1865-1869. 



January, 363 

February, 316 

March, 338 

April, 301 

May, 318 

June, 249 



July, 332 

August, 596 

September, 814 

October, 973 

November, 754 

December, 493 



1871.] PUBLIC DOCUMENT— No. 37. 163 

It is to be remembered that the origin of the disease must be 
transferred to the month preceding that in which death occurred. 

We may say then that while typhoid occurs in every month 
of the year, the causes, whatever they are, which produce it are 
in greatest activity in August, September and October. 

The liability of the sexes seems to be equal. 

Age is an element of more importance. The registration 
returns are not to be depended on to determine its prevalence 
in infancy, since custom has permitted deaths from infantile 
fever (whatever that may be) to be incorporated with typhoid. 
It is well known and will be generally admitted that while 
rare, the disease does occur in infancy, and also at advanced age. 
It is, however, specially a disease of adolescence and early 
maturity, the maximum of deaths in any decade appearing 
between the ages of twenty and thirty. 

Before attempting to examine the alleged causes of typhoid 
fever in Massachusetts, let us first see what has been the pre- 
vailing belief on this subject. 

The late Dr. Nathan Smith, of Hanover, N. H., whose 
opinions upon all medical questions have had great weight in 
New England, is one of the few writers of preceding generations 
who have examined the causes of this disease. His observations 
were made, for the most part, on cases which he had seen along 
the Connecticut River, from Hanover to Middletown, during the 
years between 1787 and 1821. He believed typhoid fever to be 
propagated by contagion, and gives many examples in proof; 
also that, like other contagious diseases, it rarely affects the 
same person twice. Dr. Smith says : — 

" I have not observed that situation has any influence either in 
producing or preventing this disease. It affects alike persons living 
on mountains and in villages, on plains and the banks of rivers, and 
on the borders of lakes and stagnant ponds. And I have not per- 
ceived that occupation or habits of life make any difference in their 
liability to receive this disease, nor has it in this country been con- 
fined to the poor and filthy ; but affects nearly alike the rich, the 
poor and middle classes. * * * * It seems to possess a migratory 
character, and travels from place to place, and after remaining in 
one village for a longer or shorter time, as from one year to two or 
three, it ceases, and appears in another. ***** The fact of the 
absence of typhus in a large section of country for an interval of 



164 STATE BOARD OP HEALTH. [Jan. 

more than twenty years would lead us to doubt the possibility of its 
being produced by accidental causes ; for in such an extent, and 
among so many people, it is impossible but that some of these cir- 
cumstances should have occurred, and the disease of course be pro- 
duced. Besides, if it can be communicated from one person to 
another, it has a specific cause, and I know no disease that ai-ises 
from a specific cause that can be produced without the agency of 
that cause." 

Dr. Smith's views with regard to contagion have certainly not 
been universally, perhaps not generally, received, but what he 
says about the migratory character of fever, and its disposition 
to attack all classes of persons without regard to location or 
habits of life, has, until recently, been generally believed by the 
medical profession in New England ever since his time. It is 
doubtless the present opinion of a large number of our corre- 
spondents who have replied briefly to our questions, and among 
them are some of the most intelligent observers of disease among 
us. This view is expressed by our correspondent at Cambridge 
unreservedly, and by many others with certain qualifications. 
Our correspondent at Leyden says that at certain seasons " it 
comes, and we know not whence." 

But the disposition to pry into all the secrets of nature which 
marks the present period, and in which the medical profession 
has been foremost, has led to more careful inquiry and com- 
parison with regard to the whole tribe of epidemics. Men of 
research and of great ability have probed the history of the 
epidemics of the middle ages and have made it appear more 
than probable that their virulence, if not their origin, was due 
to the filthy habits of the people. Special epidemics among 
the inferior animals have been studied with great success dur- 
ing the past twenty years and their causes shown. (See Parlia- 
mentary Reports on Cattle Plague ; also Pasteur's investigation 
of the cause of " Pebrine " in the silk-worm.) Diseases of 
men previously quite as obscure in their causes as typhoid fever 
is to-day have been made plain and intelligible. (See modern 
investigations of Trichina disease in Germany and England, 
and the report on Charbon by Dr. Nichols in the present 
volume.) 

The medico-scientific world is now profoundly impressed with 
the idea (we may almost say the belief) that zymotic diseases, 



1871.] PUBLIC DOCUMENT— No. 37. 165 

including all the so-called epidemics, are propagated by distinct 
particles, conveyed by air or by water. We need not call them 
" germs " or even seeds, or by any other name which would 
lead us into a labyrinth of speculation, involving doctrines of 
spontaneous generation and mysteries as yet unfathomable. It 
is sufficient to call them " contagion-particles " as is done by 
Dr. Burdon Sanderson in a recent paper of great interest pub- 
lished in the " Twelfth Report of the Medical Officer of the 
(English) Privy Council." No man has yet seen the distinct 
thing which, once introduced into the living body, produces 
such disturbance as to cause the symptoms of scarlet fever, or 
measles, or typhoid, but its real existence may be assumed from 
its observed effects, just as Leverrier assumed the existence of 
the planet Neptune before he saw it, or as chemists assume the 
existence of an elementary substance before its separation from 
its compounds. 

The conditions and surroundings of typhoid fever in the 
period of its commencement are now more closely watched 
than ever before. The general result of this study on the 
opinions of the medical world has been to encourage the belief 
that in some way typhoid fever and filth stand in certain rela- 
tions. There are as we before said many disbelievers, and 
they are men whose opinions cannot be lightly put aside. But 
out of this very widely diffused impression have grown various 
hypotheses, all based upon the propagation of typhoid fever by 
a poison as definite as that which causes vaccine disease, and 
all seeking to explain the nature of this poison and the manner 
of its introduction into the healthy human body. They may 
be thus divided. 

First. — Propagation by drinking water made foul by the de- 
composition of any organic matter whether animal or vegeta- 
ble, and specially by the presence in such water of excremen- 
titious matters discharged from the bodies of those suffering 
from typhoid fever. 

Second. — Propagation by air contaminated by any form of 
filth, and specially by privies, cess-pools, pigsties, manure 
heaps, rotten vegetables in cellars, leaky or obstructed drains. 

Third. — Emanations from the earth, occurring specially in 
the autumnal months and in seasons of drouth. 



166 STATE BOARD OF HEALTH. [Jan. 

We propose to see how far the evidence collected in Massa- 
chusetts corresponds with these hypotheses. 

The first is essentially English. In reading the reports of ty- 
phoid epidemics occurring in England of late years, it so far 
predominates over all other imaginable causes that we are led 
to believe either that the English drinking-water must be ex- 
ceptionally dirty, or that medical observers are unconsciously 
influenced by preconceived opinions based upon the ingenious 
speculations of men of ability who have directed their attention 
to this form of danger. 

Dr. Snow of London investigated the causes of the propaga- 
tion of cholera, and advanced the perfectly original although 
rather shocking idea that the disease was communicated 
through the discharges from the bodies of those suffering from 
this disease thrown upon the ground within the area of drain- 
age of the water supply or into rivers, and thus conveyed in 
the form of drinking-water to the bodies of those in health. 
The history of the famous " Broad Street pump " in 1854, and 
the tracing of cholera from the water supply of different parts 
of London was strongly confirmatory of this doctrine. Many 
other observers have transferred this hypothesis to the propaga- 
tion of enteric fever, and there is much evidence to make it 
probable. Dr. William Budd of Bristol has been conspicuous 
in its advocacy. He believes that typhoid fever is contagious, 
and that the emanations from the sick are the means of its dif- 
fusion, — that the affection of the bowels is the specific eruption 
corresponding to the skin eruption of other contagious diseases, 
and that the discharges from the intestines contain the specific 
virulent poison by which typhoid fever is communicated. 

If this is so, if the contagion particles are given off in the 
discharges of the sick, and thus, through the drainage of soil, 
pollute the sources of drinking-water ; certainly, if this mode 
of diffusing typhoid fever is the one most active, we should ex- 
pect to find the disease most frequent and virulent where privies 
and wells are in closest proximity. 

There are many large towns in Massachusetts where the sur- 
face of the ground is dotted all over with these structures. 
Lowell, Newburyport, New Bedford, among the most populous 
places, occur to us as examples. Every one familiar with the 
State knows that there are a very large number of towns with 



1871.] PUBLIC DOCUMENT— No. 37. 167 

a population of from five to ten thousand, compactly built, with 
no water supply except from wells, and no means of disposing 
of excrement except by privies, and we know from the regis- 
tration returns that the people of these towns are more free 
from the pest of typhoid in proportion to population than the 
inhabitants of agricultural districts. It is impossible for us to 
believe that this would be so if water contaminated in the way 
referred to were the preeminent cause of this disease in Massa- 
chusetts. Our Lowell correspondent speaks of a well used by 
at least one hundred families, containing 52 grains of inorganic 
and 25 grains of organic residue to the gallon (see his letter 
for details), and yet the people using it seem to be even less 
liable to typhoid than others using water of better quality. It 
is true that he does not give us the experience of a long term 
of years, but the fact reported is evidently not in contradiction 
of professional experience in that very crowded city. 

The testimony of Boston, as expressed in figures represent- 
ing deaths from typhoid, ought to be far more positive than it 
really is, if the drinking-water pollution is the preeminent 
cause our English friends suppose. Old Boston, previous to 
1848, was riddled with wells and privies, side by side, all over 
its limited and very crowded territory. Sewage contamina- 
tion of drinking-water was inevitable. The water must have 
been continually charged with the products of decomposition, 
and even direct mixture of decomposing animal matter of the 
most repulsive kind must have been frequent. 

Since 1848, the Boston water from Lake Cochituate has been 
almost as free and abundant as air, and (except, perhaps, from 
the influence of lead pipe) is of the purest possible quality. 
Very few wells are now in use, or have been for many years. 
We do not know of the use of a single one. Here are condi- 
tions to test the influence of drinking-water as a means of prop- 
agating typhoid, on a grand scale, and, for aught we see, com- 
plete. The result seems to be a diminution of typhoid, but in 
no very striking degree ; only such a diminution as might be 
looked for if the purification of air rather than of water were 
in question. The sewers are now at all times discharging very 
large amounts of water, and carrying away from among us 
impurities which otherwise would linger in the drains. The 
sewers are more thoroughly washed, — and the people, too. 



168 STATE BOARD OF HEALTH. [Jan. 

See also what our Winchester letter says of three years' ex- 
perience of a foul well supplying water for seven or eight fami- 
lies, and with only a single case of typhoid among them in that 
period. 

The testimony of Worcester and Springfield accords with that 
of Boston, — that is to say, typhoid is a less frequent disease 
since the introduction of pure water from without those cities, 
but the difference is by no means so marked as it would be if 
contaminated drinking-water were the prominent cause of the 
disease. 

On the other hand, there is satisfactory proof that typhoid 
fever has been propagated in Massachusetts by drinking-water 
made foul in various ways. The letter from Sutton is exceed- 
ingly clear in its evidence on this subject. The boys' school 
at Pittsfield is another case in point. See also the Williams- 
town cases, and the letters from Huntington, Leominster, 
Leyden and Wrentham. Also the Maple Street cases in our 
Worcester correspondence. 

Some of these are stated in a very general way, but others 
are so definite as to leave no doubt that the fever-poison was 
received through drinking-water. 

The specific poisons of the zymotic diseases seem to be usu- 
ally communicated to the blood either through direct inocula- 
tion, or as is much more frequently the case by mixture with 
the air we breathe, through which they are brought in contact 
in the lungs with the whole torrent of blood rushing through 
those organs. 

Typhoid fever and Asiatic cholera, in so far as they are 
transmitted through the alimentary canal, are apparent excep- 
tions to this general rule. The most virulent animal poisons 
of which we have any knowledge, as the snake poisons, syphilis 
(according to Ricord), glanders and charbon seem to be de- 
composed, or to lose their virulent properties, or to be unap- 
propriated, when introduced directly to the stomach. 

Typhoid poison however seems capable at times of resisting 
the power of rejection or of change which the stomach so 
often exhibits when noxious things have succeeded in passing 
the sentinels of sight and taste. Cases are reported in which 
it is impossible to doubt that the disease was received by ab- 
sorption through the alimentary canal, but in the great major- 



1871.] PUBLIC DOCUMENT— No. 37. 169 

ity of cases occurring in Massachusetts in which causes can be 
traced, air (and not water) must be regarded as the vehicle. 

We come now to the second class of probable causes of ty- 
phoid, viz. : propagation by air contaminated by filth. 

The evidence is here still more direct. Among the most 
striking experiences are those given in the letters from Swamp- 
scott, Hadley, Watertown, Lexington and Marshfield. The 
Kearsage Avenue cases in Boston seem very conclusive on this 
point. Running through the whole correspondence is a recog- 
nition, more or less complete, of the agency of putrid air in 
causing typhoid fever. This faith is not universal, yet it seems 
quite general in the medical profession. There are those who 
see it plainly and express it clearly, as in the words of our 
venerable correspondent at Oxford : " So firm is my belief of 
this (referring to exhalations from foul drains, cellars, privies 
and pigsties), that when I meet with a case of typhoid fever 
not readily traceable to some of these causes, 1 infer that the 
truth has not been told me, or that my perceptive faculties have 
been at fault." 

And this leads us to refer to the difficulty which is often en- 
countered in tracing to its hiding place the real or probable 
cause of the mischief. A man almost instinctively resents the 
supposition that his premises may be foul. It is a kind of per- 
sonal affront which a physician may well doubt the propriety of 
giving on mere suspicion, and without proof. A sensible man 
should, of course, receive such suggestions in the spirit in 
which they are offered, but, unhappily, all people are not sensi- 
ble. But suppose suspicion to be excited concerning the state 
of a cesspool or a drain, or any other concealed structure, or 
even one only half concealed, like a privy vault. It is by no 
means an easy thing to learn their exact condition. The bad 
smell which they may emit is no certain indication (or, per- 
haps we should say, no certain measure) of their danger to 
health. There is reason to suspect that the fever-producing 
poison is odorless, and that, under certain circumstances, it 
may be set free from decomposing substances before the foul- 
smelling compounds of hydrogen come to give us warning. 

The danger may be greatest when decomposition is (so to 
speak) going on under difficulties ; when it is impeded, sup- 
pressed, or imperfect. 
22 



170 STATE BOARD OF HEALTH. [Jan. 

But we shall have occasion to refer to this point again, as it 
seems to be of special significance. 

A physician may suspect a connection between a sink-spout 
or a drain and the family well, but unless the water is offen- 
sive to the taste he finds it very hard to prove it without 
breaking up the ground with much cost and labor. He may 
suspect similar connections of conduits for air or water or 
both combined which would poison a family, but the work of 
tracing them is expensive and troublesome, and requires time 
and special skill which may not be at his command. It needs 
perseverance, and a kind of training to be got only by experi- 
ence to unearth these half-hidden nuisances. Look at the 
history of the typhoid poisoning of a family in Watertown in 
1868 in the preceding correspondence. The first examination 
of the drain proved nothing ; the second was only partially 
successful ; the third made evident the cause of the disease. 
If the proprietor of this house or his physician had been con- 
tent with the first search the record of these cases would have 
come down to us, like that of so many others, as from " causes 
unknown and perfectly mysterious." 

Our readers will observe that decaying vegetables in cellars 
are very often referred to in the preceding letters as among the 
causes of typhoid. It is the custom in the country to store 
potatoes and other vegetables for winter use beneath the dwell- 
ing. There is no reason to believe that this practice is harm- 
ful provided the vegetables do not decay, but in our long 
winters it often happens that partial decay cannot be prevented. 

A generalization of many of the probable causes of typhoid 
referred to throughout this inquiry, is to be found in a single 
expression of our correspondent in Westborough, who says 
that he has witnessed a connection between decomposing mat- 
ter and typhoid when the rotting material was under cover. 
This may be interpreted to mean only that the pestilential at- 
mosphere is thus more concentrated, but we are inclined to 
believe that it signifies more than this. The air of a whole 
town like Brighton may be filled for months or years with the 
stench of putridity, — or, as our Brookline correspondent says, 
filth may be, at certain seasons, strewn upon the lawns so as to 
taint the atmosphere for weeks, or land may be covered with 
decaying fish, and yet none of these things produce typhoid 



1871.] PUBLIC DOCUMENT— No. 37. 171 

fever, as a general rule ; although we are not unmindful of 
the apparent exception to this statement in the epidemic fol- 
lowing the fish-manuring at Mr. Webster's farm described in 
our Marshfield letter, and possibly also the fever described in 
our Provincetown letter. But instances are very numerous in 
the preceding correspondence where decomposition under cover, 
whether of a cellar or a drain, with a far less noticeable odor 
accompanying it than is often met with in the open air, or with 
no perceptible odor, has produced the most disastrous conse- 
quences.* Shall we ask organic chemistry to tell us what this 
certain something is which putrefying material gives forth 
under such circumstances ? As yet we shall ask in vain. 

The third class of probable causes of typhoid fever may be 
considered under the general designation of emanations from 
the soil. 

This includes a large number of well-authenticated observa- 
tions by physicians, in which the fever-poison seemed to spring 
from the earth beneath or immediately around the persons 
affected. In some of these cases the ground was polluted by 
human agency,, and in very many others it was only exposed to 
those causes by which vegetable matter, the natural product of 
the soil, was undergoing those changes through which it be- 
comes that brown, pulverulent substance known as " humus," 
or " garden mould." 

It is not always easy to separate these two agencies in the 
production of that condition of the earth with which the origin 
of typhoid fever appears to be, in some way, intimately con- 
nected. In both of them, however, soil seems at certain 
seasons to afford the conditions required for the concoction of 
this subtle poison, and air to be the vehicle by which it enters 
the human body. 

Our correspondence is full of illustrations of this general 
fact. 

The exposure of the bottom of ponds and reservoirs in the 
season of heat and the season of decay, — thus charging the air 
with the products of the decomposition of leaves, wood, and all 

*Dr. Benjamin Rush (" Medical Inquiries and Observations ") said sixty years ago, 
in speaking of miasmata exhaled from putrid vegetable and animal matters, that 
they are more destructive from articles which have been confined, than from those which 
have decayed in the open air. In the same connection he refers to the greater danger 
from the decay of salted than of fresh meats and fish. 



172 STATE BOARD OF HEALTH. [Jan. 

forms of vegetable life mingled with whatever the soil may add 
to these products, or changed, as the soil alone seems to have 
power to change them — is, of all others, the most frequent 
single cause assigned for the production of epidemics of typhoid 
fever in Massachusetts. 

It is referred to in our letters from Berkley, Brookline, 
Brewster, Coleraine, Dennis, Hadley, Harwich, Hudson, Kings- 
ton, Leverett, Mendon, Montague, Pembroke, Rowe, South- 
ampton, Stow, Truro, Walpole, Waltham, Westminster and 
Hancock. 

From Orleaus and other towns on Cape Cod, we have similar 
testimony with regard to ground partially covered in ordinary 
seasons with mingled fresh and salt water, but occasionally 
exposed to the action of sun and air. 

The effect of turning up soil in causing epidemics of fever is 
attested by our correspondents in Brookline (both as regards 
that town and Brighton), Concord and Leverett, and it may be 
questioned whether the cases described in our Pittsfield letter, 
as occurring to men who were engaged in laying drain-tiles in 
a meadow, may not fairly be classed with them. 

The Ashland epidemic breaking out in houses just built upon 
land newly cleared and covered with decaying leaves may 
also fall in the same category. These cases, especially those of 
Concord and Brookline, surely point to some poison coming 
directly from the earth. 

The singular difference in the liability of the people of 
Martha's Vineyard to suffer from typhoid fever according as 
they may happen to live in the eastern or western half of the 
island, will arrest the attention of all who are interested in the 
study of the causes of disease. It seems extremely improbable 
that the different water-supply can explain it, as is suggested 
by one of our correspondents on the island. The portion sup- 
plied by wells is in this respect like almost every other dis- 
trict of the same size in the State. There is however a broad 
distinction between the eastern and western half of the island 
in the character of the geological formation, and of the super- 
ficial soil. Professor Hitchcock's geological map of the State 
(1841) represents Martha's Vineyard in two portions, divided 
by a line running north-east and south-west, and corresponding 
very nearly with the line referred to in the preceding letters as 



1871.] PUBLIC DOCUMENT— No. 37. 173 

marking the boundary between the typhoidal and non-typhoidal 
portions of the island* The western section is geologically 
unlike any other part of Massachusetts, and is described as 
corresponding to the deposit in Europe long known under the 
name of Plastic Clay, but now as a part of the Eocene Terti- 
ary. It crops out in the cliffs of Gay Head, forming from the 
various colors displayed a remarkable and picturesque object 
well known to geologists. The eastern section is quite differ- 
ent, being composed like Cape Cod of diluvium or drift. 

But the peculiarities of the surface are probably quite as 
important for our present inquiry as the underlying formations 
which are the special subject of geological research. In the 
western, or typhoidal section of Martha's Vineyard there are 
hills and valleys with abundant vegetation on a rich surface 
soil, overlying a stratum of clay. In the eastern, or non-ty- 
phoidal section there is a blank, level, barren expanse of sandy 
drift, perfectly pervious to water at all depths. 

This combination of rich surface soil with a subsoil of clay 
has been elsewhere remarked in. our letters as seeming to co- 
exist with typhoid. The high hill described in our letter from 
Newton had a " subsoil of tough marl," while the village had 
an " unfathomed bed of gravel." Fever occurred on the hill, 
and was almost unknown in the village. See also the letter 
from Rutland in which, although not fully explained with 
reference to this particular point, the circumstances would 
appear to be similar. 

If we may suppose that a clay subsoil tolerably near the 
surface prevents the subsidence of materials undergoing decay 
to a point where they would meet the constantly moving cur- 
rent of subsoil water, it would seem probable that a ledge of 
rock would have the same effect. Our correspondents at Wor- 
cester, at Rockport, and at Beverly have remarked something 
of this sort. At Worcester there is a ledge thinly covered 
with earth, on which are built excellent houses, having all pro- 

* The line of division on the geological map of Massachusetts runs from Muddy Cove 
near the northern extremity of Great Tisbury Pond to the southern extremity of Lagoon 
Pond. 

The Eocene Tertiary includes all of Chilmark, two-thirds of Tisbury, and a little 
corner of Edgartown. The Drift includes one-third of Tisbury and nearly all of Edgar- 
town. These two portions of Martha's Vineyard are of apparently equal extent. 



174 STATE BOARD OF HEALTH. [Jan. 

visions for health and comfort, but typhoid is a more frequent 
visitor there than in other parts of the city. 

In a manuscript report of lectures on continued fever by the 
late Dr. James Jackson of Boston, taken in his lecture-room 
about forty years ago, we find these passages. After speaking 
of the great obscurity of the subject, he says : — 

" From analogy with intermittents, we are led to suspect the 
cause from local miasm, occasionally confined to a particular house, 
continuing perhaps six months, and affecting the members of the 
family successively." 

Dr. Jackson reports cases in proof, as follows : — 

" A family moved from the country into a new double-house in 
Boylston Street, and were all attacked with fever. No visitors 
took the disease. None were sick in the other part of the same 
house, though both drank from the same well ; and none were sick 
in the vicinity. No nuisance could be discovered, and yet we 
must suppose some local cause ■ not offensive to the senses as in 
other cases, or else contagion, which last we have seen did not 
exist. Such family diseases often occur. Dr. Jackson had known 
thirteen persons sick in one family, isolated in the country. Some- 
times the disease is limited to small districts ; most often in Boston 
at the South End, and about Hartford Place and Fort Hill. Per- 
sons going to these districts take the disease, but persons removed 
from them do not communicate it. This must be caused by some 
material in the ground itself, not by the water or anything on the 
surface. 

" Sometimes it pervades a whole city ; it is then of a more mild 
character. Nor is this peculiar to thick settlements, but it occurs 
in limited districts in the country. An argument against con- 
tagion is that the fever breaks out in many different spots at the 
same time. Sometimes a very large district is infected, perhaps a 
hundred miles square, as was the case in the epidemic of spotted 
fever. In all cases the disease is confined to a limited district, and 
many are affected without any communication with diseased per- 
sons. So that all the cases of the disease cannot be attributed to 
contagion, and if most cases can be accounted for without conta- 
gion, it is probable that all may be. 

" The cause of disease is in the soil itself, for if it was from the 
atmosphere, the disease would be much more extensive than if from 



1871.] PUBLIC DOCUMENT— No. 37. 175 

the soil, and even there it is very slowly developed. It rises in- 
deed into the air, hut is then so much diluted* as not to produce 
disease. The analogy with intermittent fever renders this proba- 
ble." 

In Dr. Jackson's published lectures (1825), after referring 
to the subject in similar terms to those just quoted, he says : — 

" These facts taken together and compared with what is known 
respecting the causes of intermittents, create a probability that 
some emanation may take place from the soil capable of producing 
continued fever ; yet, if this be admitted, it must be allowed that 
the material thus emanating is not known, the qualities of the soil 
from which it arises are not known, and the only advantage from 
the observation is to lead us to avoid the places in which fever 
prevails." 

Certainly here is to a certain extent corroboration of the 
modern views of Pettenkofer to which reference has already 
been made. Pettenkofer says that when soil is " typhoid ripe " 
the disease appears ; and that it becomes ripe through " organic 
processes" taking place in the earth. This expression is con- 
stantly used by him, but we have been unable to find in any of 
his writings on the subject any more definite explanation of 
the term. That he would convey the idea that these " organic 
processes " are the changes involved in decomposition seems 
evident enough. 

It will be seen from the tabulated replies to the second ques- 
tion of our typhoid circular, and from the letters which we 
publish, that it is not possible as yet to know whether the 
same rule with regard to ground-water holds good in Massachu- 
setts as in Munich — that is to say, whether the fall and rise of 
subsoil water corresponds with the increase and subsidence of 
typhoid epidemics. There can be no doubt whatever that the 
season when the level of water in the wells is as a rule very 
low from the absence of rain, is the season of typhoid fever 
throughout New England. A perfectly well-marked coinci- 
dence is here observable. Beyond this, the special ideas of Pet- 
tenkofer concerning ground-water have not been put to the 
proof. 

* See the remarks of our correspondent in Dudley about sleeping on the ground floor. 



176 STATE BOARD OF HEALTH. [Jan. 

A large number of correspondents assure us that in future 
epidemics the change of water level in the wells will be noted. 

If we may imagine that the organic matter retained in soil 
near the surface under certain conditions of season and tem- 
perature gives rise, in the course of its return to inorganic 
elements, to some specific product as yet unrecognized by or- 
ganic chemistry, we may see how the specific poison of typhoid 
fever may be generated. 

The secrets of organic changes are for the most part hid 
from human eyes. Yet the poisonous aldehyde, produced 
under certain circumstances in the process of acetous fermen- 
tation is now well known. We may not despair of yet seeing 
the typhoid poison made equally manifest. 

Physicians know that in the decomposition of the human 
body there is a period, soon after death, and previous to the 
evolution of offensive gases, when the fluids often possess poison- 
ous properties. Dissection wounds are then far more danger- 
ous than when decomposition has become advanced. 

So we may find that when the decay of organic matter, 
whether in soil or anywhere else, has become evident to the 
sense of smell, the danger to the health of those exposed to it, 
in so far as that portion is concerned, may have passed its maxi- 
mum. But these are mere speculations, to be overthrown or 
confirmed as science advances. 

We have no disposition to enter at length upon so obscure a 
subject as the influence which may be exerted on health by 
dwelling upon special soils. Yet we cannot forbear to express 
our conviction that in this direction will be ultimately found 
an explanation of many things in the history of disease which 
are now mysterious. The property which earth possesses to 
render harmless the most revolting substances, a property 
known to the Jews from the earliest times and recently revived 
in plans for the disinfection of human excrement ; the salu- 
tary virtues which fresh clods of earth are known to possess in 
removing animal poisons, as known to the Indians and to us 
their successors in America, and recently employed in the 
dressing of suppurating wounds; the influence which dwelling 
upon loet soil has been recently shown to have upon consump- 
tion ; the influence (recognized in all time) which certain 
soils have upon intermittent and remittent fevers, — all these 



1871.] PUBLIC DOCUMENT— No. 37. 177 

observations point to the earth and the changes as yet unex- 
plained which are there constantly taking place as the source 
of influences bearing directly upon our health and life. 

The analogy between fevers generally known as miasmatic 
(intermittent and remittent) and the continued or typhoid 
fever of New England, pointed out by Dr. Jackson, becomes 
very significant when we look at the experience of practitioners 
all over the State with reference to the bottoms of ponds and 
reservoirs laid bare in the seasons of drought. These are the 
very places which would surely give rise to intermittents in our 
Southern country. Here they give rise to fever without re- 
missions, — to typhoid. 

Another analogy with intermittents may be seen in the 
greater liability to typhoid on the part of new residents, as 
referred to in our letters from Ashland, Fall River and Lowell. 

Some of the possible influences of soil on health become 
more intelligible when we consider how much air it contains, 
and how readily this may become the means of transmitting 
anything which the soil may hold to those who dwell above it. 
A vessel of any sort filled with dry earth compressed as much as 
possible will still absorb one-quarter to one-third of its bulk of 
water without overflow. All this water represents space which 
has been previously occupied by air. If we look upon the 
soil as a kind of cover to what lies beneath it we must remem- 
ber that the cover is not tight, that it is always partially open, 
and that whatever recondite properties the soil may hold, 
whether for good or evil, will be sure to come to the surface 
through the agency of air, which must change its position with 
the slightest change of temperature, such as must be occa- 
sioned by the alternations of day and night. Gases produced 
by decomposition must of necessity rise to the surface ; more- 
over our houses are, in effect, bell-shaped enclosures, in which 
are retained with more or less completeness whatever the soil 
beneath us may have to render up. 

On the question of the propagation of typhoid fever by con- 
tagion there is little new to be said, and what is old is contra- 
dictory. When two such authorities concerning the fever of 
New England as Dr. Nathan Smith and Dr. James Jackson 
differ in opinion on this point, we may be sure that it is one 
not readily settled. That typhoid is contagious in the same 

23 



178 STATE BOARD OF HEALTH. [Jan. 

degree as smallpox, measles or scarlet fever, no one perhaps 
would affirm ; yet many believe it to be communicable at times 
like erysipelas and puerperal fever. 

Facts and opinions relating to the contagiousness of typhoid 
fever may be found in our letters from Dennis and Franklin. 

The single continuous thread of probability which we have 
been able to follow in this inquiry leads uniformly to the de- 
composition of organized (and chiefly vegetable) substances as 
the cause of typhoid fever as it occurs in Massachusetts. 

Whether the vehicle be drinking-water made foul by human 
excrement, sink drains, or soiled clothing ; or air made foul in 
enclosed places by drains, decaying vegetables or fish (Swamp- 
scott), or old timber (Tisbury), or in open places by pigsties, 
drained ponds or reservoirs, stagnant water, accumulations of 
filth of every sort, the one thing present in all these circum- 
stances is decomposition. 

And may not the influence of soil charged with vegetable 
remains, in the season of heat and of drought, be also referred 
to the same cause ? Although not yet proved, it is exceed- 
ingly probable that a rich and fertile soil in whick decompos- 
able substances are retained near the surface by any cause, 
whether a clay subsoil, or a ledge of rock, or a protracted 
drought, is a soil favorable to the production of this special 
disease. 

The all-important question remains to be answered, whether, 
if these are the causes, typhoid fever can be avoided. With 
the single exception of such changes as may occur in soil 
through natural processes, all the various causes assigned are 
within human control ; they are indeed instances of human 
neglect ; of the omission of what all human experience has 
shown to be necessary for the preservation of the highest con- 
dition of general health. And standing in the connection they 
do to one of our most destructive special diseases, they but 
enforce the truth of the general statement that clean air and 
clean water are among our greatest blessings. 

As regards soil, and the obscure processes, doubtless con- 
nected with decomposition, which seem at certain seasons, and 
under circumstances as yet ill-defined, to play so important a 
part in the production of continued fever, we are certainly far 



1871.] PUBLIC DOCUMENT— No. 37. 179 

less able to guard against its influence. Yet we are not quite 
so powerless in this respect as might be inferred from a passage 
quoted from the lectures of the late Dr. James Jackson. It is 
now more evident from what kind of soil typhoid fever springs. 

The comparative exemption of crowded cities and towns 
leads us to believe that their more solid pavement, seldom 
disturbed, and free from vegetation, is a real protection against 
the emanations of the earth. Although those who live in 
the country are necessarily surrounded by open ground, they 
can have cellars thoroughly cemented,* and, in the season of 
typhoid at least, they can usually avoid sleeping on the ground 
floor. 

We cannot more fitly conclude these remarks on the proba- 
ble causes of the typhoid fever of Massachusetts than by again 
quoting one of the most original and far-seeing men of the last 
century, Dr. Benjamin Rush, who says : " To every evil the 
Author of Nature has kindly prepared an antidote. Pestilen- 
tial fevers furnish no exception to this remark. The means of 
preventing them are as much under the power of human rea- 
son and industry as the means of preventing the evils of light- 
ning or common fire. I am so satisfied of the truth of this 
opinion that I look for the time when our courts of law shall 
punish cities and villages for permitting any of the sources of 
bilious and malignant fevers to exist within their jurisdiction." 

* It is greatly to be desired that some material more impervious to gases than hydrau- 
lic cement should be used for the floor of cellars in both country and city. 



LETTER 



CHAIRMAN OF THE STATE BOARD OF HEALTH, 

CONCERNING 

HOUSES FOR THE PEOPLE, CONVALESCENT HOMES, 



SEWAGE QUESTION. 



182 STATE BOARD OF HEALTH. [Jan. 



LETTER. 



Boston, December 10, 1870. 
To the Members of the State Board of Health of Massachusetts : — 

Gentlemen, — During the past summer, while I was residing 
in London, I thought I could not serve Massachusetts better 
than by investigating, as thoroughly as I could in the short time 
at my disposal, the homes of the London poor, and some of the 
means now used to improve them, together with some other 
topics of similar importance. The results have been of very 
great interest to me. I have therefore embodied them in this 
letter to you, hoping that you may regard my labors as not 
wholly useless in our important public work. The subjects 
may be divided into several sections, each of which is a distinct 
statement, and may be read without regard to its companions. 

First. A night-stroll with a London police inspector, com- 
pared with a similar one taken afterwards in Boston. 

Second. Operations of philanthropy, solely or chiefly as 
shown in the Peabody Buildings and Miss Burdett Coutts's 
Market, Reading-Room and Home at Columbia Square. 

Third. The operations of the " Improved Industrial Dwell- 
ing Company ; " or, philanthropy and capital united, with suc- 
cess to both. 

Fourth. The Jarrow Building Company, by which a tenant 
becomes a proprietor of the home he lives in. 

Fifth. Organized work among the poor, inaugurated by 
Miss Octavia Hill, assisted by Mr. Ruskin and others. 

Sixth. A comparison between a model lodging-house, and a 
low tenement-house in Boston. 

Seventh. Convalescent homes. 

Eighth. The " sewage question " in England. 



1871.] PUBLIC DOCUMENT— No. 37. 183 



I. 

A NIGHT-STROLL WITH AN INSPECTOR OF THE LONDON 
METROPOLITAN POLICE, AND A SIMILAR WALK IN BOSTON. 



On the evening of July 20, 1870, I started with a friend on 
a walk through the purlieus of Whitechapel and of Ratcliffe 
Highway, two of the most noted thoroughfares of vice, poverty 
and crime in London. Our arrangements had been previously 
made with the chief of the Metropolitan Police. We were 
directed to report ourselves at 9 P.M., at the L Street Sta- 
tion, there to meet Inspector G . Prompt at the moment 

named, we appeared, and were graciously received by the chief 
of the station, who introduced us to our guide. 

We had confidence in him from the first glance. He had a 
mild, but, at the same time, a fearless look, and his muscular 
powers were evidently such as to make him capable of coping 
with the roughest. After examining the station itself, its 
arrangements for the comfort and convenience of the policemen, 
and the cells for the prisoners, we started for the specific object 
we had in view, viz., inspection of the public lodging-houses of 
the poor and criminals in that part of London, and over which, 
in certain points, the police have an almost supreme control. 

During that long walk from 9 P.M. until 2 1 A.M., I met 
with persons and events of the deepest interest. We visited the 
lowest dens of private degraded poverty and crime, and strolled 
leisurely through whole streets in the " thieves' quarter," so 
called because occupied by these prominent members of " the 
dangerous classes." We saw women and children working at 
dead of night under the bright gas-light of the obscure and filthy 
courts in which they lived. We found an orphan girl about 14 
years of age thus toiling for a mere pittance, to support three 
younger brothers and sisters. We followed closely in the steps 
often before trod by Dickens, and saw the opium-smoking hag 
he has so graphically described in Edwin Drood. She blew out 
before us, as before the great novelist, huge blasts of smoke 



184 STATE BOARD OF HEALTH. [Jan. 

from her broad animal-like nostrils, as she lay in a half-dreamy 
state across her filthy bed. In one dark alley, so narrow that 
our party went in single file, and I was the last, I observed a 
little girl flitting around me, and while scarcely able to see 
them, I felt her tiny fingers fly about my pockets with a light- 
ness, and an exquisite delicacy of touch, worthy of one of Fagin's 
most apt scholars. Though I knew she would be unsuccessful, 
because, foreseeing such an occurrence, I had carefully emptied 
every pocket, nevertheless, the sensation was anything but 
agreeable during the few moments I felt the process going on 
in entire silence, and almost complete darkness. Almost every- 
where in these dark passages were dimly seen or heard, dusky 
human beings lying or sitting, sleeping or talking in under- 
tones. At times they were sauntering about as if the night 
hours were their " opening day," and home was no place for 
them. Indeed, the private houses into which our guide led us, 
were wretched and filthy enough to drive away any one not 
wholly lost to decency and cleanliness. Our walk culminated 
with a bloody assault made by a noted bully upon a young girl, 
probably some poor outcast, who having no proper home in 
which she could rest, was flaunting out in one of the narrow 
streets of the " thieves' quarter," as late as when the morning 
was just breaking. We entered and examined one of the pub- 
lic lodging-houses, where the poor, vicious or criminal congre- 
gate at night, and which, for the past few years, have been under 
the strict surveillance of the police. Any man has a right to 
open one of these houses, but he must do so in strict conformity 
to law, and be constantly inspected by the police. We saw one 
house capable of receiving three hundred males. We stumbled 
up the clean, but uneven and rather circuitous staircase, and 
entered a large room nearly filled with single and narrow cots. 
Many of them were occupied with stalwart men. In the dim 
light of a low gas-jet their half-naked forms looked Herculean, 
as the men either slept unconscious of our presence, or hastily 
drew up the covering which the warmth of the night had in- 
duced them to throw off. Every such public house is obliged 
to be kept clean, and to provide at least three hundred cubic 
feet of air for each lodger. Usually there are passages for ven- 
tilation permanently opened in the walls. Plenty of water and 
numerous wash-basins are found below. Immense kitchens, 



1871.] PUBLIC DOCUMENT— No. 37. 185 

with their perpetually burning fire in the grate, afford to each 
lodger the means of cooking his meal. In one of these houses, 
occupied by known thieves, nothing easily portable is seen. 
Even the brass stoppers of the wash basins have disappeared, — 
a bit of cork, having no real value, alone remains. No knives 
or forks are to be found ; they have been stolen, and no new 
ones have since been bought. In such lodging houses, whether 
in the " thieves' quarter " or elsewhere, 3d. per night is the 
price for lodging, or 18d. per week. 

One or more lodging houses we visited in which both sexes 
are admitted. Theoretically, only married persons are admit- 
ted, and each couple has one pen so to speak, allotted them for 
6d. per night. That is, a large room is divided into compart- 
ments just big enough to hold a double bed, and to allow a 
small space in which to move around. Each partition wall is 
about eight feet high, but not reaching to the ceiling, which 
gives in a general way some circulation of air. One cannot be 
sure that such places may not be used at times as assignation 
houses. But there is little danger of this difficulty becoming 
very common, for over these, too, the police have despotic con- 
trol ; and a house would be closed that became infamous for 
prostitution when intended simply as a healthful lodging house. 
Long after midnight our walk continued. About a quarter to 
one A.M., our guide rang the bell of the " Casual Ward " of 
the district. Similar places, under the same name, are now 
found almost everywhere in England, and usually in connection 
with the union poor-houses. 

Wherever in England a houseless wanderer appears at night, 
there will these evidences of Dickens's generous heart and all- 
powerful pen be found ready to receive him. They have their 
origin in the fact that he, in the very locality -where we were 
then standing, had, during one of his midnight strolls with the 
police, seen many persons lying one cold night on the doorsteps 
of the Union Workhouse, — they had been refused admission 
even there, " because of want of room." Dickens's feelings 
were enlisted, and he used most efficiently his voice and his 
pen, until, by law, every man, woman and child in England who 
needs shelter can claim at least for one night, lodging, a supper, 
a warm bath and breakfast next morning, and perhaps some 
articles of new clothing are given if those used before entrance 

24 



186 STATE BOARD OF HEALTH. [Jan. 

be ruined or contain any " contagium " that will be injurious to 
the public health. In payment, a certain amount of labor is 
performed if required. 

The porter soon responded to our summons. We examined 
everything about the establishment. It was of that exquisite 
neatness and cleanliness so peculiar to England. The bath-tub 
was as white as the driven snow ; the beds were compact and 
clean ; the floors without a trace of dirt. In the reception 
room we saw the signature made by Dickens at his last visit to 
the spot, only a very few months before his death. 

In conclusion, I will express my admiration for the way in 
which English law,* and its official, who accompanied us under 
that law, deal with the public lodging-house system of the poor, 
and with the poor and vicious themselves of London. The rooms 
and walls of some of the buildings used as common lodging- 
houses in Whitechapel, are as clean, if not so fine, as those of 
many a palace, or humbler English home. At present the law 
does not feel at liberty to be so despotic in regard to the English 
working-man's private home. If he choose to have filth in his 
own premises the law does not usually prevent it. It is his 
castle, and therefore sacred to private right, — a most noble 
maxim indeed, unless it be carried too far. I believe the time 
will come in England, and in Massachusetts also, and it will 
come with the consent of the whole people, when the community 
will feel that an impure moral or physical private abode is a 
nuisance and crime against humanity, as much in quality if not 
in degree, as the filthy, ill-ventilated public lodging-house, and 
as such, it will be abated, if need be, by law. 

Again, this thorough police inspection of public lodging- 
houses of the poor is the commencement of a great sanitary 
reform. It is .complimentary to the many private enterprises 
for improving the houses of the people, as now carried on by 
private charity, or by enlightened capitalists. 

Before examining the private London enterprises to improve 
the homes of the poor, we must compare my experience during 
a walk with the police of Boston with this which I had in 
London. Some captious person may exclaim: Why tell us 
about London purlieus and England's " thieves' quarters," and 

* Appendix A, for summary of English law on Common Lodging-Houses. 



1871.] PUBLIC DOCUMENT— No. 87. 187 

other abominations and her laws ? Have we any such places, 
and do we need any such laws ? To such a critic I would say : 
Come with us in our walk with the police in Boston's " highways 
and by-ways." 

I shall be surprised if the critic, after the perusal of the fol- 
lowing account of our walk in our Radcliffe Highway, does not 
see some reason for my details upon the abominations of Lon- 
don, and still more for my account of the efforts recently made 
by English law, and by private and public charity and capital 
to relieve these abominations. The very similarity between 
London and Boston in one respect, viz., in the wretchedness of 
the houses of the poor in both, and the contrast between the 
two cities in their relative action, tending even partially to re- 
lieve that wretchedness, will I think, suggest topics worthy of 
serious reflection by every man and woman in the State. 

At 81 P. M., of Dec. 1st, 1870, we* met by previous appoint- 
ment at the Hanover Street police station. Our guide not hav- 
ing arrived we sat a half hour, and during that time, a well- 
dressed but drunken woman was brought in reeling, and she 
was forthwith transferred to the cells below. Soon afterwards 
a man who said he was about 50 years old — a " worker along 
shore," and who got his meals " here and there on the street 
once in a while," and who " had no home," claimed a lodging. 
He was kindly received, but I saw none of the paraphernalia of 
Dickens's Casual Ward, and no food is usually given. 

The station, in every respect, is superior to that at L 

Street, London, both for the police and the prisoners. This was 
probably owing, in some measure, to the fact that the Boston 
station was built for the purpose, whereas that in London is an 
old building, aristocratic looking, it is true, with its sweeping 
and ornamented staircases, and its large rooms. But they are 
not adapted to the purposes intended, even in that portion oc- 
cupied by the police ; and in others where the prisoners were 
kept they were rather crowded. The Boston station, however, 
I do not think, in some respects at least, entirely proper for 
human beings, however degraded, to be compelled to stay in 
even for a short time. The cells are in the cellar. They seem 
clean. The outsides of them are scrupulously nice. The com- 

* The Secretary' of the Board, Dr. Derby, had previously made arrangements with 
the Chief of the Police. We went together during the evening. 



188 STATE BOARD OF HEALTH. [Jan. 

forts for passing the night are very small. Four persons can be 
shut in one room. Four bunks are arranged in some, and these 
are made of strips of thin iron about an inch wide. At the 
head these strips are sloped, apparently to serve as a pillow. 
No mattress or even straw to lie upon, or covering of any kind 
were visible. The whole cellar at the time of our visit was 
heated intensely by means of steam, or hot- water pipes. " We 
have no blankets," said our guide, " so we have to keep the 
room warm." The earnest appeals for cold water from the 
various cells were quite striking to us strangers, and the behav- 
ior of one of the prisoners when the cell door was opened, 
was quite suggestive of suffering undergone. Hastily, and 
without waitiiig for the ceremony of a cup, he ran towards the 
pipe, and bending down with his face turned upward, and his 
mouth distended, gulped down a long draught of Cochituate 
from the open water-pipe. It was like the long draught of a 
thirsty animal taken from some running stream during the hot 
noon-day. 

Soon afterwards we started on our walk and almost imme- 
diately entered Stone's yard, where about a year ago a murder 
was committed. Our guide lighting a bit of tallow candle 
which he carried with him, led us up a broken and dirty stair- 
case, which, for its filth and dilapidated condition, was quite 
equal to anything I saw in London. In the chamber of mur- 
der we found a mass of extreme wretchedness. A young man 
was crouching beside a hot hard-coal iron-pot stove, while 
another, a red-eyed, sinister and dogged-looking youth, was 
seated apparently for want of any better place, on the foot of a 
nasty bed. One old woman was gleaning with her skinny fin- 
gers bits of coal from a mass of half-burned ashes and cinders, 
while another stealthily looked at us from a corner where she 
sat upon the floor. I felt quite secure with our guide, but I 
should have shrunk from being there alone at night. " How 
came you here ? " asked our guide of the red-eyed individual 
above alluded to. " I came to visit that man," was the only 
and curt reply. " And who is he to whom you spoke ? " I asked, 
after leaving the filthy spot, and getting into the open air. " He 
is a thief, and has no other business. He is not a bold operator. 
He steals little things, here and there. He loves to rob drunken 
men when they are asleep upon the sidewalk or door-steps, and 



1871.] PUBLIC DOCUMENT— No. 37. 189 

sometimes lie makes a fine business of it. One of the prisoners 
you saw this evening was found drunk, and with over two hun- 
dred dollars in his pocket." The passage-way leading to this 
court, and the court itself, are simply infamous with their 
stinks. That sharp, Saxon word alone expresses the thought I 
wish to convey. The privies were filled to overflowing, and 
covered with nastiness to the extent of two or three feet from 
the seats, when I visited and inspected them six months ago, 
and from what our noses and our eyes, with the aid of our dim 
light could perceive, there has been no improvement in the 
interval. 

In these passages were passing and repassing several persons, 
young and old, male and female, apparently peering at us in- 
truders in their private premises, and yet how did they stand 
with relation to the landlord of these filthy abodes? As our 
guide informed us, the rent is rigidly exacted, and if not paid 
the scanty furniture is summarily pitched out into the filthy 
passage-way, and the tenant is ejected. My indignation is ex- 
cited to think that the city authorities allow even one such 
tenement to remain to taint the atmosphere, both physically and 
morally, of the whole neighborhood, especially when we have 
laws stringent enough to abate this and many more similar 
nuisances that are scattered here and there in Boston. More 
especially am I indignant to think that some of these houses 
are at times owned by men living in luxury, in our most fash- 
ionable places, men moving in political power, nay men of 
irreproachable religious appearances, who talk of Christianity? 
and perhaps listen with becoming gravity to the beautiful teach- 
ings of the Sermon on the Mount, Sunday after Sunday. 

These men will either themselves, or through some paid 
agent, receive of the landlords who sub-let these hells on earth, 
the hard-earned pittance obtained by vice or crime perpetrated 
by the denizens of these filthy tenements. While in London I 
heard from what I deemed good authority of nobles of the land 
fattening on the price gained by whole streets of brothels, and 
even some ancient ecclesiastical establishments, surfeited with 
the wealth which land in London gives to every large proprietor 
of it, have not, it was said, quite clean skirts in this particular. 
Similar men and similar buildings exist in Boston. Public 
opinion ought to condemn such persons and such buildings as I 



190 STATE BOARD OF HEALTH. [Jan. 

have described in London, and shall still farther describe as 
seen during this walk. But neither Old nor New England at 
present cares to do so. Every one has a right to let his own 
house as he pleases. If he choose to sub-let to a Carker, or even 
a Fagin, no one can complain. He may, week after week, shut 
his eyes to the real cruelties and enormities perpetrated on his 
own premises, provided only that the fawning agent will pay 
into his patron's already overflowing coffers the rent justly (?) 
his due. This may seem hard language ; nevertheless I believe 
it strictly true. Public opinion should bring such landlords to 
strict social justice, and the public law should summarily abate 
the physical nuisances on their property. But let us walk on. 
Every other house in certain large parts of North, Cross and 
Richmond Streets has a dancing hall connected with it. We 
visited several of them. Nothing improper in the behavior of 
the inmates was observable. In one place blacks and whites 
were mingled in the mazy waltz, and the gentle whirls of the 
dance, as performed by a beautiful white girl of about sixteen, 
with her negro partner, presented nothing (save in that union) 
that would have been inconsistent with society as seen in any of 
the palatial residences in the Commonwealth or Fifth Avenues 
of Boston or of New York. Bars stand near each dancing 
room, and after the dance is over those engaged pay ten cents 
and " treat " their partners, I was glad to see not to intoxicat- 
ing drinks, but to milder beverages. The proprietors of these 
places know their own interest too well to allow of liquor being 
sold. That would produce riot, and riot would soon close the 
establishments. The proprietors know the varied allurements, 
strange as that word may sound, of these places are enough 
without dram-drinking, and as I watched the dance going on, I 
thought that possibly it was the only ray of real pleasure that 
shines down upon at least some there who were engaged in it. 
The young love to dance, and the child trips with her feet to 
the sound of music as naturally and as gleefully as the lamb 
skips under sunny skies over the greensward. The act of it- 
self is harmless, though Puritan religion formerly condemned 
it as always fraught with evil. It may be sanctified to virtue 
and to the highest amenities of human life when used legiti- 
mately within the precincts of home. Those living in these 
places, however, have no proper home. Many of the lodging 



1871.] PUBLIC DOCUMENT— No. 37. 191 

places are simply horrible. To know this, stoop with us, and 
crawl cat-like down this dark cellar-way, and see a home in Bos- 
ton ! This cellar room is scarcely high enough for us to stand 
erect. One can easily almost touch each of the four sides while 
standing in the centre of it. The floor is dark, dirty and broken ; 
apparently wet also, possibly from the tide oozing up. Two 
women are there, commonly, yet rather tawdrily dressed, and 
doing nothing but apparently waiting, spider-like, for some 
unlucky, erring insect to be caught in their dusty but strong 
meshes. Tubs, tables, bed-clothes and china ware, are huddled 
incongruously together. Our guide strikes a match by the 
stove, and then opens a door into a so-called bed-room. It is a 
box, just large enough to hold a double bed. No window is in 
it, no means of ventilation, save through the common room 
up the cellar steps. The bed is of straw, covered only by a 
dirty blanket. Everywhere is the picture of loathsome filth. 
The stench, too, of the premises is horrible, owing to long ac- 
cumulated dirt, and from the belching up of effluvia from 
solutions of dark mud, reeking with sewage water from the 
city drains and water-closets. It is difficult for us to breathe in 
the tainted atmosphere. We feel ourselves enveloped in a phys- 
ical atmosphere most horrible, and a moral one most degraded. 
We glance into another " bed-room ! " opening by another door 
into this common room/ It is a fac-simile of its neighbor. 
Upon the dirty blanket lie recently washed and finely starched 
wrist-cuffs, and the jaunty modern hat and feather now worn 
by all. The strange contrast between fashionable neatness and 
exterior properties of appearance with supreme nastiness was 
never more strongly manifested. " How much do you pay for 
these rooms ? " we asked as we turned to leave. " Four dollars 
a week ! " 

" Take care of your heads" said our guide, as we again, in 
single file, crept up the cellar stairs, and tried to breathe again 
freely in the open street, after stooping low to avoid the blow 
we should inevitably have received if we had walked erect. 
"Yet," quietly remarked our guide, "in just such places, 
strangers, men of respectability from the country, go and lose 
their money and their watches, and then come stealthily to us 
begging us to regain their property without bringing shame on 
themselves." What a revelation ! I saw no worse home in 



192 STATE BOARD OF HEALTH. [Jan. 

Whitechapel. I even doubt whether any so bad can exist under 
English law. And this was not a solitary example. We visited 
several of the same type. If any faith can be put in the idea 
of an overruling, retribution-paying Justice ; if any confidence 
can be placed in all the deductions of modern sanitary science, 
Boston will sometime suffer the heaviest of penalties for its 
great guilt in these matters. Nay, is it not even now suffering 
the direst of calamities in the deleterious influences exerted on 
every child born within such dens ? In one place, while our 
guide, with the usual nonchalence that long possession of 
known and acknowledged authority always gives, was lighting 
his candle, a woman earnestly called out, " Please take care 
and don't wake the baby." " Oh, no," replied our guide in 
kindly tones, " the baby shall be taken care of." Following 
his light, we with difficulty ascended a very narrow and 
broken staircase leading from the cellar to a chamber, if it 
might be so called, above. It was of an irregular shape from 
three to five feet broad, twelve to fifteen long, and contained 
three beds. One of them was a small one and on it lay a 
beautiful babe about six months old. Its little arm was lying 
outside the dark and soiled bed-clothes ; its dimpled fingers 
were as delicate and beautiful as a child's alone can be. It was 
calmly sleeping in that den of all uncleanness, unconscious of 
its future fate. And how hard must inevitably be its fate, it 
was plain enough to foresee. Born amid the haunts of vice 
and crime, bred in filth, how could it ever know, at least in its 
tenderest years, the sweet delights of a clean and happy home ? 
What more natural than the thought which arose uppermost in 
my mind while looking down upon the little sleeper, " Would 
that you had never been born. Here you are, beautiful of form, 
and with all the capacities perchance of an archangel for intel- 
lectual development and for moral worth. Yet what chance 
have you, in this fierce struggle of life, of gaining either?" 
One might as well hope to train up a California pine in the 
darkness of a cellar, while bruising each hour some tender 
shoot as it is struggling towards the light and air of heaven, as 
to raise a child to perfect physical health, real learning and 
virtue in such a spot. And yet such spots are numerous in 
Boston. Proud is our city and justly so of her churches, her 
religious freedom and her public schools. But of what use are 



1871.] PUBLIC DOCUMENT— No. 37. 193 

her churches, her freedom and her schools to those of her 
children, whom she allows to grow up in such places as these I 
have attempted to describe. All these advantages are a mock- 
ery even and a snare ; for while we piously exclaim, " See 
how good and learned we can make our citizens," at the 
same moment, we are allowing such evil influences to exist 
broadcast amongst us. I am not such an optimist as to believe 
that we can root out all vice by building houses, but I do con- 
tend that if for no other purpose, for the physical good of the 
persons themselves, and for the safety of the public health, 
nuisances like this vile abode I have attempted to describe 
should be summarily dealt with by the law, and that better 
houses should be everywhere erected for the people, even the 
most vicious and degraded. Where are our lines of Peabody, 
Burdett Coutts or Waterlow buildings ; our " Casual Ward " 
or our cheap public lodging houses, with plenty of air and fresh 
water given to every one by the law of the land ? Where are 
our " organized workers among the poor " ? For sanitary if 
not for moral reasons would I urge these questions warmly 
home upon our citizens individually, and upon the public 
authorities. 



II. 

OPERATIONS OF PHILANTHROPISTS FOR THE IMPROVEMENT 
OF THE DWELLINGS OF THE POOR IN LONDON. 



Under this head I shall allude to the Peabody Buildings, and 
to those erected by Miss Burdett Coutts. 

I fully concur in the following words emanating from three 
eminent men of Great Britain, viz. : Dr. W. T. Gairdner of 
Glasgow, Mr. Rawlinson and Mr. Druit of London. 

Dr. Gairdner says : " On whatever other points sanitarians 
may differ, there is a remarkable concurrence of opinion as to 
the primary need of improved house accommodation for the 
lower classes." (Remarks on the Sanitary Condition of Glas- 
gow. — London Lancet, Oct. 15, 1870.) 

25 



194 STATE BOARD OF HEALTH. [Jan. 

Mr. Rawlinson, in his address before the recent Social 
Science meeting at Newcastle, stated in rather strong, but I 
think true words, that " defective house accommodations pro- 
duce disease, immorality, pauperism and crime, from generation 
to generation, until vice has become a second nature, and mor- 
ality, virtue, truth and honesty are to human beings so debased, 
mere names." 

Mr. Druit (address at the meeting of the Association of 
Medical Officers of Health, as reported in Medical Times and 
Gazette, Oct. 22, 1870) : " For myself, I do not hesitate to 
avow my belief that, for the dwellings of the laboring classes in 
cities, provision must be made by public authority." 

A philanthropy, which raises a man's self-respect and not a 
mere charity (which usually lowers it) lies at the basis of the 
operations seen in the Peabody and Burdett Coutts Buildings. 

The Peabody Buildings. 

The world knows the fact of their establishment in London 
by the late Mr. George Peabody, who gave £500,000 as a fund 
for that purpose. In his letter to the trustees, he writes that 
he wishes " the fund or a portion of it to be used in the con- 
struction of such improved dwellings for the poor, as may com- 
bine in the utmost possible degree the essentials of healthfulness, 
comfort, social enjoyment and economy." 

I have visited and examined carefully all the buildings at 
present erected, I have conversed with the superintendents of 
each, and will here give a general summary of the results of 
these inquiries. 

There are five series of houses, viz. : at Chelsea, Spitalfields, 
Islington, Shadwell and Westminster. 

The following table shows the number of buildings and num- 
ber of families that can be received, and the general rates of 
prices per week :-— 



1871.] 



PUBLIC DOCUMENT— No. 37. 



195 





No. of 
Buildings 
at each. 


No. of 
Fumilies 
each can 
receive. 


Prices. 


the Buildings are 
Erected. 


One Room. 


Two 
Rooms. 


Three Two small 
Rooms. 1 Rooms. 


Chelsea, 
Islington, 
Spitalfields, . 
Shadwell, . 
Westminster, 


4 
4 

* 

4 
3 


136 
165 
58 
200 
175 


2s. 6d. 
2 6 
2 6 
2 6f 


is. Od 

4 
4 
4 0J 


5s. Od. 
5 
5 
5 0§ 


3s. 6d. 


Total, . 




734 











* Spitalfields buildings are built on an irregularly shaped lot of land, in a great thor- 
oughfare, and therefore cannot be compared with the others, 
t Reduced lately in consequence of trade falling off, to 2s. 3d. 
X Reduced lately in consequence of trade falling off, to 3s. 3c?. 
§ Reduced lately in consequence of trade falling off, to 4s. 3d. 



No tenant can enter the buildings if he receives more than 
thirty shillings weekly. It would thus appear that these build- 
ings are intended for the poorest. They are scattered in various 
districts of the metropolis. Some are more in demand than 
others. Westminster, for example, is constantly full, with ap- 
plicants in advance. Shadwell, on the contrary, though of 
most palatial grandeur and with fine appointments, has recently 
lost several of its tenants, because trade (in ship building), 
which was very brisk a few years ago, has now wholly left the 
Thames, in consequence of the persistent strikes in which the 
workmen on the Thames have indulged. The trustees have, 
therefore, felt obliged to reduce the rents of all these rooms, 
and one-quarter of them, at the time of my visit, were unoccupied. 

With the exception of Spitalfields, which being on an irregu- 
lar and rather confined thoroughfare, is of an irregular shape, 
the groups of buildings are all erected in a rectangular form, 
with broad intervening spaces, allowing free access of light, 
sun and air, and at the same time, in the centre is a play- 
ground for the children. The surroundings and the passages 
are all very neat, and generally paved, either with flat flag or 
flint stones, and in one instance simply covered with graveL 



196 STATE BOARD OF HEALTH. [Jan. 

In these, parties of laughing children are almost always play- 
ing. None from the outside are allowed to enter. To one 
standing in these squares, the buildings present not only a very 
neat appearance, but some of them (Westminster and Shadwell) 
have an air of real grandeur. Moreover, the enthusiasm of 
almost all the occupants of the rooms for the cultivation of 
flowers, which of late years seems to have become a real passion 
with the English people, increases the beauty of the building, 
as some most brilliant displays of blooming plants are made 
from many windows. If the scene at times becomes very strik- 
ing and picturesque even to the eye of the casual visitor, so it 
must have a benign and refining influence upon all the inhabit- 
ants of the place.* 

A small black or bright brass knocker is upon each family's 
door, and it was touched by the superintendent with as much 
deference, when calling upon the occupants, as if he were tap- 
ping upon a street door in Belgravia or of Beacon Street. The 
Peabody Trustees evidently mean that every man shall consider 
himself as really at home, when he enters their buildings, as if 
he occupied a palace at Hyde Park. The deportment of all the 
superintendents in this wise impressed me very favorably. 

The rooms were clean, and the various arrangements for cook- 
ing were admirable. The houses have long corridors running 
directly through the centre and along the entire length of each 
story. These corridors communicate with a central staircase 
of stone steps. The ceilings are not very high, and the corri- 
dors are ventilated and lighted by a window at each end and 
partially by the central staircase opening. There are two 
water-closets at each extremity of each corridor. All the 
front doors open on these same passages. Hence I should fear 
two results may, at times, happen deleterious to health. Unless 
great care be constantly taken, the passages may gradually 
become soiled. Filth may accumulate and noxious vapors 
arise from the water-closets, provided they are not strictly and 
daily washed, or oftener. In case of an epidemic it would be 
impossible to isolate completely any apartment, as the front 
door of each opens into this general pathway. The reply to 
these objections is that the care taken hitherto has prevented 

* Societies are formed in many parishes to promote this object, and prizes are given for 
the best specimens of the most common flowers. 



1871.] PUBLIC DOCUMENT— No. 37. 197 

malaria from the water-closets, and no epidemics have as yet 
ever appeared in either of the houses, although at times diseases 
have prevailed extensively in the immediate neighborhoods. 
The attics are used, in common, as large washing, drying and 
bathing rooms. This community of goods in other places 
usually does not succeed well. Finally, I cannot think that 
the universal custom of leaving the brick walls and partitions 
uncovered, save by a white or colored wash, is agreeable to the 
eye, or can be so humelike as others covered with neat paper, 
&c. 

In making these brief criticisms I trust that no one will deem 
that I undervalue the magnificent plan of the benefactor, or 
would throw the slightest shade upon the labors of the trustees. 
They are both beyond praise. But if any one in Massachusetts 
thinks of imitating this great act of benevolence, and seeks for 
light from these buildings, let him consider these points and 
compare them with the views of Sir Sydney Waterlow and Mr. 
Allen, which I shall give later in this letter. 

I conversed long and freely with each superintendent of the 
Peabody Buildings. The resume of the whole may be made as 
follows : Sickness is very rare. Epidemics have not raged 
inside, though, at times, prevalent immediately outside of the 
buildings. The general care of personal appearance of each 
tenant improves. This is remarkable, chiefly in the women and 
children. In some instances (as the superintendent at ^h ad- 
well remarked), the change in men is "wonderful; miracu- 
lous." A drunkard, slovenly and dirty ; a husband, neglectful 
of wife and home, under the influence of the silent example of 
his neighbors in these buildings, and from his own growing 
self-respect, became careful of his person, and his evil habits of 
drunkenness left him. He was literally a man renewed. 
Many, from being quarrelsome when drunk, have, without 
giving up wholly their bad habits of drinking, learned to suffi- 
ciently restrain themselves as to become less offensive to family 
and neighbors. Knowing that, according to the strict rule laid 
down by the noble donor, no one will be allowed openly to be 
vicious, he hides the fault, and that is a great deal, at least for 
others even if it be less than one could wish for himself. The 
influence on children is almost constant. They may enter the 
buildings uncleanly and. with torn garments. But they rarely 



198 STATE BOARD OF HEALTH. [Jan. 

remain long so. Maternal pride and the stimulus applied to it 
by the desire of the child to appear as well and as neat as its 
playmates, work wonderful cures. There are some however 
who are incorrigibly wrong-doers and filthy, and some whose 
nature seems to need an occasional broil. An extremely dirty 
tenant, or " a weekly fight," said one of the superintendents, 
" I cannot allow, and I have had to discharge some, though 
very rarely, for their filth or their brutality." Discharges for 
nonpayment become less and less frequent. The sense of in- 
dependence on the part of the occupants is often most ludi- 
crously shown. Some refuse even favors, such as the purchase 
of coal at wholesale prices through the intervention of the 
superintendent, preferring to buy according to their " own 
sweet wills," even if they pay higher ! 

One superintendent informed me that very absurd stories were 
propagated about the rules and regulations of the buildings 
when first opened. It was currently asserted that every one 
must give up a little of his manliness if he entered as a tenant. 
Hence, perhaps, has arisen such insane protests as that above 
described, instead of a real manliness of character. 

The result of my whole examination has been that of great 
admiration. The influence of these buildings for good upon 
the health, physical and moral, of the people residing therein, 
is immense They are like oases in the desert of miserable, 
dark and dirty abodes such as I saw among the separate 
residences of Whitechapel and of Radcliffe Row. They are 
immeasurably superior in every respect to the public lodging- 
houses so cared for by the police, and of which I have already 
given some account in my " Night Stroll with an Inspector of 
the Metropolitan Police." Wherever hereafter an inquirer may 
ask about ameliorating the dwellings of the poor, there will the 
name of George Peabody be mentioned with respect and love ; 
for be it remembered that institutions managed as the Peabody 
Buildings, are almost purely philanthropic. The percentage 
for rents on the original outlays is so small that no capitalist 
would desire to employ his surplus funds without greater gain. 
We must look in other directions for plans and successful ex- 
periments in which philanthropy and capital join hands.* 

Before closing wholly these remarks I cannot forbear repeat- 

t See III. Reports of Improved Industrial Dwelling Company. 



1871.] PUBLIC DOCUMENT— No. 37. 199 

ing a remark made by one of the most eminent of London capi- 
talists, one who perhaps more than all others has labored in this 
cause of raising the homes of the people. The remark was 
made to me when speaking of the Peabody Buildings : " Excel- 
lent as they are, how much more good would have been done, 
and how many more families would have been placed in health- 
ful homes if, instead of building these large and expensive 
tenements, the fund had, in part at least, been spent in the pur- 
chase of suitable sites which might have been let at such low 
ground-rent as to induce capitalists to build houses according 
to certain specifications to be laid down by the trustees." The 
more I reflect on the subject the more reasonable seems this 
suggestion from the London capitalist. 

Miss Burdett Coutts's Market House, Lodging House, and 
Reading Room at Columbia Square. 

I know of no place which displays more the union of fine 
taste, with philanthropic zeal and Christian feeling, than these 
grand works erected by Miss Burdett Coutts for the people 
resident near Columbia Square. Columbia Square seems ex- 
actly the spot for such a series of institutions. In my walk to 
it I passed through streets filled with houses of an inferior kind, 
and out of which flocked troops of lively children, who evidently 
were born in the most humble life. Many of these legions of 
children seemed to be checked by their hard fate in some of the 
sweetest attributes of childhood. They were often thin and 
rarely clean, and although on many of the countenances was 
the peculiar bloom of young English life, the average of physical 
health was far less than would have appeared in any similar 
number of children growing up under happier auspices. Hence 
it seemed that Miss Coutts had wisely selected the spot for her 
philanthropic object. 

The market-house covers a large open square, and is entered 
by various gothic arches of medium height. Small shops, and an 
inn (over the front of which appears an inscription to the mem- 
ory of Sir Francis Burdett), occupy the basements of the quad- 
rangle. In the open space of the quadrangle, at certain parts 
of the day, congregate the buyers and sellers. Over the various 
arches, and cut in the stone, appear mottoes, some of them taken 
from the Bible, and all appropriate for the place, and to be 



200 STATE BOARD OF HEALTH. [Jan. 

plainly read by all ; for example, " The earth is the Lord's and 
fulness thereof, the world and they that dwell therein ;" " Speak 
every man truth with his neighbor ; " " Study to be quiet and 
do your own business ; " "A false balance is an abomination 
unto the Lord, but a just weight is his delight." The " practical " 
man may doubt about the value of these mottoes ; the sceptic 
may sneer ; the positivist complain of them as savoring of what 
he calls a bygone superstition — and finally the capitalist, as he 
wants to make money, would exclude the whole of them, and 
with them perhaps all the other graces that abound in the 
building, on the ground that they do not " pay." Nevertheless, 
I honor the filial piety, the aesthetic taste and the generous phil- 
anthropy that led Miss Coutts thus to shower, as it were, beauty 
and holy thoughts over the common ways and actions of the 
people and of their children. When that gentle lady is no more, 
thousands of hearts will bless her for the sweet impressions daily 
given them in their childhood and youth by the market walls of 
Columbia Square. 

Adjacent to the square is a large hall, two stories in height, 
but really only one hall with four galleries, two on each side. 
Round tables are in each, and the newspapers of the day are 
there. One halfpenny is charged for entrance into this almost 
palace-like hall, with its polished granite columns, and, in sum- 
mer, with its baskets of blooming flowers, its brilliant gas, and 
its numerous conveniences for reading, writing, playing chess, 
chequers, cards, eating, and even, in one portion, for smoking. 
1 went into it and found most of the news I should have read at 
a club house. A number of persons were in each compartment. 
I regret to say that such a place evidently could not " pay." 
Nevertheless, it attracts by its cheapness and quiet, and pre- 
vents some, perhaps, from resorting to the dram shop, where, 
heretofore alone, the poor have been obliged to go for relaxation 
from daily toil. Therefore I hail it as one of the prophecies for 
the future health, moral and physical, of the people. 

Directly behind the market and reading room, stands the 
lodge or home for the people. 

It consists of a rectangular block of four handsome brick 
buildings, finished with stone. A very graceful clock-tower rises 
in the middle, which is surrounded by a small flower garden, 
the whole producing a very picturesque appearance. 



1871.] PUBLIC DOCUMENT— No. 37. 201 

The houses are built much on the plan of the Peabody Build- 
ings, and should receive the same commendation and the same 
criticisms. I observed that the blue-tinted bricks of the walls 
look more pleasantly in the' rooms than the plain white or 
lighter colors. The superintendent reports the same results as 
in the Peabody Buildings about freedom from epidemics and the 
improvement in the deportment of the inmates. He has known 
cases of intoxication radically cured after residence there. 
There is an evening school connected with it, and lectures are 
frequently delivered in the hall adjacent to the market. His 
rules for cleanliness are to brush out daily, wash up weekly, 
coloring of walls every three or four years. The prices range as 
follows : — 



For one room, 
two rooms, 
three " 
four , " 
five " 



2s. per week. 
2s. 6d. or 3s. 6d. 
3s. 6d. or 4s. or 4s. 6d. 
4s. 3d. or 4s. 6d. 
5s. 6d. 



He receives any one who applies, but first examines his actual 
residence and gets references. It differs in general principles 
from the Peabody Building chiefly only in receiving those as 
tenants who may earn more than 30s. per week, above which 
the latter does not go for tenants. 



III. 

"THE IMPROVED INDUSTRIAL DWELLING COMPANY," OR THE 

UNION OF PHILANTHROPY WITH CAPITAL, AND WITH 

PERFECTLY SUCCESSFUL RESULT TO BOTH PARTIES. 



A thorough insight into the operations of this company is all- 
important for all who desire to know how to erect good homes 
for the people. In Boston, the experiment has been successfully 
tried on a small scale. Two or three model lodging houses 



26 



202 STATE BOARD OF HEALTH. [Jan. 

have been built, and have done good to a few families, and at the 
same time they have returned six per cent, interest on capital 
over and above all incidental expenses. But nothing has ever 
been carried out on so grand a scale as by the above named 
company in London. 

Whilst the Peabody and the Columbia Square Buildings do 
not pretend to pay more than the smallest return to capital, the 
buildings of the Industrial Company give such ample returns 
that the directors have refused (because so fully occupied 
with erecting new buildings) to receive more money for the 
present year. While the former cannot give an entire home 
and separate water-closets, washing-room, &c, to each family, 
the latter have contrived to do so, though at a somewhat higher 
rent. Nay, it is one of the cardinal ideas of the prominent 
workers of this company, not only to provide such a home, but 
to so arrange it that the parents shall always have a chamber, 
and that the sexes shall be entirely apart among children. More- 
over, the buildings are so planned that every room or bed- 
chamber may be exposed to the open air, and shall not open 
intoJong corridors flanked by water closets at either extremity, 
as in the Peabody and Coutts Buildings. All of these arrange- 
ments of the " Waterlow " Buildings are infinitely superior, in 
a sanitary point of view, to arrangements for the same purpose 
found in the other two. Previous to the rising of this company, 
some unsuccessful experiments had been made to unite these 
two apparently hostile elements, capital and philanthropy. 

During my night walk with the police inspector, and in one 
of the most filthy streets I passed through, I saw a dirty-looking, 
two-storied brick building, planned differently from all adjacent 
to it, and somewhat in the form of the model lodging houses of 
the present day. The windows and steps were unswept, some 
of the glasses were broken, and it bore all the marks of being 
inhabited by a rude, careless set. No flowers bloomed from its 
window sills ; the steps leading to it were rickety, and the fence 
near it had that zigzag appearance so significant of a drunkard's 
home. There was an entire want of thrift about the whole 
premises. " There," said my guide, " is a model lodging 
house, built from a most benevolent desire to raise the miser- 
able, and at the same time to get some return for capital, — you 
see how it looks now, — the poor man who built it failed in his 



1871.] PUBLIC DOCUMENT— No. 37. 203 

undertaking." To my inquiries, our guide gave the following 
further history : " It was originally built rather extravagantly 
by one full of benevolence, but of little practical experience. It 
stood in the very midst of an abandoned community. Hence, 
no one that was respectable would occupy it. The owner had 
not the ability or wish to collect his own rents j* consequently, 
great arrearages were allowed to accumulate. Finally, in de- 
spair, he leased it to another, with the idea of his sub-letting the 
tenements. The lessee was a man of no principle, and soon, to 
his horror, our philanthropist found that what he had erected 
for the improvement of the neighborhood was its curse, — it be- 
came the most elegant brothel of the street. Of course all this 
was stopped, but it was too late, the house never recovered from 
this blow to its reputation." Truly here was a monument sug- 
gestive of reflections of no very pleasant nature. These reflec- 
tions, however, were amply replied to by the results accruing 
from the Industrial Dwelling Company's operations, and still 
more agreeably and forcibly met by the "Organized Work among 
the Poor," originated and so successfully carried on by Miss 
Octavia Hill of London, f 

Again, previously to the rising of the Industrial Dwelling 
Company, another company had been formed. This was called 
the Metropolitan. It arose from the idea first brought out by 
that most excellent, as well as exalted person, the late Prince 
Consort, who proposed it at the First World's International 
Exhibition, viz., in his "Model Lodging House." The com- 
pany arose very soon after this exhibition, and under that stim- 
ulus ; but it failed to bring more than 11 to 2 per cent. It 
gradually drooped and settled up its affairs as a comparative, if 
not a real, failure. Although its operations were more success- 
ful than its predecessor's, it failed of getting what moneyed men 
deemed a good return for their capital employed. Of course 
capital shrunk from philanthropy, and philanthropy without 
these " sinews " became weak. 

At length the two leading spirits of the Improved Industrial 
Company that has accomplished this complete union, met; — 
employer and employed, each a genius in his own department. 

* Possibly, if this gentleman had had the tact and wisdom evinced by Miss Hill, he 
would have succeeded in his kind undertaking. See section entitled " Organized Work 
among the Poor." 

t See Statement V. 



204 STATE BOARD OF HEALTH. [Jan. 

The able financier, the wealthy humane man, one of broad, 
generous views, and of a good common sense, the head of a 
large printing establishment, alderman of the city of London, 
Sir Sydney Waterlow, agreed to advance money to the practical 
mason, Mr. Allen. This mason labored with his hands, but his 
heart was full of good will to the poor, among whom he was 
born and had lived nearly half a century. He saw them daily 
everywhere around him suffering for want of " good, healthy 
and tasteful homes." His head became full of plans for the 
erection of buildings for that desirable object. He knew all 
the dire wants of the case, for he had grown up under the 
same pressure. Hitherto the home of the workingman has 
been neglected ; " consequently," remarked Mr. Allen, " he 
has resorted to the tap-room, where alone he has found bright- 
ness and mirth." Fortunately, Mr. Allen was brought into re- 
lations with the rich capitalist above alluded to, who had em- 
ployed him as a mason, and with him he urged his plea. Sir 
Sydney Waterlow listened with attention and interest, and with 
three other friends agreed to advance the means upon the plan 
suggested by Mr. Allen, provided, on its examination by an 
accomplished architect, it should be found to be according to 
strict legal and architectural principles, so as to give safety to 
every room and individual in it. The result was favorable, and 
from that time to this, viz., from 1863, Sir Sydney with others, 
forming a limited company, have continued to build and to ex- 
tend their operations, Mr. Allen remaining as their architect 
and chief superintendent. 

This company was originated in the above named year, and 
made its first half yearly report in 1864. Sir Sydney has been 
its chairman and mainspring since its origin, and to the vigor, 
fine spirit and practical sense of these two men, with ample 
means at their disposal, it doubtless owes its perfect success. 
The following extracts from the remarks of Mr. Goshen, Mem- 
ber of Parliament, at the 7th half yearly meeting held at the 
Mansion House, February 14, 1867, may be quoted. He said 
that he felt " that the Company was not only one of great pri- 
vate interest, but also of great public importance ; " and that 
" the greater the extent to which the principle could be carried, 
the better we should be able to solve the great problem as to 
how our laboring classes are to be accommodated." k ' It has 



1871.] PUBLIC DOCUMENT— No. 37. 205 

been asserted that when a low class of houses are pulled down, 
and new buildings replete with all the improved sanitary ar- 
rangements are erected in their stead, it can only be done at a 
loss. I consider that it is the object of this company to dis- 
prove that assertion, and to show that good buildings can be 
erected in the place of bad ones at a profit instead of at a loss." 
" A profitable business can be done if sites are judiciously se- 
lected." Some of the speakers alluded, as capitalists, to their 
gratification at the fact of the good return for the money in- 
vested. One regretted that the houses were not for the very 
poor laborer, but rather for the common mechanic. To which 
reply was made that, if the artisan leaves his present home the 
laborer will move into it, and thus both be improved in con- 
dition. 

The directors in their report say, " during the previous four 
half years dividends of five per cent, had been paid, and a sum 
equal to 25 per cent, of the net profit was carried to a reserve 
fund." The directors believe that, from their previous experi- 
ence, there was a fair prospect of an annual profit of at least 
six per cent., after making liberal allowance for contingent ex- 
penses. 

The following appears in the Fourteenth Half- Yearly Report 
made at a meeting held at the Mansion House, June 12, 1870. 

The whole of the share-capital, viz., £125,000, has been sub- 
scribed, and a further sum will be borrowed at 4 per cent, from 
the Public Work Loan Commissioners, which will represent a 
total capital of £ 250,000. The company had generally houses 
well occupied, except at Greenwich where, owing to the de- 
pression of trade in that locality, they suffered as the Peabody 
Buildings at Shadwell had, viz., from a loss of tenants. 

The estates of the company, with number of tenements in 
each, are as follows : — 



206 



STATE BOARD OF HEALTH. 



[Jan. 





Tenements. 




3 Rooms. 


2 Rooms. 


1 Room. 


Shop. 


Total. 


Cobden Buildings, King's Cross 












Road, ..... 


8 


10 


- 


2 


20 


Nelson Buildings, Bridge Street, 












Greenwich, .... 


20 


20 


- 


- 


40 


Tower Buildings,Brew House Lane, 












High Street, Wapping, 


30 


30 


- 


- 


60 


Stanivy Buildings, Old Saint Pan- 












eras Road, King's Cross, . 


51 


50 


- 


3 


104 


Palmurston Buildings, City Garden 












Row, City Road, 


36 


36 


- 


- 


72 


Cromwell Buildings, Red Cross St., 












South wark, .... 


10 


12 


- 


2 


24 


Derby Buildings, Britannia St and 












Wieklow St , King's Cross Road, 


40 


118 


- 


10 


168 


Glad*tone Buildings, Willow St., 












Finsbnry, ..... 


84 


S4 


- 


- 


168 


Waterlow Buildings, Bethnal Green 












Estate, ..... 


21 


48 


3 


- 


72 


Total completed, 


300 


408 


3 


17 


728 


Buildings in course of erection at 












Ebury Street, .... 


50 


60 


- 


10 


120 


Buildings in course of erection at 












Ebury Square, .... 


40 


25 


- 


4 


69 


Buildings in course of erection at 












Bethnal Green,. 


40 


130 


*- 


- 


170 


Total either erected or being 










erected, .... 


430 


623 


3 


31 


1,087 



With exception of 72 tenements in the Derby Buildings, 
where one scullery and copper, &c, are provided for every 
three dwellings, each tenement has a separate washroom, 
copper for heating water, water supply and other conveniences, 
the cost of which is about equal to that of a room. 

The methods pursued in raising the funded capital is as fol- 
lows. I quote from the prospectus issued in the year 1867 : — 

"Capital £250,000, of which £65,000 were then subscribed. 
Shares £25 each, £5 to be paid on allotment and the remainder in 
calls of not more than £5 per share, at intervals of not less than 
three months. 

" A bill has been recently passed which will enable the company 
to largely increase the extent of its operations, by borrowing of the 



1871.] PUBLIC DOCUMENT— No. 37. 207 

government at 4 per cent, interest, a sum equal to the outlay on its 
buildings. A profit of £5 Is. per cent, interest (being nearly one 
per cent, less than the estimated annual profit) will be sufficient to 
repay both principal and interest of the loan at 4 per cent., from 
which it will follow: (1st.) That the saving of nearly one per 
cent, on the borrowed portion will increase the profit on the share- 
holders' part of the capital to seven per cent. ; and (2d), that at 
the expiration of forty years (during which the loan is current^), the 
unencumbered reversion to the buildings created by the investment 
of the borrowed money, will double the value of the company's 
estate. This anticipation, too, is irrespective of the ordinary pro- 
gressive increase in the value of landed property. Houses in some 
districts of London double in value in the course of a few years. 

" The evils of great towns spring almost entirely from over- 
crowded and ill-constructed dwellings, and no permanent benefit 
can be conferred on the working classes until this, the primary 
evil, is removed." 

Of the buildings mentioned above, I visited the Cobden, 
Derby, Stanley, Cromwell, Gladstone and Tower. I also ex- 
amined a new block erecting at the expense of Mr. Allen, and 
called by his name. They all have the same general appear- 
ance, excepting that the Derby has a less imposing aspect than 
the rest. The others present a very neat appearance, not to 
use a higher epithet, built as they are of brick and manufac- 
tured stone, with stone finishings and steps, and iron balus- 
trades on each. Everything I saw looked very clean, and the 
superintendents assured me that the same general results as to 
health and morals followed in their train, as noticed in the 
Peabody and Coutts Buildings. Tenants dislike to leave, and if 
trade for a time compels them to leave, they gladly return. 
The sole objection is that above alluded to, viz, : that the rents 
necessarily are a little higher than most of the very poorest 
can pay, averaging about twice as much as is asked in the Pea- 
body Buildings, while giving many more conveniences and an 
entire home to each family. The following table shows the 
rents per week for some of the buildings and gives an idea of 
the whole : — 



203 



STATE BOARD OF HEALTH. 



[Jan. 



Buildings. 


05 ci 

E ^ 

O * 

O G 

* 3 


a <§ 

o 
o o 


tn 6 

a *z 

o 
o c 

— ° 

Q 

o it 
I* 


o § 
K | 

O 


a 

03 

fa 


Derby, 


- 


7s. 6d. ; at top, 5s. 9d. 


7s. 3d. 


at top, 5s. 5d. 


- 


168 


Cobden, . 


- 


7s. ; 4th story, 6s. 6d. 


5s. 6d. 


4th story, 5s. 


- 


- 


Stanley, . 


- 


7s. ; at top, 5s. 6d. 


6s. 6d. 


at top, 5s * 


- 


101 


Allen, 


9s. 


- 


5s. 6d. 


6s. 6d. 


4s. 


70 



* With two bed closets. 



In the building now erecting at Bethnal Green, one room 
only is provided. We cannot but hope that this also will 
prove a success, even at a lower rate. Nevertheless, consider- 
ing the very perfect houses, thus provided with two, three or 
more rooms and all their addenda, and this within very short 
distances from the workman's place of labor, we cannot call 
the rents high. 

Of course it was important to see and converse with the men 
most interested in this great, this growing and most successful 
company, whether we consider it in the light of the investment 
of capital or as a matter of sanitary reform, destined to exert 
immense influence on the future health of the English people. 
These interviews I sought. They only convinced me more 
than ever of the philanthropic views and the wisdom and far- 
reaching sagacity of Sir Sydney Waterlow and of his able 
assistant, Mr. Allen. " I build for the future," said the latter 
to me on one occasion. " I have lived and toiled among the 
working men of London over forty years, and I know their 
necessities and their desires. They have been all that while 
steadily but slowly improving. I feel sure that sometime after 
I am dead, every mechanic will live in such buildings as we 
are now erecting. Each one will have his own neat, tasteful 
home." Mr. Allen believes in cultivating the aesthetic part of 
the nature of man. A well-trained flower on the window sill 
reveals to him humanity somewhat more developed and a better 
tenant to be chosen for his newly-built houses, than when he 
finds neglect in this particular. Yet this man is a workman 



Improved Homes for the People _ in Allen & son. Finsbury, London. 

This sketch represents on a scale of i inch to a foot,one halfof the latest building erected by MrAllen & finished Sept. 1870. 




.V. '/ 

Xo.l Contains four rooms <(-,■ Weekly raU S b 

; 2 ■■ two do 6 

'In'''' ■■ do 7 :i I The Sadlery or wcushroom atta-clw/i/ to each 6talduta,co'/ttazJts 

■ '* viree .. do lj .'i a,waier closet, sinJo, cocdsbiri bovLen&e.as marked z/i-JFo../ , 

•5 two .. do '5 6 

6 four .. „ ,/„ 9 n 



1871.] PUBLIC DOCUMENT— No. 37. 209 

and uses his trowel if need be and dresses as a workman should 
when at his daily labor. Sir Sydney is the complement of him, 
a philanthropic financier, with ample means and full of enthu- 
siasm for the ideas underlying their great mutual undertak- 
ing. Sir Sydney considers the company as equally a fine 
success as a sanitary measure and as an investment for capital. 
Everything is conducted on the most rigid economy ; no 
salaries are given. Mr. Allen, who has already amassed a suf- 
ficient sum to enable him to build a block of buildings on his 
own account, assures me that the company never makes less 
than twelve per cent. He expects to make that with his own 
at the prices above named, and all the rooms are engaged before 
the house is finished. 

On the plan herewith given, are seen the arrangements of six 
tenements or one-half of one story of "Allen's Building " near 
Finsbury Square. It is the latest tenement erected by Mr. 
Allen, and was opened in September, 1870. The building is of 
brick, with stone finishing. It is five stories high. The rooms 
are eight and a half feet high from floor to ceiling. The front 
is about one hundred feet on the street. Its depth is a 
little over forty feet. The central part of the front line is set 
back a short distance, and has four bay windows on each story. 
The two end portions present, therefore, the appearance of 
wings added on each side" of a more elaborately constructed 
centre. The structure has a certain degree of elegance and 
refinement about its exterior, which would make it not in- 
appropriate for any of the fashionable streets of the metropolis. 
Yet it is filled wholly with a series of small tenements, very 
convenient and perfectly lighted and ventilated, the homes of 
some of the humblest of the people of London. These homes 
are constantly occupied. The site of the building is directly 
opposite a wretched, low tenement house analogous to the 
" Crystal Palace" in Lincoln Street, Boston. Mr. Allen feels 
sure, from his previous experience of the influence of the 
Waterlow Buildings, that the silent example of his house will 
tend to elevate the character of its opposite neighbor. 

Sir Sydney and Mr. Allen were both very earnest about their 
system of ventilation, which gives free access of the air to 
every room, and allows, when two or three doors are opened, a 
free circulation of air through the whole house. They both 

27 



210 STATE BOARD OP HEALTH. [Jan. 

disapproved of the long corridors, and a community of water- 
closets flanking them, as in the Peabody, Coutts and other 
buildings. Mr. Allen spoke very decidedly on this point, and 
said that he thought fifty years hence all buildings constructed 
with such corridors would be among the past, and either 
wholly re-organized or occupied by a degraded set of tenants. 
Whether such prophecies will prove true remains to be seen. 
Meanwhile, there is no doubt on which side the sanitarian ob- 
server would stand on this question, for unless great and per- 
sistent care be daily taken, evil will sometimes result in the 
corridor water-closet system. 



IV. 

JARROW BUILDING COMPANY. 



From the preceding statements it will be seen that a great 
step forward has been successfully taken in London. It has 
been proved that capitalists can safely pull down poor houses 
which are unfit for human dwellings and which tend to propa- 
gate ill health, crime and vice, and instead of these pests can 
build up healthful and tasteful homes for the people, and while 
thus doing they can gain money for themselves, and by the 
same act raise the human race to a higher grade of physical 
and moral health. This idea is springing up in various other 
parts of England. Everywhere men and women are thinking 
upon the subject. 1 happened to be at Newcastle-on-Tyne, and 
found there some buildings just erected in that city. At Jar- 
-row-on-the-Tyne I visited some of the small tenements built 
under the direction, and at the expense of the Jarrow Build- 
ing Company. These arose at first from a desire on the part of 
a large iron ship building company to provide proper tenements 
for its own workmen. The company has been in existence 
since 1863, and very successful too have been its operations. 
These operations consist in putting up separate small buildings 
on land large enough to give a small yard to each. The build- 



187!.] PUBLIC DOCUMENT— No. 37. 211 

ings are two stories high, have two and sometimes three rooms, 
with washhouse, &c, to each. They form long streets, which 
are broad and well paved, and have neat sidewalks on both 
sides. 

On taking possession of any premises with the intention of 
eventually purchasing it, the tenant signs the following 
agreement with the trustees of the company, viz. : to pay an- 
nually ten per cent, of the price named ; viz. : five per cent, for 
the rent and five per cent, towards the price of the estate ; 
such payments to be made in fortnightly instalments ; that if 
he fail to make such fortnightly instalment he shall be fined 
3d., if a second time 6d., a third time 9d., and so on ; that if 
at any time such fines amount to the sum already paid by the 
tenant, the trustees are to have the right to enter and hold the 
premises, as if nothing had been paid, and to eject the tenant ; 
that possession shall be given after signing of the agreement, 
but that a full deed shall not be demanded until three months 
after the final payment, when the trustees agree to give such 
deed, the tenant paying the necessary expenses ; that the tenant 
must keep the premises in good order and shall not sell them 
without permission from the trustees. 

The above summary gives an idea of the nature of the trans- 
actions between the trustees and tenants at Jarrow. I ex- 
amined the houses and found them neat and simple homes, and 
learned that the affair had been quite successful, and that, one 
after the other, each workman was becoming a proprietor of his 
own place of residence. The stimulus thus given to every 
individual mind among the workmen has been very beneficial. 
It had also proved an excellent sanitary measure. 



212 STATE BOARD OF HEALTH. [Jan. 



V. 

ORGANIZED WORK AMONG THE POOR. 



In all that precedes we have found it needful to have either 
vast police authority, great private benevolence, or finally a 
combination of philanthropic effort with capital, in order to 
raise to a proper healthful standing the homes of the poor and 
of the laboring population. 

We now come to consider perhaps the most interesting, as 
certainly it is the most extraordinary experiment of all yet 
instituted, viz.: what Miss Octavia Hill, the originator of it 
calls " organized work among the poor." It shows what a sin- 
gle individual can do if one only will act with patience, perfect 
self-control and wisdom and, if need be, self-sacrifice in a good 
cause. By these qualities, and with very little money, Miss 
Hill has succeeded in conquering difficulties seemingly, at first 
sight, insuperable. She has herself explained her methods in 
the "Fortnightly Review" for Nov., 1866, and in "McMillan's 
Magazine" for July. 1869, and more recently in a private way, 
at the request of Mr. Wilkinson, she drew up a statment which 
she has kindly had copied for my use, and the greater part of 
which I will here present. It tersely tells the story of what has 
been done. Later in this paper I will describe her usual method 
in more detail : — 

Miss Hill's Statement, July, 1870.* 
" The main principle on which the following experiment was 
founded, is that personal influence is the lever by which the poor 
can be raised ; that this is exercised better by those who stand in 
some recognized relation to them, such as that of landlord. 

* A short time before I left London in November, Miss H. informed me that she had 
given the paper for publication elsewhere. 



1871.] PUBLIC DOCUMENT— No. 37. 213 

" The first property, three houses of six rooms each, was bought 
in 1864 for £828. It was leasehold with an unexpired term of 
fifty-six years. It has paid five per cent, from the day of purchase 
on the capital invested. It has repaid a portion of the capital : a 
further sum of £40 has accumulated from the profits, which sum, 
Mr. Ruskin, the pi-oprietor, wishes to devote to benevolent pur- 
poses. It has also paid for building a room for social gatherings. 
These sums have been realized after providing for the repair and 
continuous improvements of the property. The second purchase 
was a freehold consisting of land, on which stood five houses of 
four rooms each, and one of fourteen rooms, and some old cowsheds. 
It was bought in 1866, and cost £2,725. The cowsheds were de- 
molished, and the space used as a playground for the neighborhood. 
An additional floor has been added to the houses, making forty-five 
rooms in all. This property has realized five per cent, also, and 
considerable sums for repairs and improvements. 

"Encouraged by the result of the experiment, Mrs. Stopford 
Brooke last autumn bought the leasehold of five houses in Bar- 
nett's Court. Each house contains ten rooms ; these also have paid 
five per cent., and already begin to pay the capital. Lady Ducie 
last Christmas bought the leasehold of six houses in the same Court. 
They also promise to pay well. 

" Another lady has purchased a plot of freehold ground in the 
poorest district in Marylebone. A sum of £2,000 for building on it 
has been contributed by four ladies, and the plans are in prepara- 
tion. 

" In all these instances a marked change has taken place in the 
manners, habits and morals of the tenants, who in most cases are 
the same as were in the houses at the time of purchase. The rents 
have been rigidly exacted, and perhaps the sense of fulfilment of a 
duty has much contributed to raise the spirit and tone of the people. 

" In keeping such houses in repair a great deal of carpentering, 
plastering, white-washing, and other rough work has to be done. 
In times of scarcity of work this forms a valuable means of giving 
employment, thereby assisting, without demoralizing the poor. 
Great care should be directed to supervising the cleanliness of the 
houses. Health more often depends on the way the house is kept 
than in its construction and appliances. The reckless destructive- 
ness of this class of people has been greatly cured by setting aside 
a fixed sum for repairs and improvements, of which an account is 
rendered quarterly to each tenant, and if there is a surplus the 
tenants in turn decide how it shall be spent in improvements. 



214 STATE BOARD OF HEALTH. [Jan. 

" In times of want no charity has been given, but work has when 
possible been found. The amusements of the tenants have been 
provided for as far as possible. Excursions in the country ; social 
meetings in winter, concerts, &c, have been arranged, and have 
brought into more friendly contact the tenants, and those inter- 
ested in them." 

It is evident, from the above account, that the plan succeeded 
because Miss Hill, an intelligent, well-educated lady, fully ap- 
preciated not only the difficult and delicate relations of land- 
lord and tenant under such circumstances, but knew moreover 
the influence she could exert for good over rougher and less 
cultivated natures. 

I sought an introduction to Miss Hill, and I had long con- 
versations with her. I had previously visited one of her houses. 
Her lady-like self-possession, and accurate and prompt ways 
command the respect of every one who comes in contact with 
her. One feels that there is no sentimental nonsense about 
her, but a downright honest and clear way of looking at un- 
pleasant circumstances, and an unswerving determination to 
carry out what she deems a simple duty. This duty would be 
to most people very irksome, nay, in many respects absolutely 
repulsive. Few would undertake it, because of this essen- 
tially disagreeable nature. What she has undertaken and has 
accomplished, most people would say was entirely " out of 
woman's sphere." I cannot present her plan to the Americans 
in any better way than by the following hypothesis : — 

Suppose any lady in New York or Boston should say : I will 
buy the worst den at Five Points or in North Street, even if in- 
habited by cut-throats and garroters. I will become their land- 
lady. I will call personally every week for my rent, and 
rigidly require it ; I will give no charity, but will if possible 
provide work ; I will enlist their sympathies by being myself 
interested in their welfare. If they are ill I will try to com- 
fort them ; if they are uncleanly, I will try indirectly to make 
them cleaner. I will occasionally induce the parents to bring 
the children out into the Central Park, or into the Public Gar- 
den, in order that they may feel the beauty of flowers, and may 
taste the sweet freshness of the pure air. I will try to open 
their eyes to all the fair things of art. Miss Hill has not only 



1871.] PUBLIC DOCUMENT— No. 37. 215 

proposed, but has actually done all this.* She has taken 
charge of houses in most wretched and low neighborhoods, in 
one of which the previous landlord had been a drunkard, and 
his tenants had copied his example. The filth of this place was 
extreme. The yard and wash-house were choked up with the 
nasty accumulation of years, so that it was impossible to use 
either, and therefore they had been definitely closed for some 
time. Very many of the windows of the various rooms were 
broken and filled up with old clothing. No paint had touched 
the house for a great while. The tenants were a wild, swearing, 
destroying race. Miss Hill gave notice to them of the change of 
landlords ; told them she should simply clean up the house and 
repair some of the broken parts ; that she wanted them to aid 
her by treating the premises properly ; that she should ask for 
the rent previously demanded ; that it must be promptly paid 
weekly, and that neglect of that bounden duty for two weeks 
would produce a legal summons to quit the premises. 

At first no good result seemed to arise, as the next time she 
went she found even the new places injured, and at times wan- 
tonly broken. She said that she hoped such a result would not 
happen again, and that she had made up her mind to spend 
upon the house a certain sum annually for repairs or improve- 
ments, if actual repairs were not needed ; that she should 
charge each tenant with whatever injury was found in his or 
her room. Of course, therefore, they would see that the better 
care they took the more would be left for the general improve- 
ment of the premises. Upon the precise method of expenditure 
to be made with the saved funds, she should consult the tenants 
each in turn, and perhaps follow his or her counsel. The re- 
sult was all that could be desired. The manners of all improved. 
Instead of vieing with one another how things could be injured 
the emulation was to save as much as possible. Each tenant 
has tried to improve his own premises. The savings thus accru- 
ing have enabled the landlady to add a new story to the house, 
and to introduce an ample water supply. A playground for the 
children, and pleasant shady space for elders has been opened 
in front of the building. Trees are growing where formerly 
were dirty sheds, and green vines climb over walls formerly be- 

* Since writing this I have heard of one similar undertaking by a young lady in 
Boston. 



216 STATE BOARD OF HEALTH. [Jan. 

smeared with filth. The men have more self-respect, the women 
are more cleanly, the children are better clothed, and go more 
regularly to school. 

Similar results have taken place in another dilapidated, door- 
less house, " a perfect rat-hole." 

The previous landlord had been garroted and nearly killed 
on demanding his rent. Mr. Ruskin, though aiding with 
pecuniary means, deemed it almost hopeless even to attempt to 
do anything with such a place. But Miss H. succeeded. I 
asked to be allowed to go around with Miss Hill when she col- 
lected her rents, and she permitted me to do so. Into every 
tenement she went she quietly asked for her dues, but had some 
word to say about the family. The smiling and bright answers 
she got from almost all showed how different the relations must 
be between her and her tenants, than those which had existed 
between them and her predecessor. In one dark and dirty 
alley, however, I anticipated evil and rough treatment, for the 
agent informed Miss Hill that one of the tenants had sworn he 
would not submit to a summons that had been served upon 
him, to quit for non-payment of rent. We went our rounds, 
however, as if no remark had been made. We found the house 
in rather a poor condition. As it had been only recently taken 
in charge, there was some want of neatness about the stairs, 
&c. Miss Hill remarked upon it and added, " we have to edu- 
cate ourselves to wait in hope. We cannot make them suddenly 
clean. For three weeks I have been trying to induce them to 
properly wash that window. It is, as you see, still dirty. They 
will, however, learn by and by." 

At length we arrived at the upper part of the house, and 
entered a very low room, evidently inhabited by drunkards. 
Everything was disorderly and comfortless. A sulky, rough 
man, and a bloated-looking woman, his wife, were there. 

Miss H. merely said, " Mr. , I learn that you decline 

receiving the summons. You will understand that it has been 
legally served, and if the rent be not paid next week, you 
must leave." He answered very doggedly, and pounded furi- 
ously upon the shoe he was mending, possibly to overcome the 
inclination he had to lay violent hands on his landlady. He 
was well enough able to work if he chose to do so, and could 
also pay his rent if he would not drink. This man was the 



1871.] PUBLIC DOCUMENT— No. 37. 217 

ruffian about whom we had been warned. A low muttering 
from husband and wife was the only reply, as we turned to 
leave the room.* 

The whole visit was a very valuable one. It showed that 
the qualities named in the earlier part of these remarks were 
all that were needed. The last house I have no doubt will be 
redeemed and the tenants raised morally, as in the others 
alluded to, and disease, too, will strike them less generally 
under the mental, moral and physical cleansings that have been 
inaugurated. 

I may mention as a proper finale to this whole story, that 
Miss Hill, when speaking of the gradual education of her ten- 
ants, remarked " that some of the lowest had so far risen in 
self-respect, and their means of support having consequently 
perhaps increased, they wished to get into higher and better 
rooms, out of their old pathways ! " She had encouraged them 
to do so. In fact, she is now beginning to arrange a better 
class of houses, just above the level of these lowest dens, and 
hopes that she shall win many up to them, even if they have 
more rent to pay out of their small earnings in order to gain 
that end. 

Summary op the Whole Investigations upon Some of the 
Means now in Operation in England for Improving the 
Homes of the People, and the Results of these Oper- 
ations on the Health and Morality of the Occupants. 

I have thus given five separate statements alluded to in the 
first portion of this letter. Although each can be read by it- 
self, an important idea underlies and runs through the whole, 
viz. : that by improving the homes of the people ; by making 
them neat and wholesome instead of filthy and stinking, we 
raise men, women and children to a higher standard of physi- 
cal and moral health. The first paper entitled a " Night 
Stroll, &c," proves that English law jealously guards the public 
lodging houses of the poor and vicious. It prescribes rigid 
rules in regard to cleanliness, amount of air, water, &c, for 
each lodger. At the same time the same law allows the private 

*About three months after this interview, I asked Miss Hill what became of her rough 
tenant. " Oh," replied she, " he did very well. He forthwith paid his rent, and I have 
had no further trouble from him." 

28 



218 STATE BOARD OF HEALTH. [Jan. 

houses of the miserable and degraded of the same class to be- 
come by their filth, moral and physical pests of the neighbor- 
hood in vast districts in London. As an addendum to this 
paper, I have given another by which Boston seems to vie with 
London in its low tenements, and in disregard for sanitary law 
it is perhaps superior to the English metropolis. 

Second. I have briefly described the Peabody and Burdett 
Coutts Buildings. I have given them as illustrations of philan- 
thropy, and of its effects upon the dwellings of the laborers, 
and their results upon the health and morals of the people. 

Third. I have shown in my notice of the operations of the 
operations of the " Improved Industrial Dwelling Company," 
how philanthropy and capital can join hands and each reap an 
ample return for its efforts made and for means given. 

Fourth. I have indicated the workings of the Jarrow 
Building Company, in which the tenant, besides gaining all the 
advantages afforded by the preceding methods, is stimulated to 
become himself the proprietor of his own home. 

Fifth. I have described the extraordinary and yet simple 
labors of Miss Hill, aided by the well known writer on art, Mr. 
Ruskin, Rev. Stopford Brooke, &c. By these labors the vilest 
dens of London have been reformed to neatness and morality, 
by the personal influence of the individuals engaged in the 
matter, while at the same time the relations of landlord and 
tenant have been rigidly enforced, all money-giving charity 
has been virtually abolished, and with all this there has been 
an ample return for capital invested. 



VI. 

COMPARISON OF THE COMPARATIVE VALUES OF A MODEL 

LODGING HOUSE AND COMMON TENEMENT BUILDING 

IN BOSTON. 



In the last year's report of your Board, you regretted that it 
was impossible to finish the account of the " Comparison of 
model lodging houses and common tenement houses, in their 



1871.] PUBLIC DOCUMENT— No. 37. 219 

relative effects upon the health and morals of the people." 
Though signed by the whole Board, the final statement really 
devolved upon myself, who had commenced the investigation. 

Circumstances beyond my control compelled me very soon 
afterward to leave America, and I have been unable to make 
out a final report till within the past week, which renders it 
less complete than I could wish. I should regret this very 
much if I had not been able during my enforced absence to 
make the preceding investigations, which I deem, and I hope 
the Board will consider, not only not irrelevant, but rather, as 
it were, adding to the foundation of the practical results of our 
last year's investigations in Boston. To these results I propose 
now to draw your attention. 

A thorough examination was made by Dr. A. L. Haskins, 
under the direction of the Board, and according to a certain 
definite plan of questions, at each particular tenement in two 
houses, viz. : the model lodging houses in Osborn Place, and 
the so-called " Crystal Palace," a common tenement building 
in Lincoln Street. Replies believed to be accurate, or nearly so, 
were obtained from these two. Subsequently, buildings in 
Stone's Yard, in Cross and Stillman Streets, Institute Avenue, 
Endicott Street, and Friend Street Court were seen. All of 
these are of the lowest and most degraded class of' buildings. 
Prom all these last the returns were rather imperfect. In one, 
the proprietor compelled the tenants to eject our agent. 

Model Lodging House in Osborn Place, Boston. 
The results obtained may be summarily stated as follows : 
The model lodging house consisting really of three brick 
buildings, provides a residence for poor families. They contain 
all the appliances for comfort and health provided by modern 
society, at a cheap rate, and yet large enough to be amply 
remunerative to the proprietors. 

It is situated on the original soil on a somewhat elevated 
part of the city, where the tides never reach. It is five stories 
high, built of brick ; is of a very neat appearance. It has an 
ample supply of fresh air around it. It has a large common 
entry, and private entries for each family home. Each family 
has 3 or 4 rooms with windows in each. There are 182 persons 
in the building, 65 of whom are children. The basements are 



220 



STATE BOARD OF HEALTH. 



[Jan. 



used for storage, not for dwellings. The buildings are gener- 
ally clean and sweet smelling, save when, by carelessness, offal is 
allowed to remain longer in the dust-bin than is proper. The 
families ventilate their rooms by frequent opening of the win- 
dows. Sunlight enters every room. An average of 931 cubic 
feet of air is provided for each occupant. Each family has its 
own water-closet, which is kept scrupulously clean. There are 
no " privies " on the place. Cleanliness and absence of un- 
pleasant odors are manifest everywhere. The drainage is ex- 
cellent. Each family has its own bath-room in one building. 
Two common bath-rooms are found in the basements of the two 
other buildings. Thrift, neatness, quiet, and orderly deport- 
ment prevail throughout. All the tenants praise the building ; 
dislike to leave it except when necessity compels a change 
of residence. The result to the proprietors is a six per cent, 
investment and the payment of all expenses. 

The birth-places of the tenants are as follows : — 



United States, 

Ireland, 

Nova Scotia, . 

Newfoundland, 

France, . 

Germany, 

England, 



The health report is as follows :- 

It was good before entrance, 
Improved since " 

111 before and since " 
111 since, .... 



42 
1 

1 
1 
1 

1 

2 

49 



48.98 per cent. 
24.44 

14.29 " 
14.28 " 



The death-rate is much less than the average death-rate of 
the city. 

Common Tenement House, or Crystal Palace, so called. 
In striking contrast with this report let us now look at the 
aspect of the " Crystal Palace " in Lincoln Street. It is a large, 
filthy-looking building, with brick ends, but chiefly of wood. 



1871.] PUBLIC DOCUMENT— No. 37. 221 

Long open piazzas run in front and back of it at each story, 
upon which immediately open each sitting or living room. 
The ventilation depends upon the doors opening on these 
piazzas, and upon a small window adjacent, opening on the 
same. The bed-room, back of the sitting room, gets its only 
light and air from these two apertures. 

Like the model lodging house, it returns a good percentage, 
but the rents are oppressively great. There are no modern 
appliances. The tides come up very near to the basement 
floor, but being built on made land no cellar exists. It is five 
stories in height. The air circulates freely around it, and the 
sun can reach some of the sitting rooms. It never penetrates 
any bed-rooms. There are sixty-two families. Each has only 
a sitting room and the dark bed-room above described. There 
are 295 persons in the building, 149 of whom are children. 
The basements are below the level of the street, and each 
family in them has four rooms, the bed-rooms being opened, 
and thus a passage is given through from the front to the back 
of the building. They are all damp, dark and dirty. Sunlight 
enters a little at the front door and window. Of cubic feet of air 
in the house we find only about one-third of what is found in 
the model lodging house for each tenant. No water-closets, 
but only a filthy privy in the yard is furnished the inmates. 
This privy was in a shockingly dirty state when our agent 
called ; it was choked up. Odor from that and an obstructed 
urinal was very bad, even in November. No bath-room is 
found on the premises. Drunkenness and theft are not uncom- 
mon. None of the tenants praise the residence, though com- 
pelled to stay, owing to the cheap rents. Some were indifferent, 
and some even said they liked the place. The result to the 
proprietor is that he sub-lets to another who keeps a shop, and 
contrives to reap an ample reward, the exact amount being 
unknown. In other words, the house though so miserable in 
all its appointments, gives good returns of money to two persons 
from rent obtained. 

The birth-places of the tenants by families are as follows : — 

United States, 1 

Ireland, 60 

Nova Scotia, 1 — 62 



222 STATE BOARD OF HEALTH. [Jan. 

The health report is as follows : — 

Good before entrance, . . . . .67.74 
Improved since entrance, . . . .3.22 
111 before and since entrance, . . . .9.67 
111 since entrance, ...... 19.35 

The death-rate presents some peculiar, not to say extraordi- 
nary results. Suffice it to say it was not so great as one would 
anticipate, save in the basements, where one-half of all the 
deaths occurred, and the death-rate there was higher than in 
the city at large. I forbear to give the few statistics obtained 
because further investigation on the point will be necessary. 

Remarks on the above Statements. 
I might well leave these vivid contrasts between the two 
buildings to speak for themselves. Health, physical and moral, 
are the results of the model lodging house. Less physical dis- 
ease and less mortality are noticed in some parts of the tene- 
ment house, than one would anticipate ; but intemperance and 
degradation of character are rife in them. From the former 
come neat, industrious, quiet, hard-working, temperate citizens 
and their wives and children. From the latter steal out some 
of our thieves, or stagger forth the reeling drunkards. Neat- 
ness of body and of dwelling is seen in Osborn Place. Beast- 
liness of filth and noisome smells salute the senses in Lincoln 
Street. Sunlight, so bountifully shed upon every human being, 
is admitted to every room in the model lodging house. It is 
excluded, or but grudgingly admitted, in more than one-third 
of all the rooms of the low tenement, while into the bed-room, 
where the tender bodies of children spend more than half of 
their young lives, not a single ray can, by any possibility, enter. 
Ventilation is everywhere amply provided for in a manner 
appropriate to our climate, in the large entries, the windows in 
every room, and the ventilating shafts of the model lodging 
house. It is partially obtained in the tenement house only by 
opening the door or window in the living room, even in the 
depth of winter. This last fact, however, though, at first sight, 
it may seem a cruel exposure of a family, especially during the 
depth of our winter, is perhaps, a real blessing in disguise. 



1871.] PUBLIC DOCUMENT— No. 37. 223 

For the inmates, though exposed to bleak and sometimes to 
biting cold wind, gain by this frequent opening to the street of 
their single door a freer circulation of air, comparatively pure, 
than is given to some of those who live luxuriously in the 
stifling furnace-heated houses of fashionable quarters of the 
city. 

Such are the general characteristics of the houses and of 
their occupants broadly considered. But it will be well to 
examine them a little more in detail, and in conclusion sug- 
gest certain obvious remedial measures that may be necessary, 
or at least allowable, in connection with the tenement buildings 
generally in the cities of Massachusetts. In this examination 
I will refer to various items given above. 

No. 1. Site of the house. — There is no doubt that the site of 
the model lodging house upon the somewhat elevated native 
soil of the city is really better for the health of persons living 
there, than are many parts of the newly-made land composed 
of mud and filth of every kind, but on which some of the 
richest houses of our city now stand. Investigations in this 
country and in England have fully proved the fact that actual 
disease is more liable to occur in a house standing on a damp 
than on a dry soil. In choosing, therefore, hereafter, a site for 
a tenement house, we should not neglect this consideration, 
even if the effects of it be not strongly manifested in the pres- 
ent returns. 

No. 3. The evil of using a basement for a residence is dis- 
tinctly seen in these returns. The model lodging houses have 
well-lighted, dry, airy basements, legitimately used for storage. 
The low tenement house uses the basement for residences. 
It virtually slaughters human beings by so doing, the rate of 
mortality being very many times greater in the basement than 
in the rooms above it, and greater than that of the city at large. 
In the basement fever, diarrhcea, scrofula and consumption are 
liable to prevail, and if an epidemic occur, the dwellers in such 
a place are peculiarly exposed to its influence. The State 
should forbid any owner of a house to rent a basement. 
Proper inspectors should have authority to shut up such places 
as being dangerous to the public welfare. In fact, I think the 
law as it now stands, if enforced, could apply a remedy. 



224 



STATE BOARD OF HEALTH. 



[Jan. 



The comparative healthfulness of the two tenements is not so 
evident as one would have thought it would have been. But 
the advantages of the model lodging, and the disadvantages of 
its opponent can be clearly seen on a closer inspection. The 
returns from the model house may be deemed more accurate 
than those from the low tenement house, because, first, the 
character of the residents is higher, and second, there is always 
more willingness to tell of good qualities, than of the bad 
qualities of one's homestead. Making these deductions we can 
say : First, a smaller proportion of these entering the model 
lodging house were said to be perfectly healthy ; but notwith- 
standing this, nearly one-fourth of all of them gained in health 
during their residence, whereas only a very small proportion 
in the tenement house said that they had gained in health. Of 
these latter, we may infer that the tenement house, poor as it 
was, was really superior in its hygienic influences to their 
previous residence. For, of these families, one had lost eight 
children by croup, lung fever and convulsions, and another 
five children within six years previous to their entrance into 
the tenement house. 

Second. Five per cent, more fell ill at the low tenement 
house than at the model house. 

Third. A severer form of acute and of chronic disease is 
found in the tenement house than in the model lodging house, 
as the following statement indicates : — 

Diseases Reported. 



In Model Lodging House. 


In both. 


In Low Tenement. 


Effects of pregnancy. 


Catarrh. 


Rheumatism. 


Congenital diseases. 


Bronchial trouble. 


Typhoid Fever. 


Debility. 


Whooping Cough. 


Conjunctivitis. 




Rheumatism. 


Bright's Disease. 




Lung Disease. 


Children in poor health. 




Diarrhoea. 






Scarlet Fever. 






Measles. 





1871.] PUBLIC DOCUMENT— No. 37. 225 

It may be remarked, moreover, that from the results obtained 
from Boston during the cholera, and other epidemics, and also 
from London and other large cities, the filthy state of the low- 
tenement house, is just the condition upon which these, some- 
times rapidly fatal, diseases seize with awful violence. Such 
places thus become real food for contagious influences, nuisan- 
ces to all in the vicinity. 

In comparing the number of deaths in the two residences 
results different from what were anticipated, have been arrived 
at. The question will arise whether there may not be some 
error in the returns. The only answer that we can make is 
that Dr. Haskins recorded carefully, and believed he got the 
truth. Even during the investigation he was surprised not to 
find greater discrepancies in the mortality, as reported by the 
occupants of the two houses, apparently so different. Never- 
theless, there is a difference, and the model lodging house holds 
its preeminence over its rival, and over the city at large. Prob- 
ably the fact that air circulates freely about this particular 
low tenement house, the " Crystal Palace," and that other fact 
already referred to, viz , that every time the door of the living 
room is opened the inmates have access to this air from the 
street, may so improve this filthy place that people live there 
perhaps in spite of, what usually are deemed, very pernicious 
influences. 

It would seem, however, that there may be some deleterious 
power or powers at work in the community at large, upon the 
rich as much as the poor, that must raise the death-rate for the 
city at large. I would suggest the following considerations as 
bearing materially upon the mortality of the city at large, 
and which have little or no influence on the occupants of 
this tenement house. The almost universal use of closely fas- 
tened double windows, and hot air or water or steam heated 
rooms; the various exposures in dress; the want of regular 
physical exercise in the open air; the turning of night into 
day ; the merry-makings of the rich, and long labors of the 
poor in ill-ventilated shops by day, and the night-watches of 
artisans at work for their employers ; the long weary hours 
of the seamstress, <fec ; the over-excited mental condition of 
society at large, — these causes, from most of which the tene- 
ment lodger is free, tend to raise the death-rate of the city. 

29 



226 STATE BOARD OF HEALTH. [Jan. 

When we look, however, at the terrible mortality connected 
with a residence in the cellar, or basement of the tenement 
building, and find that notwithstanding the greater freedom 
in the circulation of air in the bed-rooms of the basement, than 
in the rooms above (the bed-rooms being opened into one 
another so that a stream of air may be made to pass through 
the four rooms in which the family live), the death-rate becomes 
higher than that of the city at large, and that one-half of all 
the deaths in the building occurred there, we recognize the 
deleterious effects of a residence in that low, damp, dark and 
dismal place. Certainly here, if ever, the law ought to step in 
between landlord and tenant and should declare what the pro- 
prietors of the model lodging house virtually admit, viz. : that 
the basement is unfit for human habitation. 

The part of our Report which gives the relative moral and 
individual conditions of tenants of the two houses, appeals to 
every humane instinct of our nature. We report the thrift, 
neatness and temperance that mark the model house, and on 
the contrary the filth, dirt, crime, drunkenness, and what is 
worse the apparently stolid indifference to their degraded con- 
dition that mark several of the occupants of the tenement 
house. The Rev. Dr. Charming used to say that the statement, 
if true, that the slave was happy in his lot, was no valid argu- 
ment in favor of slavery, but rather one of the strongest 
arguments against it, inasmuch as the fact of his remaining 
satisfied and happy in such a lot, proved that slavery had 
thoroughly degraded all manly instincts. Hence when we read 
in our returns from the tenement house, that thirteen out of 
sixty-two families liked their wretched and filthy residence, and 
that twenty-one out of the sixty-two were indifferent whether 
they should go or stay, we feel the degradation to which human 
nature can fall. And we then turn with pleasure to the fact 
that forty-eight out of forty-nine in the model lodging house were 
delighted with their humble, but clean and healthy homes. 
Twenty-eight, however, of the sixty-two in the tenement house 
disliked it, and the reason for that distaste was the amount of 
noise, of drunkenness, filth, and possible theft that surrounded 
them. In other words, more than one-third of the dwellers in 
this wretched place virtually appeal, though mildly, like the 
poor Franciscan, to us for help. Should not help be extended to 



1871.] PUBLIC DOCUMENT— No. 37. 227 

them by some one ? Who among our rich men are ready to 
come forward, and either individually, or by large combination 
of capital, erect model lodging houses like those described in 
this paper, or like those recently erected in London by the regal 
munificence of our distinguished countryman, Mr. Peabody, or 
by Sir Sydney Waterlow and Mr. Allen ? 

The examination relative to receipts for capital expended 
presents items that are eminently satisfactory from both houses. 
The income cleared from both is all that could be wished, not- 
withstanding the totally different class of building which 
gains the rent. 

Prepayment for short periods, a week or thereabout, is the 
invariable rule in both. Doubtless much depends on the vigi- 
lance and decision of character of the proprietors, and of their 
agent. But when pure philanthropy and a steady six per cent, 
interest on capital can be combined, even the most practical com- 
mon-sense business men need no longer stand aloof from this 
great undertaking of building suitable houses for the poor. In 
Boston this appeal is the more urgent at the present time, owing 
to the large improvements that are now making at Fort Hill, 
whereby thousands of our poor are driven from their homes, in 
order that their sites may be turned into vast thoroughfares of 
business. In this appeal let us suggest the following to the 
advocates of temperance. What human being is there who if 
compelled to live in such filthy homes as that presented by the 
low tenement house, would not be degraded and almost 
inevitably tend to drunkenness? Is not drunkenness, if for no 
other reason than to drown for a moment the sense of sur- 
rounding wretchedness, a most natural result? The cause of 
temperance thus becomes intimately blended with that of build- 
ing pleasant homes for the poor. 

Intemperance claims our attention under the law, and it 
strikes at the root of all health. Take away a man's or woman's 
self-respect, and you tend to drive them to low habits of body, 
and thence come disease and death. They no longer revolt at 
a filtby, unhealthy home. Place the same persons in clean, 
well-appointed apartments, where they can live in comfort with 
their families, and can attend to the decencies and proprieties 
of life, and they are lifted up morally ; their intellect usually 
follows with an almost equal pace towards a true manliness and 



228 STATE BOARD OF HEALTH. [Jan. 

womanliness of character and behavior, and with these comes 
a greater health of body. 

But long before private charity and enterprise shall have 
erected homes for the poor, cannot the city authorities or the 
State do something towards improving this and many more 
tenements, equally or perhaps more degraded than the subject 
of our investigations ? 

By ordinance, the aldermen of the city of Boston act as a 
board of health for the city. By law they can examine all 
nuisances and order their removal. They can punish a man 
who disobeys the mandates of the board or council. They 
may notify tenants living in a place that proves a nuisance, and 
order its abatement. 

They may even forcibly enter into any place supposed to con- 
tain a nuisance, and all opposers of their authority can be 
punished. 

There would seem therefore to be law enough, if it were only 
carried out effectually. 

Why is it therefore that such nuisances are allowed to exist ? 
Is it possible that men can consider such places as not nuisances 
in the eye of the law ? Surely anything that can add fury to 
a pestilence ought to be called a nuisance. These vile tene- 
ments do this. A basement that brings death at a greater rate 
than in the city at large, ought to be summarily closed as a 
place of residence, as a nuisance of the grossest kind. 

This excuse therefore cannot be offered. The old-time maxim 
" What is everybody's business is nobody's business," really is 
the reason for the neglect. How can we expect the mayor and 
aldermen of the city of Boston to attend to such things ? 
From the nature of the case it would be impossible for these 
officials to be able, if willing, personally to manage such details. 
It remains, however, as their duty, and they are bound by some 
means to abate such evils. 



1871.] PUBLIC DOCUMENT— No. 3T. 229 



VII. 

CONVALESCENT HOMES. 



These noblest of charities and promoters of the health of the 
people, have recently sprung up in many of the chief cities of 
England. They do, perhaps, quite as much service to the poor 
as the various hospitals of the kingdom. They are intended — 

1st. — To provide in the country rest from labor, and proper 
food and lodging for those who, while usually living and working 
in the crowded cities, become not really ill, but are in that con- 
dition, that if care be not taken, they will either fall into a state 
requiring hospital treatment, or become seriously and perhaps 
permanently ill. 

2d. — To take care of that numerous class of patients who, 
having stayed a long time at the hospitals have recovered so far 
as to be discharged, and yet they are unable to attend to their 
daily work, and really need a few weeks of country air to 
thoroughly restore them to labor. Or 

3d. — For perhaps an equally large class who, while having 
remained a long time at their own homes ill, are still unable to 
work, and do not seem to gain farther good from any remedy. 
Nothing has seemed to do them any good, — and their natures, 
as it were, unconsciously sigh for a breath of country life.* 

For all of these classes of invalids the Convalescent Home 
is a boon of inestimable value. Almost every person in the 
larger cities of Massachusetts has seen such invalids, and has 
lamented, if he have thought at all upon the subject, that there 
was not such a sanitarium a short distance from his own town, 
to which he could direct the sufferer. 

Only a few years ago (comparatively speaking) a gentleman 
in London met such a case in a young female who had been 

* " What these persons want are not hospital comforts, however liberally bestowed, no 
medicines, however skilfully prescribed, but the natural restoratives of fresh country air, 
good food, gentle exercise out of doors, and that mental quiet and freedom from anxiety 
which cannot possibly be the lot of the laboring man, while struggling at once against 
poverty and bodily weakness." — Report of the Metropolitan Convalescent Institution, 
1856. 



230 STATE BOARD OP HEALTH. [Jan. 

discharged from one of the hospitals in that city, too weak to 
work, without money, and with hardly a spot on which to lay 
her head. She appealed to the philanthropist. He saw her 
wants, but had no means himself to send her even for a few 
weeks into the country. He appealed through the journals for 
means to attend to this particular case. That newspaper article 
was the nucleus around which similar thoughts in the com- 
munity immediately crystallized. And from it has arisen the 
really fine practical result, which declares that every community 
of any size, and each hospital in large metropolitan districts 
must have a convalescent home, or.be faithless to the duties of a 
high humanity, which requires of each individual and each State 
to promote as much as possible, and by every reasonable means 
the general health of all. I wish to bring to your notice three 
institutions that I visited, in order to personally examine their 
working. 

First. — The oldest and most comprehensive is the Metro- 
politan Convalescent Institution. It was founded in 1840. It 
has three homes, viz., the Asylum at Walton-on-Thames, and 
two children branches. In these last are taken children from 
two to fourteen years of age ; one for girls at Hendon, Middle- 
sex ; and another for boys at Witcham. It has a central office 
at 32 Sackville Street, Piccadilly, London. The asylum at 
Walton is a large new building erected in a dry and healthy, 
but somewhat uncultivated spot. It presents an imposing ap- 
pearance, — with its broad front, and with grounds tastefully 
arranged with shrubs and flowers in that peculiar beauty of 
landscape gardening much seen in England at the present time. 
The interior has large and airy corridors opening into wards or 
saloons for sitting, eating, sleeping, &c. All these have abun- 
dance of sunlight and sun-heat during the day, and free ventila- 
tion during day and night. Nothing extravagant or expensive 
is observable, but everything is provided to promote that com- 
plete rest for the body and soul which the worn-out invalid 
needs. In 1856 (after sixteen years of existence) the directors 
report that 8,000 had been received from the opening of it. 
Last year they reported that the building contains 260 beds, and 
that the " total number received annually exceeds 3,000. Pa- 
tients from the various hospitals and dispensaries, and from the 
crowded courts and alleys all over the metropolis, are con- 



1871.] PUBLIC DOCUMENT— No. 37. 231 

stantly being received into it, and they in general are able to 
return to their employment with their health fully restored in a 
little more than three weeks." 

The Institution is under the patronage of the queen and 
nobility, and is supported by voluntary subscriptions of very 
many private persons. It has a board of management consist- 
ing of 27 persons, and four trustees. Honorary and attending 
boards of physicians and surgeons are connected with it. 

"Annual subscribers of one guinea, and donors of ten guineas, 
have the privilege of recommending one patient yearly. Annual 
subscribers of two guineas, and donors of twenty guineas, two 
patients ; and every donor of thirty guineas and upwards, and every 
annual subscriber of three guineas and upwards, becomes a governor 
of the institution, and has the privilege of attending and voting at 
the general meetings of the governors, and of recommending three 
patients annually. 

" Every clergyman who either lends, or himself makes use of his 
pulpit for a sermon in aid of the charity, has the privilege, if the 
sum amount to twenty guineas, of recommending for admission one 
patient yearly for the term of ten years, and for every additional 
fifteen guineas so collected, one additional patient yearly for the 
same term, provided that the words ' sums collected ' be held to 
mean the actual amount paid in to the Secretary of the Institution 
exclusive of expense of collection, and exclusive of donations and 
subscriptions, for which the donor may claim a separate privilege." 

I have entered into these details because this institution was 
the first, and is perhaps the most complete in its organization, 
and I have wanted to present the subject in a practical and sug- 
gestive form to the citizens of Massachusetts. 

The institution for girls atHendon I visited. It is under the 
same management. That and its companion for boys, at Witch- 
am, are smaller ; but judging from what I saw when visiting 
the Home at Hendon, it is under capital management, and pro- 
motes greatly the health of the few children from London their 
present means allow them to receive. The children grow 
stronger and recover health, and leave the place with sorrow. 
The home is in avillage sweetly situated about a half-hour's ride 
from London. A conservatory and large playground and open 
green fields are adjacent, and to all of these the children have 



232 STATE BOARD OF HEALTH. [Jan. 

free access. From three to four hundred children have each 
passed three weeks or a month there during the past summer. 
Only those who can walk about are received. If confined to 
the bed they are returned to a hospital or to their home. They 
have plenty of good wholesome food and fresh air, and the 
physician visits the place chiefly to see these remedies are freely 
administered. • 

In the report of the directors, 1870, 1 find the following : — 

" It would be superfluous now to enlarge upon the great advan- 
tages which attend the careful working of Convalescent Institu- 
tions. Dr. Chadwick says that ' no town hospital will be consid- 
ered completely fitted for the discharge of its beneficent functions 
unless there be associated with it a Convalescent Institution at some 
distance in a country situation.' " 

And this last remark naturally leads me to give a brief de- 
scription of the magnificent Convalescent Hospital or Home 
recently opened under the direction, and for the sole use of St. 
George's Hospital in London. 

It is situated a few miles from London, but fully removed 
from its noise and smoke, in the midst of a beautifully diversi- 
fied, undulating country. It opens to the South, and the sun 
bathes it all daylong. It commands an extensive view of at 
least a five or six miles' radius over hill and dale and woodland 
and cultivated fields. Flocks and herds quietly graze within 
view of the place, and the rooks caw over the adjacent fields. 
Everything is redolent of country life. It is a spot that of itself 
would prove a balm to many a sick soul wearied and almost 
worn down by London labor in a London atmosphere. It arose 
in this wise. 

Mr. Atkinson Morley was one of the most active of the gov- 
ernors of St. George's Hospital. That institution needed more 
accommodations and Mr. Morley had determined to enlarge it. 
But difficulties arose about getting the land adjacent to the in- 
stitution in London, and a suggestion was made, why not build 
a new establishment in the country which may prove a con- 
valescent home as well as really a ward of the hospital? 
The result was that Mr. Morley left by will .£150,000 for the 
object. By direction of the lord chancellor about =£50,000 have 
been used in purchasing the land and erecting the building, 



1871.] PUBLIC DOCUMENT— No. 37. 233 

leaving thus a large balance to meet current expenses. It lias 
an imposing but very neat appearance. It is evident that while 
taste has presided in its erection, simplicity and economy have 
been sedulously attended to. It is built in the form of the 
letter T. The wards are grand in breadth and length, and 
fifteen feet from floor to ceiling. Ample room is given to each 
bed. The windows open to the south. The superintendent is 
allowed at present to receive one hundred patients only, fifty of 
each sex. It was opened less than a year since, and no report 
has yet been printed of the results. But no one can visit it 
and doubt for a moment of the immense aid it is destined to 
give its metropolitan parent, from whose wards alone the in- 
valids are to come. The two are merely complementary, one of 
the other. Similar institutions ought immediately to arise in 
all the large cities of this country. Will Massachusetts take the 
lead in this most beneficent of sanitary measures ? 

The two methods of public hospital and of private benevolent 
subscriptions might easily be united. In Boston, for example, 
what prevents the united efforts of the various hospitals and 
of the Boston dispensaries with private charity establishing a 
convalescent home in some healthy suburb of the metropolis ? 
And why should not Worcester, Lowell, Lynn, Fitchburg, &c, 
have each its " sanitarium " of the same nature ? I suggest 
these facts and these reflections to the Board, and through the 
Board to the people of Massachusetts, in the sincere hope that 
they will tend to the practical result of the establishment of such 
institutions wherever they may be needed in our Stale. 



VIII. 

SEWAGE. WHAT SHALL WE DO WITH IT ? THE EARTH-CLOSET. 
IRRIGATION OF LAND. DRAINAGE TO THE RIVERS OR SEA. 



There is no single subject that is attracting more attention in 
England, and which excites (strange as the remark may seem 
to some people in Massachusetts) more heated partisanship, 
30 



234 STATE BOARD OF HEALTH. [Jan. 

than the vast questions looming up under the various names 
of " earth-closet," " water-closet," " sewage," " its danger to 
health," " its widespread and fatal waste," " its utilization as a 
manure," &c. In other words the great sanitary question of 
to day throughout Great Britain is the economic removal from 
houses of what is deleterious to man, and the proper use, as a 
source of income, of what has been heretofore wholly wasted. 
Thousands of pounds sterling are annually sent from England 
to Egypt to gather up the old mummied remains of past centu- 
ries of men, or merchant vessels sail round the world in order 
to gather the fseees of birds, that perhaps for equally long cycles 
of time have brooded, over some one or more of the beautiful 
islands of the Pacific Ocean. And all this expense is incurred, 
while actually throwing away immense quantities of a material 
having the highest fertilizing qualities. 

These vexed questions cropped out and were bandied about 
from section to section of the meeting of the British Association 
for the Advancement of Science, recently held at Liverpool, and 
presided over by the celebrated Huxley. 

First. The section on health spoke often of it in regard to 
sanitary measures. Then it occupied an entire session of the 
engineering department. Finally, it absorbed much of another 
session of the chemical section in hearing public reports on the 
subject, and in listening to the appeals of Mr. Forbes for his 
plan of so " throwing down'''' all the substances deleterious to 
health, while saving them for manures ; and he informed us 
that he did that so thoroughly and cleansed the sewage water of 
the Thames. Mr. Forbes was willing to pour into a wine-glass 
a portion of the water thus purified and, martyr-like (as some 
of us thought), sipped it in our presence to prove its perfect 
innocuousness and sweetness ! These questions, more than 
any other, were in fact the marplots of many sections and had 
to be frequently suppressed, or rather repressed, by the presiding 
officer of the particular section in which it appeared. For ex- 
ample, the chemist kept the discussion simply to the chemical 
aspects of the question, and all engineering or simply sanitary 
ideas were sedulously kept away. They had, strictly speaking, 
no right in the laboratory. And so it was with the other sec- 
tions. I mention these facts simply to prove the great and 
wide-spread interest in the subject. 



1871.] PUBLIC DOCUMENT— No. 37. 235 

In the social science programmes, widely distributed during 
the meeting of the British Association, it was distinctly brought 
out as a reason for going to Newcastle-on-Tyne that the subject 
of sewage would be thoroughly examined in all its bearings 
upon the health and prosperity of the community. Induced by 
that fact I attended that meeting. The subject was every day 
brought up in some way or another in the health section, and I 
soon found that partisan violence was not confined to republics 
alone, nor to political parties, nor could theology ever produce 
more bitter denunciations than were poured out by one party 
upon the other upon this subject. If I had not been amused 
I should have been indignant at hearing men whose works I 
have read for a quarter of a century, and thought were men of 
consummate wisdom, sagacity and coolness, use language 
worthy of Billingsgate toward an unlucky and persistent sup- 
porter of the " earth-closet " idea. This poor, abused article, 
which many have found so serviceable to their houses, and pri- 
vate rooms, would have been utterly annihilated if the vener- 
able statistician and writer on health could by any word of his 
have gained that end. One opponent of this unhappy article 
declared, for his part, that he was unwilling to " take counsel" 
from so foolish a creature as the cat who, from the time of Noah, 
has quietly been teaching what Rev. Mr. Moule proclaimed, ex 
cathedra, only a few years ago. Dr. Farr at length came to the 
mediation of both parties by suggesting that, after all, both had 
the same object at heart, viz. : the disinfection and removal of 
unwholesome articles from our homesteads, and the only diver- 
sity of opinion was on a minor point, viz., the method to be 
pursued for that disinfection and removal. 

Surely a subject that excites so much attention in England as 
a sanitary and economical and, incidentally, a vast engineering 
measure deserves our candid attention. I cannot throw much 
light upon the subject. Nevertheless, as 1 looked into some of 
the practical schemes now in operation, I propose to give to 
the Board the results of my experience in this matter. I begin 
with the 

Eaeth-Closet. 
I saw this in full operation in two places, viz. : at the villages 
of Halton and Beverly near Tring, and at the International Hos- 



238 STATE BOARD OF HEALTH. [Jan. 

pital at Bingen on the Rhine. In all these places it was a per- 
fect success. Halton and Beverly are small villages containing 
about fifty families each. Till Mr. James, an intelligent gen- 
tleman residing in the neighborhood, introduced the earth-closet 
system, every family either had its own privy close to its own 
premises, or used one in common with others, thus contaminat- 
ing, as I learned on inquiry from the tenants, the houses in 
which they lived. About five years since Mr. James, being an- 
noyed by effluvia from the privy adjacent to his own house, and 
which he vainly endeavored to remedy, tried Mr. Moule's system 
and with entire relief. Accordingly, with an excellent public 
spirit, and the sagacity of a practical farmer, he determined to 
persuade his humbler neighbors to adopt the same. The plan 
he pursued was as follows : Under a few small sheds he 
arranged an iron plate three-quarters of an inch thick, about 
four feet square, and raised upon bricks about a foot from the 
ground, to allow a fire to be lighted under it. The brick walls 
rise two feet above it. Thus a large pan or furnace with a 
strong iron bottom and brick sides is made for drying the earth. 
A load of earth can be dried sufficiently by one night's subjec- 
tion to this heat. Half a load answers for a family of six for 
three months. He has used upon his land from eighty to ninety 
of such loads, after having passed through the closets twice. 
The result has been excellent. All the crops have been supe- 
rior to those produced on neighboring estates treated on the old 
plan. The manure acts better than London manure or guano ; 
especially does the amount of grass very greatly increase in 
quantity and apparently in quality. 

Meanwhile the villagers find a great relief from the use of 
it.* All odor is absolutely removed — what was a nuisance and 
discomfort, to say the least, headaches, &c, not to allude to 
higher dangers which some sanitarians claim to come from, 
and which do at times undoubtedly come from the taint of 
privies and bad-smelling drains ; all these have disappeared. I 
conversed with the villagers, and all who have employed it 
like the method. A man is kept continually employed by Mr. 
James to dry the original earth, to carry enough for a week in 
turns to the various houses, and to remove that which has been 

* It is used now by five-sixths of the families, and in two schools of 200 children and 
with equal success in all. 



1871.] PUBLIC DOCUMENT— No. 87. 287 

mixed with human excreta, liquid and solid. This hy the sub- 
tle alchemy of nature, is found to be simply a dry, disinte- 
grated pulverulent gray mass of inodorous matter. Even paper 
wholly disappears in it. The accumulations from the various 
families are placed under sheds opened in front, so that free 
access is given to the external air. After three months it is 
again dried and used anew. I visited these various places, the 
privies, the sheds, furnaces, &c, and found no perceptibly un- 
pleasant odor, even in that portion most recently taken from 
the village. It was evident that arrangements could be made 
for boxes (earth-closet privies) of any size requiring removal, 
either by the week or year. All would be alike inodorous 
and cleanly. Surely here was a success in every respect. The 
village health and the purity of the home were improved, with 
great pecuniary gain to the far-seeing farmer, and the waste 
which was previously allowed of valuable manure was no longer 
possible after such positively good results. The earth-closet 
cannot be styled a "quackery," as the venerable ultraist of the 
water-closet system called it at the social science meeting at 
Newcastle. 

I saw the same system carried out at the International Hos- 
pital under Dr. Thudichum. At one end of the camp street a 
furnace has been erected similar to that at Halton. Each hos- 
pital tent has its own earth-eloset, and it was absolutely devoid 
of smell, so far as I could judge, and the surgeon in charge had 
found it to act perfectly as a deodorizer, and without any of the 
unpleasant accompaniments that chloride of lime and other 
disinfectants usually carry as a necessary result of their use * 
Similar results have followed its use in America, and it there- 
fore should be considered as an invaluable addendum to modern 
civilization.! 

* Mr. Edward C. C. Stamford, F. C. S , Chemical News, April 19, and Oct 22, 1869, 
advocates the use of pulverized charcoal as being very efficient, being much less bulky 
than earth. He employs sea-weed charcoal. Mixed with the excreta, the whole soon 
becomes an inodorous dry mass which can be used again, and if need be reburned. 
One cwt. of charcoal will serve for a month in a closet used by six persons, and may be 
allowed to fall into a cess pit under the house. 

t For a most thoroughly exhaustive examination of the earth-closet, and a detailed 
account of its use in villages, towns, &c, in England and elsewhere, see Dr. Buchanan's 
admirable account in the last Eeport of the Medical Officer of the Privy Council, 1870. I 
read Buchanan's paper after preparing this letter, but preferred not to alter my own state- 
ments, as they did not clash at all with the results obtained by that gentleman. 



238 STATE BOARD OF HEALTH. [Jan. 

But it will be doubted whether its use can be extended with 
sufficient ease to large cities, although the earnest advocates of 
it claim that it is perfectly easy so to do. I will not pretend to 
discuss this point, but will describe two visits I made, in order 
to observe two applications of the water system. They present, 
both of them, examples of what is now constantly being done in 
England, viz. : of the carrying away of materials supposed to be 
always, and certainly at times, very destructive to human health 
and often causing wide-spread mortality. 

A few years ago the Thames became so offensive to the nos- 
trils of all the citizens who came near it, that with one accord 
the believers in the actual noxiousness of these exhalations 
from it, polluted as it was by thousands of water-closets, and all 
others who did not like to have any unpleasant smell come be- 
twixt " the wind and their nobility" even if it be not unhealthy, 
united for the cleansing of the Thames. Accordingly, the 
city of London under the "engineering skill" of Mr. Bazo- 
lette, made two immense sewers, one on each side of the 
Thames, from the metropolis down to short distances below the 
two villages of Barking on one side and Crossness on the other. 
At these two spots, by means of huge openings closed by 
an elaborate system of gates, the flood of water from all Lon- 
don, after being dammed up for some hours, is twice daily at 
high tide let out into the Thames. 1st, To waste all the 
mauurial qualities it contains. 2d, To contaminate the villages 
near and below these outlets on the Thames. This is strongly 
urged by some and with some show of argument drawn from 
special cases of local infection from drains, &c. By others and 
by thoughful physicians and sanitarians too, this broad asser- 
tion is doubted — as one eminent member of the medical pro- 
fession (whose works at the present time have much influence) 
said to me : " It was the stink rather than the proved uuhealth- 
fulness of the emanations from the Thames that compelled the 
city to carry the water-closet draining to Barking." This was 
accomplished at the enormous expense of £4,250,000, or 
X 180,262 per annum, the cost to be paid off in forty years by 
rating "* 3d, To gradually fill up the Thames, and thus se- 
riously to interfere with navigation. This too is doubted. A 
parliamentary commission, on investigation declared both of the 

* A Chemist's View of the Sewage Question. Chemical News, 495, p. 6. 



1871.1 PUBLIC DOCUMENT— No. 37. 239 

latter propositions false. But one can hardly see how if sew- 
age emanations be pernicious to Londoners, they should not be 
so likewise to simple villagers. 

I wanted to see and judge for myself, so far as I could by in- 
spection and conversation with the inhabitants, what effects had 
been produced, and what would be the influence on my own 
senses of the emanations at the outlet. Accordingly I visited 
Barking, and fortunately met Dr. Parsons, the officer of the 
Union in that town, an active, earnest and thoroughly accom- 
plished physician, one too who has the power to examine care- 
fully facts, and to modify his opinions, if need be, under the 
influence of facts. He had joined with his fellow citizens in 
protesting against the allowing of London sewage to enter the 
Thames two miles below Barking, lie felt persuaded that it 
must be injurious. He was called upon by the government 
commission to present facts, and he began to collect them under 
the impression that the .result would be as he and his fellow 
citizens had supposed. But he has found that death statistics do 
not at present (after a lapse of two years' exposure) sustain that 
view. Seventeen per thousand living is the death-rate of Bark- 
ing. He was surprised at this result. He remembered, more- 
over, that he had not been especially called to persons residing 
near the outlets, and there was no greater amount or peculiar 
character of disease prevailing there than at other spots in his cir- 
cle of practice. Dr. Parsons drove me to the outlet. Our course 
for nearly half a mile was directly upon the top of the drain. 
Every lew yi rds I saw gratings of iron, which I learned were 
the ventilators of the sewer, but I observed no special odor aris- 
ing from them as I had expected. We were driving simply over 
a smooth greensward. Arrived at the mouth I placed myself 
directly over the partially running stream. It was low tide, 
and I could see the whole of the opening. I stood over the 
ventilator just above the gates, and where I knew that there 
was a large quantity of sewage water. I was still more sur- 
prised at the absence of odor in all these places. The keeper 
of the gates has a house and rears a family above, and between 
them and the outlet into the Thames. He assured me that 
he never observed any peculiar odor, and that his family en- 
joyed good health. 

The inferences I was obliged to make were : 1st, That by 



240 STATE BOARD OF HEALTH. [Jan. 

some means unknown to me the excreta had become deodorized 
during the water carriage ; and 2d, That at present there was 
no proof that this deodorized sewage water of London does 
actual harm to those dwelling near it. I remembered Boston 
and other cities of Massachusetts with a sense of, at least, par- 
tial relief to my previous thought that a drainage that merely 
empties our water-closets into the docks around our city must 
inevitably be injurious to the health of our citizens. It is true 
that I am not aware of any city in Massachusetts having such 
long sewers as those from London, and therefore Boston, 
Charlestown, &c, have not exactly analogous circumstances 
with those of Barking and Crossness. 

But there is one fatal defect of London and of all American 
sewage, and that is its waste. Probably there is no such wide- 
spread recklessness of spendthrift prodigality anywhere so 
noticeable among civilized nations as this throwing away of such 
vast amounts of this most excellent of manures. We take 
thousands of tons from the earth annually, and totally ignoring^ 
Nature's law of economy, which declares that what has been 
once taken away must be returned again to earth, otherwise 
the earth itself will become impoverished and will refuse to 
labor for us, I say totally ignoring this law, we squander an 
immense amount of really valuable property.* 

Among those who have protested against this wholesale waste 
none has been more prominent than William Hope, Esq., V. C.,f 
the lessee of the now famous Breton Farm. By his energy a 
bill was passed by Parliament at its last session, authorizing 
a company to use this wasted material. For some private 
reason the measures intended to be carried out by its provis- 
ions have not been inaugurated. Meanwhile Mr. Hope took 
the Breton Farm under the following circumstances. I visited 
and examined his works, and propose to give a slight account 
of what I saw and heard there. 

* It is calculated that not less than £1.000,000 is annually thus thrown away hy Lon- 
don alone. Digest of Facts relative to the Treatment and Utilization of Sewage, by 
W. H. Corfield, M. A., M. B. Oxen, &c, &c, for the Committee of the British Associa- 
tion for the Advancement of Science. McMillan & Co., 1870. 

t Mr. Hope (see address for London Society of Arts, Feb. 25th, 1870, Journal, page 
209, vol. 18) takes the strongest grounds on this matter, and claims that English pauper- 
ism is vastly increased by this wholesale waste of material, which if used according to 
modem science and with modern appliances, would enable a vast deal more of cheap food 
to be raised. 



1871.] PUBLIC DOCUMENT— No. 37. 241 

The town of Romford contains 8,000 inhabitants. It was 
desirous of a better system of sewage, and having introduced 
a supply of water, conducted its sewers into the adjacent river. 
This the inhabitants living below the town protested against as 
polluting the water they had previously had pure for use. An 
injunction of the Lord Chancellor was laid upon the town 
authorities, who, in looking around for a remedy, bethought 
themselves of using the whole for fertilization of the Breton 
Farm, about three miles from the town. Accordingly the 
sewer mouths opening on the river were closed, and a system 
of drainage by large iron pipes conveyed the sewage to the 
Farm. For some unknown reasons the plan was not success- 
ful, and Mr. Hope came to the rescue, and has taken the land 
at less than £3 per acre, and as he pays about £Q per acre for 
sewage from the town, the sum is less than £9 per acre for all 
expense of hiring land and manure. He commenced twelve 
months since, and the first crops were put in last March. The 
result, though in every respect gratifying as a pecuniary invest- 
ment for Mr. Hope and as a sanitary measure for the town, 
cannot as yet be thoroughly estimated until after a longer trial. 
I visited and examined the farm thus laid out for cultiva- 
tion. It is on a tolerably level piece of ground, but by means 
of his steam-shovel Mr. Hope levels and arranges, with tolerable 
ease, very uneven surfaces. " 

A large cemented reservoir receives the water from the pipes. 
It is a thick, dark fluid ; but strangely enough, scarcely any 
odor comes from it. It is pumped by a eteam-engine into a 
tank and distributed in a fluid state by means of open iron 
troughs where the height is too great, and cemented pipes 
where near the ground. These troughs are a foot and a half 
broad and equally deep, and rounded at the bottom. The 
cemented ones have apertures thirty feet apart, with gates for 
closing when necessary or for communicating with gutters in 
the ground which run in straight lines 150 to 200 feet. In 
this way the farm is divided into several rectangular lots which 
give an opportunity for rotation of crops. The extraordinary 
growth of every plant thus fertilized draws the attention of 
every visitor. Carrots, four and a half inches in diameter at 
their top, and a foot long! Mangolds, twenty-nine and thirty-six 
inches in diameter, and pressing up like huge monsters from 

31 



242 STATE BOARD OF HEALTH. [Jan. 

the ground. Cabbages, huge and compact. Immense beds of 
rich and firm cauliflowers. Potatoes, eight or nine inches long, 
and weighing at times two lbs. ! Hay, of delicate fibre and 
eagerly sought for by cattle, can be raised in three crops annu- 
ally, and in quantity five acres produced twice as much as 
twenty-five treated by the usual former method. I leave all 
these results, however, for the practical farmer and agriculturist 
of Massachusetts to consider, and will finish this brief sketch of 
the whole subject with two cautions in a sanitary point of view. 

While walking over the ground I perceived that the grass 
had the rich green usually noticed in wet lands, and my shoes 
often came into muddy spots, while no spot over the entire sur- 
face was dry. The whole land was in fact filled with moisture, 
doubtless fertilizing and raising crops unheard of previously. 
But I remembered two well established facts upon which I base 
two sanitary cautions : 1st, moisture of the soil is now fully 
proved to be a promoter of consumption in England as in New 
England. Probably the same law, modified doubtless by cir- 
cumstances, holds good everywhere. Hence the workmen 
should not live in houses too near such sewaged earth, but 
rather on dry, elevated spots a little removed from it. 

2d. Sewaged water has heretofore and may hereafter con- 
taminate wells of drinking-water. Hence great caution must 
be, for the present at least, observed in the use of wells that are 
in the midst of such earth. 

One very serious difficulty arises in the use of sewage water 
in this country as practised at Breton Farm. The irrigation is 
continued with ease in the climate of England during the winter. 
The heavy snows and freezing cold of a New England winter 
would seriously obstruct similar plans here, and although per- 
haps these difficulties might not be insuperable, they would 
have to be taken into serious consideration by any one who 
should propose to try irrigation in our Northern climate. The 
same objections do not exist against the earth-closet. The 
question arises whether at times both methods may not be used, 
but at different seasons of the year. 

Final Appeal. 
For all these various sanitary and philanthropic measures 
what need have I to add a single word of appeal to the capital- 



1871.] PUBLIC DOCUMENT— No. 37. 243 

ist and philanthropist of Massachusetts ? Is there anything but 
the will and individual and cooperative action needed in order 
to inaugurate in our State systems similar to, at least, some of 
those described in this communication ? Who are prepared to 
give to all laboring men neat and healthy homes ? Without 
these it is all vain to try to raise the people to a proper self- 
respect, and enable them to bring up their children in a man- 
ner worthy of a great and free Commonwealth ; and some of 
these children must inevitably become the future parents of the 
State. 

Who will spring forward to aid the heavily-burdened laborer, 
or seamstress, or shop-girl, or hospital invalid, all sighing for a 
breath of country air, and of their abundance will build and 
amply endow convalescent homes ? 

What farmer or town will, while removing sources of disease 
and mortality from house or town, follow the dictates of Nature 
and utilize their sewage, or at least deodorize it by the use of 
the earth-closet, or by the more thorough and more expensive 
plan of irrigation, make use of it ? 

All these questions I submit to the Board, as guardians of 
the public health. 

Respectfully, your friend and colleague, 

HENRY I. BOWDITCH. 



Appendix A. 



Summary of English Law in regard to Common Lodging- 

Houses. 

The two Acts for " the well ordering of Common Lodging- 
Houses " of England under which the police act, were passed July 
24, 1851, and August 4, 1853. 

Their provisions are as follows : — 

The Act is to be executed either, 1st, by the Commissioners of 
Police of the Metropolis ; 2d, Local Boards of Health ; 3d, Mayor, 



244 STATE BOARD OF HEALTH. [Jan. '71. 

Aldermen and Burgesses of the Borough; 4th, Commissioners, 
Trustees or other body by whatever name known, for executing the 
" Improvement Act " (an Act which was passed relative to paving, 
drainage, lighting, watching, etc., of any place) ; 5th, Justices of 
the Peace acting in petty session for the place. 

The expenses are to be charged to the general accounts incurred 
under each of the above departments. 

Notice is to be given to each Public Lodging-House keeper 
requiring him to register his house. 

Which register is to be kept by the local authority. 

After one month's notice no lodging-house to be used as such 
until " inspected and approved " by the " local authority," and 
registered. 

The " local authority " may make regulations for governing such 
houses, which must be approved by one of the principal Secretaries 
of State. 

Penalties may be imposed by " local authority " for violation of 
such regulations. 

The keeper of a Lodging-House must give notice to the Medical 
Inspector of cases of contagious disease. 

He shall allow the Inspector to enter when he may think proper. 

He must keep his premises clean, to the satisfaction of the authori- 
ties, and attend to drains, privies, &c. 

He may be fined £5 for neglect of any of the regulations, or im- 
prisoned if he do not pay, or for third offence may have his license 
taken from him. 

The above are some of the items of the law of 1851. That of 
1853 confirms the above, and adds, — 

That unless a Lodging-House keeper can get a certificate of good 
character the register of his house may be refused. 

The " local authority " may require a more perfect supply of pure 
water. 

Sick persons affected with infectious or contagious disease may 
be removed to the hospital, and their clothing disinfected or de- 
stroyed at the public expense. 

Reports of those who resort to the Lodging-Houses may be or- 
dered from keepers. 

The " local authority " has power to remove nuisances. 



OOERESPOJSTDE^TOE 



CONCERNING THE EFFECTS 

OF THE USE OF INTOXICATING LIQUOE. 



246 STATE BOARD OF HEALTH. [Jan. 



KEPLIES 

To Inquiries concerning the Effects of Intoxicating Drinks on 
Public Health, received from our Correspondents in Massachu- 
setts. 



One hundred and sixty-four (164) correspondents have 
answered the following question : — 

"What, in your judgment, has heen the effect of the use of 
intoxicating liquor as a beverage upon the health and lives of the 
people in your town, or in the region in which you practise ? " 



The replies are as follows : — 

Very destructive to life and health, .... 
Injurious in a greater or less degree, 
Public health not affected by use in their towns, 
The people of their towns very temperate, 
Intoxicating drinks not used in their towns, 
The effect is bad upon foreigners in their towns, but not 
upon natives, ....... 

Useful in the decline of life, 

Use promotes longevity, ...... 

Indefinite replies, ....... 



48 
49 
16 

27 
5 

4 

1 

1 

13 



The following extracts from letters give more information 
on this subject : — 

" I am satisfied that the free use of intoxicating drinks is a moral 
evil that tends strongly to injure the physical health." 



" Observation has satisfied me that the use of intoxicating liquors 
as a beverage does not improve the physical or mental system, but 
is adverse to the best condition of both. I am positive that drunk- 
ards die from consumption." 



1871.] PUBLIC DOCUMENT— No. 37. 247 

" As far as my observations extend in a practice of more than 
thirty years, the use of intoxicating liquoi» has not been injurious to 
the health or shortened the lives of those who have used them tem- 
perately. The intemperate use of alcoholic drinks, and other excesses 
to which it leads, has caused the death or shattered the constitutions 
of many young and middle-aged men in this vicinity ; but rarely do 
I meet with a very old man who has not been in the habitual use of 
stimulants in some form, and accustomed at the same time to active 
exercise." 



"Among the American population, not an individual is known 
whose health has been injured by drinking. Among the foreign 
population, there is hard drinking on Saturdays and Sundays, — and 
in some cases (but few, however) general health has been thereby 
injured." 

" Intemperance in the use of intoxicating liquors, with the usual 
concomitants, lewdness and debauchery, are the causes of a very 
large share of the diseases I am called upon to treat in the State 
Almshouse." 

" I do not think intoxicating drinks have any general influence 
on the health of the people in this town*. Individuals have, how- 
ever, been known to be seriously injured. It is not to be generally 
procured, and those who use it are obliged to submit to long inter- 
vals of total abstinence." 

" I have had occasion to see but few cases of suffering directly 
from the free use of intoxicating liquors, but these have been suf- 
ficient to convince me that such use is detrimental to health and 
life." 



" Delirium tremens less common now than formerly, but we see, 
as effects of intoxicating drinks, a trembling gait, and general de- 
bility of nervous system, and I have been led to think that these 
symptoms might be due to adulterations, rather than to alcohol." 



" The health of the inhabitants of this town I do not think is 
materially affected by the use of intoxicating liquors ; there are those 
who say they almost die for the want of them." 



248 STATE BOARD OF HEALTH. [Jan. 

"There is no great abuse of intoxicating liquors in this place. 
Their influence on public* health is small." 



" I do not think that intoxicating liquor has been used as a bever- 
age to such an extent or degree as to produce a perceptible effect 
upon the general health and lives of the people in the region of my 
practice." 

" Intoxicating liquor has invariably proved a curse to those who 
used it as a beverage." 

" Injurious wherever habitually used. Has destroyed many lives 
in the fifty years of my observation." 



Not injurious unless taken to excess." 



" Intoxicating liquors have greatly injured the health and lives of 
those who use them habitually as a beverage." 



" As regards the use of intoxicating liquors, I believe that there 
are individuals who would enjoy better health than they now do if 
they would use them temperately. But there is vastly more suffer- 
ing from intemperate use than from abstinence. On the whole, I 
think we should be more healthy, wealthy and wise if they were 
entirely banished from society." 



" I have very few cases of sickness which I am able to trace to 
the use of intoxicating liquors. Many aged persons are within the 
range of my observation who have always used liquors as a beverage 
without apparent injury. I have the impression that in this region 
persons who habitually use spirits are less subject to lung diseases 
than are the average of total abstainers, but I can give no exact data 
to prove this opinion." 

" To answer the question regarding the use of intoxicating liquor 
as a beverage, we must divide the inhabitants into two sections, 
natives and foreigners. There is no excess with the former in this 
community. The foreigners, particularly the Irish, many of them 
drink freely, and the result is most disastrous to them. Health is 
injured, and fives prematurely destroyed." 



1871.] PUBLIC DOCUMENT— No. 37. 249 

" Intoxicating liquors the source of much existing disease." 



" The use of intoxicating drinks has been so far as I can judge 
only productive of evil, and he who uses them has need to say often 
the prayer of St. Chrysostom : ' God keep my body from the doctors, 
my money from the lawyers, and my soul from the devil.' " 



" The effect of the use of intoxicating liquor is here, as every- 
where, injurious to health and destructive to life. Never useful as 
a beverage, and seldom, if ever, as a medicine. The users are not 
the only sufferers, but they leave to their children an inheritance of 
bodily and mental disease." 



" I believe that three out of four adult males use intoxicating 
drinks as a beverage, or on small pretext, but I see no effect upon 
health. Those who drink at the hotel, all belonging to the laboring 
class, are not sick oftener than others, but suffer in their pecuniary 
and social interests." 

" Intoxicating liquors are extensively used, and by a proportion 
of all classes. More was used in 1869 than in any previous year 
since 1857. No disease resulting from its use has come to my 
knowledge." 

" I think people who use liquor moderately here are less liable to 
disease than those who do not. They are also as long-lived. Used 
excessively it produces disease. I think, if liquor was pure, the 
moderate use would be conducive to health, especially in those of 
attenuated habits." 

" Intoxicating liquors have injured health and shortened life in 
proportion to their use." 

" There is no very marked effect on the life and health of our 
people from the use of intoxicating liquors. The Irish use it mopt, 
but only a few instances could be pointed out in which very special 
mischief can be attributed to it in regard to life or health. Of course 
there are cases of unthrift, of squandering, of family abuse, &c, such 
as must naturally arise from the gradually benumbed conscience." 



" Intoxicating drinks have a decidedly injurious effect upon life 
32 



250 STATE BOARD OF HEALTH. [Jan. 

and health, and are far too much used in the treatment of disease. 
Tobacco is doing even more than liquor to undermine the constitu- 
tions of the men of this region." 



" The abuse of alcoholic liquors is a fruitful source of both crime 
and disease ; but their use under certain conditions appears to me to 
be indispensable." 

" The effects of intoxicating drinks among our inhabitants have 
been rather moral than physical." 



" The use of intoxicating liquor has a very injurious effect upon 
our inhabitants. We are but three miles from the New York State 
line, where liquor is sold freely ; and our poor Irish laborers spend 
their money for that which brings them only sickness and poverty, 
with all its privations and exposures." 



" The same general law operates here as elsewhere. They who 
sin through intemperance suffer its penalties. The amount of sick- 
ness and the rate of mortality are increased by the use of intoxi- 
cating liquors." 

" Temperance is the rule ; intemperance the rare exception here. 
I remember one man who killed himself by the daily use of N. Y. 
brandy, and another who drank all the N". E. rum he could get, but 
would drink no other form of spirits, and who was intoxicated the 
most of his time, who lived to the age of ninety-three." 



" The effect of the use of intoxicating liquor has been to ruin 
health, and shorten the lives of the people." 



" Predisposes to fever and rheumatism, and shortens life very 
decidedly." 

"In my judgment a very disastrous sequence of results follows 
the use of alcoholic liquors as a beverage. They impair the vigor 
and elasticity of the body, and impede the functions of its organs; 
they produce diseases of the nervous system, and I have no doubt of 
their hereditary influence." 



1871.] PUBLIC DOCUMENT— No. 37. 251 

"Injurious always, from first to last." 



" Impaired health, shortened lives, feeble offspring." 



The cause of much debility and disease." 



" Better health and longer life would have been secured had the 
population abstained entirely from the use of intoxicating liquors as 
a beverage." 

" The effects of alcoholic drinks are plainly seen in the families of 
those who in past years drank to excess. Tobacco is now doing 
more to shorten life than liquor." 



" When I came here forty years ago there were three stores and 
four hotels where liquors were sold, and they all prospered, — they 
sell none now. The difference is very visible. Comparing the past 
with the present confirms the belief that the use of liquor as a bever- 
age is very injurious; that it often acted as the primary or predis- 
posing cause of hepatitis, gastritis, enteritis and rheumatism. If 
there was a proclivity to any disease, it often excited that latent 
principle to action, and hastened it on to a fatal issue. It has been, 
and still is injurious to the health of the individual, to the health 
and happiness of his family, and to the treasury of the town." 



" I think that the use of liquor impairs the health, and has short- 
ened the lives of some, especially when used to excess. I think 
that persons who drink liquor do not bear up under acute attacks of 
disease as well as those who abstain from its use." 



"The use of malted, fermented, or distilled liquors in this place 
has affected neither the health or lives of the people to any extent." 



" Intoxicating liquors kill more than all diseases." 



" My impression is, that the use of intoxicating liquor as a bever- 
age not only exercises a very pernicious influence on the moral and 



252 STATE BOARD OF HEALTH. [Jan. 

social condition of our people, but undermines health and shortens 
life." 

" I know of but few instances in which such liquors are used at 
the family table ; in those few instances it is mainly wine, and I 
think it beneficial. The drinking of ale and distilled liquors at 
secret bars is sufficiently common to come to my attention as cause, 
direct and indirect, of no little disease. Were open bars allowed I 
know no reason why this evil should be less." 



"On the whole, the effect is injurious. I should, however, make 
a distinction between the use of intoxicating liquors and the lighter 
drinks. If we could so manage as to furnish the people with light 
wines, lager beer, and such drink, and dispense with distilled liquors, 
I believe that the community would be immensely benefited." 



" I have had a large practice among the Germans for twenty years, 
and my observation has been that they are remarkably free from 
consumption and chronic diseases. I have attributed it to their free 
use of lager beer. I believe that the moderate use of the lighter 
drinks is beneficial." 



" Many persons can use liquor as a constant beverage without in- 
jury to their health, but I am confident the majority cannot, and 
are injured by its daily use. My judgment is that the health of the 
people would be better and their lives longer without the use of 
intoxicating liquor as a beverage." 



" People very temperate. A very few persons use liquors exces- 
sively and thereby injure their health and perhaps shorten their 
lives. One instance only, I now remember." 



" I know of no disease in this town traceable to the use of intoxi- 
cating drinks." 

" From a comparison of the habits of life of the aged persons, 
who have died here since my remembrance, I have formed the opin- 
ion that a moderate use of spirits has no tendency to shorten life, 
or impair its vigor ; while an immoderate use tends to produce both 
these results. I am not partial to its use in consumption. In cases 



1871.] PUBLIC DOCUMENT— No. 37. 253 

attended with bleeding from the lungs it shortens the disease by- 
shortening the life of the patient." 



" Effects injurious, and more so of late from the bad character of 
the liquors sold." 

" There are cases where the use of intoxicating liquor as a bev- 
erage is useful, especially in the decline of life. Where the body is 
gradually becoming weakened by age its use in moderate quantities, 
of good quality, taken with regularity, has a tendency to keep up 
the tone of the system, and to prolong life." 



" Unfavorable to health. The same may be said of strong tea 
and coffee." 



" When used temperately such liquor has seemed to do no harm ; 
when used intemperately its effects are disastrous." 



" I cannot see but that moderate drinkers are as healthy as any." 



"I have observed no peculiar effects on health in this town 
from the use of intoxicating drinks, but the habit of opium-eating 
and the use of preparations of opium demands attention." 



" We have little intemperance, but it is found to be invariably 
destructive to health and life. Moderate drinkers suffer from the 
habit when attacked by ordinary diseases." 



"Happily we have no grog-shops, no place where liquor is sold. 
But very few of our people are habitual drinkers. The blighting 
curse of rum is not upon us." 



" We see but little disease caused by intoxicating drinks. In 
more than thirty years I have seen not more than two or three 
cases of delirium tremens. Among the few persons using such 
drinks, we see diminished ability to labor, and such diseases in their 
families as are engendered by want, care and discouragement. All 



254 STATE BOARD OF HEALTH. [Jan. 

cases of gangrene senile, which have come under my observation 
have been persons accustomed to indulge in strong drink. Most 
cases of cancer have been either among hard drinkers or their im- 
mediate descendants. My own belief is that the use of intoxicating 
drinks, combined with the free use of pork as food, constitute a 
prolific source of cancer. Confirmation of this belief, of course, 
needs a far wider sphere of observation." 



" This is a quiet farming town, without a railroad until the present 
year, and there have been but few persons addicted to the use of 
intoxicating drinks. But in such cases the effects are unequivocal. 
Sometimes death from delirium tremens, or from accidents occurring 
while intoxicated. In others, where the liquor is used more moder- 
ately, its subjects are rendered more irritable, more easily affected 
by disease, and less likely to recover from it. 1 have had many 
patients whose life or death was apparently determined by their pre- 
vious habits as regards the use of intoxicating drink. I have often 
noticed also that one or more of the children of a drinking parent 
possessed a feeble constitution, or mental incapacity, or both, and 
perhaps a scrofulous tendency. But this is not true of the children 
of all such parents. The propensity to drink is also sometimes trans- 
mitted, although not very generally, because the children are warned 
by the effects which they see. I recall the family of one notorious 
drinker, but one of whose children was addicted to the habit, but 
several of whose grandchildren (and not sons of the drinking son), 
inherited the propensity. On the whole, therefore, I judge that the 
effect of the use of intoxicating liquor as a beverage is deleterious, 
and frequently ruinous to the health, and that it very often shortens 
the duration of fife." 

"There is a great deal of intoxicating drink sold in this town. 
The population is but little over two thousand, and there are prob- 
ably a dozen places where it can be bought. I do not propose to 
discuss the effect of this from a moral point of view, but to speak 
of it physiologically. I am of opinion, as the result of observa- 
tion, that the use of these drinks is the cause of ill health not so 
much to the drinker himself as to those Avith whom he holds inti- 
mate relations. It is very seldom that I am called to a case of sick- 
ness where I can say that alcohol was the direct cause of the disease. 
Excluding cases of disease of the liver and kidneys and delirium 
tremens, it seems to me that habitual drinkers enjoy as good health 
and are as long lived as their more temperate brethren. I am very 



1871.] PUBLIC DOCUMENT— No. 37. 255 

seldom called to treat a case of consumption in an habitual drinker, 
and when we do find such, the disease seems to he brought on by the 
attendant vice, debauchery and poverty, rather than by the spirit- 
drinking itself. I do not find that spirit drinkers are more subject 
to inflammatory diseases. 

" I have run over my day-book far enough to include the last one 
thousand cases for which I have prescribed, and among them all I 
find but eleven caused by alcohol. These eleven cases apply to 
seven individuals, as some of them applied for treatment at different 
periods. I have not been able to see that any of the children born 
in this town during the treatment of these one thousand cases have 
inherited any physical weakness or any disease from their parents 
being addicted to drink. This does not prove that the inordinate 
use of liquor is not at all injurious to offspring but it seems to show 
that individuals may at times even drink to excess and still the off- 
spring not be injured by it. I know a number of men who have 
large families of healthy children and yet during all their married 
life have been hard drinkers. One reason for this may be that the 
children were begotten before the intemperate habits of the fathers 
had injured their systems. The effect of drunkenness of mothers 
upon their children would no doubt be worse. I know of but one 
such, and her children born since the habit became confirmed seem 
to be as sound as the others ; but one case is not enough for proof. 
With few exceptions, the bad effect of spirit-drinking on the health 
of the people of this town, as they now drink, is an indirect one, — 
not so much affecting the drinker as his family, — subjecting them 
to hardships and mortifications, and by the well-known weakening 
process of these influences, rendering them more open to the inroads 
of disease. The practical conclusions which may be derived from 
the preceding observations are these : Moderate drinkers are not 
more subject to disease than the strictly temperate, if we except 
cirrhosis, and perhaps Bright's disease. Immoderate drinkers suffer 
from disease which is attributable to the collateral dissipation and 
exposure rather than to the spirit itself. The proportion of disease 
caused directly by drink to disease of all kinds is only one per cent, 
in my experience. 

" The children of moderate drinkers are as perfect as those of the 
strictly temperate, both physically and intellectually. The children 
of fathers who were excessive drinkers, unless their fathers were 
intoxicated during the act of their generation, are apparently equally 
sound. The effect of alcohol on the physical economy, in not ex- 
cessive quantities does not appear to be the direct cause of any of 
our prevailing diseases. 



256 STATE BOARD OF HEALTH. [Jan. 

" That alcohol, used to excess, has an injurious effect on the moral 
and intellectual faculties, and that it leads to vice of all kinds, and 
is the cause of great domestic misery, and is thus the indirect cause 
of much physical suffering, there can be no doubt." 



" This may be called a temperate community. The effect of the 
use of intoxicating liquors is by no means uniform. While I can 
recall many instances of ill-health from its use I can recollect very 
few where it manifestly shortened life. There have been many 
notable instances of great age in men who have always drank." 

This closes the remarks on this subject by our correspondents 
in Massachusetts. We now present the correspondence from 
foreign countries. 

The following letter was addressed by the Chairman of the 
State Board of Health to a great number of representatives of 
the United States Government in every part of the world : — 

Boston, Feb. 23, 1870. 

Dear Sir :— The State Board of Health of Massachusetts is, by 
law, ordered to study the influence of intoxicating drinks on the 
health and prosperity, etc., of our people. It desires to get informa- 
tion from various countries in regard to the whole subject. 1 would 
therefore respectfully ask you to be kind enough to tell me : — 

1st. — What are the chief intoxicating articles used in . 

2d. — What amount of crime is produced by them ; and their 
effects on the health and prosperity of the people. 

Under the last question we would like to have your opinion (if 
you are willing to give it) as to the relative amount of intoxication 
in the country where you are now residing, and that seen in the 
United States. 

We would like also any official statistics of the amount of intoxi- 
cation and of crime resulting therefrom. 

I remain, very respectfully yours, 

Henry I. Bowditch, M. D., 

Chairman of the State Board of Health of Massachusetts, ( U. S. A.) 

The following replies were received previous to January 14, 

1871. 



1871.] PUBLIC DOCUMENT— No. 37. 257 

Ancona, May 12, 1870. 

Dear Sir: — In answer to your communication dated the 23d 
February, ultimo, requesting me to give information respecting 
intoxicating drinks used in this country, and their influence on the 
people, though only a short time living here, I have been able to 
form the following ideas. 

The Italian people as a body are not addicted to strong drinks. 
The principal drink of the country is wine, which is not intoxicat- 
ing except when taken in great quantities. Spirits are only indulged 
in by the lower orders, and that in a very small proportion. 

As for crime being committed under the influence of liquor, such 
a thing I may safely assert is unknown, and in case crime is com- 
mitted under the influence of drink, in this country, it is taken as 
an extenuating circumstance in favor of the accused, a proceeding 
which is not always allowed in countries where intoxication is too 
prevalent. 

The manufacturing and sales of liquors of all descriptions are per- 
fectly free, government in no way interferes, nor is a license of any 
kind requisite for the sale or manufacturing of liquors. 

You ask for a comparison of the amount of intoxication in this 
country and the United States. There is none ; unfortunately the 
habit is too extended in the States to admit of a comparison with 
this country. 

To sum up in a few words, intoxication as a general rule does not 
exist in this country, and in consequence the health and prosperity 
of the people are not in any way injured from the effects thereof. 

I am, sir, very respectfully, your obedient servant, 

Orrin J. Rose, U. S. Consul. 



Athens, May 20, 1870. 

Sir : — I have now the pleasure to reply to your circular letter of 
the 23d of February last, which, as I have before advised you, did 
not reach me until the 28th of April. You ask, 1st. — What are 
the chief intoxicating articles used in Greece ? 

The chief intoxicating article is wine ; the native growth of the 
country. It is of pure grape juice, fermented naturally in barrels, 
without any artificial aid beyond the addition to the fresh must 
when put in the barrels, of about ten per cent, of common resin 
gathered from the bark of the pine-tree. This wine is very cheap, 
costing about thirty leptas an oke, or 15 leptas a bottle (say three 
cents). But little is exported, and that chiefly to Turkey and 
Russia. It may be said to be the universal drink of the people. 
33 



258 STATE BOARD OF HEALTH. [Jan. 

The average annual consumption in the city of Athens, — which 
contains a population of nearly 50,000 souls, — is about 1,900,000 
okes of resined wine or 3,800,000 bottles. Of other spirits the 
estimate is 40,000 bottles. Rum and brandy are chiefly consumed 
by foreigners, of whom the greater part are sailors. The Greeks 
consume also, in small quantities, a spirit called raki, which is dis- 
tilled from the lees of wine and from figs. Alcoholic drinks, spirits, 
rum, etc., are very deleterious in these warm climates. This fact, 
and the comparative high cost of these stimulants, limit their con- 
sumption. The light wine of the country on the contrary is gener- 
ally regarded as harmless in its effects, if not positively wholesome, 
when drunk in moderation. A medical gentleman who has had large 
experience among the peasantry, informs me that "when not abused 
the tonic effect of the resined wine is rather beneficial than other- 
wise, its bitter pungency acting against the feverish influences of 
the summer miasmas." " In the village of Menidi near Athens," 
says my informant, " I know an old priest who, from the testimony 
of his neighbors, has consumed daily, ever since he was an adult, no 
less than two okes (four bottles) of the wine of the country at each 
of his meals, besides extra glasses at odd times, making in all about 
six okes or twelve bottles per day. This man is now ninety years 
old, is hale and strong and continues the same practice still." 

2d. — What amount of crime is produced by them and their effects 
on the health and prosperity of the people ? 

It is very difficult to make an estimate of the amount of crime 
produced by intoxication, where no statistical information on the 
subject can be obtained; but from what has been already stated 
with regard to the character and use of the wine of Greece, you will 
infer that, as a general thing, crime cannot be attributed to this cause. 
So far as figures go it may be assumed that not more than one- 
sixteenth of the crime committed can be said to arise from intoxica- 
tion. The Greeks are eminently a temperate people, and excepting 
on high feasts and holidays, a drunken man is rarely seen. My own 
observation is not a fair test as I am not frequently in quarters of 
the city where tavern brawls occur, yet it is worthy of remark that 
during two years' residence in Greece I have not seen as many as 
two Greeks in the condition called "dead drunk;" while it is a not 
uncommon sight to see sailors from foreign ships, reeling through 
the streets in various stages of intoxication. Drinking may occa- 
sion brawls and quarrels leading to high words and much volubility 
of speech, — for the Greeks are easily excited and much given to 
profuse language, — but I may say they seldom come to blows or to 
worse results, such as homicide, in consequence of excessive drink- 



1871.] 



PUBLIC DOCUMENT— No. 37. 



259 



ing. This is to be attributed, chiefly perhaps, to the quality of the 
liquor drank, the wine of the country, as has been already stated, 
not having the same effect as spirits in this respect. The Greeks 
also are an orderly people, easily excited to anger it is true, which, 
however, is but momentary. The following return of deaths in the 
city of Athens (taken from the published register), during the 
last nine years, will show what an astonishingly small amount of 
deaths were due to strong drinks or delirium tremens. You will 
observe the proportion of foreigners is very great. These form 
scarcely one per cent, of the whole population, and the result is 
owing to the strong alcoholic drinks which they consume, while the 
Greeks, as a rule, confine themselves to the light wine of the country. 

Registered Deaths in the City of Athens from the effects of Strong 
Drinks, " Encephalopathie Crapuleuse " and " Delirium Tre- 
mens." 



Foreigners 



1860, 

1861, 

1862, 

1863, 

1864, 

1865, 

1866, 

1867, 

1868, 

1869, 

Total in a population of 50,000, 



26 



16 



42 



This statement may not be perfectly reliable owing to the fact 
that the certificate which must be given by the physician, before 
permission for burial can be obtained, is sometimes incorrect. It 
may happen, when the cause is habitual intoxication, that sensitive 
relatives induce the physician to call the disease by some other 
name. It is, however, well known that cases of delirium tremens 
are so very rare in Athens, as to excite the astonishment of the 
medical faculty who are unacquainted with the country. 

3d. — What is the relative amount of intoxication in Greece and 
in the Urn ted States? 

The relative amount of intoxication is very small indeed com- 
pared with that of most other countries. There are no statistics of 
intemperance in Greece, but from what has already been said you 



260 STATE BOARD OF HEALTH. [Jan. 

will perceive that there is no comparison whatever in this respect 
with the intoxication and intemperance which prevail in the United 
States. Probably there is less intemperance in strong drinks 
here, than in any other part of the world, unless it be in Turkey and 
other Mussulman States. 

I remain, sir, very respectfully, yours, 

Chas. K. Tuckerman. 



Basle, Switzerland, 8th June, 1870. 

Dear Sir: — Your letter, making inquiries in regard to a subject 
to which I paid a great deal of attention, owing to its great vital 
importance in the United States, viz., the cause of temperance, I 
received in due time ; the very wish to answer it fully, supported by 
documents of official statistics, caused my delay in writing to you 
sooner. Some two months ago I tried to get official information 
from the canton of Berne, where, owing to peculiar circumstances 
and laws, strong alcoholic liquors (schnapps) are manufactured and 
consumed, and where there is more immorality, crime and misery, 
it is said, than elsewhere in Switzerland ; but failed to receive it up 
to this day. 

Hence I answer the questions desired as best I can from my own 
observation and study. 

Question 1st. What are the chief intoxicating articles used in 
Basle and vicinity ? 

Answer 1. This being a border state of France and Germany, 
where wine grows very abundantly, and costs retail from 10 to 25 
cents a pint only, a great deal of wine is consumed even by poor 
persons and day-laborers (wood-cutters receive a bottle a day, serv- 
ants from two to three bottles a week in each family). Beer is more 
of a luxury, and indulged in more freely by the middle and higher 
ciass, besides wine, every day, Sunday not excepted. 

Question 2. What amount of crime is produced by these intox- 
icating drinks, etc. ? 

Basle is one of the most orderly, quiet and moral cities in Europe, 
I believe, and one of the richest of its size. In its vicinity there are 
immense silk ribbon factories. The higher and middle classes enjoy 
excellent health, and are prosperous. 

The working classes, gaining small wages, consume proportionately 
a good deal of cheap wines as a substitute for more substantial food, 
such as meat, which factory people obtain, perhaps, only once or 
twice a week. 



1871.] PUBLIC DOCUMENT— No. 37. 261 

There is nothing like the same amount of intoxication witnessed 
here as in the United States, or other countries, where strong 
drinks are resorted to instead of wine or beer, and is always of less 
dangerous consequences, rarely leading to fighting, if ever to murder. 
Drinking is here connected with amusements, conversations, music, 
etc., indoors and outdoors ; does not take place at bars, or secretly. 

I am, very respectfully, your obedient servant, 

J. C. Erni, United States Consul. 



Legation of the U. S. of America in Switzerland. 
Berne, July 27th, 1870. 

Sir : — Tour circular letter, asking for information respecting the 
use and effects of intoxicating liquors in Switzerland, was received 
at this legation in April last. At the time, I was absent on leave 
from the State Department, and, on my return, about the 1st of 
June, I began making inquiries with the hope of collecting materials 
for a satisfactory reply to your questions. Considerable time has 
elapsed, and I regret to say that I have been able to obtain only 
very insufficient data for this letter. The evils consequent upon the 
intemperate use of intoxicating drinks have not attracted as much 
attention here as in the United States, perhaps for the reason that 
they have not been as seriously felt. Nevertheless, in some parts of 
Switzerland, and especially in the canton of Berne, intemperance 
prevails to such an extent, that recently, the cantonal legislation has 
sought to find measures for abating the evil. 

The few statistics that I have been able to collect on the subject 
of the use of intoxicating drinks in Switzerland relate to the canton 
of Berne. That canton, however, includes a fifth part of the popu- 
lation of Switzerland, and it is the part of the country where, I am 
assured, the greatest amount proportionately of intemperance is 
found. 

Your first question is : " What are the chief intoxicating drinks 
used ? " These are wine, beer, and a species of brandy, or schnapps, 
distilled from potatoes, or from the pulp of grapes after the wine has 
been pressed out. French brandy, or kirschwasser, and various 
liquors imported from abroad, are also used to some extent, but very 
little by the mass of the people. 

From official sources, I learn that the annual average importation 
of wine, beer and cider, in the canton of Berne, which contains a 
population, in round numbers, of 500,000, amounts to from eight to 
nine million maas (a Swiss maas is equivalent to one quart and three 
gills English measure). A large quantity of beer is manufactured in 



262 STATE BOARD OF HEALTH. [Jan. 

the canton, but I have not been able to obtain the approximate 
amount. There is also manufactured from the vineyards of the 
canton about 1,750,000 maas of wine per annum. The annual im- 
portation of brandies and other spirituous liquors reaches about 
700,000 maas, and about the same quantity of spirits, principally 
schnapps or potato brandy, is distilled annually in the canton. The 
greater part of all the above-mentioned drinks is consumed within 
the canton. But little is used except for drinking purposes. After 
making due allowance for the large consumption by travellers during 
the summer months, there still remains sufficient ground for the 
conclusion that the people of this part of Switzerland are not the 
most temperate people in the world. 

Your second question is : " What amount of crime is produced 
by the use of intoxicating drinks, and their effects on the health and 
prosperity of the people?" Upon this subject, I sought for infor- 
mation from the Federal Bureau of Statistics, the chief of which, in 
reply to my application says : " We have no statistics on the sub- 
ject. It may, however, be taken as granted that manslaughter and 
many acts of violence are frequently the result of intemperance. In 
cases of suicide, without considering other causes, many persons 
destroy themselves while in a state of intoxication. Of fifty-three 
suicides in the year 1868, eleven were intoxicated when they com- 
mitted the act, or were notorious drunkards. In this canton, as 
elsewhere, one may see that the health and prosperity of those who 
have fallen into the habit of drunkenness are soon destroyed. Many 
families are ruined by this vice, and the children of drunkards 
tainted with hereditary disease." 

I am told that the evil effects of intemperance here are chiefly 
visible in that class of the population addicted to the drinking of 
schnapps. This liquor is very cheap, and is the principal stimulant 
used by the poorer classes. Its manufacture and use have greatly 
increased of late years. It is drunk by the people of the rural dis- 
tricts, who either cannot afford or cannot obtain other liquors. 
Since Switzerland has been traversed by railroads, and is annually 
visited by multitudes of foreign travellers, the prices of all kinds of 
country produce have largely increased. The poor classes are not 
as well fed as formerly. The excellent milk of the country, formerly 
consumed by the people, is sold to the hotels, or manufactured into 
cheese for exportation. Many of the people live almost exclusively 
on potatoes, and a writer on the subject, whose essays have attracted 
a good deal of attention here, Mr. J. F. Schneeberger, of Berne, 
attributes the craving for alcoholic drinks, so much more noticeable 
now than formerly, to the lack of nutritious and proper food. 



1871.] PUBLIC DOCUMENT— No. 37. 2G3 

The general impression among those with whom I have conversed 
on this topic, is that the wines of the country are wholesome, and 
that the best method of introducing a temperance reform would be 
to bring wine or beer within the reach of the masses of the people, 
and discourage the use of stronger drinks. A very intelligent 
gentleman at Lucerne, a member of the cantonal legislature, with 
whom I conversed on this subject, said that some years since he had 
charge of enrolling the citizens of that canton subject to military 
service, and was struck with the difference between the people of 
certain valleys where wine is produced, and has always been a com- 
mon beverage, and those of other districts where wine is not used, 
and schnapps is a common drink. The physical superiority of the 
former class was, according to his account, very striking, and the 
percentage of able-bodied men in the wine-producing districts very 
much the greater. He attributed the difference, in great part, if not 
to the positive virtues of wine as a beverage, at least to the positive 
evils produced by schnapps-drinking. Nevertheless, I suspect there 
were other causes. In the wine-producing districts there is usually 
a more generous soil, a milder climate, and more wealth among the 
people, who are consequently better housed and better fed, and 
might be expected, as a consequence, to exhibit, in their persons, 
the superiority which he remarked. 

Last year two laws were enacted by the cantonal legislature of 
Berne, one having for its object the restriction of the use of distilled 
spirituous liquors, by increasing the tax on their manufacture and 
importation, and diminishing the taxes on wine and malt liquors. 
The other seeks to protect the public from adulterated liquors, pro- 
vides for the inspection of distilleries, in order that only such appa- 
ratus shall be used as will produce an article as little injurious as 
possible, and affixes penalties for the violation of the law. A small 
tax still remains on imported wine and beer, and it is proposed that 
this shall be repealed in order to encourage the substitution of such 
beverages in place of stronger drinks. 

Some efforts have been also made to counteract the immoderate 
use of strong liquors by the private and voluntary action of citizens. 
A temperance society was formed in the city of Berne several years 
ago. The members abstain from distilled liquors, and the society 
publishes prize essays for the instruction of the people in regard to 
the injurious effects of the immoderate use of intoxicating drinks. 

You request me, finally, to give my opinion as to the relative 
amount of intoxication in this country and that seen in the United 
States. As my residence here has been comparatively brief, and my 
opportunities of seeing the common, every-day life of the people 



264 STATE BOARD OP HEALTH. [Jan. 

somewhat limited, my opinion is liable to be erroneous. Judging 
from what I have seen, I must say it is my impression that, while 
the drinking of intoxicating liquors is much more general here than 
in the United States, there are fewer instances of actual inebriation 
than are witnessed there. As far as my observation has extended, 
it is not so common to see men reeling or noisy, under the influence 
of intoxicating drinks, upon the streets here, as in most parts of the 
United States with which I am familiar. In all the towns of Switz- 
erland there is a market day once in each week. Almost the whole 
rural population of the vicinity seem to visit the city on that day. 
The cafes and restaurants are filled with people ; there is apparently 
a great deal of drinking, and towards night, it is not unusual to see 
occasionally a person intoxicated. But I think that, under similar 
circumstances, much worse results would be witnessed in the United 
States than are seen here on such occasions. This is perhaps due in 
part to the fact that the people are in general of a less excitable 
organization than ours, and in part to the fact that the American 
custom of " treating " is but little practised here. 

Regretting that I have not been able to collect more complete 
statistics upon the subject, 

I remain, very respectfully, yours, 

Horace Rubles. 



Berlin, April 26th, 1870. 
My Dear Dr. Bowditch: — I have your letter of the 18th ult. 
The German intoxicating drinks are made of brandy, distilled from 
rye or from potatoes. The " schnapp " is but such brandy or spirit 
distilled with sugar. The beer used here cannot be called an in- 
toxicating drink. I have no opportunity of observing the people 
in their places of indulgence, and cannot offer an opinion of my 
own on "the relative amount of intoxication in this country." 
Those of whom I inquire do not think the health and prosperity of 
the people greatly injured by the use of spirituous liquors. 
I am ever, most truly yours, 

Geo. Bancroft. 



Bremen, May 7th, 1870. 
Sir : — An answer to your first interrogatory contained in your 
favor of 23d Feb., will necessarily answer your second, namely : 
"What are the chief intoxicating articles used in Bremen and 



1871.] PUBLIC DOCUMENT— No. 37. 265 

vicinity?" No intoxicating or alcoholic spirits are used in Bremen. 
Wines and beer are the favorite beverages, and are used and con- 
sumed in almost unlimited quantities. These are so cheap as to 
come within the means of all classes, more beer however being 
consumed by the middle and lower classes than any other. My ob- 
servation has led me to conclude that no evil grows out of the use 
of these. For now, after quite a year's residence among the people 
here, I have yet to see the drunkenness and rioting which prevail 
in most of our American cities ; the natural and consequent results 
from the sale and use of the intemperate spirituous liquors. 

I am, very respectfully, yours, 

R. M. Hanson, XI. S. Consul. 



TJ. S. Legation, Constantinople, May 27th, 1870. 
Sir : — In reply to yours of February last I beg to say : 

1. The intoxicating drinks most in use in Turkey are raki (pop- 
ularly called mastica), and brandy. The former is simply rum 
flavored with mastic, to give it an aromatic taste. The rum was 
for the most part imported from New England, but this importation 
has now almost ceased, being undersold by the rum of Austria 
and France. Brandy and Cognac are imported from France Eng- 
land. 

2. The use of intoxicating drinks is confined to the Christian 
populations, and of these the Greeks are the most addicted to them. 
Even among those who indulge in spirituous liquors intoxication is 
very rare, and habitual drunkenness is comparatively unknown. 
Sobriety is the rule and intemperance the exception. Drunken 
men are seldom seen in the streets of this city, and when a case 
occurs, it is generally a foreign sailor. The English sailors, I am 
sorry to say, are conspicuous for drunken habits on shore. Their 
intemperance is a fruitful source of outrage and crime. 

The Mohammedans by religion and habit are temperate, and they 
regard drunkenness with aversion, as degrading to human nature. 
They abstain as a rule, from the use of intoxicating drinks. None 
are sold in their cafes, and by imperial authority they are not 
allowed to be offered for sale in the vicinity of the Imperial Palaces, 
government offices, kiosks frequented by the Sultan, and the mili- 
tary barracks. At the review held last year on the plain of Hun- 
kiar Iskelepi, of 30,000 Turkish troops before the Sultan, the 
Empress Eugenie and the Emperor of Austria, and in the presence 
of 50,000 spectators, not a drop of liquor was sold in the cafes and 
34 



266 STATE BOARD OF HEALTH. [Jan. 

refreshment tents. Not a single drunken man marred the order and 
decency of the scene. It has never been my lot to witness a more 
respectable and decorously behaved multitude. The same good 
order prevails at all Turkish festivals. 

I regret to be obliged to admit that Mussulmen exhibit a vast 
superiority to Christians in their abstinence from intoxicating 
drinks. 

3. I have no means of furnishing you reliable data as to the 
amount of crime produced in Turkey by intoxicating drinks, as no 
statistics are collated here, except a few on commercial matters. I 
am safe in saying, however, that it is inconsiderable. The habitual 
use of ardent spirits in this country leads to gastric fevers, to apo- 
plexy, paralysis, and a rapid decay of physical and mental health. 
He who is careful of his health abstains from them altogether, total 
abstinence being the wisest and safest rule. 

I think it proper to add that wines, native and foreign, are cheap, 
and in general consumption among Christians. When not adulter- 
ated by drugs, and drank moderately at meals as beverages, they 
are regarded by physicians as wholesome in their influence. 

I am sir, very respectfully, your obedient servant, 

E. Joy Morris. 



Constantinople, Turkey, July 12th, 1870. 

Sir : — Your letter of inquiry as to the varieties of wines or spirit- 
uous liquors used in Greece, and their apparent effect upon the 
character and behavior of the people, was received two months 
since. 

Immediately after I commenced a somewhat extended tour in the 
Peloponnesus and islands, and found neither opportunity nor leisure 
to furnish the information you desired. 

And now I can only give my own impressions, formed after such 
inquiries as I have been able to make, and subject to mistake. 
Should I be able hereafter to get at any more definite facts I will 
make it a duty to communicate them. 

First, — the kind of intoxicating liquors used in Greece is almost 
exclusively wine. 

There are manufactories of rakee at Calamas, and at other places 
in the Peloponnesus, but usually the people prefer to drink the 
wine, and only take the rakee when much exhausted, as a stimulant. 

I have never seen in an eight months' residence in Greece, a man 
make himself drunk with rakee. This rakee, it should be said, 



1871.] PUBLIC DOCUMENT— No. 37. 267 

is exceedingly strong. As to the Greek wines, probably tbey are 
purer than those of any other country in Europe. 

When one becomes habituated to the resinated wine, which is the 
common drink — the pooi-er people liking no other so well — he dis- 
cerns the purity of the wine from all other admixture, and under 
the cloak of the resin can distinguish easily the different grapes 
from which different wines have been made. 

The proportion of resin varies from J of 1 per cent, to 5 per cent. 
Its addition is considered to make the wine more healthy, to facili- 
tate digestion, and to counteract any ill effects which the lime- 
water of the country may have. 

Passing the other day, from Athens to Smyrna, as soon as I 
tasted the light wine of that country, I could perceive the spirit in 
it to a degree which I had not known in Greece. There is perhaps 
no country in the world where wines are cheaper than in Greece. 
New wine is sold in Arabia in the fall for four or five cents per gal- 
lon. Before the grape disease of '53, '54, '55, '56, &c, there were 
times when it was sold for one or two cents. On the high plain of 
Arcadia, and in the mild valley of Acarnania — in fact in all of 
western Hellas — wine with bread and olives and oil makes a chief 
article of food ; babies, even, drink it. 

It is the most abundant of all products, and the easiest procured. 
In Acarnania you will often find wine when you would hardly find, 
bread. 

I should say that from the purity of the wine used, that an excess 
of it caused little injury to the health, and ready as the Greeks are 
to quarrel, I am inclined to think that comparatively few quarrels 
take their origin in drink. 

I believe that ten per cent, would be much above the proportion 
of crimes of all sorts, directly or remotely connected with the use 
of wine or spirituous liquors. During my residence in Greece, and 
my travels in it, I have scarcely seen half a dozen drunken men. 

I am, sir, with great respect, obediently yours, 

Robert P. Keef, 
U. 8. Consul Pirceus, Greece. 

N. B. — The rakee in Greece is usually made from figs. 



Cadiz, April 20, 1870. 
Dear Sir : — Your favor of the 23d of February last is received, 
and I will try to comply with your request as far as I know. 

The chief intoxicating articles used in Cadiz and vicinity are : 



268 STATE BOARD OF HEALTH. [Jan. 

cherry wine, burgundy and aguardiente ; this last is the whiskey of 
Spain. 

No crime whatever is committed on account of drunkenness ; the 
Spaniards do not generally drink, and the only cases of intoxication 
belong to foreigners coming here as sailors, and to them alone is 
attributed all disturbance of peace. As far as I have been able to 
see, the intoxication leads those foreigners to quarrels and fighting, 
but nothing more, and permit me to inform you, that in my opinion 
either of the above liquids have on the inhabitants of this part of 
the country the effect to make them indolent ; this, however, may 
come on account of the climate. No Spaniards carry on here any 
business of any importance, but, however, they are all in an easy 
social position. The people living in the country drink a good deal of 
aguardiente, which is the most dangerous of the above liquids men- 
tioned. This aguardiente is of a white color, but not exactly, having 
a yellowish appearance, and its taste is very much like annisette. I 
have remarked often, as soon as these people have drunk sufficiently 
of this liquid, they were led to cheerfulness, and after to a complete 
state of indolence ; but I never saw one in a state of intoxication. 
It is also the favorite drink of our sailors coming here. Now there 
are many robberies committed in the mountains, but the robberies 
and crimes which may be committed by brigands are committed in 
cool blood, as never or very seldom have they been found with any 
intoxicating liquid even in their camp. The health is generally very 
good, and in a population of 60 to 70,000 inhabitants, the daily aver- 
age of deaths is three to four per day. Cherry wine and burgundy 
are the only wines shipped to the United States, of which the 
greatest part goes to New York, Philadelphia, New Orleans and 
Boston. Very respectfully, yours, 

A. N. Duffle, United States Consul. 



United States Legation, Copenhagen, ) 
2d May, 1870. $ 

Dear Sir :— On the receipt of your favor of the 23d February, 
only a few days ago, I sought an interview with Mr. C. N. David, 
Chief of the Bureau of Statistics in Denmark, and one of the best 
authorities upon all such subjects in Europe. 

I left with him a copy of your letter, and now enclose you his 
letter to me of the 30th April. As his statistics cover the period 
since the severance of the Duchies of Holstein and Schleswig, they 
may be taken as applicable to what is called " Denmark proper," 
and therefore, a population, I believe, of about 1,600,000. 



1871.] PUBLIC DOCUMENT— No. 37. 269 

In conversation with me, Mr. David deemed it extremely difficult, 
indeed impossible, to say what proportion of crime is caused by the 
use of intoxicating drinks. He only speaks certainly and confidently 
of suicide ; but as to the general list of crimes, I take his impression 
to be that intoxication does not have here so marked an effect as it 
is generally supposed to have in the United States. Still he is very 
cautious to say that accuracy cannot even be approached on the 
subject. 

He informs me that the quantity distilled, and the average con- 
sumption per head, are much greater than twenty or thirty years 
ago; but, with his accustomed caution, he adds that in making this 
statement, he speaks from official figures, and that the law affecting 
the manufacture being now stricter and better administered, he can- 
not say how far the estimate would be affected by former clandestine 
distillation, which is now very rare. 

He assures me that while the average consumption has thus 
seemed to increase largely, the number of cases of manifest and 
public intoxication has greatly decreased ; which he attributes partly 
to improved manners, morals and education, but mainly to improve- 
ment in the quantity and quality of food the people use, believing 
that well-fed people can support more alcoholic stimulus than poorly 
fed people. 

He thinks the tendency and habit of intoxication somewhat 
greater in the cities than in the rural and agricultural districts. 

In reference to retail sale in small quantities, there are two sorts 
of license : one to sell, with permission to use on the premises ; and 
the other to sell, without such permission ; and he thinks the per- 
mission to remain and use the liquor on the premises much more 
injurious to the purchasers. Practically there is no difficulty or im- 
pediment whatever in the way of those who want it, and are able to 
pay for it. He did not discuss prohibition at any length, but does 
not seem to regard it as an efficient remedy, and intimated an 
opinion that it would only increase the clandestine manufacture, sale 
and use. 

Beer is very largely used here, as elsewhere in Northern Europe, 
but is not deemed an intoxicating beverage. It is said to be not 
nearly as strong as English beer, and I think is not so strong as that 
made in the United States. 

The strong drink, or " brandy," is mainly distilled from barley ; 
potatoes were formerly much used, but have been very little used 
since the appearance of the potato disease some years ago. 

I cannot give any definite or intelligent opinion of the relative 
amount of intoxication here and in the United States, especially in 



270 



STATE BOARD OF HEALTH. 



[Jan. 



the N. E. States, where I have seen so little of the people. There is 
certainly much less visible and outbreaking intoxication here than in 
those parts of the United States where my opportunity for observa- 
tion has been best ; but on the other hand, I must admit my surprise 
at the large aggregate and average consumption shown by Mr. 
David's figures. The people of this country are remarkably quiet, 
steady, peaceful, plodding and law-abiding ; given to much out-door 
and open-air congregation and amusement, but always with an order 
and decorum that have commanded my admiration. It is possible 
that owing to these manners, and to the climate, the same amount 
of intoxication would not be so much seen and heard here as where 
I live. Very respectfully, your obedient servant, 

Geo. H. Yeaman. 



Copenhagen, 30th April, 1870. 
By returning the included letter of Mr. Bowditch of Massachu- 
setts, I have the honor to communicate to your Excellency a notice 
concerning the produce of the home-distilleries in Denmark in the 
years 18|f-18||, and the importation of brandy, or a kind of rum, 
from abroad, during the same five years. 



TEARS. 


Home Distilleries. 


Exported. 


1864-5, 

1865-6, 

1866-7, 

1867-8, 

1868-9, 


34,753,000 pots. 
35,794,000 " 
33,071,000 " 
31,614,000 « 
32,632,000 " 


1,498,000 pots. 

735,000 " 
1,045,000 " 
1,141,000 " 

864,000 " 



Five pots are about 1 gallon. The home distilleries produced on 
an average 33,570,000 pots, or about 6,700,000 gallons, of which 
1,257,000 pots (250,000 gallons) yearly are exported. 



YEARS. 


Importation of Brandy. 


Re-exportation. 


1864-5, 

1865-6, 

1866-7, 

1867-8, 

1868-9, 


1,500,000 pots. 
2,403,000 " 
2,137,000 " 
1,875,000 " 
2,486,000 " 


249,000 pots. 
596,000 " 
453,000 " 
481,000 " 
837,000 " 



1871.] PUBLIC DOCUMENT— No. 37. 271 

On an average, 2,080,000 pots of foreign brandy were imported 
(416,000 gallons), of which about 520,000 pots (104,000 gallons) 
were re-exported. 

No doubt that this large consumption of intoxicating drinks in 
Denmark, as in other countries, has a very lamentable influence upon 
the moral and physical constitution of the people, though the state 
of the climate and the nourishment of the people, in accordance to 
its better condition and common welfare, to a certain degree, can 
mitigate this obnoxious influence ; but it is in my opinion impos- 
sible definitely to ascertain the amount of crime and the deplorable 
effects on the health and prosperity of the people, which can be 
ascribed to the consumption of intoxicating drinks. 

The sole fact, which I think in this respect can be quoted, is that 
among 100 self-murderers — and the number of self-murders is very 
large in Denmark, — according to the inquests of the coroners, 26.5 
are declared " drunkards," or " fallen into the abuse of drinking," 
say for men 32.6, and for women, 8.7. 

Your Excellency, most obedient, 

C. N. David. 

To His Excellency, G.H. Yeaman, Minister of the United States. 

Copenhagen, 4th May, 1870. 

Dear Sir: — Since my letter of the 2d inst., it has occurred to me 
that the information was not so full upon the subject of health as 
you might have expected, but I do not find that I can make it much 
more explicit. 

I have to-day sought an interview with Professor E. Fenger, for- 
merly at once a leading medical practitioner in this city, a medical 
teacher in the university and in charge of one of the principal hos- 
pitals ; and who has since devoted himself very much to all sorts 
of statistics, and is now acting as president of the principal life 
assurance company of this kingdom. 

He agrees with Mr. David that there are very few reliable statis- 
tics on the subject, except in relation to suicide, which having been 
unusually and painfully frequent here, led to inquiries as to the 
causes. 

He thinks that intoxication or excessive drinking often superin- 
duces chronic diseases of the hVer and kidneys, and at other times 
leads to dropsy and diseases of the bowels, but he does not think 
any accurate figures or proportions can be given. 

He regards the consumption here as " very large," and when I 
referred to the general opinion that it is much larger in Sweden 
and Norway than here, he replied that he believed the consumption 



272 



STATE BOARD OF HEALTH. 



[Jan. 



here is larger, but that individual cases of drunkenness and intoxi- 
cation are much rarer here. 

In the country agricultural laborers generally eat five times a 
day, and the custom is that the employer must furnish a glass or 
two of brandy three times a day. Many of the country people mix 
it with their tea and coffee, especially with tea. On convivial occa- 
sions punch is used, made of West India rum, lemons and sugar, 
but the brandy I have spoken of is the common daily drink. Liter- 
ally translated, its name is " corn brandy ; " is very cheap, and is 
not so strong as Swedish " banes " or American whiskey. It is so 
cheap, the professor says, that a strong man can get drunk on two- 
pence. 

The well-to-do classes here use freely the wines from Central and 
Southern Europe, but I have never heard an intimation that any- 
body used them injuriously. 

Professor Fenger agrees with Mr. David that while the consump- 
tion of brandy has increased, the proportion of visible cases of in- 
toxication has very greatly decreased ; that the people are well fed, 
and that that is one reason why they can drink more. 

You see from these statements the extreme difficulty of estimat- 
ing the effect either upon health or " prosperity." Here is a people 
evidently more prosperous than formerly, evidently using more 
brandy than formerly and evidently less given to intoxication than 
formerly. Of course, all will admit that the diminution of drunken- 
ness is an increase of prosperity, but I have found nobody to claim 
that the increase in the quantity of brandy used has increased the 
prosperity of the people. The people here appear so very sober, 
that I have been simply astonished to find how much brandy they 
really use. 

Professor Fenger refers me to an elaborate and scientific work, 
Alcoholismus, by Dr. Huss of Sweden, printed in Swedish, and, he 
thinks, translated into German. If you wish, I shall try to procure 
it for you. 

The only figures to which he can at present refer me are the fol- 
lowing in relation to insanity, taken from the report of the lunatic 
asylum for the city of Copenhagen : — 



New Cases 
Admitted. 



Attributed 
to Intoxication. 



1864, 
1865, 
1866, 
1867, 



116 
119 
152 
120 



12 
14 
23 
11 



1871.] PUBLIC DOCUMENT— No. 37. 273 

Regretting my inability to furnish you with fuller and more de- 
tailed information, I remain, 

Very respectfully, your obedient servant, 

Geo. H. Yeaman. 

Copenhagen, 5th May, 1870. 

Dear Sir : — I should perhaps make a correction in that part of 
my letter of yesterday relating to the lunatic asylum for Copen- 
hagen'. I used the expression " attributed to intoxication." In the 
printed tables the word " drik " — drink — only is used ; and I cannot 
tell whether those who made the estimates and framed the tables 
of causes used this word to express the habit of drinking or the 
habit of intoxication. But as it is quite possible for a man habitu- 
ally to drink too much without ever getting really drunk, they may 
have had in view only the habit of drinking too much. 

I would add that the popidation of the city is about 170,000, 
and that but few cases are admitted into the asylum from other 
provinces. 

Very respectfully, your obedient servant, 

Geo. H. Yeaaian. 

P. S. — In regard to the increased prosperity of the Danish people 
of which I have spoken, and of which there seems to be no doubt, 
it ought to be mentioned that several important facts have con- 
curred with it, and, no doubt, have contributed to it. 

Among these I would now only mention the improved condition 
of land tenure and distribution, as well as improved agriculture, 
greatly enlarged political franchise and improved educational facili- 
ties. There is, perhaps, no country in Europe, except Prussia, 
where the average standard of education and intelligence is so high 
as in Denmark — very nearly approaching in these two countries the 
standard attained in those States of the Union where the system of 
public common schools has been long established. I have said that 
agricultural laborers eat five times a day. The statement is true 
of the entire laboring population, except, perhaps, the household 
domestics of the upper classes. Well-to-do families have generally 
four meals, or two meals and two refreshments, which may be 
called in English, coffee, breakfast or lunch, dinner and tea. Even 
the inmates of the "poorhouse" eat five times a day, but are not 
furnished with the " brandy." • G. H. Y. 

35 



274 STATE BOARD OF HEALTH. [Jan. 

United States Consular Agency, } 
Cologne, 8th July, 1870. ) 

Dear Sir : — Your letter of the 23d February last has been duly 
received, and in reply I beg to express to you my sincerest regret 
that I have not succeeded in answering your questions in the way 
I wished to be able to do, although I endeavored to get information 
everywhere. 

The chief intoxicating drinks used in this country are beer and 
brandy, and in the vine countries the most inferior descriptions of 
wine ; however, it is particularly the brandy which produces the 
most disadvantageous influence on the health and prosperity of the 
people. From the inclosed communications, which the Board of 
Health of the Nether-Rhine at Dusseldorf has kindly given me on 
my application, you will learn that there are no official statistics 
existing in this country with regard to the amount of intoxication 
and of crime resulting therefrom, but it may be taken for granted 
that nearly seventy-five per cent, of the number of criminals have 
committed their crimes by the influence of intoxicating drinks. 

I may still add that a correspondence has taken place on the 
matter between the said Board of Health and Dr. Varrentrapp of 
Frankfort-on-the-Main, who is an experienced man in the branch 
of prison matters, and that he was likewise unable to answer fully 
your questions, but being about to send some books to Boston he 
promised to add some pamphlets referring to the matter for you, 
which I have every reason to believe he will have done. 
I remain, very respectfully, yours, 

George Holscher, U. S. Consular Agent. 

Mr. Holscher subsequently forwarded the following documents : — 

(Translations.) 
Sir : — Allow me to answer your very kind letter of the 20th of 
this month. The question raised in the royal ministry in regard 
to statistics concerning "what influence the use of intoxicating 
drinks had on the number of committed crimes," was not taken into 
consideration particularly, and other official statistical statements 
forjudging this question are unknown. 

The Chief Procurator, (Signed,) Bolling. 
Cologne, April 27, 1870. 

Cologne, May 13, 1870. 
Sir : — I have the honor to answer your very kind letter of the 
6th, and regret very much that I am unable to answer your inquiry 
in regard to the statistical information of " what influence the use 



1871.] PUBLIC DOCUMENT— No. 37. 275 

of intoxicating liquor has on crimes," and can furnish you no mate- 
rials. It is generally known what a powerful influence it exercises, 
and for this in particular all institutions for correction are in the 
same position. To prove facts in different ways with the multitude 
of examples there are, so far as I know, no statistical proofs, and if 
there are such in existence, they are to be regarded only as not 
even approaching the truth ; the difficulty in presenting them does 
not need any further explanation. So far as regards the institutions 
of punishment, I am unable to give you any statistical information, 
though for the last twenty years I have spent my time in works of 
statistics, particularly in relation to improvement in institutions of 
prisons very minutely. The Director, Von Gotzen. 

To the Superintendent of the Society ) 
of Public Health, Dr. Lent. 5 

Cologne. 

Dr. Lent : — You honor me with your letter of May 17th, refer- 
ring to the letter of our Agent, Pastor Schiffer, of May 7th. Allow 
me to answer. 

All the gentlemen connected with the Institutions of Punishment, 
the Directors, Inspectors of our provinces, to whom we addressed 
ourselves — namely, the President of the State Commission of 
Health of the United Provinces, for the purpose of finding out 
what influence the use of intoxicating liquor has in the amount of 
crimes in this country, answer as follows : 

Proper statistical material was not communicated, and is very 
difficult according to the nature of the matter, because in many 
institutions the personal acts of the imprisoned are not brought 
forward, and the experience of a few does not give sufficient stand- 
point to make statistical results. 

We have the honor to collect the information of single institu- 
tions. 

The Director of the Institution for Correction at Herfordt, com- 
municates that in the House of Correction, in the Province of 
Westphalia, where there are the most Protestant prisoners, minute 
statistical notices are not extant. It would come very near the 
truth to say, that seventy-five per cent, of the crimes of prisoners, 
particularly murder, manslaughter, resistance against authority, 
criminals against morality, assault and battery, thieving, house- 
breaking, and even a higher percentage of some of these crimes can 
be traced to intoxicating drink. In Munster a great penitentiary, 
where there are from 600 to 700 Catholic prisoners, only since 
February when the new Director came, have they begun to collect 
such notes. For this an answer is not possible. 



276 STATE BOARD OF HEALTH. [Jan. 

The Director of the Central Institution at Hamm, A. L., where 
there are from 400 to 500 prisoners, communicates the fact that 
two-fifths of the cases of assault and battery were due to the in- 
fluence of liquor. The Inspector of the prison on the Spaumberg, 
near Bielefeld, where the prisoners aggregate 70 or 80 per day from 
the district Minten, says one-third are punished for stealing, one- 
sixth for heavy assault and battery, one-sixth vagabonds, one-sixth 
for loafing and insulting, and the last one-sixth for depredations. 
With the exception of youthful thieves, the use of intoxicating 
drink was the direct or indirect cause of nearly all this crime. The 
Director of the House of Correction at Benninghausen, answers 
that he has no statistical material ; still the report of the Director 
of Brauweiler and our own experience show, that without excep- 
tion beggars and vagabonds come in this way. 

We observe still, that besides the above named Institutions, there 
are a great number of prisoners whose time is three months. 

Regarding the Rhenish Provinces, we did not receive any infor- 
mation from the Director at Werden, he having been there only 
two months. 

The Superintendents at Dusseldorf, Cleve, Bonn, and Coblenz, re- 
gret not to be able to give any satisfaction. 

The Director of the Cologne Institution answered that he sent 
you his report as asked. The Director of the House of Arrest, in 
Aachon, estimates according to his experience, the number of per- 
sons made criminals in consequence of intoxicating liquor, at 75 
per cent. 

From the report of the Inspector of the House of Ai*rest, whose 
daily statements are about 200 prisoners, it is found that 75 per 
cent, of the imprisoned became criminals by brandy. Not only 
grown persons, but youths and even the female sex, are not exclud- 
ed from it. Young persons from seventeen to eighteen years of 
age, and old men after being dismissed, are brought in again for 
new crimes, entirely drunk on the next day. 

On dismissal the prisoners are saluted, partly by their parents, 
partly by their male and female friends, with a bottle of schnapps at 
the very gate of the Institution. Of those who have been deprived 
of their liberty, and present themselves for punishment, hardly one 
is sober, and almost daily, because entirely drunk, they are sent off 
again. The excuse, " Yes,»he is a very good fellow, but he likes to 
drink," parents do not hesitate to say of their children of tender 
years. 

The Director of the Institution for Correction at Tsier, where 
prisoners are retained one-quarter in the House of Correction, and 



1871.] PUBLIC DOCUMENT— No. 37. 277 

three-quarters in jails, reports that of 1,091 prisoners for 1869, 
brought in to undergo punishment, 380, were punished for assault 
and battery, indecent exposure, destroying property, and as nuisan- 
ces in the street. Beer and brandy are not much drank ; on the 
contrary very much cheap wine, or cider called " tietz " is used, 
just as much intoxicating as any other intoxicating drink. 

Among the 70 prisoners in the House of Correction, there are 
found 51 criminals among old men, seventy to eighty years of age, 
punished for lewdness, many of them with small children. Even 
here the excessive use of intoxicating liquor can, with certainty, be 
regarded as the cause of this crime. 

Sie : — In response to your kind letter of the 14th of this month, 
I have the honor to say, that I am not in the position to furnish 
you with statistical notices on the question of " what influence does 
the use of intoxicating drinks have in the number of crimes in this 
district ? " There is no doubt, that the excessive use of spirituous 
drinks, particularly schnapps, in one word, drunkenness is the cause 
of the imprisonment of the greatest part of the inhabitants of the 
institutions for males in this place. 

A great number have by the excessive use of schnapps, been 
broken down morally, so far that they ignore entirely the duty im- 
posed by the Creator on every man, to earn his living by work, and 
they prefer rather to be beggars and vagabonds. 

Another part, among whom I count mechanics, are ruined in 
consequence of this vice, so far that they are no longer able to fulfil 
the moderate expectations of the trade. Such individuals are found 
regularly on the travel, but they do not have the will to accept 
work, but go about begging, to satisfy their appetite for drink. 
They succumb to the law. 

Again, there are others, who by excessive use of schnapps, are 
not able to perform even the lightest kind of work. Homeless, 
they are loafing about, and at last for want of support they are im- 
prisoned and punished. 

To this class also belong fathers of families, who do not use 
their daily wages for the support of their families, but spend them 
for schnapps, and let their fimiilies suffer. According to law they 
are subjects for imprisonment, and liable to be sentenced. 

I repeat that schnapps in most cases is the cause of vagabonds 
beggars, and being without homes. How much the vice of drunk- 
enness can captivate a man, in other words stick to him, can be proved 
by the fact, that most persons imprisoned here, have nothing else to 
do, as soon as they are set free, than to quickly find a rum-hole, and 



278 STATE BOARD OF HEALTH. [Jan. 

with a real rapacity fall upon this devilish drink, after having been 
deprived for months, and even years. 

I am convinced that a' great number of prisoners, if they have 
opportunity, would rather stretch out their hands for a glass of 
schnapps than a piece of coal. 

The above sad descriptions are not all based on exaggerations, 

but they rest on my many years' experience, and are an imperfect 

picture of the naked reality. 

With high esteem, yours, 

Muxler, Director. 
Brauweiler, May 25th, 1870. 

We declare ourselves ready to contribute in the future, as far as 
possible further explanations on this point of law, and of society, 
which makes our work so difficult. 

We sign with tbe highest esteem. The Committee of the 
Society of Prisons of Rhenish Westphalia, 

(Signed,) Scheffer. 

Dusseldorf, June 23d, 1870. 



Dublin, May 6, 1870. 
Dear Dr. Bowditch : — Your letter dated March 8, was duly 
received, and the very day it reached me I placed your questions in 
the hands of Mr. Russell, the agent of the Irish Permissive Bill 
Association, a man of great zeal and ability, and who is, I think, 
better qualified to answer your inquiries than any one else I know 
of. He travels extensively through the country, and is a person of 
great intelligence. He promised, and I believe intended to reply 
very soon ; but I suppose his numerous engagements prevented his 
doing so. I will keep him in mind, and will let you know as soon 

as I possibly can. 

Yours, with great regard, 

Richard D. Webb. 

The following is the reply of Mr. Russell, since received : — 

Query No. 1. — " What are the chief intoxicating articles used in 
Ireland?" Amongst the poor and middle classes, whiskey and 
porter. Amongst the rich, wines and brandy. 

It has been found of recent years that ether has been used to a 
very considerable extent in several northern towns, notably in 
Draperstown and Maghera. 

Query No. 2. — " What amount of crime is produced by them, 
and their effects on health and prosperity of the people ? " 



1871.] PUBLIC DOCUMENT— No. 37. 279 

In 1868, the last year for which I have "judicial statistics," 
76,000, men and women, were charged before the magistrates 
throughout the country on the ground of drunkenness, Dublin, 
with a population of 250,000, contributing 16,000. 

With the exception of the class of crime known as agrarian, near 
the whole crime of Ireland is due to drink. 

Testimonies on this Head. 
" The cases -which will come before you originated entirely in the indulgence 
of intoxicating drinks. If our poor people in this country were free from this 
vice, not a single case would come before you at these assizes. We have in 
Ireland less crime than in other countries ; but it would be still further 
diminished if the indulgence in intoxicating drink was completely stopped, or 
at least far less practised than at present." — Mr. Justice O'Hagan (now Lord- 
Chancellor') to grand jury at Monaghan, 1868. 

" Our experience leads us to the conclusion that all the crimes we meet 
with on circuit are more or less, directly or indirectly, caused by drunken- 
ness." — Mr. Justice Lanson to grand jury at Armagh, 1869. 

" I have been thirty years chairman of quarter sessions in several counties 
in Ireland. I have, perhaps, presided at more criminal trials than most men 
living, and I can truly say that I have had scarcely a case before me with 
reference to the class of offences known as against the person that was not the 
consequence of drunkenness." — Mr. M. O'Shaughnessy, Q. C, Chairman of 
Quarter Sessions, County Clare. 

The effects of drinking upon the prosperity of the people may be 
gauged by the following statistics. The consumption of drink has 
rather increased since 1865, but the figures given are all under the 
mark rather than above : — 

Consumption and Cost of Liquor in Ireland, 1865. 
Home-made sjmits retained for consumption (gallons), 5,036,814 

Foreign and Colonial, " 325,995 

Wines of all sorts, " 1,208,233 

Beer, (barrels), 1,538,209 

Cost. 

Home-made spirits, at 16s. per gallon, . . . £4,029,451 

Foreign and Colonial, at 20s. per gallon, . . . 325,995 

Wines, at 15s. per gallon, 906,174 

Beer, at 37s. per barrel, 2,840,137 



£8,102,757 



This expenditure, in proportion to the population, is greatly below 
that of either England or Scotland, but still it is enormous, being 



280 STATE BOARD OF HEALTH. [Jan. 

at the rate of £1 9s. for each individual, or nearly £7 10s. for each 
family in the country. 

It is £2,043,477 more than the value of the entire im- 
ports into Ireland, that being in 1865 .... £6,059,280 

It is £1,318,217 more than the total revenue of Ire- 
land, that being in 1865 6,784,540 

It is nearly five times as much as the total receipts 
of the railroad^ in Ireland, that being in 1865 . . 1,737,061 

It is nearly eight times as much as the whole county 
cess of Ireland, that being in 1865 .... 1,061,399 

It is more than ten times as great as the entire sum 
voted by parliament for primary education, that being 
in 1865 . . . * 336,770 

And were these added together, the whole receipt of the rail- 
ways, county cess, entire sums expended on poor relief and primary 
education, it would not amount to one-half of the sum expended on 
intoxicating liquors. 

Sum expended on intoxicating liquors, . . . £8,102,757 

Receipts of railroads, . £1,737,061 

Grand Jury cess, 1,061,399 

Poor rate, 731,851 

Education grant, .... 326,770 

3,857,081 



Balance, £4,545,676 

The poverty of the country is thus intensified by the drinking 
habits of the people. 

I am not in a position to say what the results are upon the health 
of the people generally. But medical men are clear in their testi- 
mony that a very large percentage of the disease brought under 
their notice arises from drink. T. W. Russell. 



Elsinore, Denmark, 3d May, 1870. 

Sir : — I have the honor to acknowledge the receipt of your circu- 
lar letter of the 23d February, making inquiries as to the influence 
of intoxicating drinks on the health and prosperity of the people of 
this country ; and in reply to the several questions contained there- 
in, I now beg to inform you. 

1st. That the principal intoxicating drinks used in this country by 
the middle and lower classes of the population are beer and spirits 



1871.] PUBLIC DOCUMENT— No. 37. 281 

distilled from barley and rye, under the denomination of corn bran- 
dy. Under this head, I give you the statistics of the quantities 
annually consumed, as far as I have been enabled to collect them. 
They are as follows : — 

Of home manufactured spirits (corn brandy), about 6,500,000 gallons. 

Imported spirits, 450,000 " 

Wines, 400,000 » 

Of the exact quantity of beer consumed, I am sorry to say I have 
not been able to obtain any correct and positive returns, no duties 
or excise being levied on this article. From the information which, 
however, I have been able to get from intelligent brewers and 
others, I think it can safely be put down as at least twenty gallons 
annually for each head of the population. The principal brewer in 
this town has given me the amount brewed here and sold for con- 
sumption by the population of this town and the neighboring land 
districts ; to say a population of about 12,000, and the quantity of 
beer sold about 275,000 gallons, and this would appear to confirm 
the calculation above mentioned of twenty gallons per head. 

It must, at the same time, be borne in mind that the great part 
of the beer consumed is very thin and weak, as the prices will show, 
beer being sold here at prices varying from one to four cents per 
bottle. 

Denmark has a population of about 1,600,000 inhabitants, which 
will give a consumption of about four and a half gallons of wines 
and spirits per head, and this added to the amount of beer con- 
sumed, will, in my opinion, give a heavy average amount of con- 
sumption as compared with other countries. 

Strange to say, this large annual consumption does not seem to 
have any injurious effects on the health of the people. The Danes 
are a remarkably strong and hardy race, and the average duration 
of life will bear a favorable comparison with any country in Europe 
and is certainly superior to that of the United States. There is 
much less energy of character to be observed amongst the people 
generally here as compared with us, but whether this is to be attrib- 
uted to effect of climate, or to the too great use of intoxicating 
drinks, I am not in a position to say. During my short stay in this 
country, I have been much struck with the general sluggishness 
and small amount of work obtained out of the laboring classes as 
compared with the same classes in the States, and I have been a fre- 
quent witness to the strange sights of ship carpenters, masons, house 
carpenters and other trades, knocking off in their work to take a 
drink out of their bottles of beer or spirits. 
36 



282 STATE BOARD OF HEALTH. [Jan. 

Cognizant as I have been of the large quantities of these drinks 
generally consumed here, I have been considerably surprised at the 
exceptional cases of intoxicated people I have seen, either in the 
streets of this town or in my frequent visits to Copenhagen, the 
capital of the country, and I have no hesitation in saying that I 
have "witnessed a much greater amount of intoxication in the towns 
in the United States than I have in this country. 

2d. As regards the amount of crime produced by the use of these 
drinks, I cannot find any statistical tables to supply me with such 
information, but I am told by the police magistrate of this town, 
that in his jurisdiction no cases of murder, homicide, or theft, that 
have ever been brought before him, could be traced to the influence 
of drink, and that even arrests for street disorders are very rare 
amongst the inhabitants, and chiefly confined to the foreign seamen 
frequenting the place. 

As far as my own personal observations go, the Danes seem to be 
a remarkably peaceable and orderly people. There is no rowdyism 
to be seen in the towns, and the very few intoxicated people I have 
seen in the streets, seem to stagger along without making any at- 
tempt to molest the passers by. The very low prices of these arti- 
cles in this country, say ten cents for a bottle of corn brandy, and 
one to two cents for a bottle of ordinary beer, accounts, doubtless, 
in a great measure for the small amount of poverty which might be 
expected from so large a consumption of intoxicating drinks. 
I have the honor to be, your most obedient servant, 

C. C. Sheats, IT. S. Consul. 



Consulate-General of the United States, ) 
Frankfort-on-the-Main, May 20, 1870. > 

Dear Sir : — I have the honor to acknowledge the receipt of your 
circular, dated February 23d, 1870, and now transmit a reply to 
the same. 

I incorporate herewith, as a part of this reply, a communication 
upon the subject made to me by the vice-consul, at this consulate, 
who has resided in this vicinity nearly the whole of a long life, and 
who is very competent in every respect, being himself a German, 
to give an accurate history of the uses of drinks in Germany. 

To your first inquiry : What are the chief intoxicating articles 
used in Frankfort and vicinity ? 

I answer, — wines, beer and cider. French brandies are used in 
very small quantities by some, but very rarely by native Germans. 
The qualities of wines used depend upon the rank, condition, means 



1871.] PUBLIC DOCUMENT— No. 37. 283 

and associations of the individual. The wealthiest classes use 
champagne in free quantities, sparkling Hock, the best Rhine wines, 
and the purest and richest Bordeaux wines. The middle classes 
use champagne and hock in small quantities, but generally drink 
light and cheap pure Rhine wines, and Bordeaux wines of a cheaper 
kind, and certain kinds of beer called "vien" and "Bairisch" beer. 
The poorer classes use a brandy made of potatoes, cheap and poor 
beer, costing about one-half as much as the beer known as " vien " 
or "Bairisch," and cider, all of which is drank very largely. Water 
is not much drank. To your second inquiry, " What amount of 
crime is produced by them ? and their effects on health and pros- 
perity of the people," I answer, that it is impossible to find any 
statistics of crime which go so far as to inform of the causes of 
crimes. Observation alone can enable any one to form an opinion 
of the proportion of crimes caused by the use of intoxicating drinks. 
I believe that but very little crime is committed in this part of 
Germany. There are few high crimes committed. An ordinary 
assault is very rare. Larceny is the most common offence. The 
surveillance of the police is searching and ever alert. People are 
restrained from the commission of crime by the fear of punishment, 
which is most certain to follow. Intoxication is very rare. During 
a residence of a year in Frankfort I have not seen more than five 
persons intoxicated. All of them were of the lowest order of 
laborers, and still not quarrelsome, but very hilarious and good- 
natured. I have seen no one stupidly drunk or as we say " dead 
drunk." I have seen no well-dressed person, nor any person claim- 
ing to be of a respectable condition or having any business or call- 
ing, whom I supposed to be under the influence of intoxicating 
liquor, in a noticeable degree. 

Either from climate, temperament, mode of life, habits, or from 
necessity, the German seems to be of a quiet charactei-. I can 
hardly say contented, nor happy, nor much more of a prosperous 
character. Originally, from the necessity of a common defence, 
they congregated into small, compact and ill-ventilated and badly 
planned and constructed villages ; and now from choice they con- 
tinue in the same old villages, instead of scattering along the lines 
of the highways ; and from them every morning sally out the men 
and women (and more women than men) to labor in the adjoining 
fields, or to work in the near cities, spending the day upon a pit- 
tance of bread, and return at night into their village at dark to 
enjoy the only meal of the day, and to spend their evenings in 
smoking and drinking their beer in crowds or cliques. 

The lot of the German laborer seems to be hard. He travels 



284 STATE BOARD OF HEALTH. [Jan. 

miles to his daily work, he works hard, he fares most scantily, he 
receives very small pay for his labor, he returns at night tired, worn, 
weary, and in his house he finds no comfort, and yet he does not 
resort to intoxication for a relief from pressing sorrow or despair. 
He rises again, eager to go through the same routine. He commits 
no crime. He thinks of no evil. He expects to labor, and looks to 
nothing more, and for nothing more. He seldom complains, what- 
ever may be his suffering. He receives but little, he subsists on 
little. His expectations are not great, and are cheaply and easily 
gratified. 

They seem to be healthy, both the men and women. The women 
will do as much labor in the field as the men, and perform the same 
labor as the men. 

I cannot say that the drinks now in common use add to or in any 
way contribute to the health and prosperity of the people of Ger- 
many. Neither can I say that the common drinks, such as beer 
and cider, seem to be injurious to the health. 

If some kind of drink, beyond water, is to be used, the milder, 
the weaker, and the purer the drink the better. If coffee can be 
made satisfactory, it would seem to be the best drink. And I 
believe that the common hourly use of it in Germany keeps out of 
use a mass of intoxicating drinks. 

I will add that the use of fancy mixed drinks is not known here. 
There is no standing at the bar to drink, and no bars to attract. 
You will thus see that the amount of intoxication in this country is 
much less than in the United States. I attribute the fact to the 
different kinds of intoxicating drinks in common use, and to the 
different ways in which those drinks are used. 

In the city of Frankfort, with a population of one hundred thou- 
sand persons, intoxication is rare. Crime is rare. The health of 
the people is good. As a whole the people are prosperous. The 
habits of the people contribute greatly, if they do not wholly pro- 
duce this state of things. 

I take the liberty to send to you herpwith certain statistical in- 
formation in the inclosed jDamphlet, which you may be able to pe- 
ruse. I can find no similar information in any other form. 
I have the honor to be, your obedient servant, 

W. Peentiss Webster, U. B. Consul- General. 

Statement of Vice-Consul. 
The chief intoxicating article used in Frankfort and vicinity is 
the common brandy distilled from potatoes. Twenty years ago the 
city and country were full of dram-shops, which, owing to the im- 



1871.] PUBLIC DOCUMENT— No. 37. 285 

provement of the beer and the introduction of coffee amongst the 
laboring class, have nearly entirely disappeared. At that time the 
out-door mechanic, such as carpenters, masons, and those employed 
in factories, who live out of town, had merely one warm meal, which 
was the supper. Their breakfast, dinner and vesper consisted then 
of brown rye-bread, some home-made cheese, and common brandy. 
The latter was then taken in large quantities, and they became 
gradually drunkards and ended in misery. 

The field laborers, men as well as women, employed upon the 
farms, come in the spring from the mountains, very sterile parts, 
where, during the winter, the men are employed as wood-cutters, 
and the women spin, and live mostly upon what they have earned 
during the summer as farm laborers. They receive there regular 
meals, dinner and supper, and generally two pounds of rye-bread, 
and a half bottle of common brandy. 

It has been in vain tried to give them, instead of the brandy, the 
money therefor ; but they prefer (men and women) to take their 
ration of brandy, which after awhile proves not to be sufficient for 
them, and they spend for more their hard-earned money. Most of 
the drunkards now seen consist of this class of people, whose 
winter habits in the mountains follow them to the fields and to the 
city. 

The middle classes of the people of this part of Germany drank 
heretofore, as a beverage, cider, principally in the evening, often to 
excess. As cider, drank in large quantities, produces generally 
sourness of the stomach, they added, in the belief of remedying 
this, a glass or more of brandy, and many became in that way 
drunkards. 

The better class, and all able to pay therefor, drank generally 
light wines, and there were but few drunkards among them. 

Such was the state twenty years ago. By the improvements in 
making better beer, things have been changed. The drunkards 
have disappeared. A great deal less of cider and wine is consumed. 
The people now generally drink beer. Many drink to excess even 
now. Intoxication has decreased. 

Now, owing to the fact that in the 'German army coffee in the 
morning has been introduced, the young men get accustomed 
thereto. At noon they now cook themselves coffee instead of 
drinking, as heretofore, brandy with their bread. They drink now 
also in the afternoon coffee or beer. So that now they consume 
little or no brandy. The field laborers, men as well as women, 
continue, however, to drink brandy, notwithstanding that in the 
morning on many farms they now receive coffee. 



286 STATE BOARD OF HEALTH. [Jan. 

The laws of Prussia do not allow intoxication as a plea in the 
defence for crimes. It is left to the judges to take accidental intoxi- 
cation into consideration. No statistics are therefore kept as to 
the causes of crime. Intoxication continually occurs, not habitual, 
and not causing crime ; hut it is more accidental, from over hilarity 
in drinking. 

It cannot be said that the general health of the people has suf- 
fered or suffers in this part of Germany. In the city of Frankfort, 
with a population of one hundred thousand persons and an average 
annual mortality of fifteen hundred persons, hardly an average of 
five persons have died of delirium tremens. 

As a general fact in Germany, in those parts where wine grows 
and where the chief beverage is beer, there, intoxication is less and 
has been decreasing. 

The contrary is the case where there are large distilleries, and 
more ardent spirits are consumed. 

It cannot be said that the prosperity of the people has suffered. 
If it has not increased in equal rate with other countries, it is more 
in consequence of the increased extravagance in the luxury of dress 
among the females, and the passion of hunting after pleasure. 
During the winter, not only all the beer-houses, but all other places 
of amusement are now filled. In summer, public gardens and 
excursion-trips and the amusements of the Sunday generally use up 
the earnings of the week. Very few of the common people lay up 
money. 

Florence, May 20, 1870. 

Sir : — I have received your circular of February 23, 1870, asking 
information in regard to the use and effects of intoxicating drinks 
in Italy, and I proceed to reply. 

The intoxicating drinks consumed in Italy are, — First. The 
native wines of the country, which are abundant and very various 
in quality. In general the Italian wines are not so light as those 
of western France, nor are they, though often excellent, so carefully 
or so skilfully prepared. As in other wine-producing countries, the 
wines designed for sale are largely adulterated, and the better 
qualities extensively counterfeited, so that pure wine is scarcely to 
be had except directly from the producers. As a general rule, 
Italian hotel keepers in the large towns furnish only such native 
wines as it is impossible to drink, in order to compel their customers 
to order foreign wines on which they make a larger profit, and of 
course travellers, who judge Italian wines by those they take at 
hotel tables, can form no just opinion of their quality. 



y 



1871.] PUBLIC DOCUMENT— No. 37. 287 

Secondly. Foreign wines, imported chiefly from France, and in 
smaller proportion from the valley of the Rhine, from Austria, in- 
cluding Hungary, from Spain, Portugal and Greece. The foreign 
wines are used principally by foreigners travelling or residing in 
Italy, but wealthy Italians consume a good deal of French wine, 
and the products of the Austrian and Hungarian vineyards, intro- 
duced into Venetia and Lombardy during the Austrian rule, have 
acquired a certain favor in those provinces, and are still imported 
and used by the inhabitants to a considerable extent. The native 
Lombard and Venetian wines are generally of inferior quality, and 
this circumstance also encourages the importation of those of 
northern growth in preference to the less carefully prepared wines 
of Southern Italy, to which the taste of the people of the newly 
acquired territory is not yet accustomed. 

Thirdly. Spirituous liquors, generally of inferior quality, distilled 
in the country, and a certain amount of French brandy, Holland 
gin, and American and Scotch whiskey and rum, a considerable 
part of all which is used as the basis of different liquors and cor- 
dials. The employment of distilled spirits as a beverage, except as 
an ingredient in cordials which are taken in very small quantities, 
and as a zest for coffee, is recent in Italy, and is due principally to 
the diminished quantity and increased price of wine, in consequence 
of the prevalence of the grape disease. 

Fourthly. The same cause has greatly increased the consumption 
of beer which is both manufactured in Italy, and imported from the 
German States. The malt liquors preferred by the Italians are 
mild, and as their table does not tempt them to excess in these 
beverages, it is perhaps hardly just to class such liquors among the 
intoxicating drinks consumed in Italy. 

I am not aware of the existence of any trustworthy statistical 
information in regard to the amount of crime produced by intoxicat- 
ing drinks in this country, but, if one can trust the police reports, 
the excitement of intoxication is the source of a by no means 
inconsiderable proportion of the offences which are brought to the 
notice of the public authorities. 

So far as my observation extends, I should judge that the 
breaches of the peace and other violences traceable directly to in- 
toxication, are much more frequently due to the use of ordinary 
distilled liquors and of absinthe and other like detestable mixtures, 
than to that of wine. 

Wine is used in Italy as a beverage for quenching thirst, or as an 
accompaniment of solid food, and but rarely for the sake of its 
action as an excitant. It is the habitual every-day drink of the 



288 STATE BOARD OF HEALTH. [Jan. 

people, from a very early age, and it does not, when taken in the 
moderate quantity which satisfies a common Italian appetite, seem 
to produce the same stimulating effect upon their constitutions as 
upon those of nations less accustomed to it. 

The educated and refined classes make very little use of distilled 
liquors, domestic or foreign, and they seldom indulge freely even 
in wine, though it is always within the reach of every one, except 
the poorest. Intoxication is therefore extremely rare among per- 
sons of even no more than average culture, and it scarcely occurs 
except among the badly fed, badly clothed and badly sheltered, who 
have too often become previously debased by indulgence in other 
vices. In short, intemperance is not so prevalent in Italy as to 
rank among the great social evils which force themselves upon the 
attention of the criminal legislator, the public economist and the 
philanthropist alike, and the subject has but little of that terrible 
importance which attaches to it in the United States and the 
British Empire. 

I have no doubt that this remark is equally applicable to most — 
I am sorry I cannot say all — wine-producing countries, and I am 
inclined to the opinion that an abundant supply of cheap, light 
wines would tend, in the long run, to diminish rather than increase 
intemperance in the United States. 

But this is a question upon which I cannot venture to pronounce 
confidently, without fuller information than I possess and more 
mature consideration than I have been able to bestow upon it. 
The climatic and other physical conditions of the United States, 
not to speak of long established habits among the people, are so 
different from those of European vine-growing countries, that we 
must use much circumspection in reasoning from one to the other. 
Aside from the mere gratification of the palate, the habit of smok- 
ing — for the Italian is guiltless of the filthiness of chewing — tobacco, 
is almost the only provocative of intemperance which is common 
to the people of the United States and those of Italy. Each 
country has its special temptations and incentives to this vice, but 
in Italy they are more easily resisted, the habit of indulgence in 
stimulants is more readily conquered, and there is no possibility 
of doubt that intemperance is both a vastly more common and a 
more destructive vice in the United States than in the European 
countries situated between the same parallels. 

From the effect of a cold winter climate and a more abundant sup- 
ply, the American consumes habitually a very much larger proportion 
of animal food than the inhabitant of Southern Europe, and this he 
seasons with a much greater quantity of salt and other thirst-excit- 



1871.] PUBLIC DOCUMENT— No. 37. 289 

ing condiments ; the frosty air, which he inhales with every breath 
for a large part of the year, smites his vitals with a chill which 
seems to demand a fiery fluid for its expulsion, and when the short 
season of agricultural toil returns, he uses more muscular effort, and 
that too during the hottest months of the year and the hottest 
hours of the day. These circumstances create in the American a 
chronic appetite for drink which is not easily assuaged by " thin 
potations," and he craves, if he does not actually need, beverages 
rather strongly accentuated in their appeals to the palate. 

It is certainly not»probable that persons long habituated to the 
use of distilled liquors would readily abandon them for the milder 
wines, or indeed for any fermented drink however generous, and 
cases would no doubt occur, where persons previously altogether 
abstemious would be seduced into excess by the temptation of a 
cheap and agreeable drink, the intoxicating properties of which 
might be as questionable, or at least as stoutly disputed as those of 
lager beer, but it is to be hoped that the use of fight wines, espec- 
ially at meals, would prevent the formation of habits of indulgence 
in stronger beverages by thousands who are now ruined in mind, 
body and estate by intemperance. 

I am, sir, respectfully yours, 

George P. Marsh. 



Fayax, Azores, 15th May, 1870. 

Sir : — Your favor of 23d February, via Lisbon, only reached me 
on the 28th ult. I regret that I cannot give you any information 
worthy of your notice, in regard to the very important and interest- 
ing subject on which you wrote. 

Until the almost entire destruction of the vines in 1855, compara- 
tively little spirit was consumed in these islands, the common wine 
of the country, which was freely used, costing only from eight (8) 
to ten (10) cents per gallon. At present, wine is quite expensive 
and rum has taken its place, but I cannot ;i say that there has been 
any marked increase of intoxication. These people, like all the 
Latin races, I believe, are far more temperate than the Anglo- 
Saxons, and there is very much less intoxication here than in the 
United States. No statistics are to be had of the amount of in- 
toxication and crime resulting therefrom, but the islanders (of the 
westernmost islands especially) are a quiet, inoffensive people and 
crime is very rare. I sincerely wish that I could have been the 
means of throwing more fight on the important inquiries you are 
making, and remain, Yours respectfully, 

37 John P. Dabney. 



290 STATE BOARD OF HEALTH. [Jan. 

Geneva, May 2, 1870. 

Dear Sir : — In reply to your questions, 1st, what are the chief 
intoxicating drinks used in Geneva and vicinity ? and, 2d, what 
amount of crime is produced by them and their effects on health 
and prosperity of the people ? 

I answer to the 1st, the most deleterious intoxicating drink used 
here is absinthe, which is a strong and generally mean eau-de-vie 
flavored with wormwood (not brandy, for this is called cognac or 
champagne Jin), made of the must of poor grapes, or perhaps ot 
potatoes, and paralleled in our country by that, pine-top whiskey or 
apple brandy, which " are warranted to kill at forty rods ; " next to 
this is a mean white wine, which taken in excess, destroys the 
digestive organs. If, which is rare, one of the better class of men 
is given over to the disease of intemperance his career is generally 
ended with absinthe. For the poor, the destroyer of health and 
promoter of quarrels is the aforesaid white wine. 

An experience of several years has satisfied me that there is far 
less intoxication, and crime as its resultant, among the Swiss than 
with us. A stranger would be deceived as to this by noting the 
multitude of cafes, which answer to our saloons or restaurants, and 
the crowds which frequent them ; but an attentive observer will 
note that rarely is any one seen to leave the better class of cafes 
the worse for what he has drank — which is coffee or beer or wine 
or a small cordial glass of brandy with a lump of sugar — but he 
will also be surprised to find so much quiet in a large crowd when 
there are persons engaged with newspapers or playing chess or cards 
or billiards, or in earnest conversation around tables where half a 
dozen may gather, and all furnished with the means of exhilaration. 
The truth is wine, vin ordinaire, or the wine of the country (known 
among us as claret) is the daily drink of every family whose circum- 
stances will permit it, and this includes all but the very poor. This 
wine is less exhilarating than our cider and more healthy, and to 
this, and the quiet lives of the people, may be attributed the ab- 
sence of drunkenness, for it is not common to see a staggering 
drunkard in the streets here. 

I have never seen any statistics of crime in Switzerland. 
The prosperity of this people would be increased by a diminution 
of the number of cafes where they waste their time rather than 
their health. 

Very respectfully, your obedient servant, 

Chas. H. Upton, U. S. Consul. 



.871.] PUBLIC DOCUMENT— No. 37. 291 

Leipsic, May 4, 1870. 

Dear Sir : — Your favor of February 23, making inquiries con- 
cerning the chief intoxicating articles used in Leipsic, and the 
amount of crimes produced by them, has been received. In reply I 
have the honor to give you a few, only approximately correct, 
statistics relative to these inquiries. 

The chief intoxicating articles used in Leipsic, are beer and wine. 
Comparatively little whiskey or rum is consumed as beverages. 
Among a population of about 95,000 inhabitants (independent of 
the large floating population during the three annual fairs), there 
are annually consumed in Leipsic about 400,000 gallons of beer and 
150,000 gallons of wine. 

The number of arrests made by the police during the month of 
April was 506, of which number were 42 for drunkenness. This, 
according to my recollection, is a fair average of the arrests made 
during every month of the year, so that among the annual arrests of 
6,072 persons, 504, or nearly eight per cent, of those arrested, 
are arrested for drunkenness, or a little more than one-half per cent, 
of the entire population. That drunkenness occurs unknown to the 
police I freely admit, but, I believe, so far as my observation goes, 
not half as much as in American cities of a like f number of inhabi- 
tants. 

As to what amount of crime is produced by the use of beer and 
wine I have no data according to which I might make my calcula- 
tions. But so far as the publicity of these crimes is concerned 
the percentage, according to my observation, is comparatively small. 

As to the influence of these drinks upon the health and prosperity 
of the people I have no means of judging excej:>t my own observa- 
tion. I cannot say that either my own observation or the opinion 
of physicians teaches me that a moderate use of these drinks acts in 
a deteriorating manner upon the health of the public ; for, according 
to the testimony of physicians, the general health of the public is 
good. Of course there are always exceptions, and perhaps many. 

As to the influence of these drinks upon the prosperity of the pub- 
lic I have no data except my own observation. Considering, first, 
the comparatively low wages of the laboring classes ; and, second, 
the universal practice of smoking cigars, independent of, and during, 
the drinking of these beverages, I cannot but believe that both 
these practices consume a comparatively large amount of the weekly 
wages of the laboring classes, thus reducing their home comforts to 
the lowest possible degree, and producing in many cases an actual 
want of the necessaries of life. 

I have given you, without fear or favor my opinion, based upon 



292 STATE BOARD OF HEALTH. [Jan. 

my observation, concerning the amount and influence of intoxicating 
drinks consumed in Leipsic. Of course in some particulars I may- 
be, for ought I know, wrong. 

Very respectfully yours, 

M. J. Cramer, U. S. Consul. 



United States Consulate, Tower Building, South Water St., ) 

Liverpool, June 13, 1870. > 

Gentlemen : — Your letter making inquiry about the influence of 
intoxicating drinks upon the people of Liverpool and England was 
duly received. Not having the requisite information myself to 
make a correct and proper report upon the subject, or the time to 
spare from my official duties to obtain the facts, I referred your let- 
ter to an esteemed friend, not only competent but reliable, to obtain 
them for me. I now have much pleasure in enclosing to you Mr. 
Patterson's report. His knowledge of the subject and his charac- 
ter and standing as a man are a sufficient guarantee for what he 
says, and if more were necessary I might add that my residence for 
more than eight years in the country confirms me in the belief that 
he has not in the least overstated or exaggerated the truth. 
I am, sir, very respectfully, your obedient servant, 

Thomas H. Dudley. 

Liverpool, May 27, 1870. 
Thomas H. Dudley, Esq., U. 8. Consulate, Liverpool. 

My Dear Sir : — In acknowledging receipt of your note and re- 
plying to your inquiry as to the influence of intoxicating drinks 
upon the well-being of our population, I have judged it advisable to 
accompany my remarks by two documents, bearing upon the ques- 
tion in its moral and physical aspects. 

The first is the report and abstract of evidence upon intemperance 
of a committee of convocation of the province of Canterbury, being 
the highest ecclesiastical authority of the Established Church, and 
they, after an exhaustive examination, concur with the opinions 
heretofore expressed by Presbyterians, Methodists, Baptists and 
others as regards the evils inflicted upon the people by the excessive 
use or abuse of intoxicating drinks, whilst they attribute the prev- 
alence of this vicious abuse largely to the facilities for obtaining the 
same, and that, in the cases where landed proprietors have prevented 
the opening of drinking-houses upon their property, great blessings 
have resulted in the peace and sobriety of such parishes. 

The second document is one of a more local character. The coin- 



1871.] PUBLIC DOCUMENT— No. 37. 293 

cidence of an excessive death-rate in Liverpool with an increase of 
public-houses led to much discussion, and the policy of the magis- 
trates in opening the trade to all comers with suitable houses against 
whom no bad characters could be proven was impeached, not be- 
cause it shut the door against favoritism, which was a good thing 
but because its (impartial) operation added to the numbers of a trade 
already excessive in the town. This led the town council to an ex- 
amination, and I may remark that so far as I know no teetotaller 
had a place, as none has at present, upon the magisterial bench or 
the town council, whilst upon the latter body the liquor traffic has a 
powerful representation, and a brewer and owner of a large number 
of public-houses was a member of the sub-committee of the health 
committee of the town council, appointed to inquire into the mor- 
tality of the town. Their report, page ix, assigns to intemperance 
the foremost place as a cause of increased death-rate, and in my 
humble opinion rightly. 

There is a topic upon which I am, perhaps, not competent to en- 
large, nor can I readily refer to printed evidence beyond margin, 
but which I would venture to indicate as deserving of attention, 
namely, the increase of drunkenness amongst women. Our re- 
spected stipendiary (police) magistrate has, in my hearing, remarked 
upon it as one of the saddest features of our black record in Liver- 
pool. It can hardly be doubted that the increase of beer-houses 
has, by carrying drink to nearly every corner, largely contributed 
thereto. 

Another point deserving more investigation than I can give to it 
is how far incautious alcoholic medication may contribute to the in- 
crease and perpetuation of drunkenness. It is only by the medical 
profession such can be explored and remedied, but there is a grow- 
ing feeling amongst social reformers (in which I share) that not only 
are nurses and other officials in our hospitals, &c, exposed to de- 
moralization from the quantities of alcoholic drinks passing through 
their hands or under their care for supposed medical uses, but that 
in many cases a taste for the article may be formed or (more 
frequently) revived by the administration of liquor in a palatable 
form, and, however Valuable as a medicine, it appears needful that 
more care should be taken in its exhibition. The remedies sug- 
gested for the cure of existing evils are mainly upon the one hand 
moral suasion and temperance pledges, which are much relied upon 
by some teetotallers, whilst others go for legislative restrictions 
upon the traffic. Upon this persuasive or pledge aspect of the case 
it may be remarked that whilst most indisputably great good has 
been done by teetotallers both in the prevention and cure of drunk- 



294 STATE BOARD OF HEALTH. [Jan. 

enness, and especially by preventing the use of drink amongst the 
young, thus guarding against the habit, multitudes who have signed 
pledges do not now abstain, and it is doubtful if much over ten per 
cent, of our adult population are abstainers from choice continuously. 
Whilst trade and social usages still make drinking alcoholic liquors 
an institution, no party or organization has yet adopted (here) the 
Maine liquor platform, but the United Kingdom Alliance proposes 
to give to parishes and municipalities (by imperial legislation) 
powers to prohibit the common sale of intoxicating drinks upon 
the vote of two-thirds of the rate-payers to that effect. 

Another organization exists for the suppression of Sunday trading 
and another for restriction and regulation of hours, &c, of public 
houses, whilst another section of reformers (who are not yet an or- 
ganization) suggest that legislation either imperial or permissible to 
localities should close drinking houses, but not prevent the im- 
portation, manufacture, or sale of drink " not to be consumed upon 
the premises," leaving all persons at liberty to buy and consume at 
their own houses. This latter would probably involve the recogni- 
tion of hotels as the temporary homes of bona fide travellers and 
permit sale of drink in them to their lodgers. To this latter section 
of opinion Dr. Temple, Bishop of Exeter, has given the weight of 
his experienced judgment. 

The non-abstaining reformers indicate mainly two agencies, one, 
the competition of scientific pursuits and amusements upon the 
Lord's Day with the open public-house, but it is justly responded 
that the people who drink evidence no such predilection for 
museums, scientific lectures, &c, as to make the experiment hope- 
ful, whilst its friends do not evince much confidence in its success 
or they would provide such gratis, as is done by professors of Chris- 
tianity who hire lecture- halls, theatres, &c, for the preaching of the 
Gospel without money and without price. 

The scientific demand, not a very loud one however, being that 
public servants in museums, libraries, &c, who are paid for six days' 
work should labor seven. The only legal obstacle, so far as known 
to me, being that as no charge can be made for admission on the 
Lord's Day to lectures or concerts they cannot be made self-sup- 
porting. That amusements would check drunkenness is a theory 
somewhat insisted upon, but as to which few, if any, proofs are 
alleged. 

The sheet-anchor, however, of social reformers who are opposed 
to repressive legislation is education ; educate the people, say they, 
and they will not drink. But at the threshold practical men meet 
this by denying that it can be done. Twenty thousand street Arabs 



1871.] PUBLIC DOCUMENT— No. 37. 295 

need education in Liverpool, but they need food first ; as they are 
the children of drinking parents they must beg or steal, sell matches 
or in some inscrutable way get bread ; shut them up in schools and 
educate them ; £40,000 per annum will do this ; but to feed them, 
and feed you must, if the parents go on drinking, £200,000 more is 
needful. Besides it by no means follows that in the next ten years 
your 20,000 will fall to 10,000 needing sustentation. It is more 
probable it will increase to 40,000, as, if the drunkards' children are 
fed and educated at the public cost, an increase may be expected to 
follow from natural law. 

I have endeavored to place before you facts and theories, well 
knowing that the intelligent persons for whom you seek the infor- 
mation are well able to sift, and I hope in due time to be favored 
with a sight of the results of their inquiries. 

Some extended knowledge of the people of this United Kingdom 
and short visits to our great colonies upon the St. Lawrence, Hud- 
son, Delaware, Chesapeake, Ohio and Mississippi, as well as " the 
Hub" itself, have impressed'me with the idea that our Great Family 
have a mighty part to play in the world's history, but that if the 
Anglo-Saxon race is to lose its primacy amongst the nations it will 
be from the miry clay of drunkenness destroying the cohesion of its 
iron nature, and whenever the stone may strike the right foot in 
England or the left in America it will be the just judgment of the 
mighty Ruler amongst the nations, who is even now warning us un- 
mistakably to set our houses in order if we would retain the high 
place he has given our ocean-parted yet heart-joined nation in the 
midst of the earth, for England and America are one in origin and 
destiny. I remain, my dear sir, yours faithfully, 

John Patterson. 

P. S. — Adulteration is alleged upon most respectable authority to 
be chargeable with much of the deadly effects of drink, but I am 
not aware of any facts disclosed upon coroners' inquests or elsewhere 
which indicate that one person out of each hundred " slain by 
drink " was poisoned by any substance other than alcohol. J. P. 

London, 21st April, 1870. 

Dear Sib: — Your letter of 23d February last, requesting on 
behalf of the State Board of Health of Massachusetts information in 
regard to the influence of intoxicating drinks on national health 
and prosperity, was received a few days ago. 

You propound two questions : 1st, "What are the chief intoxi- 
cating articles used in England?" In reply, I have to say that 



296 STATE BOARD OF HEALTH. [Jan. 

the Board of Trade returns show that for the year 1869 there were 
bought in Great Britain for home consumption, — 

Of foreign wine, 15,151,741 gallons. 

Of home and foreign spirits, .... 29,407,499 " 
Of ale and beer, 896,533,056 « 

You ask, secondly, as to the amount of crime produced by them, 
and their effects on the health and prosperity of the people, with 
which question is coupled another as to the relative amount of 
intoxication in Great Britain and the United States. 

You will pardon me if I do not attempt to give any answer to 
these inquiries. 

The subject is too vast and too grave for me to treat of it super- 
ficially, and I have not the time, consistently with my attention to 
absorbing official business, to make investigations which would be 
of value to you. 

I enclose two pamphlets, which seem to me to contain consider- 
able and interesting information on the subject of temperance, 
although they have an unpretending appearance. 

It will give me pleasure also to send you such other statistics or 
official information as I can find. 

I am, very respectfully, yours, 

John Lotheop Motley. 



United States Consulate, Malta, 13th May, 1870. 

Dear Sib : — In reply to your circular letter, dated 23d February, 
1870, I have to say: — 

1st. The chief "intoxicating articles" used in Malta are, for the 
native population, a common white wine imported from Marsala, 
Sicily, and a common red wine from Riposto di Mascali, Sicily, sold 
at three to three and a half pence per quart bottle. 

The lower orders use also a common brandy from Sicily, fre- 
quently mixed with anise-seed. 

The better classes use the principal wines of Europe, chiefly the 
red and white French wines, Madeira, Marsala, port and sherry, 
besides a sort of stomachic, which I hear is coming into favor, com- 
pounded of spirits, Peruvian bark and cloves or cinnamon. No 
wine is made in the island, and, I believe, no spirits. 

As for the foreign population, which is almost exclusively Eng- 
lish, their habits here are precisely what they are in all other parts 
of the world. They eschew the lighter wines, and drink beer of all 



1871.] PUBLIC DOCUMENT— No. 37. 297 

brands (English), heavy wines (sherry, port, Madeira and Marsala) 
and spirits. 

2d. In the absence of any government bureau of statistics, I 
cannot accurately give the amount of crime due to drunkenness or 
effects on health and prosperity of the people. Among the soldiers 
and sailors — from five to six thousand — there is the usual amount 
of drunkenness to be found in a great garrison town. One of the 
chief surgeons of the fleet tells me there is more pulmonary disease 
among seamen here than at any other station in the British service, 
but he does not account for it. 

The native population is certainly very temperate. The amount 
of drunkenness to be seen here is as nothing compared with what 
is seen in the United States. Yet I am told there is a manifest 
deterioration within the memory of obseiwers — more intemperance 
and more disease or debility than a generation ago. I think it is 
due to the presence and example of the garrison. 

Respectfully, your obedient servant, 

Ltell T. Adams, TJ. S. Consul. 



Manchester, May 19, 1870. 
Dear Sir : — I have this day forwarded to you through the State 
Department an answer to your letter of 23d of February last making 
inquiries in regard to alcoholic drinks in this country. 
I also send a report of the Committee of Convocation. 
If your letter was mailed oh the day of date, it must have been 
detained a long timeon the way. 

I am, respectfully, yours, 

C. H. Branscombe, V. S. Consul. 

United States Consulate, Manchester, May 19, 1870. 

Sir : — In reply to your letter of inquiry dated February 23d, 1870, 
I have the pleasure to give the information attached, the result of 
investigations pursued by me personally, and by English friends 
with whom I have put myself into communication upon the ques- 
tions referred to. 

1. The principal intoxicating liquors used in England are gin, 
brandy, beer, wine and cider. The wine is chiefly imported, 
though varieties of " British wines," made from currants, &c, mixed 
with distilled spirits, are manufactured and sold. Among spirits, 
gin is chiefly used by the poorer classes and brandy by the richer ; 
beer (including ales of every kind) is most largely used by all 
classes ; wine is used by the wealthier, though cheap and highly 
38 



298 



STATE BOARD OF HEALTH. 



[Jan. 



adulterated sorts are also in extensive use among the middle 
classes ; cider and perry are mostly confined to some of the agricul- 
tural counties of the west and south. 

In Scotland and Ireland the principal alcoholic liquor used is 
whiskey, though wine and beer are also consumed to a considerable 
extent. Since the reduction of the duty on brandy, this liquor is 
competing more than formerly with home-made spirits. 

Rum is chiefly used by the middle and lower orders of the three 
kingdoms. Professor Levi estimated that, taking the proof spirit in 
each kind of intoxicating drink consumed in each kingdom, the 
consumption of proof spirit in 1866 per head was as follows : — 



PROOF SPIRITS USED. 


England. 
Imperial Gallon. 


Scotland. 
Imperial Gallon. 


Ireland. 
Imperial Gallon. 


In Gin and Whiskey, . 
In Brandy, Rum, &c, 
In Beer and Ale, 

In Wine, 

In Cider and Perry, . 


0.536 
0.328 • 
3393 
0.159 
0.021 


1.659 
0.188 
1.050 
0.087 


0.800 
057 
0.710 
0.064 




4.437 


2.984 


1.631 



(English proof spirit is about one-half alcohol and one-half water, 
or exactly by volume, alcohol .57, water .43 ; by weight, alcohol 
49.24, water 50.76.) Thus the annual consumption of alcohol in 
England, chiefly in the form of beer, is two gallons and a gill, in 
Scotland one gallon and nearly a half, in Ireland rather more than 
four-fifths of a gallon. There is, however, no means of accurately 
estimating the quantity of beer and wine used in each kingdom 
distinctively, the estimate of the population of Ireland in 1866 being 
more uncertain than for that of either England or Scotland. 

2. All the law, judicial, police and other authorities in this 
country concur that a very large proportion of the crime and 
poverty, sickness and premature death, is caused by the drinking 
habits of the people ; and not merely by the grosser forms of intoxi- 
cation which too visibly prevail. Of crime, it is considered that 
two-thirds, and of poverty three-fourths, arise directly or indirectly 
from the use of alcoholic liquors. Much valuable information on 
this subject is contained in the report of the Committee of Con- 
vocation appointed to inquire into the extent and action of intem- 
perance, a copy of which accompanies the present letter. 

Here, as in the United States, the drinking customs render much 



1871.] PUBLIC DOCUMENT— No. 37. 299 

crime possible which else would be impossible ; they also prompt 
and excite to criminal offences of all kinds ; they bring great num- 
bers into a condition where they readily become subject to criminal 
attacks; and they plunge vast masses into a low and degraded 
social state, from which the transition into crime becomes easy, 
rapid, and humanly speaking, in the case of multitudes well nigh 
inevitable. The statistics of drunkenness give no proper conception 
of the extent of that vice ; for, unless incapable or violent, intoxi- 
cated persons are seldom "arrested, and the process of manufacturing 
sober men and women into drunkards goes on with steady regu- 
larity in the drinking shops of all classes without any practical 
hindrance from the administration of the law. So long as very 
flagrant and repeated disorder is avoided, the publican or beer- 
seller is sure to remain in undisturbed possession of the license 
when once granted ; and even where police charges are made and 
convictions ensue, a reprimand or warning is usually all that is 
administered at the annual licensing day. 

Upon health, life and commercial prosperity, the drinking cus- 
toms act very injuriously, and not least when the signs of external 
excess are absent. The great quantities of beer drunk in England 
slowly but certainly sajj constitutional vigor, and, according to high 
medical testimony, there is no form of disease which does not find 
food and fuel in the vital degeneration brought about, even where 
there is a complaisant confidence in the innocuousness of so-called 
"moderation." 

The inquests in England and Wales (inquests are not held in 
Scotland and Ireland) in the year ending September 29th, 1868, 
were 24,774, and every coroner confesses that, besides the number 
of cases in which excessive drinking is distinctly named as the direct 
cause of death, a very large proportion of the other cases springs, 
either from the physical effect of intemperate or tippling habits from 
the congenital disease, or from the destitution or recklessness con- 
nected with the drinking habits of fathers and mothers. 

The commercial interests of the country suffer sadly by the pov- 
erty and pauperism, created by the idle and irregular habits thus 
induced, by the loss of skill and vigor attending alcoholic indul- 
gence, and by the enormous expenditure of money on the purchase of 
intoxicating liquors, amounting to a hundred million sterling, besides 
the waste of grain, capital and labor, in the production of such 
drinks, and above all, of the labor force wasted in the excitement of 
drinking. 

3. Comparing certain towns in the two countries most nearly 
alike, as Liverpool and New York, Bradford and Cleveland, Bristol 



300 STATE BOARD OF HEALTH. [Jan. 

and Boston, and certain corresponding classes, such as the com- 
mercial, the fast and the fashionable, one does not see much differ- 
ence as to the prevalence and results of drinking. The disorder, 
degradation, pauperism, prostitution, lunacy and crime are in both 
appalling. But on the other hand, looking at the moral and religious 
classes in the smaller towns and villages of the two countries, com- 
paring the social and domestic usages of the respectable classes of 
our New England States, or of Pennsylvania and of Ohio, with the 
corresponding classes and communities of England, there can be no 
doubt that the balance of sobriety is very greatly in favor of the 
former, and more particularly of Connecticut, Rhode Island, New 
Hampshire, Vermont, Massachusetts and Maine. 

In this country there are hundreds of villages, some large districts 
and several little towns, from which the liquor traffic has been ban- 
ished by magisterial and proprietorial power with the most gratify- 
ing results. Crime has ceased, pauperism has almost vanished, lun- 
acy has disappeared, and industrial and moral progress has been 
made. These facts seem to have taken hold of the hearts and 
thoughts of the people, and some years ago an agitation (under the 
direction of the United Kingdom Alliance for the Suppression of the 
Liquor Traffic) was commenced, which has risen into great political 
influence. Its parliamentary leader, Sir Wilfred Lawson, Baronet, 
M. P. for Carlisle, supported by Sir Thomas Bazley, Baronet, M. P. 
for Manchester, is about to introduce for the third time, his Per- 
missive Bill into the House of Commons, which proposes to give to 
all the rate-payers and owners of property the power to veto the 
common sale of intoxicating liquors within their parish or district. 
The second reading of this bill is fixed for the 13th July next. 
Eight hundred theusand persons petitioned for the passing of the 
bill last year, and 94 members voted for it, representing a constit- 
uency of 7,000,000. 

I remain, yours, very respectfully, 

C. H. Branscombe, 

United States Consul, Manchester. 



United States Consulate, Odessa, Russia, ) 

May 4, 1870. ) 

Dear Sir : — In reply to the questions placed in your favor of 
February 23d, — 

The chief intoxicating article used here is " vodka," or in plain 
English, whiskey. It is made and sold under the direction of the 
government. It is prepared in different forms, — that is, clear and 



1871.] PUBLIC DOCUMENT— No. 37. 301 

pure; clear and sweetened; colored (in tempting colors), such as 
green, red, yellow, rose ; and also flavored with different spices and 
herbs. It is sold, I am told, in something like two thousand 
" licensed horrors " in this city, and at every little village and sta- 
tion all through the country, at the very moderate price of about 
three to five cents a gill. This is the strong drink of the common 
people (as they are called), emancipated serfs, laborers, soldiers and 
their females, who frequently outdo their husbands and brothers. 

Wine is made (red and white) in large quantities in the Crimea, 
in Bessarabia, and in the different German villages (of which there 
are many in the south of Russia), and to some extent in the Russian 
villages. Quantities of it are brought into this place in large casks 
(of two hundred gallons) in the autumn, and sold (the pure unfer- 
mented juice) for, say, twenty to fifty cents a gallon, and afterwards 
retailed out at higher prices, say, twenty to fifty cents a bottle. 
Excellent brandy is distilled in some places from the wine of this 
country. Beer and ale are also made here. Besides this, all kinds 
of liquors, winesj cordials, beer, porter, are imported from other 
countries and sold without restriction except the duties and tax for 
license. These articles are mostly used by the different strata of 
society above the " common people " or peasantry. 

It is the custom, very general with these classes, to have wine at 
least for dinner (frequently for breakfast also, at ten, eleven or 
twelve o'clock), and very often they begin with a small glass of raw 
brandy or other spirit. 

There are wine tipplers and jolly parties who drink wine and beer 
(perhaps even spirits) at all hours of the day and night, but such 
persons are, for the most part, idlers and shiftless persons or young 
rowdies, the custom being to drink little at other times than break- 
fast and dinner. It is rarely seen, a drunken person of the classes 
last mentioned. 

You may meet them, often enough a little hazy after dinner, and 
often enough their appearance indicates free living, but seldom are 
they to be seen past perfect self-control. 

Those who drink " vodka," on the contrary, are often to be seen 
staggering about (men and women), or lying in some corner insen- 
sible. This is much more often the case on Sundays and holidays, 
of which latter the number is very great in Russia. 

There are no statistics as to the amount of crime chargeable to 
intoxicating or exciting drinks, but from my own observation, I 
should say at least three-fourths of all. They are, without doubt, a 
great plague and drawback to material and moral progress in this 
country. The effects of all such exciting chinks are, in my opinion, 



302 STATE BOARD OF HEALTH. [Jan. 

prejudicial to the health, happiness and prosperity oi those who hab- 
itually use them, and, generally in proportion to the freedom with 
which they are used. 

The moderate and immoderate drinkers, if they be habitual, are 
all sufferers, and visibly sufferers in these three respects. My own 
belief is, whiskey, rum, gin, brandy, wine, beer, ale, porter, — all bad, 
and the stronger the worse. 

I might add coffee, tea, tobacco and all unnatural excitants of the 
nervous, muscular and circulatory systems. 
Yery respectfully, yours, 

Timothy C. Smith. 



Teneriefe, July 15th, 1870. 
Dear Sir : — A very long time has elapsed since the receipt of 
your favor of February 23d, making some inquiries respecting the 
use and abuse of intoxicating drinks in this island, the reason for 
which has been, that there being no statistics on the subject, I asked 
one of the principal physicians to give me his and some of his col- 
leagues' opinions on the subject, which he promised to do ; but 
Spanish like, this was put off from day to day, until at last he sud- 
denly embarked for Spain, but promising to be back in a month, I 
still waited for him. On his return he again renewed his promise, 
but nearly a month having elapsed without his reply being received, 
I have resolved not to wait any longer, but to address you now in 
answer myself, and whenever his opinion is received, I shall send it 
to you. 

Your first question is, what is the chief intoxicating drink used in 
these islands? Up to 1845 this was eminently a wine-producing 
country, this island alone having produced as much as 25,000 pipes. 
The oidium having destroyed the vines about that time, the drinks 
substituted have been the rum of West Indies, and gin of England 
and Holland. You are of course aware that in wine-producing 
countries intoxication is rare, and this was the case here while only 
wine was drank ; since then the vice has increased, but not to any 
considerable degree, although I should say that the use of alcoholic 
drinks has told upon the health and shortened the lives of many, and 
perhaps caused some crimes. 

I should say that there was far less intoxication here, among a 

given number, than in the United States, owing to the Spaniards 

being an abstemious people generally, and I don't know where you 

can find a soberer class of people than the peasants of these islands. 

I remain, your most obedient, 

Wm, H. Dabney. 



1871.] PUBLIC DOCUMENT— No. 37. 303 

United States Legation, Vienna, > 
June 17th, 1870. ) 

Sir : — In reply to your circular note, dated February 23d (but 
wbich did not reach rne until a much later date), asking for advice 
touching the intoxicating drinks used in Austria, and their effect 
upon the health, prosperity and morals of the people, I beg to say 
that I have delayed my response, in the hope of procuring some reli- 
able information, which I have not yet received. 

Upon the receipt of your letter, I requested Mr. Delaplaine, the 
Secretary of Legation at this post, who has lived in Vienna some 
sixteen years, and has a large circle of acquaintance, to apply to such 
gentlemen as he thought might be able and willing to answer your 
questions. 

Most of those to whom he applied seemed unable or unwilling to 
give their assistance, [but Dr. Adolph Ficker, one of the Court 
Counsellors, and a Director of the Administrative Statistical Bureau, 
obligingly promised to examine the matter carefully, and report in 
writing, with statistics of the amount of alcoholic and other liquors 
consumed in the empire. As the promise was given several weeks 
since, Dr. Ficker's report has been for some time expected at the 
Legation, but it has not yet been^received. I have also made a re- 
quest at the Foreign Office for such information as may be gathered 
in the Bureau of Statistics, and I am in hopes of being soon able to 
send you, in part at least, satisfactory answers to your questions. 

In view of the short time that I have been in Vienna, and of my 
very limited opportunities of ^observation in the provinces, I am 
sensible that my opinion (for which you are pleased to ask) upon a 
question so properly soluble]by statistics, and by a comparison of the 
opinions of many experts, can be of little practical value. 

I am advised by those in whose judgment I have confidence, that 
the chief intoxicating drinks in Austria are beer and wine, and that 
but comparatively a small amount of spirituous liquors is consumed, 
excepting in Gallicia ; that the relative consumption of wine by 
the people is diminishing, and that that of beer is increasing ; that 
the beer in general use is of a light kind, requiring the consumption 
of a large amount either to stupefy or to intoxicate; and that the 
influence of intoxicating drinks in Austria in producing crime is less 
marked than in our own country, and in England. 

Touching " the relative amount of intoxication in the country 
where I am residing and that seen in the United States," I may say 
that I have seen more intoxicated persons in the streets of New 
York in one day than I have chanced to see in Vienna during the 
past year. I am sir, very respectfully yours, 

John Jay. 



304 STATE BOARD OF HEALTH. [Jan. 

[Translation.] 
Report from Statistical Central Bureau op Austria, trans- 
mitted THROUGH THE I. R. MINISTER OP FOREIGN OfPICE TO 

Mr. Jay. 

Consul option of spirituous liquors in Austria-Hungary. 
The use of spirituous beverages in the Austro-Hungarian mon- 
archy can only with approximate exactness be determined from the 
annual production, and with proper consideration of the transfer 
in way of trade. We here present estimates of the following 
quantities for the whole monarchy during the last five years : — 



1871.] 



PUBLIC DOCUMENT— No. 37. 



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1871.] PUBLIC DOCUMENT— No. 37. 307 

If there be adopted, pursuant to the official trade valuation during 
several years, an eimer beer at five florins, an eimer wine at eight 
florins, and an eimer brandy at twenty-three florins, the result is, 
by an estimate of thirty-five millions of population, an average 
annual expenditure for each individual of four florins twenty-six 
kreuzers for wine, one florin twenty-nine kreuzers for beer, and one 
florin sixty-seven kreuzers for brandy, whereby each would expend 
annually seven florins eighty-five kreuzers for spirituous beverages. 

This consumption must be held as being extraordinarily greater if 
it be contrasted with the use of other products, in the quantity of 
which a graduated rule for the social development may be found. 

So, for example, it is ascertained that out of the annual quantity 
of cast-iron and wrought-iron products and steel in Austria and 
Hungary, 3,560,000 centner in weight ai'e required for the use of 
the agricultural economy. A centner of weight in such products, 
estimated at nine kreuzers, would allow for the expenditure for iron 
during the year the sum of ninety kreuzers for each individual of 
the entire population. Accordingly each inhabitant of Austria- 
Hungary would be expending for spirituous liquors eight times as 
much money as for iron, the most important agent of active 
industry. 

Naturally what has been suggested here can only be regarded as 
an average estimate upon the whole consumption, inasmuch as 
the use of spirituous beverages varies exceedingly not only with 
individuals, but in the different provinces of the Monarchy. Espe- 
cially can three groups of provinces be named as varying most : 

1, the actual German provinces, with Bohemia, Moravia and Silesia, 
in which the consumption of beer plays the most important part ; 

2, the Hungarian provinces, where the use of wine is greatest ; 
and 3, Galicia, with the North of Hungary, and Transylvania also, 
but in a less degree, the Alpine Highlands at the west, where 
most of the brandy is consumed ; and although specific numerical 
statements cannot be adduced, yet the effects of this consumption 
upon the social development is an undeniable fact. 

Already the wine-consuming Hungarian population, as regards 
the degree of industrial and professional ability, stands in the eyes 
of every impartial observer much below that which the inhabitants 
of the western provinces of the Monarchy have attained, while the 
Galician peasant, who ruinously exchanges for brandy his corn 
before it is ripe and yet in the pod, is lowest in the scale of indus- 
trial development. 

He knows nothing of the valuable resources for improvement in 



308 STATE BOARD OP HEALTH. [Jan. 

agriculture, secured through industry and science, and grows visibly 
poorer. 

Indeed the degeneracy of the race in Galicia, although perhaps 
other agencies may contribute to it, is to be sought mainly in the 
excessive indulgence in corn-brandy ; and thence it comes to pass, 
that out of the men called to military duty in Galicia, 37.9 per 
cent, are rejected as unserviceable on account of physical disability 
and infirmity, and 18 per cent, on account of under stature ; accord- 
ingly in all 55.9 per cent, of those called are found unserviceable, 
whilst in the entire Monarchy only 9.2 per cent, appear as unser- 
viceable fo£ the army through under size, and 33.5 per cent, on 
account of physical disability and infirmity. 

Temperance societies have as yet never been started in Austria, 
and the attempts at such, made particularly in Galicia, in imitation 
of those in some communities in Russia, have been without a suc- 
cessful result, mainly because of the " Propinations " privilege which 
exists and produces a large revenue to the landed proprietors, who 
therefore oppose to the utmost all such attempts, which may reduce 
their incomes. 

I have been informed that the " Propinations " privilege consists 
in the right, claimed by land proprietors, and included in every 
lease from them to inn or tavern keepers, requiring the latter to 
purchase from the land proprietors all stores of spirituous liquors to 
be consumed in such inns or taverns, or, if that right be waived, 
then, that a large pecuniary consideration for the same be annually 
paid to the land owners. 

Zurich, May 10th, 1870. 

Dear Sir : — Your letter making certain inquiries about intoxicat- 
ing drink, &c, &c, is at hand. In reply permit me to say that my 
residence here has been of but a few months' duration, hence my 
observations have not been very extended ; but to the questions : 

1st. Sour wines and lager-bier are used here in immense quanti- 
ties. French and German wines are also used, but in much less 
quantities, by those able to import. 

2d. I judge that the per cent, of disorder and crime arising from 
the use of intoxicating drinks is large. Yet I find no statistics on 
the subject. I am positive, however, that the enects on health and 
the prosperity of the people are very bad. 

I am credibly informed that in certain cantons where wine in 
very great quantities is used, steady nerves are rare, while a great 
tremulousness of the hand is common. I am impelled to believe 
however, that intoxication prevails to a less extent in Zurich than 



1871.] PUBLIC DOCUMENT— No. 37. 309 

in American cities. Poor or sour wine and beer stupefy more than 
they intoxicate when used in ordinary quantities. 

I am not in possession of any printed statistics on the subject, or 
I would forward with pleasure. 

Very respectfully, 

S. H. M. Btees, TI. 8. Consul. 



United States Consulate, Funchal, Madeira, ^ 

May 8th, 1870. ) 

Sir : — I have the honor to acknowledge the receipt of your com- 
munication of February 23d, last past, requesting certain information 
in regard to the use of intoxicating drinks, and their effects upon 
the population of this island. 

In regard to your first question, I have to say that the chief 
intoxicating drinks are wine and cane brandy ; the former mild, but 
yet a heavy-bodied wine, and the latter inferior to the grape brandy 
of France, yet stronger than our American whiskey. 

In answer to your second question, I have to say that the people 
here are a most exemplary people in the main, in regard to the use 
of intoxicating articles. Few are seen drunk, or even overly 
excited from the effects of drink. Indeed one seldom hears of a 
person being destroyed from its use. Considerable amounts of both 
brandy and wine are, it is true, consumed by the population, the 
better classes using wine daily at dinner, and the commoner people 
using both wine and brandy, without reference to time, but yet in 
great moderation. You can therefore well understand, that as a 
consequence, there are but few cases of crime resulting from their 
use. Indeed, I believe I have not heard of a single case since I am 
on the island, now going on five years. As to the impression upon 
the general prosperity of the masses, I think it is somewhat damag- 
ing, as the price of ordinary labor is very low, thirty cents per day 
being the price to a common laborer, which is in itself scarcely suf- 
ficient to maintain a family, even in the midst of almost the greatest 
poverty, since every cent taken from that amount for brandy or 
wine is most seriously felt by the poor families ; and as nearly all 
drink a little, the amount of absolute poverty is very great. 

As to the relative amount of intoxication in this island, as com- 
pared to the United States, I must say, that whilst no statistics are 
kept or collected by any one, yet I have no hesitation in giving it 
as my opinion, that the difference is greatly against our people in 
America. 



310 STATE BOARD OF HEALTH. [Jan. 

I regret that I am unable to forward you any statistical informa- 
tion upon the subjects you have referred to. 

With great respect, I have the honor to be, your very good 
friend, Chas. A. Lees, U. 8. Consul. 

United States Consulate-General, Beirut, Syria, ) 

May 9, 1870. 5 

Dear Sir : — Referring to your communication of the 23d Feb- 
ruary, I have the honor to observe that the influence of intoxication 
upon the people of Syria is almost imperceptible. 

The native wine is not made in large quantities, yet sufficiently 
so as to give the middle class population at least, the use of that 
beverage, but its effect as such, is not to produce intoxication, which 
is almost unknown. There is, however, a colorless liquid called 
arak or rakia, which is distilled from the wine or made from the 
pumice. This is very intoxicating, but is used so temperately as to 
seldom produce bad results. Dr. Thomson, who has resided in 
Syria for about thirty-five years, says that he never saw a drunken 
man during the larger part of that time. During, and since the 
French occupation, which followed the massacres, foreign wines 
and some other liquors were introduced, and the former is now to 
be seen in many of the more wealthy families, yet almost never 
used to excess. There are two classes of the population upon 
whom the introduction of foreign brandy and whiskey is known to 
produce bad effects — the Turks or official class, and the lower for- 
eigners, such as Greeks and Italians. Not until recently could a 
dram-shop be found, but now there are several, patronized almost 
exclusively by the low class of foreigners. 

Your second question is in effect already answered. There being 
almost no intoxication, still less can crime be traced to that cause. 
In fact, very little crime is committed in Syria. Formerly, in 
the mountain districts of Lebanon, the existence of blood feuds 
led to many violent deaths, but the killing was done openly and in 
the name of justice. Three executions by Daoud Pasha, the first 
Christian governor-general after the massacres, have had the effect 
of almost suppressing this ancient custom. It happens now occa- 
sionally that different villages or factions will have a bloody affray, 
but the cause is generally some religious superstition. The larger 
part of the cases which come before the Turkish and consular courts 
relate to property and contracts, rather than crime. Assault, bur- 
glary and assassination are almost unknown, though a few horrible 
cases of the latter have occurred, yet have never been traced to the 
use of intoxicating liquor. 



1871.] PUBLIC DOCUMENT— No. 37. 311 

If the use of liquor in the general, but temperate manner habit- 
ual with this people has a gradual undermining effect upon health 
or constitution it is impossible to estimate it, nor have medical 
men given the question their attention. 

I do not believe the people are less prosperous on account of its 
use, according to their customs, not because there would be no 
saving if they would abstain, but rather because their recreation 
and dissipation take such a mild, harmless form, that those who 
are most interested in their welfare would not interfere with their 
long established and harmless usage, believing that if they were 
led to abandon these habits — perhaps not entirely unobjectionable — 
they would in pursuit of recreation fall into the worse habits which 
a higher civilization generally brings with it. 

Whoever has seen these people after the day's confinement in the 
close, dark, dirty bazaars, and the muezzin has sounded for evening- 
prayers, assembled under large arbors in the public places, generally 
on an elevation where the cooler winds may reach them, seated on 
low stools smoking the nargelia, drinking coffee or arak from the 
smallest of cups, listening perhaps for the hundredth time to a stoiy 
teller, who with wild gestures is reciting the tale of Ali Baba and 
his forty thieves ; sitting thus for one or two hours after sunset, 
and then returning quietly to their homes until the streets become 
as noiseless and deserted as those of Palmyra, most of those who 
have thus observed their habits will not be inclined to condemn 
them very severely. 

After the foregoing it will be unnecessary to express an opinion 
as to the relation of the amount of intoxication seen in this coun- 
try to that of the United States. It would be impossible to give 
statistics, either as to intoxication or crime as no records are kept. 
My remarks are the result of observation only ; but I am sustained 
by the opinion of some of the most reliable residents. 

I am, sir, very respectfully, your obedient servant, 

Lorenzo M. Johnson, 
Vice- Consul- General in charge of the office. 



No. 30 Chatham Street, Colombo, Ceylon, 13th August, 1870. 

Sir : — On the 30th of May last, I had the honor to address you 
in relation to your letter received on the 17th of that month. 

I have found it more difficult than I anticipated in obtaining the 
required information, either from a disinclination or want of time 
on the part of some of the government officials. 

I am informed a census is being taken, and when the Legislative 



312 STATE BOARD OF HEALTH. [Jan. 

Council convenes, which will be in the latter part of September, I 
may be able to send you more and later information. 

Since my arrival in Ceylon, I have been located at the seaports 
of Galle and Colombo, in the most southern extremity of the island. 
It will therefore be out of my power, from my own experience, to 
give you any more information than is customary, where, in a foreign 
port, the jack-tars of all nations have a day's liberty on shore. 
From your queries, I am of opinion, you desire more particularly 
information in regard to the native inhabitants of Ceylon. 

I therefore annex copies of letters on the subject, with which I 
have been kindly favored by parties who have been born on the 
island or have been long residents, which I trust you will find of 
interest. The first is from Dr. Julian L. Vanderstraaten, Assistant 
Colonial Surgeon for the Southern Province. 

1st. All the European liquors are used by the better class. 
Chiefly drink arrack, which is prepared by the distillation of toddy, 
and is not unlike whiskey. 

The juice of the flower and stems of the palm tribe yield the sweet 
liquor called toddy ; it contains sugar, and when drank in the cut of 
the morning is an agreeable beverage which acts like a mild aperi- 
ent ; when the day gets warm it begins to ferment, and in this 
stage is prepared by the lower classes as an intoxicating liquor 
owing to its being very cheap. When this is fermented for days, it 
becomes converted into good vinegar, but the larger quantity is 
distilled for arrack. 

2d. There is no doubt that the sale of arrack at a cheap rate 
(nine pence half-penny per bottle) has caused a great increase in 
crime of late. The natives, " Arrack Renters," as they are called, 
purchase the right of selling arrack from government at the annual 
sales, and then open taverns in the villages and towns. Under this 
system the illicit distillation is checked ; by which a large revenue 
is obtained, and the use of arrack becomes much more common 
than before. The sober and steady class of natives, although ex- 
ceedingly fond of litigation, seldom commit any serious crimes 
excepting once a year, viz., at their Singhalese New Year, 11th 
April, when they make merry, imbibing a good portion of arrack, 
under the influence of which they become quarrelsome and end by 
knocking each other over the head with clubs. It is only in cases 
of revenge and jealousy that crimes are committed without arrack 
beinar the inciting cause. When assassins are hired to commit a 
murder they can only be compelled to do it under the influence of 
arrack, money being no consideration with men of this class. 

The use of arrack, particularly the fresh liquor sold in taverns, 



1871.] PUBLIC DOCUMENT— No. 37. 313 

speedily induces inflammation of the liver which ends in dropsy. 
Good old arrack seasoned in wine cases is a choice liquor. It is 
only served to troops after having been kept for years in store. 

" Arrack drinkers are by no means industrious ; they sleep away 
their time, while the female portion of the community have to work 
for their upkeep." 

Dr. Samuel F. Green, of the American Mission, located in the ex- 
treme north of the island, has favored me with the following answers 
to your queries, viz. : — 

" 1st. Palm toddy and arrack. 

" 2d. A great deal of crime, the effect on the health and pros- 
perity of drunkards and their households markedly evil. 

" 3d. I should think it about equal. 

" As the sale of arrack and toddy is favored, the comparative 
amounts paid annually, would elucidate the subject. 

" I trust the investigation of the Board of Health may result in 
the formation of some effective plan, for the lessening of this great 
scourge of the human race." 

The Rev. J. C. Smith, also of the American Mission in the north 
of the island, writes, — 

" My own impressions accord with Dr. Green's, — this system of arrack 
rents is an unmitigated evil, and ruins many every year. We hope the agi- 
tation of the subject may result in checking the increase of the evil." 

James Loos, M. D., Member of the Royal College of Physicians, 
Edinburgh, colonial surgeon, born in Ceylon, has also favored me, 
viz. : " The chief intoxicating articles in use among the natives of 
Ceylon are arrack and toddy. 

" Toddy is the juice drawn from cocoanut palm in all parts of the 
island, except the north, where it is obtained from the palmyra 
( Borassus flabelli forrnis). The toddy is a favorite beverage. In 
its fresh state it is sweet and pleasant and can scarcely be said to be 
intoxicating, but it is not sold in the taverns for use until it has 
undergone fermentation to some extent, when it becomes sour and 
intoxicating. The spirit obtained from the distillation of toddy 
is arrack, which may be said to be the national drink of the Singha- 
lese. The right to distil arrack is sold annually by government 
with whom it is a source of revenue. The arrack renter, as he is 
called, sells spirits by wholesale to tavern-keepers. Opium and 
Ganjah or hemp, are used by the Malays and Hindoos, and some of 
the natives of Ceylon have imbibed a taste for these drinks, but 
they cannot be said to be in common use. There is a large con- 
40 



314 STATE BOARD OF HEALTH. [Jan. 

sumption of brandy, beer, and the common beverages of the 
European. These are more plentiful and cheaper in the shops now 
than formerly, and the natives in towns prefer them to arrack and 
toddy, which they regard as common and vulgar drinks. 

" There is no doubt that a large amount of crime in this country 
arises from the use of intoxicating drinks, and that their effects on 
the health and prosperity of the people are very marked. Cases 
of horrors (delirium tremens) are not found among natives, and it 
is believed that the use of arrack does not produce it ; but I have 
frequently traced the occurrence of other diseases among the na- 
tives, to the abuse of alcohol. I am aware, that in the country, 
taverns have sprung up of late, which did not exist before, and that 
dissipation and crime have increased in the villages. 

" I fear you are not likely to obtain official statistics of the amount 
of crime' caused by intoxication anywhere. We are still greatly 
behindhand in such matters. We are only now beginning to take 
steps to obtain a correct census of the island, and to register 
properly births and deaths. 

u When I had a medical connection with the principal jail in 
Colombo, it was not customary to inquire into the habits or pre- 
vious history of prisoners ; but it is possible that some advance has 
been made since that time in the collection of information on these 
and other points." 

I find in the " Colombo Observer " of 21st of July, an article, by 
its editor, headed, — " Crime in Ceylon and its Causes," which has a 
bearing upon the subject under discussion, and I think will not be 
considered out of place : — 

" Believing as we do in the dangers of moral contagion, we have endeavored 
to steer clear as much as possible of the law courts and their surroundings. 
A period of enforced attendance as juror, however, has certainly given us a 
view more vivid than ever of the prevalence of crime around us, even in the 
districts where Christianity, in some form or other, has been taught for length- 
ened periods. The comparative impunity too with which wrong-doers can 
long pursue a career of crime, without the arm of justice being able to reach 
them, has been forcibly impressed upon us by the details of a case from Min- 
nangodde near Negombo, which occupied the whole of the 19th, and with 
reference to which the jury felt compelled by a sense of duty, to ask the pre- 
siding judge to make a representation to the executive government. Minnan- 
godde is close to Negombo, which is the seat of a district judge, the village 
has the usual complement of peace officers, and a regular police station stands 
within a short distance of it. The Roman Catholic missionaries have been at 
work around Negombo for centuries, and for about half a century the Wes- 
leyans have done their best for the people, and yet with reference to events 
which took place near Minnangodde in December, 1869, the serious attention 



1871.] PUBLIC DOCUMENT— No. 37. 315 

of the executive government has to be called to the fearful state of disorgani- 
zation and crime into which the district had fallen. A regular manufactory 
of crime and criminals seems to have been kept for years by the Vidahu of 
the village, -where cock-fighting, gambling, and arrack drinking were pursued 
day and night. At length a wretched gambler was deprived of life in the 
Vidahu's ' hell,' and although all who ought to have aided justice (including 
the regular police) seem to have done their best to defeat the efforts made to 
punish the criminals and repress crime, retribution at last overtook the lead- 
ing wrong-doers. Under the auspices of the Vidahu, at his direct invitation, 
it would seem a crowd of people, not fewer than a hundred probably, assem- 
bled to witness cock-fighting, to drink arrack illegally sold to them, and to take 
part in gambling. Those who went inside the gambling house actually paid an 
entrance fee of one shilling each to the Vidahu (the man who had been appointed 
by government specially to repress such breaches of the law), and he and a 
henchman of his seem to have held the stakes. It came out in evidence that the 
man who met his death in the gambling house had placed £20 in the hands of the 
Vidahu, depositing £8 with the other man. A witness questioned as to the 
possibility of such large sums changing hands amongst native gamblers, in- 
sisted that similar transactions were not uncommon. Be this as it may, the 
unfortunate gambler, who was excited by drink, asked for some of his money 
back, and not getting what he'considered enough applied insulting terms to 
the Vidahu. The latter gave the order ' strike,' an order which his assistant 
readily obeyed, the man was seen to be violently kicked and beaten, and was 
heard to cry out ' Oh ! I am lost !' a hand was seen to take hold of his throat, 
and then the lamps were overturned. In the darkness there can be no doubt 
the victim was strangled to death, the post mortem examination disclosing all 
the usual signs of strangulation, while such violence was used that the larynx 
was displaced. The Crown, as may be imagined, experienced great difficulty 
in obtaining evidence, and one of the witnesses had himself the charge of 
murder hanging over him. The jury, however, though they mercifully ac- 
quitted the prisoners of murder, had no hesitation in finding them guilty of 
manslaughter, a verdict in which the presiding judge said he fully agreed. Mr. 
Justice Lawson in passing sentence, dwelt on the peculiar atrocity of the con- 
duct of the peace officer in systematically violating the laws he was appointed to 
enforce. As a warning to other head men an exemplary sentence was neces- 
sary. The Vidahu, therefore, would be punished by ten years' imprisonment 
with hard labor ; his companion receiving a punishment lighter by one-half. 
The surprise and despair of the well-to-do prisoners, who had evidently cal- 
culated on an acquittal, were extreme, and we trust the moral effect in Min- 
nangodde and elsewhere will lead to much needed reformation. There can 
be no doubt that arrack drinking and gambling are at the root of much of 
the crime committed in Ceylon, and that the police, rural and regular, require, 
to say the very least, strict looking after." 

In looking over the Administration Reports, for 1868, just issued, 
I find there is no mention of intoxication or drunkenness. I sub- 
join the statement contained therein of the revenue, derived by 



316 



STATE BOARD OF HEALTH. 



[Jan. 



government, sold in the different provinces, to the arrack renters, 
viz. : — 



PROVINCES. 


18G7-G8. 


18G8-6S*. 


"Western, 

Central, ..... 

North- Western, 

Northern, ..... 

Eastern, 

Southern, 


£70,696 5s. 9frf. 

49,800 

10,823 8 

3,963 

4,230 10 

1,326 13 4 


£63,986 5s. lOd. 

48,505 

12,393 14 1\ 

3,629 

4,057 6 8 

1,094 14 6 


Total in American gold, 


£140,839 17s. lfrf. 

$681,664 88 


£133,666 Is. l\d. 
$646,943 72 



I have the honor to be, sir, with respect, your most obedient 
servant, 

George W. Prescott, JJ. S. Commercial Agent. 



Consulate of the United States of America, > 
Yedo (Tokei), Japan, July, 1870. > 

Sir : — Herein is the report of Dr. J. H. Kidder, U. S. Navy, to 
whom I referred your letter of February 23d. 

Dr. Kidder has spent much time in studying the Japanese, their 
character and habits, and I take pleasure in forwarding his opinions, 
knowing them to be the intelligent result of careful investigation. 
I am, sir, very respectfully, your obedient servant, 

C. O. Shepard, U. S. Consul. 



U. S. STOREsnrp " Idaho," 1st rate, 
Harbor of Yokohama, Japan, July 8th, 1870. 

'Sir : — I beg leave to acknowledge the receipt of your letter of 
June 28th, inclosing a communication (herewith returned) from 
Dr. Henry I. Bowditch, chairman of the State Board of Health 
of Massachusetts, which contains certain inquiries concerning the 
use and abuse of intoxicating liquors in Japan. 

I take great pleasure in complying with your request and answer- 
ing Dr. Bowditch's questions to the best of my ability, although the 
accuracy which he desires is not attainable in this country as yet, 
both on account of the peculiar light in which intoxication is looked 
upon in Japan, and the fact that it has not, so far as I can learn, 
ever been made the subject of official investigation. 



1871.] PUBLIC DOCUMENT— No. 37. 317 

1st. Saki is the generic name for all native intoxicating drinks. 
They agree in that they are all obtained by the distillation of rice, 
but differ greatly in strength and flavor, according to the degree of 
dilution and mode of manufacture. While some varieties resemble 
liqueurs, being of great strength, largely sweetened and highly 
flavored with aromatic herbs, others, equally intoxicating, are fiery, 
acrid and unpleasant to the taste, and others still (these the brands 
in common use), are largely diluted with water, mawkish and 
slightly nauseous in taste, and not more intoxicating to foreigners 
than ordinary draught ale or old cider. A specimen of this 
commoner sort, taken at random, I have found to contain about 
eleven per cent of alcohol. A brand of especial excellence, known 
as the Sho-gwats saki (New-Year's wine), and produced only at 
New- Year's calls, is in flavor and strength not unlike the common 
Rhine wines. The natives themselves are remarkably susceptible 
to the influence of saki, and show by flushed faces and excited 
bearing a marked degree of intoxication after drinking an amount 
which makes scarcely a perceptible impression upon foreigners. 
The cups in universal use for saki are exceedingly small, rarely 
holding so much as a fluid ounce. 

2d. The amount of crime which can be directly traced to intoxi- 
cation in this country is almost inappreciable, and this is due, as I 
think, to the following among other reasons : first, the mild and 
inoffensive type of the national character, which impels the people 
when drunk, rather to dancing, singing and displays of affection, 
than to combativeness ; secondly, the great dilution of the ordinary 
qualities of saki, almost universally used ; thirdly, the small size of 
the drinking cups mentioned above (perhaps this is rather effect 
than cause) ; and fourthly, the state of public opinion, which looks 
upon intoxication as a misfortune, a species of illness, and not as a 
legitimate mode of enjoyment, or subject of ridicule. 

It is true, that occasionally one of the drunken samourai (class 
entitled to wear two swords) will on meeting with foreigners, ac- 
tuated by his early prejudices and military training, draw his sword, 
and make an attack, which would have been refrained from had he 
been sober. But such instances are exceedingly rare, and when 
they do occur it is still more rare that mischief is not prevented by 
his perhaps equally drunk but less quarrelsome companions. Dur- 
ing a residence of more than two years in Japan I have frequently 
been with the Japanese of the better and more dangerous class, at 
their convivial meetings, sometimes alone, and although they have 
generally ended by getting tolerably drunk, I have never seen 
swords drawn, or any exhibition of ill-temper or malice. Twice in 



318 STATE BOARD OF HEALTH. [Jan. 

the streets of the native cities I have seen drunken Japanese offi- 
cers attempt to draw their swords upon foreigners, hut in neither 
case did any ill-result follow, their friends interfering almost before 
the action could be noticed. Quarrels among themselves caused by- 
drinking are exceedingly rare. As for other kinds of crime, I have 
yet to hear of the first instance of a connection between such and 
drunkenness. 

Like all Eastern nations the Japanese are exceedingly temperate. 
Habitual drunkenness is almost unknown. At the general holidays, 
which occur about forty times a year, and at private family festivals, 
all the natives, men, women and children, drink more or less saki, 
but at other times they rarely touch it. Saki is brought out at the 
family festivals, is drunk with great ceremony at funerals, and on 
special occasions of jollity, but is rarely allowed to interfere with 
business or labor. Last month there was an unusually important 
Matzri (festival) at Yokohama, to the Goddess of Heaven, the an- 
cestress of the Mikado dynasty. This holiday lasted for three days, 
during which it is safe to say that the entire native population of 
Yokohama was more or less intoxicated. The streets were crowded 
with processions and shouting bands of men with flushed faces, 
capering, singing and playing practical jokes. With all this drunk- 
enness, there was not a single instance of assault, much less mur- 
der, reported. Comparing this result with that of a 4th of July in 
America, or with similar holidays in other countries, I cannot hes- 
itate in declaring that not only is the comparative intoxication of 
this country less in degree than that of other nations, but that it 
differs in kind, leading to few or none of the evils to society which 
have caused the temperance movement at home. 

Since the government has never recognized drinking as a cause of 
crime, or as a greater evil than any other excess, it has never been 
made the subject of official investigation, and there are therefore 
no official statistics. 

I am sir, very respectfully yours, 

J. H. Kidder, A. M., M. D., 

Asst. Surgeon U. 8- Navy. 
C. 0. Shepard, Esq., U. S. Consul, Tokei, Japan. 

United States oe America Legation, > 
Yokohama, Japan, June 20, 1870. 5 

Dear Sir:— Your communication of the 23d of February, 1870, 
propounding the following inquiries, to wit : — 

1st. " What are the chief intoxicating articles used in Japan ? " 
2d, "What amount of crime is produced by them, and their 



1871.] PUBLIC DOCUMENT— No. 37. 819 

effects on health and prosperity of the people ? " and also, asking my 
opinion as to the relative amount of intoxication in this country, 
&c, is now before me. 

In reply to question No. 1, my answer is Saki, a liquor brewed 
from rice. 

In answer to the second question, having no statistics to guide 
me, I can only answer it relatively by saying : less crime resulting 
from intoxication occurs here than any other country I ever was in, 
and less evil effects upon the health and prosperity of the people 
from this cause is observable than in the United States. 

This is not a country in which any statistics in regard to this 
matter are obtainable, but after receiving your letter, I conferred up- 
on the subject with a number of gentlemen of long residence here, 
and close observation, and from them I learned that their convic- 
tions coincided with my own as already stated, and as follows, to 
wit : The free use of intoxicating drinks is allowed all classes of 
Japanese people by law, the original object of allowing which was 
to prevent their resorting to the use of opium as the Chinese do, 
and it succeeded, as opium is not used by this people. Secondly, — 
the people are rigidly and by birthright divided into castes, the 
upper class or Samourai commencing with the Emperor, concludes 
with the private soldier, all of whom constantly wear swords and 
never perform manual labor. The second class includes farmers, 
mechanics, merchants, and thus on down to Coolies, in the order 
here stated. They perform all the labor of the country, are not 
eligible to any office, and hold their lives and property by a very 
delicate thread that this upper class stand upon little ceremony in 
severing, if sufficient excuse is offered ; hence this lower class, from 
sheer fear of offending some of the Samourai, and meeting with 
severe and summary punishment, are not addicted to drunkenness, 
in which condition they would be most liable to do or say some- 
thing that would bring punishment upon them. Any member of 
the Samourai class, although but a private soldier, is eligible to any 
office in the gift of the Emperor, and generally all offices are filled 
by men promoted for their skill or wisdom. To be known to be 
addicted to drink, or even to be seen once intoxicated, would have 
the effect to seriously diminish the chances of one's promotion, and 
as they are generally an ambitious and aspiring people they avoid 
this evil in aid of their ambitions, and besides this as they rarely 
quarrel without fighting, and as all of them go constantly armed 
with most formidable weapons, they avoid drink as likely to pro- 
duce fighting, and fighting with them means the death of one or 
the other of the antagonists. Thus sobriety is the rule and intoxi- 



320 STATE BOARD OF HEALTH. [Jan. 

cation the rare exception with this people. My Secretary, Mr. A, 
L. C. Portman, who has been a constant resident here now some 
ten years, and has mixed very much with all classes of the people, 
assures me that Japanese women make no use of intoxicating 
liquors at all, and that he has during his whole residence never seen 
but one Japanese woman under the influence of liquor. Regretting 
that I am unable to furnish you with any statistical information as 
requested, and apologizing for the meagreness of the information 
hereby given, 

I remain, yours most truly, C. E. DeLong. 

P. S. Since writing the foregoing I have met and conferred 
upon the subject with Doctor Hepburn, a missionary gentleman and 
a physician here of the highest repute, who has lived here a long 
time, keeps a dispensary, and has many Japanese patients, and from 
him I learn that drinking is much more frequent than I supposed 
amongst the Japanese, who as he says quietly drink at home very 
considerably, both men and women, but as the intoxicating quali- 
ties of Saki are only about equal to lager-bier, it is used almost as a 
beverage, and but little evil consequences comparatively speaking 
are produced by its use. This information I deem most reliable 
and therefore send it with my own views. 

Yours, respectfully, DeLong. 



Agency and Consulate-General of the U. S. of A. in Egypt, > 

Alexandria, July 25, 1870. 5 

Deaji Sir : — Your queries in behalf of the State Board of Health, 
regarding the influence of intoxicating drinks on the health and 
prosperity of our people, addressed to me at Calcutta, have been 
received in Egypt, to which country my government was pleased 
to transfer me. 

I will, however, cheerfully answer the questions to the extent of 
my ability. 

1st. The chief intoxicating articles are, "arrack," champagnes 
and red wines. 

This being a Mohammedan country, drunkenness is almost 
unknown, and confined entirely to the foreign Christians residing 
here. 

2d. Crime is almost entirely committed by the foreign population, 
and altogether so when it is caused by drunkenness. Murder, theft, 
rape, burglary, forgery and other grave crimes are monopolized by 
the Greeks, Italians, French and other Christians resident in Alex- 
andria and Cairo. 



1871.] PUBLIC DOCUMENT— No. 37. 321 

Of course, under these circumstances there can be no relative 
amount of intoxication between the two countries. In the United 
States and England, the capacity to hold a vast quantity of liquor 
is taught as one of the highest attributes of manhood. In this 
benighted land, to be drunk involves the most extreme social and 
religious disgrace. And while the teachings of the Prophet hold 
sway, there is no prospect of these infidels becoming civilized in 
that respect. 

3d. There are no statistics of intoxication and crime in this 
country ; the records from the Christian nations will therefore have 
to furnish warnings to the good people of the grand old Common- 
wealth of Massachusetts which in matter of temperance may 
proudly say she is almost Mohammedan. 

I remain, with the highest respect, your obedient servant, 

George H. Butler. 



Consulate of the U. S , Island of Zanzibar, ) 

May 21, 1870. > 

Dear Sir: — I received on the 18th inst., your letter of February 
23, 1870, asking information as to, — 1st. What are the intoxicating 
articles used in Muscat ? In several visits to that place I have never 
heard of or seen anything of the kind, but once, on which occasion 
a vessel arrived from Mauritius with about sixty casks of rum. At 
Zanzibar the Arabs drink German gin and French cognac of the 
vilest description, and the negroes cocoanut rum of their own 
manufacture. 2d. What amount of crime is produced by them, 
and their effects on the health and prosperity of the place ? 

As the religion of the people is Mahometan, Avhich forbids the 
use of intoxicating drinks, those who use them do so in secret, 
taking care to confine their appetites within bounds so as to retain 
the outward respect of each other, and we only see drunkenness 
when English or American sailors are on shore here. No compari- 
son therefore is possible between the two countries. I believe that 
intoxication seldom if ever, leads to crime in these dominions. 
I am, sir, very respectfully yours, 

Francis R. Webb, TI. S. Consicl. 



United States Consulate, Cape Haytien, > 

July 1, 1870. 5 

Dear Sir : — I have to acknowledge your circular of February 

23, which reached me only on the 14th June, and I have now the 

pleasure to reply to it. 

41 



822 STATE BOARD OF HEALTH. [Jan. 

Before entering however upon the proposed questions, I find it 
necessary to make a few preliminary observations. Intoxication by 
ardent drinks and other narcotic drugs, alike with smoking, as a 
general vice, presupposes an advanced state of society, when men 
strive to forget the realities and hardships of life by over-exciting 
their nervous system. For, the proper use of drinks is, to quench 
thirst ; and for this purpose, nature has afforded to man, one of her 
richest and most abundant gifts, the limpid, cooling and enticing 
draught of springs, wells and rivers, which abound nowhere more 
than in the West Indies. 

The masses of pure African descent in Hayti are a semi-civilized 
race, of the simplest tastes and habits ; their wants are few and 
amply provided for by the fertility of the soil, their undisputed 
property. As a general rule they have rather an abhorrence for 
strong drinks, to the use of which only habit and social intercourse 
lead. Living isolated in their mountain fastnesses, and in no or 
little contact with foreigners, nor even with the inhabitants of the 
ports, the habit of convivial meetings lacks encouragement. 

To reply to query 1, the chief intoxicating drink of Hayti is 
cane-spirit, called here " Tafia." At the time of French colonial 
rule until Christophe, cane sirup was only used for the production 
of sugar; distilleries for the production of spirits were scarce. 
Since the independence of the island and the cessation of sugar 
boiling, most of the sirup goes to the distilleries (guldives), which 
were then established in districts favorable to that particular 
industry, and " tafia " became the general stimulant drink. 

But the character of the masses and the paucity of the " guldives " 
over a vast area of inhabited plains and hills, the constant repeti- 
tion of civil contests almost in every decennium, interrupting and 
ruining industrial enterprise, prevented the development of the 
propensity among the masses. The chief consumption remained 
confined at the seaport towns to sailors, foreigners and such Haytien 
half-breeds who had visited Europe and imported European habits. 
Under the late government of Salnave, the commodity became so 
scarce that a law was passed to import foreign rum, free of duty, 
I suppose under the then circumstances of the country, with very 
small results. 

Query 2d. Hence there may be, though rarely, drunken frays 
between sailors and other habitual tipplers, but within my knowl- 
edge, I never heard of the committal of any serious crime by 
negroes in consequence of immoderate drinking. 

Polydipsia and inebriety, as effects of a morbid state of health, 
such as hypochondriasis, hysteria, &c., are, in a country where 



1871.] PUBLIC DOCUMENT— No. 37. 323 

morals and sexual intercourse are unrestrained, almost unknown. 
On the other side, diseases consequent on immoderate use of ardent 
liquors, such as dropsy, scirrhus ventriculi, delirium tremens, con- 
sumption, are of rare occurrence among Creoles. The general 
health is favorable, when compared with other similarly constituted 
countries. Cholera never touched these shores, whilst desolating 
almost all the surrounding islands. 

In spite of the political turbulence since the liberation from 
French rule, the people live at ease, and generally prosper. Statis- 
tical accounts in a country where the population are from time to 
time decimated by civil war, and an organized administration is 
impracticable, are out of question. I shall however endeavor to 
collect materials in my district, where I am only a short time 
located, for further communication. 

I remain, very respectfully yours, 

Abm. Crosswell, U. S. Vice- Consul. 



Legation of ttie U. S. A., Nicaragua, Leon, 

May 15, 1870. 

Dear Sir : — I regret that, in reply to your letter of February 
23d last, received the 1st instant, I am unable to furnish you with 
any statistics or definite information on the interesting subject 
alluded to therein. 

As in all Spanish-American countries, so in Nicaragua, the gov- 
ernment has monopolized for itself the sale of strong liquors. The 
article almost exclusively used by the mass of the people is rum, 
made of sugar-cane, sold and drunk perfectly pure and unadulter- 
ated. The higher classes indulge in the vilest stuff imaginable, im- 
ported mostly from France as cognac, champagne, &c, &c. 

There are remarkably few cases of drunkenness noticeable in 
public and among the lower classes, who drink rum, while, for good 
reasons, I always found it wise on occasion of banquets, dinner or 
other parties, both public and private, among the higher classes, to 
withdraw at an early hour. If the native rum, which seems but 
in exceptional cases to be indulged in to excess, has any injurious 
effect on the health and prosperity of the people, which I am 
rather inclined to doubt, it certainly is very insignificant. 

During a residence of nearly seven years in Central America 
(Costa Rica and Nicaragua), I do not think that half a dozen of 
unfortunates, bent upon self-destruction by strong drinks, among 
the natives, have fallen under my observation. 

I am most confident that the amount of intoxication in this coun- 



324 STATE BOARD OF HEALTH. [Jan. 

try falls immensely short of that seen and not seen in our own 
land. Even here, I regret to say, our countrymen are by no means 
distinguished for sobriety. 

I have heard it asserted, both in Costa Rica and here, that de- 
lirium tremens is never the consequence of excessive indulgence in 
rum, but will inevitably follow as soon as the rum-drinker turns to 
foreign, i. e., European and American strong liquors. 

I have the honor, sir, to be your obedient servant, 

C. N. Riotte. 



U. S. Consulate, St. Croix, W. I., > 
June 13, 1870. $ 

Sir : — Yours of February 23d has been received. In answer to 
your first question, I would inform you that the " chief intoxicating 
articles used in Santa Cruz," are rum, brandy, wines and malt liq- 
uors, all of which, except the ram, are imported from Europe. The 
rum is manufactured here, and is the almost only intoxicating 
drink used by the laboring population. The higher classes only 
use wines and malt liquors, and brandy more than rum. 

It is impossible for me to answer your second question with any 
degree of satisfaction, as there are no statistics on this subject pub- 
lished here. Crime of a serious character is very uncommon. Pil- 
fering produces most of the tenants of our prisons, and I believe 
there is no country in the world where one is safer from assault and 
robbery than in the island of Santa Cruz. This results, doubtless, 
in some measure, from our isolated position and the difficulty of 
escape. " Rum-shops " are abundant, and rum is sold at them in 
any quantity down to one cent's worth. Still I am of opinion that 
drunkenness is less common with the laboring classes than in the 
United States. An exhibition of it in the streets is certainly less 
common. This, however, may be owing in part to police regula- 
tions and the fear of arrest. I think the effect of the use of intox- 
icating drinks is more apparent among the higher classes. Wines 
and liquors are used at all social gatherings very freely, and by a 
considerable number of the people at all times too freely. That 
the effect is pernicious to health, and injurious to the prosperity of 
those who thus indulge their appetites, I know from personal ob- 
servation. I do not think, however, any amount of crime is pro- 
duced by the use of spirituous liquors. Upon the whole, I am in- 
clined to the opinion that the use of intoxicating drinks is much 
more universal here than with us, and that intemperate drinking 



1871.] PUBLIC DOCUMENT— No. 37. 325 

is more common among the higher, and less common among the 
lower classes than in the United States. 

I am, sir, with great respect, your obedient servant, 

E. H. Perkins, XI. S. Consul. 



Toronto, Ontario, April 17th, 1870. 

I have to acknowledge the receipt of your communication bear- 
ing date 23d February, 1870, and, in reply, briefly give you such 
information as seems to me jDertinent to the subject you have under 
advisement. 

In reply to your first inquiry, " What are the chief intoxicating 
articles used in Canada ? " I answer, that brandy, gin, whiskey, 
sherry, champagne, together with the various kinds of ale and beer, 
make up, in the main, the list of " intoxicating articles " used in 
Canada. 

In answer to your second inquiry, " What amount of crime is 
produced by them, and their effects on health and prosperity of the 
people?" I have to report that, in my judgment, founded on large 
observation, ninety -eight per cent, of all the crimes committed here 
grow out of the use of intoxicating drinks. In the police court of 
this city the daily arrests vary from five to twenty. I have very 
frequently visited the same, and I do not now recollect a single 
committal to have been ordered, or a fine imposed, since I came 
here, where the prisoner was a consistent temperance man or wo- 
man. Intemperance almost invariably lies at the bottom of all the 
crimes which swell the criminal calendar of this city and entire 
Province. 

As to the relative amount of intoxication in Canada and that 
seen in the United States, I may say that it would be difficult to 
determine what ratio there was between the two countries, owing 
to the difference in the quality of the intoxicating drinks used. In 
Canada, as a general rule, liquors are cheaper and purer than in the 
States, and as a consequence more can be used with less apparent 
injurious effect here, than would be possible there. 

Pure liquors do not affect the habitual drinker as do the vile 
compounds sold in such alarming quantities in the United States. 
There is a marked difference in the effect produced by pure and 
drugged liquors. In the one case, the effect is the reverse of the 
other. One using drugged liquors seems to be for the time in a 
state of frenzied insanity. 
The general use of wines and liquors in Canada, as a social 



326 STATE BOARD OF HEALTH. [Jan. 

custom, is in marked contrast to the growing abstinence in many 
of the leading families in the States. 

Intemperance here, as is the case everywhere, breeds crime, and 
daily leads to the committal of monstrous wrongs. The subject 
you have in hand is one of very great importance to society the 
world over, and I am sincerely sorry that pressing duties will not 
permit me to more fully develop an inquiry almost boundless in 
its bearings. 

Sympathizing most fully as I do in your researches, as set forth 
in the circular you forwarded me, I shall look with interest to the 
results of your labor. The social problems of the day are the great 
questions of the age, and he who succeeds in providing a practical 
remedy for the evils now threatening the future prosperity of our 
body politic, will earn for himself the commendation of all mankind. 
Faithfully yours, 

A. D. Shaw, TJ. B. Consul. 



United States Consulate, Trinidad de Cuba, 

April 11, 1870. 

Sik : — On the ninth instant I had the honor to receive your com- 
munication dated February 23d, requesting information toward elu- 
cidating the subject of the "influence of intoxicating drinks on the 
health and prosperity of the people of the United States," and I 
cheerfully give you the little information which I possess in behalf 
of a subject of so great an importance. 

With regard to question 1st, " What are the chief intoxicating 
articles used in Trinidad or vicinity?" I would reply, that the usual 
intoxicating drink made use of here is called " aguardiente ; " it is 
distilled from molasses, is sold at a cheap rate, and is made free use 
of, not only for drinking, but also for bathing. 

This liquor, although used so freely as a drink by the poorer class 
of whites, and the blacks, yet I must in justice add, that notwith- 
standing its liberal use, it is very seldom that it is drank to excess, 
so much so, that it is an extremely rare thing to see a person intox- 
icated in the streets. 

The cheap claret wine from Spain (principally from Catalonia) is 
made use of here very generally at meal times, but scarcely ever is 
drank to cause intoxication. Indeed, it is a fact which has often 
attracted my attention, that in a country where intoxicating drinks 
are to be had so cheaply as to be within the reach of every one, and 
I may say, in such general use, that so very few cases of drunken- 
ness are seen. This, I conclude, is in part owing to the fact that an 



1871.] PUBLIC DOCUMENT— No. 37. 327 

habitual drunkard is looked upon by these people with disgust and 
contempt. One may be a gambler (and there are a hundred of them 
to one habitual drunkard), or anything else immoral and improper, 
and this will not deprive him of a respectable position in society, 
whilst to be a drunkard is almost an unpardonable sin. 

With regard to question 2d, " "What amount of crime is produced 
from the use of intoxicating drinks, and the effects on health and 
prosperity of the people ?" would say, that really in this town, where 
I have resided for thirty years, the amount of crime proceeding 
directly from the use of intoxicating drinks is so small that I can 
safely say that it does not amount to one per cent, of the total of 
crimes from all causes. Consequently I may say that the " prosperity" 
of the inhabitants is scarcely affected, if at all, from the effects of 
intoxicating drinks. I would add that a large number of coolies 
have been imported into this island, and that they are much addicted 
to the use of opium; this is the cause of the death of many of the 
coolies, and also, under its influence, or from its effects, they commit 
many crimes, and I have no hesitation in saying that there are fifty 
deaths among the coolies from the effect of opium, to one amongst 
the Creoles from that of intoxicating drinks. 

With regard to the " relative amount of intoxication in this town 
compared to that seen in the United States," you may well infer 
from the foregoing that the latter country must sutler most lament- 
ably from the comparison. It is impossible for me to remit any 
" official statistics of the amount of intoxication and crime resulting 
therefrom," as you request, as no such records have ever been kept 
here to my knowledge. 

In conclusion, would say that I wish to be understood as referring 
to this city (Trinidad de Cuba) exclusively in the foregoing observa- 
tions, and with my best wishes for your cause, 

I remain, your obedient servant, 

Horatio Fox, Consul. 



Legation of the United States oe America 
Lima, Peru, May 22d, 



UERICA, > 

1870. 5 
Dear Sir : — I have the honor of acknowledging the receipt of 

your letter, dated the 23d of February last, inquiring, 1st, " What 

are the chief intoxicating articles used in Peru?" and 

2d, "What amount of crime is produced by them, and their effects 

on health and prosperity of the people ? " 

In answer to the first question, I may briefly say that all kinds of 

European liquors and wines are used in Peru. To those may be 



328 STATE BOARD OF HEALTH. [Jan. 

added " Italia " and " Pisco," Peruvian brandies, made from the 
grape, " Chicha," made from maize, and similar in taste and character 
to the beer in our whiskey distilleries after the fermentation. 

The wines of the country are very fair, but still the higher classes 
mostly use foreign importations, and at their tables, Bordeaux, 
sherry, and on special occasions champagne, will be found. 

Your second inquiry is more difficult to answer. As a people, the 
Peruvians are much more pacific than our own, and crime is not so 
common. After six years' residence in Lima, a city containing 
180,000 inhabitants, I have only seen one assault and battery — only 
four or five homicides have been committed, and pickpockets are 
unknown. The newspapers also show that such occurrences are 
very rare. 

The Peruvians are far less given to drunkenness than the people 
of the United States. Among gentlemen such offences are of rare 
occurrence, and foreigners certainly excel them in all such " gentle- 
manly vices." 

As to the health of the people, I can only state that I believe the 
average age of adults in Lima far exceeds that in the United States. 
From appearances, it would not be difficult to find in Lima at least 
one hundred persons over one hundred years of age. 

Temperance societies are unknown here, and all drink who have 
the means to pay for it. My impressions are, that the use of light 
wines, and " Chicha," in this climate, add to the cause of temper- 
ance and health, by banishing the stronger alcoholic beverages and 
giving tone to the stomach and circulation of the blood. Life here 
seems to me torpid, and stimulants necessary. 

As there are no statistics of intoxication and crime, except as 
stated in the daily journals, I regret that my reply to your note 
could not be more thorough and satisfactory. 

I have the honor to be, your obedient servant, 

Alvix P. Hovey, 
Envoy Extraordinary and 3Iinister Plenipotentiary 

of the United States of America to Peru. 



Para, 23d May, 1870. 

Dear Sir : — I am in receipt of your communication of 23d Feb. ; 
illness has prevented my replying to it sooner. 

1st. The chief intoxicating article used in Brazil is " CachaQa," 
rum (made from the sugar cane). 

2d. In the absence of statistics, it is impossible to give a satis- 
factory reply to your second interrogatory, but habitual intoxication 



1871.] PUBLIC DOCUMENT— No. 37. 329 

is rare in Brazil, and is, I may say (of course with individual excep- 
tions), limited to the lowest class of the population. Even among 
these it cannot be said to be prevalent. The blacks will get drunk 
sometimes, but even among them the vice is not general. Our 
country population, the Sapuyos or civilized Indians, are as a rule 
temperate, but they will all get drunk on certain " festas " (Church 
holidays), when they gather from miles around at the district chapel. 

You will observe that my observations apply more particularly to 
the Amazonian provinces, but I have resided in the south as well as 
in the north of Brazil, and with exception of the reference to the 
Sapuyo, a race found only on the Amazon, I believe they may be 
applicable to the country genei-ally. 

The word " bebado," drunkard, is a term of great reproach — in 
the cities, it is too often and too justly connected with the word 
" Inglez," and I am sorry to say that the national designation prop- 
erly includes our own countrymen. 

A great deal of porter and ale is consumed in the country, im- 
ported from England. 

There is a festa held yearly at a chapel in the suburbs of this city ; 
last year, on the principal night, when I think not less than from 10 
to 15,000 people of all classes were assembled in the square, I passed 
through the crowd, and observing carefully, could not find one 
drunken man ; nor was there any row nor any fight ; later in the 
evening two drunken men appeared, both respectable foreigners. 

With these exceptions, I do not remember to have seen more than 
two men (one a slave) drunk in the streets during the past six 
months. 

You will see from these remarks that no comparison can be made 
as to the amount of intoxication in this country, and the extent of 
the national vice which so sadly disfigures our own. 
Very respectfully, your obedient, 

James R. Bond, United States Consul. 

It is proper that I should add, that the consumption of " cachacji" 
is large, — there is a grog-shop at almost every corner, not limited 
however to sale of liquors. How it happens that there are so many 
moderate drinkers and so little drunkenness I cannot tell. 



Consulate of the United States of America, ) 
At Peknambuco, July 1st, 1870. 5 

Dear Sir : — I have the honor to reply to your inquiries as far as 

I can gather them, viz : — 

The chief intoxicating drink of this city and province, is the 

42 



330 STATE BOARD OF HEALTH. [Jan. 

liquor distilled from the sirup of sugar-cane, commonly called 
canoe?, or Brazil rum ; there is quite a large quantity of it distilled 
in this province, but it is not all consumed here ; a considerable 
quantity of it is exported to the south. 

Most of the natives drink this, particularly the lower classes, as it 
is cheap, the cost being about forty cents per gallon. The crime 
that is produced from this drink, so far as I can learn, is very small. 
A person may travel through the streets of this city, for a week, and 
in fact the province (I have travelled much through it), and not see 
a Brazilian intoxicated. 

Most of the crime that is committed through the influence of 
strong drink is by foreigners, principally seamen, and that only 
trifling cases of assault and battery. 

Most of the foreigners that reside here are English, German and 
French. The English and Germans drink more or less beer, which 
is mostly imported from Europe. Many of the English drink brandy, 
and other intoxicating drinks, which has a bad effect in this hot cli- 
mate, producing fever, and often death with the continued use of 
strong drink and exposure ; although this is a healthy port, and 
clear of all contagioiis diseases, and has been since I came here, and 
for several years past, as I have learned. 

I think the use of rum, or ardent spirits, is no detriment to the 
prosperity of the people, as they do not use it yet to excess, but 
the use of it is increasing, and may in time reach to bad results, as 
the manufacture of it increases yearly. 

The most of the crime committed here is caused from jealousy 
and revenge, and done in cool blood; not intoxicated, hot and angry 
with spirit as in our country, but premeditated and cool ; mostly of 
a dangerous chai-acter. 

I have known several persons stabbed since I have been here, 
from jealousy, which is the cause of most of the capital crimes that 
are committed ; not from drinking spirit but in the coolest manner, 
by attacking the party unsuspected and dealing a dangerous blow. 

As to the amount of intoxication between this country and ours, 
there is no comparison, for here you seldom see a drunken man. 

I came from the city of Philadelphia, where most of the crime is 
caused by intoxication, or the effects of it, and here none compara- 
tively, so little that it caused me to make close observations as to 
its effects on the habits of the people. As for statistics of crime 
on account of drunkenness, I think there are none, at least in this 
city that I can find ; if there is any crime from intoxication it is 
recorded from other causes. 



1871.] PUBLIC DOCUMENT— No. 37. 331 

I bope the above will be satisfactory, as it embraces most of the 
facts, as near as I can gather them from observations and statistics. 
I am sir, with the greatest respect, your obclt. servant, 

Samuel G. Moffitt, U. S. Consul. 



TJ. S. Consulate, Sax Juan del Sur. Now at Coetnto, 

May 27th, 1870. 

Dear Sir : — Yours of February 23d is received, and I cheerfully 
give you such answers to your questions as I am able. I should say, 
however, that my facilities are not good for getting accurate infor- 
mation on the subject in question, as my business confines me the 
greater part of the time at this port, a town of small population. 

The chief, and almost the only intoxicating drink used by the 
masses of the people in this Republic is neio rum, manufactured 
from cane molasses. It is a government monopoly, made by con- 
tract, at about forty-five cents per gallon, and sold by the govern- 
ment for $2. From this it derives an important revenue. The 
wealthier classes use cheap brandy. Claret wine is used quite gen- 
erally, and I think a considerable amount of other wines, among 
those who can afford it. 

No statistics of crime can be'obtained resulting from this or other 
causes, but my impression is that intoxication here gives about the 
same proclivity to vice as elsewhere. 

There are very few people here who are strictly temperate and 
very few who can be called inebriates, but I am quite positive that 
there is far less intoxication here than in the United States, and 
vastly less evil resulting therefrom. My opportunities for general 
observation in neither country would qualify me for giving a relia- 
ble statement of the relative amounts. 

I am sir, very respectfully yours, 

Rufus Mead, IT. S. Consul. 



Consulate of the United States of America, > 
Trieste, October 13th, 1870. 5 

Dear Sir : — Some months since I had the honor to receive from 
you a circular letter requesting information upon the influence of 
intoxicating drinks on the health and prosperity of the people un- 
der my daily observation, your inquiries being given under two 
general heads, to which I will reply after a preliminary remark or 
two. 

Trieste (proper) contains a population in round numbers of 
about 90,000 souls. It is not only the principal seat of commerce 



332 STATE BOARD OF HEALTH. [Jan. 

on the Adriatic, but of a large manufacturing industry. It has ex- 
tensive iron-works, large ship-building establishments, and a great 
number of coopers' and cabinet-makers' shops. The want of dock 
and wharf accommodations, and of machinery for the manipulations 
of its immense grain and lumber commerce compels the employ- 
ment of a very large number of lighter-men and laborers, not 
needed in American ports. Again there are rarely less than a hun- 
dred vessels in port — not counting of course, fishing smacks and the 
like, and I have known the number to reach 430. The arrivals of 
sailing vessels in 1869 were in number 7,376, of which 1,725 were 
from ports outside the Adriatic; arrivals of steamships 1,719, more 
than two-thirds of which were from ports outside the Adriatic — 
mostly large vessels of 800 to 2,C00 tons. We have, therefore, sel- 
dom less than 500, often 2,000 or more seamen in port. No English 
or American (Atlantic) sea-port has so large a number of laboring 
men in proportion to the whole population, as Trieste. As boarding- 
houses (in the American sense of the term) are unknown, the un- 
manned and a large proportion of the married men collect in the 
eating-houses for their supper, when the day's work is ended, and 
are thus exposed constantly to the temptation to indulge in strong 
drink. 

The " liquoristas " scattered through the town to the number of 
seventy-eight, correspond to the old American "bar-rooms," except 
that they are not connected with the inns. They are independent 
shops and furnished in all degrees of elegance. All sorts of liquors 
and high-priced foreign wines are sold by the glass in those of the 
higher class, ordinary liquors only in the lowest, but no common 
wines or beer. How these liquoristas exist is a mystery to me, for 
in the many I pass daily, I seldom see more than three or four per- 
sons, and the gulping down of glass after glass of brandy, gin or 
rum is utterly unknown among the native population. The glasses 
used are exceedingly small, and the liquor, usually unmixed with 
water, is sipped slowly at intervals, as a gentleman with us takes 
his maraschino after dinner. Mixtures like "juleps," "cobblers," 
and the other wonders described by English tourists in the United 
States, are unknown. 

The " Osterias," one hundred and eighteen in number, are the 
ordinary eating-houses of the middle and lower classes of the peo- 
ple. In them, as a rule, I believe without exception, no drink but 
wine is to be obtained ; the light red and white wines from neigh- 
boring districts, drawn from the casks. 

The " Trattonas " and " Birrarias," restaurants and beer-houses, 
rank higher than the last, and are in the main supported by the 



1871.] 



PUBLIC DOCUMENT— No. 37. 



!33 



mercantile class, the officers of the army and navy, and generally 
the Teutonic in contra-distinction to the Italian and Sclavonic pop- 
ulation. Beer is the principal beverage in these fifty-five establish- 
ments, though wines are also furnished, and the occasional demand 
for a small glass of cognac or other fine liquor is supplied. 

In the fifty-four coffee-houses also, all the finer liquors and spirits 
are dispensed, but invariably in the smallest of " portions." 

In the hotels are no bar-rooms, but the guest is supplied, at table 
or in his room, with whatever beverage, from beer to brandy, he 
may demand. 

It will be seen from the above that no restraint whatever is im- 
posed upon the purchase of spirituous liquors, except that in the 
licenses granted to the lower classes of eating-houses, the proprie- 
tors are deprived of the power of tempting to drunkenness by the 
sale of anything except wines or beer. 

The following tables, drawn from the very exact records of the 
Chamber of Commerce, will give a fair view of the consumption of 
beer, wines and liquors by this population of 90,000. Everything 
of the kind that enters the city by sea or land is recorded in " cent- 
ner," hundred weights. 





k^-; j 




E 


E 


B 


k 




B rt ^ E O 

■^ •a c S u 


is 


o S 


« 


« 
© 




YEARS. 


" 1 K « -a 


m 


° 




BO 






t! — o -2 


O 


S 2 




O *S 


m *f 






a. 




& $ 




a o 






K" 




E ° 


X o 


X. P. 




'- 


a 


W 




W 


W 


1860, . 


190,950 


171,802 


19,148 


9,374 


33,440 


24,066 


1861, . 




163,829 


140,515 


23,314 


12,224 


29,946 


17,722 


1862, . 




156,364 


110,613 


45,749 


10,997 


32,976 


21,999 


1S63, . 




159,150 


139,260 


19,890 j 


2,657 


33,367 


30,680 


1864, . 




209,574 


182,988 


26,587 j 


5,275 


39,466 


34,181 


1865, . 




199,079 


171,060 


28,019 


4,225 


39,476 


35,251 


1866, . 




181,872 


160,988 


20,884 1 


6,754 


32,056 


25,302 


1867, . 




179,890 


163,805 


16,085 i 


2,668 


31,636 


28,968 


1868, . 




256,588 


226,108 


29,171 


7,538 


43,681 


36,143 


1869, . 


274,239 


224,230 


46,431 


1,340 


60,982 


59,642 






- 


- 


275,278 


- 


313,954 



Excess of Export, 



38,675 



There are no distilleries in Trieste ; making due allowance, there- 
fore, for the ordinary consumption of alcohol in manufactures, the 
great excess of the export of the mixture here called " rum " over 
the import of the real article, reduces the amount of spirits used as 



834 



STATE BOARD OF HEALTH. 



[Jan. 



a beverage to an exceedingly small quantity. That is to say, sta- 
tistics, also, prove that spirits are in no form a common drink ot 
any class of people in this city. 

Total Imports and Exports by Sea and Land. 





Wine. 


Beek. 


YEARS. 


Imports, 


Exports, 


Excess of 


Import by 


Export by 


Excess of 




(•Wt. 


cwt. 


Import,cwt.| 


land, cwt. 


sen, cwt. 


Import,cwt. 


1860, 


173,976 


47,237 


126,739 


71,475 


21,958 


49,517 


1861, 


106,599 


47,791 


58,808 


82,520 


28,094 


54,426 


1862, 


137,421 


30,395 


107,026 ; 


84,081 


32,207 


51,874 


1863, 


176,028 


30,514 


145,514 , 


72,924 


29,025 


43,899 


1864, 


180,045 


33,139 


146,906 


72,704 


29,920 


42,784 


1865, 


183,781 


36,414 


147,367 


84,978 


40,167 


44,811 


1866, 


214,030 


30,198 


183,832 


73,879 


51,273 


22,606 


1867, 


192,854 


37,009 


155,845 


93,614 


48,669 


44,945 


1868, 


194,525 


44,738 


149,787 


113,856 


68,413 


45,443 


1869, 


208,667 


60,449 


148,218 


137,028 


71,377 


65,651 



[N. B. The discrepancy in the beer statistics for 1866 is caused 
by the opening of a splendid new brewery, just back of the town, 
in the spring of that year, the product of which does not appear in 
the figures that season, except partly in the column of export.] 

These tables and the preceding remarks aiford a full answer to 
query 1 of your circular, viz. : that wines are the chief intoxicating 
article used in this part of Austria. So far as my observation ex- 
tends, no person intoxicates himself on beer, and very few, if any, 
upon spirits. 

As to the second question, " What amount of crime is produced 
by intoxicating liquors ? " I have to report that no statistics bear- 
ing on this point have been kept at the police office, and that a 
police commissioner with whom I conversed on the subject is of 
opinion that the amount of crime directly traceable to the use of 
liquor is trifling, if any. The few drunken brawls, which arise in 
the course of the year, and cause arrests for assault and battery, 
are for the most part confined to the crews of American and Eng- 
lish vessels. 

The drinking of wine and beer is universal. Oil is used in cook- 
ing and at table in great quantity, but very little vinegar ; and 
light, sour table wines are the corrective. From infancy to age 
they are the common beverage, but are generally, as by Homer's 
heroes, mixed with water. 

As I have been home but once (1863), and then only for a period 



1871.] PUBLIC DOCUMENT— No. 37. 385 

of seven weeks, since 1858, I am not competent to offer an opinion 
upon the comparative amount of intoxication here and there. I 
can only say that at that time, the American bar-rooms in New 
York, Washington and Boston, so frequented by respectably dressed 
people, and especially young men evidently of the better classes of 
society, pouring down spirits of all sorts, caused me a feeling which 
I can only describe as one of horror. 

Here in Trieste, on the evenings of Saturdays and holidays, one 
may see a pretty large number of the laboring class of people in- 
toxicated, but they are always "jolly drunk," not "savage drunk," 
— in my view a broad distinction. They make night hideous in the 
cheap eating-houses and occasionally in the streets, by the unearth- 
ly yelling which they suppose to be singing, and wordy wars are 
not infrequent, — though even in this a stranger easily mistakes — 
and at the moment he expects to see a blow, he hears a burst of 
laughter. Addison wrote 170 years ago of the Italian recitative — 
" I have often seen our audiences extremely mistaken as to what 
has been doing upon the stage, and expecting to see the hero knock 
down his messenger, when he has been asking him a question ; or 
fancying that he quarrels with his friend, when he only bids him 
good-morrow." On Saturday and Sunday evenings the laboring 
men, often Avith wives and children, sup together, as before re- 
marked, in the public house, drink wines at a cost of less than 60 
cents (gold) per gallon, to various degrees of intoxication, reel 
home supported by wife or friend, sleep off the effects, and next 
morning go to work as usual, (retting savagely drunk and going 
home to abuse and beat % wife and children, is something unknown 
here. 

Turning to the better classes of society, I have to remark that 
no instance is known of a merchant, lawyer,- physician, shop-keeper 
or master-mechanic, becoming an inebriate and gradually losing 
position, property and business, and sinking into a drunkard's 
grave. That is to say, among the native population ; for there 
have been three or four instances of Englishmen becoming more or 
less confirmed sots. One remarkable case of a man who sank so 
low as to sell his wife's and children's clothing for spirits, who be- 
came a nuisance to the family into which he married, and to the 
police, who reeled about the streets, lay in the gutters, and at last 
died in the common hospital at Naples, may be mentioned. He 
was an American. 

There are no official statistics of the " amount of intoxication 
and of crime resulting therefrom " obtainable for Trieste ; but upon 
a comparison of my observations here during the last six years, 



336 STATE BOARD OF HEALTH. [Jan. 

with my recollections of those made between 1840 and 1850 at 
Cambridge and Boston, I should consider it a most happy change 
could the spirit drinking of Boston be bartered for the wine and 
beer drinking of this city. As I rarely taste anything intoxicating, 
I am in so far a disinterested witness. 

I am, sir, very respectfully, your obedient servant, 
^Signed,) Alexander W. Thayer, IT. S. Consul. 

N. B. I find an omission in connection with the tables, viz., that 
the " centner " of export is the hundred-weight of Vienna ; that of 
import the hundred-weight of the customs. The former is twelve 
per centum greater than the latter. 

The following interesting letter is from the venerable Dr. 
Christison of Edinburgh : — 

Edinburgh, 26 July, 1870. 

Dear Sir : — When your letter of 23d February arrived here, 
requesting information about drunkenness in Scotland, I was con- 
fined by illness, and for some weeks in order to keep my University 
work going it .was necessary for me to take great care by avoiding 
and postponing as much as possible of my other rather manifold 
duties. Thus it happened that I had to delay replying to your letter, 
until my undischarged debt to you has been brought up before me 
by the accidental discovery of the letter, and an unfinished answer, 
this morning. I fear the information I have to give you may be 
too late for any practical use you might have intended to put it to. 
But nevertheless I must not let you go on supposing, as you were 
well entitled to do, that I have been utterly regardless of your 
request. 

I have several times bethought me how I could best give you 
a clear idea of the extent and evil effects of excess in the use of 
stimulants among my fellow-countrymen. The conclusion I have 
come to is to discard the favorite statistical method of inquiry 
among modern enthusiasts, as being full of fallacy, and apt to lead 
to dangerous and blundering practical conclusions. I am sure that 
you and your friends of the Massachusetts Board of Health will 
come much nearer the truth of things, if I tell you the general re- 
sult of the observation of a long life, during which my attention has 
been seldom long withdrawn from the evils of drunkenness in vari- 
ous branches of the population of Scotland. There are really no 
statistical returns on the subject which are worth their cost in paper 
and ink. 



1871.] PUBLIC DOCUMENT— No. 37. 337 

In the first place, you ask " What is the chief intoxicating liquor 
used in Scotland ? " The foremost is whiskey ; the next is whis- 
key ; the third is still whiskey ; and any other is " nowhere," in 
racing phraseology. When the vice of drunkenness commences in 
any one of the middle or upper walks of life, wine may set it ago- 
ing ; hut that vehicle is soon changed to brandy, or to whiskey. 
Among the working classes there is no other from first to last than 
whiskey. Beer, a common intoxicating liquor among Englishmen, 
is not in use as such in Scotland. In the middle and upper ranks 
it is very widely used in moderation as a beverage during dinner, 
when wine is not taken. Scottish workmen unfortunately use it 
extremely little in that way, but, if they take any stimulant dieteti- 
cally, it is whiskey ; and hence the passage to excess is too easy. I 
do not recollect in fact to have ever seen a beer-drunk Scotsman 
but once ; and that was an unfortunate gentleman of high reputa- 
tion in a learned profession, who gradually fell into " rambles " of 
continuous drinking, and who, on one of these occasions, when the 
ladies of his house in the country had carefully locked up every 
bottle of strong drink they could think of, ferreted out, and got 
drunk upon, nine bottles of the smallest of small beer. 

During last century the habit of frequent and extreme intoxi- 
cation prevailed very much in all ranks of life. When one regards 
indeed what has been handed down of the correlative practices of 
the day, it is scarcely possible to avoid the conclusion that the up- 
per and middle ranks, and even the educated and professional in the 
community carried off the palm in prowess as well as in frequency 
of indulgence. The close of last, and beginning of the present 
century saw a gradual change set in for the better. But even in 
my young days, when I began to go into company, about 1820, 
drunkenness in good society was far from uncommon. Almost any 
party of gentlemen, left in the dining-room, according to the fashion 
of the day, by the ladies, would rejoin them in the drawing-room 
with two, three or more much flustered, or drop one or two in the 
lobby incapable of showing face upstairs. But a rapid reform took 
place, and for a long time past any sign of alcoholic excitement in the 
drawing-room after dinner would lead to remark, and displeasure, 
and to quiet measures for withdrawing the offender. Cases of gross 
intoxication do occur certainly. But these are cases of the passion 
of drinking, " oinomania," or, in plain English, insane " drunkenism." 
There is thus a vast improvement in the habits of good society in 
Scotland, in the use of stimulants, during the last fifty years. 

But I grieve to say that there is far from a similar improvement 
in the working classes. I am certain that proportionally drunken* 
43 



338 STATE BOARD OF HEALTH. [Jan. 

ness is more frequent there than it was. I cannot give you statisti- 
cal proof. I would not give a rush for any such proof that may be 
offered me on one side or the other. But I can give you the result 
of my observation on the street and country roads. For, when I 
was a young man, and indeed till about thirty years ago, it was a 
very rare thing to meet a working man, either in town or country, 
who was drunk until the evening, after his work for the day was 
over; but for some time past such cases may be seen frequently at 
all hours of the day, and especially between one and two o'clock, 
which is their interval of work for dinner. I first observed this 
curious change, and mentioned my observation to various friends 
at the time who confirmed it, when about twenty-five or thirty years 
ago a great reduction was made in the excise duty on spirits. 
Within a few years the very high duty was restored, indeed was 
made greater than ever in Scotland ; but there has been no im- 
provement effected thereby in the appearance of things in our 
streets. Great exertions have been made by the educated classes 
to cure this fearful malady; and I must not say anything to under- 
value their exertions in establishing temperance societies, and total- 
abstaining clubs. Bnt I doubt whether many drunkards have thus 
been permanently reformed, and of the many guiltless who join 
these associations in youth, it may be a question whether any 
material number would have fallen victims to the vice if unpro- 
tected by the pledge, simply because a preponderating mass of the 
population have no natural tendency to fall in this way. 

You also ask " what amount of crime is produced by the abuse 
of stimulating liquors?" When I was professor of medical juris- 
prudence for ten years, and for ten years more during which I kept 
up my connection with criminal trials as a crown referee and wit- 
ness, I had ample occasion to verify the statement made by our 
procurators-fiscal, sheriffs, and public prosecutors, — that three- 
fourths of crimes against the person are more or less connected with 
drunkenness, and very many owing to that cause alone. 

Lastly, you ask " what are the effects of the abuse of alcoholics 
on the health and prosperity of the people?" Here however two 
questions are embraced in one. I shall answer only that which re- 
lates to the health of the community. But if the vice of drunken- 
ness damages the health of the people, and accounts for even only 
one-half of the cases of crime against the person, I imagine it will 
be unnecessary to answer the second branch of your third question, — 
" what is the effect of the abuse of alcoholics on the prosperity ot 
the people ? " 

The influence of the vice of drunkenness on the health was 



1871.] PUBLIC DOCUMENT— No. 37. 339 

brought very early under my notice, in consequence of my being 
for very many years, and from a very early age, a medical officer of 
our infirmary, at a time when various epidemics prevailed ; and, as 
professor of materia medica, I have had time to methodize my 
views on this subject as a branch of the action of alcoholics, in re- 
lation both to diet, and to medicines proper. Thus, in the first 
place, I recognize certain diseases which originate in the vice of 
drunkenness alone, which are delirium tremens, cirrhosis of the 
liver, many cases of Bright's disease of the kidneys, and dipso- 
mania or insane drunkenism. Then I recognize many other dis- 
eases in regard to which excess in alcoholics acts as a powerful pre- 
disposing cause, such as gout, gravel, aneurism, paralysis, apoplexy, 
epilepsy, cystitis, premature incontinence of urine, erysipelas, spread- 
ing cellular inflammation, tendency of wounds and sores to gangrene. 
Next, I recognize as a wide-spread result of habitual excess, an in- 
ability of the constitution to resist the attack of diseases at large. 
And lastly, I recognize a greater inability, than in the sober, to sus- 
tain the treatment which is necessary or most serviceable in dis- 
eases generally. If all these ways of influencing mortality be taken 
into account, it is evident that the sum total must be very great 
indeed, although it may be impossible to express it numerically. 
How can we ever hope to express numerically the influence of 
drunkenness in aggravating the mortality from fevers, cholera, dys- 
entery, and other zymotics ? How much more difficult, when the 
question is with apoplexy and the long catalogue of other diseases 
of which the vice is the predisposing cause ? No hospital physician, 
however, of long experience can doubt for a moment the enormous 
effect of habits of drunkenness in increasing one way and another 
hospital mortality, — that is, the mortality of the working classes. 
Details on this head would lead me to write a book, in place of a 
letter. But let me conclude with one illustrative fact. I have had 
a fearful amount of experience of continued fever in our infirmary 
during many an epidemic, and in all my experience I have only 
once known an intemperate man of forty or upwards recover. He 
was the exceptio qucejlrmat regulam. 

I will gladly learn what you think of all this. But remember 
I am not one of those who would deprive the world of alcoholics, 
for the sake of those who abuse them ; I am not one of those smug 
philanthropists, who would ask a government " to permit me to pre- 
vent you from having your grog." If a man, in face of universally 
admitted consequences, will insist on habitually getting drunk, — 
quid facias illi? Jubeas miserum esse, libenter quatenus idfacit. 
I am yours most faithfully, D. R, Christison. 



340 STATE BOARD OF HEALTH. [Jan. 

United States Consulate, Rotterdam, \ 
Nov. 9th, 1870. > 

Sir: — T have the honor to transmit to you the enclosed docu- 
ments which I have just received after so long a delay. In for- 
warding them to me, the secretary of the society* explained that 
delay by stating that my letter was only received after the preced- 
ing trimestrial meeting, and that it had to be referred to the follow- 
ing meeting. 

The within statement is an extract of the letter which accom- 
panied the pamphlet. 

I shall always be very happy to do anything for which you may 
have an opportunity of applying to this Consulate. 
Yery respectfully yours, 
(Signed) Frederick Schutz, U. S. Consul. 



In this country gin is the beverage of the people, and to such 
an extent as to create a general anxiety about the future of a nation 
committing excesses in that beverage, condemned as well for moral 
as physical and economical reasons. 

The minister of finances estimated the revenue on gin for 1871 
at 14,200,000 florins, gin paying 53 florins duty per hectolitre of 
fifty degrees strength. The quantity used for technical or other 
purposes is hardly anything. 

Calculating the population of the Netherlands at three and a half 
millions, and taking off three-fourths for women, children and very 
old people, show that one-fourth of the whole population furnishes 
a tax of more than 14 millions of guilders, and undoubtedly the 
same amount to inn-keepers, etc. 

It is calculated that twenty-eight-thirtieths millions of florins are 
spent in gin by the people. 

"We believe that every drop of alcohol is injurious and the begin- 
ning of wilful poisoning, as it is incessantly proclaimed by our 
renowned oculist, Professor Donders ; and that this kind of alcohol, 
obtained by distilling, does not mix itself with the blood, but runs 
through all blood vessels, acting injuriously on the brain and impair- 
ing the best human faculties down to second and third generations. 

The investigations of the society have led to the result that the 
number of drinkers of gin has considerably decreased, that the 
use of that beverage by higher and middle classes is considered 
indecent, and that the people are coming to the conviction that, in 

* Society N^erlandaise pour l'abolition des boissons fortes. 



1871.] PUBLIC DOCUMENT— No. 37. 341 

the interest of peace and public order, intoxicating liquors must 
be abolished. 

By statistics it is shown that fifteen-sixteenths of the crimes 
committed result from the use of gin. 



Hiojo, Japan, Oct. 17th, 1870. 

Dear Sir :— Your letter of the 23d of February was handed not 
long since by Mr. Stewart, the American Consul, with the request 
that I should answer it. 

The chief intoxicating drinks used in Japan are a simple fer- 
mented liquor from rice, called Saki, and a distilled liquor called 
Shochin. 

In the island of Kinsin, wine is made from grapes. 

There is a great deal of saki consumed in Japan ; but probably 
less drunkenness seen on the streets, at least, than in America ; and 
whether there is really less drunkenness it is hard to say. The 
opinion of the best informed men is, that most of the drinking is 
done at home, and hence not noticed by casual observers, but that 
there is more drinking to excess here than at home. 

With reference to the amount of crime traceable to the use of 
intoxicating liquors, there are no statistics at my disposal, and the 
observation of the most favored foreigners has been so limited that 
any opinion would be of no value. I have written to the author- 
ities on the subject, but have as yet received no answer ; if one 
arrives with any information oh the subject, I shall be most happy 
to forward it to you. 

Yours, very respectfully, 

D. C. Greene. 



Concord, Mass., Dec. 17th, 1870. 

Dear Sir : — I have just received through Mr. Brewer, your cir- 
cular of February 10, an answer to which, I fear, I shall not be 
able to make very satisfactory from the imperfect data I have at 
hand. Had I been consulted in season, I would have advised the 
addressing your circular either to Attorney-General Stephen H. 
Phillips, or to Dr. G. P. Judd of Honolulu, or to some other resident 
physician. Mr. Phillips is now on a visit to his friends in Salem, 
Mass. 

The amount of crime caused by the use of alcoholic drinks can 
only be determined by the records of police courts, of which I have 
no reports. 



312 



STATE BOARD OF HEALTH. 



[Jan. 



The answer to your first question, " what are the chief intoxicat- 
ing articles used in the Sandwich Islands ? " may be found in the 
Honolulu custom-house returns, from which I copy as follows : — 



Invoice Values. 








186T. 


1868. 


1869. 


Importation of English " ale and 
porter " and German " beer," 
chiefly lager beer, 

Importation of " spirits " (consisting 
of American whiskey, French 
brandies, Holland gin and West 
India rum), .... 

Importation of " wines " (mostly 
French and German, with a small 
proportion of California), . 


$38,526 18 

23,288 70 
8,451 37 


$38,073 70 

35,907 21 
12,030 60 


$20,246 16 

33,870 98 
15,801 46 



/Spirits taken out of Bond for consumption in 1869. 



Rum, 


. 396 gals. 


Port, 


. 201 gals. 


Gin, 


. 5,239 " 


Bitters, . 


. 177 " 


Brandy, . 


. 4,537 " 


Sundries, 


. 328 " 


"Whiskey, 


. 4,177 " 







Alcohol, . 


. 799 " 




17,016 gals. 


Sherry, . 


. 1,162 " 







Estimated revenue from duties on spirits and wines for two years, 
1870-1 and 1871-2, $85,000 * 

The distillation of spirits in the Hawaiian Islands is prohibited 
by law. Illicit distillation, however, has been carried on to a con- 
siderable extent; and the government has never been able to 
entirely suppress it. The amount of the domestic article is insignifi- 
cant when compared with the amount imported. It is the product 
of a native root called " Ti" root which is rich in saccharine mat- 
ter. The traffic in "Ava,"also a native root, is legalized, used 
chiefly by natives, as a medicine ostensibly, but really for no other 
than intoxicating purposes. With its narcotic stimulant properties 
and its action on the skin, you are doubtless familiar. 



* Vide Ministerial Keport.— Duty on spirits, 
cents per gallon. 



1.50 per gallon. Duty on wines, 50 



1871.] PUBLIC DOCUMENT— No. 37. U 

The traffic in opium is legalized, and its consumption, though 
chiefly confined to the Chinese, is beginning to find favor with the 
native population. A Chinese merchant paid, about two years 
since $9,000 for the exclusive right of the trade in opium in the 
Hawaiian Islands. 

Besides the product of the "Ti" root (a spirit of about the 
strength of American whiskey), the natives prepare a stimulating 
beverage by the fermentation of sweet potatoes and of molasses 
when they can obtain it ; not openly, however, as this also is un- 
lawful. 

The native population of the islands is about 55,000. 

White foreign population does not exceed 4,000. 

Chinese population about 2,000. 

Of the foreign white population, not more than one-half are ad- 
dicted to the use of intoxicating drinks. Very little, if any, is 
taken by the Chinese. And as the sale of all intoxicating bever- 
ages to natives is prohibited by law, enforced with severe penalties, 
the consumption by this class of the population is comparatively 
trifling. 

The amount of alcoholic drinks imported into the Hawaiian 
Islands appears large when compared with the whole number of 
consumers, probably not exceeding two or at most three thousand. 
But by far the largest consumption is, no doubt, to be placed to the 
account of the great number of seamen annually visiting the differ- 
ent ports of the islands. 

Your circular calls for the " relative amount of intoxication " (at 
the Sandwich Islands) and "that seen in the United States." 
But having resided abroad for thirty years past I have had but 
little opportunity of observation as it respects the relative or actual 
consumption of spirits in this country. And I have therefore given 
the total amount of the consumption at the Sandwich Islands 
with the number of consumers as nearly as can be ascertained, 
leaving the comparison with the United States to be made by those 
better informed than myself. As I am in doubt also as to the 
limitations (if any) under which the word " intoxication " is to be 
taken in the circular, I have preferred giving the facts, leaving the 
effects to be inferred. 

In regard to the " effects " however " of alcoholic beverages upon 
the health and prosperity of the people " of the Hawaiian Islands, 
instead of my own " opinion " I am able to give you what will have 
far more weight — the views of the Hawaiian government— which 
may be inferred by its course of legislation in respect to alcoholic 
beverages during a period of fifty years. The importation of in- 



3U STATE BOARD OF HEALTH. [Jan. 

toxicating beverages into the Hawaiian Islands, except for medicinal 
use, was some years subsequently to the arrival of the American 
missioneries, 1820, absolutely prohibited, and this prohibition con- 
tinued in force till 1839, when (in July of that year) it is well 
known that the king of the Sandwich Islands, in order to avert the 
threatened bombardment of his capital by the French frigate 
" Artimise," signed a treaty, urged at the cannon's mouth by Capt. 
La Place, admitting French brandies (" eaux-de-vie ") at a duty not 
exceeding five per cent. Subsequently other nations in treaty with 
the Sandwich Islands claimed the same privilege by the " parity 
clause." For several years subsequent to the visit of the "Artimise," 
the French consul and other interested persons, made strenuous 
efforts, though without success, to induce the Hawaiian Legisla- 
ture to repeal the law prohibiting the sale of intoxicating drinks to 
natives. The French consul insisted that the law contravened the 
spirit of the treaty, but this pretension was finally abandoned. 

In contrast with the treatment of the Hawaiian Islands by the 
French, we are reminded of the very different policy they found it 
necessary to adopt for the government of Tahaite, of which they 
took possession in 1839. Very soon after its occupation by the 
French, intoxicating beverages were classed with the contrabands, 
and the prohibition has been continued to the present time. 

With more time, I might have made my answer more full and 
direct to the points of your circular, but Mr. Brewer informed me 
that you desired a reply without delay. 

Very truly yours, 

R. W. Wood. 



Utrecht, December 22, 1870. 

Dear Sir : — The honorable Mr. J. J. Van Osteyee asked the favor 
of me to answer your favor of February 23, and so I have the honor 
to inform you, that the principal strong drinks which are consumed 
in the Netherlands are, Genevee, which is made out of corn, and 
used principally by the poorer classes, whilst the wealthier folks 
drink punch and different strong liquors. 

We have in the Netherlands for the last twenty-five years a 
society, which does not work strictly for temperance, whose limits 
are difficult to define, but whose aim is to abolish the consumption 
of sti'ong drinks, which, owing to the misery they produce, can be 
called a canker which destroys the prosperity of the people. Spread 
out over different sections of the country, the society, which counts 



1871.] PUBLIC DOCUMENT— No. 3T. 345 

already several thousand members and increases always more and 
more, endeavors to persuade the people with the help of tracts and 
public meetings, what awful consequences arise from the abuse of 
these drinks, and although it has done a great deal of good in that 
direction, the members of the society giving good example by words 
and deeds, it waits always for severe measures on the part of the 
government. 

Concerning your second question with regard to the consequen- 
ces which these hurtful drinks exercise upon the health and pros- 
perity of the people, the best answer will be the statement of our 
two most renowned medical professors, which was accompanied by 
the signatures of more than six hundred physicians throughout the 
Netherlands, of whom twenty-two live in our city, the contents of 
which statement is as follows : — 

The undersigned physicians will sustain as much as possible the members of 
the Nederlandish Society for abolition of the consumption of strong drinks 
in their efforts in this behalf, and will work to remove the wide-spread pre- 
judice as to the usefulness of the moderate use of strong drinks, and in conse- 
quence consider it their duty to give the following explanations as to the 
influence of strong drinks on the human body : 

1. The moderate use of strong drinks is always unhealthy, even when the 
body is in healthy condition ; it does not do any good to the digestion, but 
even interferes with that process, for strong drinks can only temporarily 
increase the feeling of hunger, but not in favor of digestion, after which 
strong reaction must follow, and evils which are usually attributed to other 
causes, but often result from the habitual use with moderate drinkers. 

2. The assertions, that intoxicating drinks used moderately, are naturally 
innocent means of cheering up, that they are useful in severe colds, or that 
they are with laboring men equivalents for sufficient nourishment, or useful in 
misty and humid air, or for people obliged to work in the water, or a protec- 
tion against contagious diseases, are without any foundation, and contradictory 
to experience and to human reason, and the habitual use of the same has 
therefore an unhealthy effect, and an influence unlike what people expect 
from them. 

3. The habitual use of strong drinks works most perniciously on all diseases 
and especially on consumption. 

4. Regarded as the usual drink of all classes, they are not only improper 
on account of the above reasons, but also against moral development and 
material prosperity in such measure, as to be considered and to be stamped 
as the greatest underminers of the actual welfare of mankind. 

(Signed) C. B. Tilamus, 

P. U. Swingar, 
Amsterdam, March 19, 1846 Professors. 

44 



346 STATE BOARD OF HEALTH. [Jan. 

In spite of this concise explanation, which was printed and dis- 
tributed among the people and of all the efforts which the society 
uses, to work against the abuse in the consumption of strong drinks, 
the number of those, who are the slaves of this evil and subject to 
the consequences arising from the same, is still very great. 

It can be said according to a source based on an eighteen years' 
experience, that the number of misdeeds committed under the 
influence of intoxication amounts to more than seventy-five to 
eighty per cent. I should be glad if these lines were satisfactory 
to your philanthropic intentions. 

The delay in answering your favor is due to the lack of time in 
consequence of the same being taken up by my profession, I being 
principal teacher (superintendent) of the public schools. 

Hoping that you will excuse the delay, I wish that you may work 
for our principles in your industrial country on the other side of the 
Atlantic, and that you may be able to contribute something towards 
the abolition of the mischievous drinking, in order that your fellow- 
citizens may become temperate, economical and industrious mem- 
bers of your republic, striving for perfection. 

I have the honor to be with high esteem, very respectfully yours, 
J. Visschee, Chairman for the Department of Utrecht, 
of the Nederlandish Society for the Abolition of Strong Drinks. 



Boston, January 29, 1871. 

Dear Sir: — The chief intoxicating articles used in Panama and 
Darien are annisette, cocoa-nut milk, wine from the wine-palm, a 
drink made from bananas and plantains, and a milky-looking liquid 
made only by the Sassardi-Morti Indians at Darien. ' 

The annisette is brought wholly from Cartagena or Santa Marta, 
and is not made by the Indians. A little over a thimbleful will 
intoxicate any person not used to it, and none can bear more than 
an ordinary sized wine-glass full. It is nearly colorless, though 
slightly tinged with violet. It is said to be very injurious in its 
effects, few constitutions being able to bear constant use of it but a 
few years, or in some cases, months. 

Cocoa-nut milk is made by covering half ripe nuts with a few 
inches of sand on the seashore, just above high tide, and leaving 
them for about six weeks. In this length of time the milk ferments 
and becomes as thick as cream, and next to annisette (or the 
European drink, aguadente), is the most intoxicating drink used by 
the natives. As it will not keep, the Indians as a general rule 
have their stock of buried cocoa-nuts, which they use as they want. 



1871.] PUBLIC DOCUMENT— No. 37. 347 

The wine made from the wine-palm is produced by squeezing the 
fruit in a press similar to the sorghum presses used in the West. 
The Indians make considerable quantities of it, and use it exten- 
sively in their households. It is only a moderate kind of stimulant, 
I believe, and seemingly not injurious when used moderately. 

The drink made from bananas and plantains is quite similar to 
the cocoa-nut milk, though not nearly so powerful in its effects. 
There does not seem to be a great quantity of it used, from the 
fact I suppose of the cocoa-nut milk being easier to manufacture ; 
but the Indians appear to drink it with great relish whenever they 
can obtain it. 

The milky-looking liquid is manufactured by the Sassardi-Morti 
Indians principally ; it may be by the others also, but Sassardi is 
the only place where I have ever seen it. Its composition is wholly 
unknown to me, but I imagine it has several component parts. It 
is not very strong, and is said by those who have tasted it to be a 
very pleasant acid drink, little stronger, if any, than cider. 

The amount of crime produced by the use of the aforesaid drinks 
is a thing impossible to ascertain, but I judge not nearly so much 
as with white people under the same circumstances. 

The relative amount of intoxication in Panama and Darien 
(among the Indians) is much less than has been commonly believed. 
Of course there are certain ones among them that are drunkards, 
but as a general rule, they are a much more temperate set than the 
whites. One circumstance was noticeable everywhere, — the less 
the civilization, the less the intoxication. At San Bias (Carti), 
where the Indians are far more advanced in civilization than at 
Caledonia Bay, or the Atrato, the amount of intoxication was fully 
two hundred per cent. more. But even there the number of 
drunken Indians in the little community was far less, I should judge, 
than it is in correspondingly large towns in the United States. 
Respectfully yours, 

E. W. Bowditch, 
Late Mineralogist Darien Expedition of 1870. 



MORTALITY OF THE CITY OF BOSTON 
In 18 7 0. 



350 STATE BOARD OF HEALTH. [Jan. 



MORTALITY OF THE CITY OF BOSTON IN 1870. 



The mortality of a great city like Boston is usually expressed 
by a death-rate applied to the whole population. Sometimes 
the death-rate can be given by wards, but such divisions of 
territory are unsatisfactory for sanitary comparison. A portion 
of a ward may be good and another portion obviously bad in 
this respect. Ward six illustrates the difference. One side of 
Beacon Hill is made up of the very best, and the other side of 
the very worst houses ; yet both are included in the same ward 
lines. It is desirable to be able to compare the death-rate in 
certain sections of Boston which are marked by various distinc- 
tions which may be supposed to influence the duration of life. 
With this view the city has been divided into twenty-four 
Health Districts, which are represented on the accompanying 
map. They are numbered from twenty to forty-three to avoid 
all chance of their being confounded with wards. 

The " new land," or land reclaimed from the sea by filling 
with earth, is represented on the map by a dark gray tint. It 
will be seen that it includes already as much territory as was 
comprised in the peninsula of old Boston. The process of 
" filling," commenced in the last century, is still going on. 

A word of caution may be given with regard to the fair inter- 
pretation to be put on results thus reached. Every one will of 
course see that there are many considerations relating to the 
general circumstances of the inhabitants to be weighed before 
a judgment can be formed as to the salubrity of "made land." 
The new land of Rochester and Genesee Streets is not neces- 
sarily chargeable with the high death-rate of that section, for it 
is quite equalled by the death-rate of the orginal land of the 
North End. Neither must the new land of the Back Bay be 



1871.] PUBLIC DOCUMENT— No. 37. 351 

credited with the low death-rate of that region, since the 
original land of the Highlands (District 41) is equally exempt 
from mortality. Another consideration, less obvious, is equally 
important to remember. There are large sections in which the 
number of servants nearly equals the number of persons of all 
ages in the families employing them. These domestics do not 
have their own children with them, and in case of severe illness, 
preceding death, they very often go to other places. 

District No. 20 is East Boston. 

District No. 21 is ward two, or the North End east of Haver- 
hill and Blackstone Streets. A large part is made up of ware- 
houses. Streets narrow. Inhabitants chiefly Irish. 

District No. 22 is the portion of ward three, east of Poplar 
Street. It includes the streets on either side of Leverett 
Street, and a portion of the old "mill pond." 

District No. 23 is a district of which the Massachusetts Hos- 
pital is the centre, and includes the north side of Beacon Hill. 
It contains a large proportion of all the colored inhabitants of 
the city. 

District No. 21 is that portion of ward four, enclosed by 
Hanover, Court and Green Streets. Portland Street runs 
through the middle of this district. It includes most of the 
old " mill pond." 

District No. 25 takes the rest of ward four. 

District No. 26 is ward five. 

District No. 27 is the south side of Beacon Hill, from Revere 
Street to the Common, and from the State House to Charles 
Street. It also includes a small territory on the north side of 
Beacon Hill, on either side of Hancock Street. It is nearly all 
original soil. The inhabitants are almost exclusively American. 

District No. 28 is all " made land." It extends from Com- 
monwealth Avenue to Charles River, and also includes the 
territory between Charles Street and the river, down as far as 
Cambridge Bridge. Inhabitants almost exclusively American. 

District No. 29 is the portion of ward seven on the Old- 
Boston side of the channel. It is all " South Cove" land, re- 
claimed from the sea. Inhabitants chiefly Irish and German. 

District No. 30 is the northern half of South Boston. A 
very large proportion of the inhabitants are Irish. 

District No. 31 is ward eight. Its centre is about the cor 



352 STATE BOARD OF HEALTH. [Jan. 

ner of Hollis and Washington Streets. It includes a portion of 
" South Cove " made land. A mixed population of Americans, 
Irish, Germans, and a good many Jews. 

District No. 32 is that part of ward nine which lies west of 
Berkeley Street and Columbus Avenue. It is all made land, 
and is occupied almost exclusively by Americans. 

District No. 33 is the " Church Street District." Many Jews 
live in this region. It is nearly all " made land." 

District No. 34 is the " Suffolk Street District." Nearly all 
"made land." 

District No. 35 is ward ten, west of Dover Street. More 
than half is " made land." 

District No. 36 is ward eleven, east of Northampton Street. 

District No. 37 takes the rest of ward eleven, and the por- 
tion of ward fourteen north and east of Washington Street. 
It includes the sunken Buggies Street territory which the health 
authorities of Boston have suffered to be covered with expensive 
houses in 1870. 

District No. 38 is the southern half of South Boston, includ 
ing Washington Village, and (together with No. 39) the low, 
marshy region on the borders of the South Bay, referred to in 
the " Report on Flats and Water Areas," presented to the last 
Legislature. 

District No. 39 is ward thirteen. Like the preceding dis- 
trict a large portion is so low as to make drainage difficult if 
not impossible. It is being occupied, however, by tenement 
and other houses, in violation of the law relating to " wet and 
spongy lands." 

District No. 40 is ward fourteen, south and west of Wash- 
ington Street, and including Mount Pleasant. 

District No. 41 is Roxbury Highlands, or the portion of ward 
fifteen, south of Washington Street. 

District No. 42 is the portion of ward fifteen, north of 
Washington Street. It includes the upper part of Tremont 
Street, the breweries, bone-boiling establishments, and what 
is known as "Grab Village." A mixed population of Irish, 
Germans and Americans. 

District No. 43 is Dorchester, extending south to Neponset 
River, and including territory of great extent, but (as compared 
with old Boston) sparsely peopled. 



1871.] PUBLIC DOCUMENT— No. 37. 353 

The deaths and their causes in each of these districts have 
been obtained through the kindness of Mr. Apollonio, the City 
Registrar, by whom they are always recorded with great fidelity. 
He has allowed the State Board of Health every opportunity to 
examine the returns. 

The population of the Districts has been obtained from the 
enumerators engaged in making the census of 1870. Applica- 
tion was made to the United States authorities at Washington, 
for permission to employ these officers in noting on the margin 
of their returns the facts we required. This was freely given, 
and by the kind co-operation of Gen. Andrews, U. S. Marshal, 
we have been enabled to obtain such information as was needed 
to carry out the original design. 

The facts thus collected have been arranged in such manner 
as to show the comparative prevalence of each of the most 
prominent causes of death in all parts of Boston. 

The following tables, by which this result is reached, have 
been prepared, since the close of the year to which they refer, 
by Dr. Frank W. Draper of Boston. 

45 



354 



STATE BOARD OF HEALTH. 



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1871.] PUBLIC DOCUMENT— No. 37. 



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356 



STATE BOARD OF HEALTH. 



[Jan. 









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1871.] PUBLIC DOCUMENT— No. 37. 357 



1 


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II I I I I I s 



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358 



STATE BOARD OF HEALTH. 



[Jan. 







CO 


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1871.] 



PUBLIC DOCUMENT— No. 37. 



359 



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360 



STATE BOARD OF HEALTH. 



[Jan. 







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lO 


lO 


CO 


CM 


CO 


CO 


t~ 


CM 


CO 


•^ 


•"*! 


a 


•J3A0 PUB 5 


e>r 




co 


CO 


lO 


■* 


CM 


co 


CM 


co 


CO 


o 


D 




CM 


CM 










i—i 








CM 


rH 






























o 






















































H 




o 


O 


co 


co 


co 


co 


o 


■* 


CO 


t- 


o 


CO 


<i 


•3Al6nlO 

-nt 't <n x 


b~ 




■* 


o 


00 


co 


CO 


W 


<M 


iO 


rH 


CO 


p 
m 


CM^ 

of 


co 
cm" 


t~ 


t- 


CO 




GO 


rH 


r-l 


CO 


co 


o 


o 




























Ph 






























•* 


o 


t* 


■hh 


CO 


CM 


CO 


co 


O 


co 


t~ 


CO 






CO 


cm 


CO 


co 


o 


<M 


lO 


co 


CO 


rH 


o 


co 






co 


t~ 


CM 


i— ( 


r-l 




CM 






CO 


o 


rH 




I Jopuft 






















1— 1 






EH 




























O 
















































































































H 




























CO 
























































a 




























w 




























H 




























►J 




























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g 




























a 


o 


,_ 


<N 


eo 


** 


irj 


O 


t» 


0(0 


o 


o 


T* 


1 




cm 


cm 


5* 


cm 


cm 


CM 


eM 


CM 


cm 


CM 


OS 


ec 



1871.] 



PUBLIC DOCUMENT— No. 37. 



361 



1 


1 


1 


' 


1 


1 


CM 


rH 


1 


1 


1 


■! 


r-j 


1 


1 


1 


l 


1 


1 


CM 


1—1 


1 


1 


1 


i 

1 


rH 


1 ! 1 1 1 1 » 1 1 1 1 1 


1 


I 1 1 1 1 1 1 1 1 1 1 1 


1 


1 


1 


CO 


l 


rH 


1 


CM 


rH 


1 


1 


1 


. 


CM 


... 
| 1 | 1 1 1 CM 1 1 1 1 1 


eo 
© 


2.7 




i 


1 


os 

rH 

rH 


l 


1 


1 


1 


OS 


1 


1 


1 


i 


CO 
CM 


TjH 


CM 


cq 


OS 


co 


to 


1 


OS 
rH 


OS 


cq 


eo 


lO 


CO 


CO 


CM 


■* 


°l 


i-j 


CM 


1 


■>cH 


1© 


1 


iH 


CM 


1 

CM 



I co 



I b- CM OS i-J rH 

rH CO 1© OS CM 



I I 



cq ^ 

rH CO 



I OS I CM ■* 



<M OS 

eo" ■* 



rH CO 

!>• OS 

iq_ °5. 



HH OS © 

O O OS 

t-^ cq^ cq 

© t> h 



os co 

XO CO " 

co" go" 



O to 

cq t^ 

co" co" co" cm" 



OS CO CM 
O CM I lO 



CO tH b- OS 



CM (M 

to co 

eo to 

t^ © 



t>. \0 >© "* 00 rH 

CO ** OS CM ta rH 

go cq cq^ os^ co^ C^ 

I©" t> W" ^ Co" rH 



•HH CM 

CM CO 
CO lO 



CO b- 

os co 

■* OS 



tW CO OS OS 



CO 


OS 


OS 


co 


>© 


os 


■* 


m 


CO 


O 


co 


OS 


CM 


to 




rH 


CM 




CM 


rH 


CM 



O CM rH OS 



5'ieO"*K^?*t»aoes©'rH5 i »eo 



O 



46 



362 



STATE BOARD OF HEALTH. 



[Jan. 



>s 



si 



3 







GO 


CM 


co 


GO 




OS 


rH 


eo 


CO 


l> 


■* 


co 


K 


"IB?OX 


CM 


■>* 


W 


tH 


eo 




■* 


CM 


T-( 


•* 


>* 


co 




OS 


in 


OS 


rH 


OS 


OS 


co 


tH 


co 


OS 


os 


co 


5 

Ph 


•J9A0 pUB g 


CM 


■* 


in 


lO 


CM 




■* 


CM 


rH 


** 


■* 


CO 




























00 


•aAfsnp 


OS 


OS 


1 


1 


co 


1 


rH 


1 


1 


rH 


m 


t~ 


o 


-u; 'f. <n i 




rH 






lO 




rH 






CM 


rH 


rH 




m 


GO 


GO 




co 


1 


GO 


1 


1 


-* 


GO 


| 




•I japufi 


■* 


CM 


co 


co 


GO 

T-\ 




t^ 






CD 


-H 








m 


OS 


in 


GO 


rH 


■* 


co 


eo 


<* 


rH 


os 


rH 


X 
P 


•I«?ox 


1-H 


CM 


T-l 


rH 


CO 




rH 






eo 


CM 


rH 




























H 




1 


1 


1 


1 


1 


1 


1 


1 


1 


1 


1 




% 


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a 






















































5 


•3AISUI0 


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CO 


CO 


1 


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1 


1 


eo 


CD 


co 


9 


-ui '* Oi I 


CM 


t> 


iO 


co 


CM 




CO 






t~ 


CO 


eo 






CM 


•* 


GO 


m 




os 


GO 


co 


co 


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m 


OS 




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m 


CD 


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rH 


CD 


o 


o 


o 


eo 


CM 


tH 


CM 






** 


t- 


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OS 


lO 
rH 


OS 


lO 


co 


eo 


l>- 


t- 


m 




H 




OS 


CM 


OS 


CO 


CD 


OS 


t~ 


m 


1 


LO 




GO 


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rH 




rH 


f— 1 










rH 


rH 
































CO 


co 


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os 


tH 


os 


co 


m 


1 


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CO 


t- 


Q 


U3AO PUB S 


























55 






















































< 


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T* 


co 


co 


1 


I 


CO 


I 


1 


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l 


< 

8 


-ui 'f <n I 


CM 


co 


l-H 


rH 






m 






CM 


rH 




ta 
3 






















































3 

5 




5D 


i— i 


<# 


t- 


OS 


I 


GO 


1 


1 


co 


CO 


co 


•X aapnn. 


CO 


GO 


i-H 


CM 


m 




rH 






m 


CO 


o 




rH 


i—l 


i—l 


TJ< 


tH 




rH 






cm 


T-l 


rH 






•18)01 


OS 


GO 


00 


!>• 


m 


>* 


OS 


CO 


«* 


** 


tH 


co 
























































f» 


\I8A0 pUB 8 


OS 


GO 


OS 


GO 


lO 


>* 


co 


GO 


■* 


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eo 


t» 


fa 























































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•3Aienp 


CO 


i— ( 


1 


1 


1 


1 


CM 


1 


I 


rH 


CO 


t- 


w 

CM 
1" 

Eh 


-ui 'f o» I 


i— 1 


i— 1 










CM 






rH 




rH 






























•T Jspnjl 


1 


1 


1 


1 






1 


1 


1 








«i 


•IB^oj, 


GO 


m 


co 


CO 


«* 


1 


m 


co 


1 


CO 


t~ 


CM 


PS 
H 

a 

1 5 

Ph 

5 




























U3A0 pUB fi 


CM 


rH 


1 


1 


I 


1 


1 


l 


1 


1 


rH 


1 


•aAisniD 


t~ 




t~ 


co 


co 


1 


t~ 


l 


1 


T-l 


OS 


CO 




-ui '* OJ I 


m 


co 


CM 


CM 


IQ 




co 






eo 


eo 


eo 


































CM 


1 




1 


I 


os 


co 


1 


1 


os 


1 


M 
O 


•i aspun 


co 


T* 




co 






eo 


o 

CO 






-CH 






s ^ 




























►2 « 




























< H 




























H oc 




























"3 


































CN 




*# 


«fli 


CO 


*■• 


GO 


e» 


o 


TM 






2*J 


CM 


o» 


e* 


eM 


«* 


«N 


«N 


CM 


CN 


OS 


eo 



1871.] 



PUBLIC DOCUMENT— No. 37. 



363 



o 


lO 


OS 


t~ 


!>• 


t* 


CN 


"* 


** 


CN 


■* 


OS 


iD 


CM 


CO 


CJ 


co 


CN 


co 


CN 


co 


CN 


tH 


lO 


*"* 


CO 


<* 


CD 


os 


os 


co 


CD 


lO 


os 


CD 


*# 


1— I 


CN 


co 


CN 


co 


D) 


co 


CN 


CO 


CN 


CO 


CN 


i-H 


CO 


C) 


co 


t- 


,_, 


t- 


m 


1 


OS 


1 


I 


1 


1 


»-i 


1 


^ 


•* 


co 


CO 


i— i 




1—1 










' i-H 




t—l 


1 


1 


1 


I 


1 


1 


1 


1 


1 


1 


1 


1 


>D 


























CN 


CO 


•* 


lO 


«* 


■* 


OS 


i-H 




t^ 


CN 


t^ 


CD 


i—l 


1 


1 


CN 

1 


i— i 

i 


1 


1— ( 

1 


CO 
1 


co 

I 


1 


1 


co 
1 


CN 
1 


Dl 

1 


1 


iH 


lO 


iO 




CO 


i— I 


o 


co 


os 


i» 


co 


t- 




CO 


t~ 


T— 1 


1 


lO 


T* 


CO 


i—i 


CN 


o 


ID 


iO 


CO 




t~ 


os 


OS 


co 


lO 


OS 


os 




CD 


1-H 


OS 


CD 


CN 


•^ 


CD 


■* 


tM 


OS 


o 


CD 


b- 


CO 


■** 


t^ 


id 


i— 1 


OS 


CD 


CO 


lO 


CO 

1—1 


t» 


t~ 


CO 


CO 


co 


CO 




00 


CN 


CD 


lO 


lO 


t-; 


<* 


CN 

i-H 


CN 


co 


CO 
CN 


rJH 


r-5 


1 


1 


i— 1 


co 


co 


CN 


CO 


!>; 


CN 


l 


CO 


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co 


co 


1 


t>- 




t>- 


co 


1 


1 


1 


ID 


lO 


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CO 


os 




co 


CO 


CN 


CN 








i— 1 


CO 


iH 


CN 


co 




t^ 


CO 


CD 


Dl 


t~ 


t- 


1 


CN 


OS 


CN 


CO 


on 


CM 


co 


-* 


i— c 


O 


t- 


os 




CD 


OS 


CO 


CO 


i— i 


i—l 


CN 




1— 1 


«— 1 




i— i 






CM 








1 


i—l 


CD 


CD 


•* 


lO 


CN 


CD 


» co 


i— 1 


CN 


1» 


co 




i—l 


















1-1 






1 


CM 


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CN 


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i—l 


















1-1 






I I I 1 1 1 1 1 1 1 1 1 
1 1 1 1 1 1 1 1 ( 1 l I 


CO 

1 


co 


CD 


■* 


CD 


rH 


CO 


CN 

i-H 


CN 

i-H 


1 


1 


** 


co 


CO 


i 


CN 


co 


i-H 


i— 1 


CN 


CO 


co 


1 


1 


1 


CN 


1—1 


t^ 


D) 


OS 




t- 


co 


r* 


to 


1 


1 


CN 


co 


co 


■^ 


CD 


i— i 


CD 


CN 


CD 


CN 


tr~ 






co 


o 


■* 


1 


1 


I 


co 


1 


1 


1 


os 


, 


1 


1 


. 


ID 








tH 


















CN 


























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C3 




















































O 


























H 


























T3 


























a 


























cS 


























u 


























O 


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eo 


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its 


CO 


fc» 


oo 


cs 


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eo 




so 


e* 


co 


eo 


eo 


eo 


eo 


eo 


"# 


** 


^< 


** 





364 



STATE BOARD OF HEALTH. 



[Jan. 







t- 


Ol 


TH 


i-H 


t- 


Ol 




CO 


t- 


eo 


co 


m 




•IBiOX 








CO 


co 


m 


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in 


m 


t^ 


m 


Oi 






rH 


Ol 


Ol 


Ol 


Ol 


rH 


Ol 


rH 




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CO 


t- 


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t- 


co 


co 


CO 


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a 

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\I8A0 pUB fi 






CO 


O 


m 


Ol 


CO 


co 


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co 


tH 


m 




i— 1 


rH 


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rH 


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rH 


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co 


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co 


m 


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CO 


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co 


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co 


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CO 




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co 


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co 


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co 


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co 


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co 


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rH 






in 


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co 


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cm 


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CM 


CM 


CM 




CM 


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366 STATE BOARD OF HEALTH. [Jan. 

An examination of the tables brings to light many interesting 
facts which have not before been attainable. 

The first gives in numerical form the condensed material 
obtained from the death records. The second gives the total 
population of each District, and the number of children under 
one and between one and five years of age living in each. 

Then comes the list of those diseases whose comparative prev- 
alence in a series of years determines the death-rate of all com- 
munities in Massachusetts. The list is seen to include those 
which have the strongest claims to be regarded as preventable 
diseases. 

By tracing along the columns one may see how destructive 
each disease was in each District, and what proportion of a 
thousand died from it among the infants, among the young 
children, and among the adults. Thus, for instance, in the 
very populous northern half of South Boston (No. 30), we see 
that among 1,007 infants 4.9 in 1,000 died from scarlet fever, 
while in the region east of the Providence Railroad crossing, in 
what was lately Roxbury (No. 42), among 301 infants the 
deaths from the same cause were at the rate of 26.4 in 1,000. 

Croup and diphtheria are in the same way discovered to have 
been more prevalent in Districts 38 and 39, while three Districts 
have had no deaths from this cause. 

Typhoid is found to have been most prevalent in Districts 42, 
33, 22, 20, 26 and 21 ; dysentery and diarrhoea in 42. Cholera 
infantum is seen to have killed very nearly 68 in a thousand of 
all the nursing children in the city, and this in such enormously 
disproportionate numbers in the various Districts as may sur- 
prise those who do not already know the influence which over- 
crowding and filth have upon this disease. As the cholera in- 
fantum column should be studied chiefly in the age under one 
year, so the next in the list, consumption, should be judged by 
the ages over five. The greatest mortality is seen to be in Dis- 
tricts 42, 22, 23, 29 and 30, and the least mortality in Districts 
25, 41 and 28. 

Marasmus is the somewhat indefinite disease assigned in the 
case of a certain number of children in whom a gradual wasting 
of flesh and strength has preceded death. Districts 23, 38, 25, 
24 and 21 show very plainly that this mortality among infants 
is associated with a dense population. Pneumonia, a disease of 



1871.] PUBLIC DOCUMENT— No. 37. 367 

all ages, but especially fatal at the extremes of life, shows a 
greater uniformity in its distribution through the districts than 
any other of the list. 

Coming now to the aggregate mortality from all causes we 
find that in District 24 nearly half of all the infants died within 
the year. This is to be accounted for in part by the large num- 
ber received at an establishment in Portland Street, where wet 
nurses are always to be obtained. 

In District 25 the ratio is also very large, but it will be seen 
that the whole number is small. 

In Districts 38 and 23 more than one-third of the whole num- 
ber of infants died; in Districts 42, 21, 29 and 30 more than 
one-quarter, and in Districts 39, 27, 40, 26, 22, 31, 36, 34 and 
20 more than one-fifth. On the other hand in District 41 the 
mortality among infants was less than one-tenth. 

Looking now at the general death-rates for all ages we see a 
very great disparity in the several Districts, ranging from 5.7 
(District 28), 9.1 (District 41), and 9.8 (District 32), up to the 
enormous rate of 37.9 in a thousand in District 42. This latter 
region is low, imperfectly drained, in parts densely peopled and 
full of nuisances which have been allowed to grow and fester un- 
checked by the city authorities. Stony Brook between Tremont 
Street and the Providence Railroad, and also in the neighborhood 
of Parker Street, has been a source of disease to all the dwellers 
in its vicinity. The stench from this neighborhood has been 
often perceptible during the past summer at the distance of a 
mile. District 42 is also in the immediate neighborhood and 
under the influence of the sunken tract about Ruggles Street, 
in District 37, on which water has been standing continually 
during the past hot summer. Fortunately the tract in question 
is hardly peopled as yet, although covered with new houses 
which must be raised, like Church and Suffolk Streets, at a vast 
expense, most of which might have been saved if the health 
authorities of the city had done their duty. District 21 is next 
most fatal to life. It is very densely peopled and contains the 
worst tenement houses in Boston. District 29, with its crowded 
and narrow streets leading from Harrison Avenue to the South 
Bay, comes next in order ; 38, 24, 23, 30, 39 and 22 follow not 
far behind in their ratios of death to population. 

The death-rates of East Boston and the North End present a 



368 STATE BOARD OF HEALTH. [Jan. 

contrast which is worthy of examination. These Districts are 
of nearly equal population and the numbers at all ages very 
nearly correspond, yet the mortality in one is half as great 
again as in the other. One is crowded, in great part deprived 
of sunlight, and full of nuisances ; the other has abundance of 
light and air. Can a stronger argument be offered in favor of 
providing breathing spaces for the people than is presented by 
the figures in the first two horizontal lines of our second table, 
from one end to the other ? 

The very limited time which is given us between the comple- 
tion of this tabular analysis at the close of the year, and the 
presentation of our Report to the legislature, must prevent more 
extended comment on the many instructive facts which it makes 
apparent. 



\ 



THE VENTILATION OF SCHOOL-HOUSES. 

By A. C. MARTIN, Architect, 



OF BOSTON. 



47 



370 STATE BOARD OF HEALTH. [Jan. 



THE VENTILATION OF SCHOOL-HOUSES. 



The importance of thoroughly ventilating school-houses is 
acknowledged by everybody, while the number of persons who 
have considered the amount of ventilation required to keep a 
room in a wholesome condition, and the best way to produce 
the necessary change of air is comparatively small. 

All know that the condition of the air in most school-rooms 
an hour after the session has commenced is very bad, so bad as 
to induce a morbid condition of the system, impairing the men- 
tal vigor of both teachers and scholars. 

The cause of the trouble is commonly stated to be the presence 
of carbonic acid in the air which we exhale. When first 
thrown off from the lungs, it is warmer than the surrounding 
air and therefore rises to the upper part of the room ; conse- 
quently, in the popular idea, the bad air is always at the top of 
the room. According to the same theory it is only necessary 
to make a hole somewhere in or near the ceiling to let it off, 
and thus the room is properly ventilated. This theory of ven- 
tilation, it should be noticed, makes no provision whatever for 
a supply of fresh air in those school-rooms (no small proportion 
of the whole number), which are warmed by stoves. In cases 
where furnaces are used, they are commonly regarded as sources 
merely of heat ; seldom as the means of a supply of fresh air. 
Registers are placed somewhere in the floor, but their size and 
disposition are left to convenience or to the discretion of the fur- 
nace dealer, whose sole aim is to furnish heat, not air. True, 
some air must make its way through the hot-air pipes, but as 
soon as the temperature of the room is so high as to be too 
warm for comfort, the register is closed, thus shutting off en- 
tirely any supply of fresh air except what may creep in through 
the crevices around the doors and windows. If further relief 
from heat or close air becomes necessary, the windows are let 



1871.] PUBLIC DOCUMENT— No. 37. 371 

down a little from the top. The result of this is that the cold 
air rushes in and fills the bottom of the room, causing danger- 
ous draughts for those who sit near the windows, and cold feet 
for everybody. 

If we examine this popular notion concerning the theory and 
practice of ventilation, we shall find its explanation of the cause 
of the difficulty falls as far short of stating the whole case, as 
the remedy proposed fails to accomplish the desired end. 

As we have seen, the carbonic acid gas exhaled from the 
lungs is looked upon as the principal evil. Its presence is, in- 
deed, clearly recognized and the amount given off by the lungs 
has been determined to be about four per cent, of the air ex- 
haled.* 

But so far from its being the principal evil in vitiated air, it 
is proved by experiment that a still larger proportion of car- 
bonic acid than is contained in the close air of an unventilated 
room, may be mixed mechanically with ordinary air, and 
breathed without inconvenience. The workmen engaged in the 
manufacture of soda-water do not experience any ill effects from 
breathing large quantities of it. 

We must, then, seek further for sufficient causes for the foul 
condition of the air in an occupied room. We shall discover 
in it not only this deleterious acid, but in still greater propor- 
tion the watery vapor and the animal matter thrown off by both 
lungs and skin. The amount of watery vapor given off by the 
lungs and skin has been variously estimated as from twenty to 
forty ounces in the twenty-four hours, or about six to twelve 
grains (troy) per minute. This vapor contains animal matter 
which seems to putrefy almost immediately after being thrown 
into the air. It is the source of the vile odor in an ill-ventilated 
room, and, in its effects on the health, is far more dangerous 
than carbonic acid gas, which is now generally considered as 
acting rather as an obstructor of respiration than as a positive 
poison. No surer or more exact test than a well-educated nose 
has, as yet, been discovered to measure the amount of vitiating 
animal matter thus thrown into the air, but of its sources we 
can form some inferences. 

* The difference in quantity is caused by varying circumstances. The amount thrown 
off is least during the night and greatest duriug the day. It would seem that the maxi- 
mum and minimum amounts depend upon the state of digestion or the degree of physical 
exertion. 



372 STATE BOARD OF HEALTH. [Jan. 

The immediate emanations of the body itself we have just 
mentioned. All clothing, carpets and furniture are adding con- 
stantly to the air the minute particles worn off by friction. A 
beam of sunlight thrown across the best-kept room marks its way 
on the dust in the air, and we all remember what we have seen 
floating in the air of school-rooms. Still another element of 
evil must be counted in the clothing of children of the poorer 
classes, which is worn and kept in homes that have never known 
an airing. It is easy to detect, in some school-rooms, the odors 
resulting from the different occupations of the children's parents, 
mingled with the scent from the frying of the family doughnuts 
or the smoke of the paternal tobacco-pipe. What science hints 
of the germs of disease in the air about us, might startle the 
most careless, but such details are unnecessary when we are 
discussing ventilation, not for cases where great crowds of 
people are assembled, or where unusual causes create foul air, 
as in the sick-wards of a hospital, but in relation to the far sim- 
pler question how we can best ventilate and warm our school- 
rooms. 

One general consideration remains to be added to this brief 
statement of the elements of evil in foul air. The air we 
breathe is exhausted of its life-giving power after a few inhala- 
tions. Deprived of its normal proportion of oxygen, it is thus 
rendered unfit for its proper uses. Again, the carbonic acid, 
the watery vapor, the animal matter and the minute dust are 
soon diffused throughout the room. The question where the 
air is worst may be taken up later, but it must be manifest from 
what has been said that the entire air of a close room soon be- 
comes vitiated in every part. Still further, — we are consider- 
ing rooms in which the children daily spend five or six hours, 
the teachers, often seven or eight. The children are at an age 
when respiration is most active and when nature demands an 
ample supply of air of the purest quality. 

We are, then, forced to conclude from the nature of the evil 
and from the imperative necessity of its entire removal, that no 
remedy can be successful which does not ensure a full and com- 
plete renewal of the air in the room as often as it becomes foul 
or dead. Nothing less than an absolute change of the whole 
volume of air can accomplish the object. 

How often this should be done within a given time must de- 



1871.] PUBLIC DOCUMENT— No. 37. 373 

pend upon the size of the room and the number and age of the 
persons occupying it. Authorities differ as to the amount of air 
to be supplied to insure a proper ventilation, but it is generally 
admitted that it should be not less than ten cubic feet per 
minute for each person. It may be that children require as 
much as adults, as they breathe faster. The actual amount of 
air-space in the room must also be carefully considered. 

The Royal Commissioners appointed by the British govern- 
ment to inquire into the sanitary condition of barracks and hos- 
pitals, reported in 1857 that the capacity of the rooms should 
be not less than six hundred (600) cubic feet of air-space for 
each soldier, and the supply of air, per minute and per man, 
not less than twenty cubic feet. Messrs. Fairbairn, Glaisher 
and Wheatstone reported about the same time to the general 
bureau of health that the supply should be from fifteen to 
twenty cubic feet per minute for each individual. Gen. Morin, 
the director of the " Conservatoire des Arts et Metiers," gives 
the amount at from twenty to thirty cubic feet. These esti- 
mates, it will be observed, are for adults, and, in the case of the 
soldiers, for sleeping-rooms occupied from eight to nine hours 
consecutively. For children and school-rooms, the amount of 
air required varies, according to Gen. Morin, from seven to 
eighteen cubic feet per minute, in proportion to age ; and the 
air-space from two to three hundred feet. 

As an illustration, we will take an ordinary grammar school- 
room for fifty-six scholars. Such rooms in Boston are twenty- 
eight feet wide, thirty-two feet long and twelve feet high ; con- 
taining 10,752 cubic feet, or 192 cubic feet to each scholar. If 
we assume ten cubic feet per minute as the minimum supply for 
each scholar, it will require 560 cubic feet of fresh air per 
minute for the school-room; or 33,600 cubic feet per hour. 
This supply would renew the whole volume of air in the room 
three times in an hour. If we assume fifteen cubic feet per 
minute for each scholar, it will require for the whole school 840 
cubic feet per minute and 50,400 per hour, thus demanding the 
renewal of the whole volume of the air a little more than four 
and a half times per hour. The second estimate would prove, 
in practice, the proper one in the school-room designated, which 
is not large enough for so many occupants. It should contain 
at least 220 cubic feet of air-space for each individual. 



374 STATE BOARD OF HEALTH. [Jan. 

"We have now to consider the means of obtaining this indis- 
pensable fresh air. If the mere supply of warm air would ven- 
tilate an occupied room, we should have had the question of 
ventilation, for the cold season at least, settled thoroughly dur- 
ing the reign of hot-air furnaces. For the twenty years pre- 
ceding the last decade, most school-houses put up in the cities 
contained neither grates or fire-places, for the furnace was con- 
sidered the best means of heating and ventilating rooms, and 
even now some dealers specially advertise their wares as venti- 
lating- furnaces. 

It is obvious that no means of supplying air can accomplish 
ventilation which does not also provide for the removal of the 
old and foul air. Any person accustomed to an open fire in a 
room partially heated by a furnace feels at once the difference 
in the quality of the air on going into the room of his neighbor 
who depends solely upon the hot-air register. The open chim- 
ney in the one case is constantly drawing off the bad air. In 
the other it escapes slowly, if at all, through crevices or by the 
occasional opening of the door. It not unfrequently happens 
that the hot air ceases to enter through the register for the want 
of an outlet, and the door must be opened in order to start it. 

Our object, then, should be to seek such means of renewal 
and supply as shall cause and maintain a perfect balance between 
the in-coming and the out-going air. The old-fashioned fire- 
place is the first suggestion of the idea. The popular practice 
we have before mentioned was supposed to be an advance of im- 
provement. It makes a hole near the ceiling to let out the bad 
air, opens the furnace registers, and considers the work done. 
On this principle no proper diffusion of fresh air could be ob- 
tained. A steady current would soon be established between 
the register and the ventilator, leaving dead air eddying up and 
down in the lower part of the room, which may be breathed over 
and over again before it is drawn into the main current and 
taken out of the room. Where a running stream passes by a 
cove of comparatively still water, a counter-current is almost 
always seen setting up along the shore. 

When the air from the register is heated in the winter the 
difficulty is increased, as the current is accelerated and cold air 
remains nearly undisturbed, or settles down disagreeably upon 
the head and shoulders. A person sitting in a church near one 



1871.] PUBLIC DOCUMENT— No. 37. 375 

of the large hot-air registers will not unfrequently be annoyed by 
very perceptible counter-currents of cold air which set down- 
wards beside the ascending hot stream. 

To avoid these difficulties and secure the proper diffusion of 
the air are the main questions in all discussions of the subject. 
The systems proposed seem to have divided themselves into two 
great classes by taking up the subject at its two opposite ends, 
one looking to the out-going of the air, the other to its in-com- 
ing, though both have as a common aim the perfect balance of 
the two. 

One system concerns itself only with supplying the air, leaving 
it to make its way out through ducts provided for the purpose. 
It accomplishes this by blowers or fans which press the air into 
the room. It is the plenum method, and may be farther char- 
acterized as the mechanical. It is expensive and requires great 
and constant care in working, while its success is sometimes 
doubtful. For these reasons it need not farther be considered 
for school-house ventilation. 

The other system is directed to the withdrawal of the foul 
air, and this may be accomplished by means of natural laws re- 
quiring no machinery other than simple ducts. It is the 
vacuum method. It avails itself of the natural tendency of 
warm air to rise, which is the result of the law of the dilatation 
of gases. 

" A volume of air heated from the freezing point to the boiling 
point of water (Barometer at 30 in.), expands .375 or about § 
of its volume, or .002 for each degree Fahr." — {Gut/ Lussac's 
law.} 

If the temperature of the air in a school-room is 20° higher 
than that of the exterior air its volume has been increased 
.002 x 20 = .04 or ^ ; consequently it is lighter than the ex- 
terior air and tends to rise. If a vertical duct or shaft, leading 
directly upward and out of the building, be connected with such 
a room a current of air will at once set up through it (subject 
to the conditions hereafter stated), unless it happens that the 
shaft or duct be cooled down to the exterior temperature by con- 
tact with the outer air. If necessary, heat can be applied to the 
lower end of the shaft, or the smoke-pipe from the furnace may 
be carried up through the duct, to increase its draught. 

The necessary supply of an equal amount of fresh air will be 



376 STATE BOARD OF HEALTH. [Jan. 

drawn into the room, either through the hot-air pipes of the fur- 
nace or some special ducts prepared for the purpose, or, failing 
these, it will work its way in about the doors and windows. 

It will be readily understood from what we have before said 
that the mere hap-hazard arrangement of the register in the 
floor and the hole in the ceiling will not answer. Good ventila- 
tion consists in the proper distribution of the ducts for the oufc- 
going and in-coming air, and in their proper relation and cor- 
respondence with each other, so as to secure the perfect removal 
of the bad air and the thorough diffusion of the new. 

The power of a vertical duct to draw the air from a room re- 
sults from the velocity of the flow of air through it. This velo- 
city depends, — 

First, Upon the difference between the external and internal 
temperature. 

Second, Upon the height of the duct. 

Third, Upon the resistance or friction ; that is to say, upon 
the straightness and smoothness of the duct. 

Fourth, Upon the sufficiency of the supply of air to replace 
that which is drawn from the room. 

The amount of air evacuated by such a duct in a given time 
depends on the same four conditions, and also upon the area of 
a cross-section of a duct, that is, upon its size. The following 
general equations express these relations, in which, — 

V is the mean velocity of the air in the duct. 
K is a numerical co-efficient dependant upon the form, disposi- 
tion and friction of the duct, and is constant for each duct. 
T is interior temperature. 
T' is exterior temperature. 
H is height of the duct. 
A is the area of a cross-section of the duct. 
Q is the volume of air passing in one second. 

1. V=K V (T— T') H. 

2. Q=KA y/ (T— T') H. 

By an inspection of the above equations it will be seen that 
to increase the velocity of the flow of the air through a vertical 
duct, and consequently the drawing power of the duct, and also 
the amount of air evacuated in a given time, we must either in- 



1871.] PUBLIC DOCUMENT— No. 37. 377 

crease its height or the excess of the interior temperature above 
the exterior. By the interior temperature is meant that of the 
air in the duct, and this is practically the same as that of the 
room,, .unless additional heat is applied to the duct. 

From the above principles it follows that when the height and 
disposition of the vertical ducts have been determined by the 
character of the building, their size should be estimated for sum- 
mer ventilation when there is the least difference of temperature ; 
and also that the ducts for the upper parts of a building should 
be made larger than those for the rooms below, if they are re- 
quired to evacuate the same amount of air. The same reason- 
ing applies to the hot-air pipes. They should be larger in area 
or cross-section for the rooms below than for those above, 
because they are shorter and consequently the velocity of the 
air would be less than in the longer pipes for the rooms above. 

The question next arises as to the way of adapting the means 
to the end. Shall the vertical ducts lead out from the top or 
the bottom of the room ? Shall the fresh air be taken in at the 
floor or at the ceiling ? Which will work to best advantage, an 
upward or a downward movement in the air of the room ? 

It might seem at first a matter of small consequence where 
the air is taken out, since it is safe to say it would soon become 
bad in every part of a room, but the importance of the point 
will appear as we proceed. 

At first sight it would seem easier to ventilate a room by the 
general upward movement of the air, because its tendency, when 
first exhaled from the lungs, is to rise. 

A cubic foot of air at 60° Fahr., dew point 40° (Bar. 30 inches), 
will weigh 534.27 grs. A cubic foot of expired air at 95°, dew 
point 85°, containing 12.78 grs. of vapor and say four per cent, 
of carbonic acid, will weigh only 494.12 grs., or seven and 
one-half per cent. less. 

This tendency is further increased by the heat given out from 
the body, which warms the air in immediate contact with it, so 
as to cause upward motion enough to be measured by the 
anemometer. 

Nevertheless this upward movement, even when aided by the 
flow of hot air from the furnace fails to secure a proper diffusion 
of the fresh air. We have shown, in discussing the claims of 
furnaces as ventilators, how quickly a steady current will be 

48 



378 STATE BOARD OF HEALTH. [Jan. 

formed between the inlet and the outlet, leaving the bad air 
almost or quite unmoved, and only slowly and partially drawn 
into the current. If the attempt be made to diffuse the air by 
taking it in at several different places, it is apt to cause disagree- 
able draughts of warm air upon persons near the registers. 
Another objection will be found in the difficulty of heating a 
room ventilated in this way, because the hot air is drawn off too 
rapidly, while the great mass of cold air remains at the bottom 
of the room, thus making a marked difference of temperature be- 
tween the air at the floor of the room and that at the level of 
the head, amounting often to six or seven degrees. 

If, on the other hand, we connect the duct withdrawing the 
air with the lower part of the room, we shall have, in the first 
place, an advantage as obvious as it is important, in the removal 
of the foul air as nearly as possible at its source. By that law 
of the diffusion of gases, by which aeriform bodies diffuse them- 
selves through each other's masses to an unlimited extent, the 
carbonic acid in expired air would undoubtedly be diffused 
throughout the whole room. The aqueous vapor, loaded with 
animal matter, must also contaminate the whole atmosphere, so 
that, although after a full school-room has been shut up an 
hour, it would be hard to say where the air in it is worst, it is 
plain that the evil can be reached at its source, and should be 
removed at once before it spreads through the whole apartment. 
By using the downward movement the dust also (no small part 
of the trouble), will be drawn off immediately and not scattered 
everywhere. The emanations from skin and clothing are got 
rid of far sooner, and the clean and tidy children will not suffer 
so much from their less tidy neighbors. The good accomplished 
by the open fire-place is precisely on this principle of taking 
the air out of the bottom of the room. The whole subject may 
be well illustrated by the case of a reservoir or pond where some 
special cause of defilement exists at one end. If, instead of 
drawing or pumping out the foul water as nearly at the spot as 
possible, an engineer should undertake to draw it off through 
the clean water, allowing it to diffuse itself all the way, what 
folly it would seem. 

The foul air should be taken out by openings so distributed 
around the bottom of the room that the currents of withdrawal 
shall affect all parts of it, while the fresh air should be intro- 
duced at the top. If it comes in at a temperature lower than 



1871.] PUBLIC DOCUMENT— No. 37. 379 

that of the room, it should be distributed as much as possible, and 
directed upward and along the ceiling, so as not to fall directly 
down upon the heads of those below. 

If the air be heated and drawn in by a constant current, it 
will diffuse itself under the whole ceiling, and, arranging itself 
in layers, the warmest at the top, will gradually settle down 
through the room. The diffusion would be nearly or quite 
perfect, but for the unequal cooling of the air by contact with 
the outer walls. This inequality would be perceptible, how- 
ever, only in extreme cases, and the heating of the room would 
be accomplished without draughts of any sort. For by taking 
the air out from the bottom of the room at a number of places, 
the velocity of the current of withdrawal through the registers 
can be easily made so small as not to be perceived ; a cur- 
rent of air of the same temperature as the rest of the room is 
not unpleasant unless quite rapid, while a current of a higher 
or a lower temperature is disagreeable, though its velocity be no 
greater than the former. 

So far we have considered the question in its simplest form, 
viz. : a vertical duct leading directly from the room into the 
open air. This would be impracticable in a large building, but 
the principle can be applied with equal success to any number 
or arrangement of rooms. The ducts should be made to con- 
nect with the bottom of a central shaft or chimney, of size and 
height sufficient to create a strong drawing power in all of 
them. The smoke-pipe of the furnace passing up through the 
chimney would aid the draught, or a fire can be built in a grate 
prepared for the purpose near the bottom. In this way, every 
part of a large school-house, rooms, halls, water-closets, can be 
effectually ventilated. 

This method has a strong claim to favor from the facility 
with which the air of a room may be heated to a certain given 
point. To maintain an even temperature when the heat from 
the lungs and body is constantly thrown into the room, is one 
of the chief difficulties in the problem of good ventilation. Tbe 
success attainable by the use of the downward movement has 
been repeatedly demonstrated in Europe, where it has been 
adopted for many years. It is clearly shown in the re'sume" of 
one of the most interesting of Gen. Morin's experiments. His 
object was to heat and ventilate the two amphitheatres or 



380 STATE BOARD OF HEALTH. [Jan. 

lecture-rooms of the Conservatoire des Arts et Metiers at Paris, 
and his success is the more remarkable on account of the 
special difficulties of adapting ducts to the walls and rooms of 
an old building. On this account it was necessary to place the 
ventilating shaft or chimney in the court yard, at a distance 
from the two rooms. The ducts, which led from many open- 
ings around the bottom of both rooms, were connected with the 
bottom of the chimney where a grate was placed in which a 
fire was lighted while the rooms were in use, in order to quicken 
the draught. Both rooms were warmed by furnaces, the heat 
being taken in at many points around the top of the room. 
Cold-air flues were so arranged in connection with the hot-air 
pipes that the hot and cold air might be varied in quantity by 
opening and shutting valves, and thus the fresh air might be let 
into the room at just the right temperature. Gen. Morin gives 
a series of observations on the working of this system from 
December 16th, to January 9th. The small hall, which will seat 
360 persons, held during this time an audience varying from 35 
to 360 persons. In the large hall, seating 700, it varied from 
278 to 680. Two sessions a day were held and the observations 
extended through twenty-eight sessions. The temperature out 
of doors ranged from 32° to 46° Fahr. In the small hall the 
mean temperature was 68°. The highest at any time was 72°, 
and this was reached but three times. The lowest, occurring 
but once, was 64.40°. In the large hall, the mean temperature 
was 67.^°. The highest was 72°, the lowest 64°, neither of 
which extremes was reached more than once. 

Remarkable as this uniformity from day to day appears, the 
equality of temperatures at the top and bottom of the room is 
still more worthy of note. Though the audience was trebled in 
one room and increased tenfold in the other, the thermometers 
at the floor and at the ceiling never differed more than 3£° Fahr. 

It might be supposed that results so successful were attained 
only by the employment of attendants of great skill and ex- 
perience. On the contrary, the furnace and ventilating appara- 
tus were managed by the regular porter whom Gen. Morin 
describes as of the ordinary intelligence and faithfulness of his 
class. He adds : " After a very few days, the attendant became 
so familiar with the management of the apparatus that what- 
ever the number of the audience or the exterior temperature, 



1871.] PUBLIC DOCUMENT— No. 37. 381 

he succeeded in limiting the range of the interior temperature 
between 65° and 70° Fahr." 

Many large buildings are warmed with air heated by passing 
over two or three coils of steam-pipe. In such cases too great 
heat could easily be avoided by the use of valves to shut off the 
steam from one or more of the coils of pipe, leaving the fresh 
air to flow unchecked. This plan avoids entirely the fault of 
shutting the register in a school-room, thus excluding the fresh 
air as well as the heat. 

If the common furnace is used, great care should be taken to 
manage the fire so as not to throw the dangerous gases from 
hard coal into the air-chamber, whence they will inevitably be 
carried into every room. The valve in the smoke-pipe often 
causes much harm in this way, when it is used to check the 
draught ; the draught itself should not be checked too soon or 
too much, lest the coal be burned without giving out its proper 
amount of heat, and the poisonous carbonic oxide be evolved 
from it. Mistaken economy is often the unsuspected cause of 
the trouble from gas in houses and school-rooms. 

Can we plead too strongly for a thoughtful consideration of 
this subject ? Fresh air is not a luxury, not even an essential 
comfort, but an absolute necessity for the children. The duty 
of providing it is imperative. The cost is to be counted 'a trifle 
in proportion to the good to be gained. We build our walls 
tight and strong to keep out the cold, and then complain that 
we must pay money for fresh air, the most bountiful gift of 
nature. Let the school-houses at least be planned and built, in 
the first instance, with free channels for the air to come and go, 
then the item of ventilation will make small show in the con- 
struction accounts. When the blessing of ventilation is fully 
understood, the most grumbling of tax-payers will admit that 
money spent for it was never better invested. Then shall it no 
longer be said that teaching is more wearing than any other 
profession requiring the same actual labor, but teachers and 
scholars shall work without over-fatigue or listlessness in their 
fresh, sweet school-rooms. 

Explanation op Wood-Cuts. 
Nos. 1 and 2 show the plan and section of a small country 
school-house for fifty-six scholars. The room is heated by a 
stove, surrounded by an envelope. This casing will prevent the 



382 STATE BOARD OF HEALTH. [Jan. 

direct radiation of the heat which makes the seats near by so 
uncomfortably warm. But its main purpose is to aid "in heating 
the fresh air which comes in by a duct (marked A) made under 
the floor, with an opening beneath the stove. It is precisely 
similar to the " cold-air box" of a furnace, and should be made 
large and have a valve for regulating the supply of fresh air. 
The cold air from out of doors is thus warmed by the stove and 
rises up within the envelope to the top of the room, where it is 
diffused along the ceiling and thence is drawn down by the ac- 
tion of the ventilating ducts. Of these there are four horizon- 
tal ones, shown by the dotted lines. They may be made 
between the floor timbers, and should be as smooth as possible, 
with the angles rounded where a change of direction is neces- 
sary. Each of them has four inlets (shown by the pairs of 
curved arrows), making for the room sixteen outlets for foul air. 
These openings into the ducts should be protected by a raised 
hood placed under the seat with a wire guard over it (see 
figure 7). Moreover the ducts should have partitions under 
each opening (see figure 8), to insure a flow of air 
through each of them. These ducts are all connected with 
the vertical shaft at B. The smoke-pipe from the stove is car- 
ried up through its whole height so that the heat radiated from 
it may be utilized in rarefying the air in the shaft, in order to 
help the draught. 

The sizes of foul air registers, ducts and shaft, are calculated 
as follows :— - 

There are fifty-six scholars, each requiring fifteen cubic feet of 
air per minute, which makes for the whole room, 840 cubic feet, or 
fourteen cubic feet per second. For ventilation in early fall or 
late spring, when it is too warm for fires and too cold for open win- 
dows, we can obtain a velocity of three and a half feet per second 
in the shaft by the aid of a small stove placed in the bottom of it. 
Therefore the shaft must have a cross-section of four square feet, 
in order at that velocity to draw off the required fourteen cubic 
feet per second. Each horizontal duct must pass one-quarter of 
fourteen cubic feet per second, or three and a half cubic feet, 
with a velocity of about two and a half feet per second. A 
cross-section must then be one and one-fourth square feet, or 
twelve by fifteen inches. Each foul-air register will be required 
to pass one-fourth of three and a half cubic feet per second with 
a velocity of two feet. Its area must then be .4375 square feet s 



1871.] PUBLIC DOCUMENT— No. 37. 383 

equal to sixty-three square inches or eight by eight inches. 
The outflow of air can be increased or diminished by the use 
of a valve in the shaft by which its withdrawing power can be 
controlled. In case more fresh air is required than that sup- 
plied through the envelope of the stove, when the valve in the 
fresh-air duct is wide open, openings (C) are made through the 
ceiling into the attic in which is a window (D) which can be 
raised and lowered by means of a cord below. The drawing 
power of the ventilating shaft will at once determine an influx 
of cold air which should be directed and diffused along the ceil- 
ing. Should a furnace be used to heat such a room, the ducts 
for withdrawing the air should be precisely the same as in the 
plan. The hot-air flues should be carried up to the ceiling with 
passages for cold air beside them in order to temper the heat if 
desired. See figure 6. The valve can be held by the cord in 
any position required, so as to admit all cold or all hot air or 
any proportion necessary. (The figure shows the cold air 
entirely cut off.) The power of the current in the vertical 
shaft will secure the upward flow of the cold air. 

Figures 3, 4 and 5 represent the basement and first and sec- 
ond stories of an eight-room school-house. In such a building 
there is generally a large hall in the third story which prevents 
carrying the vertical ducts up through the roof ; therefore it is 
more convenient to carry the foul air down into the basement 
by ducts connected with a ventilating chimney (see Gen. 
Morin's experiments, above), which should be large enough to 
ventilate the whole building, including the large hall. Fig. 3, 
shows the secondary collecting ducts under the basement floor, 
and their connection with the bottom of the chimney. 

The calculations for this case are precisely like those for one 
room. The minimum velocity of the flow of air in the chimney 
should be about six feet per second. It may be increased by 
steam coils or a fire in the bottom to nine, or, in cold weather, 
even twelve feet per second. 

In room M, Fig. 4, the horizontal ducts are shown with the 
foul-air registers. Room N shows the distribution of the fresh 
air through a hollow cornice made for the purpose. Room 
shows the position of the desks. 

Fig. 5. is a section taken on the line X — Y of the plan, and 
shows the primary and secondary collecting ducts and the main 
shaft. 




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THE WATER OF MYSTIC POND 



SOURCES OF SUPPLY. 



49 



386 STATE BOARD OF HEALTH. [Jan. 



EXAMINATION OF THE WATER OF MYSTIC POND, 

AND OF ITS SOURCES OF SUPPLY. 



The pollution of streams by industrial establishments and by 
the sewage of towns, has-been several times during the past 
year brought to the notice of the State Board of Health.* 
Judging from the history of still more densely populated manu- 
facturing districts in other parts of the world, the general sub- 
ject will continue to claim the attention of the people of 
Massachusetts for many years to come. As the interests of life 
and health become more definite and more valued, and as 
manufactories and population grow and multiply, the apparent 
conflict in this respect between health and industry will yearly 
become more evident. It is our duty, if possible, to show that 
these important interests are not irreconcilable, and to give a 
word of warning in season to prevent their relations from being 
forgotten until it is too late to remedy the omission except at 
enormous cost. 

It was thought best, for the present year, to take a single 
instance of alleged pollution of a stream, and examine it 
thoroughly. The selection of Mystic Pond and the sources of 
its supply was made chiefly in consequence of information 
received from a gentleman familiar with the locality, who re- 
quested us to investigate the " condition of the streams and 
ponds in the town of Woburn as affecting its inhabitants, and 
also the supply of the Charlestown water-works. The chief 
occupation of Woburn is that of tanning, and many of the 
establishments are placed near to some small stream which 
receives the filth from the beam-house where the hides are 
scraped and cleaned. These streams flow southward through 
Winchester, and supply the Mystic Pond and Charlestown 
water-works. There are also two glue factories, and a bone- 

* At Stoneham and Melrose as well as at Woburn. 



1871.] PUBLIC DOCUMENT— No. 37. 387 

boiling establishment, which are far worse than the tanneries. 
The offensive odor of one of these streams has often been a 
source of complaint among those inhabitants who live south of 
Railroad Street, in a thickly-settled part of the town. This 
nuisance may be remedied without pecuniary loss, for the filth 
of these brooks may all be used as a fertilizer, by being collected 
in vats at the tanneries. This has already been done at one 
large establishment in Winchester, the tank being cleaned out 
often, and its contents distributed upon neighboring farms." 

Our correspondent also refers to the foul condition, at times, 
of Horn Pond, the waters of which flow into Mystic Pond ; but, 
as will subsequently appear, they were not so found during the 
past summer. 

The chemical examination of the waters of Mystic Pond and 
its tributaries was committed to Mr. William Ripley Nichols, 
Assistant Professor of General Chemistry at the Massachusetts 
Institute of Technology. In company with Mr. Nichols, the 
Secretary visited and selected the points at which specimens of 
water were taken on the first of April. A second set of 
specimens was taken on the ninth of August, after a drought so 
prolonged that some of the smaller streams of April 1st had 
disappeared. The report of Mr. Nichols is as follows : — 

Mass. Institute of Technology, ) 
- Boston, September 15th, 1870.- ) 

George Derby, M. D., Secretary of Mass. State Board of Health : 

Dear Sir: — The examination of the waters supplying Mystic 

Pond was made at two different dates. The first set of specimens 

was taken April 1st, 1870. The description and locality of these 

waters, which are denoted by Arabic numerals in the Table, are as 

follows : — 

No. 1. — A sample taken from a brook in North Woburn, about 
half a mile above Eaton's Chemical Works, at a point where the 
brook crosses the Lowell Railroad. Yellow. 

No. 2. — From the same stream, just below the chemical works. 
Colorless. 

No. 3. — From the surface of Horn Pond at its outlet. The pond 
was full and a rapid current setting out. Slightly turbid. No 
disagreeable odor or taste. 

No. 4. — From a small stream draining a number of tanneries and 
emptying into the outlet of Horn Pond, at some distance from the 



388 STATE BOARD OF HEALTH. [Jan, 

pond. The sample was taken at a point near its junction with said 
outlet, where the stream was flowing over numerous rocks, produc- 
ing much foam. A disagreeable odor was apparent in its vicinity. 

No. 5. — From the upper end of the reservoir, near " Bacon's 
Bridge." 

No. 6. — At the dam opposite Whitney's Machine-shop, Win- 
chester. 

No. 7. — From the same stream as No. 4, as it issues from the 
Cummings Tannery, where it is scarcely more than a drain. 
There was a rapid flow. 

No. 8. — Mystic water drawn in Charlestown, April 5th. 

No. 9. — Cochituate water drawn in the Laboratory of the 
Institute of Technology. 

The second collection was made August 9th, after a very long 
period of dry weather. The ponds were moderately low and 
covered near their margins with a growth of aquatic plants. I 
observed no green scum or unpleasant odor. The draining stream 
from which Nos. 4 and 7 were taken in April, was perfectly dry. 
These samples, indicated in the Table by Roman numerals, were 
as follows : — 

No. I. — From a brook in Cummingsville, Woburn, above Bacon's 
Patent Leather Factory. Small brook in a cow-pasture, with little 
flow. 

No. II. — From the same stream near its entrance into Horn 
Pond. The ground, marsh meadow; the brook of considerable 
size, flowing sluggishly ; the water clear. 

No. III. — From Horn Pond. Same locality as No. 3. Flow 
from pond slow ; slightly turbid. 

No. IV. — From a stream in East Woburn, at the place where it 
crosses Washington Street. Quite clear. 

No. V. — Opposite Whitney's Machine-shop, Winchester. Same 
locality as No. 6. 

No. VI. — From Bacon's Bridge. Same locality as No. 5. 

No. VII. — Mystic water drawn in Charlestown, August 13th. 

No. VIII. — Cochituate water from upper (eastern) part of lake, 
near the shore, August 31st. 

No. IX. — Cochituate from Laboratory of Institute of Technology. 

No. X. — The same. 



1871.] 



PUBLIC DOCUMENT— No. 37. 



389 



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390 STATE BOARD OF HEALTH. [Jan. 

Explanation of the Table. 

The results are calculated both in terms of parts in 100,000, and 
of grains in a United States gallon of 58372.1754 grains (231 
cubic inches), with the exception of those in the first two columns 
which are to be regarded simply as comparative. 

The permanganate test was applied to the waters the day after 
they were collected, by adding to the water, after acidulation with 
sulphuric acid, a dilute solution of permanganate of potassium 
until a red color was produced which lasted ten minutes. [1,020 
cubic centimetres of this solution oxidized 0.63 gram, crystallized 
oxalic acid.] For this test and for the determination of the dry 
residue, the waters were allowed to settle and were then drawn off 
from any sediment. 

The hardness was determined by adding to 100 cubic centimetres 
of the water a dilute alcoholic solution of soap, until a permanent 
froth (lasting three minutes) was obtained. [34.2 cubic centimetres 
of the soap solution were required for 100 cubic centimetres of a 
solution containing 0.02775 gram, chloride of calcium.] 

The test for niti'ites was applied by adding to equal quantities 
(75 or 100 cubic centimetres) of the waters a drop or two of dilute 
sulphuric acid and a small quantity of iodide of potassium and 
starch ; the amount of the blue coloration of the liquid was then 
observed. 

In the second set of specimens, the chlorine was determined 
volumetrically by the use of a standard solution of nitrate of 
silver. 

The map is traced from the " Map of Boston and its Environs," 
published by Baker and Tilden, Boston, 1867. 

Respectfully submitted, 
(Signed) Wm. Ripley Nichols. 

The conclusions reached by this investigation may be thus 
expressed : — 

The permanganate test, showing the comparative amounts of 
readily oxidizable material contained in the water, is of a certain 
significance as marking the impurity of the tannery stream of 
April 1st, Nos. 7 and 4. Even at the latter point, where the 
current was swift and broken, it had not cleared itself of the 
foul character acquired a half mile above. But the perman- 
ganate test alone is not conclusive, since oxidizable substances 
in water may not be harmful, and we see this in the amount 



1871.] PUBLIC DOCUMENT— No. 37. 391 

found present in the specimen taken from the brook in the 
woods of North Woburn (No. 1) above all the sources of pol- 
lution. It was here due without doubt to vegetable matter 
derived from the banks or from fallen leaves. Horn Pond and 
the Winchester reservoir show no foulness by this test ; al- 
though it will be observed that the amount of permanganate 
required increases in the second examination all the way along 
from Cummingsville to the reservoir. Here it requires less, 
and at Charlestown the water is found in this respect to be 
even more free from oxidizable material than the water of 
Boston. . 

The test for nitrites indicates the amount of nitrogenous 
matter undergoing decomposition ; and the test for nitrates the 
amount of the same material which has undergone complete 
oxidation. The tannery stream (Nos. 7 and 4, April 1st) and 
the inlet of Horn Pond give evidence of the presence of such 
impurity. 

' As regards chlorine, it is agreed by chemists that all waters 
near the sea must contain a certain proportion. It is conveyed 
in the air in the form of common salt and deposited upon both 
earth and water. A familiar evidence of this general fact is 
found in the greater need of supplying salt to animals in the 
inland districts. It is also not improbable that Mystic Pond 
may contain some traces of sea-salt left by the ocean when it 
had access to its waters. 

With these reservations the presence of any but minute 
amounts of chlorine may be taken as evidence that it has been 
caused by some form of impurity added to the water by man. 

Chlorine increases quite steadily in amount from Cummings- 
ville to the reservoir ; the great and exceptional increase at the 
inlet of Horn Pond being due to the morocco factory just 
above. In the reservoir, uniting with other sources of supply, 
it is diluted, so that, when it reaches Charlestown, the amount 
is found to be about the same as at -the outlet of Horn Pond, — 
considerably greater than in the Boston water. 

The soap test is of practical value as denoting the amount 
of lime salts, or of other salts which harden the water. 

Finally, it may be said that in so far as the Mystic water as 
delivered at Charlestown is concerned, the fears naturally enter- 
tained by those who were familiar with the foul conditions 



392 STATE BOARD OF HEALTH. [Jan. 

through which a small portion of it is known to pass are not 
confirmed. 

The impurities derived from the tanneries, when mixed with 
the great mass of water coming from sources of unquestionable 
purity, would probably, by the effect of dilution alone, make 
but little change in its general character. But there is a puri- 
fying influence constantly at work in the power which water 
possesses when freely exposed to air, and particularly when 
moved as in a running stream of ridding itself of oxidizable 
material. Water absorbs oxygen very freely, so that the gases 
held by water contain a larger proportion than the atmosphere. 

The proportion of oxygen contained in the gases of ordinary 
water is as 33 in 100 parts by volume, while in air it is but 21. 

These two influences, dilution and oxidation, are sufficient at 
present in the case of Mystic water to render it as received at 
Charlestown, Somerville and East Boston unquestionably good 
and wholesome. 

That in the reaction for chlorides, nitrites and nitrates, and 
calcareous salts, it is not quite equal to the water of Boston, is 
not to be regarded as to its discredit, since the water of Cochit- 
uate Lake is of exceptional excellence. 

The future of Mystic water depends upon the care which 
shall be taken to keep it free from additional impurity. When 
the stream which disappeared in the dry season between April 
and August began to flow again, it must have washed into 
Mystic Pond a large part of the refuse material which had 
accumulated about the tanneries on its banks. When, instead 
of twenty or thirty tanneries and glue factories and chemical 
works, there may be hundreds of such establishments on the 
little streams flowing into Mystic Pond, there will be reason to 
fear a dangerous pollution of its waters. Before that time 
arrives it is to be hoped that some economical and safe way 
may be universally adopted, not only to prevent the fouling of 
water, which like air should be kept pure for the benefit of all, 
but to return decomposing material to the land which may 
rightfully claim it as its due. 

What we recognize as filth is only " matter in a wrong 
place." 



1871.] 



PUBLIC DOCUMENT— No. 37. 



393 



The water of Charlestown, derived from Mystic Pond, stands 
thus as compared with the water of other cities : — 

Numbers representing grains in United States gallon. 





Solid residue. 


Inorganic 
matter. 


Organic and 
volatile. 


Charlestown,* 

New York,:): 

Philadelphia,§ 


4.48 
2.45 
4.78 
4.08 


3 27 
1.80 
4.11 
4.04 


1.21 

0.65 
0.67 
0.04 



Numbers representing parts in 100,000. 



Charlestown,* 


7.69 


5.62 


2.07 


Boston,-)- 


4.20 


3.08 


1.12 


New York,$ - . 


8.20 


7.07 


1.15 


Philadelphia,§ 


6.99 


6.93 


0.06 



* Prof. W. It. Nichols. Mean of results in preceding report. 

t Prof. W. K. Nichols. Examination of Boston water, made at Institute of Tech- 
nology, December, 1870. 
% Prof. Chandler. 1870. 

§ Prof. Boye. 1852. " Report of the Watering Committee." 
50 



AIR, AND SOME OF ITS IMPURITIES. 



396 STATE BOARD OF HEALTH. [Jan. 



AIR, AND SOME OF ITS IMPURITIES. 



No one can study the causes of disease without being con- 
vinced of the infinite importance of pure air to the preservation 
of health. This general truth meets us at every turn. Some- 
times, as in the case of air spoiled by respiration, the reason is 
obvious enough to every one who understands the changes 
which take place in breathing ; certainly, in so far as the inter- 
change of oxygen and carbonic acid is concerned. 

In other cases, as when air seems to be the vehicle for the 
transfer of the hidden poison of the zymotic diseases, it is, as 
yet, obscure. We do not propose, at present, to enter on this 
dangerous (because, as yet, partly hypothetical) ground. Allu- 
sion to it will be found in many pages of the present volume. 
Indeed, in any study of the causes of disease, at the present day, 
it is impossible to ignore it, however anxious we may be to keep 
within the strict bounds of scientific truth. In some way, as 
yet but imperfectly understood, the organic matter in air seems 
either to be or to contain the agent by which certain changes 
are impressed upon the blood in the lungs, which changes be- 
come the proximate cause of the phenomena of typhoid fever, 
and scarlet fever, and measles, and many other of our most 
destructive maladies. Whether this organic matter be waste 
tissue which has once had life and has now undergone some 
metamorphosis incident to decay, or whether it be living organ- 
ism, seed, germ, spore or vital radicle of any sort, no one yet 
knows, or perhaps we should say, that no one who thinks he 
knows can yet prove his knowledge. The search for this foe to 
our health, for this hidden something which works with such 
fatal power, is keen. The chemists, the microscopists, the 
natural philosophers are all aiding in the study of its origin, 
its character, and the means of separating it from the air 
which all believe conveys it. It has even become, through the 



1871.] PUBLIC DOCUMENT— No. 37. 397 

popular teachings of Professors Tyndall and Huxley, a subject 
of rather general discussion during the past year. It should, 
however, never be forgotten that it is to the unobtrusive labors 
of men devoted to science like Dr. R. Angus Smith of England, 
labors pursued unremittingly for a quarter of a century, and 
modestly published in scientific reports, that we know all, or 
nearly all which is available in speculations on this obscure 
subject. The eloquent men who have recently interpreted the 
facts of Angus Smith and Pasteur and Beale and Hallier and 
Sanderson to the general public in a way to arrest the attention 
of the busy world, have in this respect done good service, but 
they have added almost nothing to the stock of existing knowl- 
edge. 

We would gladly contribute our proportion of exact observa- 
tion, however small it may be, to this great subject so full of 
interest and promise. 

During the present year, careful note has been made of the 
proportion of carbonic acid contained in the air of enclosed 
places of various sorts, and also of the outer air at different 
seasons of the year. We hope to continue this line of research 
in future years, and, by the aid of chemists and microscopists, 
to determine the amount of organic matter which the air may 
hold under various circumstances, and to learn, if possible, 
something of its nature. 

Although carbonic acid is not now generally regarded as. a 
poisonous gas, but rather as an obstructor of respiration, and 
therefore impeding all vital processes, its amount in crowded 
and ill-ventilated rooms is a tolerably correct measure of the 
degree of impurity there present, and is specially worthy of 
observation as an index of the proportion of dangerous material 
coming from the waste of the body, with which, under such cir- 
cumstances, it is always associated. 

The amount of carbonic acid found in the fresh outer air will 
furnish a standard of the quality of the normal air of Massa- 
chusetts, and may also lead to a better knowledge of some of 
the peculiarities of the climate of our State in comparison with 
that of other countries. 

In illustration of the value of the determination of very 
small amounts of impurity in air, we quote the following re- 
marks of Dr. R. Angus Smith, from a paper on " Chemical 



898 STATE BOARD OF HEALTH. [Jan. 

Climatology," in the Scottish Meteorological Journal, January, 
1870:— 

" Some people will pi-obably inquire why we should give so much 
attention to such minute quantities, — between 20.980 and 20.999 of 
oxygen, — thinking these small differences can no way affect us. A 
little more or less oxygen might not affect us, but supposing its 
place occupied by hurtful matter, we must not look on the amount 
as too small. Subtracting 0.980 from 0.999 we have a difference 
of 190 in a million. In a gallon of water there are 70,000 grains ; 
let us put into it an impurity at the rate of 190 in a million ; it 
amounts to 13.3 grains in a gallon. This amount would be con- 
sidered enormous if it consisted of putrefying matter, or any organic 
matter usually found in waters, but we drink only a comparatively 
small quantity of water, and the whole thii'teen grains would not 
be swallowed in a day, whereas we take into our lungs from one 
thousand to two thousand gallons of air daily. The detection of 
impurities in air is, therefore, of the utmost importance ; and it is 
only by the finest methods that they can be ascertained in small 
quantities of air, even when present in such quantity as to prove 
deleterious to health." * * * * * * " If, by inhalation, we 
took up at the rate of thirteen grains of unwholesome matter per 
day, — half a grain per hour, — we need not be surprised if it hurt 
us. Such an amount is an enormous dose of some poisons, and yet 
this is not above one two-thousandth part of a grain at every inha- 
lation. It is marvellous what small amounts may affect us, even 
when, by repeated action, they do not cumulate as certain poisons 
do. The carbonic acid numbers might have been used for this 
illustration, instead of the oxygen numbers, with the same result." 

The examinations of air for carbonic acid were made at the 
Massachusetts Institute of Technology, under the direction of 
Professor Frank H. Storer, by Mr. A. H. Pearson of Haverhill. 
The results are as follows : — 



1871.] 



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1871.] PUBLIC DOCUMENT— No. 37. 403 

Note. — The method employed in the above analyses was the 
one generally known as Pettenkofer's. It consists in acting up- 
on a known volume of air, with a certain quantity of standard 
baryta-water, and so removing the carbonic acid as carbonate 
of baryta. 

After acting upon the air for about half an hour, the baryta 
solution is poured into a cylinder, allowed to deposit, with ex- 
clusion of air, the carbonate of baryta which has been formed, 
and then the free baryta remaining in solution is determined 
with a standard oxalic acid solution. 

The difference between the amounts of oxalic acid required 
to neutralize the baryta, before and after the operation repre- 
sents the carbonate of baryta formed, and consequently the 
carbonic acid present. 

The baryta solution is prepared by dissolving seven grammes 
of hydrate of baryta in one litre of water; one cubic centimetre 
of this solution corresponds to about one milligramme of car- 
bonic acid. The precise strength of the solution is determined 
by means of oxalic acid as described below. In the above ex- 
periments 1.087 cubic centimetres of the baryta solution cor- 
responded to one cubic centimetre of oxalic acid solution. 

The oxalic acid solution is prepared by dissolving 2.8G36 
grammes of pure oxalic acid in water, and dilating the solu- 
tion to the volume of one litre. One cubic centimetre of this 
solution corresponds to one milligramme of carbonic acid. 

The strength of the baryta-water is determined by running 
the oxalic solution from a burette into a certain quantity of 
the baryta-water, until a drop of the mixture fails to give a 
brown ring on delicate turmeric paper. 

It will be observed that all the examinations of air by Mr. 
Pearson were made in the spring of 1870. 

Another series was made for the Board of Health in winter, 
when the average temperature of the outer air was at about the 
standard of our three coldest months — a little below the freez- 
ing point of water. The following record shows the results of 
examination of the outer air for carbonic acid made at the 
Laboratory of Harvard University, Cambridge, by Mr. H. B. 
Hill, Assistant in Chemistry. 

While this Report is passing through the press Mr. Hill sends 
us also a record of three examinations of air for carbonic acid, 
made in a recitation room of Harvard College. 



404 



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1871.] PUBLIC DOCUMENT— No. 37. 405 

Mr. Pearson's twenty-one observations of the outer air of 
Boston in spring give an average of 385 parts of carbonic acid 
in a million. Mr. Hill's eleven observations of the outer air of 
Cambridge in winter give an average of 337 parts of carbonic 
acid in a million.* 

In the forty school-rooms examined by Mr. Pearson, the 
average proportion of carbonic acid found was 1,393 parts in a 
million, or nearly four times the normal amount existing in the 
outer air. The highest was 1,993, and the lowest 773 parts in 
a million. 

It would not be fair to regard these figures as representing 
the amount of ventilation in different schools, as the examina- 
tions were made sometimes near the close of a session, and 
sometimes immediately after a recess when the windows had 
been open. The weather would also greatly influence the ac- 
tivity of air currents. But the average may be taken as a cor- 
rect statement of the quality of air in the Boston schools. 

The following letter from Mr. Charles Stodder, of Boston, an 
accomplished microscopist, will show what he was requested to 
do for the Board of Health. Although his results are inconclu- 
sive and almost completely negative, it is thought right to pub- 
lish an account of this honest effort to reach the truth. 

The presence in air of objects too minute for identification, 
leaves the whole question open for future investigation and dis- 
covery. The molecular movement of particles devoid of life is 
clearly exhibited by Mr. Stodder to whoever will examine his 
specimens. 

The examination of dust deposited on a beam eight or ten 
feet from the floor, in a large room at the Springfield Armory, 
shows how metals may be floated about in the air, and if metals 
surely anything else in particles equally minute. 

* Dr. Angus Smith (1869) gives the following amounts of carbonic acid found in the 
open air in England: — 

Hills above 3,000 feet high, 336 parts in a million. 

between 1,000 and 2,000 feet high, 334 " " 

below 1,000 feet high, 337 " " 

At the bottom of the same hills, 341 " " 

Streets of London, (summer,) 380 " " 

London Parks, 301 " " 

On the Thames, at London, 343 " " 

Manchester Street, (ordinary weather,) 403 " " 

During fogs in Manchester, 679 " . u 



406 STATE BOARD OF HEALTH. [Jan. 

Dr. George Derby, Secretary of the State Board of Health : 

Dear Sir : — So much interest had been created in the medical 
profession and among microscopists, by the various reports of the 
microscopical investigation of the dust floating in the air, especially 
by the surprising results said to have been obtained by Mr. Dancer, 
of Manchester, England, as reported by Dr. Angus Smith, and by 
the widely published lecture of Prof. Tyndall, on " Dust and Dis- 
ease," that it was with pleasure I received your request to search 
for the microscopic contents of the air of Boston. 

Dr. Angus Smith obtained his examples by putting a small quan- 
tity of water into a large bottle, and shaking the bottle, repeating 
the process many times, with new volumes of air and the same 
water. This appeared to me to be an unsatisfactory mode, and I 
devised an apparatus by which I could pass some thousands of 
measured volumes of air through one volume of water, thus, as I then 
thought, completely washing the air which passed through. Yet 
when we reflect that the bubbles of air in the water, though they 
may be only the one-hundredth, or even half an hundredth of an 
inch in diameter, are of large size when compared with the parti- 
cles of matter in the air, many of which are so small as one-one-hun- 
dred thousandth (tooVo^) °f an inch, we see that such may escape 
contact with the water, and thus elude observation. Still, the sub- 
stances detained by the water are probably nearly all the larger 
particles, and representations in kind, if not in quantity, of those 
floating in the atmosphere. 

My first experiment was made with filtered Cochituate water, 
which to the eye appeared perfectly clear and free from foreign 
matter. In this I found such objects as will be hereafter mentioned, 
but especially scaly particles of apparently organic origin, and nu- 
merous minute, translucent spherical or granular bodies, — such as I 
suppose Mr. Dancer called germs. Something created suspicion 
that the water was not pure. A little of it was evaporated on a 
glass slide, and examined with the microscope. It had left a 
deposit of the same scaly and sj>herical particles. Other observers 
had used distilled water. I procured some from two sources, which 
had been distilled some weeks, but kept with care ; both proved 
more impure microscopically than the filtered water. This put a 
stop to experiments for several weeks until a new supply of fresh 
distilled water could be obtained. A friend prepared some ex- 
pressly for me with the utmost care, with the best apparatus. To 
my surprise, a drop of this water, evaporated, left a deposit visible 
to the naked eye, and, under the microscope, showing (as you 
yourself have seen) abundance of the same scales and granules. 



1871.] PUBLIC DOCUMENT— No. 37. 407 

This result put an end to this mode of investigation, and throws a 
cloud of suspicion on all reported researches in this line, when 
water was the medium used* My object in the use of water was, 
that if spores, germs or eggs were found, their development and 
growth might be watched, and, if possible, their nature might be 
ascertained, or at least it might be determined that they really 
were spores or germs, believing as I do, that mere particles of mat- 
ter have been taken for organisms. Other modes of collecting the 
dust of the atmosphere are by taking the deposited dust of rooms, 
or by causing a current of air to impinge against a surface of glass 
smeared with glycerine, when a portion of the floating particles 
will be caught by the viscid surface. In these methods, we can 
judge of the nature of the dust only by its present appearance, — 
there will be no growth. Both of these methods I have tried, but 
not so extensively as is desirable ; my observations have been en- 
tirely on the air in a room in Dover Street, and that of the yard 
attached, a locality tolerably free from the dust of the street, and 
with but little vegetation in the neighborhood. I have used a 
Tones' microscope with object glasses of " unsurpassed excellence," 
magnifying from 250 to 1,200 diameters. 

The dust collected in the yard varied but little in its contents 
from that in the room. I have found scales resembling dead epi- 
thelial scales, filaments of cotton, wool and flax, woody fibres, all 
abundant ; some pollen grains, scales of moths' wings, hairs and 
parts of insects, starch grains, grains of inorganic matter, sand, &c. 
Such things are reported by all observers ; besides, some of them 
report immense numbers of spores or germs. I find great numbers 
of particles ; I cannot say that they are germs or are not, that they 
are organisms or are not, or even that they are organic or inorganic. 
Some observers have used a power of 250 or 300 diameters, per- 
haps poor quality at that, found something, and rushed to the 
printer. Any microscope shows objects (in such collections) too 
minute to be identified. Increase of "power" may identify them, 
if the instrument is a good one, but it only brings into sight 
another set, in the same category ; another increase of power re- 
peats the process with a third set, and so it may continue ad infi- 
nitum. I doubt if the best microscopes (inferior ones are out of 
the question) can determine whether a minute particle is, I will 
not say an organism, but whether it is organic matter. Some ob- 
servers have apparently considered motion an evidence of life. 
Certain movements may be positive evidence, but there is a molecu- 

* It is to be remarked that we know nothing concerning the special means employed 
by Mr. Dancer to secure the purity of water. — Sec't. 



408 STATE BOARD OF HEALTH. [Jan.'71. 

lar movement common to particles of inorganic (clay, chalk, &c), 
as well as to organic matter which may be mistaken for life even 
by experts, and the particles themselves for animated beings. I 
have a slide of coagulated albumen which has been prepared and 
closed up for seventeen months ; in this there may be seen, in the 
field of the microscope, at one view, thousands of minute globules 
(too small to be distinguished with a power of 200 diameters), in 
constant movement. There can be no life in the matter, yet nu- 
merous experts have seen it and pronounced it life, and only one 
recognized it for what it is. Such things should teach caution to 
investigators to be not hasty in pronouncing conclusions. 

In workshops and manufactories, dust may be and is present in 
such quantity and quality as may be supposed capable of impairing 
health. As for example, I examined at your request the dust de- 
posited in the polishing shop of the U. S. armory in Springfield. 
It is a fine black powder. I found in it a few vegetable fibres, a 
few apparently organic fragments and broken crystals ; but two- 
thirds to three-fourths of it was particles of iron, in amorphous 
fragments and of various dimensions from 1-100 m. m. upward, 
and curved and irregular fibres and masses of iron, with sharp, jag- 
ged edges, from 5 to 15 m. m. ; and some very minute perfect 
spheres, probably iron. It can hardly be doubted that continual 
breathing an atmosphere charged with such dust must be injurious, 
— but that belongs to the medical profession to decide, not to me. 

I thought I might separate the iron of this dust from the other 
constituents, by means of a magnet. To my surprise, the magnet 
took the whole of the dust from a white paper, as completely as 
could have been done with a brush. As the iron is all that is really 
attracted by the magnet, is it probable that all the particles of the 
dust are sufficiently coated with oil to be adhesive, so that they all 
stick together. This suggests a means by which it is likely a large 
portion, if not all, of the dust may be separated from the air, and 
thus rendered harmless. Let permanent, or, by preference, electro- 
magnets be placed abundantly about the grindstones and polishing 
wheels, and the dust will adhere. 

I have only to add my regret that I have been able to accomplish 
so little. 

Respectfully yours, 
(Signed) Charles Stodder. 

Boston, Dec. 25th, 1870. 



HEALTH OF MOOES 



EMPLOYED IN 



MANUFACTORIES OF COTTON, WOOLLEN, SILK, FLAX AND JUTE. 



52 



410 STATE BOARD OF HEALTH. [Jan. 



HEALTH OF MINORS. 



The legislature of 1870 passed the following Resolve : — 

" Hesolved, That it shall be the duty of the Board of Health to 
specially ascertain and include in their annual report to the legis- 
lature on the whole number of minors employed in all the cotton, 
woollen, silk, flax, and jute manufactories in this Commonwealth, and 
the cause, amount and rate of mortality among them, and how it 
compares with the mortality of all other persons of the same age in 
this Commonwealth during the same periods of time, and how far 
the particular employment of such minors affects their general 
health as compared with the effects of other employments upon the 
general health of other persons of similar ages." 

In compliance with this Resolve the State Board of Health 
made application to the Secretary of the " American-House 
Manufacturer's Committee," for a list of persons or corporations 
engaged in such manufactures. 

This information was furnished in July, 1870, and on the 1st 
day of August, the following circular was sent to 636 persons 
or corporations. (After quoting the Resolve above referred to), 
" Will you have the kindness to furnish the State Board of 
Health with replies to the following questions : — 

[It is necessary to classify the ages as between 10 and 15, and 15 and 20, in order to 
correspond with the returns of the Registration Reports and of the Census.] 

1. — What do you manufacture ? 

2. — How many persons of both sexes of the ages of 10 to 14 years, both in- 
clusive, were employed by you on the 1st of August, 1S70 ? 
What was the average number during the year 1870 ? 
8. — How many persons of bath sexes of the ages of 15 to 19 years, both in- 
clusive, were employed by you on the 1st of August, 1870? 
What was the average number during the year 1870 ? 
4. — How many deaths occurred among those of both sexes employed by you 
in 1870, of the ages of 10 to 14 years, both inclusive ? 



1871.] PUBLIC DOCUMENT— No. 37. 411 

Of these deaths how many were caused by — 
Accidents from machinery ? 
Consumption ? 
Other diseases ? 
5. — How many deaths occurred among those of both sexes, employed by you 
in 1870, of the ages of 15 to 19 years, both inclusive ? 
Of these deaths how many were caused by — 
Accidents from machinery ? 
Consumption ? 
Other diseases ? 
6. — What proportion of your employees of both sexes of all the above ages, 

remained in your service throughout the year 1870 ? 
1. — What was the average length of service of your employees of both sexes, 
of all the above ages, during the year 1870 ? 
[The object of the two preceding questions is to endeavor to ascertain in what degree 
the changes occurring among employees may affect the value of statistics of mortality.] 

In addition to the above information, which we are required by 
the legislature to obtain, will you also give us replies to the follow- 
ing questions : — 

8. — What was the percentage of absence from work on the part of your em- 
ployees of all ages by reason of sickness in 1870 ? 
9. — Which class of employees suffer least loss of time from sickness, those 

who live in tenements provided by you or those who live in tenements 

provided by others ? 
10. — Do those of your'employees who have been in the United States less than 

one year suffer from sickness in a greater or less degree than others ? 
11. — In case of sickness, is it the duty of any one to see that no suffering is 

caused by neglect of proper attention ? 
12 — Do you endeavor to prevent sickness, by providing fresh air in the work- 
rooms and sleeping-rooms, and by supervision of cellars, sinks, privies, 

cesspools and pigsties ? 
1 3. — Do you limit the number of persons who shall occupy sleeping-rooms of 

a certain size ? 
14. — Do you guard against smallpox, by systematic vaccination ? 
15. — How many hours do you work in each week ? 

As the report of the State Board of Health must, by statute, be 
presented to the legislature in January, it becomes necessary that 
replies to the foregoing questions should be mailed to our address 
on the first day of January, 1871. 

Very respectfully, your obedient servant, 

George Derby, M. D., 

Secretary of the State Board of Health. 



412 STATE BOARD OF HEALTH. [Jan. 

On the 20th of December, 1870, the circular was again sent 
to all parties above referred to, together with stamped and di- 
rected envelopes for replies. 

The result of this endeavor to obtain the information required 
by the legislature is seen in the following abstract. The list was 
made up January 11, 1871, and from that time to the present, 
(January 16), only three additional letters have been received. 

Abstract of Manufacturers' Replies 
To questions addressed to them by the Slate Board of Health, by order of the 

Legislature. 

Circulars were sent to 636 

Cotton, 256 

Wool, 341 

Silk, 21 

Flax, 15 

Jute, 3 

636 

Replies were reeeived from 218 

Cotton, 97 

AVool, 106 

Silk, 5 

Flax, 8 

Jute, 2 

218 

Returned by post-office, 23 

Returned by mill owners not manufacturing, 46 

Missent to manufacturers not of the above classes, ... 3 

290 

Not heard from, • . 346 

[To avoid unnecessary repetition, a general reference is here 
made in the following tabular replies to the corresponding 
numbers of the questions on pages 410 and 411.] 



1871.] 



PUBLIC DOCUMENT— No. 37. 



413 



Second Question. 





No. of 
Replies. 


Having 

none 
und«r 15. 


Aggregate No. 
employed 
under 15. 


Average 
No. 


Greatest No. 

in any one 

Mill. 


Least 
No. 


Cotton, 
Woollen, 
Silk, . 
Flax, . 
Jute, . 


94 

96 

5 

8 

2 


17 

20 
1 
4 
1 


2,350 
1,082 

77 
114 

80 


30.5 
14.2 
19.2 

28.5 
8.0 


265 

135 
62 

49 


1 
1 

1 

2 


Total, . 


205 


43 


3,653 


22.5 


265 


1 







Average. 








Cotton, 


89 


10 


2,072 


26.2 


286 


1 


Woollen, 


99 


13 


1,212 


14. 


125 


1 


Silk, . 


5 


1 


66 


14. 


52 


1 


Flax, . 


8 


4 


117 


29.2 


47 


1 


Jute, 


2 


- 


80 


40. 


50 


30 


Total, . 


203 


28 


3,457 


20.2 


286 


1 



Third Question. 





No. 
of Replies. 


No. employ- 
ing none 
under 20. 


Aggregate 
No. 


Average. 


Greatest. 


Least. 


Cotton, 
Wool,. 
Silk, . 
Flax, . 
Jute, . 


95 

102 

5 

8 
2 


8 
4 
1 

1 


5,672 

2,748 
212 

269 

78 


67.5 

27.9 
53. 
33 6 

78. 


1,106 
293 
109 
125 

78 


1 

1 
1 

4 

78 


Total, . 


212 


14 


8,979 


52. 


1,106 1 







Average. 








Cotton, 
Wool, . 
Silk, . 
Flax, . 
Jute, . 


93 

100 

5 

8 

2 


2 
2 


5,956 

2,859 

204 

283 

108 


65.4 

29.2 
40.8 
35.4 
54. 


1,100 
315 

100 
146 

78 


1 
1 

2 
3 

30 


Total, . 


206 


4 


9,410 


44.9 


1,100 


1 



414 



STATE BOARD OP HEALTH. 



[Jan. 



Fourth Question. 





"p. 



PS 


o 


o 

03 


a 


■3 

o 
H 


'3 
3 


P. 

s 

2 p 
p .2 

O -M 


1 s 

o 


o 


Cotton, .... 

Wool, 

Silk, 

Flax, 

Jute, ..... 


95 

102 

5 

8 

2 


81 

100 

5 

8 

2 


11 
2 


3 


14 
2 


3 
1 


4 


10 

1 


17 
2 


Total, .... 


212 196 


13 


3 


16 


4 


4 


11 


19 



Note. — Many of the mills report no deaths in their employees during a 
long series of years. A considerable number say, moreover, that minors 
leaving their mills are lost sight of, and that whether they subsequently die, 
from disease or otherwise, cannot therefore be known. 



Fifth Question. 





p. 
« 




p 

o 


a 


o 

SI 

4) 




a) 


,4 


O 


p 

"3 
< 


p. 

a 

3 . 

s§ 

o a 

O 


1 I 
o 


5 

o 

EH 


Cotton, 
Wool, . 
Silk, . 
Flax, . 
Jute, . 


94 

104 

5 

8 
2 


72 

94 

5 

I 


14 
6 

1 


3 

2 


2 

1 


o 
1 


1 


22 
10 

1 


1 

1 


16 
6 

1 


24 
10 


41 
17 

1 


Total, 


213 


180 


21 


5 


3 


3 


1 


33 


2 


23 


34 


59 



Sixth Question. 





Replies. 


Reporting 100 
per cent. 


Reporting none. 


Average per cent. 


Cotton, 

Wool, .... 
Silk, .... 
Flax, .... 
Jute, .... 


87 

91 

4 

8 

1 


13 
16 

1 
2 


o 
6 
1 
1 


74. 
71. 
58. 
74. 

75. 


Total, . 


191 


32 


10 


70* 



* General average. 



1871.] 



PUBLIC DOCUMENT— No. 37. 



415 



Replies to this question are given approxirnatively, the man- 
ufacturers reporting in some cases that they do not fully under- 
stand the question, in others that their records do not enable 
them to reply with accuracy, in others that they are unable to 
determine with greater precision ; only a small minority give 
absolute answers. 



Seventh Question. 



Replies. 



Average 
Months. 



Longest. Shortest. 



Cotton, 
Wool, 
Silk, . 
Flax, 
Jute, 

Total, 



74 

80 

3 

5 



161 



9 
91 

°3 

114 



12 
12 
12 
12 



12 



4 

4 

5 

11 



Eighth Question. 



Average per cent. 




Cotton, . 
Wool, . 
Silk, 

Flax, . 
Jute, 

Total, 



The replies show considerable variation in the estimate of 
absence, the extremes being 5 per cent, and 0. The great 
majority admit their replies to be only approximative, while a 
large number explain that " absence by reason of sickness " 
may mean indisposition to work from many other causes. One 
manufacturer replies that his employees " seem fresher on 
Saturday night than on Monday morning." Many assert that 
absence in their mills has been too trifling to be reckoned. 



416 



STATE BOARD OF HEALTH. 



[Jan. 



Ninth Question. 





Those in Compa- 


Those living in 


Doubt expressed, 


Total 




ny's Tenements. 


their own. 


&c. 


Replies. 


Cotton, 


22 


7 


62 


91 


Wool,. 


11 


3 


80 


94 


Silk, .... 


- 


1 


4 


5 


Flax, .... 


1 


- 


5 


6 


Jute, .... 


- 


- 


2 


2 


Total, . 


34 


11 


153 


198 



Of the 152 replies to question 9, about half say there is no 
perceptible difference ; the rest are nearly all from those who 
either exclusively do or do not own the tenements, and are 
thus unable to institute a comparison. 



Tenth Question. 



In a greater 
degree. 



In a less 


Non-com- 


degree. 


mittal. 


3 


69 


3 


72 


- 


4 


1 


4 


- 


2 


7 


151 



Cotton, 
Wool, 
Silk, . 
Flax, 
Jute, 

Total, 



15 

16 



32 



87 

91 

4 



190 



Those whose answers are not absolute, either misunderstand 
the question, and answer it "yes" or "no," instead of 
" greater " or " less ; " or " do not employ the foreigners " 
referred to, or, if employing them, " do not perceive any 
difference." 



1871.] 



PUBLIC DOCUMENT— No. 37. 



417 



Eleventh Question. 



Total. 



Cotton, .... 

Wool, .... 

Silk, .... 

Flax, .... 

Jute, .... 

Total, 



65 

58 

2 

3 



128 



27 

37 

3 

5 

1 



73 



92 

95 

5 

8 

1 



Many of the larger mills report that they make special pro- 
vision in case of sickness, in the employment of corporation 
physicians, hospitals, relief societies, nurses, &c. In some 
instances a special chamber for the sick is required to be kept 
in reserve in each corporation boarding-house. 



Twelfth Question. 





Yes, 


No. 


Total. 


Cotton, 


89 


5 


94 


Wool, 


91 


7 


98 


Silk, 


5 


_ 


5 


Flax, 


6 


_ 


6 


Jute, 


1 


- 


1 


Total, 


192 


12 


204 



The affirmative answers apply especially to the ventilation 
and cleanliness of mills, many of the replies distinctly stating 
that " they do not pay special attention " otherwise. In other 
cases careful attention is given to the sanitary condition of 
boarding-houses controlled by the manufacturers. 
53 



418 



STATE BOARD OF HEALTH. 



[Jan. 



Thirteenth Question. 



Cotton, 

Wool, 

Silk, 

Flax, 

Jute, 



Total, 



33 

I 30 
4 
1 



59 

62 

1 

5 

1 



128 



92 

92 

5 

6 

1 

196 



Many of those replying in the negative do not own tenements 
for their employees. 



Fourteenth Question. 



Yes. 



Cotton, 

Wool, 

Silk, 

Flax, 

Jute, 



Total, 



60 

37 

1 

2 



100 



33 

58 

3 

5 

1 



100 



Total. 



93 

95 

4 

7 

1 



200 



In a considerable proportion of the negative responses, the 
" town authorities " are said to " see to it." 



1871.] 



PUBLIC DOCUMENT— No. 37. 



419 



Fifteenth Question. 



Number of Hours Weekly. 


Cotton. 


Wool. 


Silk. 


Flax. 


Jute. 


Total. 


50, 




2 








2 


55, . 










_ 


1 


_ 


_ 


_ 


1 


59, . 










_ 


1 


1 


_ 


_ 


•J 


£*» 










- 


1 


_ 


- 


_ 


1 


60, . 










13 


10 


9 


9 


_ 


27 


61i 










2 


_ 


_ 


_ 


_ 


2 


63, . 










2 


9 


_ 


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4 


63^ 










1 


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2 


6 


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1 


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9 


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4 


8 


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1 


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13 


65, . 










4 


6 


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12 


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- 


1 


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66, . 










62 


54 


2 


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121 


67,. 










2 


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671, 










2 


2 


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68, . 










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64.8 


64.7 


62.2 


63.7 


66 


- 



General average, 64.4 



The comparison of death-rates among minors in factories 
with death-rates among minors in the general population can- 
not be made in strict compliance with the terms of the Resolve, 
since we do not know as yet either the numbers of the people 
at definite ages, or the deaths among them in 1870. This is a 
matter of little consequence, however, since mortality rates at 
certain ages are very nearly the same in every year. The rates 
which prevailed in 1860 and 1865 (years of census) are used 
in the following table, and we have every reason to believe that 
the record of 1870 would be similar. The diminished popula- 
tion between the ages of fifteen and twenty in 1865, as compared 
with 1860, was caused by the loss of young men in the four 
previous years of war. 



420 



STATE BOARD OF HEALTH. 



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PUBLIC DOCUMENT— No. 37. 



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422 STATE BOARD OF HEALTH. [Jan. 

The preceding table expresses the principal facts which we 
were directed to procure in so far as they can be reached by the 
means at our command. 

Most of the larger mills have made returns. Most of the 
smaller mills have not. The aggregate of nearly thirteen thou- 
sand minors is certainly a very considerable proportion of the 
whole number employed in factories in the State. 

The correspondence in death-rates between the factory pop- 
ulation and the whole population at the same ages is remark- 
ably close, so much so as to leave little to be said. A certain 
allowance is to be made for the deaths of young men in 18G5, 
the last year of the war. But for that, the deaths from all 
causes between fifteen and nineteen would have been about the 
same in the general population in 1865 as in 1860. That this 
is so is apparent by looking at the deaths from consumption in 
those two years. 

The question concerning deaths by consumption was sent to 
the manufacturers, because of the fact that very nearly forty 
per cent, of all the deaths between the ages of fifteen and nine- 
teen inclusive are from this disease in Massachusetts every 
year. 

The same proportion is seen to be also returned in 1870 
among the mill operatives. 

The result of this inquiry shows that the mortality among 
minors in factories, in so far as it is expressed by the returns 
we have received, is the same as in the general population. 

We think, however, that such returns cannot express the 
whole mortality incident to factory life. 

The operatives are migratory. They do not generally stay 
in one mill a year. (See table based on the replies to ques- 
tion 7.) 

It is reasonable to suppose that when unfit for work by rea- 
son of sickness, and particularly when gradually weakened in 
the first stages of consumption, a certain proportion of opera- 
tives go to their homes, or among their friends, and are lost 
sight of. If this is so it must surely raise the rate of mor- 
tality among minors in factories above that of minors in the 
general population. 

On the other hand, it is to be remembered that the young 
operatives in our mills are drawn for the most part from a class 



1871.] PUBLIC DOCUMENT— No. 37. 423 

of foreigners who do not live under circumstances favorable to 
health, and whose death-rate at all ages is certainly much 
higher than among the population at large. 

The influence of occupations on health is of the greatest 
interest, and its importance is fully recognized by the Board of 
Health. It is, however, a subject more difficult to study in this 
country than in any other country in the world, from the ten- 
dency of our people to change their occupations. This diffi- 
culty meets us in the present investigation. 

It is hoped, however, that the facts which we have been able 
to collect may be found useful to the legislature and to the 
people of the Commonwealth. 



REPORT 

ON THE USE OF MILK FROM COWS AFFECTED WITH 
" FOOT AND MOUTH DISEASE." 

By Arthur H. Nichols, M. D., of Boston. 



54 



426 STATE BOARD OF HEALTH. [Jan. 

[Note by the Secretary.] 

The preceding papers were presented to the legislature in manu- 
script on the 1\st day of January, 1871. At that time the effects 
upon man of the '•'•foot and mouth disease " in cattle were under in- 
vestigation by the State Board of Health, but no definite results had 
been reached. /Since that period, and while this volume was being 
printed, certain facts have been ascertained which it seems impor- 
tant to make known at once, as the disease in question still exists in 
Massachusetts. 

The singular affection of a family in Brighton excited the 
attention of their physician, Br. Marion, who reported to us early 
in January, his belief concerning the cause of the disease. 

Br. Nichols has since conclusively proved the correctness of the 
diagnosis, and has added much information on the whole subject in 
the following pages. 

The prompt and efficient action of the Cattle Commissioners has 
been attended with excellent residts, but in spite of their efforts it 
will not be surprising if the disease shall linger among us in some 
localities for many months to come. 

Boston, February 23d, 1871. 



THE EFFECTS OF THE USE OF MILK FROM COWS AF- 
FECTED WITH APHTHA EPIZOOTICA. 



Aphtha epizootica, otherwise known as vesicular murrain, or 
foot and mouth disease, (maladie apthongulaire, mund-und- 
Mauenseuche) is an exceedingly contagious disease which pre- 
vails among cattle, horses, sheep, deer, goats, pigs, etc., and is 
characterized by an erysipelatous-like eruption terminating in 
the formation of vesicles, pustules and ulcers. The attack is 
generally accompanied by slight feverish symptoms ; the animal 
exhibits an uneasiness in standing, and an unwillingness to 
move, or if an attempt is made to walk, decided lameness 
is noticed in one or more limbs. The local symptoms are thus 
described by George W. Balfour, M. D.* 

* Edin. Med. Jour., Feb. 1863, p. 707. 



1871.] PUBLIC DOCUMENT— No. 37. 427 

" There is generally a harsh and frequent cough, but this symp- 
tom is not invariable ; the mucous membrane of the mouth is 
swollen, and exhibits little reddish elevations ; there is a considera- 
ble flow of saliva from the mouth, and in about twenty-four hours 
from the first appearance of the disease, a crop of vesicles is found 
to be thrown out across the upper part of the mouth, along the 
sides of the tongue, within the lips, on the muzzle, and in the 
nostrils. 

"Vesicles are also occasionally found around the roots of the 
horns, and on the external parts of generation, while they are more 
common in the interdigital spaces and on the udder and teats, and 
these latter organs are often very much involved in those animals 
which are far advanced in gestation or in those giving milk. These 
vesicles are irregular in form, and have neither the central depres- 
sion nor the distinct inflammatory areola observed in true cow-pox. 
They are at first about the size of a millet-seed, but gradually in- 
crease in size to that of a kidney-bean, or larger. The content^ 
of these vesicles are at first pure lymph, but within a few hours this 
becomes more or less opaque from the admixture of shreds of 
lymph and pus corpuscles. Sometimes this fluid is absorbed, and 
the cuticle desquamates, leaving a raw surface ; at other times the 
vesicles burst and scabs are formed, while in severer cases ulceration 
occurs which may take eight or ten days to heal. These symptoms 
all increase till about the third day, after which they commence to 
decrease, and in mild cases the animal is well in little more than a 
week." 

The mild nature of the disease may be illustrated by an 
abstract of the report of Mr. Jeffs, by which it appears that the 
total number of diseased animals in the Bridgewater district, 
England, from August 20th to October 1st, 1869, amounted to 
1,858 cows, 541 heifers, 431 oxen, 38 bulls and 43 pigs, none of 
which died. 

It seems established then by these and similar observations, 
that a fatal termination is extremely uncommon, and even 
where death has taken place, it has apparently resulted not so 
much from the virulence of the specific poison, as from simple 
inanition, the ulcerated condition of the moutli and tongue 
preventing the animal from taking food sufficient for nourish- 
ment 

The small number of prominent symptoms, and the fact that 
there have appeared as yet no spurious forms of the malady, 



428 STATE BOARD OF HEALTH. [Jan. 

render the affection easy to distinguish, and one case presents 
therefore in every essential particular a model of all others. 

The above described distemper which in some unknown man- 
ner was introduced into England for the first time in 1839,* 
and which has recently visited this State, "presents several 
features of more than ordinary interest. The manner of its 
original introduction into the town of Brighton, where it was 
first noticed ; its radiation from this place as a central point, 
thus penetrating distant counties and States ; the mode of its 
extension, at times moving regularly along through contiguous 
farms, at others travelling over considerable districts and appear- 
ing in remote localities ; the development and propagation of 
the disease as affected by conditions of temperature and other 
atmospheric influences, — all these present practical and inter- 
esting questions for scientific investigation, the solution of 
which there is reason to believe, would demonstrate most 
forcibly the utility of " sanitary cordons " and other restrictive 
measures for preventing the spread of the malady, which have 
been recently put in operation by the State Cattle Commis- 
sioners. 

The absence of accurate data renders it impossible to settle 
conclusively many of these points, and it is proposed therefore 
in this article to answer merely one question which meets us at 
the very threshold of all inquiry, viz : in what manner can the 
disease be communicated to human beings ? 

It has long been known to medical men, that children who 
had been fed with the milk of affected cows, were not unfre- 
quently attacked with vomiting and diarrhoea, but it was main- 
tained that these symptoms might be explained without 
assuming that the specific poison of the disease had been com- 
municated, since it has been remarked that at the height of 
the disease, the milk very soon turns sour ; it also coagulates 
upon being boiled, or having its temperature very slightly 
raised, and moreover has been found at this time to contain pus 
corpuscles,! and it was thought therefore, that these facts 

* Veterinarian, Vol. XIV., p. 184. 

t It has not yet been satisfactorily ascertained whether these corpuscles are secreted 
•with the milk, or (as would seem more probable) they derive their origin from the pus- 
tules on the udder, and are transferred to the pail by the process of milking. A micros- 
copical examination was made of the miik from one cow seen at Brighton, which was 
recovering from a severe attack. In this instance neither pus nor parasitic growths were 
detected, but the milk was found to be sour four hours after it was secreted, 



1871.] PUBLIC DOCUMENT— No. 37. 429 

alone were sufficient to account for the above intestinal disor- 
ders. The recent outbreak in this State has afforded strong 
additional evidence that the use of such milk may be followed 
not only by lesions of the mouth and intestines, but also by a 
well-marked cutaneous eruption, as shown by cases which 
occurred in the practice of Dr. H. E. Marion, of Brighton, by 
whom the method of the introduction of the contagion was dis- 
tinctly traced. 

It seems that shortly after the malady appeared in the cattle- 
yards at Brighton, it attacked fourteen cows, constituting a 
dairy which is situated over a mile from the yards. Attention 
was first attracted to one of the cows from the fact that she re- 
fused to eat, and upon examination the entire inner surface of 
the mouth was found to be covered with a slimy secretion, and 
numerous ulcers were seen on the lips and tongue. Although 
this animal was immediately removed from the barn, the others 
were soon after seized in like manner. It is certain that after 
the appearance of the disease in the first cow, the milk was for 
a while consumed as usual, the symptoms not having become 
sufficiently developed to enable their true nature to be recog- 
nized *by the milkers,* so that there can be no doubt that the 
milk of one diseased cow, together with that of thirteen others, 
at that time unaffected, was distributed to various families, dur- 
ing a period not exceeding two or three days. 

In one family, the members of which partook freely of milk 
from this source, a peculiar disease broke out in the course of 
five or six days, causing at the same time similar and well- 
marked symptoms in no less than three individuals, all adults. 
These symptoms consisted of loss of appetite, nausea, slight 
acceleration of the pulse, swelling of tonsils and sub-maxillary 
glands, the appearance of a few vesicles upon the lips and 
tongue, and a singular cutaneous eruption on the lower ex- 
tremities, consisting of clusters of papules, vesicles, pustules and 
ulcers of different sizes, — the latter characterized by a dark-red 
color, while their peripheral margin was slightly elevated and 
inflamed. These appearances, in varied stages of development, 

* Injustice to the proprietor of this dairy (whose pecuniar}' loss has been heavy), it 
should be stated, that as soon as the true character of the disease became known, he at 
once notified all families supplied by him, and ordered all the milk subsequently obtained 
from diseased animals to be thrown away. 



430 STATE BOARD OF HEALTH. [Jan. 

were all seen at one and the same time, indicating that a fresh 
outbreak of vesicles was taking place as rapidly as the old 
ones disappeared. In each instance the eruption was confined 
to one limb, in two instances appearing upon the front and 
side of the thigh, and in the other just below the knee, and 
although attended by no great constitutional disturbance, was, 
nevertheless, rather tedious in its progress, lasting six or seven 
weeks. 

Inquiries were instituted with the idea of ascertaining whether 
other cases, traceable to this infected farm, existed in the town, 
and it transpired that another less pronounced instance of the 
disease occurred at exactly the same time, in a woman who had 
been supplied with milk from this dairy. Dr. Braman, of 
Brighton, by whom the case was observed, furnishes the details, 
as follows : — 

"The symptoms here noticed were an efflorescence upon both lips, 
which at a distance looked swollen and everted, and on closer ex- 
amination were found to be studded with minute vesicles and 
apthous patches \. decided swelling of the mucous membrane of the 
gums and nasal cavity, pain and tenderness in the region 6f the 
abdomen, and diarrhoea." 

In order to demonstrate more conclusively the specific nature 
^of the cutaneous eruption, quills were charged with the contents 
of these vesicles in the human subject, and the poisonous ele- 
ment was in this way transferred to the bodies of two young 
rabbits. At the expiration of two days, the inner surface 
of the upper lips was found to be swollen and covered with a 
bloody discharge ; later, several small white specks were formed 
upon the inflamed spots, and the animals were seized with con- 
vulsions and died, one in three, the other in four days from 
the time of inoculation. 

Portions of the same lymph were next introduced by the or- 
dinary method of scarification into the arm of a healthy man. In 
two days vesicles began to form at two of the three points of 
inoculation, similar to" those upon the thigh of the woman from 
whom the lymph was obtained. In four or five days more, 
these vesicles, having attained the size of a large split pea, were 



1871.] PUBLIC DOCUMENT— No. 37. 431 

ruptured, and in their places appeared unhealthy-looking 
ulcers, which instead of healing, continued to increase in size.* 

The fact that the milk of diseased cows may produce an erup- 
tion on the surface of the body of human beings, analogous to 
that developed in animals, has been satisfactorily shown by Pro- 
fessor Hertwig,| of Berlin, in a series of experiments performed 
upon himself. He began by drinking daily a quart of fresh milk 
taken from a diseased cow, and upon the second day experienced 
a slight fever, contractions of the limbs, headache, heat and dry- 
ness of the mouth, and an itching sensation in hands and 
fingers. Five days later, the mucous membrane of the mouth 
and tongue became perceptibly swollen, and small vesicles ap- 
peared. These vesicles increased in size for a few days, and at 
last burst, leaving in their place dark apthous patches, which 
did not disappear for a considerable length of time. Upon the 
hands and fingers moreover, vesicles appeared which afterwards 
burst and dried up in the same manner. Similar experiments 
were performed by Jacob, % at Basle, in which case vesicles 
were formed upon the chest. 

Two cases reported by Dr. J. B. Hislop§ are in this connec- 
tion, interesting on account of the anomalous character of the 
eruption : — 

"In August, 1862 Mrs. X.,4he wife of an extensive farmer came 
under my care, on account of an eruption of bright red spots one- 
eighth of an inch in diameter, covered with a thin white desquama- 
tion, which were so thickly sprinkled over her feet, legs, thighs, and 
the lower part of her body as to leave only minute interspaces of 
sound skin. ****** 

" On a subsequent visit to my patient I found her husband com- 
plaining of sore mouth and throat. Upon examination I found the 
mucous membrane of his lips, mouth, tongue and throat studded 
with small ulcers giving off a white slough, which left behind it a 
clean but highly-sensitive cup-shaped cavity ; his forehead was also 

* At the present date, (Feb. 22,) twelve days after inoculation, these ulcers have given 
no indication of healthy action, so that their unequivocal character leaves no doubt as to 
the contagiousness of the affection, thus distinguishing it from other forms of cutaneous 
eruption, which though somewhat similar in appearance are nevertheless non-contagious. 

A. H. N. 

t Medicinische Vereinszeitung, 1834, No. 48, p. 226. 

% Journal de Medicine V^t^rinaire, pub. a l'Ecole de Lyon, Tome II., 1846. 

§ Edin. Med. Review, Feb. 1863, p. 704. 



432 STATE BOARD OF HEALTH. [Jan. 

covered with an eruption similar to that upon the lower extremities 
of his wife. As this peculiar combination of symptoms in parties 
so closely connected was to say the least of it remarkable, I made 
strict inquiries, and distinctly ascertained that the only cause that 
could be assigned for this peculiar affection was the circumstance 
that the whole of Mr. X.'s cows were at that time laboring under 
the vesicular murrain {Aphtha Epizootica). * * * * 

" I subsequently ascertained upon inquiry the various other indi- 
viduals employed about the cattle had suffered from similar symp- 
toms, though in a less degree. * * * * 

" Several of the children about the house were also affected with 
sore throats, but the symptoms in their case were mild. * * * 
The family were in the habit of freely using the milk fresh from the 
cows." 

The disease is also capable of being communicated by direct 
contagion, by means of the viscous secretion from the mouths 
of animals, as well as by the contents of the vesicles. 

Hildebrandt* relates instances where contact with these 
secretions has produced apthous eruption in the mouth, con- 
junctivitis, and a pemphigus-like eruption on various portions 
of the skin. Broschef reports the case of two girls who had 
milked cows with diseased udders, upon whose fingers and toes 
there appeared swollen spots, upon which spots were afterward 
formed vesicles, analogous to those on the udders of the cows 
which they had milked. 

The above views may be thus stated in a condensed form. 

1. It is proved that Aphtha Epizootica may be communicated 
to man through the medium of diseased milk, as well as by 
direct contagion. 

2. The disease produced in human beings by the use of this 
milk is not usually to be dreaded, for it is by no means formid- 
able ; it is generally limited to a sore mouth, and in very rare 
instances is accompanied by an eruption on the surface of the 
body. The use of such milk by feeble persons and young chil- 
dren might however be followed by more serious consequences. 

In no well ascertained case has it been found that any ill 
effects have been produced by eating the flesh of diseased ani- 
mals, although there is abundant evidence that at the outbreak 

* Magazine fur Thierh. 1840. VI. 2. 

t Die Maul und Klauenseuche der Kinder, etc. Dresden, 1820. 



1871.] PUBLIC DOCUMENT— No. 37. 433 

of the distemper in Massachusetts, and before public attention 
had been directed to its true character, a considerable number 
of animals, in which the usual premonitory symptoms had ap- 
peared, were slaughtered and their flesh sold. 

In accordance with the general law that animal poisons are 
destroyed when subjected to a very high temperature, we are 
justified in believing that the affection can never be communi- 
cated to man through the medium of the meat, provided it be 
thoroughly cooked, and upon the same principle the milk might 
be rendered innocuous by being boiled. 

55 



BOSTON UNIVERSl" 



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