ColumtJia Wini\)tv^it^ <\ intfjeCitpofi^ehj|9orfe ^ CoUege of ^fjpsiiciansf anb ^urgeonjf 3^ef erence I^ibrarp Digitized by the Internet Archive in 2010 with funding from Open Knowledge Commons http://www.archive.org/details/statesanitationrOOwhip FREDERIC P. STEARNS tJfilVFj STATE SANITATION A REVIEW OF THE WORK OF THE MASSACHUSETTS STATE BOARD OF HEALTH BY GEORGE CHANDLER WHIPPLE PROFESSOR OF SANITARY ENGINEERING IN HARVARD UNIVERSITY AND THE MASSACHUSETTS INSTITUTE OF TECHNOLOGY MEMBER OF THE PUBLIC HEALTH COUNCIL MASSACHUSETTS STATE DEPARTMENT OF HEALTH VOLUME II CAMBRIDGE HARVARD UNIVERSITY PRESS LONDON: HUMPHREY MttFORD Oxford University Press 1917 COPYRIGHT, 19 1 7 HARVARD tJNIVERSITY PRESS \r\f r 'I FOREWORD A MOST interesting way of studying history is that of reading original documents, addresses and writings by contempora- ries of the events described; and this is just as true in the field of public health as in that of general history. There are no more important series of scientific writings on subjects pertaining to preventive medicine, hygiene and sanitation than those which have appeared in the annual reports and special reports of the Massachusetts State Board of Health during the period, covering nearly half a century, from 1869 to 1 9 14. Several hundred in number and scattered through sixty or seventy volumes, some of which can be found only with the greatest difficulty, these writings are in danger of being lost to the world, or, at least, of escaping the attention of present day students of pubhc health. The best way to rescue these reports from obhvion seemed to be to index them and in addition to prepare a series of ab- stracts of leading articles, while the best way to give new Hfe to the most important writings, which might appropriately be called the Massachusetts Classics in Sanitation, seemed to be to reprint them, with such abridgment as might be necessary to bring them within the compass of a single book. Such reprints and abstracts are given in the present volume. It is hoped that these writings which inspired the fathers will also inspire the sons. In making the selections especial prominence has been given to the subjects of water supply and sewage disposal, for it was in the investigation of these subjects that the State Board of Health of Massachusetts acquired early fame. In these writings the names of Nichols, Mills, Stearns, Drown, iv FOREWORD Sedgwick, Hazen, Goodnough and Clark stand out promi- nently. But the reprinted writings include also inspiring addresses by Dr. Henry I. Bowditch on the subjects of pub- lic health, preventive medicine, the physician of the future, and intemperance; the statesmanlike reports of Dr. Henry P. Walcott on such great metropohtan improvements as the water supply and sewerage of Boston and its suburbs, and the Charles River Basin; the wonderfully exact scientific investigations of Dr. Theobald Smith in the field of bacteri- ology; the careful statistical researches of Dr. Samuel W. Abbott; the dairy studies of the impetuous Secretary, Dr. Charles Harrington, as well as some of the more modern writings on infantile paralysis by Dr. Mark Richardson and food inspection by Mr. Hermann H. Lythgoe. The abstracts are arranged chronologically in order that the reader may obtain a better perspective of the studies with which the sanitarians of the State Board of Health were concerned at different periods of its history. The joint indices to the annual reports and special reports will be published as a third volume. The proof of this volume was corrected at long range dur- ing the author's journey to Russia as a Member of the Red Cross Mission to that country. The chances for errors to escape notice are therefore greater than usual and the reader is asked to be charitable if such are found. The index to this volume was very kindly prepared by Mr. Melville C. Whipple, Instructor in Sanitary Chemistry, Harvard Uni- versity, to whom I wish to express my sincere thanks. George Chandler Whipple. ToKio, Japan July, 1917 CONTENTS PART III REPRINTED SCIENTIFIC WRITINGS PAGE I. State Medicine 3 \ HeNHY I. BOWDITCH, 1870 II. The Public Health 9 Circular Letter, 1870 III. Intemperance in the Light of the Cosmic Law . . 12 Henry I. Bowditch, 1872 IV. Preventive Medicine and the Physician of the Future i 7 HE>fRY I. Bowditch, 1874 V. The Filtration of Potable Water 26 Wm. Ripley Nichols, 1878 VI. On Some Impurities of Drinking-water Caused by Vegetable Growths 39 Wm. G. Farlow, 1879 VII. A Study of the Relative Poisonous Effects of Coal AND Water Gas 47 Wm. T. Sedgwick and Wm. Ripley Nichols, 1884 VIII. Report of a Commission to Consider a General System OF Drainage for the Valleys of the Mystic, Black- stone AND Charles Rivers 58 Henry P. Walcott, 1886 IX. Micro-organisms in the Air of the Boston City Hos- pital 65 Greenleaf R. Tucker, 1888 X. Pollution of Ice Supplies 77 State Board of Health,^ 1889 XL Report of the State Board of Health upon the Sew- erage OF THE Mystic and Charles River Valleys 86 State Board of Health,^ 1889 XII. Suggestions as to the Selection of Sources of Water Supply 106 Frederic P. Stearns, 1890 XIII. The Growth of Children Studied by Galton's Method OF Percentile Grades 119 H. p. Bowditch, 1890 XIV. Typhoid Fever in its Relation to Water Supplies . . 131 Hiram F. Mills, 1890 XV. A Classification of the Drinking-waters of the State 139 State Board of Health,^ 1890 ' The reports of the State Board of Health were almost invariably written by the Chairman, Dr. Henry P. Walcott. vi CONTENTS XVI. The Effect of Storage upon the Taste and Odor of Surface Waters i44 Frederic P. Stearns and Thomas M. Drown, 1890 XVII. The Pollution of Streams 156 Frederic P. Stearns, 1890 XVIII. The Filtration of Sewage, a General View of Re- sults of Experiments at the Lawrence Experiment Station 172 Hiram F. Mills, 1890 XIX. The Chemical Precipitation of Sewage 188 Allen Hazen, 1890 XX. Microscopical Analysis 192 Wm. T. Sedgwick, 1890 XXI. Investigations upon Nitrification and the Nitrifying Organism 208 Edwin O. Jordan and Mrs. Ellen H. Richards, 1890 XXII. The Interpretation of Water Analyses 218 Thomas M. Drown, 1892 XXIII. Some Physical Properties of Sands and Gravels, with Special Reference to Their Use in Filtration. . 232 Allen Hazen, 1892 XXIV. Report of the Joint Board upon the Improvement of Charles River 249 Metropolitan Park Commission and State Board of Health, 1894 XXV. Report of the State Board of Health upon a Met- ropolitan Water Supply 260 State Board of Health,' 189s XXVI. A Comparative Study of the Toxin Production of Diphtheria Bacilli 274 Theobald Smith and Ernest L. Walker, 1896 XXVII. Sanitary Condition and Improvement of the Nepon- SET Meadows 293 State Board of Health,' 1897 XXVIII. A Massachusetts Life Table for the Five Years 1893-97 300 Samuel W. Abbott, 1898 XXIX. Report of the State Board of Health upon the Gen- eral Subject of the Discharge of Sewage into Boston Harbor 317 State Board of Health,' 1900 XXX. Examination of Sewer Outlets in Boston Harbor and of Tidal Waters and Flats from which Shellfish ARE TAKEN FOR FoOD 322 X. H. Goodnough, 190S XXXI. Inspection of Dairies 333 Charles W. Harrington, 1905 1 The reports of the State Board of Health were ahnost invariably written by the Chairman, Dr. Henry P. Walcott. CONTENTS vii XXXII. A Review of Twenty-one Years' Experiments upon THE Purification of Sewage at the Lawrence Ex- periment Station 341 H. W. Clark and Stephen DeM. Gage, 1908 XXXIII. The Occurrence of Infantile Paralysis in Massa- chusetts, 1907-12 350 Mark W. Richardson, 1912 XXXIV. Food and Drug Inspection of the Massachusetts State Board of Health 366 Hermann C. Lythgoe, 1914 PART IV ABSTRACTS OF SCIENTIFIC ARTICLES AND REPORTS State Board of Health; Annual Reports: First, 1870 377 Second, 1871 377 Third, 1872 380 Fourth, 1873 382 Fifth, 1874 384 Sixth, 1875 387 Seventh, 1876 388 Eighth, 1877 391 Ninth, 1878 393 Tenth, 1879 395 Eleventh, 1879 396 State Board of Health, Lunacy and Charity; Supplements to Annual Reports : First, 1879 396 Second, 1880 397 Third, 1881 398 Fourth, 1882 399 Fifth, 1883 400 Sixth, 1884 400 Seventh, 1885 401 State Board of Health; Annual Reports: Eighteenth, 1886 402 Nineteenth, 1887 402 Twentieth, 1888 403 Twenty-first, 1889 403 Twenty-second, 1890 404 State Board of Health ; Special Reports on Water Supply AND Sewerage: Part I, 1890 405 Part II, 1890 407 State Board of Health; Annual Reports: Twenty-third, 1891 410 Twenty-fourth, 1892 412 viii . CONTENTS State Board of Health; Annual Reports — continued Twenty-fifth, 1893 414 Twenty-sixth, 1894 41S Twenty-seventh, 1895 416 Twenty-eighth, 1896 416 Twenty-ninth, 1897 417 Thirtieth, 1898 417 Thirty-first, 1899 418 Thirty-second, 1900 418 Thirty-third, 1901 419 Thirty-fourth, 1902 420 Thirty-fifth, 1903 421 Thirty-sixth, 1904 421 Thirty-seventh, 1905 421 Thirty-eighth, 1906 422 Thirty-ninth, 1907 423 Fortieth, 1908 425 Forty-first, 1909 425 Forty-second, 1910 426 Forty-third, 191 1 426 Forty-fourth, 191 2 426 Forty-fifth, 1913 427 Forty-sixth, 1914 427 State Board of Health; Special Reports: Sewerage of the Mystic and Charles River Valleys, 1889 .... 429 Improvement of Charles River, 1894 43° MetropoUtan Water Supply, 1895 43° Improvement of Upper Charles River, 1896 432 Improvement of Neponset River, 1897 433 Cerebro-spinal Meningitis, 1898 433 Restoration of Green Harbor, 1898 434 Sewerage of Salem and Peabody, 1898. . . 434 Discharge of Sewage into Boston Harbor, 1900 435 Sanitary Condition of Sudbury and Concord Rivers, 1901 ... 435 Undertaking and Embalming, 1904 436 Dumping Garbage into Harbors, 1904 436 Mystic River and Ale wife Brook, 1906 436 Water Supply of Lynn, 1907 437 Sanitary Condition of Merrimack River, 1908 437 Pollution of Boston Harbor, 1908 438 Green Harbor, 1909 438 Lake Quannapowitt, 1909 438 Sewage Disposal for Worcester Insane Hospital, 1909 439 Water Supply of Salem, Beverly and Peabody, 191 1 439 Sanitary Condition of Merrimack River, 1913 439 Danvers River and its Estuaries, 1913 44° Dorchester Bay, 1913 440 Sewerage of Reading, 1914 441 Index 443 PART III SELECTIONS FROM THE REPORTS OF THE MASSACHUSETTS STATE BOARD OF HEALTH STATE MEDICINE By Dr. Henry I. Bowditch QAddress of Dr. Henry I. Bowditch to the Gentlemen of the State Board of Health at the first meeting of the Board, held at the State House, September 15, 1869. First Annual Report, 1870, p. 9. — G. C. W.] By the orders of the Governor of the Commonwealth, it de- volves upon me to call you together. As the subject-matters for our discussion may be somewhat indefinite in all of our minds, I take the hberty of addressing a few words to you, in order that you may know not only what I consider the general nature of our duties, but may also understand how high I place these duties when I consider them in their relations to the present and future health of the citizens of the state. I may be mistaken in my esti- mate of the importance of the movement, the commencement of which today devolves upon us. I confess to you that I know of no higher office in the state than that which we now hold, viz., that of inaugurating the idea of " State Medicine " in Massa- chusetts. Upon our high or low appreciation of the position and of the duties resulting from that position, and upon our wise or foolish performance of these duties, depends the success of the object aimed at in the establishment of a State Board of Health. The last Legislature, unconsciously, perhaps, on the part of many members thereof, has proposed a system that may be made by us capable of good to the citizens in all future time, or it may prove a perfect abortion. Our work is for the far future as well as for the present, and at this very opening of our labors we should try to place ourselves above the region of merely local or temporary excitement or of partisan warfare, in order that we may act wisely and for the ultimate good of the whole people. In these introductory general remarks, as you will see, my object has been to impress upon you my views of the essential dignity of the offices we now hold, and that we should assume 4 STATE SANITATION them with minds loyal to the truth and under a sense of individual responsibility in the premises. I have used one expression about which I wish to enter into some detail, viz., " State Medicine in Massachusetts." What is the precise meaning of the expression ? It is of very recent growth in our language. It has, in fact, arisen, I believe, within the last few years in England, where already it has become a great power for good. Its objects rank among the most important matters now discussed by the highest intellects and humanest hearts in Great Britain. It is, as I understand it, a special function of a state authority, which, until these later days of scientific investi- gation, has been left almost wholly unperformed, or exercised only under the greatest incitements to its operation, such as the coming of the plague, cholera, smallpox, or some other equally malignant disease. By this function the authorities of a state are bound to take care of the public health, to investigate the causes of epidemic and other diseases, in order that each citizen may not only have as long a life as nature would give him, but likewise as healthy a life as possible. As the chief object of the physician is the cure, if possible, of any ailment which is submitted to his care, so the far higher aim of State Medicine is, by its thorough and scientific investigations of the hidden causes of diseases that are constantly at work in an ignorant or debased community, to pre- vent the very origination of such diseases. Much has already been suggested in England towards the crushing out of fevers, etc. Still more recently one of the grandest results of the State Medi- cine is its virtual recognition under international law, by the appointment of joint governmental commissioners for the inves- tigation and prevention of the spread of Asiatic cholera. The history of State Medicine in Great Britain may be briefly summed up as follows: — Only twenty-one years ago, namely, in 1848, England, stimu- lated by the medical profession and the philanthropists, passed an Act establishing a " General Board of Health." It gave very ex- tensive powers, and statements of its doings from year to year were published by Parliament. The Registrar-General's reports also tended to open the eyes of all to the importance of more thorough- ness of work. STATE MEDICINE 5 In the early part of 1858, the Privy Council of England was directed to consider the matter of public health. Accordingly its chief medical officer, Mr. Simon, one of the most eminent of the medical profession of London, was ordered to report to the council on any matters pertaining to that subject. Every year since then he has sent out, under official sanction, very valuable documents. He has been allowed to call to his aid all the special talent in the kingdom; and investigations of importance, not only to the state, but to the science of medicine, have been annually made and pub- lished by the council. And I beg you to bear in mind that all these investigations have been made by the state with one sole object in view, viz., the improvement in human health, and for the lengthening out of human Hfe of each individual man or woman. Certainly no object can be nobler, none more deserving the atten- tion of learned men or of philanthropists or statesmen. Dr. Farr {Medical Twies and Gazette, July 31, 1869), in his very recent and able address as president of the section on State Medi- cine in the British Medical Association, pursues the following lines of thought upon this subject: " Pubhc hygiene is a want as much as air, and public roads and waters are public necessities, and as such must be cared for and paid for by the community." Dis- eases as disastrous as those among the Greek hosts before Troy befell the English camp in the Crimea. Before Troy, appeals by prayer were made to appease the anger of the gods; but God's divine laws of hygiene were unknown or uncared for. During the Crimean war the people of England not only prayed, but with indignant haste they hurled from power an inefficient ministry because it neglected these same laws. Out of this upheaval of the nation's heart arose Florence Nightingale and Lord Herbert, with their Christian sanitary law, bringing health and comparative comfort to the war-worn soldier. " A sanitary code," says Dr. Farr, " is needed, with proper sani- tary officers; for otherwise a code would be a dead letter." Hence, continues he, "a Ministry of Public Health will eventually be needed for the British Empire." I would remark, in passing, that Jeremy Bentham suggested in his " Constitutional Code " the same idea more than thirty years ago. " Such a ministry," says 6 STATE SANITATION Dr. Farr, " would divide itself into four departments — adminis- tration, medicine, engineering, statistics — each of which should be organized so as to work in harmony with a council of health and executive heads. Each town should have its board of health and its health physician in communication with and in aid of the Central Board of Health." But pubhc health has so wide a field that help is needed from all; from the chemist, the engineer, the naturalist, and from the humblest citizen as well as the highest statesman. " The primary object of public medicine," says Dr. Farr, " is to prevent disease, but it also surrounds the sick with conditions most favorable to recovery, and diminishes the death-roll of the people." Dr. Farr concludes his admirable address with the following thought: "Supposing every condition favorable for the perfect operation of the powers of State Medicine, we should still see grave defects in many persons; shortcomings in others; in many, organic degeneracies; in many, criminal depravities. " How out of the existing seed to raise races of men to divine perfection is the final problem of public medicine." You see, gentlemen, from these memoranda taken from Dr. Farr's address, that I am not alone in considering the object we have to care for as among the highest that can be presented to any reasonable man, or to any lover of his race. The establishment of our Board by the last general court in- augurates this system of State Medicine in Massachusetts. I think that this is the first State Board of Health established by any American state; at least, with objects as extensive as those now given to our charge. The law under which we act, while not specifying so much as the English law of 1848, gives us the amplest powers for investigation and funds at our disposal for any legitimate purpose. Let us look for a moment at some of the general objects and duties involved in the Act establishing our Board. I. It directs the Board to take cognizance of everything tending to public health, and of course requires us to endeavor to eradicate everything tending to pubhc disease and death. STATE MEDICINE 7 2. It directs us to diffuse among the people a knowledge of the means of obtaining individual and public health and of preventing disease. 3. We are ordered to investigate the effects of the use of intoxi- cating liquors upon the industry, prosperity, happiness, health and lives of the people, and it is intimated that we may suggest legislation on any or all of the subjects committed to us for investigation. Now in order that the workings of the Board may become har- monious and of real service, it is a self-evident proposition that exact methods of procedure must be followed in all cases, and that certain by-laws for the legal governance of the Board will be neces- sary, and which shall not be varied from except under special directions at a full meeting of the Board. [Dr. Bowditch then proceeded to suggest certain plans for the organization of the Board, and continued as follows] : — The law requires us to diffuse among our people any already established laws of public health, and also whatever we may here- after discover on that subject. I look upon this feature of the law with deep interest, for I believe by it we may do much service to the people. How shall we diffuse this knowledge ? Permit me to allude to a few evident methods. (a) By lectures from our Secretary or from members of the Board on various special subjects connected with public hygiene - — such as ventilating, and building, and location of houses; on various well-known diseases capable of partial or entire prevention on knowledge of causes being given. It may be a question, more- over, whether we should not authorize the Secretary to communi- cate with lecture committees of various towns and the American Literary Bureaus, and to make arrangements with physicians and others to deliver lectures relating to public health in various towns. (6) By the Secretary holding meetings in the various parts of the state for discussions on the subject, meetings analogous to those now held on education, agriculture, etc. He might invite the co-operation of local medical societies or special physicians. I 8 STATE SANITATION have no doubt that such meetings, properly conducted, would attract the attention and interest of the public. (c) By the publication in a compact form and the wide circula- tion of the pith, so to speak, of our general knowledge on public hygiene. How this should be done would remain an open ques- tion. If it could be done, there is no doubt of the good that would eventually result. (d) By our annual reports to the Legislature, which, I trust, will always be models of brevity and of compact learning — not a word too much or a word for effect merely — and so thoroughly indexed that even the busiest man on 'change can in three minutes get at the essentials, and be prepared to study the details of any part or parts he may wish further to examine. In conclusion, gentlemen, let me say that, while I feel alike our grave responsibilities and the dignity conferred on each one of us by His Excellency the Governor in his selection of us for these offices, I have at the same time no misgivings; but on the con- trary, the Hveliest hope that this Board will faithfully and in an able manner perform its duties, and thus it will become a real blessing to our state, not only at the present time, but long after every member of it has died. It will assuredly be such if we, the necessary originators of its various details, only look at our duties in the light of the broadest philanthropy and, as far as in us Kes, the wisest statesmanship, and finally with all the knowledge that modern science can at present give us. In making these introductory remarks, I have done only what seemed to be proper; but I hope that others will speak what seems to them good, so that starting on our new career with un- derstanding minds and buoyant and willing hearts, we may vigor- ously inaugurate State Medicine in Massachusetts. II THE PUBLIC HEALTH [This circular letter was issued by the State Board of Health in October, 1869, and sent to the Mayor and Board of Health of every city, to the Selectmen of every town, to every member of the Legislature of 1869, and to every clergyman and physician in Massachusetts. First Annual Report, 1870, pp. 15-17. — G. C. W.] The undersigned have recently been appointed by the governor and council to constitute the " State Board of Health," under an Act passed by the last Legislature. In entering upon our duties, which are rather advisory than executive, we desire to establish such communication with the local boards having this important subject in charge, that all may work together for the common advantage of the people, for the prevention of disease, and for the prolongation of life. We believe that all citizens have an inherent right to the enjoy- ment of pure and uncontaminated air, and water, and soil; that this right should be regarded as belonging to the whole com- munity; and that no one should be allowed to trespass upon it by his carelessness, or his avarice, or even by his ignorance. This right is in a great measure recognized by the state, as appears by the General Statutes. If these were strictly and impartially enforced, we should have a condition of public cleanliness, and of public health, which would make Massachusetts a model for all other communities. That this has not been done depends upon many causes, some of general, and others of purely local operation. It has been doubted, whether the public mind is sufficiently aware of the dangerous elements around us; whether the connec- tion between filth and disease is as yet proved to the public satis- faction; whether the people are convinced that undrained land is unwholesome to live upon. All these doubts of the public intelligence have impeded the operation of our laws. lo STATE SANITATION It is thought also that local and private interests have often been so strong as to paralyze the action of the health authorities. But we hope and believe that a better time is coming; and we confidently look to you to put in force the powers which the laws have placed in your hands. Among these laws we would particularly call your attention to — General Statutes, chapter 26, in which are comprised stringent provisions relative to the abatement of nuisances, to vaccination, to contagion, and to offensive trades. Also, to chapter 49, section 151, relative to the sale of milk pro- duced from cows fed upon the refuse of breweries or distilleries, and to the sale of milk rendered unwholesome by any cause. Also, to chapter 166, in which the law is given relative to the sale of unwholesome provisions of all kinds, whether for meat or drink; the corruption of springs, wells, reservoirs, or aqueducts; the sale of dangerous drugs, and the adulteration of drugs of every sort. It will also be seen, on reference to chapter 2 1 1 of the Acts of the year 1866, that it is in the power of any person, aggrieved by the neglect of the board of health of any city or town to abate a nui- sance, to appeal to the county commissioners, who can in that case exercise all the powers of the board of health. Chapter 253 of the Acts of 1866 authorizes boards of health to seize and destroy the meat of any calf killed when less than four weeks old. Chapter 271 of the Acts of 1866 authorizes boards of health to appoint agents, to act for them, under certain restrictions. The Legislature of 1868 passed two Acts of great importance to the public health, to which we would respectfully and earnestly ask your attention. The first, chapter 281, 1868, applies only to the city of Boston, and relates to tenement and lodging houses, placing them under very strict regulations, for the public good. The second, chapter 160, is of general application. It provides that in any city or town, lands which are wet, rotten or spongy, or covered with stagnant water, so as to be offensive, or injurious to health, shall be deemed a nuisance, to be abated by the board of THE PUBLIC HEALTH ii health of such city or town. In case they refuse to act, appeal may be made, by persons aggrieved, to the superior court or any justice thereof, who may appoint three commissioners with powers equal to those possessed by boards of health. We confidently look to you for the enforcement of these laws. We beheve that public opinion will fully support you in so doing. We will give you all the help in our power. There is a great work before us, which, if carried out in the letter and spirit of the laws referred to, we cannot doubt will justify the wisdom which framed them. In making this our first communication to the boards of health of the various cities and towns of the Commonwealth, we sincerely hope that it may serve as the opening of friendly and helpful rela- tions between us, and that it will lead to reforms, the effects of which will be evident in the improved condition of pubUc health. Communications addressed to our secretary, Dr. George Derby, State House, Boston, will be at once acknowledged, and will be laid before the State Board of Health at their next meeting. Very respectfully, your obedient servants, Henry I. Bowditch, George Derby, Robert T. Davis, Richard Frothingham, P. Emory Aldrich, Warren Sawyer, William C. Chapin, State Board of Health. Ill INTEMPERANCE IN THE LIGHT OF THE COSMIC LAW By Dr. Henry I. Bowditch [Sximmary of the principal subjects considered in a letter of Dr. Henry I. Bow- ditch to the State Board of Health on Intemperance as seen in the light of cosmic law. Third Annual Report, January, 1872, pp. 72-73, 109-112. — G. C. W.] In our Second Annual Report is printed a correspondence on the use and abuse of alcoholic stimulants among foreign nations, and a comparison of the same with our own country in this par- ticular. I think this correspondence is unique not only for the extent of the surface of the globe that it embraces, but likewise for the character of our correspondents. Last year, owing to want of time, the letters were printed without comment, except a most imperfect analysis of them. I have thought that they should receive more attention from us, and that all their essential truths or apparent truths should be sifted out and brought more clearly into view. I have had this end in view while preparing this communication for you. I cannot perhaps hope to gain the unanimous consent of the Board to all the propositions I may feel justified in laying down after a fair consideration of the various letters. But I trust you will beHeve that I have endeavored to get at the exact truth. In commencing the correspondence as your representative I had no other object in view than to get the opinions of able corre- spondents, most of them either American ambassadors to different courts or consuls from the American government stationed in all the various important countries of the world to which our com- merce extends. My questions embraced two main ideas. They were put briefly, because I believed that if I asked a few questions containing seminal principles, I should get ampler responses than if I should ask a greater number, which would necessarily require a longer time and perhaps much study to answer correctly. INTEMPERANCE 13 The two ideas were, First — to learn the nature and character of the stimulants used (if any were so used) by the inhabitants of countries to which said correspondents were accredited, and the influence of such indulgence on the health and prosperity of the people. Second — the relative amount of intoxication in said countries compared with that known by such correspondents to exist in the United States. The papers were sent to thirty-three resident American ambas- sadors and one hundred and thirty-two consuls and a few other non-official personages and friends whose opinions I knew would be of great value if obtained. Among these correspondents are many of our most distin- guished citizens, some of whom are well known for their eminent intellectual and moral qualities. Usually they have resided for some years in the places from which they write, and are of course generally well acquainted with the habits of the people, not only of the cities from which they reply, but also with those of the people of the districts or countries in which these cities are situ- ated. Most of them write as if they knew well the habits of the people, and also those of our own nation in reference to the use and abuse of stimulating drink. Hence their opinions on that subject are of great value. Summary of the Principal Subjects Considered in THIS Letter 1. Stimulants are used everywhere, and, at times, abused by savage and by civilized man. Consequently, intoxication occurs all over the globe. 2. This love of stimulants is one of the strongest of himian in- stincts. It cannot be annihilated, but may be regulated by rea- son, by conscience, by education, or by law when it encroaches on the rights of others. 3. CHmatic law governs it. The tendency to indulge to intoxi- cation being not only greater as we go from the heat of the equator towards the north, but the character of that intoxication becomes more violent. 14 STATE SANITATION 4. Owing to this cosmic law, intemperance is very rare near the equator. It is there a social crime, and a disgrace of the deepest dye. Licentiousness and gambling are small offences compared with it. To caU a man a drunkard is the highest of insults. On the contrary, at the north of 50° it is very frequent, is less of a dis- grace, is by no means a social crime. 5. Intemperance causes little or no crime toward the equator. It is the almost constant cause of crime either directly or in- directly at the north above 50°. 6. Intemperance is modified by race, as shown in the different tendencies to intoxication of different peoples. 7. Races are modified physically and morally by the kind of liquor they use, as proved by examination of the returns from Austria and Switzerland. 8. Beer, native light grape wines and ardent spirits should not be classed together, for they produce very different effects on the individual and upon the race. 9. Light German beer and ale can be used even freely without any very apparent injury to the individual, or without causing intoxication. They contain very small percentages of alcohol (4 or 4.5 to 6.50 per cent). Light grape wines, unfortified by an extra amount of alcohol, can be drunk less freely but without apparent injury to the race, and with exhilaration rather than drunkenness. Some writers think they do no harm but a real good if used moderately. They never produce the violent crazy drunkenness, so noticeable from the use of the ardent spirits of the North. Ardent spirits, on the contrary, unless used very moderately, and with great temperance, and with the determination to omit them as soon as the occasion has passed for their use, are almost always injurious, if continued even moderately for any length of time, for they gradually encroach on the vital powers. If used immoderately, they cause a beastly narcotism which makes the victim regardless of all the amenities and even the decencies of life, or perhaps they render him furiously crazy, so that he may murder his best friend. While those who live in the tropics merely sip slowly ardent spirits from the tiniest of glasses, with the INTEMPERANCE 15 slightest appreciable effect, the denizen of the frozen North swallows half tumblers full of the same to the speedy production of intoxication. 10. Races may be educated to evil by bad laws, or by the intro- duction of bad habits. England's taste for strong drinks has been fostered by legislation, and by wars of nearly two centuries since. France and parts of Switzerland are beginning to suffer from the introduction of absinthe and of schnapps. Especially is this noticeable since the late Franco-Prussian war. By classifying all liquors as equally injurious, and by endeavoring to further that idea in the community, are we not doing a real injury to the coun- try by preventing a freer use of a mild lager beer, or of native grape wine instead of the ardent spirits to which our people are now so addicted ? 11. A race, when it emigrates, carries its habits with it, and, for a time at least, those habits may override all climatic law. 12. England has thus overshadowed our whole country with its love of strong drinks, and with its habits of intoxication, as it has more recently covered Ceylon, parts of the East, and Aus- tralia. 13. This influence on our own country is greater now than it would have been if our forefathers, the early settlers, had culti- vated the vine, which would have been practicable, as seen by the recent examples of Ohio and California, and from the fact that the whole of the United States lies in the region of the earth's sur- face suited to the grape culture. 14. If these early settlers had done this, our nation would prob- ably have been more temperate, and a vast industry like that of France, of Spain and of Italy and Germany, in light native wines, would long ago have sprung up. 15. The example set by California and Ohio should be fol- lowed by the whole country, where the vine can be grown. As a temperance measure it behooves every good citizen to promote that most desirable object. We should also allow the light, un- fortified wines of Europe to be introduced free of duty instead of the large one now imposed. Instead of refusing the German lager beer, we should seek to have it introduced into the present " grog i6 STATE SANITATION shops," and thus substitute a comparatively innoxious article for those potent liquors, which now bring disaster and death into so many families. i6. " Holly Tree " branches for the sale of good food, tea and coffee chiefly to the people, should, by the benevolent co-operation of the community, be made to take the places of the numerous grog shops now open for the sale of ardent spirits. 17. The moral sense of the community should be so aroused to the enormity of the evils flowing from keeping an open bar for the sale of ardent spirits, while those for the sale of Hght wines and of lager beer should not be opposed, except for the sale to habitual drunkards, after due notice from friends. Sellers violating such law might be compelled to support for a time the family of their victim. 18. The horrid nature of drunkenness should be impressed by every means in our power upon the moral sense of the people. The habitual drunkard should be punished, or if he be a dipso- maniac, he should be placed in an inebriate asylum for medical and moral treatment, until he has gained sufficient self-respect to enable him to overcome his love of drink. These asylums should be estabHshed by the state. 19. The appendix contains various letters on intemperance in this and other countries, on reciprocity treaties for introduction of European wines, etc. In the sincere belief, gentlemen, that this analysis of our corre- spondence will, eventually at least, tend to help onward the most excellent cause of temperance everywhere, and in the hope that none will be offended at the expression, at times, of my own in- dividual opinions, which in the course of the discussion I have deemed it my right and duty to give, I remain, Your colleague and friend, Henry I. Bowditch. IV PREVENTIVE MEDICINE AND THE PHYSICIAN OF THE FUTURE By Dr. Henry I. Bowditch [Reprinted from the Fifth Annual Report, 1874, pp. 31-38 and 59-60. This article, in the form of a letter to his colleagues, was written after being chairman of the Board for five years. — G. C. W.] In my earliest communication with you I endeavored to express in a few words some general views of the great and benign objects presented before us, and the correlative public duties that de- volved upon us, by our appointment as members of the State Board of Health. I wished then to give my highest ideal of those objects and duties, and I then expressed my belief that we should not fail of doing some service to the people of Massachusetts if, with simpHcity of purpose and single-hearted devotion to that purpose, we should pursue, slowly, perhaps, but steadily, the path opening before us. It is not my intention now to review what we have already done. I may, however, be allowed to say that the annual liber- ality of the Legislature in regard to our reports, and the fact that the example of Massachusetts has been followed by several states of this Union, who have established similar boards, is certainly gratifying. It would seem that our example has stimulated others to a like course of action in regard to Preventive or State Medi- cine, as it has been sometimes called, because the improvement of the public health and the prevention of disease among the people is the object of both. This object has now occupied us for five years, and we can, perhaps, see more clearly its tendency and noble scope. We can also, perhaps, prophesy more decidedly than before the beneficial results that will accrue to mankind when the world enters heartily into its objects, and when similar boards have been formed, and have worked for many years in every civilized community. 1 8 STATE SANITATION Preventive or State Medicine is of recent origin. It has been the natural outgrowth of modern thought and resources, stimu- lated by centuries of suffering and by the sacrifice of multitudes of human beings. Modern thought, later and more scientific methods of investigation, and more rapid means of communica- tion of thought and of action have given this idea to the nations. It is true that Hygiene, or the science which would promote human health, has been discussed from earHest times, but com- monly as applied to the individual man. The scientific study of the laws of disease as they affect large masses of men, and the voluntary efforts of great states to study those laws by means of boards of health, or of experts set apart for this special purpose, are strictly of modern origin. Hippocrates, wise as he was, could not, with the imperfect means of communication in his day, have inaugurated it. Moreover, in the earher states, man as an indi- vidual never stood, in the estimation of his fellows, nor of the government, so high as he does at the present day under European or American civilization. Formerly his welfare was subordinated to that of the state. Now, the theory is exactly the reverse, and the state claims to have the tenderest interest in the welfare of each and every one, the humblest or richest of its citizens. Formerly, all persons believed, as many now beHeve, that prayer should be offered to the offended gods in order to stop plagues, famine and death. But now, most persons feel that, although prayer may avail much to enable an individual or a state to bear calmly some terrible calamity or to die bravely, if need be, in a great cause, it can never drive away fever, cholera, nor smallpox. It can never cure consumption, though it may help both sufferer and friends to bear it more patiently. To submit quietly to any remediable evil, as if to the will of Providence, is not now con- sidered an act of piety, but an unmanly and really irreligious act. It is the part of error and stupidity which does not believe in the duty of studying into the physical causes of disease, and in at least endeavoring to crush out these originators of pestilence and of death. Modern Preventive Medicine has been hinted at by Nature from the earHest time. Occasionally she has shown us how she PREVENTIVE MEDICINE 19 can summarily strangle disease, and drive it forever from its usual haunts. The great fire in London, in 1666, burned up the greater part of that metropolis. With its great sorrows, trials and losses, it brought one of London's greatest blessings, viz. : the extirpa- tion of the plague which had previously so often ravaged the inhabitants.^ Intermittent fever has ceased in certain parts of Great Britain and of this country under the influence of tillage and drainage of the soil. Till inoculation was brought from the East and taught to modern Europe, the physician could not mitigate smallpox. Jenner, led by Nature's teachings, substituted the milder disease of vaccination for the fatal scourge of smallpox. Private investigations in Europe and Amedca have, in these later days, proved that residence on a damp soil brings con- sumption; and, second, that drainage of wet soil of towns tends to lessen the ravages of that disease. We have been taught by Murchison and others that fevers are often propagated by contaminated drinking-water or milk. Our own Board investigations have proved that contaminated air may also cause it. Still more recently cholera has been brought, in its origin and progress, under law, and we know how we could probably prevent it if proper precautions against its origin were taken. A neglect of proper sanitary regulations tends to propagate this scourge, year after year, over Europe. These monitions given by Nature and individuals, as to our power of checking or preventing disease, have at last culminated in the fact that the state decides to use its moral power and material resources in aid of State or Preventive Medicine. England, in this respect, outranks all other countries. America, I think, stands next. This appears to me the general course of events hitherto in regard to public health. I do not mean to assert, however, that nothing has ever been done before by the state. On the contrary, the ParHament of Great Britain and other European states and the legislatures of our various states have at times spasmodically ^ 68,596 died of it in London, 1664-65. 20 STATE SANITATION and tentatively, for centuries past, given powers to local town boards of health. They have, moreover, at times, devised im- portant plans for the health of the people and for the prevention of the spread of certain diseases. But all these were trivial com- pared with the present position of England and of some states of this Union where state boards of health have been established. Again, physicians have heretofore devoted themselves chiefly not to the prevention, but to the " cure " of disease. How utterly impotent have commonly been their efforts to cope with great epidemics! The giving of medicine during a disease, not the pre- vention of it, has been their chief aim, and the community now generally believes that the physician is simply an administrator of drugs. How rarely is a physician called upon to mark out the course a man should pursue to prevent their use ! Nevertheless, modern times will bear ample witness to the zeal with which some of the most distinguished of our number have protested against the too free use of medicine, and have declared that our art must be pursued more in accordance with Nature's laws, and not in total neglect of them, as was too frequently the case in former days. Some few even, though I would protest against it, have carried their skepticism so far as to lead one to believe that they think the practice of Physic hitherto has been an unmitigated evil. With one accord I beheve it may be said that the whole pro- fession has cordially greeted the advent of State or Preventive Medicine. What, it may now be asked, will be the effect upon the public and the profession after two or three centuries of growth of the principles of Preventive Medicine ? I look forward with high hopes for the future of this young idea, founded as it is on the duty of the state to investigate the laws of all diseases so that, as far as possible, all shall hereafter be prevented. I think that idea cannot fail of making a stalwart growth. It may make many errors, but it must make yearly progress in the knowledge of the more hidden causes of disease. At least three good results will arise from it: — I. The profession will learn that a system of therapeutics, dependent on materia medica simply, is much less valuable PREVENTIVE MEDICINE 21 than that which seeks to defend its patients from the insidious approaches of the causes of disease. 2. The people will themselves learn to avoid many evils into which they now fall, because of their ignorance of the laws of health. They will have less faith in drugs, more in nature; more in anticipating and preventing evil than in curing it after it has begun. 3. The knowledge of the precise effects of special drugs, and of their various compounds one with another, will become more and more accurate under the teaching of modern experimental physi- ology, and still more under chnical experience. Though it may take centuries to develop, even to a small extent, the future materia medica, the future physician will use each article with a finer knowledge of the precise effects of each drug and of its com- binations, than it is possible for us now to have. We can scarcely foresee the time that will be required for this materia medica to become even tolerably perfect. In fact, the knowledge of the special action of drugs at the present day, compared with what we have yet to learn upon this important subject, is a mere trifle. Meanwhile, as the profession of medicine becomes more thoroughly scientific, the people will also gradually learn that all filth, physical, moral or intellectual, is absolute poison; that no violation of physical, moral or intellectual law can be made, even momentarily, without injury to human comfort and Hfe, and possibly without causing premature death. It will learn that it is not only worse than useless, but a vile wrong to one's self, to use various articles as incautiously as they are generally now used. But it may be asked. What is to become of the physician and his practice, when the public takes care of its own health more than it does at present ? Will the profession be useless ? Far from it. It will stand higher than ever. It will be the prophet of the future, and will direct men how to govern their own bodies in order to get the full amount of work and of joy that is possible out of each body that appears in life. I feel sure that more than at the present day will the wise adviser and practitioner of medicine be then needed, whenever misfortune or wilfulness or carelessness, folly or crime, shall have brought disease and per- 22 STATE SANITATION haps a tendency to early death into a family. It will be the phy- sician's duty to show the way out of such impending evil. He will take the child at its birth, and will cast its horoscope from the past and present of its family tendencies, and its actual surround- ings. Having well considered these data he will lay down the rules of life which should rigidly be pursued by parents and by himself in order to gain possession of as much of perfect health as he is capable of having. As the dentist now undertakes to modify and to guide the various processes of dentition from earliest child- hood to old age, so the physician will be the monitor and guide for the entire body from birth to death. The dentist is, philosophi- cally speaking, in advance of the physician of the present day, inasmuch as in his own specialty he of tener acts on the principle of Preventive Medicine. It m^ust be admitted, moreover, that however wise a prophet the physician may be, and however skilled in hygienic law the people may become, there will always be a very wide margin of ignorance, folly and of adverse cir- cumstances on the part of the public, which must be met, and, if possible, remedied by the professors of our art. To be able to aid in inaugurating such a future state of pro- fessional and lay knowledge is surely an object worthy of our highest effort. It is satisfactory to me, and I hope also to you, to think that we are allowed to advocate this noble cause in Massachusetts. It is my hope that by the efforts of the Board the state will annually become more aHve to its best interests, and to its duties towards the people. Hygienic laws will be enacted and they will be obeyed by the many, if from no other motive, from self-interest. May we not hope that our country homes will be more carefully guarded from the many causes of disease that now, through ignorance beset them. I trust that in our cities large tenements for the poor, in which there are common corridors and water-closets or privies for two or three hundred people, in which the comforts of home and all the amenities of human Kfe are set at naught, in which it is impossible to educate a family in decency, and where disease and crime pre- vail, will be declared public nuisances and pest-houses. I look forward to the time when a city government will be considered PREVENTIVE MEDICINE 23 criminal which, like the city of Boston, allows, year after year, sewers to be introduced as unwisely as they are at present, and its sewage to be thrown broadcast about its borders, thereby at times overwhelming its inhabitants with a tainted atmosphere. The same government will, I trust, feel the importance of having proper administration of the laws about drunkenness, guard- ing itself alike against the futile waste of time of attempting to enforce a general prohibition, or the allowing, as at present, of unbridled license in the sale of liquor. When Preventive Medi- cine has full sway, men will not be allowed day after day to disturb the pubKc peace or the comfort of their own famihes by beastly drunkenness. The authorities of that day wiU promptly decide whether it be the result of disease or of crime, and will seclude the wrong-doer either in a drunkard's sanitarium or a prison. I feel sure, moreover, that the time will come when the selling of rum to an avowed and well-known drunkard will be deemed one of the most dreadful of crimes, inasmuch as drunken- ness strikes at the root of the physical, moral and intellectual health of the people. These are only a few of the blessings that will arise when Preventive Medicine shall have its full sway over our people, and when individuals and laws shall have been gradually moulded by it. As an example, imperfect though it must be, of what I think will be the relations of physicians and the community compared with those which they respectively hold at present, let me imagine the following: Suppose two parents have hereditary tendencies to consumption, and they are desirous of knowing how best to manage their child that has just been born. They wish that it may have the best chance of arriving at a good old age after a life of health. Let us suppose that both parents have this ancestral tendency to that disease of the lungs which is known as con- sumption. According to some modem writers, it has many antecedents or causes, but we shall probably know it for centuries to come, as it has been known in the past, as the one disease of the lungs that slays a large percentage of all who die in New England. There are certainly some general topics, even with our present knowledge of its antecedents, which would naturally and physi- 24 STATE SANITATION ologically come under discussion in replying to the inquiries. Among them are some which are generally applicable to all human beings, whether in health or disease, viz.: residence, nutrition, clothing^ care of the skin, bathing, etc., recreations, education, profession, exercise, walking, running, dancing, horse- back exercise, driving, gymnastics, bowling, rowing, swimming. Let me try to give most briefly some general ideas on each of these topics.^ I have thus given you my views of the grand scope of Preven- tive Medicine, and, as a most imperfect illustration of its future usefulness, I have run through a series of recommendations that I think any experienced physician might even now give, accord- ing to the principles and rules of action that will weigh with the physician of the future. And I believe that if these recommenda- tions, with others that might be added by any family physician, should be thoroughly carried out by the parent during childhood, and by the man or woman when arrived at adult life, many that will die of consumption would escape that calamity. In saying this I do not mean to intimate that during the whole period no other remedies, strictly so called, might not be neces- sary. Doubtless they would be; and of the exact mode of appli- cation of those remedies physiological experiment and clinical experience of physicians are teaching us more and more every day. I contend, therefore, that the physician of the future will stand higher than ever, as Preventive Medicine advances. In this statement I take a position exactly the reverse of that assumed by President Barnard in his late address before the Health Asso- ciation at its recent meeting in New York. That gentleman quietly informed his medical hearers that their doom was sealed under the steady advance of modern science. Their services would become less and less necessary, and would finally be no longer needed by the laity. I think he is wrong and that my views are correct, because, while human free agency and human imperfection exist, while accidents, moral and physical, occur, there wiU always be some occurrences tending to injure health which no skiU in prophecy can foresee. The wise physician will ^ Discussion of these topics is omitted from this abstract. PREVENTIVE MEDICINE 25 therefore be summoned to act immediately on important cases of disease or threatened death. These he will meet not only by wise preventive regulations for the future health of his patient, but likewise by a careful administration of medicine, properly so called, during the actual attack. Henry I. Bowditch. THE FILTRATION OF POTABLE WATER By Professor William Ripley Nichols I^At the time when this paper was written the filtration of water was practiced but little in the United States, although filters had been in use in London for over twenty years. Professor Nichols discussed the subject in a scholarly and scientific manner and those familiar with the subject will appreciate his keen powers of observation. He did not then have a knowledge of bacteria and the germ theory of disease and this accounts for his view that filtration will not purify polluted water. Reprinted from the Ninth Annual Report, 1878, p. 139. — G. C. W.] Prominent among the requirements of various commissions, which have been busied in different places with the matter of water-supply, is the statement which needs no commission to estabhsh; namely, that a good drinking-water should be free from all suspended matter, and as far as possible free from color. Comparatively few towns can congratulate themselves on having in their possession, or even within their reach, a supply of water which shall correspond in all points to the ideal drinking- water. Often the question must be decided between an extrav- agant expenditure of money, and a water which is of inferior quahty although not actually unwholesome. In theory, financial considerations stand behind sanitary considerations; yet in practice there is always a limit which cannot reasonably be exceeded. It is not proposed at this time to enter into any discussion as to what may be, theoretically, the best source from which the supply of water for town or city use should if possible be taken : in actual practice it is often found necessary to choose as a source of supply a river or pond, which, although it may not have become unfit for use by reason of pollution, is of inferior quality owing to the presence of suspended particles of vegetable or mineral matter, or to excessive hardness, or to coloring matter of vegetable origin in solution. In such cases it is possible to improve the quality of 26 FILTRATION OF WATER 27 water which in its natural condition is not well suited for use. It may, however, be regarded as a principle in sanitary science, that a water which is polluted by admixture of substances known or generally suspected to be injurious, to such an extent as to require actual purification, should be rejected at once as a source of domestic supply; but a water too hard for use may be softened by Clark's process, which is applicable on the large scale; ^ and a water containing matter in suspension may be clarified by some process of filtration, to be preceded as a rule, in the case of run- ning streams, by subsidence. It is the purpose of the present paper to consider, in the light of American and foreign experience, artificial filtration on the large scale, especially with reference to the conditions which obtain in our own state; and, on account of its intimate connection with the same subject, we shall also con- sider the so-called natural filtration method of water-supply, and the filtration of water in the household. Before beginning upon the subject proper, attention is called to certain definitions, which to some will seem, no doubt, very elementary. There is, however, a great deal of confusion in the minds of even well-educated people, as to the use of the terms in solution, and in suspension, as referred to waters; a great deal of confusion, also, with reference to the distinction between clear and colorless, ideas which are by no means synonymous. The accurate use of the terms can probably best be made plain by illustrations. If, for instance, we put some common salt into a quantity of water, after a time the salt disappears, the ultimate particles being distributed through the water so that they are no ^ The so-called hardness of water is due in the main to the presence of compounds of lime and magnesia in solution. These compounds are generally the sulphates and bicarbonates. When the hardness is due to the bicarbonates of Hme and mag- nesia, the water becomes softer on boiling, because the bicarbonates are decomposed into carbonic-acid gas, which escapes, and the carbonates of lime and of magnesia, which are insoluble in water. Practically the same effect as that produced by boil- ing may be brought about by the addition of a proper amoimt of milk of lime. The lime unites with the bicarbonates to form simple carbonates, which are deposited as a white powder, incidentally removing at the same time most of the suspended matter which the water originally contained, and often removing more or less color- ing matter. There is no serious difficulty in applying this process on a very large scale. 28 STATE SANITATION longer distinguishable by the eye, even aided by the most power- ful microscope: the salt cannot be removed by simple filtration; and, although the solution is somewhat less mobile than water, it is still transparent. This is a case of solution. Suppose instead of the salt we take a quantity of blue vitriol (sulphate of copper) . The phenomena would be similar, but the blue color of the com- pound would show itself in the solution. If the solution were saturated, i. e., if the water had dissolved as much as it could, the transparency of the Hquid would be diminished on account of the depth of color; it would be easy, however, to take a very thick layer of the solution, and satisfy one's self of its transparence. Such a hquid is colored, but is also clear. Suppose, now, we take some clay, shake it with water, and then allow it to settle. The grosser particles will subside to the bottom of the vessel, but the finer particles will remain in suspension. Very finely divided clay will refuse to settle for weeks, and some- times even for months. In such cases the Hquid appears some- what turbid and opaque; and although the individual particles are too fine to be readily removed by ordinary filters, and too small to be distinguished as particles by the eye, still the clay has not dissolved, and the very turbidity or opacity of the liquid shows the presence of soKd particles, although they are extremely minute. Such an appearance is not to be described as being colored, although finely divided clay and other material may be suspended in a liquid which does of itself possess a distinct color. One often meets with the expression, and that too in standard works, " the water is discolored by clay," when really it is a ques- tion of a colorless water carrying particles in suspension. The water in many of our New England streams is at seasons highly colored by vegetable extractive matter in solution, while the water may at the same time be perfectly clear and transparent. On the other hand, our pond waters are often decidedly green; but simple filtration gives a colorless water, and shows the green color to have been due to particles of green (vegetable) matter which were suspended in the liquid. FILTRATION OF WATER 29 Artificial Filtration on the Large Scale The filtration of water on the large scale has been practiced in England and on the Continent of Europe for many years, and has become very general in cases where the supply is taken from streams or ponds. From statistics which were laid before the Diisseldorf meeting of the German PubKc Health Association, in 1876, by Engineer Grahn, it would seem that in Germany since 1858 there has been no town of considerable size supplied with unfiltered river water, while the increase with reference to other sources of supply may be seen from the following data : — Table i Total N^JMBER of Inhabitants in Eighty Towns of Germany, German- Austria, AND Switzerland Supplied With i8s8 1876 Unfiltered river water 460,000 460,000 Filtered river water 1,060,000 1,697,000 Spring and ground water (by gravitation) 25,000 1,519,000 Spring and ground water (by pumping) 45,ooo 1,719,000 In the United States the practice of the filtration of water on the large scale is but just beginning to come into use. In the year 1866, James P. Kirkwood, C.E., went to Europe in the interests of the city of St. Louis to study the clarification of river waters used for the supply of cities; and his elaborate report ^ on the subject of filtration in general is almost the only book on the subject which is at all comprehensive. Full details of Euro- pean practice are there given, as well as plans and suggestions for filtering-beds for St. Louis. St. Louis has not yet adopted any system of filtration, but several other cities of smaller size have done so with more or less success: namely, Poughkeepsie, N. Y., in 1871; Hudson, N. Y., in 1874; Columbus, Ohio, in 1874; Toledo, Ohio, in 1875. The necessity of filtration is, however, in many places felt, and would no doubt have been long since undertaken were it not for the additional outlay required for subsiding-basins and filter-beds, and the expense of maintenance. 1 Kirkwood, " Filtration of River Waters." New York, 1869. 30 STATE SANITATION Object and Results oe Filtration on the Large Scale Having considered the method of filtration in common use we may now profitably inquire more closely into the object which it aims to accomplish, and the results which are actually obtained. Although, as we shall see later, something more is incidentally accomplished, filtration in its strict sense is simply a mechanical operation, and consists in causing a liquid containing suspended particles of soHd matter to pass through some material, the pores of which, although large enough to permit the passage of Hquids, are still too small for the passage of the soHd particles suspended in the Hquid. The suspended matter which by its presence in our water-supplies makes filtration desirable is somewhat various in character. Most rivers are Hable, particularly at times of freshet, to carry a greater or smaller quantity of mineral matters in sus- pension; this may be, first, of such a character as to settle quite readily by virtue of the comparatively high specific gravity of the particles, as will be the case of the mineral matter consisting of sand, mica, etc. Such material as this is readily removed by filtration; but it is generally more economical to subject the water to a process of sedimentation first, and settHng-basins are quite universally regarded as a necessary preliminary to successful filtration. It is evident that without sedimentation a slower rate of filtration must be employed, and the sand must be cleaned more frequently. The suspended matter may obstinately refuse to settle, as is the case of rivers rendered turbid by the presence of clay in sus- pension; in which case it is almost impossible as a rule to filter the water slowly enough to obtain good results if the turbid water without previous sedimentation is put directly upon the filter- beds. Even with sedimentation the result is not always as good as might be desired. The following table, taken from the Sixth Report of the Rivers Pollution Commission^ will give an idea of the efficiency of the filtration as practiced by the various London companies. The observations being made on monthly samples, the statements of the table will perhaps hardly give a FILTRATION OF WATER 31 just idea of the results obtained day by day; but they will serve to indicate the fact that the mere possession of filter-beds does not secure perfectly clear water at all times. Table 2 Thames and Lee Water. Comparative Efficiency of Different Rates OF Filtration during the Years 1868 to 1873, Inclusive Maximum Rate of Filtration Expressed in Inches Per Hour Number of Monthly Occasions When — Name of Company Clear Slightly Turbid Turbid Very Turbid Thames Chelsea 7.27 4.71 6.00 6.97 12.00 S-OO 3.8s 49 75 41 55 42 70 51 15 24 14 II 4 18 5 5 7 12 3 6 West Middlesex Southwark and Vauxhall Grand Junction 4 Lambeth 10 Lee New River East London 2 In speaking of suspended matters it is hardly necessary to allude to fish and small animals, or to chips and sawdust and other such substances, intentionally thrown into running streams, or to leaves and other fragments of vegetable matter which have fallen from the trees and forests along their banks. Most of such floating matter can be arrested by suitable screens, which would be without effect as far as removing the finer particles is concerned. We have spoken of the turbidity of many streams: ponds are less liable to be turbid from the causes alluded to, being, in fact, settling reservoirs; and in the case of old ponds with sandy or gravelly sides and bottom there is seldom anything to complain of or to necessitate filtration. Ponds are, however, particularly liable to other sorts of suspended matters : namely, to growths of minute vegetable organisms. This trouble concerns so intimately the water-supphes of this region, where the water is quite com- monly taken from natural or artificial ponds, that we may dwell upon it somewhat in detail. 32 STATE SANITATION No natural water which is exposed to the air and light, whether in pond or river, is ever entirely free from vegetable growth. The non-professional and non-botanical observer might very Hkely divide the various plants found growing in the water into three classes : ist, and most readily recognized as plants, are those commonly known as eel-grass, pond-weed, pickerel- weed, Hlies, etc., which have roots and leaves, and also, at the proper season, flowers; 2d, and less readily recognized as plants, are the con- fervoid growths,^ as they are often called, of filamentous structure, grass-green or in some cases bluish-green in color, forming tangled masses readily removed from the water, and, when so removed, shrinking enormously in apparent bulk, and drying away to a grayish or colorless mass, in some cases looking almost like coarse paper. Plants of this character grow in almost all reservoirs, or other bodies of water exposed to the light and air, both in still and running water; they either float in masses in the water, or grow attached more or less firmly to the rocks and stones of the bottom of the pond or reservoir. By their growth they do no harm to the water in which they flourish; and as they are readily arrested by ordinary wire screens, or easily removed by rakes or scoop-nets, their presence causes no serious inconvenience in water used for town-supply. The third division of the non-professional would include, if indeed they were recognized as plants, those minute organisms which appear as greenish specks, or minute straight or curved threads, diffused through the water, visible enough if a large quantity of water be looked at, but perhaps almost escaping notice in the small quantity which would be taken up in a single glass. It is true that the individual plants are in some cases dis- tinguishable by the naked eye, but their form and structure can be made out only by use of the microscope. If collected together as a scum, which often happens, especially on the windward shore of a pond, the scum is not coherent, is easily broken up, either by a wind setting in the opposite direction, by a shower of rain, or by ^ These, as well as those mentioned below, belong to the class of cryptogamous (non-flowering) plants, which the botanists call algae, — plants which grow in the water, or in moist places, and usually contain chlorophyll (green coloring matter), or some allied substance. To their number and variety there is almost no end. FILTRATION OF WATER 33 artificial agitation. The appearance has been sometimes de- scribed as that of meal or of fine dust scattered through the water. The number of individuals is almost infinite, and under favorable conditions they increase with great rapidity. Their presence gives a decidedly green or greenish-yellow tinge to large bodies of water; and their death and decay often cause considerable offence to the sense of smell of those sojourning in the neighbor- hood, and to the sense of taste of those obhged to drink the water. While very many species of the minute algae present this gen- eral appearance, as far as my own observation and information extend, the number of species which are known to increase to such a great extent as to completely fill the waters of ponds of many acres in area, and to cause sensible inconvenience, is comparatively small; the most common in this neighborhood (New England) seeming to be the Clathrocystis (zruginosa, but certain plants referable to the Nostochinea are not uncommon alone, or in company with the Clathrocystis} The inconvenience caused by the presence of the plant is felt first by those who use the water for town-supply, and, secondly, by those who cut ice upon the pond. While the plant is ahve and growing, there is little taste or odor given to the water, hardly noticeable if the water is iced. When the plants enter into the first stage of decay, the water acquires a pecuHar taste and odor. Light and a certain degree of temperature are requisite for the normal growth of these algae, and the decay often takes place in the mains and service-pipes; it will not infrequently happen that the water in a reservoir or pond will have almost no taste, while the water as delivered to consumers will have a decided taste. By the settling of the green growth to the bottom in a more or less decayed state, the ponds are generally cleared before the cold weather sets in; but, in several cases which have come under my observation, the material floats up to ^ It may be interesting to note, with reference to the chemical effect of the pres- ence of these algae, that they are highly nitrogenous. A sample collected in the Ludlow Reservoir was dried, and was found to contain 11. 18 per cent of nitrogen. The sample consisted mainly of the Clathrocystis, but of course it was impossible to separate the microscopic animal organisms from the vegetable. 34 STATE SANITATION the under surface of the ice, and is frozen into the ice, making it unmarketable. Among the various questions which are often propounded with reference to the matter are the following : 1 . What is the cause of the trouble ? 2. Is it injurious to health ? 3. Can anything be done to prevent it ? (A) The Cause of the Trouble. — Although there is no doubt that the trouble is caused by minute vegetable organisms, of whose Ufe-history a good deal is known to botanists, various suggestions have been made as to the cause of its appearance. By many it has been supposed to be a sort of fermentation, a process of purification.^ In some cases, this abundant appear- ance of the green matter has seemed to follow the apparent in- crease of sewage and other impurities discharged into the pond. I have within the last few years examined a great many ponds affected in this way, and cannot satisfy myself that there is any connection between such discharge of sewage and the growth of these algae: the amount of soluble nitrogenous matter, of am- moniacal salts, of phosphates, and of other mineral compounds necessary for their growth, are everywhere present; and it would be unsafe to prophesy the security therefrom of any pond. Al- though it would seem that ponds recently made by flowing marshy or cultivated land were peculiarly Hable to the trouble, especially if shallow, my observations have led me to make even this statement less emphatic than I was at first incHned. Although these plants are not all killed by a considerable degree of cold, still they thrive only in warm weather. Observations on this point are incomplete; but such as I have been able to collect would seem to point to a temperature of 70° F., or thereabout, below which the trouble is not Hkely to begin. Extended obser- vations on this point are much needed. 1 I have often found that residents (farmers and others) on the banks of large ponds are familiar with what they call a " fomentation " in the pond, taking place with some regularity at certain seasons of the year, which phenomenon is, in some cases at least, a growth of these minute algae. FILTRATION OF WATER 35 I have been unable to satisfy myself that the presence of aquatic plants at the margins of the ponds has other effect than that of entangling and holding masses of scum, which if then exposed to a hot summer sun rapidly enter into decay. (B) Is the Matter Injurious to Health? — The observations as to the effect on the human organism of water containing these algae, are not, of course, very definite or complete. In some places, however, where the only source of supply is thus affected, opportunity for observation is afforded. I have not been able to obtain any evidence of the unwholesomeness of the water from a supply which is in other respects of good quality. When the algae are alive and fresh, horses and cattle drink the water readily, in preference to spring water: when decay has taken place, the water sometimes becomes so offensive that they refuse to drink it. In this condition it is manifestly unsuited for domestic use. (C) Can Anything he done to prevent the Trouble? — As far as our present knowledge extends, nothing. Various plans of local applicability are pursued in different places, by which the annoyance is lessened. Sometimes while the vegetable matter is a scum, water may be wasted from the sur- face of the reservoir, at a point where the material has collected; and sometimes the pond may be left to itself, and an alternate supply made use of. There is no difficulty in removing the vegetable matter com- pletely by sand filtration, although of course the filters become rapidly clogged. This clogging is aided also by the development upon the beds themselves of confervoid growth, which in un- covered beds becomes so abundant and vigorous as to form a sort of carpet on the surface of the sand, which can be raked off in coherent sheets, or rolled up. If the vegetable matter in the water, or that which grows in the beds, enters into decay, and communicates an unpleasant taste to the water, the filtration may be unable to remove the taste completely.^ 1 I would be distinctly understood as not asserting that all bad tastes and odors to which water-supplies are subject are due to the presence of these or other algae. They are the real cause of a real trouble. The occurrence of a fishy, musty, cucum- $6 STATE SANITATION It also seems that filtration through sand does not remove the germs or spores of the plants; so that if the filtered water be stored in open reservoirs, exposed to fight, it is again fiable to vegetable growth. For this reason, such water, when once filtered, should be defivered at once into the distribution-pipes; or, if storage is necessary, it should be stored in covered reservoirs, preferably of such size as to be readily emptied and cleaned if occasion require. Conclusions I will here bring together the general conclusions reached from a study of the practice and results at home and abroad, and from my own experiments. 1. No material has yet been brought into practical use for artificial filtration on the large scale, except sand. 2. With our present knowledge we have no evidence that sand filtration can be regarded as an efficient means of purification of polluted water; although it may, if properly carried out, lessen the habihty of ill effects. 3. All visible suspended particles, and an appreciable pro- portion of organic matter actually in solution, may be removed by properly conducted filtration through sand. 4. For the present, at any rate, it will be best to regard arti- ficial filtration mainly as a means for the removal of suspended matters, although under the management of a person of intelli- gence, education, and experience, the simple sand filter is capable of producing sensible improvement in respect to the organic matter which is dissolved in the water. In ordinary practice, however, it is quite certain that sufficient care will not be taken to secure such results; and, in view of what is actually accom- ber, green corn, or other peculiar odor or taste, may be due to the presence or de- composition of certain algae; but it may be produced by the decay of more highly organized plants, or by causes of which we are ignorant. For instance, the cucum- ber taste which affected the Chestnut Hill Reservoir of the Boston Water Works in 1875 w^3,s traceable to no such cause, nor, indeed, to any assignable cause, although careful examinations were made from a chemical, from a botanical, and from a zoological standpoint. Other cases also have come under my observation, where no algae, fresh or decomposed, could be found in sufficient quantity to account for the unpleasant taste, which was very noticeable. FILTRATION OF WATER 37 plished in existing works, it seems to be best to regard the removal of color and unpleasant taste as incidental, and likely to vary very much according to the condition of the filter. As the public mind becomes educated in the matter, a higher standard of efficiency may be exacted; but for the present it should not be held out to towns and water-boards as a result which will follow filtration through sand, that a water which is naturally strongly colored by vegetable extractive matter will be rendered colorless in ordinary practice, although it is true, that, starting with an entirely new filter, the first portions of water filtered may be deprived of color, and such an experiment has often led into error. 5. It is not worth while to introduce a system of sand filtra- tion in the case of any town-supply unless there is the wilHngness to make such outlay for construction and maintenance as shall render the scheme thorough and efficient. This will involve properly constructed filter-beds and generally settling-basins of sufficient size ; it will involve intelligent supervision, and frequent cleansing and renewing of the material of the filter. It should also involve, in the construction, the covering of the filter-beds; and for the best effect the filtered water should be dehvered at once to the consumers. There should be at least dupHcate beds, so that there can always be one in use. If on account of lack of duplicate beds, or for other reasons, it seems necessary to store the filtered water, this should be done in covered reservoirs of small size, which can be readily emptied and cleaned if occasion require. It cannot be said too emphatically that sand filters, or indeed filters of any description, are not automatic, and that the effect obtained depends not only on the construction of the filters, but also, and even more, upon the care with which they are managed. I believe that money expended on a scheme for filtration is practically wasted unless a sufficient outlay is made to secure certain efficiency. It is possible to store the filtered water under such conditions that it shall become as bad as before filtration. A desire for economy in original outlay may lead to a scanty area of settHng-basins and filter-beds; but a subsequent larger demand than the plant can meet will necessitate either 38 STATE SANITATION too rapid filtration, by which imperfectly filtered water will be obtained, and the beds fouled throughout; or an admixture of unfiltered water, which, even if necessary for a short time only, will foul the pipes, and undo the subsequent work of the filter. I should not recommend any town to undertake the artificial filtration of their water unless they were willing to face the prob- ability of its costing from two dollars and fifty cents to three dollars per million gallons in addition to the original outlay for the works. VI ON SOME IMPURITIES OF DRINKING-WATER CAUSED BY VEGETABLE GROWTHS By Dr. W. G. Farlow QThis was probably the first paper in the United States to discuss adequately the character of the microscopic organisms which cause tastes and odors in water. Supplement to First Annual Report, Board of Health, Lunacy and Charity, 1879, p. 131. — G. C.W.] The object of the present paper is to present in a popular form a statement of what is known with regard to the effect of the growth of different plants upon the water in the ponds, streams, and basins which supply the cities and towns of the Common- wealth. In this connection the subject will be discussed from a botanical point of view; and we can only consider certain strik- ing properties, such as smell and taste, with relation to the par- ticular species of plants which produce them, without taking into account the more subtile changes which can only be detected by chemical analysis. It is desirable that all who, in any sense, have charge of the pubHc health, should have some familiarity with the common forms of plants Hkely to pollute drinking-water; because, as the matter now stands, the pubhc are at the mercy of any person, who, armed with a compound microscope and a supply of Latin and Greek names, chooses to alarm the neighborhood by the announcement of the appearance in the water-supplies of plants whose injurious nature is supposed to be in direct proportion to the length and incomprehensibility of their names. The pubHc are now beginning to read about the germ- theory of disease; and hearing that fevers may be produced by germs, and being told that germs are found in water, they very naturally but illogically infer that any small bodies found in the water are the germs of disease. Whatever of truth there may be in the germ-theory of disease, there is no doubt that designing persons impose on the 40 STATE SANITATION credulity and fears of the public by representing as germs of disease microscopic plants which could not possibly have caused any of the diseases which have been supposed by scientific men to be produced by germs of a vegetable nature. The most striking plants which are found in fresh water are those which are commonly called weeds; as, for example, pond-weed, pickerel-weed, eel-grass, etc. They all have distinct stems and leaves, and produce flowers, using the word in a botanical sense. In some cases, as in the pickerel-weed and pond- lihes, the flowers are striking, and readily recognized as such; but in most of the water-weeds they are small and obscure, and pass unrecognized by the public. The mass of the water-weeds of this region belong to a comparatively few botanical genera; e. g., Myriophyllum, Ceratophyllum, Callitriche, Utricularia, Anacharis, Potamogeton, Naias, V allisneria, etc. They all start from roots at the bottom of ponds and streams, and may attain a length of several feet. Late in the season, and especially when the water has been disturbed by strong winds, they break from their attachments, and are washed ashore often in large heaps. The Lemnae, or duck-weeds as they are popularly called {see Plate I, Figs. 4, 5), although classed by botanists with flowering- plants, differ in habit from our other common water-weeds. Instead of growing from the bottom, and having stems and leaves, they float in immense numbers on the surface of the water, form- ing a scum, as may be seen in the ponds of the town of Winchester, and at other points in the Mystic Valley. The duck-weeds have no distinct stem and leaves, but consist merely of more or less roundish, grass-green disks, not usually more than a quarter of an inch in diameter, from the under side of which delicate roots project into the water. All the flowering plants commonly in- cluded under the name of water-weeds, whether they grow from the bottom, as is usually the case, and have distinct stems and leaves, or, as in the exceptional case of the duck-weeds, float on the surface in the form of a scum, may, under ordinary circum- stances, be considered harmless as far as any direct effect pro- duced on drinking-water is concerned. VEGETABLE GROWTHS 41 They may, however, be sources of trouble in two ways. In the first place, they may cause a mechanical difficulty, when growing luxuriantly, by choking up small streams or bodies of shallow water. This difficulty is not so Hkely to arise in bodies of water used as water-supplies as in the small sheets of water used for ornamental purposes. In the latter case, it not infrequently happens that the means taken for avoiding a growth of plants, such as cementing or stoning the bottoms and margins of small ponds, seem to encourage the growth of certain species of weeds which do not flourish to any very great extent in natural basins. In an artificial pond supplied by a brook in the neighborhood of Boston, the water was completely filled, and the pond disfigured, by a growth, of the common "water-starwort, Callitriche verna, which in this region rarely grows in large quantities in brooks. We may here refer to the well-known case of the plant known in England as Babington's curse, because it was introduced into that country from America by Professor C. C, Babington of Cambridge University. It is the species known to American botanists under the name of Anacharis Canadensis, which, although not at all rare in this country, is not so common as to prove a nuisance, or at least has not been so until within a com- paratively few years. Introduced into England, and thence trans- ferred to the Continent, it grew so luxuriantly as to choke small water-courses, and thus became a great pest. Even in this coun- try, the species is becoming more common, and that, too, in places where special efforts are made to keep the water clear of weeds. We may instance as an example Fresh Pond, now used as a source of water-supply for the city of Cambridge, in which the Anacharis has become so abundant that the pond has to be periodically dredged. Just why certain species increase in bodies of water which have been artificially stoned or embanked is not clear. It may be that, by removing the larger weeds, a better chance is given to the smaller species, among which Anacharis is included. It may also be true, in the case of small pieces of water, that the lime or other ingredients of the stones and cement used may make the water better adapted to the growth of some species at the expense of others. 42 STATE SANITATION A second source of danger from the presence of large masses of weeds, especially in basins Liable to frequent changes in the height of the water-level, lies in the fact that they may serve as places of attachment or shelter for some of the injurious small plants to which we shall have occasion to refer presently. We have said, that, under ordinary circumstances, no direct trouble is Hkely to arise from the growth of any of the larger weeds in our water-supplies. By the expression, " under ordinary circumstances," we mean to presuppose that the plants are living and flourishing. The question still arises as to the effect they would produce in decay. The answer to this question falls rather within the province of a chemist than that of a botanist; but it is safe to say that no danger is to be anticipated from the death of vegetation in the autumn, certainly provided the water for imme- diate use is stored for a time in a receiving-reservoir. The case of masses of plants suddenly killed by the lowering of the water in the heat of summer may be different. Here it is pos- sible that trouble might arise; but we have no direct evidence to show that decided injury has resulted in any particular case from drinking water coming from ponds or streams in which were decaying plants of the group which we have characterized as weeds. Neither can we say that any well-defined odor or taste marks the water containing merely weeds in a state of decomposi- tion. As we shall see, the extremely disagreeable tastes and odors are produced by plants which cannot be included in the group which we are now considering, — plants of a very different appearance and structure. Let us begin a more detailed study with an examination of some of the typical forms of the Nostoc family, which are represented in Plate II. The figures 4 and 5 represent respectively CoelosphcB- rium Kuetzingianum and Clathrocystis ceruginosa, two species found diffused in the water, or forming scums upon the surface. These two species consist of a mass of jelly, in which are embedded the cells, which are bluish-green. We speak of such collections of cells as colonies, because, in a certain sense, each cell is capable of living by itself, and the dependence of the different cells on one another is not essential, as it is in the case of the cells which form VEGETABLE GROWTHS 43 the higher plants. The cells of the Clathrocystis are spherical ; but those of the Coelosphcerium are oblong, and all have their longer axes directed towards the centre of the mucus in which they are embedded. The last-named species may be found in its earher stages attached to the leaves and stalks of water-plants; and, in that condition, the colonies are small and nearly spherical. When found floating on the surface, they are generally lobulated as in Fig. 4, and are surrounded by a colorless film of mucus, which can hardly be well shown in a drawing. The film is often fringed by a halo of very short colorless filaments, or rather rods. The rods have no direct connection with the CoelosphcErium itself but are caused by the action of small parasites, species of Bacillus and Vibrio, on the mucus in which the cells are embedded. A section through the CcelosphcBrium colonies would show that the colored cells are confined to the surface, and that the interior is a mass of mucus or jelly traversed by bands of a denser substance than the rest of the interior. The Clathrocystis, Fig. 5, begins as a small solid body resembling the young Ccelosphcerium, except in the size and shape of the cells composing it. The outer cells increase rapidly by dividing into two parts, each part growing to the size of the original cell. By repetitions of this process, the plant which was at first solid becomes a hollow mass of spheroidal shape. Certain portions of the surface then bud out from the rest, and the whole mass becomes lobulated and irregular. The projecting buds or lobes then separate from the rest of the colony; and, as a result, we have what is represented in Fig. 5, a net-shaped bag of irregular outline. The lobes or buds which have fallen off so as to leave holes in the mother colony form new colonies; and the same mode of increase and budding is repeated in them. The question as to the exact amount of harm caused by the excessive growth of Ccelospharium and Clathrocystis in the water- supphes is to be answered by physicians and sanitarians rather than by botanists. The water immediately affected becomes too offensive to drink; and the only practical question is, whether the disagreeable properties are conveyed any considerable dis- tance. During the period of the trouble in Horn Pond last sum- mer, great complaint about the water was made in East Boston, 44 STATE SANITATION which is supplied by the Mystic system. Something is perhaps to be attributed to the imagination, as rather terrifying accounts of the state of Horn Pond were published in the papers at the time. But beyond this there was undoubtedly a real repugnance to the water. As to the possibility of purifying the water by filtering, and allowing it to stand some days in a reservoir, much good may be accomplished; but, judging from the experience of last summer, the water cannot be entirely purified by these means. In one respect, the fears of the public may be set at rest. The theory that certain diseases, as fevers, are produced by germs of some low forms of plant-Kfe, whether true or not, has no bearing on the present case. On the one hand, although we know that the species described in the present article do cause the disa- greeable pig-pen odor, and do render the water at times unfit to drink, we know, on the other hand, that they do not cause the specific diseases whose origin is considered to be explained by the germ-theory. The germs, so called, are all species of bacteria, distinct from the Nostoc family and much smaller. The pubUc should receive with very great caution any statements about the . dangerous effect of bacteria in our waters; and, instead of worry- ing over the subject, had better leave the matter entirely in the hands of scientific people, who, at the present day, are the only persons who can be expected to follow the complicated and obscure relations of this difficult question. In conclusion, we must mention one or two species which pos- sess an interest in connection with those already described. One finds on the submerged iron of almost all water works a rusty- colored, slimy plant. This is Lyngbya ochracea, or, as it is more frequently called, Leptothrix ochracea, a very much more dehcate species than the Lyngbya shown in the accompanying plate. It does no harm to the water, as far as injury to its drinking prop- erties is concerned ; but it is a great pest to paper manufacturers, who require water free from all coloring matter. We must also mention a small group of plants, the Beggiatoce, classed by some writers in the Nostoc family; although they are white, not bluish-green, when seen with the naked eye. The VEGETABLE GROWTHS 45 species of Beggiatoa are filamentous, and look something like a Lyngbya destitute of a sheath. They are characterized by the rapid vibrations of their filaments, and by the fact that they give off an odor of sulphuretted hydrogen. They are common in house-drains and sluggish ditches near factories, especially where the water is made warm by discharged steam or hot water. They are also found along the seashore, and abundantly in hot springs, and appear to the naked eye like very fine white films. Under the microscope the filaments are seen to oscillate, at the same time advancing or retreating; and in the cells themselves are dark granules which consist of sulphur. From a botanical point of view, the floating Nostocs are very interesting; but it is usually dif&cult to get good material for study unless one is on the spot. The species of Anabcena are especially prone to break up and decompose when sent by express, and the various preservative fluids are of little use. To determine the species one should have the spores and heterocysts in position. The best way of preparing specimens is, by means of a pipette, to drop some of the water containing the plants upon a piece of mica or glass, and let it dry. The specimens can then be sent any dis- tance; and, on re-moistening, the filaments swell up so that they can be well studied. If they do not at once recover their form, a little ammonia or potash may be added. Information about the winter condition of the vegetation is very much wanted; and especially do we need an accurate chemical knowledge of their relation to the water in which they grow. 46 STATE SANITATION EXPLANATION OF PLATES Plate I All the species figured in this plate are grass-green, and produce no injurious effect on drinking-water. Figs. 1-3. — Chara coronata, var. Schweinitzii, A. Br. Fig. i, life size; Fig. 2, branch with antheridia, a, and sporangia, b, magnified sUghtly; Fig. 3, sporangium containing spore magnified 50 diameters. Figs. 4, 5. — Lemna polyrrhiza, L. Fig. 4, life size; Fig. 5, the same seen from the under side, and slightly magnified. Figs. 1-5 were drawn from life by Mr. C. E. Faxon. Fig. 6. — Cosmarium Botrytis, Menegh. From Ralf' s British Desmidieae. a and b are two unicellar individuals, which are represented in c and d respectively as having ruptured, their contents having xmited to form the spore, s. Diameter of spore, -g-yg^ of an inch. Fig. 7. — Spirogyra from Luerssen's Handbuch. c, chlorophyl-bands in the cells; s, spores formed by the union of the contents of two ceUs. Magnified 240 diameters. Plate II All the species figured in this plate are of a bluish-green color, and in decay give off a pig-pen odor. Fig. I. — Ccelospharium Kuetzingianum, Naeg., and Anabxna Flos-aqua, var. circinalis, Kirchner. From the surface of Basin No. 3, South Framingham, October, 1879. Magnified 300 diameters. Fig. 2. — The same, showing details of Anabcena. a, spores; b, heterocysts. Fig. 3. — A portion of Fig. 2, magnified 600 diameters. Fig. 4. — Ccelosphmrium. From Fig. i, magnified 600 diameters. A gelatinous halo is usually found roimd the colonies when seen with this power. Fig. 5. — Clathrocystis ceruginosa, Henfrey. From Fresh Pond, Cambridge, October, 1879. Mature colony magnified 400 diameters. Fig. 6. — Lyngbya Wollei, Farlow. From Horn Pond, Wobum. A portion of two filaments magnified 400 diameters, showing the bluish-green disk-shaped cells, surrounded by a colorless sheath. Plate I. Figs. 1-7. Plate II. Figs. i-6. VII A STUDY OF THE RELATIVE POISONOUS EFFECTS OF COAL AND WATER GAS By William T. Sedgwick and William Ripley Nichols [This paper was written at a time when there was a vigorous legislative contest over the subject of water gas, instigated by rival business and political interests. The object of the investigation was to obtain the scientific facts as a basis for a proper settlement of the question. In spite of the findings, the water gas interests won, and this gas has been widely used in recent years. Reprinted from Supplement to Sixth Annual Report of the State Board of Health, Lunacy and Charity, 1884, p. 275. — G. C. W.] The recent extensive employment for illuminating purposes of the so-called " water " gas, derived from the decomposition of steam by the action of incandescent coal and enriched with the vapor of naphtha, has excited a vigorous discussion of the ques- tion whether this gas is, or is not, more dangerous to the public health when distributed for the purposes of illumination, than the ordinary " coal " gas derived from the destructive distillation of bituminous coal. Up to the present time, although opinions, chiefly a priori, have been freely expressed in the afl&rmative, and especially in the negative, in answer to the question, very little experimental evidence has been available. In view of the possibihty of the general substitution of water gas for the coal gas now in common use in Massachusetts, the question has assumed a large pubHc importance, and accordingly, under the instruction and direction of the State Board of Health, Lunacy and Charity, an investigation was undertaken by us, in the hope of obtaining facts which might serve to answer the question. At the outset an experimental room was built to imitate in size and closeness an ordinary sleeping-room of medium size. It was originally our intention to place in this room animals of different kinds (in order, by learning the effects upon animals in general, — since it was not possible to experiment upon men, — to infer 47 48 STATE SANITATION concerning the effects upon man himself), and then to introduce into it, through one or more burners, at a known rate, coal gas or water gas in successive experiments. This room was readily sup- plied with coal gas, and it was supposed that it would not be difficult to obtain and control a supply of water gas sufficient for our use. But in this we were disappointed, and after several attempts and many annoying delays it became evident that it would be easier and in some respects better to visit places sup- plied with water gas and there make comparative experiments. Accordingly, we visited Middletown, Conn., and Athol, Mass., both of which were supplied with water gas, and there made sev- eral experiments. Afterwards we remodelled the original room supplied with coal gas — at Newton Centre, Mass. — and there concluded our experiments upon animals. More recently, one of us has made a special experiment in a room in his own house, and has also studied the influence upon coal gas of its passage through artificial soils. For the special details of most of these experiments reference must be made to the appendix ^ to this paper. There also will be found the description of the methods employed in sampHng, in analysis, etc. In the present place it will suffice to state the results to which our experiments have led us, and also certain practical conclusions which naturally follow. I. With ordinary gas fixtures it is generally difficult to get more than three per cent of illuminating gas into an ordinary room. By using one burner alone it is difficult to exceed one per cent. The explanation of these facts is very simple and depends upon the rapid leakage and diffusion — the " natural " ventila- tion — which is all the time going on through the walls, ceiHng and floor, and through the " cracks " about the doors and win- dows. The rate at which this goes on keeps pace in a general way with the amount of inflow, increasing as the inflow increases, so that no extensive accumulation can take place. Rather, a bal- ance, so to speak, is struck if the inflow be constant, between the amount flowing in and that flowing out, so that a tolerably definite quantity is always in the room. But as the outflow ^ Not here reprinted. GAS POISONING 49 increases more rapidly in proportion, in order to raise to any- great extent the amount that shall remain in the room, it is necessary that a very much larger amount shall flow in. For example : with six feet per hour it is difficult to keep one per cent in a small room, but it would be much more difficult to reach two per cent with twelve feet per hour, and quite impossible (under ordinary circumstances) to reach six per cent with thirty- six feet per hour. II. With coal gas it is a matter of some difficulty to get into an ordinary apartment through the ordinary burners gas enough to produce upon healthy animals distinctly poisonous effects. With water gas, on the contrary, it is comparatively easy to get into an ordinary apartment, through the ordinary burners, gas enough to produce poisonous and even fatal effects. This is not because water gas flows in more freely, or accumu- lates in any way, in the room. For the percentages present under similar circumstances, after the lapse of the same time, do not materially differ with the two gases. The only explanation which we have been able to discover is, that under the same circum- stances water gas is considerably more poisonous than coal gas. There is little doubt that in order to produce poisoning by either gas, a certain percentage of carbonic oxide must be present. And upon this view the facts are readily interpreted, for water gas contains enough of carbonic oxide to supply imder these cir- cumstances a dangerous amount while coal gas does not. It must certainly be accounted a curious fact, though it appears to be true, that in the combination of ordinary apartments, ordinary gas fixtures and ordinary coal gas, there happens to be compara- tive safety, while in the combination of ordinary apartments, ordinary gas fixtures and ordinary water gas, there is comparative danger. III. It does not follow that because one illuminating gas con- tains three, four or five times as much carbonic oxide as another it is therefore only three, four or five times as dangerous to life. A little consideration will show that no such simple relation can possibly exist. For it is not conceivable that a gas containing 50 STATE SANITATION ninety per cent of carbonic oxide would be exactly twice as dan- gerous to inhale as one with forty-five per cent: both would be extremely dangerous. Nor would pure carbonic oxide be merely one thousand times as dangerous, if inhaled, as a mixture of air and carbonic oxide in which the latter amounted to o.i per cent: it would be infinitely more dangerous. Again, a mixture of air and illuminating gas might be inhaled for a short time, which con- tained only o.ooi per cent of carbonic oxide, but to say that this was precisely half as dangerous as a mixture containing 0.002 per cent would be obviously absurd: neither would be noticed at all. From the experiments of others, and from our own work, there is no doubt that atmospheres containing eight per cent or more of either coal gas or water gas will destroy life very quickly, and that atmospheres containing 0.2 per cent or less of either gas may be breathed for a long time without producing distinctly poisonous effects. But, between these limits, there is for each gas a per- centage (different in the two gases and always a lower percentage with water gas than with coal gas), above which the danger increases, and below which it diminishes, very rapidly. This percentage is known as the " danger-Hne," or " threshold," and varies widely with individuals, sex, physical condition, etc. In terms of carbonic oxide it is probably never very far from 0.5 per cent for the human species. The reason why water gas is so much more dangerous than coal gas appears to be that this danger line is comparatively easily reached or overstepped with water gas, rich as it is in carbonic oxide, while the comparative poverty of coal gas, in this respect, brings it well below the line into the region of comparative safety.^ IV. Our experiments confirm the work of Gruber and others who claim that carbonic oxide is not a cumulative poison. That is, the breathing of a small quantity for a long time is not equiva- ^ In these particulars carbonic oxide is not different from many other poisons. Thus a grain of morphia generally proves fatal to a healthy adult. A quarter of a grain is generally harmless. Obviously, the grain is not merely four times as dan- gerous. But between the quarter and the whole there must be some quantity which is a sort of limit of safety, and above which danger becomes imminent, whUe below it safety rapidly increases. GAS POISONING 51 lent to the breathing of a large quantity for a short time. A similar conclusion may be drawn for all the constituents of illuminating gas. This, however, does not preclude the possibility, which can hardly be doubted, that even small quantities produce their proper physiological effects, though these may not be immedi- ately perceptible. From the fact that carbonic oxide is not a cumulative poison and from the considerations mentioned before concerning the rapid increase of danger above, and the decrease of it below the " danger Kne," it follows that, within certain limits, the less carbonic oxide there is in illuminating gas the safer it is for pubKc use. For about the danger Hne a very moderate decrease of carbonic oxide may very greatly enhance its safety, while a moderate increase may very greatly multiply the dangers arising from its use. Nevertheless, with very high percentages of carbonic oxide and with very low ones this does not hold good, because far above and far below the danger Hne, the effect of slight variations is very little. We may now illustrate the foregoing conclusions by examples drawn from our own experiments and more fully described in the appendix. 1 And first, as to the difficulty of charging rooms heavily with illuminating gis. A room containing 1,140 cubic feet of space was suppHed with four ordinary burners. Through these there entered the room at a tolerably constant rate during 24 hours, 1,200 feet of coal gas. Yet at the end of the 24 hours the top of the room just above the burners contained a mixture of gas and air of which the former composed only three per cent, while the lower portions of the room showed less than one per cent. Again, a room holding about the same amount of air received 55 feet of water gas during i| hours. At the end of that time the largest amount discoverable in the room was i.i per cent of gas in the whole mixture of gas and air. To illustrate the second conclusion, viz., that it is somewhat difficult to get in enough gas by the ordinary fixtures to kill, if the 1 Not included in this volume. 52 STATE SANITATION gas be coal gas, but relatively easy if it be water gas, it is only necessary to note the effects of the two experiments just quoted. In the former (coal gas) after 24 hours the animals though some- what drowsy and stupefied were not seriously affected, while in the latter, after i| hours only, similar animals showed most alarming symptoms and one was dead from the effects of the gas. From other experiments it is certain that had this experiment been long continued, others, and probably all the animals would soon have perished. Similar considerations illustrate the third conclusion, for it is impossible to say that in the latter case the animals were only four or five times worse off than in the former. It is plain that as their lives were in imminent danger and as they were vomiting and in distress, it is not possible to express their relative danger mathe- matically. The first experiment just mentioned also indicates that carbonic oxide is not cumulative, for exposure to a small amount for 24 hours led to no serious consequences. As to the time required to produce poisoning : this seems to be merely the time required to attain a poisonous percentage of carbonic oxide; and this clearly depends on the rate of inflow, the size of the room, the leakage, etc. Nevertheless, owing to the peculiar fact already mentioned that the danger Hne for both kinds of gas probably lies between 0.2 of one per cent and eight per cent of gas in a mixture with air (though always lower with water gas than with coal gas), and that with ordinary rooms and ordinary fixtures such percentages are liable to be obtained, it becomes interesting to compare the time relations in such apartments. The following experiments illustrate this, besides showing how, under certain circumstances, a very moderate inflow of the two gases may lead, respectively, to totally different consequences: By means of partitions, two rooms — one in Newton and one in Athol — were made as much aKke as possible, both as to shape and cubic space. Each room had a capacity of about 700 cubic feet, which was somewhat larger than a room in Middletown in which a fatal case of poisoning from water gas actually occurred. Three dogs, two cats and two rabbits were placed in the room in GAS POISONING 53 Athol, and the water gas in use there, containing about thirty per cent of carbonic oxide, was allowed to flow in from a single ordi- nary burner, at the rate of six feet per hour. The experiment began at 11. 15 a.m., and at 12.45 P-^- vomiting, delirium, convul- sions, etc., had already been noted. Half an hour later, all the animals were unconscious, or apparently so, failing to respond to calls and to vigorous knocks upon the walls. At 2.30 p.m., or about three hours from the start, two cats were dead, and the other animals were prone and quite unconscious. The dogs died at 3, 4, and 6.30 o'clock, respectively, — the rabbits, also, at 6.30. In a word, symptoms of poisoning were well developed in an hour and a half. Deaths began to occur in a little more than three hours, and all were dead within eight hours. In the corresponding experiment at Newton, made with coal gas containing about seven per cent of carbonic oxide, two dogs, two cats, two rabbits and two pigeons were placed in the room, and the gas was introduced from an ordinary burner, as before, and at the same rate, — six feet per hour. The experiment began at 8 A.M., and for three and one-hajf hours no symptoms of con- sequence were observed, and then only drowsiness and general anxiety, with salivation in one case. At 4 p.m., i. e., after eight hours, at the end of which time in the other experiment all the animals were dead, nothing more than a gradual exaggeration of the symptoms had occurred. Recovery, apparently, would have been still possible and even easy, at this time. After 24 hours, i. e., at 8 a.m. of the next day, one cat and one rabbit were dead, but the others though stupefied were not unconscious, being still responsive to knocks and calls. There is little doubt, moreover, that as the night was extremely cold (below 0° F.) and the rabbit was young it was somewhat chiUed by the cold and thus succumbed the more readily to the gas. In view of the foregoing conclusions based upon experimental evidence herewith presented, it seems to us that it must be ad- mitted by all that water gas with its thirty per cent, more or less, of carbonic oxide is a more dangerous substance than coal gas with its six per cent or seven per cent of carbonic oxide, and that the only question that can be raised is, How much practical im- 54 STATE SANITATION portance is to be attached to this more poisonous character ? It will help to answer this question if we consider under what cir- cumstances accidents are hkely to occur as a result of the general distribution of gas for illuminating purposes. There are five principal ways in which such injuries are Hkely to arise, as follows: — 1. By suffocation: as when workmen are overpowered in the trenches by large quantities of gas escaping from broken or leaky mains. 2. By the formation of explosive mixtures with air, owing to the escape of the gas in any manner. 3. By poisoning during sleep, from the escape into the sleep- ing-room of gas from the burner because, owing to defective fix- tures, to accident, intention or ignorance, the light has been put out while the gas is still allowed to flow in. 4. By the slow and obscure poisoning (especially of feeble or anaemic persons) owing to leaks in or about pipes or burners in ordinary dwelling-rooms. 5. By poisoning, especially at night, when doors and windows are generally closed, with gas escaping from broken (street) mains into the earth, afterwards passing through drains or through the soil to the basements of dwellings, and thence upwards through- out the house. The question has been raised, whether the gas in passing for some distajice through the ground might not lose its odor and thus escape into houses or other buildings without being perceived. Everyone knows that the ground in the vicinity of leaky gas pipes becomes impregnated with the characteristic odor; we should therefore infer that the gas must lose some of its odorous ingredients. It may, however, be the case, that the amount lost by any given volume of the gas is proportionally too small to make a noticeable difference in the gas itself, although the con- tinued passage of the gas makes the soil decidedly odorous. The experience of those connected with gas distribution has shown that leaks may occur in the mains without the facts being dis- covered by the odor of escaping gas, and, in fact, it was deter- mined by the experts of the Berlin gas works, some years since, GAS POISONING 55 that a leak of not more than 0.2 cubic meter in 24 hours would not attract observation. It seems to be generally agreed that there is a peculiar and characteristic odor which may be removed if the gas passes for a sufficient distance through the ground, but the gas does not, as a rule, become perfectly odorless, and probably persons who were not experts would pronounce the odor that of gas. The gas which escapes through the ground is also noticed to be less luminous than before. This may be due in part to its being mixed with air, for it is possible to diminish the illuminating power very considerably, by an admixture of air (especially ground air with its higher proportion of carbonic acid), without producing an explosive mixture. The generally conceived idea is that, in passing through the ground, the gas loses a greater or less portion of the heavy hydrocarbons — the illuminants — along with the peculiar odorous substance or substances, the exact nature of which is not known. The only experiments with which we are acquainted, where analyses were made of the gas before and after passing through the soil, are those of Biefel and Poleck, who passed gas slowly through a pipe 2.35 meters (say seven and one-half feet) long, and five centimeters (say two inches) in diameter, filled with sandy loam. The pipe was connected with the gas main between the purifiers and the gas holders. The analysis of the gas before and after its passage through the soil gave the following results : — Table 3 Before After Carbonic acid 3.06 2.23 Oxygen 0.00 6.55 Illuminants 4.66 0.69 Carbonic oxide 10.52 i3-93 Marsh gas 31-24 17-76 Hydrogen 49.44 47.13 Nitrogen 1.08 11. 71 100.00 100.00 These analyses are not altogether satisfactory, and it would appear that the air originally in the pipe had not been entirely displaced when the issuing gas was taken for analysis. 56 STATE SANITATION We have made some experiments in the same direction. A galvanized iron cylinder, ten feet long and eight inches in diame- ter, was filled with the material under examination; the gas was passed slowly in at one end through a quarter-inch tube, and issued at the other end through a similar tube. If gas be intro- duced into such a pipe it does not force the air out bodily before it, but mixes with it more or less, at first, and we think that in some experiments which have been made with reference to this matter, the diminished odor and illuminating power of the gas may have been partly due to the fact that it contained air mixed with it. In our experiments the gas entered at the top of the cylinder which was placed vertically in order to take advantage of the lower specific gravity of the gas and avoid mixing as much as possible; the gas was allowed to flow slowly (one cubic foot in from twenty-five minutes to two hours) , and samples of the air or gas which escaped from the bottom of the cyfinder were taken at intervals. If, after the air was entirely displaced, the issuing gas was not different in composition from that which entered, an end was put to the experiment; if there was a marked difference, the gas was allowed to flow for a longer period. For two materials which might be regarded as most likely and least likely to absorb the heavy hydrocarbons, we employed fine, pure, siliceous sand (kindly furnished by the Berkshire Glass Sand Company, Che- shire, Mass.), and ordinary coal ashes such as are frequently used in filling low land. We also employed a mixture of dry clay with three times its bulk of sand. The general results may be briefly expressed as follows: The capacity of the cylinder was approximately three and one-half cubic feet, about two-thirds of which would be occupied by the substance of the filling material, and one-third, say one and one- sixth cubic feet, would at the beginning of the experiment be filled with air. When gas was introduced, at the rate of one cubic foot in from twenty-five minutes to two hours, the issuing mixture would begin to burn as soon as from 1.2 to 2 cubic feet had entered the apparatus; the air was not, however, displaced com- pletely until about four cubic feet of gas had flowed in. What escaped thereafter was either gas, or gas robbed of some portion GAS POISONING 57 of its constituents. With clean, siliceous sand, or with a mixture of sand and dry clay, the gas did not seem to be affected to any appreciable extent. When, however, the cylinder was filled with coal ashes such as are used in " making " land, the results were very different. The passage through only ten feet of this material at the rate of one cubic foot in fifty minutes, the temperature being about 70° F., was sufficient to cause an almost complete removal of the heavy hydrocarbons, and with them of a great deal of the odor and of the illuminating power. It is thus evident that coal gas (and the case would be the same with water gas) in passing through the ground may lose its odor to a great extent, and it would appear that land made by filling in with ashes (where, owing to settlement, leaks would be likely to occur) would be particularly Hable to unnoticed escape of gas. VIII REPORT OF A COMMISSION TO CONSIDER A GENERAL SYSTEM OF DRAINAGE FOR THE VALLEYS OF THE MYSTIC, BLACKSTONE AND CHARLES RIVERS By Dr. Henry P. Walcott Published as a separate document in 1886. [This report, while not found in the annual reports of the State Board of Health, is important as it laid the foundation for the work of the Board in connection with the Purity of Inland Waters. Its forceful and eloquent words have been the inspiration of Massachusetts engineers for more than thirty years, and should con- tinue to give inspiration for all time to come. The portion of the report quoted is said to have been written by Dr. Henry P. Walcott. — G. C. W.] The undersigned commissioners appointed to consider and report systems of drainage for the Mystic, Blackstone and Charles rivers, and for some other purposes recited in a resolve of the Legislature, which received your official approval on the twenty-eighth day of May, 1884, beg leave to state that they have attended to the duty assigned them, and desire to submit the following report: — We think it very desirable that there should be some expert authority to consult with towns and cities looking for pure and adequate water supplies, or searching for unobjectionable methods of sewerage. The difficulties in these directions are becoming greater each year and the resultant confusion and complication more embar- rassing. In the two years eighty-three and eighty-four alone, some fifty or sixty towns came up to the State House for leave to take or increase a water supply, and more than two score of private companies obtained similar privileges, and the indications are that these applications will show Httle diminution for many years to come. Each one of these towns, and many others in like case will, in no long time, find that water supply and sewerage are for the most part inseparable companions. Then, instead of a carefully prearranged plan of sewers, a piecemeal, hand to mouth 58 GENERAL SYSTEM OF DRAINAGE 59 sort of a makeshift device is likely to be improvised from day to day, entailing unnecessary expense and danger, and finally total loss. And again the scramble for the best and most accessible waters is responsible for a good deal of avoidable contention and imperfectly matured legislation. There is water enough for all if it be equitably shared. But the Legislature is annually be- sieged by importunate suitors who are bound to disregard all claims but the needs of their own constituents. It would be far better, in our opinion, if there were some competent board where all these jostling demands could be calmly considered and sys- tematically adjusted. We have accordingly inserted a section in one of the subjoined forms of statute conferring such discretion upon a board as we think will tend to promote scientific sewerage and a fair and judicious distribution of pure water. Once more disclaiming any design on our part to attribute any especial propriety to the forms of legislation which we submit and which we wish to be regarded as auxiliary suggestions rather than settled conclusions, we approach the end of these observations. Coming to the final division of our report, we have again pre- ferred to enlarge rather than restrict the scope of the jurisdiction which can be strictly derived from the bare text of the resolve. We " may consider and report upon the needs of any other por- tion of the Commonwealth as to the disposal of sewage and the protection of the public water supplies therein." We have deter- mined to regard the whole remaining body of the state, and not any particular division, as the " other portion " as to which we are at liberty to submit our views upon the propriety of throwing further safeguards about its suppHes of drinking water and attempting greater system in the disposal of its sewage. This interpretation brings within the purview of our commission the whole subject of water pollution and its restriction or prevention within the state. We take it that no one will controvert the general proposition of law that every holder of property, however absolute and unquali- fied be his title, holds it under the impHed Kabihty that his use of it may be so regulated that it shall not be injurious to the rights of the community. 6o STATE SANITATION In the exercise of its undoubted prerogative to watch over the general welfare and to guard the public rights by the ample police powers with which it is armed, the Legislature may make exactly such rules respecting the pollution of streams and ponds or other inland waters as it may judge requisite and necessary for the public welfare. It may absolutely prohibit, under suitable penalty, any contamination of any water within the borders of the Commonwealth, if it so please. It is a question always of expediency what degree of interference with individual liberty is required by the circumstances. Thus far the Legislature has been content to forbid any pollution of waters used directly or indirectly for a water supply by any city or town within twenty miles above the point of taking, provided this prohibition be not held to impair rights granted by statute before July i, 1878, or prescriptive rights of drainage, to the extent to which they law- fully existed on that date. The Merrimack and Connecticut rivers and so much of the Concord as lies within the city of Lowell are also exempt from this rule. Nor can any person save those employed in getting ice or hauKng lumber drive a horse on any pond used as a water supply for domestic purposes by a city or town. Neither is bathing permitted in any such pond. The Legislature seems to have drawn the Kne at drinking-water. Water dedicated to household uses is protected, within certain limits and to a certain degree, by a speedy, peremptory and effectual process. Municipal authorities may obtain an injunc- tion at any time, from any justice of the Supreme or Superior Court, to restrain any person from violating the 80th chapter of the General Statutes, which we have recited above. But aU other waters are left to the ordinary rules of the common law. We think that a comprehensive knowledge of all the facts will satisfy any unbiased inquirer that under this kind of customary guardianship of no one in particular the general condition of our waters has suffered a steady degradation, or, to borrow the language of the State Board as long ago as 1876, " any defence against the impurities which so conveniently flow into our waters from the settlements and works on their banks has thus far been merely nominal; that is, the law can be used to prevent a nuisance from GENERAL SYSTEM OF DRAINAGE 6 1 continuing to be poured into the river, but it is not used, because the process is too slow, cumbersome and expensive." The lapse of nine years has only served to point and emphasize this com- mentary. The growth of population, the spread of modem re- finements of living, the increase in industrial establishments, and all the indefinite multipKcation of incidents appertaining to a prosperous and progressive community, must naturally and perhaps inevitably tend to vitiate the water of its rivers and lakes. But even if a certain degree of taint be unavoidable, there is a vast amount which is wanton and preventable. A cursory glance at the report of Mr. Clarke^ will convince anyone that there is no necessity whatever for a large part of the abuse to which our water courses are subjected. It is a question of time only, and that not a long time either, when, if we hold to the path we are traveling, we shall find ourselves face to face with a state of things as intolerable as that of England twenty-five years ago, when the Sewage of Towns Commission denounced it as an " evil of national urgency requiring the earliest and most serious attention." The condition of many of its important and frequented streams had become so filthy and disgusting, that a universal protest arose, and large sums of money had to be ex- pended in haste to mitigate the extremity of the offence. Mean- while untold misery and mischief had been inflicted. Now preventive measures are far less costly and much more effective than remedial expedients. We think it is high time that some steps should be taken here to arrest the progress of rivers pollu- tion at the point it has reached today in Massachusetts, and gradually to retrieve some portion, at least, of the ground we have carelessly yielded. Impressed with this conviction, we yet consider it impracticable to ask for a summary enforcement of the extreme right of the community in its waters now for the first time. Apart from technical points of law, and taking itupon broad, equitable grounds, it would be felt to be unfair for the community suddenly to insist upon a rigid exaction of its abstract right to clean waters after so many years of License and neglect. Even if it be law that no one can prescribe for a public nuisance, it does 1 Eliot C. Clarke. 62 STATE SANITATION not necessarily follow that it is policy to abate all nuisances forth- with. And supposing such a project of law to have been enacted, we do not believe that the statute could or would be enforced. Certainly the existing law is not, then why should one so much more severe ? We therefore cast about a good deal to hit upon some principle of classification, some scheme of discrimination, or even a mere frame of fixed regulations to guide the steps of a guardian of public waters. It was suggested that schedules might be made of streams which could be allowed a certain kind and amount of pollution, to be carefully defined, either in general or for each individual case. Certain others might be set apart and reserved for the standard purity expected for drinking-water. While possibly a few might be left to take care of themselves, at least for the present. It was held to be reasonable to forbid cer- tain more dangerous or offensive trades from seating themselves in future at or near the fountain heads of rivers or brooks. It was urged that there would be no hardship in compelling a new- comer, whose labors must grievously deteriorate the quality of the water, to go below the industries which already depended upon the water as they were getting it, and could not endure without suffering any additional impairment of its purity. These expedients and many Uke them were canvassed and weighed in turn, but to all there seemed to be grave objections. After much consideration it was decided to propound a plan of action which seemed to fit the exigency as well or better than any which occurred to us. It had besides the strong recommendation of shaping itself in exact conformity with precedents which have stood the test of time and have proved themselves to be valuable working agencies. In the year 1879 the Legislature intrusted the care of " the lands, flats, shores and rights in tide-waters belong- ing to the Commonwealth," and the supervision of " all its tide- waters and all the flats and lands flowed thereby," to a Board whom it empowered " to prevent and remove unauthorized en- croachments " or whatever " in any way injures their channels." Every work done within tide-water, not sanctioned by them or authorized by the General Court, where a Hcense is required, is declared to be a nuisance, and the Board may order suits on GENERAL SYSTEM OF DRAINAGE 63 behalf of the Commonwealth to prevent it or stop the removal of material from any bar or breakwater of any harbor. This legisla- tion is strictly in line with that we offer. It is, indeed, almost identical with it. Alter its wording but a little and it would suit our purpose exactly. Precisely the same principle which enjoins a watchful care over the exterior waters of the state would seem to call for at least an equal solicitude concerning the abuse of its interior waters. But mindful of the tenderness with which Massa- chusetts has always treated her industrial classes, we think it would be wise to embrace in the enactment one pecuKarly char- acteristic feature borrowed from the act estabUshing a Railroad Commission, and which has proved strong enough to enforce amply all the rights of the public in that class of highways called railroads. This distinctive trait is the use of advisory as dis- tinguished from mandatory power. We think it would be well, then, for the Legislature to designate some one or more persons to look after the public interests in this direction. Let these guardians of inland waters be charged to acquaint themselves with the actual condition of all waters within the state as respects their pollution or purity, and to inform themselves particularly as to the relation which that condition bears to the health and well-being of any part of the people of the Commonwealth. Let them do away, as far as possible, with all remediable pollution, and use every means in their power to prevent further vitiation. Let them make it their business to advise and assist cities or towns desiring a supply of water or a system of sewerage. They shall put themselves at the disposal of manufactories and others using rivers, streams or ponds, or in any way misusing them, to suggest the best means of minimizing the amount of dirt in their efSuent, and to experiment upon methods of reducing or avoiding pollution. They shall warn the persistent violator of all reason- able regulation in the management of water of the consequences of his acts. In a word, it shall be their especial function to guard the public interest and the pubHc health in its relation with water, whether pure or defiled, with the ultimate hope, which must never be abandoned, that sooner or later ways may be found to redeem and preserve all the waters of the state. We propose to clothe 64 STATE SANITATION the Board with no other power than the power to examine, advise and report, except in cases of violation of the statutes. Such cases, if persisted in after notice, are to be referred to the At- torney-General for action. Other than this, its decisions must look for their sanction to their own intrinsic sense and soundness. Its last protest against wilful and obstinate defilement will be to the General Court. To that tribunal it shall report all the facts, leaving to its supreme discretion the final disposition of such offenders. If such a Board be able to commend itself by its con- duct to the approval of the great court of pubHc opinion, it will have no difficulty, we think, in materially reducing the disorders and abuses which are threatening to give great trouble in future if not speedily checked. If, however, we err in this expectation, and more drastic measures prove indispensable, the mandate of the state can always be invoked to re-enforce its advice. In conclusion, it may be well to explain, in order to avoid mis- conception, that we do not regard the form which we suggest as very material. We wish it understood that although we propose a fresh commission to build the Mystic or the Charles River sewers, we do not deny that they can very possibly be as well done by the Governor and Council, by the city of Boston, or some other agency, if the Legislature prefer, and when we recommend that the prevention of rivers pollution be assigned to a Board, we do not intend to prejudge the question whether that Board shall be an existing Board or a fresh creation. It seems to us compara- tively immaterial by what instruments our ends are wrought, provided only the work be done economically and speedily, and above all, be done well. John Q. Adams, Solomon B. Stebbins, Edmund W. Converse, Edward D. Hayden, Leverett S. Tuckerman. December 24, 1885. IX MICRO-ORGANISMS IN THE AIR OF THE BOSTON CITY HOSPITAL By Greenleaf R. Tucker, S.B. [The use of solid-culture media for quantitative bacteriological investigations began in 1881 with the work of Dr. Koch. During the next few years various adaptations of it were made. Professor Sedgwick and Dr. Tucker studied its appli- cation to the determination of bacteria in the air. The method suggested in this paper is with some modifications still in use. The original paper is here much abridged, statistical results being largely omitted. Reprinted from the Twentieth Annual Report, 1888, p. 161. — G. C. W.] In compliance with a vote of the State Board of Health which was passed in March, 1888, the writer of the following paper was requested to make an investigation relative to the quality of the air of hospital wards, which should have for its special objects to determine the number and distribution of micro-organisms in the air of such wards; the causes which affect their number and dis- tribution; and as far as possible to determine their character. A study of the germs themselves was soon found to be imprac- ticable, and it was thought advisable to reserve this part of the subject for future investigation. Transfers of colonies from the air of the wards, to the number of about two hundred, have been made and preserved for this purpose. It is believed that these cultures will represent most of the forms habitually present in the air of these buildings. The experiments to be described began in November, 1888, and were continued uninterruptedly for a period of three months. Some regret is felt that a portion of the work at least could not be conducted under the conditions of weather to be expected at that time of year. The winter was exceptionally mild, and the ground practically free from snow. The investigation of indoor air began by taking samples in the afternoon, between two and three o'clock; the time being so chosen because the wards are then in their normal condition, only such work being done as the necessities of the sick demand. On Monday, Tuesday, Thursday and Saturday of each week, friends 6s 66 STATE SANITATION of patients are admitted from 2 to 3 p.m., usually to the number of two to three hundred, and distribute themselves throughout the various wards, the number of visitors in each ward being often equal to the number of patients; this afforded opportunity to observe the effect upon the air of increased numbers of people over those habitually present. It was found necessary to Hmit the number of experiments each day to five, including the outside air. The total number of wards being eighteen, four or five days elapsed before a return could be made to a given point; and the entire month was necessary to accumulate sufficient data for each ward, from which to draw conclusions. During December, samples were taken mornings, generally between eight and ten o'clock, the wards at that time being in a more or less disturbed condition, — beds are made, floors swept, surgical dressings changed, and the general comfort of the patients attended to. By following this plan, two series of results were obtained, showing the condition of the air under quiet and dis- turbing influences. The month of January and part of February were devoted to special investigation, which the previous work had shown to be necessary. Methods employed in the Quantitative Determination OF Micro-organisms in the Air The introduction by Koch in 188 1 of a soKd-culture medium for the study of micro-organisms has resulted in methods by which we can determine with facihty, and approximately, if not with accuracy, the number of micro-organisms in the air. Koch himself exposed plates coated with a soHd nutrient gelatine, upon which aerial microbes settled, and could be counted after develop- ment. Hesse, however, was the first to apply this principle quantitatively to investigations of the air, and in 1883 pubHshed the well-known method bearing his name. Petrie, in Germany, and Frankland, in England, have proposed methods, which, while retaining the soHd-culture medium of Koch, differ essentially from the method of Hesse and from each other, in detail. In this country, also, some new methods of culture have been practiced by the writer, in conjunction with Professor Sedgwick, in a series INVESTIGATIONS OF MICRO-ORGANISMS 67 of investigations conducted at the Massachusetts Institute of Technology. Hesse's Method Hesse makes use of the fact previously ascertained, — that micro-organisms rapidly settle out in a quiet atmosphere. He employs a long glass tube of large bore, coated inside with steri- lized nutrient gelatine. The tube is fastened to a photographic tripod in a horizontal position, and, by a suitable connection with two aspirator-bottles, a slow current of air (one Liter in three minutes) is drawn through the tube. The germs are all supposed to settle out during the passage of the air through the tube, and remain fixed by the moist, soHd gelatine, where they become visible after several days as isolated colonies. Frankland's Method This method consists in aspirating a known volume of air through a glass tube containing two sterile plugs of glass-wool alone, or glass-wool and fine sugar-powder; after which the germ- laden filter is transferred to a flask containing melted steriHzed nutrient gelatine, the two thoroughly shaken together, and sohdi- fied upon the sides of the flask by cooling, where the colonies which develop can be counted. Petrie's Method Petrie uses fine sand as a filter, packed in a small glass tube, and held in place by disks of wire gauze. After drawing through sufficient air by means of an air pump, the sand, with its occluded germs, is poured into several small double dishes of glass, con- taining nutrient gelatine, the object being to distribute the sand and germs over a considerable surface, so that the colonies may be more readily counted. The method employed in the present investigation was first used by the writer, in association with Professor Sedgwick,^ in a ^ The complete paper was presented to the National Academy of Sciences at Washington, April 18, 1888, under the title, " A New Method for the Biological Examination of Air: with a Description of an Aercbioscope." 68 STATE SANITATION series of experiments in 1887, and will be described somewhat in detail. The actual requirements of a quantitative method for the bac- teriological examination of air, briefly stated, are as follows: — First. — A means of collecting and accurately measuring the volume of air to be examined. Second. — A suitable filtering medium for holding back the micro-organ- isms contained in the air. Third. — A soHd-culture medium, in which the germ-laden filter can be diffused, and where, on cooling and incubating for a sufficient length of time, the germs may develop and be counted as isolated colonies. The apparatus consists essentially of three parts: (i) A glass tube of special form, to which the name of aerobioscope has been given; (2) a stout copper cyhnder of about sixteen hters capacity, provided with a vacuum gauge; (3) an air pump. The aerobi- oscope through which the air is aspirated is six inches long, and one and three-quarters inches in diameter at its expanded part; the upper end of it is narrowed somewhat to a neck one inch in diameter and one inch long. To the lower end is fused a piece of glass tubing six inches long and three-sixteenths of an inch in bore, in which to place the filtering material. Preparation of the aerobioscope : Upon the narrow part of the tube, two inches from the lower end, a slight mark is made with a file, and a Httle roll of brass gauze is inserted, which serves as a stop for the filter to be placed above it. Beneath the gauze stop is placed a small plug of cotton wool, and the open ends are then plugged with cotton wool; the tube is now placed in a sterilizer, and subjected to a heat of at least 150° C. for one or two hours. When cool, the non-sterilized cotton-wool plug is carefully re- moved from the neck, and sterilized No. 50 granulated sugar is poured in, until it just fills the four inches of narrow tube above the gauze stop. This column of sugar weighs one gram and is the filtering material employed to engage and retain the micro- organisms. The cotton-wool plug being replaced, the tube is again placed in the sterilizer, and re-sterilized for several hours at 120° C. INVESTIGATIONS OF MICRO-ORGANISMS 69 STERILIZED COTTON WOOL PLUG Taking the air sample : In order to measure the amount of air used, the value of each degree on the vacuum gauge is determined in terms of air, by means of an air meter, or by calculation from the known capacity of the cylinder. This fact ascertained, the negative pressure indicated by the needle on exhausting the cylinder shows the volume of air which must pass into it to fill the vacuum. By means of the air pump, one exhausts the cylinder until the needle reaches the mark corresponding to the amount of air required. A steril- ized aerobioscope is attached to the cylinder, in an upright position, by means of a clamp; and, to estab- lish communication between the two, they are joined together by means of a rubber tube attached to the lower end of the aerobioscope and to a stop-cock on the cylinder. For removing and protecting the sterilized cotton-wool plug while the air is being drawn through the tube, a very simple device is used. A glass shield with a neck slightly larger than the neck of the aero- bioscope, and bearing a rubber finger-cot, is pushed down over the cotton-wool plug; when, by com- pressing the rubber, the plug can be removed (inside the shield), and remains suspended there. The plug removed^ the cock is opened, when air will pass through the aerobioscope, leaving its germs in the sterilized sugar filter. STERILIZED GRANULATED SUGAR WIRE GAUZE STOP COTTON WOOL- COTTON WOOL PLUG Fig. Aerobioscope 70 STATE SANITATION Cultivation of the germs: The aerobioscope, after the air has been drawn through, is taken to the culture room for further treatment. The tube being held in a nearly horizontal position, the sugar (with the contained germs) is made to run into the body of the tube, by a gentle tapping. Melted steriUzed nutrient gelatine (25 c.c.) is now added, under proper precautions, and A AEROBIOSCOPE B AIR CYLINDER C VACUUM GAUGE D AIR PUMP E GLASS SHIELD Fig. 2. Apparatus for Determining the Number of Bacteria m Am the neck closed with a perforated sterilized rubber stopper, plugged with cotton wool. On rotating the tube, the sugar all dissolves in the gelatine, leaving the germs uniformly distributed through it. The gelatine is now congealed in an even fihn upon the inside of the tube, where, after four or five days, the colonies will develop, and can be counted by the aid of squares engraved upon the glass. The illustration above shows the apparatus set up ready for use. INVESTIGATIONS OF MICRO-ORGANISMS 71 This method has several advantages not to be found in other methods. In the first place, the use of a vacuum cylinder permits a known volume of air to be aspirated with great ease, and the rate of flow through the filter is controlled to a nicety. The advantage of a soluble filter (sterilized granulated sugar), leaving only the germs imbedded in the gelatine, cannot be overestimated; for any insoluble substances seriously interfere with the counting. Again, the aerobioscope, quite apart from the filter, constitutes an important advance, since it obviates the necessity of transfer- ring the filter (and contained germs) , thereby avoiding accidental loss or gain of germs. The whole apparatus is portable, and the method, as compared with others, is exceedingly rapid of execution. Outside Air In order to have data for comparison with the work done in- doors, the outside air was examined nearly every day during this investigation. The results are of some value in themselves, as showing the condition of the air of Boston in a rather secluded place, but in the immediate vicinity of its trafiic. The samples were all taken at the same place, at the foot of the surgical steps, four feet from the ground, on the north side of the hospital, except on rainy days, when the apparatus was moved under the steps, to avoid annoyance from the rain. The direction and strength of the wind, temperature, time of day, and any dis- turbing influences likely to affect the results, were observed. The ground was free from snow and the weather was mild throughout, while the prevaihng winds were strong. The general averages for the months of November and December, 1888, and January, 1889, are shown in the following table: — Table 4 Date Number of Experiments Average Number of Bacteria Average Number of Moulds Ratio of Bacteria to Moulds November, 1888 December, 1888 . January, 1889 . . 19 22 15 10.4 14-5 13.2 6.8 5-6 3-5 1-5 2.6 3-8 All figures representing bacteria and moulds are for lo liters of air. 72 STATE SANITATION The average numbers of bacteria are thus seen to be about the same for the three months, and representing, as they do, less than two per liter of air, must be considered small. Carnelly {Phil. Trans, of the Royal Society of London, vol. 178) found recently in the town of Dundee, in quiet places, as a mean of fourteen experiments, less than one bacterium per Kter of air; while, in certain streets where the ratio of bacteria to moulds was very high, the total number of organisms was 17.5 per Hter of air. A comparison between the numbers of organisms found on clear and on rainy days is shown in the next table: — Table q November December January Condition of Weather No. of Deter- mina- tions Aver- age No. of Bacteria Aver- age No. of Mouldb No. of Deter- mina- tions Aver- age No. of Bacteria Aver- age No. of Moulds No. of Deter- mina- tions Aver- age No. of Bacteria Aver- age No. of Moulds Rain Clear 5 14 7.6 11.4 7-8 6.4 3 18 9-3 15.0 6.3 5-4 9 2-5 19.0 3-0 3-5 The number of bacteria present in the air on clear days is greater than on rainy days, but the number of moulds remains the same; i. e., rain washes out bacteria from the air, but does not Table 6 November December January No. of Deter- mina- tions Bacteria Moulds No. of Deter- mina- tions Bacteria Moulds No. of Deter- mina- tions Bacteria Moulds Wind slight . . . Wind strong . . 2 IS 2-S II.O 18.0 4-3 6 IS 12 IS 9-3 4.4 2 10 4-S 17.0 3 4 remove moulds. Both bacteria and moulds were more numerous on rainy days than was expected; and this is perhaps accounted for by the fact that the experiments were made under some stone steps, near a basement door frequently opened by employees. INVESTIGATIONS OF MICRO-ORGANISMS 73 No deductions could be drawn from the effect of the direction of the wind upon the micro-organisms, owing to the position of the buildings. The quarter from which the wind blew was taken from a neighboring weather-vane; but the direction, as felt by the observer, seldom coincided, being generally either easterly or westerly. The effect of the strength of the wind is, however, worthy of notice, being to increase the numbers of bacteria. Conclusions The results obtained from buildings of the hospital group occupied by employees, investigated for the sake of comparison with the wards, taken together with the results furnished by out- side air, furnish abundant proof that the air of the hospital is remarkably free from micro-organisms. Whether the numbers found are greater or less than would be found in similar institu- tions is not known. So far as I am famihar with the work of other investigators in this field, the results show that hospitals of this class, as compared with other buildings, will take first rank in the freedom of their air from micro-organisms. This is as it should be: bacteria, in a way, represent so much dirt. In a well-managed hospital, one has an approach to an ideal degree of cleanhness, and in no class of buildings is the same care taken to secure freedom from dirt as is taken in such a hospital. Undoubtedly, the systematic, thorough renovation which is going on continually in the hospital is of great importance in removing accumulations of germs, which must inevitably occur in the wear and tear of a building. This hospital is particularly fortunate in this respect; with its large tent service, wards in turn can be vacated during the summer months, and put in thorough repair, to an extent not otherwise possible. In this connection, it will be interesting to reproduce some valuable tables prepared by Professor Thomas Carnelly and his colleagues,^ showing the number of micro-organisms in the air of clean and unclean buildings in Dundee. ^ I take great pleasure in referring the reader interested in this subject to the work of Carnelly, it being the first attempt, so far as I am aware, to systematically determine the number of micro-organisms in the air of buildings. 74 STATE SANITATION I ABLE 7 Bacteria in lo Liters of Air One-roomed houses, dean i8o " " dirty 410 " " dirtier 490 " " very dirty 930 Naturally ventilated schools, cleaner 910 " " " average cleanliness 1,250 " " " dirtier 1,980 Mechanically ventilated schools, cleanest 30 « " clean 160 " " " less clean 300 These results leave no doubt that the cleanliness of rooms and of persons also is of the greatest importance in preventing ac- cumulations of micro-organisms. It will be noticed that the numbers found in mechanically ventilated schools are far less than for those ventilated naturally; but the results as a whole, both in schools and dwelling-houses, are enormous, as compared with those obtained in this hospital. On the other hand, Carnelly found in the wards of the Dundee Royal Infirmary, between 4 and 5 o'clock p.m., from 10 to 20 bacteria. Neumann made thirty-five experiments by Hesse's method. At different eleva- tions, from 1.40 to 3.26 meters, about the same number of organisms were found. In the morning, after sweeping, 10 Hters of air gave from 80 to 140 bacteria, while four consecutive deter- minations at the same height showed a gradual decrease; the last examination, at 8 p.m., giving from 4 to 10 bacteria. The results obtained in both the above hospitals are in perfect accord with those obtained in this investigation. The extent of vitiation which the air of dwelling-houses may reach is further shown by determinations made by Carnelly, on one, two and four-roomed houses, between 12.30 and 4.30 a.m. Bacteria Moulds One-roomed houses 580 1 2 Two-roomed houses 430 22 Four-roomed houses, and more 160 10 When it is remembered that the air of the Boston City Hospital is practically free from bacteria at the hour of midnight, the above results, representing the condition of the air breathed by human INVESTIGATIONS OF MICRO-ORGANISMS 75 beings, is certainly startling, and goes far to show the value of the information furnished by such determinations. The atmosphere of a building vitiated by micro-organisms can be so readily brought at least to a moderate state of purity, by a proper degree of cleanhness and oversight, that there is no legitimate reason why the air of public buildings should reach the condition of vitiation shown by Carnelly's experiments, in certain buildings in Dundee. In any comparison of the number of micro-organisms found in the air of a hospital with those of other buildings, allowance must of course be made for the fact that a very small nutnber of organ- isms found in hospital air, if pathogenic, might be more dangerous than large numbers of non-pathogenic forms found elsewhere. The great majority of micro-organisms found in air are probably harmless; but their functions as yet are so imperfectly under- stood, that it would seem unwise to consider them entirely harm- less. Many of them evince a power in the decomposition of the various culture media, which is suggestive of what might happen in or upon the human system, should they find there a suitable nidus for development. Although no attempt was made in this investigation, except in a very general way, to determine the character of the germs present, it was found that the same species which occurred in the outside air were met with in the hospital; but certain species were met with in the hospital that were not found in outside air. In the ward devoted to diphtheria, species were always fewer in number than elsewhere, and the colonies were not unlike those obtained from the material furnished by the patients themselves, although no proof of their identity was obtained. The presence of pathogenic bacteria has frequently been demonstrated in the air of hospital wards; for example, Cornet, of Koch's Hygienic Institute, found bacilH tuberculosis in fifteen out of twenty-one wards in seven hospitals in Berlin, and out of ninety-four animals inoculated, twenty died of tuber- culosis. Von Eiselsberg in an erysipelas room of the hospital found erysipelas cocci; also, in a surgical ward, where wounds were treated under aseptic precautions, the presence of staphylo- coccus pyogenes aureus was demonstrated. Emmerich not only 76 STATE SANITATION found erysipelas cocci in the air of an old dissecting room, but also in the plastering and walls and ceiling. In this connection, it should be stated that the ordinary methods employed in the cultivation of the germs of the air would fail to reveal the presence of certain pathogenic bacteria, as, for example, bacilli tuberculosis ; such forms, however, are not diffi- cult to determine by special means. Pathogenic bacteria are as likely to exist in this hospital as in any other, and probably do exist; but it is worthy of note that the general health of em- ployees is excellent, that contagious diseases are seldom con- tracted by them, or by patients themselves, although isolated cases occasionally occur. The importance of obtaining definite information regarding the dangerous or innocuous character of micro-organisms found in the atmosphere is evident; but, until methods are so amplified that species can be identified with a greater degree of certainty and far less expenditure of time than at present, we must be con- tent with a determination of the number and distribution of bacteria in the air of buildings. Carnelly has proposed a standard for the air of dwellings and schools; i. e., twenty micro-organisms per liter, or two hundred per ten liters (excess over outside air), — numbers so greatly in excess of all results obtained in this hospital as to make evident the necessity of standards for various classes of buildings. The air of this hospital compares favorably with the external air. In the absence, then, of a standard of purity for hospital air, it would not be unreasonable to require that the number of micro- organisms in the air of a ward should but slightly exceed the numbers found in outside air. X POLLUTION OF ICE SUPPLIES [In this report we see the joint application of sanitary chemistry and bacteri- ology to a practical public health problem. Although a short report it is typical of the manner in which such questions have been answered by the Massachusetts State Board of Health, that is, by securing the facts in the case, using the best available methods of procedure. At the time this report was written relatively little was known about the effect of freezing on the quality of ice, or the relation between ice and the public health. Twenty-first Annual Report, 1889, p. 143. — G. C. W.] By chapter 84 of the Resolves of 1888, the General Court directed the State Board of Health to " make a special investiga- tion with reference to the pollution of ponds, lakes, streams or other bodies of water used as ice suppHes in this State, especially with reference to the effect of such pollution upon the health- fulness of such ice for domestic use." In accordance with this direction, the State Board of Health sent to every city and town in the state printed circulars, — to the local boards of health, to physicians, or to persons known to have an interest in the subject, asking their co-operation and their replies to the following questions : — 1 . Names of companies, firms or individuals who cut or sell ice in your city or town, and sources from which such ice is obtained. 2. What contaminating causes, if any, pollute the sources from which ice is cut ? 3. Have any cases of illness come to your knowledge from the use of ice cut from such sources ? 4. What remedies do you suggest for the prevention of such pollution ? In the responses to these circulars from one hundred and eighty- nine cities and towns, sources of pollution were noted in thirty. The answers to the third question were generally, " No." A few cases were, however, noted, where the ice supply was suspected of being the cause of illness, but none appeared to be so definitely connected with this cause as to give promise of additional knowledge if investigated further. 78 STATE SANITATION From the thirty sources where contaminating causes of pollu- tion were noted there were selected twelve which appeared to be the most polluted; and in October, 1888, samples of the water from each of these sources as it then existed, and samples of the ice in ice houses adjacent, were examined, with the following average result : — Table 8 Average or Analyses of Water and of Ice from Polluted Sources IN October, 1888 (Parts per 100,000) Color Loss on Ig- nition FLxed Re- sidue Ammonia Chlo- rine Nitrates Nitrites Bac- Free Albu- minoid teria Water .... Ice Per cent . . 0.24 0.00 1.65 0.24 15.00 6.94 1. 00 14.00 0,0143 0.0022 15.0000 0.0206 0.0027 13.0000 1. 18 O.OI 0.0343 0.0045 13.0000 0.0009 0.00005 6.0000 138 One sample of ice from an unpolluted source gave the following: 0.0 0.20 0.20 0.0000 0.0000 0.00 0.0050 0.0000 The samples of ice from the twelve most polluted sources, obtained from ice houses in October, when compared with the waters of the various ponds, as they were in October, showed that the color and salt had been removed, and that all but about thirteen per cent of the other impurities of the water, as shown by chemical analyses, had been removed. The number of bacteria in the ice averaged 138, being increased by one sample of snow ice that contained 1,246 per cubic centi- meter, while the clear part of the same cake had but 6. Two samples had none; three had less than 10; three others had between 10 and 100, and two had 199 and 433 bacteria per cubic centimeter. A single sample of clear ice from an unpolluted source was found to be nearly as free from organic impurities as distilled water. POLLUTION OF ICE SUPPLIES 79 These preliminary examinations indicated, as had been found by Dr. T. M. Prudden/ in examining Hudson River ice, that different parts of a cake of ice may differ much in quahty; and it was concluded to follow Dr. Prudden's method of making separate examinations of transparent and of snow ice. This classification was used in examinations of the ice crop of 1888-89. Experiments were planned by which the quahties of ice found under differing circumstances could be determined; but the short season in which ice formed, — Hmited to the latter part of February and the first of March in 1889, — and the almost entire failure of the ice crop in 1889-90, have prevented the carrying out of these investigations; so that the Board, while presenting the facts that have been obtained and some of the conclusions to which these lead, is unable to present demonstrations of all of the interesting problems that enter the investigation required by the resolve. As has been stated, examinations were first made of water and ice from the twelve sources which by the reports appeared to be those most polluted. On continuing the investigation other sources were included, making in all fifty-eight locaHties, some of which were from excellent water. The results are all included in the tables given below. In these tables are given chemical analyses of 76 samples of water and 236 samples of ice. Most of the samples were also examined for microscopic organisms and for bacteria. In tabulating the results of microscopical examinations, the figures represent the number of thousands of organisms in 200 cubic centimeters of water or of ice. The smallest figure given is 0.1, which expresses 100 organisms in 200 c.c. of water or of ice; where the number observed was less than 100, they are said to be " present." The figures under bacteria express the actual number found in one cubic centimeter of the water or ice. The number of bacteria was found to vary much in different parts of a cake of ice. The division adopted in the first season 1 " On Bacteria in Ice and their Relations to Disease, with Special Reference to the Ice Supply of New York City." By T. Mitchell Prudden, M.D. New York, 1887. The Medical Record, Vol. 31, Nos. 13, 14. 8o STATE SANITATION into snow ice and transparent ice made one important distinction, but others were found necessary; and in the second season three divisions were made; viz., snow ice, bubbly ice and clear ice, also top ice and bottom ice ; and in the tables the remarks at the right of the columns often indicate that the chemical analysis was made from snow ice or from the top or bottom of the cake, while the columns for bacteria show that two or more samples from the same part of the cake were examined, because there were portions of clear ice and of bubbly ice in each. In the earHer examinations, when all of the samples were in- cluded in snow ice and transparent ice, the latter included much that was bubbly; and, when clear and bubbly ice took the place of transparent, the clear ice included some which was somewhat bubbly. If the ice crop of the present season had not failed, the Board would have made other distinctions to include the circumstances under which the ice is formed. From the examinations that have been made, it appears prob- able that, when ice first forms on the surface of a pond or river, a considerable part of the impurity in the water near the surface is entangled in the first inch or less in depth, and that the ice that forms below this first inch contains but a very small percentage of the impurities of the water. If snow falls upon the thin ice, caus- ing it to sink, so that water from below saturates the snow, it will freeze without purification; or, if rain falls upon the snow and freezes, the ice thus formed contains the impurities of the snow and of the rain water, and whatever else may have settled out of the air. The method, often pursued, of flooding the ice of a pond or river, by cutting holes through it, gives a layer of ice as impure as the water of which it is formed. From all of the analyses of water and of ice taken at the same time, so that they can be fairly compared, twelve have been selected in which the sum of ammonias in the water indicated the greatest pollution, and the principal results of analyses are given in the following table : — POLLUTION OF ICE SUPPLIES 8i Table 9 MlLLBUEY. — BlACKSTONE RlVER (Parts per 100,000) Color Residue on Evaporation Ammonia Chlo- rine Nitrogen as Bacteria per c.c. Loss on Ig- nition Fixed Residue Free Albu- minoid Ni- trates Ni- trites Water or Ice Snow Ice Water Snow ice . . . Ice % Snow ice. % Ice 0.0 0.0 3.00 1.70 1. 10 57 37 11.30 2.90 2-15 26 19 .1680 .0448 .0252 27 IS .0440 .0306 .0176 70 40 0.74 O.IO O.IO 14 14 .0150 .C020 .0050 33 .0018 .0003 .0003 17 17 3762 241 6 1586 42 Water . Ice . . . Per cent. NORTHBRIDGE. — POND FeD BY BlACKSTONE RiVER 0-3 .0600 .0370 0.50 .0200 .0006 74 0.0 1.65 0.8s .0006 .0030 O.OI .0030 .0001 43 I 8 2 IS 17 60 Lowell. — Black Brook Water Snow ice . . . Ice % Snow ice . % Ice Water Ice Per cent. . . . 0.0 .0686 .0142 0.40 .0600 .0003 107 0.0 1.40 2.50 .0184 .0128 0.04 .0060 .0001 0.0 o-SS 0.4s .0036 .0040 O.OI .0050 .0000 3 27 90 10 10 33 5 28 2 8 3 39 37 Jamaica Pond 0.05 .0120 .0664 0.86 .0450 .0002 147 0.00 0-35 1. 10 .0034 .0060 0.00 .0040 .0001 I 28 9 9 50 I Worcester. — Crescent Street Pond Water Snow ice . . Ice % Snow ice % Ice o.is •0356 •0356 0.70 .0850 .0007 1200 0.00 .0046 .0094 0.03 0.00 0.45 1. 10 .0006 13 .0026 26 O.OI 4 .0060 .0000 16 2 7 I 7 I 58 82 STATE SANITATION Table 9 — continued Brighton. — Hollis Pond Color Residue on Evaporation Ammonia Chlo- rine Nitrogen as Bacteria per c.c. Loss on Ig- nition Fixed Residue Free Albu- minoid Ni- trates Ni- trites Water or Ice Snow Ice Water Ice Per cent. . . . O.I 0.0 0.30 0.60 •0354 .0012 3 .0296 .0022 7 1-59 0.00 .4000 .0030 I .0031 .0000 20000 702 3 Dorchester. — King's Pond Water. . Ice Per cent. 0.2 .0314 .0262 1. 19 .0800 .0013 412 0.0 0.50 1. 10 .0028 .0044 O.OI .0030 .0000 6 9 17 I 4 I Newton. — Hammond's Pond Water . . Ice Per cent. I.I .0038 .0450 0.54 .0040 .0003 "S 0.0 0.20 0-55 .0000 .0012 0.00 .0030 .0000 8 3 75 7 Arlington. — Little Spy Pond Water 0.2 .0058 .0390 1.70 •1750 .0020 1029 Ice 0.0 0.6S 2.68 .0026 .0068 0.02 .0020 .0000 II 61 Per cent 45 17 I I I 6 Melrose. — Ell Pond Water . . Ice Per cent. 0.2 .0240 .0202 0.94 .0650 .0009 0.0 0.68 2.20 .0020 .0028 0.02 .0050 .0000 2 8 14 2 8 Cambridge. — Fresh Pond Water . . Ice Per cent. 0.05 .0230 .0180 1.00 .0300 .0008 II 0.00 0.56 0.80 .0022 .0030 0.02 .0020 .0000 3 10 17 2 67 27 POLLUTION OF ICE SUPPLIES Table g — concluded WoBURN — Horn Pond 83 Color Residue on Evaporation Ammonia Chlo- rine Nitrogen as Bacteria per c.c. Loss on Ig- nition Fixed Residue Free Albu- minoid Ni- trates Ni- trites Water or Ice Snow Ice Water Ice Per cent. . . . 0.25 0.00 0.25 0.60 .0172 .0010 6 .0210 .0028 13 0.67 0.02 3 .0200 .0000 .0007 .0000 327 3 I The chemical results are given in parts per 100,000. The bacteria are indicated by the number found in a cubic centimeter. The percentage of each substance of the water that remained in the ice or in snow ice is given. These waters all contain more ammonias than are desirable in drinking waters; but the ice formed from these waters contains from three to twenty-one per cent as much as the waters, averag- ing eleven per cent. The amount of ammonias contained in the ice, except in the one containing the largest amount, would not cause them to be condemned as drinking waters; neither would the number of bacteria, except in the case of ice from the Black- stone River and from HolHs Pond in Brighton. But we cannot depend upon numbers alone. A large number of bacteria of one kind may be harmless, and a small number of another kind may communicate a most serious disease. It is known, from these experiments as well as from others, that many kinds of bacteria survive a long season in ice; and it has been shown by Dr. Prud- den that the bacillus of typhoid fever will live in decreasing num- bers in ice for three months at least. It is, then, the quahty of the bacteria rather than the quantity that we are to consider, and the best judgment in regard to this includes the source from which they came. If the source is one which is liable to be polluted by disease-producing bacteria, as is likely to be the case wherever sewage enters, this fact should have much more weight than the small number of bacteria found. 84 STATE SANITATION The purifying effect of freezing is greater upon substances that are in solution than it is upon those in suspension. For example, upon freezing the upper part of a body of sewage to the depth of one inch , the substances in solu tion were reduced as given below : — Table io Loss on ignition Fixed residue Free ammonia Albuminoid ammonia Chlorine Sewage Ice 10.4 1.8 19.6 2.2 1.646 0.184 0.250 0.012 4.20 0.52 Per Cent Remaining in Ice 17 II II 5 12 The parts in suspension were affected as follows: Loss on ignition Fixed residue Albuminoid ammonia 2.8 1.9 2-3 1.6 0.130 0.036 68 70 28 Of the parts that were in solution in the sewage, the freezing process caused to be removed all of the impurities except from five to seventeen per cent, while of the much smaller parts which were in suspension there remained in the ice from twenty-eight to seventy per cent. The unfrozen sewage under the ice contained the impurities which the ice had expelled. It appears that the parts that are in suspension, particularly particles that have some buoyancy in water, are not so easily expelled as the parts that are in solution. This is confirmed by the fact that a large part of the organic matter, one-half or three- quarters and sometimes more, that is found in good ice is of particles in suspension, and is readily removed by filter paper. The inch in depth of frozen sewage contained ten per cent of the organic impurity of the sewage, as indicated by the siun of ammonias; and from other experiments we have reason to con- clude that, if another inch in depth had formed under the first, it would have contained a still smaller percentage of organic im- POLLUTION OF ICE SUPPLIES 85 purity; but if the first inch had been pressed down, and the sew- age had risen above it and then frozen, this last layer would have been as impure as the sewage. This is an extreme case of impurity of the source. Taking an average of all of the water and ice used for ice sup- phes, which we have examined, we find that the organic impurities of the snow ice, as shown by the sum of ammonias, amount to sixty-nine per cent of those of the waters; that the organic im- purities of all the ice except the snow ice amount to twelve per cent, and those of what we have called clear ice amount to six per cent, of the impurities of the waters. The color of the waters was entirely removed, and the salt that they contained was nearly all removed, by the process of freezing. There were eighty-one per cent as many bacteria in the snow ice as in the waters; ten per cent as many in all other ice, and two per cent as many in the clear ice, as in the waters. While the Board, as before stated, was unable in these warm winters to make the experiments desired to settle many points of the inquiry, the results obtained lead to the conclusions that, while clear ice from polluted sources may contain so small a per- centage of the impurities of the source that it may not be re- garded as injurious to health, the snow ice and any ice, however clear, that may have been formed by flooding, is likely to contain so large a percentage of the impurities of the source, and with these impurities some of the disease germs that may be in the source, that the Board feels bound to warn the pubHc against using ice for domestic purposes that is obtained from a source polluted by sewage beyond that which would be allowable in a drinking water stream or pond; and that in general it is much safer to use, for drinking water and for placing in contact with food, that portion of the ice that is clear. H. P. Walcott, Julius H. Appleton, Hiram F. Mills, Frank W. Draper, Thornton K. Lothrop, Joseph W. Hastings, E. U. Jones, state Board of Health. XI REPORT OF THE STATE BOARD OF HEALTH UPON THE SEWERAGE OF THE MYSTIC AND CHARLES RIVER VALLEYS [This report relates to the establishment of the North Metropolitan System of sewers. It contains an interesting account of filtration experiments made to deter- mine the feasibility of disposing of the sewage of Boston on the Saugus Marshes. Special. Report, 1889. — G. C. W.] The Resolves of the General Court, under which the State Board of Health has made investigations relating to sewage dis- posal, and has made designs for a system of sewerage for the Mystic and Charles River vpUeys, are as follows: — [Chap. 95.] Resolve relating to sewage disposal in the mystic and charles river valleys Resolved, That the state board of health is hereby authorized and directed to consider and report a general system of drainage and sewerage for the rehef of the valley of Mystic river, and so much of the valley of Charles river, if any, whose rehef in the opinion of said board is to be sought in conjunction with the Mystic valley system, and for such cities and towns, or parts of cities and towns as may, in the opinion of said board, be best reheved by the use of said system; and so much of the report of the commissioners appointed under resolve approved May twenty-eighth, in the year eighteen hundred and eighty-four, as relates to the cities and towns, or parts of cities and towns, which said board shall incorporate in the system to be reported under this resolve, is hereby referred to said board for its further con- sideration, and it shall be the duty of said board, — First. To designate the cities and towns, and parts of cities and towns, which shall be tributary to and embraced in the district 86 NORTH METROPOLITAN SYSTEM OF SEWERS 87 and system so to be reported, and to define the same by their report, with plans and maps. Second. To define and show, by suitable plans and maps, such trunk line and main branches as it shall recommend to be con- structed, with outlet. Third. To define the methods by which said cities and towns, or parts of any city or town, may utihze said trunk fine and main branches as an outlet of a system of sewerage and drainage for said respective cities and towns, and said parts of cities and towns, and to show the same by plans and maps. Fourth. To cause such surveys and levels to be made as will enable said board to determine with accuracy the location and grades of said trunk fine and main branches, and also such sur- veys and levels in said cities and towns and parts of cities and towns as will enable said board to determine with accuracy the methods by which said cities and towns and parts of cities and towns may respectively utilize said trunk line and main branches and to report such methods by plans showing the main fines by which each may so provide for itself a system of sewerage and drainage with its outlet into said trunk fine or main branches. Fifth. To define the size and capacity of said trunk fine and main branches and the materials of which they should be con- structed and manner of construction, and such other particulars as will enable said board to determine the probable expense thereof. Sixth. The expenses of surveys, maps and plans made to show the method by which any city or town, or part of city or town^ may utiHze said trunk fine and main branches' shall be separately kept, and the same, showing the amount expended in each, to- gether with the expenses of the location and grade, maps and plans of said trunk fine and main branches, together with all other expenses in the premises, and the items thereof, shall be reported to the governor and council, and all such costs and expenses shall be paid out of the treasury of the Commonwealth, on bills to be approved by the governor and council. Seventh. Each city or town which wholly or in part said board shall consider should form a part of the territory to be embraced 88 STATE SANITATION in the system to be reported shall be notified thereof by said board as soon as said board shall determine the cities and towns and parts of cities and towns which shall constitute said sewerage and drainage district. Said notice shall contain the names of the cities and towns wholly, and shall designate the portions of the cities and towns not wholly but in part, incorporated therein, and each of such cities and towns may confer with said board in respect to such drainage and sewerage system, and on request in writing be heard by said board on matters relating to the method of its utihzing said trunk line and main branches and the surveys, levels, maps and plans to determine and show the same, and under the superintendence of said board may, at its own expense, make its said surveys, levels, maps and plans for the use of said board; but all questions upon which any city or town shall desire to be heard shall be submitted to said board in writing with such request. Eighth. Said board shall also consider whether any city or town within such district can more advantageously provide for itself a system of sewerage and drainage by itself and not as a part of said general system, and shall hear such city or town thereon if it shall so request, and shall also make report thereof. Ninth. To ascertain and report the cost of the construction of said trunk line and main branches and outlet, and of the annual expense of operating the same, and also what cities and towns, or parts of cities and towns, would be obliged to pump their sewage or any part thereof, at what places, the cost of the works therefor and the annual expenses thereof: provided, however, the whole amount expended under the provisions of this resolve shall not exceed the sum of ten thousand dollars ; ^ and reports under the same shall be made by the state board of health to the general court on or before the first Wednesday of January, in the year eighteen hundred and eighty-nine. [Approved June i6, iSSy. 1 In 1888 the further sum of fifteen thousand dollars. NORTH METROPOLITAN SYSTEM OF SEWERS 89 [Chap. 63.] Resolve providing for further investigations relative to sewage disposal in the mystic and charles river VALLEYS Resolved, That the state board of health be requested to desig- nate some method for the disposal of the sewage of such cities and towns as are embraced within the lower valley of the Charles river, in the report of the commissioners appointed under chapter sixty-three of the resolves of the year eighteen hundred and eighty-four, as they may not include in their report under chap- ter ninety-five of the resolves of the year eighteen hundred and eighty-seven, and so much of said report as relates thereto is hereby referred to said board for its further consideration. Such designation shall be made as a part of the report required by chapter ninety-five of the resolves of the year eighteen hundred and eighty-seven, and the expense thereof charged to the appro- priation provided for in chapter forty-two of the resolves of the year eighteen hundred and eighty-eight. [Approved April 24, The territory whose relief is, under these resolves, to be consid- ered by the State Board of Health, includes an area of one hun- dred and thirty square miles, and contains one-sixth of the population of the state. Some of the cities have more or less complete local systems of sewerage, discharging sewage at their borders, where it is offen- sive to their own citizens and to their neighbors, and has become, or is rapidly becoming, dangerous to the public health. Others of the cities and the more populous towns have Httle or no sewerage systems, and are waiting, with soKcitude for the health of their people, the action of the General Court in arranging for a com- mon method of disposal of their sewage, being prohibited by statute, or by considerations of public health, from pouring it into the streams which are the natural drains of their territory; and still other towns, sparsely settled, see less need for disposal of their own sewage, but are much concerned for the health of their 90 STATE SANITATION communities, because of the pollution of streams upon their borders by the sewage of their neighbors. To devise the most efficient systems of relief for these com- munities, and to present plans which, upon careful consideration, would meet their approval as the best that can be adopted, re- quired that the problem should be solved in all of the three prac- ticable methods of solution that have met with favor elsewhere. These methods are : — (i) The method of discharging crude sewage into a strong tidal current that will convey it to sea, whence it cannot return. (2) The method of partial purification by filtration upon the bed recommended by the Massachusetts Drainage Commission by report of December 24, 1885, or upon some other bed or beds. (3) By chemical precipitation and discharge of the clarified effluent into outgoing tide at one or more points. The Board concluded that the general consideration of each of these methods should be committed to a thoroughly competent engineer, skilled in the particular method to be planned by him, and that he should take time to investigate the whole subject in its relation to this locaHty, and work up the best plan for his method of disposal. The Board selected Mr. Howard A. Carson, civil engineer of Boston, who had been the superintendent of construction of sewers of the Boston Main Drainage System, and went abroad with Mr. Davis to study the discharge of sewers into tidal cur- rents, to make the investigations, plans and estimates by the first method, which plans and estimates for sewers, modified to meet the peculiar conditions, are used in the estimates of cost by the other methods; Mr. Phinehas Ball, civil engineer of Worcester, to make the investigations, plans and estimates appropriate to the second method; and Mr. Charles H. Swan, civil engineer of Boston, to make the investigations, plans and methods appropriate to the third method. After careful examination of the possible localities for disposal of the sewage, Mr. Carson concluded that the best outlet for the discharge of crude sewage is a Httle west from the Beacon which is one-third of a mile south from Deer Island. Mr. Ball found NORTH METROPOLITAN SYSTEM OF SEWERS 91 that territory including and in the vicinity of that selected by the Massachusetts Drainage Commission of 1885 is the only available territory where any considerable portion of the sewage of Mystic valley can be treated by filtration; and Mr. Swan selected as the most favorable for the chemical precipitation process an area in Everett, on the north bank of Mystic River, between Maiden Bridge and Island End River, A system of intercepting sewers was first designed and located upon the ground, and estimates of cost made, for receiving and conveying to each of these points of disposal the sewage from Woburn, Stoneham, Winchester, Arlington, Belmont, Medford, Melrose, Maiden, Everett, Chelsea and East Boston, and one-fifth of Somerville and one-ninth of Cambridge, containing a popula- tion estimated to be 150,000 in 1890 and to increase to 300,000 in 1930, the sewers being of sufficient capacity to serve the popula- tion of 1930. With the estimated cost of these systems of sewers by Mr. Car- son, and the estimates of Mr. Swan for the process of disposal by the aid of chemical precipitation, the chief engineer and the con- sulting engineer of the Board made for the use of the Board a comparative estimate of the cost and yearly running expenses for each of the three methods of disposal, which comparative esti- mate is given in the table on the following page to indicate the steps by which the Board has reached its final conclusions. These estimates show that the amount to be paid on the cost and maintenance of works, and yearly running expenses for the forty years for which the systems were designed to be adequate for the territory embraced, is more than fifty per cent greater for the method of disposal. by chemical precipitation at Island End River and discharge of the clarified sewage there on the but-going tide, than for the method of discharge of crude sewage into tidal currents at Deer Island Beacon. Wlien we consider a larger population than the 300,000, and find that the cost of chemicals and their application and the removal of sludge will be as much as fifty cents per inhabitant a year, while the whole yearly running expenses by the method of discharge at Deer Island are but one-half this amount, we must 92 STATE SANITATION conclude that if a larger territory as favorably situated in respect to the outlet at Deer Island be included in a system discharging there, the resulting cost will to a much greater degree be in favor of the Deer Island outlet. This result, though not anticipated by the Board, was received with satisfaction, because the effluent from chemical precipitation Table ii Comparative Estimate of Cost of Sewers for Mystic Valley for a Prospective Population of 300,000, used at First by a Population of 150,000 If Crude Sewage be Discharged Continuously into Tide Water at Deer Island Beacon If Sewage be Filtered on Saugus Marshes If Sewage be Precipitated by Chemicals at Island End River, and Effluent be Discharged at Ebb Tide First cost $2,726,995 $2,654,626 $2,384,503 Yearly running expenses and maintenance Interest and sinking fund at 4I per cent . . $55,760 129,532 $66,700 126,095 $132,800 113,264 Total yearly cost $185,292 $2,792,995 $192,795 $246,064 $2,835,651 The same sewers used by a population of 300,000 First cost •"iltering area insuf- ficient for so large a population Yearly running expenses and maintenance Interest and sinking fund at 4! per cent . . $72,020 132,667 $222,300 134,693 Total yearly cost $204,687 $356,993 in England has been found to contain nearly one-half of the putrescible material of the sewage, and in some cases it has been found necessary to still further purify it by filtering it through land before turning it into streams. In this case it is to be turned into a large body of salt water, upon which it will tend to float, and, on the first ebb, will be carried down to Fort Point channel, and with the returning tide backed into the Mystic, Chelsea and Charles rivers : in the first river, nearly to the starting point, and NORTH METROPOLITAN SYSTEM OF SEWERS 93 in the last, about up to Craigie's Bridge. On the second ebb, the new discharge of clarified sewage will mingle to some extent with water containing the former discharge, so that, as Mr. Swan shows, there will always be the effluent from as much as one and one-half days' sewage in the waters about the principal wharf fronts of Charlestown, Chelsea, East Boston, East Cambridge and Boston. This effluent is expected to be nearly colorless and clear when discharged, and will probably not be recognized as sewage after being in the river an hour. It will probably be mingled, to some extent, with the water of the river and harbor throughout its depth, but, being lighter than the salt water, will, during its pas- sage back and forth past the wharves of these cities, probably be mingled to the greater extent with the water at and near the sur- face. In calm, moist weather we can but anticipate a marked effect of this surface water containing putrescible matter in adding to the discomfort of the great number of people who breathe the muggy air which has slowly moved over these waters. Intercepting the sewage that now enters these waters, collecting it, — together with large additions from the surrounding country, — treating it with chemicals which remove the objectionable appearance and present odor of sewage, but still leaving in it one half, more or less, of the constituents which chemically distin- guish sewage from pure water, and pouring this back, in ever- increasing quantity, into these rivers, surrounded by so dense a population, is a scheme to which the State Board of Health would be unwilling to give its approval, until satisfied by experiments which have not yet been made that the results would not be detri- mental to the public health. Moreover, finding the cost of remov- ing the sewage beyond all habitations and turning it into the ocean to be decidedly less than the cost of the questionable method by chemical precipitation, the Board is relieved from further investigation of the latter method, and dismisses it as inappKcable to the present circumstances. The ordinary quantity of sewage to be pumped daily we have concluded to regard as no gallons per inhabitant, when serving a 94 STATE SANITATION population of 150,000, and 120 gallons per inhabitant when this population grows to be 300,000, — making 16,500,000 gallons per day to be pumped presently after the completion of the works, and 36,000,000 gallons to be disposed of forty years later. The area required to filter these quantities of sewage varies within a very wide range, depending upon the character and the porosity of the filtering material and the disposal to be made of the effluent. The Board has made very extended experiments upon the Saugus Marshes to determine the quantity of water that will go down through the surface when kept constantly covered with one or two inches of water, and underdrained at the depth of six feet, and the water in the drains kept from three and a half to five feet below the surface. Experiments have also been made to learn the quantity that would pass through where the surface was kept covered but a part of the time. These experiments were in charge of Mr. Ball from their com- mencement in April till the latter part of July, when owing to ill health he found it necessary to discontinue work, and they were continued till the first of October in charge of Mr. Frederick Brooks, civil engineer of Boston. At each of four different places on these marshes two circular beds were arranged with underdrains, and dikes to prevent over- flow by the tide. One of these beds retained the surface of turf; the other had the turf to the thickness of four inches removed and the surface spaded up as if to be planted. Upon these beds, about fifteen feet in diameter and separated from the surrounding marsh by a low embankment, water was applied to the depth of two inches. Outside of this embankment, a few feet away, was a second encirchng embankment; and out- side of this, a third embankment. Between these embankments water was kept, as near as practicable, at the same height as in the interior area. At one place, intermediate between two others, a single bed ten feet by twenty feet was built, with the three fines of encir- chng embankments; in this bed the surface of turf was retained. NORTH METROPOLITAN SYSTEM OF SEWERS 95 Arranging the beds in the order of the depth of peat, we give in the following table the quantity of water that passed through the surface of each when kept continually covered with water, while the water in the underdrains was kept from three and a half to five feet below the surface : — Table 12 Depth of Quantity of Water Passing Through the Surface when Continually Covered Peat In Gallons per Acre per Day Feet Natural Surface with Turf Turf Removed and Surface Spaded 1-5 1-7 2.1 3-5 S-o 39,000 40,000 100,000 21,000 3,500 34,000 32,000 23,000 3,800 Experiments were made at six of the beds on the marsh to see the effect of allowing the surface to remain dry, after each appli- cation of water, as long a time as it took for about two inches in depth of water to disappear. The result of this intermittent treatment, with intervals of one to two days, continued for ten days or two weeks, was, that very Httle increase of capacity to transmit water followed such intermission; so that during a month when the surface is covered with water half the time, but Kttle more than half the quantity of water will flow through if it be kept constantly covered. The experiments of the Board upon the filtration of sewage by other material than peat show that the amount of sewage that can be filtered, month after month, is very much less than the amount of clear water that will continually flow through the material of the filter. Most of the good filtering materials with which the Board has experimented will allow from ten times to one thousand times as much clear water to flow through them as the marsh surface, and will filter, giving an efiiuent suitable to turn into Pines River near a bathing beach, from less than one per cent to more than six per 96 STATE SANITATION cent of the amount of clear water that will at first flow through them. But the material, not peat, which has filtered satisfac- torily, and which is most nearly comparable with the marsh material, is composed of fine and coarse sand and a little fine gravel, overlaid by about twenty inches in depth of yellow loam and brown soil. This material allowed three times as much clear water to pass through it as the average of the marsh, and for a time filtered satisfactorily for the purpose there required one- third as much sewage as it at first passed of clear water ; but this quantity of sewage grew less by the choking of the surface, until but one-twentieth as much would pass as originally of clear water. Then the surface was scraped off to the depth of half an inch, when it filtered readily and satisfactorily a quantity of sewage equal to one quarter of the original quantity of clear water; but this quantity gradually grew less and in one month filtered but one-eighth of the original quantity of clear water. These results induced the Board to make experiments to deter- mine, as near as practicable in the time at its disposal, the amount of sewage that can be filtered by material taken from the marsh at the location of the four double beds above described. When digging the drain between the two beds at each place a pillar of the material two feet square and five feet high was left; and this was carefully cut in layers six inches deep and placed in order in boxes, which were taken to the experimental station at Lawrence; and each layer was carefully cut to a circle twenty inches in diameter, and the bottom layer was placed in a galva- nized iron tank twenty inches in diameter, upon a bed of six inches of coarse and fine gravel and coarse sand, which served as an underdrain; and each layer from the marsh was placed above this, in its order, filling the tank to the depth of five feet. Four tanks, filled in this way, represented as nearly as practicable the actual condition of the material in the marsh at the four localities. Sewage has been appKed to the peat in these tanks in such quantities as it would receive, for six and seven months, with results which are given in much detail because of their importance in deciding the question of the practicability of filtering sewage through a layer of peat. NORTH METROPOLITAN SYSTEM OF SEWERS 97 Tank No. i of material from Saugus Marsh, having one and a half feet in depth of peat, with the peaty sand and clear sand below, making a total depth of five feet, being completely under- drained, was supplied with sewage, keeping the surface covered continually with a depth of about five inches, for three months, with the following result: — During the first month the flow from bottom of tank was at the rate of .... 22,000 gals, per acre per day During the second month, at the rate of. . 16,000 " " " " " During the third month, at the rate of . . . 9,200 " " " " " During the fourth month the sewage on the surface, five inches deep, was allowed to settle away and disappear, which it did in twenty-eight days. The quantity flowing out decreased to 5,000 gallons on the fifth day, and on the day before sewage disap- peared from the surface the quantity flowing was but 2,400 gallons per acre. For the next three weeks about the quantity which came out was applied intermittently, allowing the surface to become uncovered after each application, and the quantity flowing out decreased to 1,200 gallons per acre per day. At the end of this time the surface dried sufl&ciently for the mass of peat to shrink away from the sides of the tank, leaving a crack through which liquid could flow down freely for some distance, so that the quantity increased for a week to 11,000 gallons per acre per day; but by keeping the surface continually covered, the peat again swelled and the crack filled with slime, and the average daily out- flow for the sixth month was 5,200 gallons, decreasing in the latter part of the month to 3,600 gallons, and during the seventh month the average daily flow for three weeks was 3,000 gallons, decreasing to 2,400 gallons per acre per day. It is evident that the sewage came through this material, for the chlorine from the salt marsh decreased in the first two months from 1,200 parts in 100,000 to 75 parts, and has since decreased to 31 parts. The ammonias, being in the first sample o.io parts in 100,000, decreased nearly in proportion to the decrease in flow in two months to 0.02 parts, and have since increased and averaged during the past month 0.26 parts. 98 STATE SANITATION The effluent is now suitable to turn into an arm of the sea near a bathing beach, but as no nitrification takes place it is probable that the filtering material is storing up ammonia that will come out later, rendering the effluent objectionable. Keeping the surface continually covered with sewage, as in the earlier experi- ments, the surface becomes covered with a disagreeable sKme, which, on account of the very slow percolation of the Hquid, accumulates rapidly, and, no doubt, has the effect to close up the interstices of the peat and cause the amount flowing through to decrease so rapidly. But the choking of the surface appears in the later experiments to be more complete when the water is allowed to drain out of the slime after it has been deposited. The experiments upon this material prove to the Board that an area of sand covered with peat to the depth of even one foot is unsuitable to be used for a filtration area. They indicate that if so used the surface will become covered with a slime which will prove a nuisance ; that sewage applied to such an area in winter will have to remain so long upon the surface that it will freeze and the whole become inoperative ; that under the most favorable circumstances the quantity of sewage which can flow through the peat is so small, and the effluent so little improved by passing, that it is not expedient to use it for this purpose; and that the only way to render such an area suitable for filtration is to remove the peat entirely from the sand and apply the sewage directly to the sand. To remove peat from the marsh surface to the depth of one foot would cost as much as four hundred dollars per acre, which indi- cates that it would be unreasonable to consider the practicability of using the marsh for filtration where there is more than one foot in depth to be removed. The whole area of the Saugus Marshes, where the depth of peat is not more than one foot, is about four hundred and twenty- eight acres, of which about sixty acres are in detached pieces, and the remainder is in three distinct areas. One of these, southwest of Pines River, near Linden Station, contains about one hundred acres with peat six inches to a foot thick, underlaid with sand. Over about one-half the area NORTH METROPOLITAN SYSTEM OF SEWERS 99 the sand is very compact, and allows water to percolate very slowly. Another section, in the vicinity of, and including the Franklin Trotting Park, contains about one hundred and twenty acres, with peat from six inches to a foot deep, much of which is under- laid with perhaps six inches of peaty sand, below which over three- quarters of the area is open sand, which alone at a proper height above tide water would be good filtering material. The other quarter of the area has, beneath, a compact material which allows water to percolate very slowly. The third section contains about one hundred and fifty acres and is on either side of Bristow Street but mostly north of it. This area is of better material than the others, about thirty acres of it being from two to four feet above the marsh level and covered with soil containing some peat, with very open sand below. This could be used advantageously for filtering, but it is also valuable for agriculture, for which it is said to be worth three or four hundred dollars per acre. Adjacent land is laid out into streets with sewers. This section of one hundred and fifty acres is subjected to a mean height of water greater than the remainder of the marsh, owing to the dam of the Newhall tide mill, which allows a range of water from high tide to only three or four feet below the surface of the marsh. The cost of the land and the removal of peat from these tracts would probably exceed five hundred dollars per acre. Diking, underdraining, preparing carriers from the pumping station and returning drains to the pumping station, would probably exceed six hundred dollars more per acre. An indefinite, but consider- able expense, must be incurred in diverting and pumping rainfall coming from surrounding higher land. The cost of pumping ground water and sewage effluent, after the sewage is filtered, would be much larger than was estimated when it was supposed that the marsh material would serve as a filter, and the whole was to be used in one area. And the most that can be expected of the three areas would be the filtration of 20,000 gallons a day per acre on 370 acres, or 7,400,000 gallons, which, at no gallons per inhabitant, would serve for 67,000 people. lOO STATE SANITATION The circumstances are so unfavorable that it is not necessary to carry the investigation further to see that the expense of prepara- tion and yearly maintenance would be so great as to exclude the use of these areas for filtering the sewage even of the adjacent towns of Maiden, Melrose, Everett, and Revere, which, in forty years, would tax the area to its full capacity. We have to conclude, then, from the additional information obtained by the experiments and investigations of the past year, that the Saugus Marshes will not serve for a filtering area for the sewage of the Mystic VaUey; and as there is no other area avail- able for filtering this sewage, its disposal by filtration must be abandoned. For the system now to be considered, including the towns of the Mystic Valley, together with Cambridge, Somerville, Charles- town, East Boston and Winthrop, which we designate the North Metropolitan Sewerage System, the only reasonably practicable method of disposal is, the discharge of crude sewage into the sea; for the method by chemical precipitation, which was too expensive for adoption, as compared with this method, when considering the smaller territory, would be so to a much greater degree when a territory containing double the population is included ; and the method by filtration upon land cannot be adopted, because there is not sufficient land available to filter one-eighth of the sewage. We have then first to consider where into the sea, and under what conditions, this quantity of sewage can be poured, at a reasonable cost, with the least resulting discomfort. Careful study of the tidal currents has been made by running floats from Shirley Gut; from Faun Bar Beacon, which is three- quarters of a mile east from Deer Island ; and from Deer Island Beacon, which is one-third of a mile south from the southern- most point of Deer Island and in the north edge of the main ship channel. For the quantity of sewage to be discharged from the North MetropoKtan District, the currents at Shirley Gut are of too short duration and would not carry the sewage beyond adjacent flats. Either of the other sites may be used, but more satisfactory dis- persion of the sewage, — because of stronger currents, — and less NORTH METROPOLITAN SYSTEM OF SEWERS loi cost in construction, render Deer Island Beacon preferable. From this locality floats have been run at all stages of the tide to determine the course that sewage will take if discharged here. From the paths of these floats it is evident that sewage dis- charged in any desired quantity, from one hour before high tide to four hours after, will not approach any shore where it can give the least offence. It will be carried to sea through the north and south channels never to return. Careful study has also been made of the results that may be expected if the sewage be discharged here continuously through the twenty-four hours. In this study observations were made upon the sewage discharged at Moon Island, where the rate of outflow during the time of discharge may be called fifteen times that of the continuous flow at Deer Island. From Moon Island the sewage flows away with the tidal current at the speed of about one mile per hour and spreads to a width of about three thousand feet. One-fifteenth of this quantity dis- charged continuously at Deer Island, flowing with a tidal current having a greater velocity, will evidently spread to a much less width. If it spreads to one- sixth the extent, or to five hundred feet, the layer of sewage upon the salt water will be much thinner than that from Moon Island, and will more quickly become dissi- pated. Assuming this to be the width, plottings have been made to show, from the paths taken by twenty floats started at different times during the rising tide, the probable position of the succes- sive areas of sewage starting from the proposed outlet on each hour before and after low water, as they would be at one hour from the time of starting and at two hours from the time of starting. These plottings are presented upon a map ^ of the harbor, on which the darker shade represents the position of the sewage within the first hour, and the lighter shade the position within the second hour after starting. As the direction of the cur- rent continually changes, the sewage dehvered between the hours will be distributed over the whole area between the paths of the floats started upon the hour, as shown by the dotted areas. ^ This map is not reproduced here. I02 STATE SANITATION The front of the body of sewage at two hours from the time of starting will, from experience at Moon Island, be entirely obliter- ated, and no appearance of sewage can be recognized farther away than the shaded area upon the map indicates, unless it be an occasional grease-ball or some other small floating sub- stance that has escaped through the racks above the pumping station. At the Moon Island outlet of the Boston Main Drainage System the sewage collected in eleven hours is generally dis- charged in a body in about half an hour, and, as stated above, no sewage is to be found in the tidal current into which it enters two hours after it leaves the sewer. That we might make observa- tions and reach just conclusions in regard to a stream of sewage discharging continuously, the officers in charge of the Boston Main Drainage Works kindly co-operated with the Board by discharg- ing continuously, on a falling tide, for four hours, about 1,500,000 gallons per hour, the equivalent of 36,000,000 gallons per day, which is the amount estimated to be discharged at Deer Island outlet when the population is between 300,000 and 400,000. When sailing in the stream of sewage, or on the leeward side of it, from near the outlet of the sewer and for a distance of half a mile along the stream, the odor of the sewage was disagreeable. Continuing in the stream of sewage beyond this distance the odor was noticeable for a time, but before reaching the distance of three-quarters of a mile from the outlet of the sewer the odor could not be distinguished. At this distance, however, the color of the water was distinctly different from the blue of sea water, — it was more opaque and browner. But there was nothing, at this distance, with wind blowing up stream toward the outlet of sewer, either in appearance or odor, that was in the least objec- tionable. The appearance of the water here was like that in the upper harbor in midstream, between the Cunard wharf and the New York and New England railroad docks. By the color and stillness of the surface the area containing sewage could be distinguished for a quarter of a mile farther, or at a distance of one mile from the outlet; but no odor could be distinguished, and there was no disagreeable appearance. NORTH METROPOLITAN SYSTEM OF SEWERS 103 At one mile and a quarter a narrow strip of smooth water and a slightly opaque character of the water, — seen only upon very careful examination, — indicated an effect from sewage; but at one and a half miles from the outlet no trace of the sewage could be seen, although floats which started with the sewage had gone far beyond. To present this subject with more definiteness than can be con- veyed by recording the observations of individuals, samples of the water taken from the middle of the stream of sewage were subjected to most careful chemical tests, in comparison wdth the adjacent salt water which was unaffected by this sewage, and with the salt water of the inner harbor. Samples of the sewage throughout the stream of observable sewage and beyond were taken within eight inches of the surface, after the stream had flowed in nearly the same place for three hours, and were subjected to chemical analysis with the following results : — Table 13 (Parts per 100,000) Free Ammonia AJbu- minoid Ammonia Sum of Ammonias .0056 .0098 .0154 .0056 .0095 .0151 2.5000 •5310 3-0310 .1944 .0636 .2580 .0416 .0254 .0670 .0224 .0116 .0340 .0184 .0156 •0340 .0136 .0108 .0244 .0104 .0096 .0200 .0480 .0154 .0634 Chlorine Salt water, up stream, from area containing sewage Salt water, down stream, from area contain ing sewage Water, within area containing sewage, at the following distances from outlet: 400 feet 1,600 " 3,200 " 4,700 " 6,200 " 7,200 " 9,200 " Water in mid stream at crossing of North Ferry to East Boston 1,67s 1,746 773 1,570 1,621 1,694 1,689 1,687 1,710 1,581 From these analyses it appears that in the stream of sewage at four hundred feet from the outlet of the sewer the upper eight I04 STATE SANITATION inches in depth was about one-half sewage. At i,6oo feet distant it contained about one-eighteenth of its bulk of sewage, and at 3,200 feet, or five-eighths of a mile distant from the outlet of the sewer, the ammonias indicated the amount of sewage added to be but one per cent of the volume of the water, and the same amount as found in mid stream at the crossing of North Ferry to East Boston. Beyond this distance the amount of ammonia added became about one-half of one per cent at a mile, and less than one- tenth of one per cent at one and four-fifths miles from the outlet. These results confirm those of direct observation. With the ordinary wave motion at this place, a mile from the outlet, the amount of sewage remaining near the surface of the water is so small that no disagreeable appearance or odor can be recognized. From these experiments and the position of the currents shown upon the map, it is evident that the sewage discharged continu- ously at Deer Island Beacon will not reach any shores, nor lodge upon any flats that are exposed at low tide, nor come into the neighborhood of any dwelling, nor of land that is capable of being used for dwellings in the future, unless it be on a portion of Deer Island. To guard against deposits of heavy material near the proposed outlet, provision has been made in the designs, and the cost of operating included in the estimates, for removing at each of the pumping stations and at the river crossings whatever material of this kind may get into the sewers. This material will come principally from the street washings of the cities which now have the combined system of sewers, and will be removed by sand pumps or other contrivances, from places where it has been allowed to settle. The outlet at Deer Island Beacon is directly into a tidal current more than fifty feet deep, in which the velocity of more than two and a half miles per hour is much greater than that in the sewer, and the scouring effect of the currents, reversed twice daily, wiU readily remove everything which the sewer can bring there. This conclusion is confirmed by the experience at Moon Island, — where the maximum velocity of the tidal current is much less, — given in the report of the chief engineer of the Board. NORTH METROPOLITAN SYSTEM OF SEWERS 105 As a result of this study, the Board has concluded that it is advisable to construct the sewage works to discharge continuously the comparatively small stream of sewage as it arrives at the out- let. Should the time ever come when such a discharge proves objectionable, and the objection can be removed by holding the sewage back for one, two, or three hours after low tide, the capac- ity of the sewer between East Boston and the outlet will for several years be sufficient to allow of such storage during the hours named; and if it becomes desirable to store the sewage through the incoming tide and discharge it only when the out- going tide will carry it directly to sea, a reservoir can be then built on Deer Island as well as at the present time ; but the Board does not anticipate the need of such a reservoir. We have thought it unnecessary to dwell upon the vital impor- tance of providing rehef for the several communities included in the two populous districts, because the action of the General Court in directing this Board to consider, not whether such relief is required, but how it can be wisely accomplished, indicates that the people of the state have grown to appreciate the necessity of action, and desire only to be shown the best method of accom- plishing the purpose. To this problem we have devoted our energies with results which we are gratified to present. These show that complete rehef can be reached by expenditures which can reasonably be made by the populous and wealthy communities interested in the healthfulness of this great metropolitan territory. Henry P. Walcott, Elijah U. Jones, JuLros H. Appleton, Thornton K. Lothrop, Frank W. Draper, HmAM F. Mills, Theodore C. Bates, State Board of Health. XII SUGGESTIONS AS TO THE SELECTION OF SOURCES OF WATER SUPPLY 1 By Frederic P. Stearns [Mr. Stearns' paper described some of the fundamental principles relating to the storage of water and its relation to the yield of catchment areas. The data given have served as the basis of much recent work. The original paper included sections not here given on the quantity of groimd water and the quality of surface and ground water. Twenty-second Annual Report, 1890, p. 335. — G. C. W.3 In selecting a source of water supply, it is essential that all water should be rejected which is seriously polluted with domestic sewage. There are other waters not so polluted, as for instance those having a disagreeable taste and odor or drawn directly from swamps, which are manifestly unfit for drinking. A water may also be rejected by reason of its extreme hardness, which makes it unsuitable for washing purposes and for use in boilers. Among the waters which may be used there is a large difference in quality, and this in connection with the quantity and cost should receive careful consideration in making the selection. Sources may be divided into two general classes, those in which the supply is taken from the ground, known as ground waters, and those obtained from lakes, ponds, streams and storage reservoirs,, known as surface waters. The prominent characteristic of ground water is freedom from color and organic matter (including microscopic organisms),, while surface waters are frequently colored with vegetable matter derived from swamps, and almost always contain a greater or less number of microscopic or larger organisms, which, when abund- ant, frequently impart to the water a disagreeable taste and odor. With regard to the question of quantity, sufficient surface water can be obtained for the largest cities, and the amount which ^ These suggestions are based mainly upon observations in Massachusetts, and, in some respects, will be inapplicable to other places where different conditions pre- vail. 106 SELECTION OF SOURCES OF WATER SUPPLY 107 can be obtained from a given watershed can be estimated in ad- vance with a large degree of accuracy. Ground water supplies, on the other hand, are much more limited in quantity, and the amount to be obtained from any given place cannot be as accur- ately predicted. As a whole we may say that when unpolluted ground water can be obtained in sufficient quantity from regions where the water does not dissolve much mineral matter and in this way become hard, it is very much to be preferred to surface water for the supply of a city or town. With these general statements we will proceed to consider in greater detail the quantity and quahty of water to be derived from surface and ground water sources, including among the ground waters those taken from wells and filter-galleries built beside streams and ponds, and deriving their water, in part, from these surface waters, by filtration. The question of the quality of waters variously situated has been so fully treated in the Special Report of the Board, Part I, 1890, that the present article will give greater prominence to the quantity of water to be obtained under different circumstances. Quantity of Surface Water All sources from which water is obtained depend for their supply upon the rain which falls upon the area from which the water can flow over the surface or under ground to the point whence it is taken for use. In a great majority of cases this area coincides with the superficial watershed of the stream or pond utilized. We have, therefore, as very important factors affecting the quantity of water, the amount of the annual rainfall and the area of the watershed. The whole of the rain which falls upon a watershed does not flow off into the streams, because much is lost by evaporation from the surface of the ground. The amount of this loss has been determined practically by comparing the quantity of water falling upon a given watershed (as deduced from the depth of rainfall and the area of the watershed) with the amount of water flowing off in the streams. Very valuable records of this character have io8 STATE SANITATION been kept by the city of Boston for many years at Cochituate Lake, Sudbury River and Mystic Lake, and the results have been published in the annual reports of the Boston Water Board. From these we learn that the average percentage of rainfall collected from these three watersheds is as follows : — Table 14 Average Rainfall Average Rainfall Collected Per Cent Collected Lake Cochituate (28 years' observations) . . . Sudbury River (16 years' observations) Mystic Lake (13 years' observations) Inches 47.82 45.80 44.11 Inches 20.55 22.67 20.22 42.97 49-5° 45-84 In attempting to determine the quantity of water which can be made available for use from any given source, the above figures, representing the average results of many years' observations, have only a limited value, because there is a marked variation in the amount of rainfall in different years and a still greater difference in the amount of rainfall collected, the rule being that the per- centage collected decreases with the amount of the annual rain- fall; moreover, there is a vast difference in the amount of rainfall collected at different seasons of the year. In view of these dif- ferences it is obviously necessary to take into account the rainfall collected during dry periods of much less than a year's duration. This can be done by means of the records of the Boston Water Works above referred to. Of these the Sudbury River records are the most accurate and the most generally applicable to conditions existing at other places, and, on account of their value as a basis for water supply estimates, they are reproduced from the reports of the Boston Water Board in the following table. "^ As has already been indicated it is necessary in estimating the capacity of sources of water supply to take into account the dryest periods which have occurred, and which consequently may recur; and for this reason it is the minimums recorded in the foregoing table which have the most value. These for periods varying in duration from one month to sixteen years have been carefuUy 1 Owing to the length of this table it has not been reproduced here. SELECTION OF SOURCES OF WATER SUPPLY 109 selected from the table, and are presented in more convenient form in the one which follows : — Table 15 Table showing the Average Daily Flow from the Sudbury River Water- shed FOR Different Periods, varying from One Month to Sixteen Years, selecting in Each Case the Dryest Period of the Given Duration Dates Average Daily Flow of Watershed Length of Period Gallons per Day per Square Mile Gallons per Day per Acre Cubic Feet per Second per Sq. Mile I month September, 1884 44,000 69 .068 2 months Sept. I 1884 to Oct. 31, 1884 64,000 100 .099 3 months July I 1883 to Sept. 30, 1883 95,000 148 .147 4 months July I 1883 to Oct. 31, 18S3 118,000 184 .183 5 months June I 1880 to Oct. 31, 1880 131,000 205 .203 6 months June I 1880 to Nov. 30, 1880 143,000 223 .221 7 months June I 1880 to Dec. 31, 1880 147,000 230 .227 8 months June I 1880 to Jan. 31, 1881 181,000 283 .280 9 months May I 1880 to Jan. 31, 1881 219,000 342 •339 10 months April I 1880 to Jan. 31, 1881 312,000 487 .483 II months Mar. I 1880 to Jan. 31, 1881 409,000 639 •633 I year Mar. I 1880 to Feb. 28, 1881 497,000 777 .769 2 years Feb. I 1882 to Jan. 31, 1884 687,000 1,073 1.063 3 years Mar. I 1880 to Feb. 28, 1883 764,000 1,194 1. 182 4 years Feb. I 1880 to Jan. 31, 1884 735,000 1,148 I-I37 5 years Jan. I 1879 to Dec. 31, 1883 769,000 1,202 1. 190 6 years Oct. I 1879 to Sept. 30, 1885 803,000 1,255 1.242 7 years Jan. I 1879 to Dec. 31, 1885 839,000 1,311 1.298 8 years Jan. I 1879 to Dec. 31, 1886 870,000 1,359 1.346 9 years Jan. I 1879 to Dec. 31, 1887 902,000 1,409 1.396 10 years April I 1878 to Mar. 31, 1888 944,000 1,475 1. 46 1 II years Jan. I 187s to Dec. 31, 1885 968,000 1,512 1.498 12 years Jan. I 1875 to Dec. 31, 1886 978,000 1,528 1-513 13 years Jan. I 1875 to Dec. 31, 1887 991,000 1,548 1-533 14 years Jan. I 1875 to Dec. 31, 1888 1,042,000 1,628 1.612 15 years Jan. I 1875 to Dec. 31, 1889 1,065,000 1,664 1.648 16 years Jan. I 187s to Dec. 31, 1890 1,079,000 1,686 1.670 With such a vast difference in the average daily flow during the dryest month and the dryest year, and also in the flow during the dryest year and a long series of years, it is obvious that the quan- tity of water which can be made available from a given water- no STATE SANITATION shed depends very much upon the amount which can be stored in seasons when water is abundant for use during seasons of drought. It is feasible to deduce from the Sudbury River records a table which will show directly the amount of storage necessary to make available different quantities of water per day from each square mile of watershed,^ where the conditions are similar to those Table i6 Table showing the Amount of Storage reqxjired to make Available Differ- ent Daily Volumes of Water per Square Mile of Watershed,^ based upon the Records of the Flow of Sudbury River from 1875 to 1890, inclusive Daily Vol- ume per Storage required per Square Mile to prevent a Deficiency in the Season of Great- est Drought when the Daily Consumption of Water is as Indi- cated in the First Column Dates when Greatest Draught from Reservoir would have occurred during the Period. 1875-1890 Length of Time Reservoir would have been Square Mile Beginning of Draught upon Reservoir Lowest Point Reached Reservoir Full Again High Water Mark GaUons Gallons 100,000 2,200,000 Sept. 1884 Oct. 1884 Nov. 1884 3 months 150,000 5,300,000 Sept. 1884 Oct. 1884 Dec. 1884 4 months 200,000 11,000,000 June, 1880 Dec. 1880 Feb. 1881 9 months 250,000 22,000,000 June, 1880 Dec. 1880 Feb. 1881 9 months 300,000 33,000,000 June, 1880 Dec. 1880 Feb. 1881 9 months 400,000 54,000,000 June, 1880 Dec. 1880 Mar. 1881 10 months 500,000 78,000,000 June, 1880 Jan. 1881 Mar. 1881 10 months 600,000 105,000,000 May, 1880 Jan. 1881 Mar. 1881 1 1 months 700,000 156,000,000 June, 1882 Dec. 1883 Mar. 1884 I yx. 10 mos. 800,000 214,000,000 June, 1882 Dec. 1883 April, 1884 I yr. II mos. 900,000 373,000,000 June, 1879 Dec. 1883 May, 1887 8 years 1,000,000 540,000,000 June, 1879 Dec. 1883 Mar. 1890 loyrs. lomos. 1,024,000 596,000,000 June, 1879 Oct. 1885 May, 1890 1 1 years which exist at Sudbury River. A table of this character is given above, which, in addition to the amount of storage required, gives the length of time the reservoir would have been below high water mark during the dryest period of the given duration, and ^ The area of the Sudbury River watershed, as used for making up the records^ includes both land and water surfaces. 2 Including water surfaces amounting to 2.31 per cent of the land surface. SELECTION OF SOURCES OF WATER SUPPLY iii the date when the water in the reservoir would have reached its lowest level. Having deduced from the Sudbury River records the facts given in the last table, we have next to consider to what extent they are apphcable to other watersheds. It may be said in a general way that the dry weather flow of different streams per square mile of watershed, without artificial storage, is hable to differ greatly; but that the total yearly flow does not vary nearly as much. In many cases it will be found, by applying the Sudbury River records directly, that there is so great a difference between the estimated yield and the amount of water required that any further refinement is unnecessary. In other cases it is necessary to take into account everything which may affect the application of these records. The chief causes of variation in the yield of different watersheds per square mile, after taking into account the in- fluence of storage, are: the amount of rainfall and its distribution throughout the year, the area of water surfaces, the character of the surface of the ground as regards topography and material, and the size of the watershed. There is also another feature which frequently requires consideration, particularly with small and steep watersheds; namely, the loss of water by leakage past dams and by filtration through the ground to a lower level. The conditions which existed upon the Sudbury River water- shed during the time included in the records were as follows : The area of the watershed from which the flow was measured was 77.764 square miles until the end of 1878, then 78.238 square miles until the end of 1880, and after that time 75.199 square miles. These areas include all water surfaces. From the begin- ning of the observations until the end of 1878, the water surfaces consisted of Farm Pond, Whitehall Pond (which was flowed in winter and drawn down in summer), several mill ponds, and the various streams. The area of these combined water surfaces was equal to i .02 per cent of the land surfaces. The construction of artificial storage reservoirs has since increased the area of water surfaces. Three reservoirs were completed and filled in 1879, making the total area of water surfaces after this date, until 1886, 2.31 per cent of the land surfaces. In 1886, Reservoir No. 4 was 112 STATE SANITATION added, increasing the per cent of water surfaces to 2.92. The dryest periods occurred between the years 1879 and 1886, and it may therefore be assumed that the water surfaces of Sudbury River which had the most effect upon the present records were 2.31 per cent of the land area. The flow of the river past the lowest dam has been greatly modi- fied by the use of the artificial reservoirs; but this does not appear in the records, because the amount flowing past the dam is cor- rected by the amount added to or drawn from storage. The object in making these corrections has been to eliminate the effect of the reservoirs and to present in the records the natural flow of the stream modified only by such storage as is furnished by ordi- nary mill ponds and by Whitehall Pond. It cannot, however, be said that the effect of the reservoirs is wholly eliminated, because the evaporation from the increased water surfaces is not taken into account; and the dry weather flows recorded are conse- quently less than they would be if these reservoirs did not exist. The average annual rainfall upon the Sudbury River water- shed is nearly the same as that in other parts of the state, so that it is not often necessary to take into account any difference of this kind. The watershed of the Sudbury River contains many hills with steep slopes, some of which are used for pasturage and others are covered with a small growth of wood. The valleys, as a rule, are not steep, and there are extensive areas of swampy land, generally covered with a growth of brush and trees. The hills are, for the most part, of rather impervious clayey material, containing boulders, while the flat land is sandy and in some cases gravelly. The special characteristics of the Sudbury River watershed have thus been described in detail, so that in applying the results to other watersheds such modifications could be made as would be rendered necessary by the difference in conditions. In this paper further consideration will be given only to the effect of a varying percentage of water surfaces upon the yield of watersheds, and to the flow during short periods of drought. With regard to the effect of water surfaces it has been a common practice to leave them out of consideration in estimating the area SELECTION OF SOURCES OF WATER SUPPLY 113 of a watershed, upon the assumption that the evaporation from water surfaces offsets the rainfall upon them. The Sudbury River records, however, were not made upon this basis, and they are therefore strictly appHcable only to watersheds which have the same proportion of water surfaces, unless a correction is made for evaporation. A table will be presented subsequently which gives the yield per square mile of land surface, when in addition to the land there is a var3dng percentage of water surfaces. Before presenting this table, however, it may be well to indicate in a general way the relation of the evaporation from water surfaces to the rainfall upon them. For determining the amount of evaporation, the most valu- able information is to be obtained from the paper ^ presented by Desmond FitzGerald, C.E., to the American Society of Civil En- gineers, based upon experiments made upon the Boston Water Works, chiefly at Chestnut Hill Reservoir, Boston. In his paper, as the result of several years' experiments, a mean evaporation for each month of the year is given. By comparing this with the mean rainfall for each month, we can obtain the relation between evaporation and rainfall in an ordinary year; and as the evapo- ration does not vary very much from year to year, we can also obtain approximately the relation between the evaporation and rainfall in a dry year, by comparing the average evaporation with the rainfall in a dry year Like 1883. The results of these comparisons are shown by the table and diagram on the pages following. It will be seen from the facts presented that the monthly rain- fall varies much less during the year than the evaporation; also that in an average year the rainfall is 6.68 inches greater than the evaporation. The average year may be divided into two periods, one extending from May to September, inclusive, in which the evaporation is 8.77 inches greater than the rainfall; and the other extending from October to April, inclusive, in which the rainfall exceeds the evaporation by 15.45 inches. ^ "Evaporation," by Desmond FitzGerald, C.E., Transactions of the American Society of Civil Engineers, vol. XV, 1886, p. 581. 114 STATE SANITATION In the year of low rainfall the evaporation was 6.34 inches greater than the rainfall. During the warmer months, from April to September, inclusive, the excess of evaporation was 15.22 inches, and during the other six months the rainfall was 8.88 inches in excess of the evaporation. These figures indicate that a Table 17 Table showing Relation of Evaporation to Rainfall (Note. \- indicates excess of rainfall; — indicates deficiency) Month Average Year Rainfall Evapora- tion Excess or Deficiency of Rainfall Year of Low Rainfall Rainfall Evapora- tion Excess or Deficiency of Rainfall January . . February . March ... April May June July August. . . September October. . November December . Inches 4.18 4.06 4.58 3-32 3.20 2.99 3-78 4-23 3-23 4.41 4.11 3-71 Inches 0.98 1. 01 1-45 2-39 3.82 5-34 6.21 5-97 4.86 3-47 2.24 1.38 Inches + 3.20 + 3-05 +3-13 +0-93 — 0.62 -2.25 -2.43 -1.74 -1.63 +0.94 + 1.87 + 2.33 Inches 2.81 3.86 1.78 I.8S 4.18 2.40 2.68 0.74 1.52 5.60 1.81 3-55 Inches 0.98 1. 01 1-45 2-39 3-82 S-34 6.21 5-97 4.86 3-47 2.24 1.38 45.80 39.12 +6. 32.78 39.12 Inches + 1.83 + 2.85 +0-33 -0-S4 +0.36 -2.94 -3-53 -5-23 -3-34 + 2.13 -0.43 + 2.17 -6.34 pond will not lower by evaporation in a dry summer more than about fifteen inches, even if it receives no water from its water- shed. In order to present in the most convenient form the yield of watersheds per square mile, the following table has been pre- pared, which gives the quantity of water which may be made available per square mile of watershed (estimating land surfaces only), with var3dng amounts of storage and a varying percentage of water surfaces. In preparing the table the records of the flow of Sudbury River and of the rainfall upon the Sudbury River SELECTION OF SOURCES OF WATER SUPPLY 115 ^an. rcb. maft. apr. may- june july aug-. scpt. oct. nov occ Fig. 3. Diagram showing the Relation of Evaporation to Rainfall Note. — The curved lines show the average evaporation in inches per month, and the horizontal lines the rainfall, also in inches, per month. The finer hatching indicates the excess of rainfall, and the coarser hatching the excess of evaporation. ii6 STATE SANITATION watershed from 1875 to 1890, inclusive, have been used; also the records of evaporation from water surfaces from observations made chiefly at Chestnut Hill Reservoir during the years 1876 to 1880 and 1885 to 1887. For other years, when the evapora- tion was not measured, the average evaporation has been used. The flow per square mile is in all cases the smallest recorded after taking into account the evaporation from water surfaces. Table 18 Table showing the Amount of Storage required to make Available Differ- ent Daily Volumes of Water per Square Mile of Watershed (estimat- ing Land Surfaces only), corrected for the Effect of Evaporation and Rainfall on Varying Percentages of Water Surfaces, not included IN estimating the Area of the Watershed Daily Vol- ume in Gals. per Square Mile of Land Surface Storage required in Gallons per Square Mile of Land Surface to prevent a Deficiency in the Season of Greatest Drought when the Daily Consumption is as indicated in the First Column, with the following Percentages of Water Surfaces 0% 3% 6% 10% 25% 100,000 556,000 3,000,000 8,800,000 150,000 3,400,000 7,100,000 13,400,000 200,000 9,400,000 11,700,000 18,000,000 250,000 19,000,000 22,200,000 25,400,000 300,000 29,800,000 33,000,000 36,100,000 400,000 52,000,000 54,400,000 57,500,000 .. 500,000 76,500,000 77,300,000 80,300,000 600,000 102,000,000 104,600,000 107,100,000 112,800,000 700,000 144,400,000 153,000,000 161,600,000 170,700,000 215,9 D0,000 800,000 202,300,000 210,900,000 219,500,000 228,600,000 273,8 D0,000 900,000 346,200,000 349,200,000 352,200,000 353,900,000 381,6 D0,000 1,000,000 514,600,000 516,700,000 519,700,000 523,600,000 532,2 DO, 000 The table shows that a daily yield of 1,000,000 gallons per square mile of land surface can be made available when there is a very large amount of storage, such as may be found in some in- stances where a large pond is fed by a very smaU watershed. To obtain this quantity, however, would require the reservoir to be below high water mark for eleven years; and during a consider- able portion of the time the water would not rise nearly to high water mark, even in the spring. In practice this would be objec- tionable as it would permit the growth of weeds, grasses and SELECTION OF SOURCES OF WATER SUPPLY 117 bushes on the exposed shores of the reservoir. Taking everything into account it may be said that the greatest amount which can be made practically available from a square mile of watershed does not exceed 900,000 gallons per day, and the cases are very rare in which more than 600,000 gallons per square mile per day can be made available when it is necessary to store the water in artificial reservoirs. As a matter of theoretical interest only, it may be said that to make available the average yield of the Sudbury River water- shed for the entire sixteen years (1,079,000 gallons per day per square mile) would require a storage capacity of not less than 725,000,000 gallons per square mile. This is about six times the amount of storage which it is now considered feasible to provide on this watershed. The amount of water which can be made available from a given watershed will not always depend upon the quantity of water which can be stored, because considerations of quahty require that the levels of the reservoir should not be made to fluctuate too much, and that the reservoir should not be drawn below high water mark for too long a time. The application in actual practice of the previous table may be better understood by giving an example. Let us assume that it is desired to know the yield of a pond having an area of 0.15 of a square mile and an available storage capacity of 225,000,000 gallons, which has draining into it 1.5 square miles of land surface. The amount of storage in this case would be equivalent to 150,000,000 gallons per square mile of land surface, and the water surface would equal ten per cent of the land surface. By looking in the column of the table headed ten per cent it will be seen that a storage of 150,000,000 gallons per square mile corre- sponds to a daily volume of between 600,000 and 700,000 gallons per square mile, or more exactly by proportion to 660,000 gallons, equal to 990,000 gallons daily for the whole watershed. The results obtained by this method will in some cases be practically correct. In other cases it will be necessary to take account of local conditions, prominent among which may be leakage past a dam or filtration through the ground to lower levels; and the ii8 STATE SANITATION application of judgment will often be necessary to determine whether the watershed under consideration will yield the same or a greater or less amount per square mile than that of the Sud- bury River. The only point remaining to be considered with regard to the quantity of surface water relates to the flow from watersheds during short periods of extreme drought. The flow during such periods is chiefly of importance when it is desired to know the minimum flow of streams on which little or no storage can be obtained. On such watersheds the water surfaces are generally insignificant, so that the Sudbury River records are not applicable unless they are corrected for evaporation. It is well known that the natural dry weather flow of streams per square mile depends much upon the extent of the watershed; because it is frequently observed that streams draim'ng but a small area dry up in sum- mer, while those draining large areas continue to flow, though with a greatly reduced volume. There is also a large variation in the dry weather flow from watersheds of the same size due to the amount of water stored in the ground and subsequently coming out in the form of springs. The records of the natural flow of streams in a very dry period are very meagre. The lowest flow of the Sudbury River occurred during the month of September, 1884, and averaged only 44,000 gallons daily per square mile of watershed. Correcting for the excess of the evaporation from water surfaces over the rainfall upon them, we obtain 97,000 ^ gallons per square mile as the amount that the flow would have been if there had been no water surfaces. The next lowest monthly record was in September, 1877, 60,000 gallons per square mile. At this date the reservoirs had not been constructed and the area of water surfaces to be corrected for evaporation was smaller. Making the correction we have as the flow per square mile 82,000 gallons per day. ^ This quantity is somewhat larger than it should be as no account is taken of the water which came from the ground adjoining the reservoirs as they were being drawn down to supply the city. XIII THE GROWTH OF CHILDREN STUDIED BY GALTON'S METHOD OF PERCENTILE GRADES By H. P. BowDiTCH, M.D. [This is but a partial reprint of Dr. Bowditch's admirable paper. Because of their length the tables are omitted, as well as many of the diagrams. It is interest- ing to observe that the method of statistical analysis here used has been recently taken up by engineers in the study of rainfall and stream-flows, and by sanitarians in the study of bacteriological data. Twenty-second Annual Report, 1890, p. 479. — G. C. W.] In the last report of the Massachusetts State Board of Health the advantages of discussing statistical data by Galton's method ^ of percentile grades were explained and illustrated in a paper en- titled " The Physique of Women in Massachusetts." The value of the method in anthropometrical work seemed so obvious that it has been thought desirable to apply it to the large body of observations on the height and weight of Boston school children which formed the basis of an article on " The Growth of Chil- dren," published by the Board of Health in 1877. In this article, at the suggestion of Mr. Charles Roberts, tables were given showing the distribution of the observations; i. e., the number of individuals at each age whose height was recorded at each successive inch or whose weight fell within successive groups of four pounds each. From these tables it was easy to calculate the values at the various percentile grades. For example, it appears that the heights of 848 boys between five and six years old were distributed as shown in the table on the next page. In this table it will be seen that five per cent, for instance, of the total number of observations is 42.4. Now since the observations corresponding to each successive inch include all the measure- ments between that inch and the next inch above, it is evident that there are i-fi-f-7 + 17 = 26 individuals less than 38 inches in height and 1-I-1 + 7 + 17-I-42 = 68 individuals less than 39 ^ See " Galton, Natural Inheritance," London, McMillan & Co., 1889. I20 STATE SANITATION inches in height. Since, therefore, 42.4 lies between 26 and 68 it follows that the height below which five per cent of the observa- tions fall must be between 38 and 39 inches. The exact height can readily be calculated by interpolation. Thus the fraction of an inch to be added to 38 to give the required height is obtained by dividing 16.4 (i. e., 42.4 — 26) by 42 (i. e., the number of observa- Table 19 Distribution of Observations on Heights of Boston Schoolboys. Age at Last Birthday Five Years Inches Number of Observations Inches Number of Observations Inches Number of Observations 47 46 45 44 43 42 4 8 20 62 119 149 41 40 39 38 37 36 190 149 79 42 17 7 35 34 33 32 31 30 Total number of observations . tions between 38 and 39 inches). This fraction is 0.39, and, therefore, 38.39 inches is the height below which five per cent and above which ninety-five per cent of the observations fall; i. e., it is the value of the five per cent grade. In this way tables i to 12 have been calculated from tables 4 to 15 inclusive of the original article.^ These tables show the heights and weights of Boston school children of both sexes and various ages at percentile grades varying from five per cent to ninety-five per cent. Separate tables are, moreover, given for children of American parentage, Irish parentage, and for the whole number of observations irrespective of nationality. The values are given in both the English and the metric system of weights and measures, and in the last column of each table are to be found the average heights and weights of children of each age as given in the original article. The conclusions which may be drawn from a study of these tables will be best understood after an examination of the curves ^ These tables are not here reproduced. GALTON'S METHOD OF GRADES 121 which have been constructed from them, and as a preliminary to this study it will be well to consider briefly the general character of curves representing values at various percentile grades. A geometrical construction of a special case will perhaps best serve to place the matter in a clear hght. Let us suppose one thousand grown men standing in line arranged according to height. The heads of these men will form a curved hne repre- sented in its general form by the curve ST in Fig. 4. In this dia- gram the line SO represents the height of the shortest and the line Q 5% 107. 2Q'l 307 40% 50% 60% 70% 80% 90-/95% Q* Fig. 4 TO^ that of the tallest man. The curve ST, representing the heights of the intermediate men, is approximately a straight Hne in a large part of its course but bends up sharply at the right and down sharply at the left owing to the presence of a few very tall and a few very short men. Mediocrity is the rule and extremes the exception in height as in everything else. If now we divide this row of men into two equal parts and as- certain the height of the five hundredth man in the row (or, more accurately speaking, the height half way between that of the five hundredth and that of the five hundred and first man) we shall have a value below which one half and above which the other haK 122 STATE SANITATION of the observations lie. This value is termed by Galton the value of the fifty percentile grade, or the median value, and is desig- nated by the letter M. In the same way the values at other per- centile grades may be determined by dividing the row at points corresponding to various percentages of the total number of ob- servations. The percentile grades indicated in Fig. 4 are those adopted by Galton, and are practically sufficient to indicate the character of the curve. With a very large number of observations it would of course be possible to determine values below five per cent and above ninety-five per cent, but in anthropometrical investigations with existing data it does not seem wise to go beyond these limits. It is evident that the value M will tend to approximate to the average value of aU the observations and will be identical with it when the curve ST is symmetrically disposed on both sides of M, i. e., when the values at sixty, seventy, eighty, ninety and ninety- five per cent exceed M by the same amount, respectively, by which the values at forty, thirty, twenty, ten and five per cent fall short of it. If A represents the average value of all the observa- tions, then the value of M — A will be a measure of the direction and extent of the asymmetry of the curve ST, for this value wiU be zero when the curve is symmetrical, positive when the values at the lower percentile grades fall short of M more than those at the higher grades exceed it, and negative when the reverse is the case. Let us now apply this test to the data in our possession, confin- ing our attention for the present to tables i, 4, 7 and 10, which give the total number of observations irrespective of nationality. By subtracting the average from the median values in these four tables the table on the next page (No. 20) has been constructed. An examination of this table or of the curves constructed from it, as given in Figures 5 and 6, shows that the asymmetry of the curves of percentile grades varies very much, at different ages, both in direction and amount. The variation in the value of M — A in the curves of height is much the same as that in the curves of weight for each sex considered by itself, but there is a great differ- ence between the two sexes. This difference shows itself most dis- tinctly between the ages of eleven and fifteen years. During this GALTON'S METHOD OF GRADES 123 time a rise in the curves for the males coincides with a fall in those for the females, while before and after this period the curves, as a rule, rise and fall together. We must conclude, therefore, that the rate of annual increase both in height and weight is different at different percentile grades, or, in other words, that large chil- dren grow differently from small ones, and moreover, that between the ages of eleven and fifteen years there is a striking difference in Table 20 Values of M — A Age at Last Birthday Heights in Inches Boys Girls Weights in Pounds Boys Girls Five Six Seven . . . , Eight .... Nine .... Ten Eleven. . . Twelve . . Thirteen . Fourteen . Fifteen. . . Sixteen . . Seventeen Eighteen . + o.io + 0.12 + 0.09 + 0.08 + 0.08 + 0.05 + 0.07 0.00 — 0.23 - 0.28 + 0.07 + 0-35 + 0.05 + 0.13 + 0.14 + 0.05 + o.ii + 0.07 + 0.17 + 0.12 — O.OI 0.00 -f 0.24 + 0.26 + O.II + 0.19 + 0.26 — O.IO + 0.13 0.15 0.17 0-3S 0.28 0.12 0.44 1.18 1.94 1.88 1. 10 0.37 0.92 0.84 - 0.03 - 0.17 - 0.16 -0-59 - 0.4s - 0-95 - 1.22 - 1-23 - 0.63 -0.68 - 0.97 - 0.76 - 2.77 - 2.52 the mode of growth of the two sexes. The significance of this conclusion will be made clearer by an examination of the curves constructed directly from the tables of percentile grades. Curves of this sort are presented in Figures 7, 8, 9 and 10, containing the total number of observations irrespective of nationality. Similar curves have been obtained from the remaining tables in which the observations are grouped according to the nationahty of the parents, but as they are less regular, owing to the smaller num- ber of observations from which they are constructed, and lead to no additional conclusions, it has not been thought worth while to present them. 124 STATE SANITATION 0.4 0.2 0.2 0.4 AGE AT LAST BIRTHDAY 5 6 7 8 9 10 tl 12 13 14 15 l6 t7 iS / / ^,- < / Wi / ^ / \ / \ /,- \ \ / •^^ 1 \y \ > \ 1>^ / \ 1 / 1/ ^ "■ ' — >-^ \ 1 1 / \ \ \, 1 / » ' \ / \ \ / \ \ / \ / \ / \ / BOY '^ / GIRL Fig. 5. Heights of Boston School Children Median Minus Average Values (M-A) AGE AT LAST BIRTHDAY 5 6 7 8 9 10 II 12 B 14 15 16 17 18 lA 7- 3 a. 6 ~— . ^-^ s^^ __ — \ •\ __^^- k \ / -.^ 1.0 \ / ^, j^^ \ \ / \ \ / \ / \ \ / \ 2.0 \ — ■ — \ \ BOY \ GIRL \ ' ^y 3.0 Fig. 6. Weights or Boston School Children Median Minus Average Values (M-A) GALTON'S METHOD OF GRADES 125 A glance at the curves in Figures 7-10 shows at once the na- ture of the asymmetry, the existence of which is indicated by the curves in Figures 5 and 6. It will be observed that during the earher years of school hfe the curves for the successive years are HEIGHT INCHES 10 20 PERCENTILE GRADES. 30 40 50 60 70 80 90 AGE YRS n 17 70 ^ ^^-^ y 16 68 ■^ __,^ ■ " -^ ^ lb 66 — ■ — ■ ^^-^ 14 . — ■ -— — ^ •^ y 64 ' , ■ ^_^ , ^ ^ — ■ "' ^ ^ 62 / -^ ^ — " ^ li X ^^ ^ ^^ -^ ^ y 60 / -^ __-j ^ ^ 12 ^-' ^ -^ •" y 58 „---■ — . — -1 .- ^ y _, ,-^ '' -^ ^ II 56 . , — " „,-- ^ ^ ^. — ^ _ — — •— ^ ^ 10 54- "^ . ^ ■ L— -^ <-' -^ -^ , — — ' "^ "^ 9 52 ^ — __ r _^ — ' ^^ ' . — ■ ~~' — ^ a 50 , " — — " r- — ^^^ ^ ^ ' __ — - — ' ^ 7 48 „^^ ' — " __ ■ . ^ ,,-— ^ — —^ .— -^ 6 46 ^ — " ^ -^ . , '^ , — ■ — ' r^ <" - — ' : ■ b _, — — - ^ — ~^ -^ — 42 •^ ' ^_-. ■ ■ -^ — ■ ' 40 — — -^ ' 38 ^ _ Fig. 7. Heights of Boston Schoolboys Irrespective of Nationality fairly symmetrical, which is in harmony with the previous obser- vation that in these years the value of M — A does not differ widely from zero. At about ten years of age in girls and eleven or twelve years in boys, the curves become distinctly asymmet- rical, owing to the values increasing more rapidly at the higher than at the lower percentile grades. At the age of twelve or thirteen years in girls and fourteen or fifteen years in boys an 126 STATE SANITATION asymmetry in the opposite direction shows itself, since at this period the values are increasing more rapidly at the lower than at the higher percentile grades. These changes correspond accur- WG'T 10 20 PERCENTILE GRADES. 30 40 50 60 70 80 90 AGE LBS YR5 170 160 17 150 y ^ ,/ lt> 140 y^ ^ y — — ' ^ y 15 130 -—-' ^-- " y 14 120 _, — ^ ' ^ y __ ■^ ^ ^-— ' / 110 _.^ ' . ^ y^ 13 / -^ ^,^ y / 100 / ^ ^ ^"^ y y X ^ ■ ' ^ ■^ 12 90 y _— -^ ' , — ' — -^ y - 1 . ^^ It 80 y^ -- — " — ' --^ '■^ 10 r- " . ■ 1 ■ - -^ ^ _ . " 1 — — ■ 9 70 — ;,,. ■—^ . ^__ " r^ 8 60 „- — • " ' ■ k^ " ' 7 50 , — - — - — ' 5 -^ —" 40 r • ' ■ r — ■ 1 ' Fig. 8. Weights of Boston Schoolboys Irrespective of Nationality ately with the fall and rise in the value of M — A, as shown in Figures 5 and 6. In the original article on the growth of children it was shown that about two years before the age of puberty there is a period dur- ing which the growth in both height and weight shows a distinct acceleration. Now, the rate of growth at the various percentile grades is represented in Figures 7-10 by the vertical distances GALTON'S METHOD OF GRADES 127 between the curves corresponding to the successive years; and an inspection of these curves shows that the prepubertal period of accelerated growth, already shown to exist by a comparison HEIGHT INCHES. 10 20 PERCENTILE GRADES. 30 40 50 60 70 AGE 80 90 YR5. 68 66 ,-** 6 5 + 64 __;:£ -s== ^ __-:; ■^ /- 62 - -^ ——' ^_^ '■^ ^ ' :rr:— . — ^ ^-^ 12 60 -;:::: _ . ^ __^ ::;?=: ==^ " ■-—" ^^ 58 ^^ ■::>^ ■^ — - — "^ , -— -1 ^^ >' , ' — ' ^ -' ' ^^ 56 ^ . — • ^ ^^ ^.-^ — ■ ^ "" y 10 54 ^ ^^ J - -— ' •^ ^ ■ ' ■ , — 52 -1 ' . ■ — - ^ H^ ^ . , — . ^— ' ^ 8 50 .„ — r - — ' ^^ ^ ^' ^ .^-^ ■^ , - ■ — ^ 7 48 ,.-^ ^ — -1 r* , ^ ^ ' _^ ■ --^ — — ' ^— -' "^ 6 46 ^ — ' ^— — 1 ' ^—^ — ' ■ ^,^ ■ ^ . — ■ — 5 _,^ r—^ ^ ■ ^ .-^ '^ — ■ __..- - — ' _ 40 -^ _^ -^ 38 y^ Fig. 9. Heights of Boston Schoolgirxs Irrespective of Nationality of average heights and weights at different ages, occurs all along the line, but that it occurs earlier at the higher than at the lower percentile grades. In other words, we find that the above- mentioned variations in the value of M — A are due to the fact that the period of acceleration, which is such a distinct phenome- non in the growth of children, occurs at an earUer age in large than in small children. 128 STATE SANITATION The following are the most obvious conclusions: — 1. The maximum yearly growth in both height and weight is at all percentile grades greater in boys than in girls, and occurs in boys two or three years later than in girls. 2. The age at which this maximum yearly growth in height and weight is reached is, in both sexes, earlier at the higher than WG'T 10 20 PERCENTILE GRADES 30 40 50 60 70 80 90 AGE LBS. YRS. 170 160 150 140 (7 y \h 130 ^' ^y 15 -^ / 14- 120 — — • -^ ^.^ /" . -^^ -—' ^^ ^ ^ 13 110 ^^^^^ -^ ^ ' / ■ "" ^„^ 100 *^ _ . ■ -" -^ / l'2 ^ -^ r- — ' ^ / 90 r^ ■^^ ^ ___^ " ,- — It 'y r^ »— ^ " ^ 80 "" __._- ■ ^--^ ^ r -^ J 10 70 — ' -^ ^ ~- ■ "^ — ' ' 9 ^ ' ^ . ^-^ 60 ^^ ■ — " . ■ — ' ^^^ a . 1 ■ ■ " / 50 1. . _,^ & ^ — ' ' , — 6 40 — -^ ■ " ■ " \ 1 30 ' — ■ Fig. io. Weights of Boston Schoolgirls Irrespective of Nationality at the lower percentile grades, the range being from twelve to fourteen years for girls and from fourteen to sixteen years for boys. In other words, large children make their most rapid growth at an earlier age than small ones. 3. The curves representing the annual growth of boys are characterized on either side of the maximum by a steeper rise and GALTON'S METHOD OF GRADES 129 fall in the lower than in the higher percentile grades, though the maximum itself may be quite as high in the former as in the latter grades. This indicates that the above-mentioned period of accel- erated growth in large boys differs from that in small boys rather in duration than in intensity. In girls a difference of this sort does not seem to exist. 4. In boys at eleven years of age there is a period of remarkably slow growth both in height and weight, the curves of annual in- crease in nearly all the percentile grades reaching at this age a lower point than for several years preceding or subsequent to this age. In girls a similar but less marked period of retarded growth in height is to be noticed at nine years of age, but the rate of growth in weight does not seem to suffer a corresponding diminu- tion.^ Among the advantages of this method of discussing anthropo- metrical results may be mentioned the facility which it affords for comparing the rates of growth of children of different nationalities by determining the percentile rank of the average children of one nationahty referred to those of another nationahty as a standard. We may take, for instance, the observations of PagHani ^ on ItaHan children, and those of Erismann^ on the employees in Russian factories, and calculate the percentile rank of the children at successive ages when referred to Boston children as a standard. The result of this calculation is given in the table on the follow- ing page. An examination of this table shows that ItaHan children of both sexes are, in early life, very much smaller than Boston children of ^ It is interesting, however, to notice that in the curves constructed by Dr. Ste- venson (see Lancet, Sept. 22, 1888) from English and American statistics, and representing the annual increase in weight of " boys and girls of the English-speaking races," the period of retarded growth is a marked phenomenon in both sexes, occur- ring in boys at eleven and in girls at nine years of age. See also Axel Key, Die. Pubertatsentwickelung. (Verhandlungen des X inter- nationalen medicinschen Congresses, Berlin, 1890. Bd. I, p. 67.) This observer finds that in Sweden the period of least increase in height and weight occurs at ten years for boys and nine years for girls. 2 " Lo SvUuppo Umano," p. 37. ' " Untersuchimgen iiber die korperliche Entwickelung der Fabrikarbeiter in Zentralrussland," Tubingen, 1889. A very thorough investigation based upon measurements of over 100,000 individuals. I30 STATE SANITATION the same age, and, though they afterwards increase in relative size, they never reach a higher percentile than 31.4 for boys and 32.4 for girls. The Russian children show in general, with increasing age, a progressive diminution in percentile rank which is probably to be Table 21 Showing the Percentile Rank of Italian and Russian Childeen compared with those of the boston public schools Age at Last Birthday Percentile Rank Italian (Pagliani) Boys Girls Russian (Erismann) Boys Girls Five Six Seven. . . . Eight.... Nine. . . . Ten Eleven. . . Twelve. . . Thirteen . Fourteen . Fifteen. . . Sixteen. . , Seventeen Eighteen . below 5 S-6 22.1 26.5 31-4 20.0 16.4 16.1 21.7 21.2 23-7 16.2 I3-I 6.6 below 5 below 5 9.2 iS-8 29.1 28.0 25-5 24.1 23-7 30.0 29-5 32-4 32.2 34-3 75-9 56.6 48.9 40.6 42.5 36.6 28.7 26.5 29.1 17.7 18.6 15.0 80.7 63-4 76.4 51-9 48.8 39-0 26.9 22.8 21.4 23-4 22.0 23.6 accounted for by the fact that during the earlier period of life only children who are unusually well developed physically are likely to find their way into manufactories. The children from seven to twelve years of age are therefore to some extent selected cases and do not represent the average development of the working popula- tion. XIV TYPHOID FEVER IN ITS RELATION TO WATER SUPPLIES By Hiram F. Mills, A.M., C.E, [At the time of publication the facts set forth in Mr. Mills' paper were novel. They are still of great interest. The correspondence between Mr. Mills and the city of Lawrence, which preceded the construction of the water filter, is given in the original paper, but not here reprinted. Twenty-second Annual Report, 1890, p. 525. — G. C. W.] Typhoid fever is one of the diseases now generally attributed to one of the bacteria known as the typhoid bacillus. Bacteria are very minute vegetable growths, and this species is a rod with rounded ends, the diameter being about one thirty- thousandth of an inch and the length about one ten-thousandth of an inch. When very highly magnified, fine hair like append- ages (cilia) may be seen extending from near either end. It may not be unreasonable to think of the invisible kingdom of bacteria as consisting of as many species as the visible vegetable kingdom and all of them doing as beneficent work, in the econ- omy of nature, as the trees and plants which we see around us; but there is a small fraction, perhaps comparable with the smaU number of poisonous plants, which are disease producing. The number actually known to produce disease is very small, and among those regarded as most carefully determined is the typhoid bacillus. It is not merely held that this germ is usually associated with typhoid fever, but that typhoid fever does not exist when this germ is not in the system; that it is the actual cause of the dis- ease. It becomes important then to determine how it can get into the system, and under what conditions it can live outside of the human body. These questions have been and are being studied with care, but there is much yet to be learned. That these germs may be taken 132 STATE SANITATION into the body with the food and drink appears to be well estab- lished. There appears to be no good ground for believing that they live in the air and are carried from place to place by winds; but it is not unreasonable to conclude that they may live in air long enough to be carried with dust on clothing or upon the per- son, from one sick-room to another, or from the sick-room to the kitchen, or to be blown about a yard where slops from a sick- room have been thrown, or blown into the windows of a sleeping- room with the dust from a privy unfortunately near. Cases following one another in the same house have been more readily explained by such communication than by the milk or drinking water obtained from the same source as that used by neighbors who were not afflicted. Milk has been regarded as an excellent food for the typhoid bacillus. When sterilized by heat so that all other bacteria are killed, the t3^hoid bacilU added to it have been found to increase one thousand-fold in twenty-four hours. Recent experiments by the Board have shown an increase of seventy-fold in steriHzed milk; but in milk received from a milk wagon on the street a certain number of the typhoid bacillus added did not increase but rather decreased; and when added to milk drawn directly from the cow, either in the usual way of milking or through a sterilized tube, there was no marked change in the number in eight hours, and httle if any increase in twenty-four hours. Many cases of prevailing typhoid fever in cities have been limited to a single milk route and typhoid fever has been found to have been at the farm whence the milk was brought. In some cases the communication appeared to be through water from a well polluted by soakings from a privy where dejecta from a typhoid patient had been deposited. But the method of com- munication has not been determined with certainty. Drinking water has many times been proven to be the medium by which t3^hoid fever has been communicated. Many marked - cases have been recorded in this country and in Europe, but the present object is not to repeat what is aheady known but to pre- sent the results of a study of the influence of the water suppUes of the State of Massachusetts upon the prevalence of typhoid fever. TYPHOID FEVER AND WATER SUPPLIES 133 The highest death-rates by typhoid fever in the state are not in the cities, but are in the towns that depend for water upon wells. The five towns highest on the Hst, for the past eighteen years, have an average death-rate of 12.82 per year for each 10,000 inhabitants; while the five cities having the highest death-rate by typhoid fever, in the past twelve years, average 7.65 per 10,000, and the average for all of the cities of the state, in the same time, has been 4.62. The town which had the highest death-rate from typhoid fever in the state was Ware. In the fifteen years previous to 1886 the average number of deaths by this disease in 10,000 inhabitants was 16.5. In 1886 this town introduced a supply of water and in the years since, although the water has not yet come to be gen- erally used, the number of deaths has fallen to 6.9, or four-tenths as many as previously. Improvement is not limited to those communities where the prevailing death-rate was high, as illustrated by the city of New- buryport, which used well water until 1881, when water was brought into the city from springs. In the nine years previous to the introduction of spring water the number of deaths yearly by typhoid fever per 10,000 inhabitants was 4.55. In the seven years since the introduction of pure water the number of deaths per 10,000 has been only 2.07, or less than half as many as previously. The general decrease in deaths by typhoid fever, resulting from abandoning wells and introducing a pubHc water supply, will be presented later. Typhoid fever is properly regarded as a preventable disease, and in considering the following facts we must conclude that some of our communities have responsibiUties that cannot be ignored in preventing yearly the death of many people scattered through all classes of society. That this is to a great extent a preventable disease is shown by these general facts : Twenty-five years ago the average number of deaths by typhoid fever in 10,000 inhabitants in the places which are now cities in this state was 7.8; the number now dying yearly from this disease in the same places is 4.6 in 10,000 inhabitants. In fact, the actual number of deaths from this disease twenty-five 134 STATE SANITATION years ago in these places, when their population was only six- tenths as much as at present, was as great as it is now; and if measures for its prevention had not been taken, and the death- rate had continued as it was twenty-five years ago, we should now have 1 ,000 deaths yearly, when the actual number in the cities is about 600. With the usual number of 600 deaths in a year, in all of the cities of the state having a population of one million and one- third, we find that two of the cities having together less than one- tenth of the population have, in the twelve months ending April i, 1891, had more than one-third as many deaths as all usually have in a year. The city of Lowell, with a population of 78,ooOj had, in the twelve months mentioned, 150 deaths from this disease, and the city of Lawrence, with 45,000 inhabitants, had 78 deaths. These two cities had 69 more deaths from this disease, in the twelve months, than the city of Boston with four times the popu- lation. If these two cities had had only as many deaths as the average of the city population, the number would have been 36 in Lowell and 21 in Lawrence. There were in Lowell, in one year, 114 more deaths and in Lawrence 57 more deaths by this disease than in the usual average of the same number of inhabitants in the cities of the state. Deaths in Boston, Lowell and Lawrence General statements have been made of the relative numbers of deaths by t3rphoid fever in Boston, Lowell and Lawrence in the twelve months, including the epidemic in the two latter cities. Additional information may be obtained by considering the deaths in these cities from this disease month by month in the past two years. The actual numbers of deaths from t3^hoid fever in each of these cities in each month of the past two years are given in the figures below, together with the population in 1890 and the number of deaths in 100,000 inhabitants. Turning to the diagram of the death-rates in Lawrence, we find that in December, 1889, and January and February, 1890, fol- TYPHOID FEVER AND WATER SUPPLIES 135 lowing a month after the high death-rates of Lowell for that year, the death-rates of Lawrence from typhoid fever were higher than those of Lowell, and eight times as high as in Boston in the same /eas /eso. /a 3/. / ■^ ... .... / ~ \ \ / \ j \ s, \ \ / \ 1 \ \ fl r V k / N c } 1 1 \ \v N, ■ \ N^ ')> >v .^ ^/ r\-,. / -N n k ^ ==' 1 ^ <^ \ / N, \ -/■ ^. ^^••^1•- ■ Fig. II. Actual Number of Deaths from Typhoid Fever in Each Month IN Boston, Lowell and Lawrence /a as. >> ^ ^ »o O ^ CJ fCOO. 3 3 S y ^ ^ ^ /a a/. *o o 44 40 n ]•- • ■ •• / :.^ ■■. J 2.' \ 24- if; \ \l\ \\ \ ^• s ~\ ^ / ,^ ^ 6 OS TO N. •^ '\f//it'V/;**'VCVv'\*yi'*V//f:/v'-'^?Y LOSS or jt HEAD Fig. i6. is first started is always high, because many air bubbles are retained in the sand; but if water not entirely saturated with air is applied continuously for some days the air bubbles are absorbed and constant normal results are obtained. Friction or Water in Sands and Gravels The frictional resistance of sand to water within certain limits of size of grain and rate of flow varies directly as the rate and as the depth of sand. This is given by Piefke ^ as Darcy's law. I have found that the friction also varies with the temperature, 1 "Zeitschrift fiir Hygiene," vol. VII, p. 115. PROPERTIES OF SANDS AND GRAVELS 245 being twice as great at the freezing point as at summer heat both for coarse and fine sands, and also that with different sands the resistance varies inversely as the square of the effective size of the sand grain. It probably varies also somewhat with the uni- formity coefficient, but no satisfactory data are at hand upon that point. Putting the available data in the shape of a formula, we have V — c d"^ J (o.'jo -^ o-osO) where (V) is the velocity of the water in meters daily in a solid column of the same area as that of the sand, (c) is a constant factor which present experiments indicate to be approximately 1,000, (d) is the effective size of sand grain, (h) is the loss of head, (I) is the thickness of sand through which water passes, (t) is the temperature on the centigrade scale { ' ^^^o"*" '° may be substituted for the last term, if desired). The data at hand only justify the appKcation of this formula to sands having a uniformity coefl&cient below 5, and effective size of grain o.io to 3.00 millimeters. The quantity of water which will filter through a sand when its pores are completely filled with water and in the entire absence of clogging, with an active head equal to the depth of sand, and at a temperature of 10° C, forms an extremely convenient basis for calculation, and for convenience is called the " maximum rate," as it is approximately equal to the greatest quantity of water which can be made to pass the sand under ordinary work- ing conditions. Thus a sand with effective size, 0.20 millimeter, has a maximum rate of 40 meters per day; with effective size 0.30 millimeter, the maximum rate is 90 meters per day, etc. 246 STATE SANITATION Table 43 Table Showing Rate at which Water will Pass through Different Sands, WITH Various Heads, at a Temperature or 10° C. Effective Size in Millimeters, lo Per Cent Finer than - o.io 0.20 0.40 300 .001 .005 .010 .050 .100 .500 1. 000 2.000 Meters per day .01 •OS .10 •50 I. 5- 10. 20. Meters per day .04 ,20 40 Meters per day 09 45 90 4- SO 9 4S 90 Meters per day .16 .80 1.60 8. 16. 80. 160. 320. Meters per day •2S 1. 25 2.50 12.50 25- 125. Meters per day 5 10 SO. 100 Meters per day 9- 45- 90. The effect of variation in the temperature is shown by the following table: — Table 44 Relative Quantities of Water passing at Different Temperatures Degrees, Centigrade. Degrees, Fahrenheit. Quantity 0° 5° 10° i.S° 20° 2.5° 32° 41° So° 59° 68° 77° •70 •85 1. 00 I-I5 1.30 1^45 30" 86° 1.60 For gravels with effective sizes above 3 millimeters the friction varies in such a way as to make the apphcation of a general for- mula very difficult. As the size increases beyond this point, the velocity with a given head does not increase as rapidly as the square of the effective size; and with coarse gravels the velocity varies as the square root of the head instead of directly with the head as in sands. The influence of temperature also becomes less marked with the coarse gravels. The available data for materials above 3 millimeters, which are far less complete than could be desired, have been obtained entirely from screened gravels with uniformity coefficients from 1.4 to 2.0, and at a temperature of 10° C, or a little above. The PROPERTIES OF SANDS AND GRAVELS 247 results obtained were plotted, making a diagram from which the table given below has been prepared. The figures given in the table must be taken as provisional, and for use only until more extended results are obtained. Table 45 Table Showing Rate at which Water will Pass through Different Gra\^ls WITH Various Heads h Effective Size in Millimeters, lo Per Cent Finer Than — 1 3 5 8 10 15 20 25 30 3S 40 Meters per day Meters per day Meters per day Meters per day Meters per day Meters per day Meters per day Meters per day Meters per day Meters per day .0005 . 3-5 10 20 30 5° 80 IIO 150 200 250 .001 . 7 21 41 58 100 148 205 275 370 450 .002 . 14 40 78 IIO 190 275 370 480 590 710 .004 . 27 77 150 208 350 480 610 740 870 1,000 .006 . 41 112 207 275 450 620 780 930 1,090 1,240 .008 . 54 142 252 340 530 720 900 1,090 1,270 1,450 .010 . 67 173 300 385 610 830 1,030 1,220 1,410 .015 . 98 238 378 480 760 1,030 1,260 1,480 .020 . 127 300 467 580 890 1,180 1,470 .030 . .050 . i8s 280 400 560 615 88s 750 1,060 1,110 1,490 1,450 .100 . 495 930 1,310 1,55° In making calculations in regard to underdrains for either sewage or water filters, or in regard to the movements of ground waters, there should be no perceptible clogging of porous materials free from stratification by a clear ground water, and the formulas given can be used with only a moderate factor of safety to cover possible errors of sampling, analysis, and errors in the formulas themselves. In estimating the actual capacity of a filter, so many other conditions come in — the presence of air bubbles and especially the increased friction in the upper layers — that it is impossible to calculate the practicable rate of flow by formulas, and we can only safely rely upon actual results from known materials. The analyses of the materials used at Lawrence have been given in previous reports of the Board in connection with the results 248 STATE SANITATION obtained from them. The following table contains the result of analyses of some other materials, which may be of general interest: — Table 46 Mechanical Analyses of Sands Effective Size 10 Per Cent Finer Than — Uniformity Coefficient Filter Tank No. i, Lawrence, Mass Filter Tank No. 9, Lawrence, Mass Filter Tank No. 2, Lawrence, Mass Sewage filters, Gardner, Mass Sewage filters, Marlborough, Mass Sewage filters, South Framingham, Mass Water filter, Lawrence, Mass Water filter, Birmingham, Eng Water filter, Southwalk & Vauxhall Co., London, Eng Water filter, Poughkeepsie, N. Y MElimeters .48 .18 .08 .10-.24 .12 •35-42 •25-30 .27 .29 •25-35 2.4 2.0 2.0 6-14 3^4 4-5 2^5-4-S 1.8 2.0 1.8-1.9 The data already collected clearly show that a well-selected material is essential to successful filtration; and, with the method of examination and calculation now proposed, we can decide with confidence many otherwise indefinite points, and thus avoid unnecessary expense and unsatisfactory results from the use of unsuitable or poorly arranged materials. xxrv REPORT OF THE JOINT BOARD UPON THE IMPROVEMENT OF CHARLES RIVER [This report was made by a joint board consisting of the Metropolitan Park Commission and the State Board of Health. Following this report the construction of the Charles River Basin was begun. Special Report, 1894, p. vii. — G. C. W.] The undersigned, members of the joint board, consisting of the Board of MetropoUtan Park Commissioners and the State Board of Health, to whom was referred, by chapter 475 of the Acts of 1893, the investigation of the sanitary condition, and the prepara- tion of plans for the improvement of the beds, shores and waters of the Charles River, between Charles River bridge and the Wal- tham line on Charles River, and for the removal of any nuisance therefrom, respectfully submit the following report: — The two boards named in the act met for organization August 10, 1893. H. P. Walcott was elected chairman of the joint board and H. S. Carruth, secretary. At a later date F. P. Stearns, C.E., was appointed engineer to the board, and Messrs. Olmsted, Olmsted and Eliot were asked to consider the subject of the im- provement of the river, to submit a report thereon and to prepare a plan of the improvements recommended. Mr. Eliot had been a member of the Charles River Improvement Commission ap- pointed under authority of chapter 390 of the Acts of 1891, had acquired complete famiharity with the actual condition of the river, and had made, in a public document, valuable suggestions for its improvement. Dr. Robert W. Greenleaf of Boston was asked to make a sanitary survey of the district designated in the act. The members of the board have personally examined the river and its banks at many times and under various conditions. They have carefully considered the reports made to them by the experts employed, and have reached the following conclusions. 250 STATE SANITATION The position of the Charles River, in its relation to the metro- politan district, has necessarily a very great influence upon the health and comfort of the people hving in its vicinity. So long as the stream was comparatively unpolluted its banks were occupied at eligible sites by dwellings of the better sort. The increase of pollution and the consequent nuisance occasioned by it have driven from the banks those who could afford to establish new homes in more attractive regions, and the places of these have been taken by a population less sensitive because they cannot afford to avoid offensive surroundings, or by manufactories that seek the stream for commercial advantage or to be at a distance from neighbors hkely to complain of offensive processes incident to the business carried on. Even in those portions of the river where the vast quantities of salt water brought in by the tide so far diminish the degree of pollution that offensive odors are not observed except at low tide and in consequence of local causes, and where some of the finest residences of the Back Bay district of the city of Boston are to be found, — even here the river has ceased to be a welcome neighbor except so far as the views to the distant hills to the north and west are enhanced by the water in the not too near foreground, a foreground consisting of a poorly kept alleyway behind a Une of unsightly sheds and stables situ- ated at the rear of the lots on the north side of Beacon Street, a rude stone wall, upon which grow tufts of seaweed and unsightly grasses, holding as sponges do the floating putrescible materials that come in contact with them, and at the base of the wall, at low tide, a muddy expanse of many acres, marred by rubbish of every description. So many of the great cities of the world have made use of the banks of rivers and basins as sites for their finest pubHc and pri- vate buildings and ornamental grounds that we cannot escape from the conviction that the disinclination to so use the Charles River within the limits under consideration rests either upon nuisances already in existence or the apprehension of danger to health. The river runs through the very centre of the metropoHs and upon its shores should naturally be placed its most attractive structures, its monuments and its finest dwelhngs. It does not IMPROVEMENT OF CHARLES RIVER 251 seem appropriate that this territory, so favored by position, lying at the very heart of our great city and upon the borders of a stream not necessarily offensive, should be condemned to its present ignoble and noxious uses. If any streams or any lowlands are to be so used in the vicinity of Boston it would be well that they should be as far as possible from the centre. An enumeration of the people who are actually resident upon the territory which lies within a distance of two miles upon either bank of the river, throughout the district now under consideration, shows a popu- lation of not less than 500,000. Here in the future will probably be found, as now, the bulk of the metropohtan population. The banks of the river and the exposed fiats have become from year to year more offensive until, on certain portions of the river, the people Hving near the stream have been exposed to the dis- agreeable and probably injurious emanations therefrom. So far reaching had this nuisance become that during the summer of 1892 a very large portion of the territory of Old Cambridge was subject to its influence, and a petition was addressed to the State Board of Health signed by hundreds of householders, and by nearly all the practicing physicians of that portion of the city, praying that some relief might be given from a condition of things beheved to be positively injurious to health, and known to be so offensive that windows had to be closed during the period of low tide in the river. The medical profession beheves that the gases arising from decomposing organic materials are injurious to health ; it has not been proved, however, that these gases do produce some one dis- tinct disease, but rather that the continued breathing of them lowers the vital resistance and predisposes the person exposed to them to diseases of various kinds and all degrees of severity. But even if the physicians are in error in beHeving such emanations to be a danger to health, it is quite certain that the owners of lands or houses on the borders of such foul smelling streams suffer a pecuniary loss in the diminished value of their property, a loss from which they should be protected if it be practicable to do so. In recent years it has been thought that the steady progress of malaria in the valley of the Charles has had a very close connec- 252 STATE SANITATION tion with the increasing pollution of the stream; the careful examination into this subject by Dr. Greenleaf does not show, however, that the cases of malarial fever have been in such near connection with the river as to make it probable that the con- taminations of its waters have had any direct influence upon the spread of the disease. Dr. Greenleaf, in the course of a house-to- house survey of the district adjoining the river, did, indeed, discover cases of malarial fever, but a satisfactory explanation of their occurrence was almost invariably found, either in local conditions not dependent upon the state of the river, or else by exposure of the affected individuals in locahties known to have become malarial in recent years. His observations lead to the same conclusions in this inquiry that other competent authorities have drawn in all parts of the world, that the most important condition to be sought for defence against the malarial infection is a thorough drainage of the soil, together with a maintenance of the water contained therein at an unchanged level. Two plans occur to us for the reHef of the conditions thus briefly sketched, assuming in both cases that the Metropolitan Sewerage System, now nearly completed, will remove the more serious forms of pollution : — (i) To dredge all flats now exposed, and to continue the em- bankment constructed in the substantial and attractive form used by the city of Boston at the Charlesbank, ultimately carrying this construction through the whole length of the estuary and upon both banks. (2) To maintain the water in the river through a greater or less length in its course at a permanent high level by the construction of a dam. The objections to the first plan are these: While the river would rise and fall against a vertical wall, thus exposing the smallest possible surface at the banks, even this surface would soon become defaced by growths more or less offensive, as has already happened to the recently constructed walls in the Charles River Basin. The embankment would be many miles in length, would entail very extensive filHngs of lowlands in order to render such lands available for any public use or profitable private IMPROVEMENT OF CHARLES RIVER 253 occupation, and the general effect would not be pleasing to the eye, except when the water is at or near high tide, and lastly, the difficulties of the construction of walls on account of poor founda- tion and their great expense would preclude for the present at least the building of them. Having a due regard to the imperative need of some measure of rehef in this valley, it does not seem safe to longer delay the adoption of a sufficient remedy, and we, therefore, recommend the second plan, the erection of a dam high enough to keep even ex- treme tides out of the basin and the maintenance of the water at a permanent level, in accordance with the plan of our engineer, F. P. Stearns, C.E., herewith presented. The place selected for the dam is about 600 feet above Craigie's bridge, where the river is not more than 1,100 feet wide. The details of this structure have been so thoroughly considered that we confidently beheve that it will answer the purposes for which it is designed, the maintenance of a nearly permanent level at all times, and no greater interference with commerce than would be produced by the operation of a draw- bridge, — indeed, not so much, should the drawbridge happen to He on the line of a railroad. Provision has been made for a lock in the dam capable of receiving the largest vessels used upon the river; and it is obvious that commerce directed to the upper por- tions of the stream would gain much from the power to ascend the river independently of the rise and fall of the tide. Vessels which might have occasion to be moored at the wharves on the river above the dam would find in this new condition of things the great advantage of floating at all times. How great this gain would be can be understood when it is stated that the river bed is practically exposed at the United States Arsenal at Watertown at low tide. Estimates have been made for a dam to be 100 feet in width, and there would thus be provided a foundation for another roadway into the city of Boston from East Cambridge and the country beyond of permanent character, a means of approach to the city hkely to be much needed when the time comes for the reconstruction of Craigie's bridge. 2 54 STATE SANITATION The landscape architect would also be able to connect this structure with the pubhc lands on both banks of the river by such additional fillings and rounding of the corners as would materially increase the area of these grounds and add new features of attraction. We cannot convince ourselves that the harbor will be notice- ably injured by the loss of the large quantities of water dis- charged by the outgoing tide. The opinions of the experts, who have from time to time examined the harbor, have in recent years been considerably modified, possibly in view of the unimpaired value of the harbor, notwithstanding the great decrease in the water areas of the Charles River and other basins. If the river below the site of the dam is only to serve the purpose of convey- ing the waters of the Charles and Miller's rivers to the sea, such diminution of its area as has already taken place will be of Httle consequence, for a smaller channel than the present would be sufficient to carry all that the Charles River alone could ever empty into it. The more certain formation of ice on the basin created by the dam ought not, in the absence of any considerable amount of winter commerce on the Charles, to be anything but favorable to the use of this stretch of several miles of river for skating, one of the best of winter exercises and sports. The probable more ready freezing of the channel of Boston Harbor below the dam would be an inconvenience if the constant movement of tugs and ferry boats were not quite certain to break up the ice almost as soon as formed. The fear is often expressed that such basins as this may be- come, by reason of an insufficient current and the accumulation of organic matter in them, sources of nuisance and a menace to the pubhc health. The statistics contained in the engineer's report show that there will be a very considerable movement of this sheet of water, and with the improvement in the quaHty likely to follow the operation of the new metropoHtan sewer but Httle danger of such contamination of the water or such accumu- lation of filth on the bottom of the basin as could produce offen- sive smells or conditions dangerous to health. But should the IMPROVEMENT OF CHARLES RIVER 255 unexpected, nevertheless, happen, the openings in the dam would easily allow of the admission of such quantities of salt water as would keep the basin in a perfectly satisfactory condition by establishing in it a very considerable circulation at each tide. We are fortunately, however, not without examples of basins quite similar to this, situated also in the midst of large populations, and in the most conspicuous example, the world-renowned Alster Basin, the water park of the city of Hamburg, there is no means of introducing any water beyond that flowing in the comparatively insignificant Alster. This basin is very shallow and has a muddy bottom, but is surrounded by some of the best private houses of this flourishing and wealthy port, and the water surface of the basin and its shores constitute the most frequented places of resort in the city. During the terrible cholera epidemic of 1892, when Hamburg suffered, as few European cities ever have suf- fered, from this pestilence, the wards in which lie the Alster Basins showed the lowest death-rates in the city. We do not intend to say that cholera spreads only where there is filth, but it is true that the conditions among which it finds its widest extension are those of unsanitary surroundings. There is no question probably in the mind of any sanitary observer that a river of moderately pure water flowing at a con- stant level between clean banks is much to be preferred to a similar stream which is subject to a rise and fall of many feet twice in the twenty-four hours. Streams of the latter description constantly deposit upon the banks the material floating on the surface, material that occasions little offence while surrounded and saturated with water, but rapidly decays when exposed to the sun and air upon the shores of the river. Whatever care may be taken of the Charles River in the time to come, if it remain an estuary, there is no doubt in our minds that the banks, sloping as now to the stream, will be more or less a nuisance; dwellings will, so far as possible, not be erected in its neighborhood, or, if they are built here, will be of the sort which are compelled to seek undesirable, consequently cheap, land. A population will be established here which will resist most obsti- nately and naturally the destruction of their homes, and one 256 STATE SANITATION more, and perhaps the greatest, opportunity to permanently improve the incomparable situation of Boston and its suburbs will have passed away. In order to protect the low-lying portions of the territory within the valley of this portion of the Charles River, it has seemed advisable to us to make the permanent level in this basin somewhat lower than that of ordinary high tides. The level which seems most advantageous is that of two feet and six inches below such tides. It is well known that exceptionally high tides have done much injury throughout the estuary of the river, both by flooding and by interference with sewers, and we may reasonably expect that still more will be occasioned on account of the increased occupation of these lowlands whenever we again have such tides as that which occurred at the time of the destruc- tion of the Minot's Ledge Hghthouse in 185 1, or, indeed, tides of much lower height. The forlorn marshes that now border upon the river would become, without the expenditure on them of a dollar, fertile meadows, scarcely needing treatment to become attractive places for recreation; and capable, with treatment, of becoming scenes of great beauty, as the designs of the landscape architects so clearly show. Some soUcitude has, in recent years, been manifested in regard to the preservation of the piles upon which are placed the foundations of so many valuable buildings in the Back Bay district of Boston. The maintenance of a basin at a constant level considerably above that at which, by city ordinance, these piles are cut off will probably increase the security of such substructures. We beheve that the amount of organic or putrescible material at present deposited on the banks and bed of the river need not present any serious obstacle to the carrying out of this plan. The completion of the whole design will be a matter of years, the addition of the most serious kind of pollution, sewage, will cease, probably, in the course of a year, the narrowing of the stream in the present basin is rapidly going on, with consequent diminution of deposit, and whatever remains after this will be profitably removed to the banks of the stream for such fillings as may be necessary to prepare the river for its new functions. IMPROVEMENT OF CHARLES RIVER 257 Whatever plan is adopted for the future treatment of the river, it seems to us essential that all the lands indicated on the plan presented by the landscape architects should be at once acquired. The mere fact that it was pubHc property would alone, we think, improve the value of all the adjoining lands to such an extent as to make the purchase a wise business transaction. Mayor Mathews, in an inaugural address dehvered in the year 1891, before the city council of Boston, used the following words : — We have in this basin the opportunity for making the finest water park in any city in the country; an opportunity which should be grasped before it is too late. The eventual solution of this whole problem should, I think, be an imita- tion of the plan adopted by the city of Hamburg, under similar circum- stances. We should dam up the stream at the narrowest point between Charlestown and Boston, and lay out a series of parks and boulevards along the basin thus created. We have incorporated in this report copies of photographs showing various aspects of the Alster Basin in Hamburg. They tell their story so effectively that minute description is hardly needed. Hamburg lies on the east bank of the Elbe, at a distance of seventy miles from the German Ocean, and is the most impor- tant commercial city of the German Empire. The population of the city and suburbs exceeds 600,000. The climate is harsh and fully as much exposed to cold and disagreeable winds as Boston, is. The thermometer does not indicate so low degrees of tempera- ture, but the difference between the two cities in this regard is not very great. In former times the Alster was a small stream fiovdng through the centre of the city and entering the Elbe at right angles to the latter's course. At the entrance of the Alster into the Elbe an estuary was formed which sheltered the small vessels engaged in the commerce of those days. With the growth of the city larger and more convenient docks, were formed on the Elbe; and the formation of the Alster Basin was begun at a point about a mile distant from the entrance of the Alster into the Elbe; dams across the stream were constructed with suitable contrivances for the passage of mastless vessels. 258 STATE SANITATION Constant improvements have been going on in this water park, some the results of the needs of a growing city and some from efforts to increase the attractions of the basin and its borders. There are two basins, an upper and a lower, separated by a bridge. About this basin are ranged some of the finest of the pri- vate houses, the principal hotels, and such shops as are usually found in the better quarters of a city. It will be noticed that the lower water park is treated in a formal way with walls, straight lines of street, and rows of trees; in the upper basin walls are replaced by beaches; the shore lines no longer run parallel to the streets, and the trees and shrubbery are grouped in effective masses. At points more distant from the city and on the upper reaches of the river, very Httle attempt has been made to improve the naturally pleasing variation of banks but slightly elevated above the stream and verdant meadows interspersed with trees, shrubbery and gardens. We desire to call attention to the evidences of appreciation of all these charms shown by the Hfe everywhere manifest, — the little steamer makes its rounds from one point to another on the water park; rowboats are plenty, and when some much-fre- quented place of resort on the stream is reached, the popular enjoyment of it all should convince this community that much labor and expense could be profitably invested in procuring for the metropohtan district the opportunity for the same innocent enjoyments. We have a framework for such scenes far superior to that possessed by Hamburg, and the expense of preparation is not excessive. That all this outdoor life is not peculiar to the German nation is well shown by the illustration of boating on the Thames. Nothing of all this has hitherto been possible in the estuary of the Charles, although some suggestion of the possibilities in this direction may be obtained from the rapidly growing use of the comparatively inaccessible fresh-water basin further up the stream extending from Waltham to Riverside. The repulsive appearance of the shores of the estuary at the lower stages of tide, the foul odors along its banks and fiats, and the difficulties experienced in passing under the low bridges at high tide, have IMPROVEMENT OF CHARLES RIVER 259 combined to make boating and the use of the stream by small steamboats unattractive and, in a measure, dangerous. In conclusion, your board feels that no treatment of the Charles River can be entirely satisfactory which does not regard the con- dition of the river above and in Waltham. At the boundary of that city, by the terms of the act under which we are directed to make our investigation and report, our labors end. We have not thought that it was necessary to submit herewith the drafts of such legislation as might seem to be required for carrying out our recommendations. We are aware that the very serious changes proposed require the co-operation of the United States, the state and various municipalities. But the questions only differ in degree from some which have already been satis- factorily determined by existing commissions whose organizations are sufl&ciently complete to enable them to promptly undertake the execution of so much of these plans as it may seem wise to the Commonwealth to enter upon. Henry P. Walcott, Chairman. Philip A. Chase, William B. de las Casas, Abraham L. Richards, Board of Metropolitan Park Commissioners. Hiram F. Mills, Frank W. Draper, Joseph W. Hastings, Gerard C. Tobey, James W. Hull, Charles H. Porter, State Board of Health. Boston, Mass., April 27, 1894. Charles F. Adams and William Chase of the Metropolitan Park Commission are absent in Europe. XXV REPORT OF THE STATE BOARD OF HEALTH UPON A METROPOLITAN WATER SUPPLY By Dr. Henry P. Walcott [Report upon a Metropolitan Water Supply, 1895, p. ix. — G. C. W.] The State Board of Health, acting under the authority of chap- ter 459 of the Acts of 1893, has investigated and considered the question of a water supply for the city of Boston and its suburbs within a radius of ten miles from the State House, and for such other cities and towns as, in its opinion, should be added thereto; and has also made the additional investigations set forth in the second section of the same act, and now desires to submit the following report : — The act under which the Board has conducted this inquiry apparently provides for the same general treatment of the ques- tion of water supply as was adopted by the General Court of 1887 for the creation of a sewerage system for a somewhat smaller district. Substantially all the arguments that were urged by this Board for the MetropoHtan Sewerage System, which, built in accordance with our recommendations, is now nearly completed, may be used with even greater force in aid of any well-devised plan for giving to a still larger district a sufi&cient supply of the best water attainable. F. P. Stearns, C.E., chief engineer of the Board, has prepared the very full and accurate statement of the present and future resources of water available for this metropohtan district, to- gether with all necessary details as to the structures at the great reservoir, the aqueduct leading from it, the new pipe lines and pumping stations, within the district; and, in addition to the information already in possession of the Board, has been able to state the results of many new inquiries undertaken for the pur- poses of this report. The financial aspects of the problem are also treated by him in an instructive manner. 360 METROPOLITAN WATER SUPPLY 261 J. P. Davis, C.E., who has been for a series of years entirely familiar with all the great municipal works for water and sewerage of the metropoKtan district, has made a careful examination of the work of our engineer, and finds it to be well considered and trust- worthy. Mr. Davis was for many years city engineer of Boston, and in this capacity designed and had charge of the construction of the works for taking water from the Sudbury River. He has also been consulting engineer to the Aqueduct Commission of the city of New York, and was one of the experts consulted as to the proposed Quaker Bridge Dam. Dexter Brackett, C.E., has embodied in two appendices the re- sults of observations and studies to which he has devoted many years. Another appendix contains a description by Desmond Fitz- Gerald, C.E., of plans for the draining of swamps, which are now under consideration for the improvement of the Sudbury watershed. Dr. Drown's paper upon the influence exercised by organic matter in the soil of reservoirs upon the water stored therein has so much that bears upon the recommendations of this report that we again publish it as an appendix. All the special information that may be found necessary to explain or support the compressed conclusions of our ow^n report will be supplied by the valuable reports of the eminent authorities above enumerated. The most famihar experience of this part of the world, at least in the matter of its water supplies, has been the failure of sources originally supposed to be abundant to properly meet the wants of their respective communities for any considerable length of time. The plans of the city of Boston, beginning with its first scheme for a general water supply in the year 1825, have proved no exception to this rule, and yet this city has had the services of the ablest men of their day. The reason for this constant disappointment is easily dis- covered. The quantity of water which the householder of today demands for the conveniences as well as for the necessities of his daily Kfe has increased beyond all expectation. If this enlarged 262 STATE SANITATION quantity can be secured without undue delay and without such injury as may easily be made whole, it is evidently for the general welfare that such provision should be made; for it seems to us reasonable to claim that no small share in the improved and still improving state of the public health may be traced to the meas- ures now adopted for the protection of the purity of waters and to the greater cleanliness of person, clothing and all surroundings which inevitably result from a practically unlimited freedom in the use of water. It is essential, then, to determine, if possible, the amount of water needed at the present day, with such fore- cast as to future requirements as can be safely made. It is, of course, true that a comparatively small amount of pure water would meet all the demands for drinking and cooking, and that a water of inferior quality would answer for other domestic purposes as well as for all municipal requirements and the de- mands of manufactures; but no satisfactory arrangement has as yet been made by which two kinds of water can be economically and safely distributed through the streets and buildings of cities and towns. It was discovered by this Board, some years since, that no in- considerable portion of the cases of typhoid fever found in certain manufacturing towns in this state was the result of the careless drinking of a dangerous water, which is used in the mills for mechanical purposes only, is understood to be dangerous and is distinctly so marked ; but this inferior water was still used by the operatives, because it was sometimes cooler, was tasteless, and generally more accessible. The Board has hoped that it might be possible to devise some plan by which the very Hmited amount of quite pure water really needed in our houses might be secured and distributed; but no satisfactory method has as yet suggested itself, nor with the present outlook for an abundant supply of very good water does such a plan seem to be an urgent need either on grounds of health or economy. The average daily consumption of water in the metropoHtan district for the year 1894 was 79,046,000 gallons, the average daily capacity of the sources now in existence for the supply of METROPOLITAN WATER SUPPLY 263 this district was only 83,700,000 gallons; that is to say, the aver- age daily supply is only 4,654,000 gallons in excess of the actual needs. Though some of the sources of supply to the district are capable of yielding larger quantities of water than are at present furnished, we are satisfied that even a very thorough develop- ment of all these sources will barely carry the district safely through a year of unusual drought, should such a season occur before the date at which the works, hereafter to be described, can be put in condition to increase the supply; and this would be true even though the cities or towns which might find themselves possessed of a surplus supply could transfer it to their neighbor in want. The population of this metropolitan district was, by the United States census of 1890, 844,814. Estimates which have been carefully made, and with a due regard to the diminution in rate of increase by reason of the depression in business, place the population for the year 1895 at 984,301. The water works of the city of Boston now supply nearly 75 per cent of all the water used in the metropolitan district. The daily average consumption of those cities and towns receiving water from the Boston works was 99 gallons in 1893, and the average for the entire district now under consideration was, for the same year, 83 gallons. It seems to be generally true that the nearer we approach the centres of population the greater becomes the use of water; and, with the inevitable growth of Boston and its suburbs, it does not appear to us wise to calculate upon a requirement per inhabitant of less than 100 gallons for the long period of years for which we seek a supply. We have not deemed it necessary or advisable to busy our- selves with the insoluble problem of the probable future increase of population in and about Boston. We have assumed that the growth will go on as it has gone on during the last quarter of a century; and for a population determined by such principles we have made provision. While every effort has been made to reconcile the views of the local authorities with our own as to their respective requirements both in regard to quantity and quality of water needed and their 264 STATE SANITATION capacity to meet such demands, the Board has in several cases arrived at results quite different from those held by these authori- ties. It is assumed that no portion of this large and intimately associated community will accept for any length of time a water inferior to that enjoyed by their neighbors, either in healthful qualities or attractive appearance and odor; and it will not be profitable as a municipal investment to offer the stranger seeking a new home anything so essential to his health and comfort as water is, that shall be decidedly poorer than the article distributed on the other side of the town's borders. It has, therefore, been assumed by us that the various com- munities under consideration will take, sooner or later, the better water, provided that the cost of taking it is not in excess or greatly in excess of that of an existing and inferior supply. It will also be found to be true, we think, that a very large amount of the best water can be provided for the district at a price per head far below that at which any municipality within the district, with the exception probably of Brookline, Newton and Waltham, can supply a water of anything Hke an equal quahty. Moreover, in our opinion, the most favored locaHty in this region has no prospect of obtaining beyond the next twenty or twenty-five years any source of supply that can be favorably compared, either on grounds of health or economy, with the source to be later described. It is by no means certain that Wal- tham, even with its present abundant and good supply, can con- tinue to depend through a series of years upon water filtered uninterruptedly in ever-increasing quantities from a river more or less polluted. Of the communities composing the metropolitan district, those using 80 per cent of the full amount of water will need the metro- poHtan supply nearly as soon as it can be furnished. It is prob- ably possible for those using 10 per cent of the full amount to extend their works so that they may give them a supply for twenty or twenty-five years, and the remaining 10 per cent will need the metropoHtan supply within a shorter time. The works of distribution have been so designed that the first cost will be increased as Httle as practicable, and that they may METROPOLITAN WATER SUPPLY 265 be in condition to supply these communities when they shall need the water, by additions to the works first constructed; but some expense must necessarily be incurred at first, on account of the prospective use by these communities. For the purpose of determining which cities and towns should be included in the district to be formed, a careful review has been undertaken of all the facts within our reach which have a bearing upon this question, — facts which will be found duly stated in the subjoined report of the engineer, Mr. Stearns; and we accordingly recommend that the cities of Boston, Cambridge, Chelsea, Everett, Lynn, Maiden, Medford, Newton, Quincy, Somerville, Waltham and Woburn, and the towns of Arlington, Belmont, Brookhne, Hyde Park, Lexington, Melrose, Milton, Nahant, Revere, Saugus, Stoneham, Swampscott, Wakefield, Water- town, Winchester and Winthrop, twenty-eight cities and towns, containing, in 1890, 848,012 inhabitants, constitute the metro- poKtan water district. Inasmuch as the cities of Cambridge, Lynn, Newton, Waltham and Woburn, and the towns of Brookline, Lexington, Nahant, Saugus, Swampscott and Winchester, together containing, in 1890, 210,252 inhabitants, beheve that they have a sufiicient supply for some years to come, we do not recommend that they be provided with water from the metropoHtan supply until they formally express their wish for it. These municipalities con- tained about one-fourth of all the people living in the proposed district in the year 1890. We have no hesitation in recording our own belief that the period at which this supply will be demanded by them is much nearer than they now anticipate; but their participation in the scheme is not essential to the success of the undertaking, nor will their absence render the immediate pro- curing of a new water supply any the less necessary. After a thorough revision of all the sources of water which have been suggested or which we could discover, we selected three which seemed worthy of critical examination, — Lake Winni- piseogee in New Hampshire, the Merrimack River above Lowell and the Nashua River above Clinton. Lake Winnipiseogee has for many years been held to be the ideal of all that was needed in the way of a perfect source of pure 266 STATE SANITATION water, and it is capable of furnishing an abundant and excellent supply. The clear depths of its waters and the apparent freedom from pollution along its shores, unlike many of the artificial reservoirs hitherto constructed, have created so strong a popular behef in its necessary superiority to anything artificial that it may not be out of place to direct attention for a moment to some of the defects to be found even here. The permanent population on the territory draining to the lake is not large, — 35 persons per square mile; but the attractive shores have become the favorite summer camping-ground of thousands, and the amount of the most serious forms of pollution directly entering the water of the lake must be large and ever-growing. Even though the State of New Hampshire might allow a certain amount of water to be taken from this lake for domestic water supply within her own limits, it is not probable that she would consent to the with- drawal of amounts of water so large as to injure her own manu- facturing industries, or to give to the people of another state any authority to interfere by police regulations with the unhampered enjoyment by her own citizens of her beautiful pleasure-grounds. The expense, however, of constructing a conduit over the shortest and best route which it has been possible to discover, and for distributing this water through the district, amounts to $34,- 000,000. This large sum does not include the cost of the damages inflicted by the diversion of water and charges incident thereto; and we are confident that the water thus obtained would have no greater value than supplies which can be obtained at much smaller cost within the limits of this state and protected by our own laws. Examinations have also been made with the view of taking the water of the Merrimack River above Lowell, subjecting it to efficient filtration and bringing it down into the metropolitan district. The quantity of water that could be obtained in this way and for this purpose is unlimited; and, if there were no way of obtaining a better supply of water and one which was above suspicion, it would be practicable to introduce water from that source at a cost somewhat less than from any other source considered. METROPOLITAN WATER SUPPLY 267 The estimated cost of filtering and conveying this water to the metropolitan district is $17,500,000; but in the opinion of the Board it will be better to pay 10 per cent more for a supply from a source that has not been polluted. The experiments carried on by this Board for a succession of years at an experiment station in Lawrence under the immediate direction of H. F. Mills, C.E., a member of this Board, and the filter constructed in connection with the water works of that city, have shown that waters as polluted as those of the Merrimack can be effectually filtered and rendered safe for domestic use; but it is also true that filtering areas require continuous care on the part of well-trained attend- ants, and that, in a few instances at least, inefficient administra- tion or inherent defects of construction have allowed disease germs to pass through filters which were assumed, by good authority, to be a sufficient protection. We are the more easily led to reject the filtered waters of the polluted Merrimack because we have found an entirely satisfac- tory water in the South Branch of the Nashua River above the city of Clinton. We find that the conduit of the Boston water works was built of much larger capacity than was needed for the conveyance of the amount of water to be derived from the Sud- bury River, being capable of taking 50,000,000 gallons a day more than is at present supphed to it. The territory from which an additional supply for this district may be sought is thus moved out to the westerly end of this conduit, or to the westerly end of the valley and reservoir connected with this conduit. The first source of considerable size found to the west of this point is the above-named South Branch of the Nashua, which, at the city of CHnton, has a watershed of 118.23 square miles, con- sisting of a sparsely settled district containing but sixty-nine persons to the square mile. The southerly and easterly slopes of Wachusett Mountain which bound this territory to the north and west are not well adapted to agriculture, and offer few induce- ments to the establishment of manufactures. In this section the rate of increase of population has been very slight, and the dis- tance from centres of population is such that no more rapid rate of growth can be expected in the future. 268 STATE SANITATION In this river, a short distance above the Lancaster Mills in Clinton, a dam can be built which will raise the water 107 feet above the surface of the existing mill pond, and flowing to the average depth of 46 feet an area of 6| square miles, with its high- water mark 385 feet above the level of high tide in Boston harbor. This reservoir will have a capacity of 63,000,000,000 gallons, and the territory draining into it will supply, in a series of very dry years, 111,000,000 gallons of water daily, which, with the 62,000,- 000 gallons obtainable from the Sudbury and Cochituate water- sheds, will make the total capacity of the combined sources 173,000,000 gallons, which is double the capacity of all the sources now utilized by the metropolitan district. The reservoir can be connected with the new Reservoir No. 5 now constructing by the city of Boston in the Sudbury River system. The connection would be made by an aqueduct a Kttle less than nine miles long, and an open channel about three miles long following the course of an existing brook. This aqueduct is designed to be built low enough to take water from the level of the present mill pond in Clinton; so that, should it become neces- sary to increase the supply to the metropoHtan district before the dam and reservoir are completed, the ordinary flow of the river could be brought down into the Sudbury system as soon as the aqueduct is built. The very great merit of the plan now submitted is to be found in the fact that this extension of the chain of the metropoHtan water supplies to the valley of the Nashua will settle forever the future water poHcy of the district, for a comparatively inexpen- sive conduit can be constructed through to the valley of the Ware River, and beyond the Ware River Hes the valley of the Swift; and, in a future so far distant that we do not venture to give a date to it, are portions of the Westfield and Deerfield rivers, capable, when united, of furnishing a supply of the best water for a municipality larger than any now found in the world. The expense of this great scheme is comparatively moderate, because the watersheds in question are sparsely settled, He among the higher regions of the state, and are not likely to be- come the seat of manufacturing industries. Moreover, all these METROPOLITAN WATER SUPPLY 269 streams can be brought down by their own natural flow from appropriate reservoirs to the existing distributing basins in the metropoHtan district. The water in the South Branch of the Nashua River is at present of good quahty, and, with the small population upon its drainage area, it will not be difficult to protect it from impurities in the future; but, in the opinion of the Board, the large reservoir to be constructed will serve as a means of very much improving the quahty of the water; its area and depth are so great that it will contain, at nearly all stages at which it is proposed to hold the water, a full year's supply when double the quantity now used in the metropoUtan district is drawn from it and the Sudbury and Cochituate areas. During the long period through which water remains in this reservoir a bleaching and purifying process will go on, which will probably cause the death of all the disease germs which may be turned into it from contributing streams, and the water thus become more agreeable to the sight and taste, and be, in fact, more wholesome than the present water from any of its contributing streams. La order that this may be the case, the Board has thought best to increase the depth of the reservoir by raising the dam, and to remove from its area the vegetable matter and soil which may cover it, and thus expend about $4,000,000 in rendering the water of the best quahty practicable. So many advantages are offered by larger storage reservoirs, as compared with the smaller basins, which local geographical pecu- Harities have compelled the metropoHtan district to build hitherto, that it has seemed advisable to us to urge the completest possible preparation of this new reservoir. After this new water has been brought into the Sudbury sys- tem, it will pass down into Chestnut Hill Reservoir, where it will for the first time require to be pumped to an elevation of thirty feet, sufiicient to give an additional head to the Boston low-service system and to carry over to Spot Pond the supply needed for the northerly portion of the metropoHtan district. In our estimates of cost a sum of money has been set aside for the improvement of Spot Pond, principally for removing its shaUow flowage, and we beHeve it will then be a valuable distributing reservoir and restored to its normal height. 27© STATE SANITATION It is estimated that no other conduit will be required in addi- tion to the present one from Sudbury River to Chestnut Hill Reservoir for ten or more years; but before the end of this period it will be necessary to build an additional conduit, extending from Reservoir No. 5 of the Boston water works to a point in the town of Weston not far from the Charles River, at such a height that the water may be conveyed in pipes to Spot Pond, and be distributed through the low-service system in the metropolitan district by gravity. This aqueduct will be thirteen and one-half miles long, and is designed to convey 250,000,000 gallons of water per day. Spot Pond is selected for a general distributing reservoir in order that the low-service district may have a pressure thirty or forty feet greater than would be supplied by Chestnut Hill Reservoir ; this increased pressure is rendered necessary in order to include large areas in the district which would be inadequately served by the lower reservoir and by the custom of constructing very high buildings upon the low-lying territory. The method of distributing the water over the metropolitan district is given in detail in the report of the chief engineer; it is designed to supply to each community within the district a sufficient quantity of water for its use at a pressure sufficient for all requirements within its territory, and it will be feasible to supply all the highest portions of the district more efficiently than at present from a much smaller number of stations and at a much diminished charge for annual maintenance. In considering the plans for the proposed reservoir above the Lancaster Mills, we have been impressed by the very serious changes which will be produced in the towns of Boylston and West Boylston. It does not appear to us to be a very important objection to our plan that certain mill sites will be eighty feet beneath the surface of the basin, nor that the homes of many industrious people dependent upon these mills for their Uving will be also submerged, because all these can be paid for, and an equiv- alent will be given, — damages for which we have caused careful estimates to be made. But we have not deemed it to be within our province to decide upon a plan for making good the^many other METROPOLITAN WATER SUPPLY 271 losses that must of necessity fall upon these sorely diminished townships, — the burden of a town debt for which much of the available security has been taken away, the loss of a near market for the farmer upon the outskirts of the town, and the many other losses which will naturally suggest themselves. We can only state that we recognize the existence of these losses, that we believe some form of compensation should be granted, and that the benefit to the metropolitan district by reason of a pure water supply in abundant quantity will be so great that this district, which contains more than half the taxable property of the state, can afford to pay for all the injury inflicted ; at the same time we must leave the suggestion, even, of the nature of the remedy, to the wisdom of your honorable body. The total assessed valuation of West Boylston for 1894 was. . $951,610 Assessed value of property to be taken 557,73° The total assessed valuation of Boylston for 1894 was .... 429,435 Assessed value of property to be taken 165,200 In preparing the estimates for the cost of the great work here sketched out, we have brought to our assistance the best expert aid, and believe that the works can be constructed within the esti- mates which have been liberally made with the usual allowance for contingencies. It may also be of interest to you to know that, of the whole watershed of the Nashua River above the city of Nashua in New Hampshire, at which place the Nashua enters the Merrimack, the proposed reservoir cuts off 22 per cent; but, with the provision which is inserted in the draft of an act herewith submitted for allowing a stated quantity of water to be discharged into the mill pond below the reservoir dam, the deprivation of water will not be so extensive as the proportion of reservoir watershed to the whole watershed of the Nashua would indicate. The estimates of cost have been made by Mr. Stearns, the chief engineer of the Board. They have been made from carefully prepared designs, and are intended to be sufficient to include the full cost of the completed work. The cost of the works necessary to supply all the communi- ties of the metropolitan district for the next ten years with the 2 72 STATE SANITATION main part of the works of sufficient capacity for a long future is estimated as follows : — Reservoir on Nashua River, including the cost of land, buildings and water rights taken, the relocation of roads and railroads, the removal of all soil from the site of the reservoir, the construc- tion of dams and dikes and all incidental expenses $9,105,000 Improvement of the watershed of the Nashua River and of the Stony Brook branch of the Sudbury River by the diversion and purification of sewage and drainage of swamps 513,000 Aqueduct from the Nashua River to the Sudbury watershed and open channel from the end of the aqueduct to Reservoir No. 5 . 2, 265,000 Additional forty-eight-inch pipe from Dam No. 3 to Dam No. i and across the Rosemary valley 78,800 Pumping stations, reservoirs and pipe systems for elevating and distributing water to all of the cities and towns in the metro- politan district, including the improvement of Spot Pond . . 5,584,000 Damages for the diversion of water from the Nashua River and incidental damages not included above 1,500,000 Total first cost of proposed works for supplying water to all of the cities and towns in the metropolitan district .... $19,045,800 The estimates of damages for the diversion of water from the Nashua River are beUeved by the Board to be ample to cover all reasonable demands, and are made large enough so that it is prob- able that some of the more important can be settled within the estimate without litigation. It is not proposed in the driest year to lower the water in the reservoir more than sixty feet, and there will always be a great fall between the surface of the water in the reservoir and in the aqueduct leading from it. It is estimated that this fall may be utiUzed to furnish 1,000 horse-power by day and 500 horse-power by night for the first fifteen years, and nearly as much for the following years. After these twenty years, should the growth of the district be as estimated, additions will have to be made by adding certain tributaries of the Assabet River, or by extending the works to the valley of the Ware River, either of which can be done at a comparatively small cost. The annual cost for interest, sinking fund and maintenance of the works for supplying the whole district when the works METROPOLITAN WATER SUPPLY 273 The estimated first cost of the proposed works for supplying water to all of the cities and towns in the metropolitan district is, as above stated $19,045,800 Within the next ten years, if the water is used by all of the cities and towns, there will be required an additional expenditure for an aqueduct from Reservoir No. 5 to Weston, and for main pipes and an aqueduct therefrom to the existing distributing system and to Spot Pond of 4,982,000 In the second ten years a further expenditure will be necessary for additional pipes from Weston and for improving a portion of the Sudbury River watershed, not included in the first estimate, of 1,300,000 Total expenditure for full development of Nashua River source, and for a supply of 173,000,000 gallons of water per day distributed to all of the cities and towns in the metro- politan district $25,327,800 are first completed is estimated to be ninety-three cents per inhabitant, and the cost will decrease with the growth of pop- ulation. In conclusion, we desire to again call your attention to our pro- found conviction of the need of prompt action in entering upon works of construction which cannot for years be completed, and of which the absolute necessity will at an early day be forced upon this community; and we are confident that we have pointed out an economical as well as practicable means of securing one of the most essential conditions for healthy human life. H. P. Walcott, J. W. Hastings, H. F. Mills, F. W. Draper, G. C. TOBEY, J. W. Hull, C. H. Porter, State Board of Health. XXVI A COMPARATIVE STUDY OF THE TOXIN PRODUCTION OF DIPHTHERIA BACILLI By Theobald Smith, M.D., and Ernest L. Walker [This paper of Dr. Smith and Mr. Walker resulted in decided improvements in the manufacture of antitoxin. It was an admirable piece of scientific investigation. The long table of results accompanying the paper is here omitted. Twenty-eighth Annual Report, 1896, p. 647. — G. C. W.] Introduction ^ This inquiry was suggested by the following important problems bearing upon the restriction of diphtheria : — 1 . Is there any difference in the pathogenic power of diphtheria bacilli from different locaHties ? 2. Is the pathogenic activity of bacilli producing diphtheria in the summer season different from that of those producing disease in winter ? 3. Is there any reduction in the pathogenic power of bacilli in cases in which they persist in the throat after recovery ? 4. Are there any differences noticeable between the bacilli of mild and those of severe cases ? The third and the fourth questions have been attacked by other observers, while the first and the second have not been especially investigated. The answers to the third and the fourth questions have been, as a rule, negative. Observers have found little or no difference in bacilli from mild and severe cases, nor have they been able to show any recognizable loss of virulence in the bacilli persisting in the throat after recovery. The reasons for entering upon this subject again were the opportunity we have had of examining cultures from different towns within the state, and more especially certain improved ^ The writer wishes to acknowledge the faithful assistance of J. R. Stewart, to whom the preparation of the culture media was chiefly intrusted. As^^will be seen from what follows, this is not a simple task. 274 TOXIN OF DIPHTHERIA BACILLI 275 methods of cultivation by which the maximum toxin-producing capacity of each bacillus could be brought out and measured more accurately than had been done heretofore. The selection of cultures for the study of the questions stated above has not been entirely satisfactory, mainly because much of the clinical information necessary to a proper choice was not accessible at the time the cultures were received, and in some instances obtainable only with difficulty at the last moment when the final results were tabulated. We hope, however, that the material at hand may be supplemented by more in the near future. The Mode of Action of Diphtheria Bacilli It is now a generally accepted theory that diphtheria bacilli act in the main through the toxins which they produce, and which are rapidly diffused into the fluids containing the vegetating bacilli. The contents of the bacilli themselves seem to be of Uttle moment as pathogenic factors. Park and Williams ^ allowed the washed diphtheria bacilli to soak for a week " in a 0.5 per cent alkaline carbolic solution." The injection of one cubic centimeter did not " produce any marked reaction in a 500-gram guinea-pig," although the bacilli themselves were powerful toxin-producers. KosseP collected the bacillar membranes from cultures, washed the bacilli repeatedly by centrifugalizing with 0.5 per cent sodium chloride; then, after killing them with vapors of chloroform, he extracted them for several days in a few cubic centimeters of weakly alkaline fluids. The extract was only feebly poisonous, for it required 5 cubic centimeters to kill a 360-gram guinea-pig in forty-eight hours. Brieger and Boer ^ found that shaking diphtheria bacilli with ammonium chloride and allowing them to stand for eighteen to twenty hours removes the toxin from the bodies of the bacilli. The bacilli after extraction were fatal to a 500-gram guinea- pig, in doses of 0.0 1 gram of bacillar substance. They acted ^ Journal of Exp. Med., I, p. 174. 2 Centralblatt f. Bakteriologie, XIX, p. 977. 3 Deutsche Med. Wochenschrift, 1896. 276 STATE SANITATION by producing local necrosis. Brieger states that antitoxin had no effect upon this action of the dead bacilli, and that immunization towards it by gradually increasing doses failed. The poison itself withstood an hour's boihng. These experimental observations, taken together, show that the toxin in the culture fluid and not the body substance of the bacilli themselves is to be looked upon as, the disease agent. The success following the prompt application of antitoxin in sufficient doses is an additional support to this view. Moreover, the bacilli them- selves do not penetrate into the body in large numbers, hence need not be specially considered as adding to the toxic effect of their products. We may, for convenience, regard the disease-producing power of diphtheria bacilli as made up of two elements, — toxicity and virulence. The former represents the rate of accumulation of toxin in culture fluids, and is easily measured; the virulence, on the other hand, which may be regarded as the behavior of diph- theria bacilli toward Hving tissue, is as yet an unknown quan- tity. This distinction between the toxic product of diphtheria bacilH and their inherent vital power to cope with living tissue seems to be established, at least experimentally, by the increase in virulence of diphtheria bacilli in their passage through a series of guinea-pigs, which has been reported by various observers. Thus, Aronson ^ states that a culture which was at first fatal to guinea-pigs of medium weight, in o. i cubic centimeter doses, was fatal, after some serial inoculations, in doses of 0.008 cubic centimeter. That is to say, its virulence was augmented twelve times. This experiment evidently means not that the toxin formed in the subcutis of guinea-pigs became twelve times stronger in quality at the end of the series, but that the baciUi injected were capable, by an adaptation of some sort, to multiply much more abundantly toward the end of the series, and hence produce more toxin. The other explanation, that the toxin itself had become more potent in quality, could only gain confidence if the bouillon culture produced much more toxin at the end of the experiment than at the beginning, the conditions remaining precisely the same. ^ Berl. klin. Wochenschr., 1893, Nos. 25 and 26. TOXIN OF DIPHTHERIA BACILLI 277 To compare the disease- producing power of diphtheria bacilli from different sources, it was, therefore, thought best to study the relative accumulation of toxin in bouillon, and eliminate the bacilU by filtration before the test upon animals. The writer is fully aware of the fact that but an instrument of pathogenic power is here dealt with, and under artificial conditions, since we do not know the nature of the nutritive fluid which the bacilli make use of on mucous membranes, nor, as a consequence, whether the toxin production in bouillon is a true index of the production of toxin on mucous membranes. The problem is, in fact, very complex, as with all infectious diseases, and all we can hope to do at a time is to examine one factor of disease as care- fully as possible, while eliminating all the others for the time being. The use of Hving cultures upon animals is of no service in these experiments, because it introduces at once three variable factors: (i) the bacilli as potential toxin-producers after injection; (2) the poison of their bodies after destruction; and (3) the toxin pre-formed in the culture fluid injected. As a consequence, all who have used cultures find them uncertain in their action, as compared with the toxin alone. The bacilli injected as nearly free from fluid as possible are equally unreliable as measures of toxicity, as the following tests show: — Two cultures of diphtheria bacilli are selected, which differ con- siderably in toxin-producing power, the toxin-producing power of one being about three times that of the other. Inclined agar cultures are prepared from each, and after six days' growth the bacilK are removed with a platinum wire, the amount of moist bacilli weighed and stirred in 5 cubic centimeters sterile bouillon, making a moderately cloudy suspension. One cubic centimeter contained by weight about 0.0007 gram of moist bacilli. Bacillus No. 14. — Five-tenths cubic centimeter of the suspension, in- jected subcutaneously into a guinea-pig weighing 313 grams, is fatal in five days; i cubic centimeter is fatal to a 330-gram pig in six days. Bacillus No. 40. — Of the suspension made in the way described, i cubic centimeter is injected into a guinea-pig weighing 315 grams. Animal just escapes death, and is chloroformed on the sixth day. Another, weighing 330 grams, receives 0.5 cubic centimeter. A slough forms at the place of injection. The guinea-pig remains in fair condition. 278 STATE SANITATION Though these tests show a greater activity on the part of Bacillus No. 14, yet we miss here not only the sharp definition in the results obtained by varying the dose of the same culture, but also in comparing the effect of the same doses of cultures from different sources. A prolonged study of the relative production of toxin in bouillon under certain uniform conditions has shown such remarkably uniform results with the same culture, even after long intervals of time, that the results obtained in this way may be accepted as showing an inherent difference in the various bacilli studied. The Method Employed in Comparing the Toxin Production of Different Cultures In a former publication ^ the writer has given the conditions which must be fulfilled in order that a maximum accumulation of toxin may take place in bouillon cultures. The facts there con- sidered and others since then brought out may be very briefly reviewed here. In 1895, Spronck ^ called attention to the fact that the variable amount of sugar present in beef was responsible for the great fluctuations observed in the toxicity of diphtheria cultures. The writer had observed this independently of Spronck, by studying the relation between the amount of toxin in cultures and the amount of sugar as determined by the fermentation test. Sugar is present in all beef, but in perhaps 10 per cent the amount is very small. In bouillon made from such beef the writer obtained very strong toxin. In bouillon from beef containing over o. I per cent sugar the toxin was very feeble. The cause for this difference lies in the acid or acids formed from the dextrose by the diphtheria bacillus, which inhibit the multiplication in a direct ratio to the amount formed. In suffi- cient quantity the growth may be entirely checked, and finally, when the acidity has reached a certain degree, the baciUi and the toxin are destroyed. Whether there are other causes at work besides mere inhibition of multiplication remains undetermined. ' Trans. Association American Physicians, for 1896. 2 Annal. de I'lnstitut Pasteur, 1895, p. 758. TOXIN OF DIPHTHERIA BACILLI 279 A small amount of dextrose, up to 0.05 per cent, is not inimical to toxin production; in fact, it seems to be more favorable than none at all, probably because a certain minimum amount is neces- sary for the cell life of the diphtheria bacilh. Bearing these facts in mind, we are better able to comprehend the various changes going on in cultures. The life of the culture begins with a rapid multiplication of the bacilli introduced and the formation of a surface membrane usually within twenty-four hours. At the same time, any sugar present is acted upon at once, with the re- sult that the reaction becomes more acid. If the acidity increases beyond 2 per cent of a normal acid solution,^ the culture is Hkely to become languid, the surface membrane rifted and settle to the bottom. Some bacilli, by a vigorous surface growth which probably oxidizes the acid products formed, may subdue a large amount of acid, even to 3.5 per cent, and cause a rapid return towards the alkahne level. The toxin appears in greatest con- centration when the alkaline level has been reached, usually within eight to twelve days, when sugar is present in small amount only. When sugar is more abundant the acid period is prolonged, during which little growth is evident. After several weeks a slow alkalizing tendency brings the culture to a more vigorous growth and to an alkaline reaction, but without much accumulation of toxin. Without going into more detail on this subject, we may sum- marize the conditions under which diphtheria bacilh produce maximum amounts of toxin in the ordinary i per cent (Witte) peptone bouillon as follows : — 1. Muscle sugar in the fluid from o to 0.05 per cent. 2. Initial reaction from 0.8 to 1.5 per cent normal acid, the lower figure pertaining to bouillon containing the largest amount of sugar, the higher to bouillon containing none. 3. A thin layer of bouillon freely exposed to the air through one or more cotton-plugged openings in the vessel, and quiescent because the surface membrane which forms within twenty-four hours must not be disturbed. ^ I. e., each 100 cubic centimeters of the culture fluid requires 2 cubic centimeters of a normal solution of alkali to bring the whole to the neutral point as determined by phenolphthallein. 28o STATE SANITATION 4. The accumulation of toxin should be permitted to go on until the growth is checked by the alkaline reaction. This appears in from eight to twelve days, according to the initial reaction and amount of sugar present, and the growth ceases when the reaction is equivalent to 0.2 to 0.3 per cent normal alkali. The main difficulty before us, therefore, is to get beef containing only traces of dextrose. The writer's original plan, to select the bouillon in accordance with the fermentation test, is not feasible, because so little can be used. Spronck's suggestion, to allow the beef to lie for several days, in order that a partial decomposition by bacteria may transform the sugar, is better, but suffers from certain difficulties. The kind of bacteria cannot be controlled, and frequently the sugar is found but partially removed. Lat- terly, the writer has given up this method for one more rapid and certain in its action. The beef infusion is prepared either by extracting the chopped beef at 60° C. for several hours, or over night in the refrigerator. After removal of the beef the infusion is inoculated with a culture of some bacterium which rapidly acts upon dextrose, and placed in the thermostat over night. The writer has tried only B. coli, and found a complete transformation of carbohydrates taking place over night. In the case of bouillon designed for diphtheria toxin the incuba- tion should be as short as possible, so as to leave a trace of sugar in the fluid. This can be accomplished by placing the inoculated infusion in the thermostat at 10 p.m. and removing early next morning (8 a.m.). The infusion is then made up in the usual way, with I per cent peptone, ^ per cent sodium chloride. The final reaction should range, according to the amount of sugar left as stated above, between 0.8 and 1.5 per cent normal acid, phenol- phthalein being used as indicator. It can easily be brought to any desired point by adding from sterile solutions the calculated amount of normal acid or alkali (HCl or NaHO). The whole procedure is very simple after it has been put into routine practice. At any rate, the bacteriologist must make up his mind to give up the early slovenly methods of preparing culture media, or else be prepared for constant reverses and failures. TOXIN OF DIPHTHERIA BACILLI 281 The bouillon must be sterilized finally in the autoclave, since the ordinary steaming frequently fails to destroy certain spore- bearing anaerobes, which begin to multiply after the diphtheria bacilli have formed a membrane and deoxidized the culture medium. These anaerobes inhibit the production of toxin. ^ Park and Williams claim ^ that the amount of dextrose in beef purchased in New York City is not sufficient to interfere with the maximum accumulation of toxin if the culture be made sufficiently alkaline to begin with. This claim I cannot support by my experience with beef bought in the Boston markets. It may be that these authors had under observation bacilli which had ac- quired, through surface cultivation, a greater power to promptly oxidize acid products. This power is not possessed, as a rule, by bacilli recently isolated from the throat, with which this article deals. A number of observers have pubKshed studies of the relative virulence of diphtheria bacilli from various sources, and those persisting in the throat after recovery for a variable length of time. It is not the object of this article to re-examine these writings and review the results obtained. For a summary of the literature the reader is referred to the article by J. H. Wright in the Boston Medical and Surgical Journal, Vol. 131, 1894, page 329, and Scientific Bulletin, No. i, of the health department, city of New York, 1895. A perusal of the various articles will show that the method of testing the virulence of the diphtheria bacilli was not adapted to give uniform or quantitative results. Thus, Park and Beebe, on page 23 of the bulletin referred to, recommend alkaline glucose bouillon as a culture medium, and the injection of cultures forty- eight hours old. Wright used sugar bouillon very largely. From what we now know of the inhibitory and destruc- tive action of the acids formed from dextrose by diphtheria bacilli, the use of more than o.i per cent dextrose in bouillon must be considered as at least unsafe. However, the authors followed ^ Since writing this, it has been observed that high temperatures in the autoclave may modify the bouillon in such a manner that only little toxin is formed subse- quently. This matter is now under investigation. 2 Journal of Experimental Medicine, I, 1896, p. 164. 282 STATE SANITATION general usage at that time, for even Escherich, in his work on diphtheria issued in 1894, page 91, states that dextrose is not decomposed in appreciable manner by diphtheria bacilli, and therefore has no influence on growth. Authors have not, so far as the writer knows, reported compara- tive tests of toxin production under conditions as nearly uniform as possible. It was mainly to fill this gap, if possible, that the series of cultures to be described were subjected to a comparative examination from the point of view of toxin production. Table I^ gives a condensed account of the work done upon which the cal- culation of toxin production rests. In this table will be found: (i) the amount of acid produced in dextrose bouillon; (2) the condition of the bouillon used for the cultures; and (3) the test of the filtrate on guinea-pigs. The acid production will be dealt with farther on. The facts relative to the bouillon used need some explanation. The beef used for bouillon, with one exception, was allowed to decompose according to Spronck's suggestion, but the results were not uniform, as stated above. In some of the bouillon the dextrose was absent, in some present in traces, in some in more appreciable amount, according to tests made with the fermenta- tion tube and B. coli. In none was it present in the amount usually found in bouillon made from fresh beef. It is not probable that this slight fluctuation in the amount of dextrose had any appreciable influence on the culture. Where a doubtful result was obtained it was usually supplemented later on with a second test. The question might be asked. Why not use the same bouiUon for all bacilli studied, in place of the many lots actually employed? This would seem the simplest procedure, provided the bouillon did not change with time under the influence of light and air. A diminution in the amount of toxin produced in bouillon which had been standing for some time in a closet not absolutely dark had been casually observed. It is probable that bouillon in vacuo and kept in a dark place might meet the conditions of the problem, but bouillon kept under ordinary conditions would not. Further ^ This table is not reproduced. TOXIN OF DIPHTHERIA BACILLI 283 investigations are now in progress to determine more precisely the degree of change produced in bouillon by age. It might be claimed that different bacilli isolated from the throat would have different rates of growth in bouillon, and that the accumulation of toxin was simply a factor of the rate of multi- phcation, rather than of any inherent differences in the physiology of the bacilli. To answer this claim a determination of the number of diphtheria bacilli in cultures is not trustworthy, for the reason that diphtheria bacilh clump together, and the number of colonies in plate cultures may not indicate the number of baciUi used in preparing the plate. Again, bacilli may die in the course of growth, and others take their places. The writer has therefore endeavored to estimate the vigor of growth by the amount of change in the reaction produced. Cultures which in a given time in the same bouillon produce nearly the same amount of alkali may be regarded as having performed the same amount of work and grown with equal vigor. The uniformity of reaction in the various groups of bacilli studied together, after ten or twelve days, was such as to leave little doubt that the growth had been equally vigorous. When any culture lagged perceptibly behind, it was usually repeated with other bouillon. The extent of the alkaH production varies with the initial reaction of the bouillon and the presence of dextrose. Cultures containing the latter became at first more acid before swinging back to alkaUnity. In Table I, therefore, it was deemed best to give both the initial reaction of the bouillon, the approximate amount of dextrose and the final reaction. Some idea may thus be gained of the ampHtude of change which the fluid underwent during the period of growth permitted. The culture vessel used at first was a large test tube placed in an inclined position after inoculation. This was soon given up for the Erlenmeyer flask, in which the depth of the bouillon was about 1.5 centimeters. The toxin formed after ten to twelve days was tested upon guinea-pigs. The fluid was passed through filter paper until clear, then diluted with sterile salt solution, so that the quantity of toxin injected was contained in i cubic centimeter. Usually o.i cubic 284 STATE SANITATION centimeter of toxin was injected. The place of injection chosen was the left side of the abdomen. Great care was exercised to deposit the fluid in the subcutis, and not to prick the muscles of the abdominal wall. A vascular injection of the omentum or peritoneum is usually a result of the introduction of some of the fluid into the abdomen. When such reddening was noted at the autopsy, the test was repeated upon another animal, since death is hastened somewhat when this occurs. Guinea-pigs weighing between 300 and 350 grams were used whenever possible. When larger ones had to be used, the increase in weight was duly taken into account. From the results of such inoculations the minimum fatal dose upon a guinea-pig weighing 300 grams was calculated. The calculation when such had to be made was based upon the fact that the minimum fatal dose usually kills a guinea-pig in from three and one-half to six days. If x represents this dose, then a guinea-pig which succumbed in two and one-half days, or sixty hours, received -g-, and one which succumbed in thirty-six hours, -9-. Guinea-pigs of greater weight do not necessarily bear an exact equivalent increase of toxin, but usually somewhat less. In general, it may be said that the values given as the minimum fatal doses may err within 10 per cent, owing to various factors which cannot be controlled. Among these is a slight variation among guinea-pigs in their tolerance of the virus, the darker (black, or black and red) animals being able to stand about 10 per cent more toxin than the white animals. Even if we allow a variation of 10 per cent in the values given in Table I, the general outcome of the comparative study is not made in any sense untrustworthy. Morphology The following description of the morphology and the staining peculiarities of the bacilli studied is based on microscopic prep- arations from cultures of twenty-four hours' growth at 35° to 37° C. on Loffler's blood-serum mixture, uniformly fixed and stained. The cover-slip preparations were dried in open air at room temperature, fixed by heating twenty minutes in a dry-air steriUzer at the temperature of 120° C., and stained eight minutes with Loffler's alkaline methylene blue solution. It may be TOXIN OF DIPHTHERIA BACILLI 285 remarked, however, that experiment shows that the method of fixation has little if any effect on the outline of the bacillus or upon the aggregation of its chromatin, and consequently upon the irregularity of its staining. In length the diphtheria bacilH vary from 1.5 )li to 13 /x, and for the purpose of description it is convenient to distinguish three groups: short bacilli, including all bacilli under 2 /i in length; bacilli of medium length, including all bacilli between 2 ju and 4.5 jLt; and long bacilh, including all bacilli over 4.5 /z in length. Bacilli in culture No. $^ are rather remarkable for their length, averaging 7.5 )U to 10 /x, while a few were found as long as 13 )u. It may be said of diphtheria bacilH in general that there appears to be a tendency for the shorter baciUi to become swollen at the middle and for the long bacilH to become swollen at the ends ; and that the short bacilli are usually straight, while the long baciUi are usually curved or bent at an obtuse angle. Comparison on the basis of length, outline and manner of staining allows the bacilli of the forty-two virulent cultures to be divided into three types, of which the following description may be given : — Type I. Bacilh of medium length, straight, cylindrical or slightly swollen in the middle, with blunt ends, and with intensely stained granules in an otherwise uniformly but less deeply stained cell. In the shorter bacilh of this type these granules are usually situated at the ends of the rod, one at each end; but in the longer bacilli there may be, in addition to these polar granules, one or more interpolar granules. These deeply stained bodies are usually of less diameter than the thickness of the bacillus, but may be of greater diameter, swelling the bacillus at the points where they are situated. Type II. Bacilh long, slender, curved, more or less swollen at one or both ends, and with alternating stained and unstained (or faintly stained) cross-segments. Type III. This includes seven of the forty-two cultures. BacilH are of various lengths, swollen in the middle, with tapering ends, and with broad, unstained terminal and intermediate segments. These unstained terminal segments may be so exten- sive that a body simulating a nucleus in the middle of the cell is 286 STATE SANITATION the only stained portion. More often the cell may consist of two stained and three unstained cross-bands. The staining of this type differs from that of Type II, in that the alternating segments of Type II are narrow and numerous and the terminal ones are always stained. Modifications of these types and intermediate forms occur even among bacilli of the same culture, but in nearly every case one form predominates sufficiently to allow the culture to be ranged under one of these three types. In the routine work of bacteri- ological diagnosis of diphtheria, as carried on under the direction of the State Board of Health, Type I and its modifications are found in about 90 per cent of the positive cases and bacilli of Type II make up the greater part of the other 10 per cent. Bacilli of Type III are very infrequently found. This classification holds good for young cultures on Loffler's serum mixture only. Bacilli belonging to these three types have so far proved viru- lent to guinea-pigs when tested according to the methods given in another part of the text. But besides these a certain number of bacilli (Nos. 3, 4, 39 and 44 of the tables) have been isolated which are non-pathogenic, and which belong to the class of pseudo-diphtheria bacilli described farther on. Toxin-Producing Power The toxicity of the culture fluid of the forty-six cultures after an incubation at 35° C. for ten to twelve days ranged as follows, the 300-gram guinea-pig being the basis of the computations: — Table 47 Cubic Centimeters In one the minimum fatal dose is 036-.04 In one the minimum fatal dose is 045 In five the minimum fatal dose is 050 In five the minimum fatal dose is 060 In four the minimum fatal dose is 070 In four the minimum fatal dose is 075 In eleven the minimum fatal dose is 080 In two the minimum fatal dose is 090 In four the minimum fatal dose is 100 In five the minimum fatal dose is 120 In four no toxin was formed TOXIN OF DIPHTHERIA BACILLI 287 Leaving aside for the moment the non-pathogenic forms, we notice in this summary, first of all, a considerable uniformity in the toxin-producing power. It is true the strongest toxin pro- ducer accumulates three times as much toxin as the weakest, but only one of such strength was found. It will be noticed also that the greater number of bacilli studied produce an 0.08 cubic centimeter toxin. If we group the cultures as follows, Cultures .036-.06 cubic centimeter toxins 12 .o7a-.o9 cubic centimeter toxins 21 .100-.12 cubic centimeter toxins 9 the predominance of the middle group is better brought out. Cultures of much greater toxin-producing power have been isolated by Park and Williams. Of these, the minimum fatal dose is reported to range from 0.002 to o.oi cubic centimeter. It is not stated whether these cultures produced this amount of toxin at the outset, or after periods of artificial cultivation. By comparing these figures with the results of earKer observers, the greater efi&ciency of the method described appears in striking relief. Experimenters when first preparing antitoxin had some difficulty in finding bacilli whose toxin would yield a minimum fatal dose of 0.08 to o.i cubic centimeter. In the series here recorded only five out of forty-two fell below this mark. Although the clinical records of the cases from which the bacilli came are very meagre, they suffice to show that any direct rela- tion between toxin production and severity of the disease is not obvious. This has been the inference of observers before us (Wright, Park and very recently Timaschew ^) , and we are able to confirm it after the application of more uniform and exact methods. This is what might be expected when we contemplate the complex nature of the disease process, the many factors which may enter into it, both on the part of the patient and the invading bacilli. There is one factor, for instance, which may modify the course of the disease, and therefore make any present-day esti- mates untrustworthy, — namely, antitoxin. If applied early enough, it may convert a potentially serious case into a mild one, ^ Centralblatt f. Bakteriologie, XXI, 1897, p. 623. 288 STATE SANITATION in spite of a virulent organism. Antitoxin was used in nearly every case from which bacilli were studied, but the time of admin- istration and the number of units injected were not reported excepting in a few cases, so that the facts on hand are not worth any serious study. All that can be said is that the toxin-produc- ing power of bacilli from mild and from severe cases varies but little, and that all throat affections must be regarded equally dangerous if diphtheria bacilli are present. The Toxin-Producing Power of Bacilli Persisting IN THE Throat after Recovery Much interest has been aroused by the patients in whose throats diphtheria bacilli may be found a variable length of time after subsidence of all symptoms of disease. Loffler, in his investigation of the etiology, found diphtheria bacilli in the throat of a healthy child. Roux and Yersin first called attention to the persistence of diphtheria bacilli after recovery, but they disseminated the impression that there was a gradual attenuation going on which eventually made them harmless. That this may be true in certain cases is not disputed, otherwise it would be difficult to account for the presence, in the mouth of some healthy persons, of bacilli in no way distinguishable from those associated with disease processes except by an absence of virulence.^ This attenuation has not been observed by subsequent investigators, however, and no reliance can be placed upon it to purge the throat of the recovered case of its infectious character. Among the forty-six cultures studied there were eleven made from the throat fifteen to sixty-two days after the appearance of the disease. Owing to the meagre records returned, it is impos- sible to state how long after the subsidence of the symptoms the bacilli were obtained from the throat; but by a reference to the table, where the relative severity of each case is noted, some idea may be gained by the reader of the probable duration. The following table summarizes these cases. It includes two from which harmless pseudo-forms were obtained : — 1 Centralblatt f. Bakteriologie, XXI, 1897, p. 37. TOXIN OF DIPHTHERIA BACILLI Table 48 289 Number of Culture Date of Earliest Symptoms f Culture Inter- val (in Days) 3, 1896 22 9, 1896 57 19, 1896 52 19, 1896 22 17, 1896 26 30, 1896 IS 29, 1896 37 4, 1897 17 16, 1897 16 19, 1897 27 25, 1897 45 23, 1897 42 I, 1897 62 Minimum Fatal Dose of Toxin (Cubic Centimeters) 23 24 26 27 34 36 39 40 42 43 44 45 46 July 12, 1896 July 14, 1896 Aug. 28, 1896 Sept. 27, 1896 Oct. 22, 1896 Nov. IS, 1896 Nov. 22, 1896 Dec. 18, 1896 Dec. 31, 1896 Feb. 20, 1897 Feb. 8, 1897 Feb. 9, 1897 Jan. 29, 1897 Aug. Sept. Oct. Oct. Nov. Nov. Dec. Jan. Jan. March March March April .07 .08 ■05 .06 ■05 .08 Not toxic .12 .07 .08 Not toxic .08 .08 If we exclude the harmless, non- toxic cultures (Nos. 39, 44), which will be discussed farther on, we observe that, so far as toxin production is concerned, the length of time the bacilli have sojourned in the throat has no tendency to reduce it below the average. This is still better brought out by arranging the cultures in the following groups : — Table 49 Group Days after Beginning of Disease Number of the Culture Toxicity (Cubic Centimeters) I IS to 20 ■ > 20 to 30 < \ 50 to 62 < 35 40 42 23 27 34 43 24 26 45 46 .08 .12 II .07 .07 .06 Ill ■05 .08 .08 •OS .08 .08 2 go STATE SANITATION Still more to the point are cultures Nos. 22 and 23, which were isolated from the same case, one three, the other twenty-two, days after the onset of the disease. Here the toxin production was practically the same for both cultures. Pseudo-Diphtheria Bacilli From the table it will be seen that four of the forty-six cultures isolated were found to be pseudo-diphtheria bacilU. It does not he within the scope of this paper to discuss at length the relation between the true diphtheria bacillus and the pseudo-diphtheria bacillus. A very good discussion will be found in the work of Park and Beebe, to which the reader is referred. Since its appear- ance nothing new has been added to this subject. These bacilU, however, influence to a certain degree the interpretation of prob- lems in pubhc sanitation, so that a brief reference to them becomes necessary. These bacilli, generally known as pseudo-diphtheria bacilli, are short rods (1.5 m to 3 m), with rounded or tapering ends (often oval in culture), and uniformly stained, or with a single narrow, unstained cross-segment. A few cylindrical, pear and hour-glass shaped bacilli are occasionally seen; but involution forms are not marked, even in old cultures. They are distinguished from diphtheria bacilli by being shorter, smaller, more uniform in size, shape and manner of staining, and, as pointed out by Escherich, by a tendency to lie parallel in cover-slip preparations. These bacilli are of occasional occurrence, both in the throats of patients suffering from non-diphtheritic throat affections and in true diphtheria mingled with the Klebs-LofHer bacilli. They are, however, almost always present in small numbers, while the diphtheria bacilli, in recent cases, are usually present in large numbers and well differentiated. It is only in convalescent cases of long duration that the pseudo-diphtheria bacilli are Ukely to cause doubt. They might be mistaken for the last few remaining diphtheria bacilli, or the reverse might occur. A few remaining virulent forms may be regarded as pseudo-forms. Diphtheria bacilli directly from the membrane from the throat, or from TOXIN OF DIPHTHERIA BACILLI 291 cultures scarcely at all developed, sometimes resemble quite closely the pseudo-diphtheria bacilli in morphology and staining. The morphological differences are reenforced by at least two biological differences of importance, — the absence of any power to produce acids in bouillon containing dextrose, and the lack of pathogenic power. In Table I,^ it will be seen that all toxin- producing bacilli, when multiplying in bouillon containing i per cent dextrose, produce a considerable amount of acid, ranging from 3.5 to 5 per cent of a normal acid solution when phenolphthal- ein is used as an indicator. A few cultures were found which produce between 5 and 6 per cent. The pseudo-diphtheria bacilli produced no acid under the same circumstances. The culture slowly becomes more alkaline, as shown in the table (Nos. 3, 4, 39, 44). The culture fluid of these bacilli was Ukewise free from toxin. Guinea-pigs which received from six to twelve times the average fatal dose of the virulent cultures showed no trace of infiltration at the place of injection and no loss in weight. Though there are these three distinctive features of pseudo- diphtheria bacilli, — characteristic morphology, absence of acid and of toxin production, — it is not a simple matter to recognize them as such promptly under the microscope when taken from throat cultures, unless the observer has had considerable training. It is highly probable, therefore, that Roux and Yersin in their earlier work may have mistaken pseudo-diphtheria bacilli for true diphtheria bacilK, when they found virulent and non-virulent forms together in the throats of convalescents. This may explain their at that time quite natural position, — that the virulent forms were being transformed into non-virulent forms. In two of the cases tabulated above (Nos. 39 and 44) the pseudo-diphtheria bacilli were isolated respectively thirty-seven and forty-five days after the beginning of the disease. Here, without a more pro- found study of the cultures, the belief might gain the upper hand that the cultures represented diphtheria bacilli which had lost their virulence. This position can no longer be upheld, and we must accept or at least act upon the presumption that the pseudo- ^ This table is not reproduced. 292 STATE SANITATION diphtheria bacilli belong to a wholly different group of bacilli^ and that a loss of pathogenic power of the genuine forms does not take place in the mouth for months after the subsidence of the disease, when such forms persist after recovery. Of the non-virulent but otherwise characteristic diphtheria bacilli, described by Park and Beebe and by others more recently, none have come imder observation. XXVII SANITARY CONDITION AND IMPROVEMENT OF THE NEPONSET MEADOWS [Written by Dr. H. P. Walcott, chairman of the Board. Special Report, T897,pp. v-x. — G. C.W.] The State Board of Health, acting under chapter 83 of the Resolves of 1895, ^^^ investigated the sanitary condition of the meadows on the Neponset River in the towns of Canton, Sharon, Norwood, Dedham, Milton, and Hyde Park, and herewith sub- mits the results of that examination, together with recommenda- tions for the improvement of the sanitary condition of these meadows and the removal of nuisance therefrom. These meadows are shown upon Plan No. i,' and cover an area of 3,662 acres. Of this surface hardly more than 600 acres appear to be in a condition adapted to profitable agriculture. From the remaining territory crops of hay are obtained occasionally, or not at all. The condition of the meadows seems to have grown worse in recent years, and many of the larger owners have abandoned the attempt to secure some degree of drainage by the mainte- nance of open ditches, on account of the steadily diminishing returns from the crops. At an earlier day and for a succession of years a grass known as the fowl meadow or false redtop grew on these meadows, — the first name still is used to designate the locality, — and, proving to be a valuable forage plant, gave a high value to the lands upon which it flourished. The present condition of the territory, how- ever, is evidently not so favorable as it once was to the growth or preservation of this grass, and it is also probable that cheaper transportation has brought into this market hay of a better quality at a price lower than that at which this marsh grass could be profitably sold. As a result of either or both of these conditions, the value of these lands has steadily fallen. ^ This map is not reproduced. 294 STATE SANITATION While it might be expected that the meadows should be unin- habited, as they are, it is not at first so easy to understand why the higher grounds in the vicinity should be still unoccupied by the rapidly increasing suburban population which seeks and finds acceptable building sites at distances from the business centre of Boston more considerable than any portion of the area in ques- tion. The facilities for transportation by convenient railroads are at least as good as can be found in other directions from Bos- ton, and the towns which make up the district appear to be desir- able places of residence. There has, however, for years existed a popular belief that the meadows have become a source of sickness, and this feeling seems recently to have increased. Intelligent observers report that these meadows are at times the source of disagreeable odors and the direct cause of much sickness. The examinations by this Board have shown that the upper portion of the stream was very seriously polluted, and the opinions of the physicians residing and practicing in the valley, which have been from time to time collected, indicate a general belief on the part of the medical profession that the conditions affecting health here are more unfavorable than they formerly were. The valley of the Neponset River has twice before been the subject of extended examinations by the State authorities, — first by the State Board of Health in 1875, and subsequently by the Massachusetts Drainage Commission in 1885. In addition to these examinations, a description of the Neponset River basin, with statistics relating to its pollution and analyses of its waters, may be found in the special report of the State Board of Health on the examination of water supplies, 1890, and in the twenty- second annual report of the Board. So much of the great body of facts collected by the Board as may be necessary for the purposes of this report will be found in the report of the engineer. The earliest notices of these meadows give evidence that even then there were prolonged periods of flooding, and that it was found necessary to clear the bed of the stream from time to time of its obstructions, consisting of fallen trees and shrubs with the entangled rubbish. With the increasing pollution of the stream, IMPROVEMENT OF NEPONSET MEADOWS 295 however, another and more persistent interference with the current became operative. The waste matters of human life and the refuse of manufactories, when added to the waters of the stream, became efficient fertihzers for the vegetable substances that find a home there, and their increased quantity became a mechanical hindrance to the current, promoted deposits in the bed of the stream, and finally, by their decay, gave to the atmos- phere odors which common experience as well as scientific knowledge declare to be injurious to health. An accurate estimate of the amount of sickness produced by the condition of these meadows, founded upon statistical inquiry, is almost impossible, and largely for the reason that the common- sense of the people and their freedom to select more salubrious locations have prevented settlements in the immediate vicinity of these low lands. We find here, at an average distance of thirteen miles from the State House, an area of more than eleven square miles which is uninhabited. The people have not had the same objections to residence near the great salt marshes which line our coast, where the conditions of flooding and soil moisture are apparently as serious as they can be in the Neponset valley, but are not associated with a seriously polluted water or excessive growth and decay of vegetable matters. We are of the opinion that the condition of these meadows and of the beds, shores and waters of the Neponset River is injurious to the public health. The opinions of the physicians of this dis- trict, as ascertained by an inquiry instituted by the Board, are also distinctly to the effect that the conditions which now exist here are unfavorable to health and that the unhealthful conditions are increasing in amount from year to year. One disease has attracted considerable attention in recent years in many portions of this state, — malarial fever, — and portions of this valley have suffered from it, and severely, when the limited population is taken into account. One farmhouse was found not far removed from the meadows, but lying many feet above their level, which, well built and well cared for, had failed to offer adequate protection against an influence which, originating beyond the immediate surroundings 296 STATE SANITATION of the house itself, was sufhciently potent to affect more than half of the ten occupants of the house. We find that malarial diseases are uniformly prevalent in the Neponset basin, though no distinct concentration of cases has been anywhere observed except in the case of the farmhouse above cited. This is a condition of things which points distinctly to some influence which pervades the whole district, and the obvious origin of such an influence is the condition of the Fowl Meadows, with the polluted river and large areas of stagnant water. While the current theories upon the subject of malarial diseases may sufficiently explain the occurrence of these diseases in a marshy region, with stagnating water and the inevitable accompaniment of decaying vegetation, we are well aware that future scientific examination may find the really essential factor in some hitherto unsuspected condition of such territories. But it fortunately is true that malarial diseases where once prevalent have disappeared upon the removal of conditions such as those now found through the Neponset valley, and that the general healthfulness has been distinctly and immediately increased thereby. Attention is also called to the report contained in the appendix ^ prepared by the chemist of the Board. With the co-operation of the owners of the larger manufactories on the river, a very com- plete examination has been made of methods for diminishing the pollution of the stream by treatment of the efiiuents from these establishments, and it has been found that these effluents, either by themselves or when mixed with ordinary town sewage, can be satisfactorily purified upon properly prepared sand filters. It is advisable, however, to remove by sedimentation from the factory effluent, before it reaches the filter, so much of the sludge con- tained therein as is possible. This sludge can be removed from the sewage by means of a settHng basin of moderate dimensions, and, as it contains much more nitrogen than ordinary sewage, could probably be readily disposed of. For the present, at least, the sparsely settled districts adjoining the meadows do not appear to be in pressing need of extended systems of sewage; but the time will come when the same pro- ^ This is not reproduced. IMPROVEMENT OF NEPONSET MEADOWS 297 vision which is here recommended for the factory refuse should be made for the collection and purification of domestic sewage. There appear to be in the valley areas of land suited to inter- mittent filtration, and sufficient in quantity for the needs of the district. Portions of the banks of the stream in the town of Hyde Park are at present in an unsanitary condition; but legislation sub- sequent to that authorizing this inquiry by the Board has pro- vided a sufficient means for the relief of this state of things, through the construction of a sewer system having an outlet into the metropolitan system of sewerage. The measures which we recommend for the remedy of the con- ditions injurious to health now existing in the Neponset valley are these : — (i) Such additional legislation as will prevent the entrance into this stream of sewage and manufacturing wastes which have not been satisfactorily purified. (2) The permanent removals of the flashboards of the dam of the Mattapan Mills, the enlargement of the cross-section of the river at points indicated on Plan No. 3,^ together with a deepening and reconstruction of the channel at such places as may be found necessary for making a channel of such width and grade as will prevent the flooding of the meadows during the times of high flows in late spring and summer. A conservative estimate of the cost of making this improve- ment, irrespective of land and water damages, is, in round num- bers, $125,000. The engineer also presents some figures to show the increase in the value of meadow lands reclaimed, and to this sum should also be added the enhanced value of the now neglected building sites immediately adjoining the meadows. It can thus be demonstrated, we think, that the work of improvement would be justifiable from a money standpoint alone. We have not considered it within our province to present the agricultural advantages of a drainage of this expanse of meadows. Land so well adapted, as this would be when drained, to the purposes of market gardening must always have a value near a great market far in advance of any price now paid for land in this district. ^ This map is not reproduced. 298 STATE SANITATION When we limit ourselves, however, to considerations of health, it scarcely seems necessary, now that a considerable portion of the state has acquired a knowledge of the depressing and dis- abling effects of malarial diseases, to insist upon the economical value of a freedom from the conditions that favor their preva- lence. We do not hesitate, therefore, to recommend the improve- ment of this district, the healthfulness of which is vital to the immediate residents therein, as well as to the occupants, present and future, of the lands lying about it. It will be remembered that, in accordance with the recom- mendations of the Massachusetts Drainage Commission, legisla- tion was had now embodied in chapter 375 of the Acts of 1888. Under the provisions of this act the State Board of Health has the general oversight and care of all inland waters. The commission which suggested the legislation above referred to used these words in their report to the Legislature of 1886: — Let these guardians of inland waters be charged to acquaint themselves with the actual condition of all waters within the state as respects their pollution or purity, and to inform themselves particularly as to the relation which that condition bears to the health and well-being of any part of the people of the Commonwealth. Let them do away, as far as possible, with all remediable pollution, and use every means in their power to prevent further vitiation. They shall put themselves at the disposal of manufac- turers and others using rivers, streams or ponds, or in any way misusing them, to suggest the best means of minimizing the amount of dirt in their eflSuent, and to experiment upon methods of reducing or avoiding pollution. They shall warn the persistent violator of all reasonable regulation in the management of water of the consequences of his acts. In a word, it shall be their especial function to guard the public interest and the public health in its relation with water, whether pure or defiled, with the ultimate hope, which must never be abandoned, that sooner or later ways may be found to redeem and preserve all the waters of the state. The suggestions contained in these sentences have governed the action of this Board during the ten years which have passed since the State Board of Health was made the official guardian of the inland waters of the Commonwealth. It is our opinion that all reasonable efforts have been exhausted in the attempt to do away with the remediable pollution of these waters, and that the time has come when the state must take more effective measures for IMPROVEMENT OF NEPONSET MEADOWS 299 the prevention of the pollution of the streams not now used as sources of domestic water supply, but still capable of injurious effect upon the pubUc health. H. P. Walcott, H. F. Mills, F. W. Draper, G. C. TOBEY, J. W. Hull, C. H. Porter, J. A. Mead. XXVIII A MASSACHUSETTS LIFE TABLE FOR THE FIVE YEARS 1893-97 By Dr. Samuel W. Abbott [Dr. Samuel W. Abbott was not only an efficient secretary, but a very able stat- istician. At this time when renewed interest is being taken in the subject of vital statistics, Dr. Abbott's study of life tables with special reference to Massachusetts is worth reviewing. Thirtieth Annual Report, 1898, p. 810. — G. C. W.] The usefulness of life tables is not confined to the work of life insurance. A life table also serves as an index of the sanitary con- dition of the community out of whose data it is constructed. Life tables differ for the same group of population from year to year, and they also differ when calculated from the statistics of different portions of a group of inhabitants, as, for example, the city of Boston, compared with any of the outlying districts beyond its borders. The work of constructing a life table for any American state or city is necessarily less satisfactory in its results than the work of making a similar table for any of the civilized nations or com- munities of Europe, since most foreign populations are much more stationary than our own. The English life tables, compiled by Dr. Farr, which have proved universally useful as standards of good work in this direc- tion, were usually calculated from the Hving population at twa successive census enumerations and from the deaths occurring in the intervening period. The factor of migration, however, in an American state affects the accuracy of such a calculation ; hence a somewhat different method has been employed in constructing the following table, and a shorter period of five years has been selected. Massachusetts has an advantage not enjoyed by many communities in having an intervening state census five years after the national census, and this advantage is especially useful in any state whose population is far from stationary. A MASSACHUSETTS LIFE TABLE 301 The materials selected as the basis of the table below are the census of 1895, and the deaths, numbering 240,215, which were registered in the state in the five years 1893, 1894, 1895, 1896, and 1907. The mid-year of this period (1895) was the census year, and the census was taken very near the middle of that year (in Table 50 Population or Massachusetts, 1895, and Deaths, 1893-97 Age Periods Population, 1895 Total Males Females Deaths, 1893-97 Total Males Females ^5 S-io 10-15 15-20 20-25 25-35 35-45 45-55 55-65 65-75 75-85 85-95 Over 95 Age unknown. 235,647- 224,119 202,900 225,881 265,983 465,943 341,535 245,586 157,651 90,088 35,405 6,123 308 3,014 118,4531 112,296 101,574 110,565 123,692 227,630 168,997 118,417 72,766 41,040 15,460 2,180 77 1,554 117,1941 111,823 101,326 115,316 142,291 238,313 172,538 127,169 84,885 49,048 19,945 3,943 231 1,460 78,779 6,730 3,460 6,305 9,982 20,148 18,832 19,377 22,334 25,561 20,547 7,105 559 496 42,710 3,345 1,655 2,899 4,899 10,103 9,619 9,895 11,278 12,694 9,675 2,713 152 378 36,069 3,385 1,805 3,406 5,083 10,045 9,222 9,482 11,056 12,867 10,872 4,392 407 118 Total 2,500,183 1,214,701 1,285,482 240,215 122,006 118,209 1 The population figures in this line (0-5) were not used in the construction of the life table, but the figures employed were estimated from the registered births and the deaths under 5 years of age. the months of May and June). The mean annual number of deaths at each age is compared with the population maintained at such age. The limitations which affect the accuracy of a Hfe table for Massachusetts are the following: — I. The Effect of Migration. The natural increase of the popu- lation, or that which results from the excess of births over deaths, has for many years constituted only a portion of the total increase from year to year. The census enumerations of 1890 and 1895 showed an increase of 261,240, of which number the excess of births formed only 36 per cent, the balance, 64 per cent, being the 302 STATE SANITATION difference between the numbers of immigrants and emigrants; or, in other words, the effect of migration exceeded that of natural increase in the ratio of nearly 2 to i. Moreover, the increment by means of immigration is not uni- form at the different age periods, fully one-half of the immigrants being between fifteen and thirty years of age, while the numbers at the extremes of life are comparatively small. Table 50 presents the classified material out of which the life table is constructed. 2. Defects of the Census. Mr. Henry Gannett, in a paper con- tributed to the " Publications of the American Statistical Asso- ciation " (Vol. IV, p. 99), estimates a " shortage in the census of 1890 of negro children of about a quarter of a million," and of the native white children " about the same." If this be correct, the entire shortage or deficiency in the total population, including that among foreign whites, must leave at least a million unac- counted for in the United States. A careful examination of the last two census enumerations of Massachusetts (those of 1890 and 1895) shows that Mr. Gan- nett's estimate is probably none too large.^ It is possible to supply the actual deficiency for the first four or five years of life, with some degree of accuracy, from the registered births; but beyond this period of Hfe it is hardly practicable to make estimates which are of greater value than mere conjectures. 3. The Practice of incorrectly reporting the Ages of the Living and the Dead. This error is of two kinds : {a) It invariably hap- pens that greater numbers of persons are reported at the even ages, 20, 30, 40, etc. (both of the living and the dead), than at 19, 21, 29, 31, etc., in consequence of the common habit of using round numbers instead of giving the more accurate ages. This is in a measure eliminated by employing the periods used in Eng- land, 25-35, 35-45, etc., instead of 20-30, 30-40. (&) The habit, especially noted among unmarried females, of understating the ages of the living. This appears to a greater or less degree to be a ^ Mr. E. B. Elliott also assumes an approximate shortage for the first five years of life alone of 100,000 in the United States census of 1870. Volume on " Vital Statistics," p. 522. A MASSACHUSETTS LIFE TABLE 303 common practice in all countries where census enumerations are made, 4. Defects in Birth and Death Registration. These defects, so far as Massachusetts is concerned, are probably insignificant, and in this respect the material collected by the registration officers of cities and towns compares favorably in its accuracy with that of foreign nations and communities having estabHshed systems of registration. Great pains are taken in most of the municipalities to obtain accurate and full returns, since a pro rata fee is allowed to the local officers for them; moreover, the certifiers of births and deaths (physicians, midwives, and undertakers) are com- pelled, under penalty, to comply with the statutes requiring such returns. There is also a comparatively small number of persons included in the census whose sex and ages are unknown, and the same may be said of the registered deaths, the latter being probably mostly deaths of prematurely born infants, and a small number of bodies of unknown persons found dead. Certain comments and explanatory statements are necessary in relation to the construction of the tables which follow. The figures for the first five years of fife have been compiled from the births, and from the deaths which occurred among children under five years of age. The census figures for these five years were disregarded, for the reasons aheady stated in former reports, and in accordance with the common usage in other countries.^ Dr. Farr says, in regard to this subject: " We can scarcely feel surprised to find, in the various censuses of Europe, errors in the statements of age, traceable to ambiguities of language. In the early years of life these mistakes demand attention, otherwise they may lead us into such grave mistakes as we have to notice." These well-known defects may be corrected without serious difficulty for the first years of life. An exact and accurate life table of any population or com- mimity can be made only by taking a definite number of persons^ 1 Twenty-sixth Annual Report Massachusetts Board of Health, p. liv; also Dr. Farr's " Vital Statistics," Memorial volume, p. 207. 304 STATE SANITATION say 100,000 or 1,000,000 at birth, and following their life history, noting the age of each person at death, until the entire number has ceased to live. Such a process is impossible, especially in an American community, subject, as it is, to the variable effect of migration. In view of this manifest impossibiHty, it is therefore necessary to construct an approximate table from such data as are acces- sible, bearing in mind the limitations, to which reference has been made, and making such corrections of errors as are customary in the construction of similar life tables for other communities. Starting with a h5^othetical 1,000,000 or 100,000 births, this generation of persons of both sexes may be followed, with a reasonable degree of accuracy, to the extinction of the last sur- vivor, at the age of one hundred or more, by the application of the rules which it is customary to employ. In the case of Massa- chusetts, we have selected the number 100,000 as the basis of the table, since this is the largest round number near the exact num- ber of annual births in the state. The sexes at the time of birth are unequally distributed, the males being in the ratio of 51.350 and the females 48.650 out of each 100,000 born during the period selected for the construction of the table. These numbers are therefore taken as the numbers at birth of the two sexes, out of the hypothetical 100,000 born. In order to ehminate the effects of epidemic years or of abnor- mal conditions existing in the census year 1905, the mean annual deaths of the five years, 1893-97, are employed to obtain the death-rates at each year of life. In the English Ufe tables it has been customary to estimate the population at the middle of a given year for life-table purposes, the census being taken on the first of April. The State census of Massachusetts being taken at a time quite near the middle of the year, no allowance has been made for the few days elapsing between the time of such taking and the mid-year, since such allowance would at most only affect the second place of decimals in a death-rate expressed as a ratio per i ,000 Uving of a given age. Moreover, the popula- tion enumerated in May, near the middle of a five-year period, differs much less from the actual mean than that which is taken A MASSACHUSETTS LIFE TABLE 305 near the middle of a ten-year period, as compared with a mean of the two extremes of such period. Dr. Billings says, in his introductory remarks in the twelfth volume of the tenth census, 1880 (page cxliii) : " The preparation for any given locality, race or occupation, in this country, of a life table which shall accurately represent the tendency to death or the probability of survival at each age, is practically impossible, because of the want of accuracy in the necessary data, and because of the irregular migrations of the population. It should be clearly understood that all tables of vital statistics, including data derived from large numbers of people, even when these are obtained by the most accurate census possible, and by the most complete system of registration which can be enforced, give probabilities only, and that scientific accuracy in this field is practically unattainable." The foregoing remarks apply with less force to Massachusetts than to the United States as a whole, since our own state has had a system of registration in existence since 1842, the results of which may now be considered as fairly accurate. Dr. BilUngs therefore publishes an approximate life table in the volume referred to for Massachusetts and for certain other communities, from such data as were obtainable for the census year 1880. In the life table pains have been taken to make it as accurate as possible from the data at hand. The compiler is entirely responsible for whatever errors or inaccuracies it may contain. One hundred thousand infants, followed throughout their first year during the period named, in Massachusetts, 3deld 90,250 years of life. To obtain this mean of the infants living through- out the first year, the following method was employed : — All of the deaths of infants imder one month old which occurred in the years 1893-97 were tabulated from the mortality returns in the office of the Secretary of State, also those of infants who died in the second and the third month of Hfe separately, then those of infants who died in the three succeeding months of life (3-6) in one group, and then those who died in the succeeding six months in another group. From these data, and from the births registered in the five years ending with June 30, 1897, the figures for the 3o6 STATE SANITATION first year of life were calculated after the method shown by Dr. Farr in his life table No. 3, page xxiii. The foregoing mean, 90,250 (the arithmetical mean of the series Iq, l^, % . . . ^i),is used as the first term of column P (see tables 53 and 54) . All of the succeeding terms in the column for the years I, 2, 3, 4, etc., are the means of the terms in the preceding col- umn Ix, using the formula P^ =— ^^ • The total number of persons living under five years of age in the state in 1895, as stated by the census, was 235,647 ; but the number as calculated from the living births in these years was 294,604, or 58,957 more than the figures of the census would indicate. No allowance is made in this estimate for migration, which would slightly increase the difference. The effect of migra- tion at this period of Ufe, however, is much less than at later ages, especially from fifteen to thirty years. Table 51 Population under 5 Years State Census of 1895 Calculated from the Births and Deaths under s Difference Males ii8,4S3 117,194 149,582 145,022 31,129 27,828 Females 235,647 294,604 58,957 Description of the Tables In tables 53 and 54, column x, ages, presents the ages for each sex from birth up to 100 years. Column dx presents the numbers of those dying in each age of life for each sex. Column 4 presents the survivors of each sex, out of 100,000 of both sexes, at each age of life, beginning with 51,350 males and 48,650 females at birth. Colunrn Px presents the population maintained by the numbers in column L. A MASSACHUSETTS LIFE TABLE 307 Column Qx shows the aggregate number of years which the per- sons at each age in the table will live, until their extinction by death. Column Ejc{ = j^) is the mean future life time of the persons living at each age in the table, the expectation of life. Column Wa; (Table 55), the mortality column, presents the mor- tality per unit of the population at each age of life, the figures being obtained by dividing the deaths in each age by the popula- tion at such ages, the proper corrections and interpolations having been applied. From this column (w^) the probability of living at each year of age {px) (Table 55) is obtained by the formula px = applied to each year of the series. Column Ix is obtained by the formula lxXpx= Ix+i, and column Px is obtained by the formula ^^• 2 What may be learned from these Tables It appears that, out of 100,000 children bom aUve in Massa- chusetts in 1895, 16,000, or nearly one-sixth, die before arriving at the age of one year; 78,963, or nearly four-fifths, attain the age of three years; 77,051 survive the age of five years, or 77 per cent; 50,126, or a little more than one-half, attain the age of fifty- three years; 25,406, or a little more than one-fourth, live to the age of seventy-two years. These figures present very decided differences as compared with those which were pubKshed for 1855 by Mr. E. B. Elhott (Sixteenth Massachusetts Registration Report, 1857). In those reports it was shown that the numbers dying before the close of the first year out of 100,000 bom were 15,510, or very nearly the same as those for the year 1895 ^^r the same age. At the end of three years the survivors were only 74 per cent, instead of 79 per cent, as in 1895, and that one-half had died before the close of the forty-first year, instead of surviving to the fifty- third, as in 1895. In consequence of the fact that the numbers of each sex are unequal at birth, the males continue in greater numbers until the 3o8 STATE SANITATION fifty-third year, when the greater death-rate of the males has reduced their number below that of the females, and the females continue in excess throughout the remainder of Hfe. Observing the table more closely, it appears that the comparative intensity of the death-rate of the sexes varies at different points in the table. For the first five years the death-rate of males exceeds that of females. From age five to age nineteen inclusive the rate of females exceeds that of males, and from age twenty to the end of life the death-rate of females is less than that of males. In Table 55 are presented two columns in which are shown the probabiHty of living one year from each age and the mortality per unit of the population at each year. At birth the probability of Uving a year is for males .82569 and for females .84939, that of boys at birth being about the same as for men of eighty-six, and that of girls about the same as that of women at eighty-six or eighty-seven. The probability of Hving a year is at its highest point for boys at age twelve (.99722), and for girls it is about the same for age eleven as at age twelve (.99695 and .99693). A comparison of the death-rates of Massachusetts at different periods presents certain points worthy of notice. The death-rate of children under five and especially of those under one year of age has not undergone very marked changes (see table); but that of all ages from five to forty has very per- ceptibly diminished, while that of ages above forty has increased. This result has been produced by the great reduction in the num- ber of deaths from infectious diseases, including consumption, which occur in the early period of life, from two years up to thirty. By this means a much larger ratio of the population than formerly survives to live throughout the useful and wage-earning period of life. This causes a material increase in the number of years lived at the later ages of life. ■ These persons being spared from the diseases incident to child- hood, the relative mortality from the diseases of adult Hfe of old age is naturally increased. This decided increase in the number of survivors throughout the useful ages of life has a marked effect upon the vitality of the A MASSACHUSETTS LIFE TABLE 309 population. It is undoubtedly due in no small degree to the increased attention which has everywhere been given in the past twenty-five years to public hygiene. The population of almost any one of the United States differs essentially from the more stationary populations of the old world in the fact that it is constantly being recruited by the addition of considerable numbers of immigrants at the healthy ages of life. These additions constitute a selected class, not only on account of their age distribution (50 per cent are between the ages of fifteen and thirty), but also because many of the weaklings must be left behind, in consequence not only of their inabihty to become wage- earners but on account of the exclusive action of the immigration laws.^ One consequence of this is the comparatively large number of persons at the later ages of Hfe, an effect which has been produced by the long continuance of immigration. The table and diagram below present the numbers of sur- vivors at each of several age periods in Sweden, England, Spain, and Massachusetts (in the latter for the year 1855 and for the period of 1893-97) . Sweden is selected as a country having a very- low death-rate, and also because it is occasionally selected as a standard of a healthy population. Spain, on the contrary, has a high death-rate, chiefly due to excessive mortality in the early years of life. In consequence of the close contiguity of the lines in the first five years of life, the figures for the first five years are given upon a separate diagram, in which the divisions representing the age- periods are increased tenfold. A brief review of the life tables of Massachusetts shows that quite marked changes have taken place from year to year in the life history of the population. The earliest life table in existence pertaining to the population of Massachusetts is that of Edward Wigglesworth, D.D., of Har- vard University, made from records of bills of mortahty collected 1 " If on examination there shall be found among such passengers any convict, limatic, idiot or any person unable to take care of himself or herself, without becom- ing a public charge, . . . such person shaU not be permitted to land." (Extract from immigration act of August 3, 1882, section 2.) 3ib STATE SANITATION Table 52 Data for Construction of Diagram of Survivors Table showing Survivors at Different Ages of Life out of 10,000 born Sweden ^ 1881-90 England and Wales' 1881-90 Massachu- setts 1893-97 Massachu- setts s 185s Spain * 1878-82 10,000 10,000 10,000 10,000 10,000 8,89s 8,536 8,400 8,449 8,083 8,586 8,067 8,054 7,733 7,060 8,399 7,878 7,896 7,424 6,433 8,258 7,758 7,786 7,258 6,151 7,882 7,495 7,487 6,873 5,747 7,713 7,423 7,366 6,726 5,602 7,551 7,281 7,167 6,437 5,413 7,338 7,090 6,906 6,100 5,164 7,109 6,844 6,615 5,748 4,908 6,876 6,550 ■ 6,308 5,408 4,596 6,628 6,216 5,988 5,078 4,378 6,349 5,839 5,651 4,748 4,088 6,043 5,405 5,275 4,409 3,765 5,687 4,891 4,821 4,022 3,381 5,239 4,275 4,272 3,597 2,914 4,658 3,534 3,622 3,065 2,327 3,900 2,684 2,869 2,475 1,666 2,948 1,786 2,042 1,833 997 1,872 970 1,266 1,059 465 894 388 654 437 149 275 100 259 118 40 14 67 20.5 •9 9 2.2 3 4 10 IS 20 25 30 35 40 45 SO 55 60 65 70 75 80 8S 90 95 100 1 For convenience of comparison with Mr. Elliott's table of 1855, the figiires of this table are re- duced to a scale of 10,000, while the diagram is made upon a scale of 100,000. * Fifty-fifth Report of Registrar General. Supplement, vol. i, p. xiv. Vol. 10, part i, p. 75. 3 Sixteenth Registration Report, Massachusetts, 1857. * Bulletin de I'lnstitut international de statisque. Note. — In consequence of corrections made after the construction of the diagram, the line for Massachusetts survivors, 1893-97, should be placed one to two millimeters lower, after age 15. prior to 1789.^ The total number of deaths employed in the construction of this table was 4,893. Its defects consisted mainly in the limited numbers used for computation, in the crude method of recording the ages of the 1 Published in the second volume of the Transactions of the American Academy, 1793- A MASSACHUSETTS LIFE TABLE 311 Fig. 17 312 STATE SANITATION population by the first census (in five periods only, all under lo, 10-16, 16-26, 26-45, ^^^ ^^^ ^'^^^ 45)' ^^^ i^ t^^ f^^t t^^t t^^ table was framed on the assumption of a stationary population. This table was for many years an authority in the courts of the Commonwealth . In 1855 a table for Massachusetts was published in the Six- teenth Registration Report (1857) by the eminent statistician, Mr. E. B. Elliott. This table is calculated from 16,086 deaths, which occurred in 166 towns of Massachusetts in the year 1855.^ In the tenth census of the United States, Vol. 12, part 2, pp. 773-791, Dr. BilHngs publishes approximate Hfe tables for the population of Massachusetts and other states, and for certain cities. Those of Massachusetts are for the white population of the state, and for the census year 1880, comprising 31,341 deaths, and also for the whole population of the state for the five years ended June 30, 1882, and comprising 171,639 deaths. The statement of Dr. Josiah Curtis in the Sixteenth Registra- tion Report of Massachusetts (1857) ^ ^s to the value of life tables is worthy of note. He says: " There are weightier reasons for desiring correct information concerning the comparative mor- tahty of our communities. The governing powers and enlight- ened statesmen are enabled better to discharge their high and responsible duties to the people by a correct knowledge of the physical powers, possessions and resources of the inhabitants. . . . The Christian philanthropist and sanitarian will be enabled to give some definiteness and efficiency to their labors, by a correct knowledge of where, and to what purpose, the laws which prevail over Hfe and death teach them to direct their laudable efforts. The question here forcibly arises, Have the records of registration in Massachusetts, or in any considerable portion thereof, ever been sufficiently complete to enable any one to determine with reliable accuracy what law or laws do prevail over the mortality ^ The calculation was limited to the returns of these 166 towns, since the system of registration then in practice in the state was not believed to be " sufficiently com- plete to furnish data for a life table for the whole state." These 166 towns consti- tuted two-thirds of the population of the state in 1855 (Sixteenth Registration Report, Massachusetts, p. 199). 2 P. 197. A MASSACHUSETTS LIFE TABLE 313 Table 53 Massachusetts Lite Table. Based on the Mortality of the Five Years, 1893-97 Males Age Dying in Each Born and Surviv- Popula- tion or Years of Life lived in Each Year of Age Years of Life Livec in and above Expec- tation of Life at Age Dying in Each Bom and Surviv- Popula- tion or Years of Life lived in Each Year of Age Years of Life Lived in and above Expec- tation of Life at Year of Age ing at Each Age Each Year of Age Each Year of Age Year of Age ing at Each Age Each Year of Age Each Year of Age X. 4. /x. P.. Qs. E,. X. d,. h. P.. (?x. E,. 8,849 51,350 46,343 2,264,048 44.09 SO 448 26,459 26,23s 543,144 20.53 I 1,794 42,501 41,604 2,217,70s 52.18 51 466 26,011 25,778 516,909 19-87 2 818 40,707 40,298 2,176,101 53.46 52 483 25,545 25,303 491,131 19-23 3 559 39,889 39,609 2,135,803 53-54 53 S02 25,062 24,811 465,828 18-59 4 424 39.330 39,118 2,096,194 S3-30 54 520 24,560 24,300 441,017 17-96 5 316 38,906 38,748 2,057,076 52.88 55 539 24.040 23,770 416,717 17-33 6 252 38,590 38,464 2,018,328 52.30 S6 561 23,501 23,220 392,947 16.72 7 20s 38,338 38,235 1,979,864 51.64 57 58s 22,940 22,647 369,727 16.12 8 170 38,133 38,048 1,941,629 50.92 58 608 22,355 22,051 347,080 15-53 9 146 37,963 37,890 1,903,581 50.14 59 636 21,747 21,429 325,029 14-95 10 123 37,817 37,755 1,865,691 49-33 60 659 21,111 20,781 303,600 14-38 11 110 37,694 37,639 1,827,936 48.49 6i 677 20,452 20,113 282,819 13-83 12 104 37,584 37,532 1,790,297 47.63 62 691 19,775 19,429 262,706 13-28 13 III 37,480 37,424 1,752,765 46.76 63 709 19,084 18,729 243,277 12-75 14 135 37,369 37,301 1,715,341 45-90 64 729 18,375 18,010 224,548 12.22 IS 159 37,234 37,154 1,678,040 4S-07 65 748 17,646 17,272 206,538 11.70 16 181 37,075 36,984 1,640,886 44.26 66 769 16,898 16,513 189,266 11.20 17 195 36,894 36,796 1,603,902 43-47 67 789 16,129 15,734 172,753 10.71 18 211 36,699 36,593 1,567,106 42.70 68 810 15,340 14,935 157,019 10.24 19 226 36,488 36,37s 1,530,513 41-94 69 827 14,530 14,116 142,084 9.78 20 241 36,262 36,141 1,494,138 41.20 70 840 13,703 13,283 127,968 9-34 21 255 36,021 35,893 1,457,997 40.48 71 845 12,863 12,440 114,685 8.92 22 268 35,766 35,632 1,422,104 39-76 72 847 12,018 11,594 102,24s 8.51 23 280 35,498 35,358 1,386,472 39-o6 73 842 11,171 10,750 90,651 8.11 24 289 3S,2i8 35,073 1,351,114 38.36 74 831 10,329 9,913 79,901 7.74 25 296 34,929 34,781 1,316,041 37.68 75 816 9,498 9,090 69,988 7-37 26 301 34,633 34,482 1,281,260 37.00 76 794 8,682 8,285 60,898 7.01 27 30s 34,332 34,179 1,246,778 36.32 77 769 7,888 7,503 52,613 6.67 28 309 34,027 33,872 1,212,599 35.64 78 741 7,119 6,748 45,110 6-34 29 313 33,718 33,561 1,178,727 34-96 79 707 6,378 6,024 38,362 6.01 30 316 33,405 33,247 1,145,166 34-28 80 672 5,671 5,335 32,338 5-70 31 318 33,089 32,930 1,111,919 33-60 81 632 4,999 4,683 27,003 5-40 32 319 32,771 32,611 1,078,989 32-93 82 S90 4,367 4,072 22,320 5-11 33 319 32,452 32,292 1,046,378 32.24 83 546 3,777 3,504 18,248 4-83 34 320 32,133 31,973 1,014,086 31-56 84 499 3,231 2,981 14,744 4-56 3S 322 31,813 31,652 982,113 30-87 85 452 2,732 2,506 11,763 4-31 36 325 31,491 31,328 950,461 30-18 86 402 2,280 2,079 9,257 4.06 37 328 31,166 3 1 ,002 919,133 29-49 87 353 1,878 1,701 7,178 3.82 38 331 30,838 30,672 888,131 28.80 88 307 1,525 1,371 5,477 3-59 39 334 30,507 30,340 857,459 28.11 89 263 1,218 1,086 4,106 3-37 40 337 30,173 30,004 827,119 27.41 90 220 955 845 3,020 3-16 41 341 29,836 29,665 797,115 26.72 91 181 735 644 2,175 2.96 42 346 29,495 29,322 767,450 26.02 92 146 554 481 1,531 2.76 43 352 29,149 28,973 738,128 25-32 93 116 408 350 1,050 2.57 44 359 28,797 28,617 709,155 24-63 94 88 292 248 700 2.40 45 368 28,438 28,254 680,538 2393 95 66 204 171 452 2.22 46 379 28,070 27,880 652,284 23.24 96 48 138 114 281 2.04 47 393 27,691 27,494 624,404 22.55 97 33 90 73 167 1.86 48 410 27,298 27,093 596,910 21.87 98 23 57 45 94 1.6s 49 429 26,888 26,673 569,817 21.19 99 IS 34 26 49 1.44 100 9 19 14 23 1. 21 314 STATE SANITATION Table 54 Massachusetts Life Table. Based on the Mortality of the Five Years, 1893-97 Females Age Dying in Each Year of Age Bom and Surviv- ing at Each Age Popula- tion or Years of Life lived in Each Year of Age Years of Life Lived in and above Each Year of Age Expec- tation of Life at Each Year of Age Age Dying in Each Year of Age Bom and Surviv- ing at Each Age Popula- tion or Years of Life lived in Each Year of Age Years of Life Lived in and above Each Year of Age Expec- tation of Life at Each Year of Age X. 4. k. P.. Qx. £.. X. 4. I.. P.. Qx. E.. 7,iSi 48,650 43.907 2,267,469 46.61 50 395 26,292 26,094 581,072 22.10 I 1,662 41,499 40,668 2,223,562 53.58 51 410 25,897 25,692 554,978 21.43 a 763 39,837 39.455 2,182,894 54-79 52 423 25,487 25,275 529,286 20.77 3 544 39.074 38,802 2,143,439 54.83 53 437 25,064 24,84s 504,011 20.11 4 385 38,530 38,337 2,104,637 54.62 54 457 24,627 24,398 479,166 19.46 S 318 38,145 37,986 2,066,300 54.17 55 ■ 476 24,170 23,932 454.768 18.81 6 250 37,827 37,702 2,028,314 53.62 S6 494 23,694 23,447 430,836 18.18 7 206 37.577 37,474 1,990,612 52.97 57 512 23,200 22,944 407,389 17.56 8 170 37,371 37,286 1,953,138 52.26 S8 530 22,688 22,423 384,44s 16.9s 9 147 37,201 37,127 1,915,852 51.50 59 SSO 22,158 21,883 362,022 16.34 10 129 37.054 26,990 1,878,72s 50.70 60 572 21,608 21,322 340,139 15.74 II 113 36,925 36,868 1,841,735 49.88 61 588 21,036 20,742 318,817 15.16 12 113 36,812 36,755 1,804,867 49.03 62 606 20,448 20,145 298,07s 14.58 13 123 36,699 36,637 1,768,112 48.18 63 625 19,842 19,530 277,930 14.01 14 146 36,576 36,503 1.731,475 47.34 64 644 19,217 18,89s 258,400 13.45 IS 172 36,430 36,344 1,694,972 46.53 65 665 i8,S73 18,240 239,505 12.90 16 195 36,258 36,160 1,658,628 45.74 66 689 17,908 17,563 221,265 12.36 17 206 36,063 35,960 1,622,468 44.99 67 71S 17,219 16,861 203,702 11.83 18 218 35.857 35,748 1,586,508 44.24 68 743 16,504 16,132 186,841 11.32 10 230 35,639 35,524 1,550,760 43.51 69 771 15.761 15,375 170,709 10.83 20 241 35.409 35,288 1,515,236 42.79 70 793 14,990 14,593 155,334 10.36 21 251 3S,i68 35,042 1,479,948 42.08 71 809 14,197 13,792 140,741 9.91 22 255 34,917 34,790 1,444,906 41.38 72 821 13,388 12,977 126,949 948 23 261 34.662 34,531 1,410,116 40.68 73 825 12,567 12,154 113,972 9.07 24 26s 34,401 34,268 1,375,585 39-99 74 824 11,742 11,330 101,818 8.67 25 269 34.136 34,001 1,341,317 39-29 75 818 10,918 10,509 90,488 8.29 26 274 33.867 33,730 1,307,316 38.60 76 806 10,100 9,697 79,979 7-92 27 278 33,593 33,454 1,273,586 37.91 77 790 9,294 8,899 70,282 7-56 28 282 33.315 33,174 1,240,132 37.22 78 768 8,504 8,120 61,383 7.22 29 286 33,033 32,890 1,206,958 36.54 79 742 7,736 7,365 53,263 6.89 30 290 32.747 32,602 1,174,068 35-85 80 711 6,994 6,638 45,898 6.56 31 294 32,457 32,310 1,141,466 35.17 81 678 6,283 5.944 39,260 6.25 32 297 32.163 32,014 1,109,156 34-48 82 640 5,605 5,285 33,316 S-94 33 301 31.866 31,715 1,077,142 33-80 83 600 4,965 4,665 28,031 5.65 34 302 31.565 31,414 1,045,427 33-12 84 559 4,365 4,08s 23,366 5-35 35 306 31.263 31,110 1,014,013 32.43 85 518 3,806 3,547 19,281 5.07 36 308 30,957 30,803 982,903 31-75 86 476 3,288 3,050 15,734 4-69 37 312 30,649 30,493 952,100 31.06 87 434 2,812 2,595 12,684 4.51 38 31S 30,337 30,180 921,607 30.38 88 393 2,378 2,181 10,089 4-33 39 318 30,022 29,863 891,427 29.69 89 351 1,98s 1,810 7,908 3.98 40 320 29,704 29,544 861,564 29.00 90 310 1,634 1,479 6,098 3.73 41 324 29,384 29,222 832,020 27.62 91 270 1,324 1,189 4,619 3-49 42 326 29,060 28,897 802,798 27.62 92 232 1,054 938 3,430 3.49 43 329 28,734 28,570 773,901 26.93 93 194 822 725 2,492 3.03 44 332 28,405 28,239 745,331 26.24 94 160 628 548 1,767 2.81 4S 335 28,073 27,905 717,092 25.54 95 129 468 403 1,219 2.60 46 346 27,738 27,565 689,187 24-85 96 100 339 289 816 2.41 47 354 27,392 27,215 661,622 24.15 97 77 239 200 527 2.20 48 367 27,038 26,854 634,407 22.78 98 55 162 134 327 2.02 49 379 26,671 26,481 607,553 22.78 99 40 107 87 193 1.80 100 27 67 53 106 l.S8 A MASSACHUSETTS LIFE TABLE 315 Table 55 Massachusetts Life Table. Based on the Mortality of the Five Years, 1893-97 m I- P X- Age m >• P z- Age Annual Mortality Probability of Annual Mortality Probability of per unit at Each living One Year per unit at Each living One Year Year of Age from Each Age X. Year of Age from Each Age X. Males Females Males Females Males Females Males Females ■1909s .16287 .82569 .84939 50 .01708 .01514 ■ 98307 .98498 I •04313 .04087 ■95778 ■95995 51 .01808 .01596 .98208 .98417 3 .02030 •01933 .97990 ■98085 52 .01909 .01674 .98109 .98340 3 .014H .01403 .98599 .98607 S3 .02023 .01759 .97997 ■98256 4 .01084 .01004 .98922 .99001 54 .02140 .01873 .97888 ■98144 S .00815 .00835 .99188 .99168 SS .02268 .01989 ■97758 .98031 6 .00655 .00663 ■99347 • 99339 56 .02416 .02107 ■97613 .97915 7 .00536 .00550 .99464 ■99452 57 ■02583 .02231 ■974SO 97793 8 .00447 ■00456 ■99556 .99546 58 ■02757 .02364 .97280 .97664 g .00386 .00396 .99616 .99606 59 .02968 .02513 ■97075 ■97518 10 .00326 .00349 •9967s .99652 60 .03171 .02683 .96878 •97353 II .00292 .00306 .99709 ■99695 61 .03366 .02835 .96689 ■97205 12 .00277 .00307 .99722 ■99693 62 •03557 .03008 ■96505 •97037 13 .00297 .00336 .99703 .99665 63 •03786 .03200 ■96285 •96850 14 .00362 .00400 .99640 .99601 64 .04048 .03408 .96032 .96648 IS .00428 •00473 ■99573 ■99528 6s .04331 .03646 ■95761 .96419 16 .00489 ■00539 ■9951 1 .99464 66 .04657 •03923 ■95449 ■96152 17 .00530 ■00573 .09471 .99429 67 .05015 .04241 •95107 .95848 18 .00577 .00610 ■99425 .99392 68 .05424 .04606 •94719 ■95498 19 .00621 .00647 ■99381 .99356 69 •05859 .05015 •94307 ■ 95108 20 .00667 .00683 .99335 .99320 70 .06324 •05434 •93869 ■94710 21 .00710 .00716 .99292 .99286 71 .06793 .05866 •93430 ■94301 22 .00752 .00733 ■99251 .09268 72 ■07306 •06327 ■92951 .93867 23 .00792 .00756 .99212 .99249 73 ■07833 .06788 .92462 93435 24 .00824 ■00773 •99179 .99230 74 .08383 .07273 ■91954 .92983 25 .00851 .00791 •99153 .99212 75 •08977 .07784 .91409 .92508 26 .00873 .00812 •99131 .99192 76 .09584 .08312 ■90854 .92020 27 .00892 .00831 .99112 .99170 77 .10249 .08877 .90251 .91500 28 .00912 .00850 .99092 ■99154 78 .10981 .09458 .89591 .90969 29 .00933 .00870 .99072 •99134 79 .11736 .10075 .88915 .90408 30 .00950 .00890 .99054 .99114 80 .12596 .10711 .88150 .89834 31 .00966 .00910 .99039 ■99094 81 .13496 .11406 .87357 .89209 32 .00978 .00928 .99026 .99077 82 .14489 .12110 .86490 .88581 33 .00988 .00949 .99017 •9905s 83 .15582 .12862 .85544 .87915 34 .OIOOI .00961 .99004 ■99043 84 .16739 .13684 .84554 .87192 ZS .01017 .00984 .98988 .99021 85 .18037 .14604 ■83455 .86390 36 .01037 .01000 .98968 .99005 86 .19336 .15607 .82369 .85523 37 .01058 .01023 .98948 .98982 87 .20752 .16724 .81199 .84567 38 .01069 .01044 .98927 .98962 88 .22392 .18019 .79863 .83470 39 .OIIOI .01063 .98905 .98942 89 .24217 •19392 • 78399 .82322 40 .01123 .01083 .98881 •98923 90 .26036 .20960 .76963 .81028 41 .0x150 .01109 .98857 .98897 91 .28106 .22708 •75357 .79607 42 .01180 .01128 .98827 .98878 92 .30353 .24733 •73647 • 77989 43 .01215 .01152 .98792 .98855 93 •33143 .26759 • 71569 .76399 44 •01255 .01176 .98753 .98831 94 •35484 .29197 .69863 .74522 45 .01302 .01200 .98706 .98802 95 •38596 .32010 .67647 .72406 46 •OI3S9 .01255 .98650 •98753 96 •42105 .34602 .65218 .70502 47 .01430 .01301 .98581 .98708 97 .45206 .38500 .63128 .67715 48 •01513 ■01367 .98498 .98643 98 •Siiii .41045 .59292 .65944 49 .01608 .01431 .98404 .98579 99 •57692 •45977 •55224 .62617 100 .64286 •S0943 •51351 •59399 3i6 STATE SANITATION of the inhabitants of the state, or such portions of it ? We con- sider this question, and its answer, taken in their broader sense and application, as the most important practical consideration connected with our system of registration, and it affords extreme gratification to be able to give an affirmative answer to the ques- tion. Aside from its intrinsic value, it is creditable to the state of Massachusetts, because it is the first instance where such data have been thus furnished and thus used in any considerable com- mimity on this continent. The great practical results in the variety of their applications of such laborious deductions will furnish, not only immediately, but for years to come, the govern- ment and intelHgent statesmen, as well as others, with the means of determining many social and political questions of high practical value hitherto undeterminable." The following table presents the mean annual death-rates at each of thirteen periods or groups of years, beginning with birth, for the five years (1893-97). To these are added as a matter of convenience the death-rates at certain other groups (1-4,0-9, etc.). Table 56 Mean Annual Death-rates at Certain Periods or Life Persons Males Females Age Periods Persons Males Females Age Periods Death-rate at Each Period Death-rate at Each Period Death-rate at Each Period Death-rate at Each Period Death-rate at Each Period Death-rate at Each Period 0-4 56.23 60.12 52.22 45-54 15-78 16.67 14.88 S-9 S-7S 5-69 S.82 55-64 28.18 30.42 26.00 10-14 3-25 3-II 340 65-74 55-34 59-67 51-37 15-19 5-48 5-29 5.68 75-84 107.22 116.20 99.88 20-24 7.40 7.48 7-32 85-94 199.71 223.50 184.81 25-34 9.06 9-33 8.78 95 + 384-43 429.20 367-07 35-44 10.97 II. 19 10.74 Additional Groups or Periods 1-4 21.86 22.38 21-33 1-19 8.61 8.62 8.60 0-9 31-93 33-97 29-83 20-59 12.24 12.73 11.74 1-9 13.10 13-31 12.89 60 and over 66.29 69.50 63.42 0-14 22.73 24.09 21-35 xxrx REPORT OF THE STATE BOARD OF HEALTH UPON THE GENERAL SUBJECT OF THE DISCHARGE OF SEWAGE INTO BOSTON HARBOR [This report relates to the establishment of the South Metiopolitan Sewage System. Special Report, 1900, p. 5. — G. C. W.J By chapter 65 of the Resolves of the General Court of Massa- chusetts of 1899, the State Board of Health is directed to consider the general subject of the discharge of sewage into Boston harbor and the disposal of sewage for the MetropoHtan districts of the Commonwealth, and to report a plan for an outlet for a high-level, gravity or other sewer for the reHef of the Charles and Neponset River valleys. Sewage is now discharged into Boston harbor at two points, one being at the northern limit of the outlet of the harbor near Deer Island Beacon and the other in a more central position nearer the main land on the north side of Moon Island. At the outlet near Deer Island Beacon, which is four and two- thirds miles from Long Wharf in Boston, and in the northerly edge of the main ship channel, sewage from the North Metro- politan district is allowed to discharge as it comes at all stages of the tide. The quantity of sewage discharged in twenty-four hours now reaches about 50,000,000 gallons; and this quantity, while distinctly visible along the northerly edge of the channel for a half mile toward the city on the incoming tide and toward the sea on the outgoing tide, gradually becomes less distinct at greater distances from the outlet, and disappears entirely within a distance of one and a quarter miles. With the increase of population in the North Metropolitan dis- trict the amount of sewage discharged will increase and will spread over a somewhat larger area; but the Board sees no reason to 3i8 STATE SANITATION anticipate any trouble from this for many years in the future upon any inhabitable shores, and believes that the only objection that can be raised to the continual discharge of sewage here will be by those sailing through or near to the stream of sewage within a mile of the outlet. At Moon Island is now discharged sewage from the main drain- age works of Boston, including that from the lower valley of Charles River and from a part of Neponset River valley, amount- ing to a maximum of about 100,000,000 gallons a day. This outlet is about one and three-quarters miles farther west than the outlet at Deer Island Beacon, and much nearer the main land, and so situated that if sewage were allowed to discharge upon the incoming tide it would be brought to habitable shores and become a nuisance ; for this reason the sewage is conveyed to reservoirs on Moon Island during the incoming tide and dis- charged only during certain hours of outgoing tide, when the currents are most favorable for conveying the sewage-laden water toward the sea through channels which render its passage the least objectionable. By storing sewage in reservoirs, even for the hours between tides, it becomes more offensive; and the large amount which must be discharged in the short time of favorable outgoing cur- rents renders the locality of the outlet and the surrounding area of a half mile radius much more objectionable than the steady dis- charge of fresh sewage at Deer Island Beacon. These conditions Umit the amount of sewage that may be concentrated at this point without creating a nuisance. The tunnel connecting Old Harbor Point and S quantum in the line of the Boston main drainage system has a maximum capacity for conveying about 150,000,000 gallons of sewage per day; and this is about the amount of sewage that may be expected forty years hence from the low-level area of Boston for which these works were designed. This amount will be about 50 per cent more than the present maximum discharge, and in the opinion of the Board this should be regarded as about the maximum amoimt that can be concentrated at Moon Island outlet without giving unreasonable offence. SOUTH METROPOLITAN SEWAGE SYSTEM 319 We think the Metropolitan Sewerage Commissioners have done well in seeking another outlet for the South Metropolitan system, with the view of ultimately removing from the Moon Island out- let all of the areas now drained which were not contemplated in the original design for the low-lying area of Boston. With the limitation above indicated, we regard the outlet at Moon Island a suitable point of discharge for the sewage of the low-lying portion of Boston. From a careful study of the channels and currents of the harbor and of the whole area which may in future be included in the South Metropolitan system, we conclude that the Metropolitan Sewerage Commissioners, in their report upon a high-level gravity sewer of February 11, 1899, have designated the channel in the harbor best suited to receive the sewage of the South Metropolitan system, viz., the channel along the northwesterly side of Peddock's Island; but after an extended study of the locality we would advise moving the outlets they propose about 2,000 feet further north, so that both will be one mile from Nut Island, one directly north from the middle thereof and the other 1,500 feet more easterly, as indicated upon the plan. Here the sewage will be discharged about 30 feet below the surface at low tide into a strong and deep current, by which it will be kept well away from inhabited shores until it disappears by commingling with enormous quantities of ever-changing salt water. The paths that will be taken by the sewage discharged at these points with their limitations upon varying conditions of wind and tide are shown upon the maps of the report of the chief engineer of the Board; and, from a study of the actual con- ditions existing at the present outlets, we conclude that the sewage of the South Metropolitan system can be discharged at these points continuously without offence except to those who are saihng in the stream of mingled sewage and water, or near its leeward side within a mile of the outlets, and that they are the most suitable points for the discharge of the sewage of the South Metropolitan system. The plan of outlet designated on pages 77 and 78 of the report of the Metropohtan Sewerage Commissioners of February 11, 320 STATE SANITATION 1899, to the General Court, with the change of position herein presented, is recommended for adoption by this Board. In considering the general subject of the disposal of sewage for the Metropolitan districts of the Commonwealth, as required by the resolve, question has arisen as to what areas were intended to be included in this study. There are areas north and northeast from the North Metro- politan sewerage system which are nearer to Boston than some of the areas which have been considered; but, as the question of dis- charge of sewage into Boston harbor from these territories is not likely to arise, except for some small areas which may become adjuncts to the North Metropolitan system, for which provision is made under existing laws, no consideration is given to these areas in this report ; but examination has been made of all terri- tory in regard to which may arise question as to whether its sewage had better be discharged into Boston harbor. After a very complete study of all of the towns of the upper Charles and Neponset River valleys, a brief statement of which is given in the report of the chief engineer of the Board, it was found that, with few exceptions, to be mentioned, it will be more economical to dispose of the sewage of these towns (which are not designated by law as belonging to one of the Metropolitan districts) by filtration upon land in each town, or by a combination of two or more towns, than by conveying it to Boston harbor. The exceptions are areas of small extent in the towns of Welles- ley, Needham and Weston, lying near to Charles River, the sew- age from which can be conveyed across the river and into the Newton main sewer and thence to the Charles River valley sewer of the Metropolitan system. These are the only additions that it may be well to make in this direction to the South Metropolitan system. South from Quincy and east from Canton are the towns of Ran- dolph, Holbrook, Braintree, Weymouth and Hingham, whose natural drainage is into Boston harbor. Randolph and Holbrook, when they need to dispose of sewage, can do so economically upon land within their respective territories; but Braintree, Wey- SOUTH METROPOLITAN SEWAGE SYSTEM 321 mouth and Hingham can best discharge their sewage into the sea through the outlets of the high-level sewer. Plans by which this may be accompHshed are presented in the report of the chief engineer of the Board. The change of the outlet herein recommended does not require the presentation of a bill for action by the General Court, because chapter 424 of the Acts of 1899, section one, provides that no part of said proposed outlet shall be constructed until plans of said out- let shall be further considered by the MetropoHtan Sewerage Commissioners and adopted and approved by the State Board of Health. It is further provided, by section two of the same act, after describing the limits of the South Metropolitan system, that " nothing herein shall be construed to vest any rights which can- not be extended to cities and towns or parts thereof other than those herein named, upon such terms and conditions as may hereafter be imposed by legislative enactment," and, as the sections of the towns of Wellesley, Needham and Weston and the towns of Braintree, Weymouth and Hingham which are not now included in the South MetropoHtan system can under this section be admitted into the system when they may in the future need to dispose of their sewage, and they can then be allowed to enter without modification of the works already planned, it does not appear necessary or expedient to prepare a bill at this time under which they may then enter. Henry P. Walcott, Hiram F. Mills, Frank W. Draper, Gerard C. Tobey, Jas. W. Hull, Chas. H. Porter, Julian A. Mead, State Board of Health. XXX EXAMINATION OF SEWER OUTLETS IN BOSTON HARBOR AND OF TIDAL WATERS AND FLATS FROM WHICH SHELLFISH ARE TAKEN FOR FOOD By X. H. GooDNOUGH {Thirty-seventh Annual Report, 1905, p. 411. — G. C. W.] The work done upon the examination of sewer outlets and the investigation of the condition of shellfish in the fiats and waters of the Commonwealth during the year 1905 has been confined to Boston harbor. The effect of the discharge of sewage from each of the principal sewer outlets into the harbor has been examined and numerous chemical and bacterial analyses have been made of water both from the neighborhood of the sewer outlets and from other parts of the harbor. The shores of the harbor and of the island therein and the flats exposed at low water have also been carefully inspected, and numerous samples of shellfish (clams) have been collected and analyzed. The results of the investiga- tion are presented in the following report. The examinations of the sewer outlets and the general condition of the harbor have been made with the assistance of Mr. Laurence Bradford, who has had many years' experience in this work. The samples of shellfish and of the harbor waters generally were collected by Mr. Henry E. Mead. The principal sewer outlet in Boston harbor is at Moon Island, where the sewage of the Boston main drainage works has been dis- charged since 1884. At the present time about 100,000,000 gal- lons of sewage are ordinarily discharged daily at this outlet. The sewage is discharged only during the second and third hours of the outgoing tide, and reservoirs have been provided on Moon Island to store the flow of sewage at other times. At the present time, consequently, about 50,000,000 gallons of sewage are dis- charged into the harbor at Moon Island on each tide, the dis- 332 SEWER OUTLETS AND TIDAL WATERS 323 charge lasting about two hours, so that the rate of discharge is approximately 25,000,000 gallons per hour. The sewage from the city sewers on its way to Moon Island passes first through large deposit sewers or tanks for the removal of heavier matters, then through a tunnel about a mile and a quarter in length under Dorchester bay, and is subsequently stored in the reservoirs for a period of several hours, and in consequence the sewage is much decomposed when it reaches the outlet. Observations of the area covered by the discharge of sewage from Moon Island show that the sewage passes out of the harbor chiefly around the southerly end of Long Island, between Long and Rainsf ord Islands ; but a portion passes north of Long Island, at least at times, and a portion also south of Rainsford Island. The outlines of the area affected by sewage are quite well defined on calm days by the greasy film or sleek upon the surface of the water. The next main sewer outlet of importance is that at Deer Island, where the sewage of the North Metropolitan Sewerage District has been discharged continuously into the harbor at all stages of the tide since 1895. There are no reservoirs or deposit sewers along the line of the main sewer leading to this outlet, and the sewage is considerably fresher than that discharged at Moon Island. The quantity of sewage discharged at Deer Island at the present time amounts to about half that discharged at Moon Island, or about 50,000,000 gallons per day; and, as the dis- charge is continuous, the rate of discharge is consequently approximately 2,000,000 gallons per hour, or a little less than one- twelfth the rate of discharge at Moon Island when the reservoirs are emptied there. The outlet is located at the end of a long sand bar exposed only at low water. On the outgoing tide the sewage at Deer Island flows rapidly to sea in a narrow field, and is rarely traceable at any considerable distance from the outlet except in calm weather, when it can be noted in the water for perhaps a mile under favorable conditions. As the tide turns, the flow of sewage turns southerly and then westerly, and after the water has risen over the bar the flow is established generally in a narrow 324 STATE SANITATION field in the direction of Apple Island; and toward high water the sleek can be noticed for a mile from the outlet on calm days, lying between the main ship channel and Deer Island. On the turn of the tide the sewage quickly passes to sea, and evidences of it dis- appear from this area. A third main sewer outlet, known as the Peddock's Island out- let, was completed last year, and is the place of disposal of the sewage of the South Metropolitan District. At this outlet the sewage is at present discharged alternately at two points, one located about i mile due north of Nut Island, and the other 1,500 feet farther east, both outlets being a short distance northwest of the southerly end of Peddock's Island. At Peddock's Island, as at Deer Island, the sewage is discharged continuously without storage at any point; and during the past year about 20,000,000 gallons of sewage per day have been discharged at all stages of the tide, the rate of flow here being a little over 800,000 gallons per hour, or about two-fifths the rate at which sewage is dis- charged at Deer Island. The observations during the past year show that the presence of the sewage in the water can ordinarily be detected only in the immediate neighborhood of the outlet. In addition to the sewage discharged at these main outlets, a large quantity of sewage overflows at times of rain from the com- bined sewer systems in Boston, Cambridge, Somerville and Chelsea, and large quantities of sewage are discharged at such times into the Charles and Mystic rivers and into the upper harbor, and a small quantity into the estuary of the Neponset River. In addition to this sewage, a considerable quantity of sewage is discharged directly into the harbor or its tributaries from a few sewers not connected with the metropolitan systems, chiefly in Chelsea. These sewers are described in the annual report of the State Board of Health for the year 1902, pages 294, 295 and 309. A very large proportion of the sewage of the city of Chelsea (population in 1905, 37,289) is discharged into the tidal waters about that city, at the head of Boston harbor, and causes very serious local nuisances, besides polluting the harbor. Con- nections have already been made by which the sewage from the principal sewers in this district could be discharged into the metro- SEWER OUTLETS AND TIDAL WATERS 325 politan sewerage system; but these connections have been shut off, on account, apparently, of the neglect of the Chelsea authori- ties to maintain their sewers in proper condition. Besides the sewage from these outlets and from the storm overflows of com- bined systems, the harbor receives also a considerable quantity of direct pollution by sewage from buildings and wharves along its shores and from vessels, and a small quantity of sewage is also discharged into the harbor from public institutions on the islands. The fiats about Spectacle Island, on which a garbage disposal plant and a rendering establishment are located, are very foul. Visible Effects of the Discharge of Sewage into Boston Harbor The sewage from the Moon Island outlet greatly discolors the water for a distance of half a mile to a mile from the outlet; but it is very difficult to trace it under favorable conditions for more than two miles, even by careful inspection. The sewer outlet at Moon Island is located at the northwesterly corner of the island, and the sewage is discharged at the level of the water. A sea wall extends for about i ,500 feet southwest from the outlet, and when the sewage is discharged it eddies against this wall throughout its length, and deposits of organic matter take place in the shallow water here during the summer season. These deposits are usually removed by the heavy easterly storms of the fall and winter, but they reappear again in the summer; and the existence of these deposits, combined with the effect of the eddy, is probably responsible in part for the constant presence of a slight excess of organic matter in the waters in this region above those of other parts of the harbor. On the incoming tide the polluted water in the neighborhood of the wall passes up along the south shore of Moon Island toward Quincy bay. Under some conditions in summer, especially on the incoming tide, a small quantity of sewage is said to work up along the northerly side of the island and deposits form at times near the shore on the northerly side of the outlet. These deposits do not appear to be permanent, and are removed by the waves and currents from time to time. With the exception of the deposits noted in the 326 STATE SANITATION neighborhood of the wall, no other noticeable deposits appear to take place in the neighborhood of this outlet. Sewage from the Deer Island outlet discolors the water for a distance of about half a mile from the outlet under favorable conditions, and is traceable for a mile to a mile and a quarter under such conditions; but at these distances the indications of sewage are so slight that they are difficult to trace, and can only be detected in places. The sewage from the Peddock's Island outlet can be traced under the most favorable conditions for less than a mile from the outlet. The odor from the Moon Island outlet is offensive for a distance of about half a mile from the outlet, and is noticeable at times at greater distances. At Deer Island an odor is rarely noticeable for a distance of more than a quarter of a mile, while at Peddock's Island an odor is observable under present conditions only immediately about the outlet. Chemical Examination of the Harbor Water about the Moon Island and Deer Island Sewer Outlets In order to determine more definitely the area in the harbor materially affected by the discharge of sewage at the Moon Island and Deer Island sewer outlets, samples of sea water were collected for chemical analysis at 24 stations in the vicinity of Moon Island and at 14 stations near Deer Island in August and September, and the results are presented in tables and a map ap- pended hereto.^ All of the samples were collected at the surface of the water, which at times was affected considerably by the wind. The first series at Moon Island was collected just before the discharge of sewage from the reservoirs, and consequently about ten hours after the previous discharge had ceased. The results show that the free ammonia at the stations, within the area which have usually, by observation, appeared to be affected by the sewage from this outlet, was considerably higher than at the stations outside, although at the times these samples were col- lected there were no visible evidences of sewage in the water except in the neighborhood of the outlet and along the sea wall. ^ These are not reproduced here. SEWER OUTLETS AND TIDAL WATERS 327 It should be stated here that in all cases a persistently high free ammonia was found in a station close to Spectacle Island, the presence of which is apparently due to local pollution from the garbage disposal plant and rendering works on this island. A second series of samples, collected between four and five hours after high tide, and consequently from one to two hours after the discharge of sewage had ceased, gave results similar to those just described, in that approximately the same area was affected which was found to be affected before the discharge had taken place; but in the latter series of samples both the free and albumi- noid ammonia were decidedly higher at practically all of the stations affected than at the previous time. A third series of samples, collected from one to two hours after low water, and consequently from four to five hours after the last discharge of sewage had ceased, shows a similar result. A slight e£fect of the sewage can be detected from these analyses on both sides of Moon Island and along both sides of Long Island to the edge of the main ship channel. It is also noticeable in the area around Rainsford, Gallup's and George's Islands. An area having a slightly greater amount of free ammonia is also notice- able about Hangman's Island in Quincy bay. This may be due to the discharge of sewage from Peddock's Island sewer, which may go in this direction for a short time after low water. A fourth series of samples, collected from three to four hours after low water, or from six to seven hours after the previous discharge of sewage had ceased, showed approximately the same results as were shown by the first series of samples already described. The results of this examination show that the sea water in the area over which sewage flows twice daily from the outlet at Moon Island contained constantly at this time a sHghtly greater quan- tity of organic matter than is found in the adjacent harbor waters not reached by the sewage from this outlet. In the area toward which sewage flows on the incoming tide from the Deer Island outlet, in the portion of the harbor north of a line drawn from Deer Island Light to Fort Independence, four samples of water were collected at regular intervals at 14 stations, 328 STATE SANITATION one sample being collected about two hours after low tide, a second about five hours after low tide, a third about two hours after high tide and a fourth about five hours after high tide. The samples collected two hours and five hours, respectively, after low tide, represent the conditions existing when sewage from the Deer Island outlet is flowing toward the section of the harbor examined. The samples collected about two hours and five hours, respectively, after high tide, represent the condition of the water in this area when the sewage from Deer Island is flowing out to sea. An examination of the results of the analyses shows, in general, that the quantity of free ammonia in the water of this area was greater about two hours after low tide than at any other time, while the least quantity was found in the samples collected five hours after low water. The differences in the quantities of free ammonia present in the water in different parts of the area were not large. The greatest quantities were present in the samples collected two hours after low water along the southerly edge of the area, i. e., along a Hne drawn from the sewer outlet toward the southerly end of Governor's Island. North of this line the quantities were less, as the following table shows : — Table 57 Table showing Quantities of Free and Albuminoid Ammonia in Waters of Boston Harbor North of the Main Ship Channel. (1905.) [Averages of results at stations in lines parallel with the ship channel.] Two Hours after Low Water Five Hours after Low Water Two Hours after High Water Five Hours after High Water Stations Free Albu- minoid Free Albu- minoid Free Albu- minoid Free Albu- minoid 4, 5, 14 3, 6, 13 2, 7,8,9.... .0177 .0130 .0136 .0118 .0105 .0109 .0043 .0072 .0072 .0103 .0098 .0102 .0095 .0102 .0092 •0093 .0100 .0100 .0128 .0107 .0115 .0107 .0095 .0100 Average . . .0148 .0111 .0062 .0101 .0096 .0098 .0117 .0101 Grouping those stations at approximately equal distances from the outlet, it appears that at two hours after low water the SEWER OUTLETS AND TIDAL WATERS 329 quantity of free ammonia in the water was less at stations 10, 11, and 12, farthest from the outlet, than at the stations nearer the outlet ; while at five hours after low water the opposite was true, i. e., the quantity of free ammonia was highest at stations 10, 11, and 12, farthest from the outlet. The quantity of free ammonia present in the water two hours after high tide was also greatest at the stations farthest from the outlet, — a condition which is probably due in part at least to pollution coming down the harbor from points above. The results of these groupings are shown by the following table : — Table 58 Table showing Quantities of Free and Albuminoid Ammonia in Waters of Boston Harbor North of the Main Ship Channel. (1905.) [Averages of results at stations at approximately equal distances from the Deer Island sewer outlet.] Two Hours after Low Water Five Hours after Low Water Two Hours after High Water Five Hours after High Water Stations Free Albu- minoid Free Albu- minoid Free Albu- minoid Free Albu- minoid 2,3,4 5,6,7 8, 9, 13, 14. . 10, II, 12.. . . .0140 .0150 .0149 .0128 .0102 .0120 .0110 .0113 .0073 .0045 .0070 .0122 .0107 .0097 .0101 .0092 .0073 .0102 .0109 .0112 ■009s .0100 .0099 .0097 .0080 .0102 •OISS .0122 .0095 .0098 .0106 .0097 Average . . . .0132 .0111 .0077 .0099 .0099 .0098 .0115 .0099 Chemical and Bacterial Analyses of the Water IN Different Parts of Boston Harbor In the latter part of September an examination was made to learn the general condition of the water in all parts of Boston harbor. For this purpose 60 stations were selected, distributed as evenly as practicable in all parts of the harbor, but includ- ing a few stations outside its entrance, and at each of these stations samples of water were collected both on the incoming and outgoing tide for chemical and bacterial analysis. The work covered a period of about five days, between September 14 and 29. 330 STATE SANITATION During the period covered by the harbor examinations in September, 1905, there was no considerable rainfall, and the waters of the upper harbor were not being polluted by the over- flow of considerable quantities of sewage during this period, as would be the case in wet weather. The outermost station at which samples of water were collected was at Three and One-half Fathom Ledge, six miles east of Deer Island Light; and the next nearest station was located about half a mile north of Outer Brewster Island, four miles from Deer Island Light. At these two stations samples collected on the out- going tide showed the presence of 27 and 24 bacteria per cubic centimeter respectively, and no coli. A sample collected on the incoming tide in the main channel a Uttle over a mile east of Deer Island Light showed the presence of 22 bacteria per cubic centimeter, and no coli. A sample collected on the incoming tide in the Black Rock channel showed the presence of a larger number of bacteria than at the other stations just referred to, and a larger number was also found in a sample collected be- tween Boston Light and Point AUerton, but no coli were found in either of these samples. All of these stations are outside the harbor. The only stations within the harbor from which samples of water free from coli were obtained, either upon the incoming or outgoing tide, were in a small channel between Crow Point and Slate Island, Hingham, where a sample collected on the incom- ing tide was found to contain 36 bacteria per cubic centimeter, and no coli, and at the bridge at Quincy Point, where a sample collected on the incoming tide was found to contain 65 bacteria, but no coli. The greatest numbers of bacteria found in any of the samples were present in those collected over the sewer outlet at Deer Island, in the neighborhood of the sewer outlet at Moon Island, in the estuary of the Neponset River, and in the main ship chaimel between Boston and East Boston. The effect of the sewer outlet near Peddock's Island was also marked by the presence of a much larger number of bacteria at a station near this outlet than was found at the other stations in this neighborhood. SEWER OUTLETS AND TIDAL WATERS 331 Grouping the results in general accordance with the main divisions of the harbor waters, we find that the smallest average number of bacteria found in samples collected within the harbor — i.e., within a line drawn from Deer Island Light to Point Allerton — was in those collected in Hingham bay. In 15 Table 59 Chemical and Bacterial Analyses of Water from Different Parts OF Boston Harbor. (1905.) Location Bacteria B. CoU Free Ammonia Albuminoid Ammonia Incom- Out- Incom- Out- Incom- Out- Incom- Out- ing Tide going Tide ing Tide gomg Tide ing Tide going Tide ing Tide gomg Tide 1,043 » 1,098 28 30 ■02 S3 .0340 .0131 .0144 526 S87 29 12 .0174 .0205 .0132 .0110 258 197 24 14 .0089 .0126 •0134 .0116 330' 251' 33 62 .0161 •019s .0143 .0206 327 797 143 117 .0103 .0131 .oiis .0136 71 86 4 I .0076 .0073 .0096 .0108 Numbers of Stations at which Samples were collected ' Inner harbor Middle harbor North side of main ship channel Dorchester bay Quincy bay Hingham bay 9-lS 4-8 1-3, 18, 19 20-30 32-38, 43, 44 46-60 1 Station numbers refer to the map. ' Omitting station ii. ' Omitting stations 29 and 30. samples collected on the incoming tide in this bay the average number of bacteria was 71, and in 13 samples collected on the outgoing tide the average number found was 86. Next to Hingham bay, the lowest numbers of bacteria found in the water of any large section of the harbor were found in the region north of the main ship channel between East Boston and Deer Island. The highest numbers were found in the samples collected in the inner harbor and the next highest in those collected in the middle harbor, i. e., in the region around Governor's Island. The greatest numbers of B. coli were found in the water of Quincy bay, and a larger number was found in Dorchester bay than in any other section of the harbor except Quincy bay. The reason for this is doubtless the fact that some of the stations in Quincy and Dorchester bays were within the area affected by the discharge of sewage at Moon Island. The smallest numbers of coli were found in the waters of Hingham bay. 332 STATE SANITATION The results of the chemical analyses correspond very closely to the results of the bacterial analyses. The greatest quantities of free ammonia present in the water of any considerable section of the harbor were found in the waters of the inner harbor and the next highest in the waters of the middle harbor. The results show that the worst polluted section of Boston harbor at the present time is the portion known as the inner harbor, extending from the neighborhood of Governor's Island and City Point up to the mouths of the Charles and Mystic rivers. XXXI INSPECTION OF DAIRIES By Dr. Charles W. Harrington [In recent years the milk situation has been vigorously discussed in Massa- chusetts and, in fact, throughout the country. Dr. Harrington was one of the pioneers in this agitation. This paper is a good summary of prevailing ideas in 1905. Thirty-seventh Annual Report, 1905, p. 519. — G. C. W.^ The causal relation of unclean milk to infantile death-rates is one of the established facts of preventive medicine; and experi- ence has shown, both in this country and abroad, that improve- ment in the sanitary conditions of milk production, handling, storage, transportation and distribution is followed by such marked diminution in the loss of infant Hfe as to make it the imperative duty of pubHc health authorities to give to this much- neglected subject the fullest possible attention. Laws against fraudulent adulteration of milk have been long in existence in most parts of the civilized world, but until very recently the more important question of wholesomeness has been confined within the limits of academic discussion, and only in a small number of cities and towns have regulations been made by local authorities, having no power of supervision beyond the Hmits of their respec- tive communities. In no state in the Union and in no foreign country has the central authority thus far enacted and enforced the strict legislation necessary for the protection of the public health against the consequences of the use of milk contaminated by the exciting causes of infective diseases, especially of cholera infantum, at the place of production and during storage, trans- portation and sale. These causes are in part inherent in the cow (garget, tuberculosis of the udder, etc.), but to a far greater extent they gain access to the milk, therein to multiply, through pre- ventable filth and dust. The production of clean, wholesome milk is dependent upon the maintenance of health in the cow; upon cleanHness of the cow, the cow stable, the milkers and the utensils employed; and upon the methods followed in cooKng, 334 STATE SANITATION handling, storage, transportation and distribution. Clean milk cannot be produced from diseased cows nor from cows encrusted with their own excrement, which in the process of milking must, to some extent at least, become dislodged as fine dust or in large particles and fall into the milking pail; and, even though the larger particles and hairs be removed in the process of straining, the harm has been done. It cannot be produced, even from clean cows, if the milking be done by milkers with unclean hands and unclean clothing, from which the infective organisms may be communicated to the contents of the pail. It cannot be produced where the milking pails, cans and other utensils are not kept in a scrupulously clean condition, and protected from bacteria-laden dust particles. Even under the most perfect sanitary conditions complete exclusion of the various fermentative organisms is im- possible, but their almost inconceivably rapid multiplication can be prevented by rapid cooling of the milk and maintenance of a low temperature thereafter, since warmth is the one most im- portant favoring condition for growth. Therefore, proper and efficient methods and means of cooling and storage are most essential. Since milk is very sensitive to odors, which it very readily absorbs to such an extent as to affect its taste, the proximity of pigs, horses, swill, stored manure and other sources of foul odors is inconsistent with prime quality. The physical condition of the cow having a direct influence upon the quality of her milk, the conditions of the stable as to ventilation, Ught and other influences affecting health should receive a generous measure of attention. It will be seen, therefore, that the production of milk fit for human, and especially infant, consumption, requires proper housing of healthy stock, general cleanliness and careful handling. Recognizing the well-demonstrated importance of an improved milk supply in its relation to the public health, the Board, acting under its general authority, began, on March i, 1905, a systematic investigation of dairies and the conditions under which milk is produced for public sale. As stated in a previous report, the examination embraces an inquiry into the health and condi- INSPECTION OF DAIRIES 335 tion of cleanliness of the cows, the sanitary condition of the stables, the water supply, the methods of drawing, cooling, handling and transportation, and other matters germane to the subject. A separate report is made on each dairy by the inspector to the secretary of the Board, who determines what changes, if any, in conditions or methods are desirable, and communicates his sug- gestions directly or indirectly to the person responsible in each instance. The investigation demonstrated from the start its necessity, for a condition of affairs was disclosed which is not creditable to the Commonwealth. It is true that in most cases the objectionable conditions reported were susceptible of im- provement without the expenditure of money, and without involving anything more than ordinary care in the matter of common cleanliness; but in many instances the conditions which obtained were found to be most revolting in character. The worst existing conditions were not, as might be supposed, found always in the poorer country districts, but often within the limits of cities. One of the worst places visited was situated within five miles of the State House, and presented the following conditions: In a barn with 9,000 cubic feet of air space, with no cellar, and inadequately lighted, were found 3 horses and 14 filthy cows, the latter being fed on brewers' grains, rotting pota- toes and a little grain. The store of potatoes was kept in an adjoining yard, which could not be crossed except by walking through mud and filth nearly 6 inches in depth. In one corner of this yard was an equally filthy pen containing ducks. The liquid manure and other drainage of the barn and yard were conducted in shallow ditches to a small creek, which constituted the sole water supply of the place for watering the stock and washing the milk pails, cans and glass jars used in delivery. The room in which the milk was cooled and handled was thoroughly in keeping with its surroundings, being filthy in all particulars, and exceed- ingly foul-smelling. The attention of the local boards of health of the cities in which this milk was being sold was called to the impossibility of producing clean and wholesome milk in such surroundings. 336 STATE SANITATION Numerous cases, equally bad in some respects, less so in others, and worse in still others, have been reported in various parts of the area covered thus far by the inspector. Condition of Cows In cases where it was possible to do so, the cows were examined as to condition of health and as to condition of cleanliness, but during the warmer months, when the cows were out, this part of the inspection necessarily could not be pursued. Of the cows examined indoors, but 46 were found to be tuberculous; 20 were afflicted with garget to such an extent that the milk contained large amounts of pus; and 10 had retained foetal membranes, with consequent purulent discharge which reached the udder. The attention of the Chief of the Cattle Bureau was called in each case to the existence of tuberculosis, and in all of the above cases the owners were warned to withhold the milk of the particular animals from the market, attention being called at the same time to the fact that the sale of milk from a diseased animal is punish- able by fine. The majority of herds observed were found to be kept in a con- dition far removed from cleanliness. In some cases an entire herd would be found to be encrusted, chiefly on the hinder parts, with wet and dry excrement. In many barns the conditions were found to be such that a cow, however clean she might be on intro- duction, could not fail to be dirty to an objectionable extent within twenty-four hours. As though the natural opportunities afforded for becoming filthy were not already ample, in no fewer than 182 cases was horse manure employed as a bedding material. Inquiry developed the fact that on most farms not only are the cows never groomed, but usually not even their udders are wiped off before the process of milking is begun. Condition of Stables Light. It is remarkable to what extent the importance of Hght, both as a purifying agent and as a necessary condition to health and well-being of cows, is neglected. In a large number of the cow stables no provision whatever existed for the admission of INSPECTION OF DAIRIES 337 light, the open door being its only point of ingress. In some instances what was formerly a glass window had been replaced by a board, or the glass, having been broken, had been replaced with wood or a bundle of straw or other material, to prevent draft. Cases were found where the single window provided had lost its utility through being obstructed by accumulated manure. In many cases an insufficient number of windows, or a sufficiently large number of windows, of inadequate size, were found. The total number of suggestions sent concerning improvement in lighting was 536. Ventilation. Contrary to expectation, the proportion of ill- ventilated barns was found to be small. In only 79 cases was it found necessary to advise the provision of better facilities for removal of foul air and admission of fresh air, and in only 5 instances were the cattle found to be so crowded as to have a far too small allowance of cubic space per head. General Cleanliness. In the great majority of stables general uncleanliness was the rule. Obviously, the parts most likely to be unclean were the platforms and the spaces back of the cows. In very many cases, however, the condition of every part of the barn was one of filth. Of the 1,720 stables which showed defects of one kind or another, no fewer than 1,437 were in need of general cleaning and whitewashing. Other objectionable conditions which were made the subject of correspondence were 106 cases of accumulated manure back of or near the cows; 17 cases of accumulation of liquid manure in depressions in the barn floor; 3 cases of abso- lute blocking of windows with manure; 132 cases of proximity of open privies to the tie-up ; 7 cases of deposits of human excre- ment over the floors; 3 cases of presence of exceedingly filthy calf pens; 2 cases of use of the tie-up for slaughtering purposes, the blood and refuse being improperly cared for; 39 cases of floors so far out of repair as to preclude all chance of cleanliness; and 14 cases of need of a proper system of drainage. In not a few instances, while the cow barn and all its appoint- ments may be maintained in a properly clean condition, its cellar appears to be regarded as of little importance; but a dirty cellar, 338 STATE SANITATION especially in summer, when insect life is active, may be quite as prolific of trouble as a dirty tie-up. In 255 cases the owner was requested to provide some means for the suitable draining of the cellar, and in 284 cases to remove the accumulated manure. In one instance the cellar contained the accumulation of three years, and in another of fifteen months. In no first-class dairy would the keeping of other animals than those which ordinarily belong there be tolerated ; but in many of our cow barns it appears to be regarded as not objectionable to stable horses, to fatten pigs, and to allow sheep, goats and fowls to wander unrestrained. Letters were sent to 272 individuals, requesting the separation of the horses from the cow tie-up by means of suitable partitions; and to 227, requesting the removal of swine and their pens to a proper distance. In 47 cases the cow barn was used for the storage of ordinary city swill, and in one case this material was stored wholesale, the owner being a city scavenger, and dealing in swill, as merchandise, with his neigh- bors. In all these cases, and in 3 1 in which fermenting and rotting brewers' grains were stored, 3 in which fertilizers were stored, 16 where rotten fruit and vegetables were scattered about, and 8 in which dead fowl were undergoing decomposition, the removal of all offensive material was directed. Letters were sent to 14 individuals, suggesting that sheep, goats or poultry be confined, and not allowed access to the tie-ups. Condition of Cow Yards. Partly due to carelessness and partly to natural difl&culties in the way of drainage, it happens not infre- quently that the cow yard, which should be at least a proper place for outdoor exercise of the stock if desired, is converted into a slough from which the gaseous products of decomposition of liquid and soHd manure are given off in such amounts as to be percep- tible hundreds of feet distant. In 52 cases the owner was re- quested to clean his cow yard; and in 149 to drain off the pools of liquid, foul-smelling manure, and to fill in the depressions and make the place less of a public and private nuisance. Water Supplies. Inasmuch as the water supply of the cow barn is frequently employed for purposes of cleansing the utensils used in the production and sale of milk, it is of extra importance INSPECTION OF DAIRIES 339 that this should be protected from pollution. Ordinary polluted water may cause no injury whatever in animals that drink it, but it may be productive of disastrous effects in man when used for the cleansing of cans, if the polluting material contain the germs of infectious human diseases; and experience has shown that not a few epidemics of typhoid fever have occurred in this state and elsewhere in consequence of the pollution of the water supply by the excreta of persons sick therewith or convalescent therefrom; and in a number of instances it has been proved that milk responsible for the dissemination of typhoid fever has been pro- duced at farms where persons, either sick or convalescent, were employed about the cows. Letters were sent in reference to water supply as follows : advising the protection of the well from surface drainage, 37; condemning the use of well water on account of obvious contamination, 15; advising the protection of the milk trough in which the milk is cooled, 9; advising a change in the method of disposal of the kitchen drainage, 6 ; directing the clos- ure of an open cesspool, 2; and directing attention to the fact that pigs were wallowing in the water used not only for the water- ing of stock but for the cleansing of utensils, i. Care of Milking Pails and Other Milk Utensils. It is generally recognized that dirty milking pails and other utensils beget sour milk, with consequent loss to the producer; therefore, in most cases these vessels are looked after with reasonable diligence. But it is not enough that they should be made clean; they should be kept in a suitable place, and under such conditions that they may not become invaded by dust, containing, as is always the case, bacteria of various kinds. The necessity of providing a milk room for the proper handhng and storage of milk was brought to the attention of 637 owners. On some of the worst-kept farms the grossest carelessness was observed in the treatment of cans and other vessels. In 24 instances cans were observed scattered over the floor; in 6, scattered about the yard; in 2, lying about in the dirty cellar; in 3, standing m manure. At 11 places cans and other utensils, strainers, etc., were found standing in un- washed condition, in the middle of the day, apparently ready for use again. In one case the milking pail was found doing service in what passed for a laundry. 340 STATE SANITATION Other matters called to the attention of producers were as follows: the undesirability of keeping cows in the house cellar, 2 ; the washing of milk cans and pails in dirty water, i ; the cool- ing of milk (a) in dirty water, 2 ; (b) in a butter tub, i ; (c) in a wash tub, I ; (d) in a dirty tub, 3 ; (e) in a tub standing in the sun, 5; (/) in a manure cellar, 13 ; (^) in a house cellar, 2 ; {h) in a drinking trough, 12; the presence of a decomposing dead horse in the cow yard, i ; the presence of rotting ensilage in the tie-up, 2 ; the presence of decomposing cow entrails underneath the tie- up, i; the necessity of raising barn to such a height from the ground that Hquid manure would not spurt up between the boards of the floor under the weight of a person crossing the same, 3 ; the use of cotton waste as bedding, 8. XXXII A REVIEW OF TWENTY-ONE YEARS' EXPERIMENTS UPON THE PURIFICATION OF SEWAGE AT THE LAWRENCE EXPERIMENT STATION By H. W. Clark and Stephen DeM. Gage [The complete paper, of which this is a part, covers nearly three hundred pages. It gives an account of the principal results obtained at the Station from 1887 to 1908. Annual Report, 1908, p. 251. — G. C. W.J The year 1908 is the twenty-first of the operation of the Law- rence Experiment Station. The act of the Legislature, under which the systematic work of the Massachusetts State Board of Health on the examination of water supplies, the purification of sewage and water, etc., was begun, was passed in 1886. The report of the Board for the year 1887 contained an account of the establishment of the experiment station and of the preliminary work done there. A chemical laboratory was installed in 1888 and a laboratory for bacteriological and microscopical work in 1890. These laboratories have been enlarged and improved from time to time, and in them about 50,000 chemical and 150,000 bacterial analyses have been made during the past twenty years, and new and more accurate chemical, biological and physical methods have been developed for the study of water, sewage, sands, soils, etc. Beginning with studies upon intermittent sand filtration of sewage and water, together with laboratory investi- gations upon nitrification, the causes of the reduction of bacteria by filtration, etc., the work of the station has grown constantly, and at the present time includes experimental investigations tending toward the development of scientific methods of sewage purification, of the purification of manufacturing wastes of many kinds, and other special investigations in sanitary science which will be referred to later. It may be said fairly that the investigations at the Lawrence Experiment Station laid the foundations for the scientific treat- 342 STATE SANITATION ment of sewage and have given the initiative for similar investi- gations in this and other countries. The work was planned by Hiram F. Mills, A.M., C.E., a member of the State Board of Health, and has been carried on under his general supervision. A full account of the early equipment of the station and of the work done there during the years 1888, 1889 and 1890 is to be found in a special report of the Board for 1890 prepared by Mr. Mills. This special report has been for many years the most widely known work upon sewage purification. The work of sub- sequent years has been published in the annual reports, and detailed information should be sought in these documents.^ It is hoped to give here, however, a clear idea of the main work carried on at the station during the past twenty-one years. Resume of Work in Different Years The report by Hiram F. Mills, A.M., C.E., mentioned above, covers thoroughly the investigations made during 1888, 1889 and 1890 upon the subject of sewage purification. During these three years, sewage had been filtered intermittently through gravel- stones, through filters made of various grades of gravel and through sand, even through a fine sand averaging but 0.004 inch in diameter, — a fine granular dust, — as well as through soils ^ At the beginning of this work, Dr. Thomas M. Drown of the Massachusetts Institute of Technology was appointed chemist to the Board and given general supervision of the chemical work, both at Lawrence and Boston. When, in 1895, Dr. Drown became president of Lehigh University, he was made consulting chemist to the Board, and served in that capacity until his death in 1904. At the station Mr. Allen Hazen was in charge imtil March, 1893, when he was succeeded by Mr. George W. Fuller. Since August, 1895, a period of fourteen years, Mr. H. W. Clark, who had been connected with the Lawrence work almost from its start, and who also succeeded Dr. Drown as chemist to the Board, has been in charge at the station, and since 1896 of the Boston laboratories of the department of water supply and sewerage. Mr. Fred B. Forbes and Mr. W. R. Copeland have been prominent among the many assistants at the station during the first twenty-one years, and Mr. Forbes is still in the employ of the Board as chief assistant in the laboratories at the State House. Mr. Stephen DeM. Gage, biologist, and Mr. George O. Adams, chemist, are the chief assistants at the station at the present time, Mr. Gage having been connected with the work since 1896 and Mr. Adams since 1900. For short periods in the beginning, the bacterial work was in the charge of various biologists; but in November, 1888, Dr. William T. Sedgwick was appointed biologist to the Board, and so remained imtU 1896. LAWRENCE EXPERIMENT STATION 343 and peats. It was found that, with all the filters, from the coarsest to the finest, purification by nitrification took place best when the sewage appUed was adapted to the working ability of the filter, and the surface not allowed to become clogged by organic matter, to the exclusion of air. It was shown, further- more, that fine soils retained water so long that the quantity of sewage which could be applied was small, although such a filter might give an effluent free from bacteria. With thicker layers of these fine soils, moreover, it was found that nitrification did not take place, and that the organic matter in the efifluent was nearly as great as in the sewage, although no bacteria probably passed through the filter. It was found that peat filters, though but one foot in depth, were practically impervious to hquid, and that intermittent filtration with such material was impracticable. Experiments with gravel-stones gave the best illustration of the essential character of intermittent filtration of sewage. Filters were constructed of stones, so large that even the coarser sus- pended particles of the sewage were not removed; yet " the slow movement of the sewage in thin films over the surface of the stones, with air in contact, caused a removal for some months of 97 per cent of the organic nitrogenous matter as well as 99 per cent of bacteria." These filters were the forerunners of the sprinkHng or trickling filters now so well known in sewage puri- fication. It was found also, and stated in the special report for 1890, that " the mechanical separation of any part of a sewage by straining through sand is but an incident which, under some con- ditions, favorably modifies the results, but the essential condi- tions are very slow motion of very thin films of liquid over the surface of the particles that have spaces between them sufficient to allow air to be in contact with the films of liquid. . . . With these conditions it is essential that certain bacteria be present to aid in the process of nitrification." It appeared, furthermore, and was so stated in the same report, that the " filters gave an effluent some time before nitrification began which contained from 20 to 40 per cent as much free and albuminoid ammonia as the sewage. During the cold months of the very cold winter in which the first filters were started there was an important step in purification 344 STATE SANITATION going on. This was the conversion of albuminoid ammonia to free ammonia, or, to state the case more definitely, it was the burning up of a part of the organic matter by the combination of oxygen with some of the carbon, producing carbonic acid, and leaving the nitrogen and hydrogen that were contained with this carbon to form ammonia, thus reducing the amount of combined nitrogen which in our analyses appears as albuminoid ammonia. This is as complete a destruction of organic matter, as far as it goes, as if the free ammonia were again oxidized, forming nitric acid or nitrates, but this process seldom, if ever, carries the destruction of the organic impurities of the sewage to such an extent that the resulting liquid contains as little impurity as when nitrification takes place. We find further that this process of reducing the albuminoid ammonia is not so destructive to bacteria as the more complete process of nitrification. It is, however, a process of purification, and the conditions of intermittent filtration are those most favorable to this step in purification." This special report for 1890 gave the results observed in all the sewage filters, nineteen in number, that were operated up to the end of 1890. It gave also many data in regard to special investi- gations concerning the mechanical and physical characteristics of the materials employed in filtration; the storage of nitrogen; time of flow of sewage through filters five feet in depth, this being measured by the change in chlorine contents of the effluent; special studies upon nitrification and nitrifying organisms; articles upon the chemical and biological work at the station, chemical precipitation of sewage, etc. The report for 1891 took up the subjects of the permanency of filters; the mechanical composition of materials used in filters, together with the conclusions drawn from a study of the materials and the results of filtration, as showing the capacity of each material to purify sewage; the best method of applying sewage to different grades of sand, etc., together with further experiments on the bacterial efficiency of the filters at that time in operation. Early in this year a gravel filter was operated at a rate of 220,000 gallons per acre daily, the sewage being applied in sixty or seventy doses per day. Good nitrification results were obtained without LAWRENCE EXPERIMENT STATION 345 artificial aeration of the filter; in fact, this was a true trickling filter as now known. In 1892 and 1893 special studies were made of the care of sewage filters; stratification and the effect of horizontal layers; filtration of sewage containing dyestuffs; the rate of filtration through various materials; the causes of clogging of sewage filters, and the removal of this clogging matter from the sand. In these years, also, studies of rapid filtration aided by artificial aeration of the filters were begun. The report for 1892 contained, in addition, a very important article upon the physical properties of sands and gravels with especial reference to their use in filtration. In 1894 a general review of the work upon sewage purification at the station up to and including that year was given. Special investigations were made at that time upon the composition of sewage and the changes which occurred in sewage as it ages. It was shown, for instance, that storage of fresh Lawrence sewage for twenty-four hours doubled the free ammonia and decreased the organic nitrogen present one-half. Other changes, such as an increase in the number of bacteria present, also took place. This work antedated the operation of septic tanks. At this time a series of sewage samples were collected at different periods of the day from various sewage-disposal areas and institutions in the state, and were examined to show the varying strengths of the sewage at different hours, and the amount of organic matter of different kinds in the sewage per person contributing to the flow. In 1895 investigations were continued as to the best methods of treating sewage filters to insure permanency; on the best pre- liminary treatment of sewage to remove sludge before filtration and the different methods of aerating sewage filters. In this year, also, were made the first experiments upon the purification by filtration of industrial sewage as seen in tanneries, paper mills, wool-scouring works, etc. The stable character of the effluents from trickhng filters operated at high rates and aerated a portion of the time by means of a current of air was first shown at this period. It was found that " the organic matter in the liquids, after rapid filtration combined with aeration, is of a different 346 STATE SANITATION character from the organic matter in the sewage resulting from other sludge-removing processes. That is to say, even when the organic matter, as shown by the albuminoid ammonia, is present in quantities as great as in the other partially purified sewages, it has passed through such chemical and biological changes that it develops offensive odors very slowly on standing." These obser- vations were made prior to the English studies upon the stability of the effluents of such filters. In this year, furthermore, certain filters of coarse materials, gravel- stones, pieces of coke, etc., were operated at rates of 1,000,000 gallons per acre daily, and were aerated generally only from one to two and one-half hours daily. The effluents of these filters contained high nitrates, were gener- ally stable, and, in fact, were practically similar to those after- wards obtained from iflters of Hke materials operated at high rates without even the slight aeration given to these filters. In 1896 and 1897 much time was devoted to the study of the purification of industrial sewage, and practicable methods for the purification of some of these wastes are definitely described in the reports for these years. From the first, studies looking to the removal of the matters in suspension in sewage by sedimentation, chemical precipitation and coke straining were made. In 1897 more elaborate experiments were begun on the purification of sewage by so-called contact filters, although one such filter had been studied at the station in 1894. During this year (1897) a trickling filter of clinker was operated also. To this the sewage was passed by means of overhead pipes and was aerated and dis- tributed by the dash-plate method. This trickling filter, and all others started after this date, received no artificial aeration. In 1898 studies were continued on the disposal of sewage, both fresh and stale, when treated in septic tanks; on the purification of industrial sewages; on the purification of sewage both by sand and contact filters. Early in 1899 there was put into operation a trickling filter ten and one-half feet in depth, constructed of broken stone and operated at the rate of 2,000,000 gallons per acre daily. In 1899, also, studies of septic tanks and of the puri- fication of septic sewage were continued, and the first tank for the treatment of sludge alone, after preliminary treatment of the LAWRENCE EXPERIMENT STATION 347 sewage in ordinary settling tanks, was put into operation and continued for several years. This variety of septic tank and method of sludge disposal has since become well known. The first hydrolytic tank was started also at the station in 1898, " as it had become evident that the greatest work in septic tanks occurred where the bacteria were most numerous, — as on the sides, bottom and top of the tank, — it was considered that a tank filled with coarse, broken stone would afford a very extensive foothold and breeding place for the classes of bacteria necessary for sludge disposal," ^ and the tank was so arranged that the sewage passed upward through this stone. As the result of other researches, it was shown that prolongation of anaerobic action might impede subsequent purification by filtration. There were made also this year special studies relating to the purification of the wastes from creameries, and to the action of iron and iron oxides on the purification of sewage by filtration. In 1900 analyses and measurements of the gas produced by septic tanks were made and investigations concerning the effi- ciency of septic treatment of different classes of sewage; also experiments upon the sterilization of septic sewage to show whether or not the air that it was necessary to introduce into some classes of septic sewage, before efficient purification by filtration could be assured, was required because of the rapid use of the oxygen by bacteria or because of its absorption by organic matter and gases. Operation of the hydrolytic tank, together with various trickling filters, and the study of purification of manufacturing wastes were continued. In 1 901 a thorough investigation was made of the stability of the effluents and of the organic matter left in the effluents of con- tact and trickling filters, together with observations on the improvement of such efffuents when mixed with river water. The rate and degree of clogging of contact filters and the methods necessary to remove this clogging material were studied also. In this year contact filters of roofing-slate and brick, with regular spaces between each pair of slates or bricks, were first put into operation. Two of these filters are described in the report for ^ P. 426, report for 1899. 348 STATE SANITATION 1 901, the slate filters being similar to those operated in more recent years in England by Dibdin. In 1902 studies of contact and trickling filters, especially those of the latter, were continued, together with special investigations concerning nitrification and the removal of organic matter from the upper layers of sand filters. In 1903 special efforts were made to learn the cause of the poorer winter nitrification in the older intermittent sand filters, in order to improve the work of these filters. Studies of septic tanks and of the operation of contact filters constructed of dif- ferent materials and depths, with special regard to permanency of operation, were continued, together with allied studies upon the stability of their effluents. Studies were made also of the purification of sewage by trickhng filters of different materials and different depths, and investigations in regard to the stability of the effluents of these filters and experiments upon sedimenta- tion, secondary filtration, etc., of these effluents were undertaken. Numerous experiments were made on the purification of dye liquors and the waste from gas works, together with studies on methods of analysis with special regard to the comparative value of albuminoid ammonia and Kjeldahl determinations of nitrogen; of incubation of effluents; and of the nitrification and denitrifi- cation caused by sand, effluents and species of bacteria from filters in which either nitrification or reducing actions were occurring. The year 1904 was devoted largely to the improvement of the sand filters that had been in operation for sixteen years, and to studies of methods for the disposal of nitrogenous and other organic matters by these filters; special studies of nitrification; studies of the respective amounts of nitrogen and carbon oxidized, stored or liberated from experimental and municipal sand filters ; studies of the determination of acidity or alkalinity as an index of the degree of purification of filter effluents; studies of the bacteriology and biochemistry of sewage purification. A new method for the determination of turbidity of the effluents of filters and of water was developed and first used during this year. Studies were made also of the time of passage of sewage through LAWRENCE EXPERIMENT STATION 349 trickling filters constructed of different materials and of different depths, and of the rapidity of oxidation and purification of these filters. In 1905 a continuation was made of the studies of the organic matters, nitrogen, fats, carbon, etc., in sludge and in sewage, and of the same substances stored in filters; studies of the relative amounts of nitrogen, carbon and fatty matters in sewage, sludge and the effluents of trickling and contact filters and appropriate methods for their analysis. Moreover, special studies were taken up again as to the refiltration of trickling filter eflluents through sand filters. In 1906 a complete resume was given of the comparative value of sand, contact and trickling filters for the disposal of organic matter, and the comparative rates at which such filters can be operated; of the rate of filtration and amount of suspended matter in sewage applied to sand filters as related to volume of sand removed; of the coagulation and mechanical filtration of the effluents of trickling filters, together with more complete studies of methods for the application of sewage to trickling filters; of the comparative rates of filtration maintained by sand filters; of continued studies on the purification of industrial wastes. In 1907 the most important special work was a continued study of methods for the distribution of sewage upon trickling filters and observations on the refiltration of trickling filter effluents through sand, coagulation and mechanical filters. The number of filters at the station — sand, contact and trick- ling filters — has increased steadily until, at the end of 1908, two hundred and fifty filters for the purification of sewage have been in operation. Since 1895, moreover, much attention has been given to the purification of wastes from manufacturing industries, and, as a result, reasonable and efficient methods for the treat- ment of most of these wastes have been developed and published in the annual reports. Among the wastes studied have been those from tanneries, paper mills, carpet mills, paint mills^ woolen mills, wool-scouring works, dye works, shoddy mills, creameries, yeast factories, glue works, gas works, etc. XXXIII THE OCCURRENCE OF INFANTILE PARALYSIS IN MASSACHUSETTS, 1907-12 ^ By Dr. Mark W. Richardson [Forty-fourth Annual Report, 1912, p. ssS-~\ It is not the purpose of this communication to present a de- tailed discussion of the disease known as anterior poHomyelitis, or infantile paralysis. Its scope will be restricted, rather, to a consideration of those facts and observations which have been noted in the experience in Massachusetts for the years 1907-12, inclusive, and which have seemed rather unusual and therefore possibly worthy of special emphasis. In the first place, if one looks at the map of Massachusetts and observes the incidence of this disease, he will notice that there seems to be a distinct preference for locaKties situated along the river beds. In 1907, for instance, the incidence of the disease 1 Investigation in Massachusetts of the disease known as anterior polio- myelitis, or infantile paralysis, was begun in 1907, at the instigation of Dr. Robert W. Lovett, who had been appointed in that year a member of the State Board of Health. The work has been continued ever since along lines which have constantly broadened, and the Board has called to its service in these investigations the assistance of a considerable number of investigators and advisers. In carrying out details of the work the Board has been fortunate in having the advice of such men as Dr. Henry P. Walcott, chairman of the Board, Dr. Robert W. Lovett, mem- ber of the Board, Professor Theobald Smith, Professor Milton J. Rosenau, Professor John L. Morse and Dr. J. Homer Wright. In the field work Dr. Phihp A. E. Shep- pard has been largely concerned. The State Inspectors of Health in their respective districts have investigated many cases, and special epidemics have been the subject of more detailed investigation by Dr. Herbert C. Emerson of Springfield, Dr. Lyman A. Jones of North Adams and Dr. Thomas P. HenneUy of Pittsfield. Special lines of investigation have been pursued, also, by Professor Theobald Smith, Professor Milton J. Rosenau, Dr. Robert B. Osgood, Dr. William P. Lucas, Dr. Arthur W. May, Dr. Benjamin Wood, Dr. J. W. Hammond, Jr., and Mr. Charles T. Brues, instructor in economic entomology in Harvard University. A paper read at the Fifteenth International Congress on Hygiene and Demography, Wash- ington, D. C, September 26, 1912. 3SO INFANTILE PARALYSIS 351 was especially noticeable in the Berkshire district along the banks of the Hoosac and Housatonic rivers. Furthermore, the valley of the Merrimack seemed also to be especially affected. In 1908 the valley of the Deerfield River was the seat of an especially marked epidemic. It may be, of course, that this apparent predilection for river beds is of no special significance, and may mean only that river beds are more likely to be more densely populated and more likely to have ordinary roads, trolley roads and railroads running through them and are therefore associated with greater possibilities of contact for larger bodies of people. In this connection, however, it must be borne in mind that bodies of water may become the breeding places for a great variety of insects, and the incidence of this disease in the neigh- borhood of bodies of water may be shown by further investigation to be due to a greater prevalence in those districts of such insects. Another fact brought out by the map of 1907 would seem to be that the distribution of infantile paralysis corresponded in a general way to the density of the population, and in this connec- tion an interesting comparison was made with the incidence of cerebro-spinal meningitis. The two diseases coincided in localization for 1907. In 1908, however, the grouping was largely different, cerebro-spinal meningitis still being more prevalent where the population was dense, whereas infantile paralysis saw its greatest epidemic in a rural community. Furthermore, it was shown that the maximum incidence of infantile paralysis in 1907 took place in September, whereas in cerebro-spinal meningitis the maximum incidence occurred in March. As far as this compari- son went, therefore, there seemed to be no parallel between these two diseases as far as epidemiological factors were concerned. The year 1908 was remarkable for a small but well-marked epidemic in the northwestern part of the state, affecting especially the towns on and adjacent to the Deerfield River. In fact, the history of this epidemic shows that per 1,000 of the population the town of Colrain in this epidemic suffered far and away the most serious damage ever noted in the State of Massachusetts. In 1 910 there occurred what seemed at the time to be a very marked epidemic in the city of Springfield, in which epidemic at 352 STATE SANITATION least 150 cases were reported, that is to say, an incidence of 1.6 per 1,000 of the population; and yet in 1908 the town of Colrain, above mentioned, with a population of 1,800 had 24 cases of infantile paralysis, that is to say, 13 cases per 1,000 of the popu- lation. It would seem, in a community so severely attacked as this incidence would indicate, that there would be abundant evidence as to the high degree of its contagiousness; and yet careful inquiry during the investigation of 67 cases, in which there was little or no attempt at isolation, shows that there were 166 children in families affected, only 4 of which later acquired the disease. In addition there were 86 children among the neighbors and friends, making a total of 252 children. Indeed, the total number of children that were more or less intimately exposed to the 66 cases was probably twice or three times the number of- known exposures. Another point of interest in this connection, it seems to me, is the following: The Colrain district in 1908 was situated only thirty or thirty-five miles from the city of Springfield. It was in comparatively intimate relation with said city through the agency of highroads, trolley roads and railroads. There was, therefore, constant interchange of population between these two districts, and yet in 1908 there were in the city of Springfield but two cases of infantile paralysis, and the intervening towns along the Connecticut River showed at most three cases in Holyoke, one in Chicopee and one in Hatfield. In view of this experience it seems to me that whatever one may think of its contagiousness as affecting persons in immediate contact with patients, transfer of the infection by indirect contact through third persons must be very rare, if it ever occurs. Another interesting point which has been noted by others is that a region once severely infected is not apt to be stricken during the succeeding year, and the Massachusetts maps of 1907 and 1908 show this phenomenon quite plainly. You will see that, for instance, in 1907 the Berkshire district had a consider- able number of cases, whereas in 1908 there were very few. Furthermore, you will note that the Colrain district, which was severely affected in 1908, has been practically free from the dis- INFANTILE PARALYSIS 353 ease ever since. In 1909 it is apparent that the Berkshire district again became severely affected, and again in 1910 the number of cases dropped off very markedly, even though the valley of the Connecticut River at this time showed a very large number of cases. The experience in Massachusetts has been that the disease is less readily transmissible than scarlet fever, typhoid fever or diphtheria, but of course in such a comparison the abortive cases of infantile paralysis were not included. Even if such cases were included, however, I have little doubt that infantile paralysis, as compared with the diseases mentioned, is very much less contagious. Another point which seems to stand out very sharply in the Massachusetts investigations is that the disease is very distinctly one of suburban or rural communities rather than one affecting more especially the cities. This statement rests upon the observa- tions of 2,138 cases which have been analyzed in this regard for the years 1907-10. The average population for the first twenty- five cities and towns most affected proved to be 5,205, whereas the average population of the twenty-five cities and towns least affected was 52,674, that is to say, cities and towns where the disease was relatively least frequent were ten times as large on the average as those where it was most frequent. As a control to this table cases of scarlet fever reported in the state for the year 1 910 showed that in the twenty-five cities and towns in which scarlet fever was most prevalent the average population was 6,446, whereas in the twenty-five where it was least prevalent the average population was 7,633. In other words, there would seem to be some conditions radically different in the spread of infantile paralysis as compared with scarlet fever. This fact, taken in connection with the experience detailed above in the relation to cerebro-spinal meningitis, which disease, together with scarlet fever, is well known to be spread by contact with the nasopharyngeal secretions, must be given very weighty considera- tion when we come to estimate the role of these same secretions in the spread of infantile paralysis; for the conditions favoring the transfer of these secretions, that is to say, the density of 354 STATE SANITATION population, school attendance, overcrowding in winter time and unhygienic surroundings — in other words, conditions found most prominently in city life — are not those which favor, appar- ently, the spread of infantile paralysis. Infantile paralysis, there- fore, being in Massachusetts, at least, a country disease, one would look for some determining cause in country conditions as the reason for this apparent predilection for the rural districts, and as a result of investigation it is found that country children are exposed very much more strongly to any possible influence which animal disease might have upon them than city children. For instance, in the twenty-five cities and towns where the disease was least prevalent, that is to say, in the larger cities and towns, there was one cow to very eighty-four inhabitants and one horse to every thirty- two inhabitants; in the twenty-five cities and towns where the disease was most prevalent there was one cow to eleven inhabitants and one horse to fourteen inhabitants. This table became very much more striking when a comparison was made of the numbers of swine, fowls and dogs. Now it is known that all these animals are subject at times to paralysis of varying types, and in a considerable number of instances paralysis in animals has been associated with paralysis in human beings. A considerable number, however, of paralyzed animals have been examined, and emulsions of their spinal cords have been injected into monkeys by Professor Theobald Smith, but as yet with no positive results. In this connection, furthermore, it is appar- ent that country children are much more subject to the bites of insects than city children, and the possibility that insects may act as intermediate hosts for the virus of infantile paralysis, and may convey this virus from infected animals or infected human beings to other animals or human beings, must always be strongly borne in mind. In 191 1 an investigation along this Hne of eighty-eight cases in seventeen cities and towns showed that in all instances the ordinary stable fly, Stomoxys calcitrans, was present in or about the house of the infected individual. Ex- periments looking to the possible infection of monkeys through the bites of this fly will be reported upon later by Professor Rosenau. INFANTILE PARALYSIS 355 Meteorological records show that since 1904 Massachusetts has been subject to a constant deficiency in rainfall. Such a deficiency would naturally be associated with a considerable increase in the amount of dust. When it is considered, however, that the disease has affected greatly other portions of the country in which there has been no such deficiency in rainfall the importance of this failure in the rain supply cannot be considered to be great. An investigation as to the occurrence of this disease in institu- tions for children showed that such children were much less liable to the disease than those leading an ordinary manner of life. They would seem to enjoy as a result of their somewhat complete isolation a freedom from infection. Osgood and Lucas found an active virus in the nasopharyngeal membrane of the monkey five and a half months after an acute attack, and in the tonsils of a human being six months after an attack. These observations have naturally a very important bearing upon the question of contagion. In the first place, it suggests very strongly that the disease is transmitted by the secretions of the nasopharyngeal membranes, and, furthermore, that danger of contagion may persist for many months, and possibly longer; this in spite of the fact that Rosenau, Sheppard and Amoss failed to demonstrate the virus in the mouth and nose of eighteen patients in various stages of the disease. It is, of course, well known that positive results have apparently been secured recently by KHng, Wernstedt and Petterson. In other words, we have to do here, as in other infectious diseases, with the question of chronic carriers of disease and their relation to its propagation. Its importance becomes especially marked when we consider the number of cases which have been in contact with chronic cases of infantile paralysis previous to infection. This persistence of the virus in the body of the infected indi- vidual may be important from another point of view, for there are a number of cases on record in the experience in Massachusetts in which the patient has apparently suffered from a second attack of the disease a few weeks, months or even years after the first attack. If such a second infection or reinfection may occur, it must be considered as possible that the patient between attacks 356 STATE SANITATION may be a chronic carrier of the disease and therefore possibly responsible for secondary cases in others. Certain it is that very closely circumscribed localities may suJBFer from the disease over a considerable period of years. For instance, in one of the larger cities in Massachusetts, within a very small circumscribed area, two cases occurred in 1903, two cases in 1908, one case in 1909 and one case in 1 910. The suggestion that a chronic carrier of in- fection was responsible for this situation is very strong. As is seen from the map for 1910 the city of Springfield, which up to that time had suffered a considerable and unexplained immunity from this disease, suffered from a quite severe epidemic. Further- more, investigation as to the mortahty from this and other acute diseases in said city showed very interesting results in that the mortahty from cholera infantum, whooping cough and scarlet fever was also very much increased during this year. In fact, the mortahty rate for cholera infantum, which for 1907, 1908 and 1909 had averaged twenty-seven, in 1910 jumped up to one hundred and six. The suggestion is, of course, that a number of these cases of death reported as cholera infantum may have been and probably were typical cases of infantile paralysis of the gastro -intestinal type. As far as therapeutics are concerned little new has been learned through the Massachusetts investigations. Osgood and Lucas, to be sure, made some experiments upon monkeys, with a cer- tain number of specific sera and vaccines, to see whether the specific immunity brought about by these sera and vaccines might not give a partial immunity to infantile paralysis. The results, however, were negative. Hexamethylenamin has been recommended to the profession of Massachusetts strongly as a possible prophylactic against the disease, and quite generally employed. A unique experiment with this drug was carried out at a cer- tain boys' school in our state, an experiment which may be worthy of repetition by others under similar circumstances. At the opening of this school in the fall a boy arrived who had been in Europe and was in intimate contact with at least twenty-five of his fellow pupils for a period extending over ten days or two INFANTILE PARALYSIS 357 weeks. He then developed infantile paralysis, much to the dis- comfort of the school authorities. The boy was isolated imme- diately, and all the other pupils given hexamethylenamin in their drinking water. Whatever may have been the effect of this medication no other cases developed in this school. On the other hand, we have had one or two other similar experiences where cases in prodromal stages have been in intimate contact with school children and where no secondary cases have occurred, even though hexamethylenamin was not administered, — facts which make us very conservative in estimating the effect of simple contact in the spread of the disease. As regards prognosis, the experience in Massachusetts has shown this to be much better than was previously supposed. In fact, the following conclusions seem justified: "In anterior poKomyehtis complete recovery or function recovery occurs in over 25 per cent of cases examined at the end of four years. Atrophy may exist without impairment of function. In about one-half of the recovered cases the onset was mild. The distribu- tion of the paralysis in such recovered cases was not essentially different from that in cases which do not recover. Recovery in many instances required months and in several cases from one to three years." Another interesting possibility is that herpes zoster may be a form of anterior poliomyehtis, due to an unusual localization of the virus. Coincidence of this disease with epidemics of infantile paralysis has been noted, especially in recent years, by English observers. In the experience in Massachusetts certain striking cases have occurred. For instance, in 191 2 there has occurred, coincidently, in the same individual, anterior poliomyehtis and herpes zoster. Furthermore, we have a history, also, of anterior poliomyehtis in the child at the same time with herpes zoster in the father. Pathologists maintain that the changes occurring in the posterior ganglia of the spinal cord in herpes zoster resemble almost exactly those found in poliomyehtis in the anterior horns of the cord, and the hypothesis that the two diseases are due to the same virus with different localizations is certainly one worthy of further investigation. 358 STATE SANITATION Finally, the experience of Massachusetts has not been such as to support the theory that infantile paralysis is spread from person to person by direct or indirect contact. The rural preponderance of the disease, the comparative immunity of children confined in institutions and hospitals, the summer incidence, the failure of the disease to find its greatest incidence in cities and localities where density of population and overcrowding are most marked, and the irregular distribution have all militated against the accept- ance of such a theory. In fact, the feehng among Massachusetts observers has been strong for some time that the epidemiology of this disease was best explained through the intermediate action of some biting insect, and evidence in support of this theory will be presented by Professor Milton J. Rosenau of Harvard University. (See below.) Some Experimental Observations upon Monkeys Concern- ing THE Transmission of Poliomyelitis through THE Agency of Stomoxys Calcitrans ^ The work we are about to report was done for, and under, the auspices of the State Board of Health of Massachusetts. We should like to have it distinctly understood, and therefore emphasize the fact right in the beginning, that this announce- ment is to be considered as a preliminary report, for the work is still in progress. Certain results have been obtained which it seems advisable to announce at this juncture. In taking this action in announcing work before it is completed we have not assumed the sole responsibihty, but have taken counsel with older and wiser heads, friends for whose judgment we have the highest regard. When we first took up the study of this disease — infantile paralysis ■ — with the State Board of Health of Massachusetts, we considered all possible modes of transference of the virus from the sick to the well, but gradually focused our attention upon the ^ A preliminary note by M. J. Rosenau, Professor Preventive Medicine and Hygiene, Harvard Medical School, Boston, Mass., and Charles T. Brues, Instructor in Economic Entomology, Bussey Institution of Harvard University. Remarks made by Professor Rosenau in the discussion of the previous paper. INFANTILE PARALYSIS 359 fact that the disease seemed to be spread rather directly from person to person. In other words, the disease appeared to us at first blush to be a " contagious " disease, but one in which mild or abortive cases, missed cases, and third persons probably played an important role in the transfer of the infection. We were probably prejudiced in favor of this viewpoint on account of the splendid work of Wickman, whose publications we studied with care. We were further influenced to regard pohomyelitis as a " contagious " disease owing to the views of Flexner, who com- pared it to epidemic cerebro-spinal meningitis, and who regarded that it spread in the light of a contact infection through the secre- tions from the mouth and nose. The analogy to meningitis was a very close one, and the experimental fact that the virus could be demonstrated in the nasal mucosa of monkeys (Osgood, Lucas and others) seems to corroborate the suspicion that we are in fact dealing with an infection spread very much as cerebro-spinal meningitis is spread. If these assumptions were correct then the virus should be demonstrable in the secretions from the nose and throat. Rose- nau, Sheppard, and Amoss therefore injected eighteen monkeys with the nasal and buccal secretions obtained from eighteen per- sons who were suffering with the disease at the time, or in the stage of convalescence, or from persons suspected of acting as carriers. These results were negative. At the same time Straus of New York had a series of negative results, and other American workers were also unable to find the virus where we assumed it should be. These negative results seemed to us to have positive significance, and was the first definite indication that we were upon the wrong trail. That pohomyelitis is not a " contagious " disease was clearly brought out by Dr. Richardson and other observers who have spoken this morning, all of whom have emphasized the point that the disease shows httle or no tendency to spread in crowded districts, in schools, in institutions, in asylums, in camps and in other places where one would expect a disease spread by contact through secretions of the mouth and nose to spread more readily. We have in mind the fact that many cases of the disease have 360 STATE SANITATION been brought into asylums and hospitals throughout the State of Massachusetts, in all stages of the infection; yet secondary cases have not occurred under such circumstances. On the con- trary the disease prevailed in Massachusetts more particularly in rural and country districts sparsely settled. Another reason that led us away from the theory of contacts, and made us believe that we were not dealing with a contagious disease in the ordinary sense of that term, was the close analogy between rabies and poliomyelitis. All investigators in labora- tories who have worked with these two viruses have been struck with the similarity between rabies and poliomyelitis. Both viruses are diffused widely throughout the body, both exist in special concentration in the central nervous system, both are filterable, etc. Rabies being a wound infection made us con- jecture that poliomyelitis may also be similarly transmitted. Our experience with yellow fever, perhaps more than anything else, influenced us concerning the probable mode of transmission of poliomyelitis. It had been the privilege of one of us to work with yellow fever both before and after the mosquito days, and many analogies came to mind which made us beheve that poliomyelitis also was not a contagious disease. All the various reasons that influenced us in turning from con- tagion to some other mode of transference need not engage our attention now, for the history of this part of the work has been ably and accurately given by Dr. Richardson in the paper which he has just read. In justice to Dr. Richardson we desire to state that all the essential conclusions of his paper were ar- rived at before he knew of the results in the laboratory with the monkeys. The work which we now briefly desire to report consists in exposing monkeys during all stages of the disease to the bites of Stomoxys calcitrans. The monkeys were infected in the usual way by bringing an emulsion of a known virus obtained from human sources in direct association with the central nervous system. After the flies had had abundant opportunity to bite these infected monkeys during the various stages of the disease, INFANTILE PARALYSIS 361 including the period of incubation, healthy monkeys were then exposed to the bites of these same flies. Of twelve healthy monkeys indications of the disease have been obtained in six, three of them in a virulent form, resulting in death, the other three with transient tremblings, partial paralysis, diarrhoea and recovery. It is interesting to note that several of the monkeys had diarrhoea, therein the disease resembles the human disease more closely than when monkeys are simply inoculated with the virus into the brain, for gastro-intestinal upsets in children are frequently associated with infantile paralysis. In these experiments it is important, we think, to use the proper technic in order to obtain successful results. The flies should be handled as little as possible. It is much better to handle the monkeys and leave the flies alone. In our experiment the flies were caught in nature, some of them were bred, placed in a large cage about six feet long by five or six feet wide, and some three or four feet high. The monkeys are stretched out at full length and wrapped in chicken wire. In this way they can be placed in in the cage and the flies have full opportunity to bite. The flies appear to need a feed of blood about every day or two. They sometimes visit water which is kept in the cage, but apparently cannot be induced to eat any other food than the blood. At least, in our experiments, bananas, fruits, and other substances exposed apparently were little visited by the flies. Furthermore, in our experiments a very large number of flies were used. In conclusion we desire simply to summarize the fact that we have apparently transferred the virus of poliomyelitis from monkey to monkey through the bite of the stable fly, Stomoxys calcitrans. We would like to emphasize the fact that this does not appear to be simply a mechanical transference, but rather a biological one, requiring a period of extrinsic incubation in the intermediate host. What conclusions can we draw from these facts ? At present it seems to us we would not be justified in drawing any conclusion — the significance of the facts if confirmed is self-evident. 362 STATE SANITATION Transmission of Poliomyelitis by Means of the Stable Fly (Stomoxys Calcitrans) ^ As a result of the thorough epidemiologic studies of poliomye- litis conducted by the Massachusetts State Board of Health from 1907 to 191 2, under the direction of Dr. Mark W. Richardson, secretary of the board, evidence was collected which led the investigators to strongly suspect that the common stable fly {Stomoxys calcitrans) played an important part in the spread of this disease. At the joint session of sections I and V of the Fifteenth Inter- national Congress on Hygiene and Demography in Washington, September 26, 1912, Dr. Milton J. Rosenau, of the Harvard Medical School, who has been working in conjunction with the Massachusetts State Board of Health, announced the result of an experiment which seemed to confirm most strikingly the inferences drawn from the epidemiologic work above mentioned. Dr. Rosenau stated that he had infected several monkeys with poHomyelitis by intracerebral inoculation, exposed them daily — from the time of inoculation till death — to the bites of several hundred Stomoxys, at the same time exposing twelve fresh mon- keys to the bites of the same flies. At the time the announce- ment was made six of these twelve monkeys were reported as having developed symptoms characteristic of poliomyeHtis, i. e., illness followed by more or less extensive paralysis. Of these six monkeys, two had died, three were paralyzed at that time, and one recovered after a brief illness. In the cord of one of the monkeys that had died were found the characteristic lesions of poHomyeHtis, that is, perivascular infiltration and destruction of the motor cells of the anterior cornu. The cord of the other monkey was reported to have shown changes less characteristic of poliomyelitis, namely, degenerations of the motor cells without perivascular infiltration. At the time of announcement a suffi.cient interval had not elapsed to determine the result of the attempt to transmit the ^ By John F. Anderson, Director Hygienic Laboratory, and Wade H. Frost, Passed Assistant Surgeon United States Public Health Service. Reprinted from Pubhc Health Reports, Washington, D. C, October 25, 191 2. INFANTILE PARALYSIS 363 infection to other monkeys by inoculation with the cord of one of the two that had died. This experiment, giving an altogether new direction to the experimental study of poliomyelitis, appeared of sufficient importance to warrant an immediate attempt at confirmation. In the experiment below reported it has been our object to repeat, as nearly as possible, the conditions of that reported by Dr. Rosenau, and we are indebted to him for assistance and advice in the details of the experiment. On October 3, rhesus No. 242 was inoculated intracerebrally with an emulsion of the cord of a monkey which had died of poliomyehtis. The virus used is a strain originally obtained from the Rockefeller Institute for Medical Research, kept at the hygienic laboratory for nearly two years, during which time it has been passed through a large series of monkeys. Two hours after inoculation the infected monkey was exposed to the bites of about three hundred Stomoxys recently collected in Washington. Thereafter until death, on October 8, this animal was exposed daily for about two hours to the bites of the same flies, plus additional fresh Stomoxys added from time to time as caught. This monkey (No. 242) developed characteristic com- plete paralysis on the afternoon of October 7 and died at 2 a.m. October 8. Another monkey (rhesus No. 246), similarly inoculated on October 5, was then exposed daily to the bites of the same flies, beginning October 7. This monkey developed paralysis on the morning of October 9, soon becoming completely paralyzed and d5dng that afternoon. Thus, from October 4 to October 9, inclusive, the flies used had access to two monkeys inoculated with poliomyehtis, first, rhesus No. 242, then rhesus No. 246. It may be noted that the incuba- tion period in both these monkeys was very short — four days from inoculation to the development of paralysis. Beginning October 4, two fresh monkeys (rhesus No. 243 and Java No. 241) were exposed daily for about two hours to the bites of these same flies; and beginning October 5, a third fresh monkey (rhesus No. 244) was similarly exposed. All three of 364 STATE SANITATION these animals subsequently developed symptoms of poliomyelitis, as follows: — Java No. 241 was found completely paralyzed on the morning of October 1 2 and died a few hours later. At autopsy tubercles were found in the lungs, liver, and spleen. Rhesus No. 244 showed paralysis of the hind legs on the same day (October 12), but was, nevertheless, exposed again to the bites of the Stomoxys from 10 a.m. till 2 p.m. At 3 p.m. the animal, being almost completely paralyzed, was chloroformed. At autopsy tubercles were found in the lungs, liver and spleen, but apparently not sufficient to have been the cause of death. Rhesus No. 243, which had appeared well on the morning of October 13, was found at 4 o'clock that afternoon to have a partial paralysis of the right hind leg. The following morning the hind legs and right fore leg were almost completely paralyzed. By 3.30 P.M. the neck also was paralyzed and the intercostal muscles somewhat affected. The animal was then chloroformed. At autopsy the internal organs appeared normal, except the spinal cord, which was edematous, the gray matter being congested. Sections of the cord, histologically examined, showed typical well-marked lesions of poliomyelitis; perivascular round-cell infiltration; foci of dense infiltration in the gray matter of the anterior horn; and destruction of some of the motor neurons. The histologic examination of the cords of monkeys Nos. 241 and 244 has not yet been completed, but it is believed, on the clinical evidence, that they died of poliomyelitis. To summarize: three monkeys exposed daily to the bites of several hundred Stomoxys, which at the same time were allowed daily to bite two intracerebrally inoculated monkeys, developed quite typical symptoms of poliomyelitis eight, seven and nine days, respectively, from the date of their first exposure. In order to confirm the diagnosis of poliomyelitis in rhesus No. 243, one cubic centimeter of an emulsion of the cord of this monkey was injected intracerebrally on October 14 into a healthy monkey (rhesus No. 250). This animal recovered promptly from the operation and remained apparently quite well till the morning of October 17, when a partial paralysis of the right fore INFANTILE PARALYSIS 365 leg was noted, progressing somewhat during the day. On the morning of October 18 both fore legs were completely paralyzed and the hind legs weak. In the afternoon of the same day the right hind leg was completely paralyzed, the left very weak, and the neck paralyzed. The monkey died at 10.30 p.m. and was immediately placed on ice until autopsy could be made at 9 a.m., October 19. At the autopsy there was found some congestion of the lower lobe of both lungs, most marked on the left side, upon which the animal had been lying after paralysis developed. The meninges of the cord were markedly congested. On section, the cord appeared edematous, and the gray matter congested, showing minute hemorrhages. The site of inoculation appeared normal except for a slight clot. Cultures from this site have shown no growth. The other organs were normal in appearance. Histologic examination of the cord showed lesions characteristic of poliomyelitis, intense congestion and perivascular infiltration, foci of round-cell infiltration here and there in the gray matter, destruction of the cells of the anterior comu, and small hemor- rhages in the anterior and posterior cornu. Conclusion These results, in confirmation of those announced by Dr. Rosenau, would seem to demonstrate conclusively that poliomye- litis may be transmitted to monkeys through the agency of the stable fly {Stomoxys calcitrans) . It remains for further work to decide whether this is the usual or the only method of transmission in nature. XXXIV FOOD AND DRUG INSPECTION OF THE MASSACHU- SETTS STATE BOARD OF HEALTH By Hermann C. Lythgoe [This is the most recent summary of the work of the Food and Drug Department and shows the improvements which have resulted from the constant supervision by the State Board of Health. Public Health Bulletin, 1914, p. 262. — G. C. W.] For thirty-one consecutive years the State Board of Health has enforced the laws relating to the sale of adulterated food and drugs, which has resulted in an improvement in the quality of the food and drug supply of the state. The prevaiHng popular opinion is that the food law is something new, and that our foods are adulterated in such a manner and to such an extent that the American public is in great danger of degeneration and exter- mination. These views are no doubt due to the fact that the federal food law, which is but seven years old, has been exten- sively advertised, the reports of the prosecutions of the Depart- ment of Agriculture and the disposition of decomposed samples being published in a somewhat sensational manner in the news- papers. Furthermore, many sensational and untrue statements about our food supply have been published in papers and maga- zines. During the period from January i, 1907, to December 31, 191 2, the Department of Agriculture has reported the completion of 2,391 prosecutions under the United States food and drug act of 1906, and during the same period the Massachusetts State Board of Health has made 1,601 prosecutions for violations of the Massachusetts food laws, — nearly two-thirds as many as the national authorities have made. When one considers that the United States Department of Agriculture operated during this time the general laboratory in Washington and twenty-one branch laboratories, many of which were larger than the food laboratory of the State Board of Health, it is surprising that the number of prosecutions carried on by the state is so large. 366 FOOD AND DRUG INSPECTION 367 State food laws deal with sales made within the state, and the national law deals with sales made between the states; both laws are independent of each other. The New Hampshire law cannot prevent the manufacturer in that state from shipping adulterated food into Massachusetts, and the United States law cannot easily convict a person who ships to himself or to his partner although goods so shipped may be subject to seizure and con- fiscation; but under the Massachusetts law the person selling such food in this state can be prosecuted. This illustration shows the vital necessity of state laws, which, as a rule, owing to local conditions, cannot be in uniformity with the national law. Shortly after the passage of the United States law many states enacted a law modeled upon it almost verbatim, yet today hardly a state possesses a law uniform with the national law, owing to the necessary changes made by the different states. There was published in the report for 191 2 a chart^ show- ing the variation in adulteration of samples of milk, foods, exclusive of milk, spices and drugs, examined by the Board dur- ing thirty years. A chart of this nature naturally would give a false impression of the amount of adulterated matter upon the market, owing to the fact that particular attention was paid to the collection and examination of those substances which experi- ence has shown to be most liable to adulteration. Furthermore, large numbers of samples are collected from suspected persons, which practice has a tendency to increase above the normal the ratio of adulteration of the samples examined. This chart shows the value of inspection, however, for one can readily perceive what would happen if inspection were to cease. The actual value of the work of the department in suppressing adulteration can be shown by the statistics of those classes of food which have been examined continuously during a period of years by the same methods of analysis. For this purpose the statistics of honey, cream of tartar, coffee, molasses, and spices have been chosen. Honey, cream of tartar, and spices have been examined for thirty-one years. No adulterated samples of spice and honey have been obtained in eight years, and of cream of tartar during three years. The largest amount of adulterated 1 This chart is not reproduced. 368 STATE SANITATION spices was obtained in 1883, when two- thirds of the samples were adulterated. After five years the adulteration of spices was reduced to less than one-fifth, and since 1908 it has been nil. The large majority of the adulterated samples of spices were manu- factured outside this state, and in such cases warning letters were sent to the dealers, — prosecution being resorted to only when the dealers did not heed the warning. In the collection of such food as spices the inspectors soon became acquainted with the reliable brands, and from dealers carrying such goods no samples were taken. During 1910 four samples of cream of tartar were reported adulterated, of which three were sold as cream of tartar substitutes without any statement of the per cent of ingredients, and have not been included in the chart. The other sample is included in the chart, and was in a can, which, judging from its appearance, may have been on the shelf of the dealer for a number of years. Coffee has been examined continuously since 1890, and the highest amount of adulteration (45 per cent) occurred in 1890. For six years no sales of adulterated coffee have been obtained when coffee was asked for. A number of samples of compound coffee have been obtained, but in all these cases compound coffee has been asked for, and the packages have been labeled " com- pound coffee "; but in many instances the per cent of the ingre- dients, as required by law, have not been stated upon the package. These sales of compound coffee are not included in the chart. Molasses has been examined for the presence of glucose since 1887. Previous to that time the examination had been confined to the detection of tin salts used in clarifying and decolorizing dark, thick molasses. Since 1907 no illegal sales of molasses containing glucose have been obtained in this state by our inspectors. Preserved Foods Since 1904 certain classes of food have been systematically examined for preservatives, and the results of these examinations are shown in the chart. The percentage of adulterated samples does not show the extent of the use of preservatives in these foods, FOOD AND DRUG INSPECTION 369 but shows the per cent of samples containing these substances when sold without the necessary label stating the name and per cent of the added preservatives. Certain classes of food, such as hamburg steak and sweet cider, invariably contain antiseptics, unless the article is prepared in the presence of the customer. In fact, it would be impossible to sell in a grocery store sweet cider free from preservatives unless the cider was sterilized and bottled in that condition, as the presence of alcohol would in one or two days become sufficient to render the dealer liable under the hquor law for selling an intoxicating beverage without a Hcense. The use of a preservative in hamburg steak is principally for the pur- pose of preventing the meat from becoming dark upon standing. Sodium sulphite is used for this purpose in amounts from 0.5 to I per cent, although occasionally samples have been found con- taining as much as 2 per cent. Meat treated with this substance will retain its bright red color until the antiseptic is destroyed. Recently sodium benzoate has been to some extent substituted for sodium sulphite in this article of food. With the exception of these two substances the use of antiseptics in food is decHning. In the foods in which the presence of antiseptics was formerly the rule, such as sausages, clams, oysters, and beer, these substances are now very rarely found, and the use of preservatives is dimin- ishing in jams, ketchup, canned and bottled fruit products, in which antiseptics are unnecessary for commercial preservation. The use of antiseptics in milk has practically ceased. Since 1908 but two samples of preserved milk have been found in this labo- ratory, one sample during 191 2 and one during 19 13, both of which contained formaldehyde. Drugs Drugs must conform to certain standards laid down in books on materia medica, one of which, the United States Pharmacopoeia, is specifically mentioned in the statutes. If a sample of drug is deficient to the standard, although its deficiency is too sHght to substantiate a prosecution in court, the records of the department must show it to be adulterated. For this reason drugs would naturally show a higher ratio of adulteration than foods which, 370 STATE SANITATION with the exception of milk and vinegar, need not conform with specific standards, but this does not account for the excessive adulteration found in drugs, the only explanation of which would be fraud, incompetency or carelessness. It is of course mani- festly impossible to expect all drugs prepared by the retail dealers to be exactly standard, and a reasonable allowance must be made for possible errors in manufacture. For example, spirit of pepper- mint should contain lo per cent by volume of peppermint oil. If two samples were examined and found to contain 9.7 per cent and 5 per cent of peppermint oil, respectively, they must both be classed as adulterated, although the former is for all practical purposes pure, and the latter is adulterated to an extent of 50 per cent. One of these samples should be the subject of a prosecu- tion, and the other is not even poor enough to merit the sending of a warning letter to the dealer from whom it was obtained. It has been the practice in this state to obtain for analysis a number of drugs which are prepared by the retail druggist, experience hav- ing shown that the largest amount of fraudulent adulteration and substitution is practiced by the small dealers. Judging from the rapidity of the improvement in the quality of the drugs examined it would appear as if the druggists watch the bulletins of the State Board of Health to find out what particular drugs are being examined, because after the publication of the results of the first prosecution of a drug, the character of which has been but recently investigated, the sale of pure and full-strength samples of this particular drug increases with great rapidity. For this reason changes in the character of drugs examined are necessary, and there has been no one variety of drug that has been examined continuously since the department has been organized; con- sequently, a drug chart similar to that of foods could not be prepared. Tincture of iodine has been examined for a longer period than any other drug, and since 1904 the ratio of adulteration has been brought down from 90 to 15 per cent. Since 1908 from 7 to 15 per cent of the samples contained less than the required seven grams of iodine per hundred cubic centimeters. Notwithstanding this, during the same period the average sample contained from FOOD AND DRUG INSPECTION 371 96 to 99 per cent and the average adulterated sample contained from 77 to 84 per cent of the required amount of iodine. During the years 1898-1904 from 81 to 84 per cent of the samples were below the standard, the average bad sample containing from 63 to 75 per cent and the average of all samples containing from 76 to 88 per cent of the required amount of iodine. The improve- ment in the quality of this drug appears to have been extended to the adulterated samples, caused by the presence of a less num- ber of the highly deficient and a proportionately greater number of the slightly deficient samples. Similar conditions exist in the statistics of the other pharmacopoeial preparations Hsted in the chart. The glycerine statistics are of unusual interest. During 1899 it was found that the glycerine on the market contained con- siderable arsenic, and as nearly all of this drug came from outside the state, notification rather than prosecution (of which latter there was but one) was resorted to for the purpose of purifying the drug. The increase in adulteration during the second year is due to the fact that the examination for arsenic in 1899 was begun in the middle of the year and the samples not examined for arsenic were reported as good, which lowered the ratio of adul- teration for the year. At that time the United States Pharma- copoeia did not specify that glycerine should be free from arsenic, and the fact that the Massachusetts market was practically cleared of the arsenical preparation before the publication of the 1900 Pharmacopoeia speaks well both for the work of the depart- ment and of the co-operation of the manufacturers in the country, who changed their process of manufacture so that the phar- macopoeial glycerine was made arsenic free. The proprietary medicine law was enacted in 1906, but was written in such a manner that except in those portions relating to cocaine it was practically useless. This law was amended in a satisfactory manner in 1907 and went into effect in 1908. For these reasons the most attention was given during 1906 and 1907 to the preparations in which cocaine might be used, and of eighty- seven samples obtained in 1906, seventy-eight were suspected of containing cocaine, in eighteen of which the drug was present. 372 STATE SANITATION In 1907 no collections were made of those medicines shown by the previous year's work to contain no objectional substances, and a vigorous campaign was carried on against the sale of medicine known to contain cocaine. This was continued during 1908 and 1909, the result of which is that it is now almost impossible to purchase cocaine in a drug store in this state without a prescrip- tion from a physician; and, furthermore, proprietary drugs Table 60 Proprietary Medicines Samples found Good Number of Samples containing — Year Cocaine Morphine Acetan- ilide Alcohol Chloro- form Total 1906 1907 1908 1909 1910 1911 1912 I913 69 84 165 73 43 SI 44 33 18 87 83 2 I 4 4 6 22 4 3 4 9 13 8 6 13 I 2 87 175 283 92 55 67 59 34 containing this substance have been eliminated from the Massa- chusetts market. In most instances the law requiring the per cent of morphine to be labeled upon the package has been lived up to, and the dealers in headache powders have now complied with the laws requiring that the amount of acetaniHde and phenacetin in such substances shall be stated upon the label of the package. The fact that the proprietary medicines are at present sold in comphance with the law does not mean that the evils of the drug habits have been eliminated. Habitual users of drugs obtain a supply in some manner, as is shown by the amount of such sub- stances which has been found upon the persons of prisoners and submitted to this Board by the police. These are not, however, proprietary drugs, but are either the pure chemicals or are tablets containing them. It appears to be impossible for a non-user of these drugs to purchase them without a prescription in those stores the proprietors of which illegally sell such sub- FOOD AND DRUG INSPECTION 373 stances to their regular customers, who naturally are known to the dispensers as habitual users of drugs. The drugs sold on the streets by peddlers are of the same nature as those dispensed in certain disreputable drug stores. Notwithstanding the fact that the traffic in hypnotic drugs is not what all would desire, the present state of afifairs is an immense improvement over conditions a few years ago, when alleged catarrh powders, asthma remedies, etc., containing cocaine were frequently sold in this state, and many persons innocently acquired the drug habit by using them in good faith as medicines. If a person uses hypnotic drugs today he must first obtain the drug, no doubt illegally, with certain knowledge of the nature of the substance he is using. PART IV ABSTRACTS OF SCIENTIFIC ARTICLES AND REPORTS PUBLISHED IN THE REGULAR SERIES OF ANNUAL REPORTS I. ABSTRACTS OF SCIENTIFIC ARTICLES AND REPORTS 1870 First Annual Report Report on Slaughtering for Boston Market. Dr. George Derby, pp. 20-37 One of the first problems to engage the attention of the State Board of Health was the nuisance caused by slaughtering animals in an insani- tary manner within six miles of the State House. This report describes the conditions, suggests remedies, and presents economic arguments in favor of their adoption. Report on the Sale of Poisons. pp. 38-41 A brief statement of the problem. The Prevention of Disease. Dr. George Derby, pp. 42-57 An address delivered at a meeting of the Boston Social Science Association, December 3, 1868, before the State Board of Health was established. 1871 Second Annual Report Poisoning by Lead Pipe used for the Conveyance of Drinking Water. pp. 22-44 A report stating the results of a study of the occurrence of lead poisoning in various cities and towns of the state. Aside from these results the report is of especial interest in that it includes an experi- mental study of the effect of various waters on lead by Professor William Ripley Nichols of the Massachusetts Institute of Technology (pp. 32-40). Trichina Disease in Massachusetts. pp. 46-50 A general discussion of this disease. Charbon in Massachusetts. Dr. Arthur H. Nichols, pp. 86-108 A report on the occurrence of charbon, or malignant vesicle, in the state. The Causes of Tj^hoid Fever in Massachusetts. pp. 1 10-179 A statistical study of the occurrence of typhoid fever in the cities and towns of the state and a discussion of the various causes suggested. 378 STATE SANITATION It was estimated that " more than one per cent of the able-bodied adult population was rendered helpless every year from this disease for a period often extending through many months." The report contains a summary of Pettenkofer's " soil theory " of the cause of typhoid fever, and this is contrasted with the English opinion that typhoid fever was caused by the contamination of water by animal excrement. The letters received from the physicians in different parts of the state are somewhat amusing in the light of present day knowledge. It is evident that at that time the idea of water supply pollution was taking hold of the popular mind, but it was decomposition of organic matter, not injection, that was being considered. That the situation was not clearly understood is evident from the fol- lowing words taken from one of the closing paragraphs of the report, — " On the question of the propagation of typhoid fever by contagion there is little new to be said, and what is old is contradictory. When two such authorities concerning the fever of New England as Dr. Nathan Smith (who believed in the contagion theory) and Dr. James Jackson (who thought it was miasmic) differ in opinion on this point, we may be sure that it is one not readily settled." The concluding paragraph, quoted from Dr. Benjamin Rush, is worth noting. He said, " To every evil the Author of Nature has kindly prepared an antidote. Pestilential fevers furnish no exception to this remark. The means of preventing them are as much under the power of human reason and industry as the means of preventing the evils of lightning 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." Letter from the Chairman, Dr. Henry I. Bowditch, concerning Houses for the People and the Sewage Question, pp. 182-244 During the summer of 1870 Dr. Bowditch resided in London. On December 10, he wrote to the board, — ''I could not serve Massa- chusetts better than by investigating the homes of the London poor and some of the means 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." This letter contained eight distinct sections having the following titles: — 1. A Night-stroll with an Inspector of the London Metropolitan Police, compared with a similar one taken in Boston. 2. Operations of Philanthropists for the Improvement of the Dwellings of the Poor in London. 3. The Improved Industrial Dwelling Company, or the Union of Philanthropy with Capital, and with Perfectly Successful Results to Both Parties. 4. The Jarrow Building Company, by which a tenant becomes a proprieter of the home he lives in. SCIENTIFIC ARTICLES AND REPORTS 379 5. Organized work among the poor, inaugurated by Miss Octavia Hill, assisted by Mr. Ruskin and others. 6. A comparison between a model lodging house, and a low tene- ment house in Boston. 7. Convalescent homes. 8. The sewage question in England. In the last section Dr. Bowditch writes, "The great sanitary ques- tion 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. There is no single sub- ject that is attracting more attention in England, and which excites more heated partisanship 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.' " 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, presided over by the celebrated Huxley. A visit to the two outfalls of the sewers of London into the Thames, at Barking and Crossness was described. Apparently at first preju- diced against the plan of these works, designed by the celebrated engineer, Bazolette, Dr. Bowditch felt obliged to make the following inferences : " First, That by some means unknown to me the excreta had become deodorized during the water carriage. Second, That at present there was no proof that this deodorized sewage water of London does actual harm to those dwelling near it. I therefore remem- bered Boston and other cities of Massachusetts with partial relief." Correspondence concerning the Effects of the Use of Intoxicating Liquor. pp. 246-347 Containing the personal opinions of one himdred and sixty-four correspondents on the subject. Chiefly interesting as showing the manner in which the State Board of Health began to comply with Section 4 of the act under which it was created. Mortality of the City of Boston in 1870. pp. 350-368 A series of statistics prepared by Dr. Frank W. Draper. The Ventilation of School-houses. A. C. Martin, pp. 369-383 The author of this paper was a Boston architect. He refers to the prevailing idea that exhaled carbonic acid was the chief cause of the vitiation of the air in crowded rooms. He rejects this as insufficient and holds that " watery vapor and the animal matter given off by the lungs and the skin " are of more importance. Carbonic acid he regards as an obstructor of respiration and not a 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 thrown into the air." Some of these ideas are now considered as modern. Martin's ideas of school-room ventilation are interesting as an example of the use of 380 STATE SANITATION many local inlets and outlets, the latter being located at the individual desks. Diagrams illustrative of the principle are given. Examination of the Water of Mystic Pond. pp. 386-393 This relates chiefly to a report made by " Mr. William Ripley Nichols, Assistant Professor of General Chemistry at the Massachusetts Institute of Technology." The results have no value today, but the state of the art of water analysis at that time is shown by the tables of analyses, which gave the following results of determinations: 1. Number of cubic centimeters of permanganate to a liter. 2. Number of cubic centimeters of soap solution to 100 cubic centimeters of water. 3. Solid residue at 100° C. (Given in parts per 100,000 and also in grains per U. S. gallon.) 4. Loss on Gentle Ignition. (Similarly expressed.) 5. Chlorine. (Similarly expressed.) 6. Reactions for Nitrites. (Stated as " slight," " distinct," etc.) 7. Reaction for Sulphates. (Stated as " slight," " distinct," etc.) The report gives a few of these determinations for the water supplies of Boston, New York, and Philadelphia. Air and Some of Its Impurities. pp. 396-408 Examinations of air for carbonic acid were made under the direction of Professor Frank H. Storer, at the Massachusetts Institute of Technology, and at Harvard College by H. B. Hill, Assistant in Chemistry. Mr. Charles Stodder, an accomplished microscopist of Boston, undertook to make a study of the dust in the air and contributed an interesting letter describing the failure of certain methods and the partial success of others. He used a glass surface smeared with gelatm to collect floating particles. Of especial interest is his reference to the iron particles found in the dust collected from one of the shops in the United States armory at Springfield. Health of Minors, employed in Manufactures of Cotton, Woolen, Silk, Flax, and Jute. pp. 409-423 A compilation of statistics. Report on the Use of Milk from Cows Affected with "Foot and Mouth Disease." Dr. Arthur H. Nichols, pp. 426-433 The conclusions were that the disease could be communicated to man through the agency of diseased milk, but that the disease so acquired was not to be dreaded. Cooked meat and boiled milk were not to be feared. 1872 Third Annual Report Arsenic in Certain Green Colors. Dr. Frank W. Draper, pp. 18-57 A study of the supposed evil effects of the use of arsenic in certain green colors used for dyeing artificial flowers, articles of dress, confec- SCIENTIFIC ARTICLES AND REPORTS 381 tionery, pastry ornaments, toys, wall papers. Instances of poisoning are cited both of manufacturers and users. Analyses of various sub- stances for arsenic are given. The public is warned against green paper, green lamp-shade, and against most things green. Milldams and other Water Obstructions. Dr. George Derby, pp. 60-70 Looking back, this seems to us of today as a curious article. Appar- ently it is an argument against the storage of water on the ground that reservoirs impede run-off and hence raise the ground water level, con- vert meadows into swamps, while the waters become foul and give forth noisome vapors. Reservoirs thus tend to produce consumption and typho-malarial fevers. Intemperance as Seen in the Light of Cosmic Law. Dr. Henry I. Bowditch, pp. 71-129 This was an analysis of the correspondence on the use and abuse of intoxicating drinks throughout the globe which was presented to the legislature in 187 1. Starting out with the idea that the love of stimu- lants is a human instinct Dr. Bowditch attempted to show the funda- mental relations between intemperance and isothermal lines, race, nature of the stimulant and the culture of the grape. In view of present day interest in the subject of alcoholic prohibition, the conclusions of Dr. Bowditch's studies are presented at some length on page 12. The letter was illustrated by a map of the world showing the distribution of intemperance. The Adulterations and Impurities of Food. Dr. Henry B. Hill, Assist- ant in Chemistry, Harvard College, pp. 132-137 A study of the action of acid fruits upon tin cans. Proper Provision for the Insane. Dr. Edward Jarvis, pp. 140-159 A general discussion of insanity, the various needs of the insane, and the proper arrangement of hospitals. The Use and Abuse of Opium. Dr. F. E. Oliver, pp. 162-177 A consideration of the drug habit in Massachusetts. Sewing Machines. Dr. Arthur H. Nichols, pp. 180-221 The sewing machine of Elias Howe, Jr., of Cambridge, was invented in 1846. Twenty-five years later we find a heated discussion as to the effect which the constant use of foot machines had on the health of the women operators. The article of Dr. Nichols describes various styles of machine and their relative tendency to injure health. The general conclusion was that moderate use of the sewing machine, say three or four hours a day, was without prejudical effect, but that better treadles might be used with advantage and the substitution of some other motive power was urged. 382 STATE SANITATION Slaughtering, Bone Boiling and Fat Melting. Dr. George Derby, pp. 224-245 A history of the efforts of the State Board of Health to bring about a reform in these processes. Vegetable Parasites and the Diseases caused by their growth upon man. Dr. James C. White, pp. 248-296 Smallpox in Massachusetts. Dr. George Derby, pp. 297-304 A discussion of certain defects in the laws relating to the control of this disease. 1873 Fourth Annual Report Sewerage; Sewage; The Pollution of Streams; The Water Supply of Towns. William Ripley Nichols, Professor General Chemistry in the Massachusetts Institute of Technology, pp. 19-108 This is interesting as being the first comprehensive report on this subject made by the State Board of Health. On April 10, 1872, the legislature had "Ordered: — that the board of health be requested ' to consider the general subject of the disposition of the sewage of towns and cities, having in view: " ^First, Its utilization as a fertilizer. " 'Second, The sanitary effects of draining the same into the waters of the Commonwealth. " 'Third, The increasing joint use of water-courses for sewers, and as sources of supply for domestic use by the people of the Common- wealth. " 'And that the said Board be requested to report to the next legis- lature their views, with such information as they can obtain upon the subject from our own or other lands.' " Professor Nichols visited England to study the new developments then being made and his report describes various processes then new, but now all but forgotten. He made a study of the existing sewerage systems in Massachusetts and classified the cities and towns on the basis of completeness of system. He also considered the effect of sew- age on streams, and in particular, the effect of the sewage of Worcester on the Blackstone River, and that of Lowell on the Merrimack River. The report contains many analyses made by Professor Nichols and it is interesting to compare these determinations with those used in his previous report on Mystic Lake two years before. Here we find figures for " ammonia," " albuminoid ammonia," " phosphoric acid," " nitrogen as nitrites and nitrates," " suspended matter." Evidently the art had advanced during the interval. The report concludes with a discussion of the water supplies from the great ponds of the state. The chief interest of this report of Professor Nichols lies in the fact that it reflects the opinions of the various sanitary authorities of that time on such general questions as the self-purification of streams, the SCIENTIFIC ARTICLES AND REPORTS 383 utilization of sewage. Interesting also is the fact that many of the water analyses were made at the Massachusetts Institute of Tech- nology by Miss Ellen H. Swallow, A.B., who afterwards became Mrs. Ellen H. Richards. The Opportunity and Possibility of Utilizing Sewage in the City of Worcester. Phineas Ball, pp. 1 09-1 16 The Great Ponds of Massachusetts. H. F. Walling, pp. 11 7-13 2 A list of the lakes and ponds with areas and name of outlets. Beer-shops and Prohibitory Laws. P. Emory Aldrich, pp. 133-144 Additional analyses of evidence as to the use and abuse of intoxi- cating liquors. Character of Substances Used for Flavoring Articles of Food and Drink. Dr. Henry K. Oliver, pp. 145-172 A study of supposed deleterious ingredients used for flavoring and coloring. Drainage for Health. Henry F. French, pp. 17 5-1 91 A discussion of building sites, cellar drainage, and sink drains. Infant Mortality. Dr. Edward Jarvis, pp. 193-233 A scholarly discussion, strikingly modern in tone. It contains statistics of infant mortality in different countries and in different parts of the United States, comparing them with figures for Massa- chusetts. The causes of infant mortality are discussed and the statements differ very little from those so much talked about today. Emphasis is laid on the need of education of mothers, both before and after the child is born. This is a paper well worth reading by modern social workers. The Food of the People of Massachusetts. Dr. George Derby, pp. 237-275 A collection of facts relating to the habits of the people of the state in the use of foods of different kinds, based on a circular letter sent to the correspondents of the board in the cities and towns. Such topics as these are touched upon: the quality of bread, variety in food, the frying of meat, the use of pastry and cakes, time devoted to meals, the use of tea and coffee, the excessive use of water, cost of labor as in- fluencing food. Speaking of too rapid eating Dr. Derby says, " The usual or average time occupied in the process of taking food by the people of this state we think does not exceed from twelve to fifteen minutes for each meal." The paper contains interesting allusions to the domestic conditions of the time. The wages of domestic servants were increasing, home life was being discouraged, people were taking refuge in hotels and boarding-houses, women were leaving homelife for the factory, pres- 384 STATE SANITATION sure of town life was increasing. Special emphasis was laid on the quality of the bread being made, the concluding words of the article being, " When bread, the staff of life in all countries, is found to be as good in Massachusetts as in Europe, it will be a sign that the point at which we should aim has been reached." The Adulteration of Milk. Dr. Arthur H. Nichols and Professor James F. Bahcock, pp. 277-306 An early study of a subject which for many years has given great concern to public health authorities. The subdivisions of the subject were: {a) The composition of milk, its variations, {b) Methods of examination, (c) Methods of adulteration, {d) Examination of samples of milk sold in Boston, (e) Legislative enactments with regard to the sale of adulterated milk. At that time Professor Bab- cock was Analyst to the City of Boston and the report of his analyses are of interest to food specialists. Some of the Causes or Antecedents of Consumption. Dr. Henry I. Bowditch, pp. 307-388 An analysis of the correspondence elicited by sending a questionnaire to many physicians showed the following opinions to be generally prevalent at that time. Consumption is influenced by hereditary tendencies. The effect of drunkenness of parents on consumption is not strongly marked, but the effect of drunkenness in the individual is marked. Consumption is favored by overwork, by certain trades, by mental trouble. Of 210 correspondents only 100 held the disease to be contagious, but 168 believed it to be caused or promoted by a wet location, — thus sup- porting a theory strongly urged by Dr. Bowditch himself. Adulterations and Impurities of Food. H. B. Hill, Assistant in Chemistry, Harvard College, pp. 389-394 The Homes of the Poor in our Cities. Dr. Frank W. Draper, pp. 395-441 A report based on a personal inspection of conditions in the following eight cities, — Boston, Fall River, Lawrence, Lowell, Lynn, Salem, Springfield, Worcester. It contains an analysis of the legislation on the subject up to that time and urges the establishment of local boards of health. Butcher's Slaughtering and Melting Association. pp. 443-447 A short report to the Board by the president of the association. 1874 Fifth Annual Report Preventive Medicine and the Physician of the Future. Dr. Henry I. Bowditch, pp. 31-60 An excellent resume of the state of the art in 1874. It is reprinted, with some omissions, on page 17. SCIENTIFIC ARTICLES AND REPORTS 385 On the Present Condition of Certain Rivers of Massachusetts, together with considerations touching the water supply of towns. Prof. William Ripley Nichols, pp. 63-152 A study made in continuation of that described in the Fourth Annual Report of the State Board of Health, pp. 19-108, and describ- ing in detail and with statements of water analysis the various rivers of Eastern Massachusetts, especially the Merrimack, Blackstone, Sudbury, Concord, Neponset, and Charles. The report contains, on page 148, a detailed description of the methods of analyses used. The only substantial difference from those used the year before was the addition of the test for dissolved oxygen. On page 103 is given a discussion of the then mooted question of the self-purification of streams. At that time the Cochituate water supply of Boston was polluted on various streams and notably by Pegan Brook at Natick. Several storage dams on this stream built for the protection of the supply are described. Certain pollutions of Mystic Lake, then used as a water supply for Charlestown, Chelsea, and other places to the north of Boston were discussed. In this report the water supplies of Lowell and Lawrence, which have long been of interest to sanitarians, come into view. Lowell at first considered a project to use sand-filter beds, but it was decided to use a " filtering-gallery," now generally called an " infiltration- gallery " instead. It is interesting to notice that in the study of this problem Nichols made determinations of iron (and alumina) , hardness and dissolved oxygen, very much as a modern chemist would do. Lawrence was then constructing its new works and it was proposed to draw water directly from the river except when it was turbid. At such times it was the intention to take water from a filtering-well near the shore. The Charles River was considered as a source of water supply by a number of communities, Dedham, West Roxbury, Brookline, New- ton, Waltham, and Watertown, and there were acrimonious discus- sions between those who favored the river and those who favored Lake Cochituate. In 1874 Waltham alone took water from the river and Nichols discussed the quality of water from this source in his report. The soundness of his ideas throughout this and other discussions are, in the light of present day knowledge, notable. The Brighton Abattoir. pp. 153-180 A description of the abattoir, a list of the regulations approved by the State Board of Health and a letter from the U. S. Commissioner at the Vienna Exhibition describing certain abattoirs in Europe. The Health of the Farmers of Massachusetts. Dr. J. F. A. Adams, pp. 181-248 A paper based largely upon correspondence with physicians. It treats of the following topics: social condition and prosperity; longev- 386 STATE SANITATION ity; general health; causes of disease; prevailing diseases; then of the farmer's work, his diet, location of dwellings, cleanliness of surroundings, drinking water, sleeping apartments, mental influences. Some Farm-Houses and Some Mistaken Ways of Living in Them. Mrs. Thomas F. Plunkett, pp. 249-259 Cerebro-Spinal Meningitis in Massachusetts. Dr. J. Baxter Upham, pp. 261-312 A report on the epidemic which occurred in Massachusetts in 1873, with an inquiry into the circumstances attending its origin or supposed cause. Correspondence with physicians was analyzed as to the occurrence of the disease in different places and the relation of the disease to sanitary conditions. The conclusions were largely negative. Hospitals. Dr. George Derby, pp. 313-332 The object of this paper, the author states, was to show the advan- tage of hospitals, constructed simply, detached from each other, and of a single story. Political Economy of Health. Dr. Edward Jarvis, pp. 333-390 A splendid discussion of public health based on a text quoted from the distinguished sanitary engineer, Baldwin Latham, " Health is the Capi- tal of the Laboring man." The subject is treated from many stand- points, — statistical, financial, political, moral, physical. Answering the question " Can the government aid in Improving Human Life ? " Jarvis refers to the threefold powers of government which are exerted. " It is mandatory, and says, thou shalt and thou shalt not." " It is permissive, and grants privileges." " It is advisory, instructive and encouraging." A resume is given of some of the more important laws relating to public health enacted in England (p. 364). School Hygiene. Dr. Frederick Winsor, pp. 391-448 A general discussion based on correspondence with physicians. Then as now the crying need was for better ventilation. Work of Local Boards of Health. Dr. Azel Ames, Jr., pp. 449-486 A description of the status of the local boards of health and their work. Use of Zinced or Galvanized Iron, for the storage and conveyance of Drinking Water. Dr. W. E. Boardman, pp. 487-510 An excellent resume of the views of scientists, with a letter from Professor William Ripley Nichols. The conclusion is well stated and the opinion stands today. "It is proved theoretically, experimentally and practically that zinc is acted upon by ordinary drinking water; that water, allowed to stand in reservoirs or drawn through pipes of zinced or galvanized iron, usually contains an appreciable amount of zinc, more or less, SCIENTIFIC ARTICLES AND REPORTS 387 according to various influences; that the zinc, contained in the water, is in the form of undissolved oxide and carbonate and of dissolved salts, the exact nature of the latter not being known; that probably under no circumstances is the oxide or the carbonate an active or gradual poison, much less in the amounts in which they can occur under the conditions mentioned; that, at least with water fit for drinking purposes in other respects, the contained zinc salts in solution do not exert any deleterious effects upon the human system; finally, that, even if all the zinc in solution were in the form of the chloride, which is known to be the most active poison of the zinc salts, the amount would still be insufficient to endanger health." 1875 Sixth Annual Report Inebriate Asylums or Hospitals. Dr. Henry I. Bowditch, pp. 25-53 Dr. Bowditch, after discussing the difference between vicious and morbid drunkenness, suggested a method of dealing with the problem by establishing state asylums for inebriates, and described his idea of how such asylums should be conducted. As a result of this paper the Board recommended to the legislature the establishment or endowment of one or more asylums as a sanitary measure of the highest importance. The Value of Health to the State. Dr. W. E. Boardman, pp. 55-75 A statistical and economic study. On the Transportation of Live-stock. /, C. Hoadley, pp. 77-132 A report by an engineer, prepared at the request of the Board. It discusses the subject " in its economical, sanitary and humane as- pects." The first of these — " abundant food at a reasonable price " — gives the key to the situation. Although a vital subject at the time, linked as it was with the studies of the abattoirs, the details of the paper are no longer of importance. Our Meat Supply, and PubUc Health. Dr. Charles F. Folsom, pp. 133-183 An account of the various ways in which decayed or infected meat may cause disease to human beings, including a study of trichina and other parasites. The Brighton Abattoir. Mr. J. N. Meriam, pp. 185-203 An account of various matters relating to the business of slaughter- ing cattle for the market. Regulations of the State Board of Health. On the Composition of the Air of the Ground-Atmosphere. Prof. William Ripley Nichols, pp. 205-224 This investigation was made, no doubt, because of the prominence at that time of the theories of Pettenkofer, which had to do with the sanitary significance of ground water and ground air. Nichols collected 388 STATE SANITATION samples of ground air by an interesting method (p. 214) at various places in the Back Bay, where the city " consisted largely of made land." These were tested for CO2, sulphuretted hydrogen, and am- monia. The CO2 results were quantitative and are given in the paper. They ranged from about 7 to 45 parts per 10,000 just below the sur- face to 25 to 200 parts at depths of 10 or 12 feet. The quantities were higher in summer than in winter. No sulphuretted hydrogen was found. Nichols, with his keen scientific mind, expresses his opinion that no very useful conclusions can be drawn from the CO2 tests. He practically gave the ground air of the Back Bay district a clean bill of health. In an appendix to his report (p. 221) he describes experiments made by Professor Fleck in Dresden to show the varia- tions in the CO2 of ground air above a decomposing body. The data given are interesting. Ventilation of Railroad Cars. Dr. Theodore W. Fisher and Professor William Ripley Nichols, pp. 225-240 A report of analyses of air in cars, especially smoking cars. The CO2 found varied from 10 to 37 parts per 10,000. References to previous studies by various writers are given. Cremation and Burial. Dr. J. F. A. Adams, pp. 241-325 An elaborate discussion of the relative advantages of the two methods, largely historical and with many references to other writings. His conclusion was that cremation is an innovation not demanded in this country on sanitary grounds. 1876 Seventh Annual Report The greater portion of this report is devoted to the subjects of stream pollution, drainage, sewage disposal and water supply. It may be regarded as one of the great classic reports of the Board. Rivers Pollution. James P. Kirkwood, C.E., pp. 21-154 In 1875 (Chapter 192) the legislature had passed an act providing for an investigation of the question of the use of running streams as common sewers in its relation to the public health. Mr. Kirkwood, of Brooklyn, N. Y., then an eminent authority was appointed by the Board to make a systematic examination of certain of the river-basins of the state. His report is divided into several parts. Part I (p. 21) is a summary of the then prevalent ideas concerning the relation between the use of unclean water supplies and disease, notably cholera. Illustrations are taken from the water supplies of London. Part II (p. 37), which comprises the body of the report, is a statis- tical study of the various drainage areas studied, with accounts of the various trade wastes encountered. The following index to these SCIENTIFIC ARTICLES AND REPORTS 389 topics will assist the reader in obtaining an idea of the scope of the investigation and be a convenience in iinding the data in the report: Woolen manufacture (p. 37), cotton manufacture (pp. 42 and 45), bleach- works (p. 45), linen and jute manufacture (p. 46), silk manu- facture (p. 49), paper manufacture (p. 50), metal manufacture (p. 60). On page 69 is given an account of the effect of various poisons in water on fish life: Blackstone River, p. 73. Neponset River, p. 89. Charles River, p. 97. Chicopee River, p. 109. Taunton River, p. 123. Part III (p. 144), contains the general conclusions and recommen- dations. Tables of Analyses. Professor William Ripley Nichols, pp. 155-174 Many samples of water were analyzed by Professor Nichols in con- nection with Kirkwood's investigation. The methods used were practically the same as had been used for several years previous. Water Supply, Drainage and Sewerage of the State, from the Sanitary Point of View. Dr. Frederick Winsor, pp. 175-275 A report of the sources of water supply and the place of sewage disposal for many of the cities and towns of the state, based upon the answer to eleven questions sent out by the author in a circular letter and answered by one hundred and eighty-eight cities and towns. It contains many points of information in regard to the water supplies of the state as they were at that time. On pages 1 80-1 91 is given a discussion of the methods of excrement removal used in England and elsewhere, with sketch of privies and arrangements of parts. The tables relating to water supplies begin on page 193, and those, on sewer outlets on page 202. Three principles stated on page 218 give a good illustration of cur- rent ideas as to the danger of water pollution. In brief they were as follows: First. Chemical analysis is not alone suflEicient to detect impurities in water for an incredibly small amount of the poison of typhoid fever or cholera is sufficient to set up specific morbid actions. Second. A water supply not enough polluted to actually cause disease or be detected by the chemist may yet gradually and insidiously lower the vigor and cause persons who may subsequently drink polluted water to succumb. Third. Where sewers must inevitably discharge into a body of water used for drinking, it should be strictly forbidden to discharge any excrement into the sewers. On page 231, et seq. are given detailed accounts of certain water supplies and sewerage works in various cities, as follows: Boston 390 STATE SANITATION (p. 232), Haverhill (p. 248), Lynn (p. 249), Salem (p. 257), South Braintree (p. 261), Winchester (p. 262), Worcester (p. 264). Well waters are discussed on page 268. The new water supply of Springfield obtained from Ludlow Reser- voir is referred to on p. 271 and mention is made of the occurrence of Anabaena (then erroneously called Nostoc) for which this supply has long been famous. The ice supply of Pittsfield is described on p. 274. The Disposal of Sewage. Dr. C. F. Folsom, pp. 276-401 This is a comprehensive discussion of current sewage disposal practice in Europe in 1875, ^ ^st of the principal topics treated will indicate its wide scope. pp. The efifect of filth on health 279 The influence of sewer gas on health 281 Water contaminated by sewage 283 Experience in England, a list of sanitary measures, with dates 285 The sewage question in England 289 Substitutes for the water-carriage system 299 Experience in France 302 Experience in Germany 307 Experience in Holland (" Liernur system ") 311 Experience in other countries 322 Processes for purifying sewage 323 Irrigation (a very interesting description) 334 Method of disposing of sewage in various European cities, with maps and estimates of cost 347 Summary and Recommendations. A report signed by the State Board of Health, and by James P. Kirkwood, Frederick Winsor, and William Ripley Nichols, pp. 402-408 The recommendations were as follows: I. That no city or town shall be allowed to discharge sewage into any water-course or pond without first purifying it according to the best process at present known, and which consists in irrigation; provided, that this regulation do not apply to the discharge from sewers already built, unless water supplies be thereby polluted; and provided, also, that any intended discharge of sewage can be shown to be at such a point or points that no nuisance will arise from it. II. That no sewage of any kind, whether purified or not, be allowed to enter any pond or stream used for domestic purposes. HI. That each water-basin should be regarded by itself in the preparation of plans of sewage and water supplies. IV. That accurate topographical surveys be always made of all towns before introducing water supplies or sewers. V. That steps should be taken, by special legislation, based upon investigations and recommendations of experts, to meet cases of SCIENTIFIC ARTICLES AND REPORTS 391 serious annoyance arising from defective arrangements for the disposal of sewage. VI. That irrigation be adopted, at first experimentally, in those places where some process of purification of sewage is necessary; and that cities and towns be authorized by law to take such land as may be necessary for that purpose. VII. That every city or town of over four thousand inhabitants be required by law to appoint a board of health, the members of which shall be required not to hold any other offices in the government of their city or town. Sanitary Hints. Dr. Henry I. Bowditch, pp. 409-422 Some experiences with typhoid-fever epidemics with some suggested practical remedies. Defects in House-Drainage and Their Remedies. Edward S. Philbrick, C.E., pp. 423-464 Some of the criticisms made in this article apply today, but for the most part the fixtures described long ago went out of use. The article is well written and well illustrated, but its value is chiefly historical. Report on an Outbreak of Intestinal Disorder Attributable to the Contamination of Drinking Water by Means of Impure Ice. Dr. Arthur H. Nichols, pp. 465-474 An outbreak of disease, often referred to as having been caused by decomposing organic matter, frozen into the ice, — a theory no longer tenable. Report on the Registration of Prevalent Diseases. Dr. Frank W. Draper, pp. 474-492 A suggested plan for getting weekly reports of prevalent diseases to be compiled and published by a " Bureau of Health Correspond- ence." The article contains charts showing variations in the occur- rence of various diseases. Health of Boston in 1875. Dr. F. E. Oliver, pp. 493-506 A statement as to the prevalence of certain diseases. The Surface-drainage of the Metropolitan District. Dr. C. W. Folsom, pp. 507-512 A description of certain fresh-water marshes and salt-water marshes. The Health of LoweU, 1875. Dr. F. Nickerson, pp. 515-524 A statement as to the prevalence of certain contagious diseases. 1877 Eighth Annual Report The Pollution of Streams, Disposal of Sewage, etc. Dr. C. F. Folsom, with Chemical Examinations by Professor William Ripley Nichols, pp. 19-79 This paper recounts the results of a sanitary survey, with map, made by Mr. E. K. Clark, C.E., of the Nashua River Basin. Included 392 STATE SANITATION in it (p. 48) is a report by Professor Nichols giving the results of analyses of water samples collected at various places. On page 68 there is a brief statement of the pollution of the Merrimack River. Then follows, on page 73, the text of an act passed in England the year before and known as the Rivers Pollution Prevention Act, 1876, The Disposal of Sewage. Dr. Charles F. Folsom, pp. 80-113 This report alludes to the experiments made at the insane asylums at Concord, N. H., Augusta, Me., and Worcester, Mass., and the women's prison at Sherborn, and to recent experiences in England. On page 88 are given the opinions of experts and on page 90 the latest English government statistics. Then follow references to German (p. 104) and French (p. 105) experiences. Effects of Bad Drainage on Health. Dr. Charles F. Folsom, pp. 1 13-136 Interest in this paper lies in the fact that it makes mention of the controversies then arising in England between Wanklyn, Frankland and others. Professor Wanklyn held that the contagium of the water- borne diseases was of an albuminoid character and could be removed by filtration. Professor Frankland belongs to the " Purist " school, and condemned the use of river waters to which sewage had access, going so far as to recommend that the Thames supply of London be abandoned on the ground that even filtration would not sufiiciently remove the " animal and other offensive matters." In this contro- versy both sides were partly right and partly wrong. The paper refers also to another controversy in Germany, Virchow holding that the level of the ground water did not always bear a relation to the occur- rence of typhoid fever, and Pettenkofer holding to his old theory that " the chief agency in the spread of typhoid fever and cholera was the decomposition of organic matter in the soil from variations in the level of the ground water, allowing the virus to escape into the air." On page 118 we find mention of bacteria and the controversy as to whether the germs of disease may arise de now from filth. Then follow several accounts of outbreaks of typhoid fever and their probable cause. One at Fort Cumberland was thought to be due to " sewage contaminated air," one at Uppingham to badly laid drains, and one at Eagley caused by watered milk. On page 124 is an account of the celebrated typhoid-fever epidemic at Lausen, Switzerland in 1872, with a statement as to the theory that it was caused by a " germ." Under the caption " Prevention of Filth Diseases " the need of adequate sewerage is pointed out and on page 130 are given the regula- tions adopted at Frankfort, where W. Lindley was Chief Engineer. Dr. Buchanan's recommendations as to the use of the running trap, or house trap, are given on page 133. Sewerage, its Advantages and Disadvantages, Construction and Maintenance. E. S. Chesborough, C.E., pp. 137-167 A general paper by the celebrated engineer of Chicago who designed some of the earliest great sewerage systems in the United States. It SCIENTIFIC ARTICLES AND REPORTS 393 treats the subject from the engineering standpoint, and is not of much interest to present day readers. The Sanitary Condition of Lynn. Dr. J. G. Pinkham, pp. 169-230 A sanitary survey, apparently quite complete and containing one unique feature, - — a table of death-rates by streets. Registration of Deaths and Diseases. Dr. Charles F. Folsom, pp. 231-271 A study of the accuracy of the returns in Massachusetts. On page 258 is a history of the registration of deaths in Massa- chusetts and a statement as to the faults in existing law. On page 262 some amusing causes of death are given as " death caused by five doctors," " delicate from birth," " coUocinphantum," " direars," " artry lung busted," etc. The Growth of Children. Dr. H. P. Bowditch, Professor of Physiology, Harvard Medical School. pp. 273-323 An elaborate and very important statistical study of the height and weight of the school children of Boston, classified by age, sex, nation- ality, and occupation of parents. The data are given both by tables and diagrams and are very valuable for purposes of comparison with more recent studies. Comparisons at the time were made with European studies by Quetelet and others. This paper has long been regarded as a classic. Disease of the Mind. Dr. Charles F. Folsom, pp. 325-433 An extended treatise of the general subject under ten headings as follows: I. Early treatment of the Insane. 2. Pinel's reform and European progress. 3. English progress and ConoUy. 4. American progress. 5. Modern methods of Less Restraint. 6. Responsibility for crime and definitions of insanity. 7. Massachusetts statistics and asylums accommodation. 8. Supervision by the state. 9. Certain asylum needs. 10. Medical education. 1878 Ninth Annual Report Drainage and Health; Sewerage; and the Pollution of Streams, report by the Board. pp. 1-80 The first sixty-six pages of this report give the results of a study of the stream pollutions of the Hoosac and Housatonic rivers by Mr. E. K. Clark, C.E., and Professor William Ripley Nichols. As a result of a three-years study of stream pollution the Board recommended the passage of a bill establishing a Rivers Pollution Commission. The reasons for this are given on page 66, and the proposed law on page 73. This was entitled " A bill to prevent the pollution of streams and for other purposes." On page 77 will be found certain other recommendations of the board in regard to privies, cess- pools, earth closets and sewerage systems. 394 STATE SANITATION Cottage Hospitals. Dr. J.F. A. Adams, pp. 81-95 A paper advocating the cottage hospital and showing sketches and floor-plans. Dangers from Color Blindness. Dr. B. Joy Jeffries, pp. 97-136 A good discussion of the subject emphasizing the dangers to the com- munity from the employment of color blind persons in certain positions, especially on railroads, where a discernment of color is necessary. Contains a long bibliography. The Filtration of Potable Water. Professor William Ripley Nichols, pp. 137-226 This is one of the early American classics on the subject of filtration written by a master mind before the days of bacteriology. A portion of the report is reprinted on page 26, in order that the student of today may see the ideas of the leading expert on the chemistry of water more than thirty-five years ago. The report is divided into three parts, treating respectively: I. Artificial filtration on a large scale (p. 141); II. Natural filtration (p. 175); III. Household filtration. The discussion of sand filtration was naturally based largely on English experience, but interesting references are made to the early American works at Hudson and Poughkeepsie, Columbus and Toledo, Springfield and Lowell. We find in this report also one of the first important discussions of the algae problem in reservoirs. FUter experiments made at Springfield in 1877, using the cement-lined pipes then common, are mentioned and analyses given. Much of the material in this paper was afterwards published in his well known volume " Water Supply," published in 1883, but still read by students. Sanitation of Public Schools. Dr. D. F. Lincoln, pp. 227-252 This paper concerns itself with the site, construction, sewerage, drainage and ventilation of schoolhouses. Like many other papers of that period it was based on data obtained from circular letters. The replies received from persons outside of Boston, scattered through nearly one hundred cities and towns, and from the Boston school authorities, represented about one-sixth of the school population of the state, and serve to give a good idea of the conditions existing at that date. Then, as now, the ventilation problem was one attracting attention. Scarlet Fever. Dr. A. H. Johnson, pp. 253-327 Statistics of the disease, sources and methods of contagion, the influence of insanitary surroundings are described and the following conclusions drawn: " The contagion is particulate, capable of exceed- ingly minute subdivision, has a very light specific gravity, is very tenacious, is not volatile." Evidently the author accepted some of the SCIENTIFIC ARTICLES AND REPORTS 395 newer ideas in regard to the germ theory then beginning to gain ground. Lastly, follow methods of disinfection, and the function of hospitals in controlling scarlet-fever. Report on the Sanitary Condition of Cambridge. Dr. Edward R. Cogswell, pp. 329-374 A fairly complete survey of the sanitary conditions in 1878, taking up the natural conditions of the city, make-up of the population, certain artificial conditions (water supply, sewerage, low lands, house drainage, etc.), vital statistics, prevailing diseases, and comparisons of health of different districts. These matters are of considerable local interest, especially the analyses of the Fresh Pond water which go back to 1872. 1879 Tenth Annual Report An Asylum, or "Hospital Home." Dr. T. S. Clouston, pp. 1-32 A detailed description of the general principles of hospital construc- tion, with suggested plans. The Growth of Children. Dr. H. P. Bowditch, pp. 33-62 A continuation of the report on the same subject published in 1877 (8th An. Report, pp. 273-323). This second paper discusses the rela- tion between growth of children in Boston schools and occupation of parents. A description is given of the anthropometrical methods used. Physical Education and Hygiene in Amherst CoUege. Professor Edward Hitchcock, pp. 63-72 An account of the manner in which the physical condition of the students was being looked after. Coal-Gas from Heating Apparatus. Dr. Frederick Winsor, pp. 73-84 Dangers from poisoning by carbonic oxide due to escape of coal-gas. Common Defects in House-Drains. Mr. Eliot C. Clarke, C.E., pp. 85-109 A very interesting description of some of the old sewers. Profusely illustrated with sketches. Evidence in Case of The City of Cambridge vs. Niles Brothers before State Board of Health. pp. 111-227 This case resulted from a complaint made by the City of Cambridge that the establishment of a proposed slaughterhouse by Niles Brothers on the catchment area of Fresh Pond would impair the quality of the public water supply of that city. The testimony and the arguments (pp. 208 and 220) give an interest- ing picture of the conception of the day as to what constitutes the pollution of a water supply. The case was not closed this year and references to it are given in subsequent reports of the Board. 396 STATE SANITATION A Contribution to the Study of Ventilation. Dr. Edward S. Wood, Professor of Chemistry, Harvard Medical School, pp. 231-248 Results of observations of temperature, humidity, air currents, etc., at the Boston City Hospital. Also tests for carbonic acid. Diagrams showing air currents at the flow level and at heights of 3, 6, 9, 12, 15 and 18 feet above the floor around the hospital beds. Apparently a very careful study of the subject. 1879 Eleventh Report. For Six Months ending June 30, 1879 No scientific papers were published in this report. General Index. Dr. Francis H. Brown, pp. 45-184 A complete alphabetical index of volumes I to XI inclusive. 1879 Supplement Supplement to the First Annual Report of the State Board of Healthy Lunacy and Charity Pollution of the Westfield and Merrimack Rivers. Dr. Charles F. Folsom, pp. 1-18 A sanitary survey made in continuation of the investigation begun by Mr. J. P. Kirkwood in 1875. Pollution of a Brook by Sulphuric Acid. Professor William Ripley Nichols, pp. 19-21 An account of an accidental discharge of sulphuric acid into a tribu- tary of Mystic Pond, by reason of a fire in chemical works. Trichinae in Relation to the PubUc Health. Dr. F. S. Billings, pp. 23-54 A description of the organism, its method of entering the body, dangers from swine, and methods of prevention are all described. Adulteration of Some Staple Groceries. Mrs. Ellen H. Richards, Instructor in Chemistry, Woman's Laboratory, Massachusetts Institute of Technology, pp. 55-65 A general report as to the adulteration of staple groceries. Contains few analyses. The Water Supply of Cambridge. Dr. Edward S. Woods, pp. 67-94 An important report on the local pollution of the catchment area of Fresh Pond. One of the water analyses quoted dates back to 1853 (p. 85). Many analyses given for years 1875-79. Observations on Fresh Pond, Cambridge. Professor William Ripley Nichols, pp. 95-107 " A contribution to the knowledge of stored waters," containing a diagram showing seasonal fluctuations in temperature of water and water analyses, — an early study of stagnation. SCIENTIFIC ARTICLES AND REPORTS 397 Examination of Mystic River, with Remarks on Frankland's Method of Water Analyses. Professor William Ripley Nichols, pp. 111-120 This is an interesting discussion of methods of water analysis. Few students of today know of the controversies of Frankland and Wanklyn as to the respective merits of the " carbon-nitrogen ratio," and the " albuminoid and free ammonia method." In this controversy Nichols sided with Wanklyn. Algae Observed in Storage Basin No. 3 of the Boston Water Supply in 1879. Alphonse Fiely, Resident Engineer, Boston Water Works, pp. 1 21-128 A study of water temperatures and algae growths in Basin No. 3, with reference to a small experimental sand filter. Diagram given. On Some Impurities of Drinking Water Caused by Vegetable Growths. Professor W. G. Farlow, Harvard University, pp. 129-152 The first report relating to algae made to the Board of Health, which contains botanical descriptions and illustrations of blue-green algae and other forms. A portion of this article is reprinted on another page (p. 39). The Effect on Health of Certain Algae in the Mystic Water Supply. PP- 153-160 A series of replies from physicians as to the use of Mystic Water. No present value. The Drainage of Summer Hotels and Country Boarding Houses. Mr. Ernest W. Bowditch, C.E., pp. 161-198 An interesting discussion of the pollution of country wells, with many diagrams. Very little present value. Suggestions on Sewerage. Mr. Eliot C. Clarke, C.E., pp. 199-238 A discussion of the engineering principles involved in sewer con- struction, starting with soil borings and float experiments and con- cluding with descriptions of sewers, sewer sections, etc. A valuable paper for present day students to consult, as many reasons for failures are given. 1880 Supplement Supplement to the Second Annual Report of the State Board of Health, Lunacy and Charity The Pollution of the Deerfield and Millers Rivers. Mr. W. E. Hoyt, C.E., pp. 1-2 1 A continuation of the sanitary surveys of the waters of the state. The Separate System of Sewerage. Mr. Eliot C. Clarke, C.E., pp. 23-44 An excellent resume of the principles of the separate system of sew- erage, then coming into notice, with simple illustrations. 398 STATE SANITATION Litermittent Fever in Massachusetts. Dr. J. F. A. Adams, pp. 45-108 Reference is made to Dr. Oliver Wendell Holmes' article published in 1836, and an account given of the recurrence of the disease (Malaria) in New England. The true medium of the spread of the disease was then unknown, and various theories, all erroneous, were being discussed. School-house Sanitation. Mr. Ernest C. Bowditch, C.E., pp. 109-147 A sanitary survey of a number of schools, some of them broader in scope than the buildings themselves, involving studies of environment, the preparation of sanitary maps, etc. Epidemic of Cholera Morbus in Adams, in Jime, 1880. Dr. J. F. A. Adams, pp. 149-163 Supposed to be caused by the public water supply. Sanitary Condition of Holyoke. E. W. Bowditch, C.E., pp. 167-176 Interesting chiefly for the diagrams showing the relative sanitary conditions in the different wards in the city. Neglect of Vaccination. Dr. Z. B. Adams, pp. 177-194 A discussion of the value of vaccination and a plan for making it more generally applicable. 1881 Third Annual Report of the State Board of Health, Lunacy and Charity (No supplement to this report was issued this year, but merely a special sanitary appendix, which contained the following papers). Circular from the Health Department of the State Board of Health, Limacy and Charity on Drainage, etc. pp. 1 07-1 16 A circular relating to cesspools and drains. Of no present value. The Worcester Sewage and the Blackstone River. Dr. Charles F. Folsom, Joseph P. Davis, C.E., Dr. Henry P. Walcott,pp. 117-133 A report of a committee containing a comparison of various possible methods of sewage treatment and recommending intermittent down- ward filtration upon an area so large that the land may be used for growing crops. Project for the Purification of the Sewage of Worcester. George E. Waring, Jr., pp. 134-146 Colonel Waring, acting for the town of Millbury, which is on the river below Worcester, presented a report recommending a separate system of sewers, screening, subsidence, aeration, a flow through ten miles of ditches at a low velocity and application to one hundred and twenty-six acres of wooded swamp land. Estimates of cost were made by Phineas Ball, S. C. Heald, and Amos Pike. SCIENTIFIC ARTICLES AND REPORTS 399 Report upon Metropolitan Drainage. E. S. Chesborough, C.E., Dr. Henry P. Walcott, Dr. Charles F. Folsom, A. W. Boardman, C.E., and Dr. Azel Ames, Jr., pp. 147-159 An important document, being the report of a legislative committee which laid the foundations for the present metropolitan system of sewers. The conclusion of the report was as follows: That a metropolitan district system be recommended, which we believe should include the entire territory naturally draining into Boston inner harbor; a system of intercepting sewers and branches to be supplemented, where found advisable, by irrigation or intermittent downward filtration works; and a Board of Commissioners to plan, carry out, and manage the works, and to make the apportionment of taxes necessary to pay for the same, subject to the supervision of the Governor and Council. We believe that the system recommended would preserve, so far as is practicable by general sewerage, the purity of the water supply of the cities included in this district. 1882 Supplement Supplement to the Fourth Annual Report of the State Board of Health, Lunacy and Charity Adulteration of Food. Professor S. P. Sharpies, pp. 1-86 An extensive treatment of the methods, chemical and microscopical, used to detect adulterations in many kinds of food, with a bibliog- raphy. A valuable paper for students of food analysis, but of no present interest to the general reader. Our Eyes and Our Industries. Dr. B. Joy Jeffries, pp. 87-117 A general discussion emphasizing the dangers of eye-strain and defective vision, and urging that greater attention be given to the care of the eyes. Leprosy as Related to P*ublic Health. Dr. Samuel W. Abbott, pp. 1 19-139 A general discussion. Reports of the Water Boards, Commissioners, and Companies of Massachusetts. pp. 141-223 A compilation of water works statistics upon a uniform basis in accordance with an act of legislature passed in 1879 requiring triennial returns. The questionnaire used is given on page 146, a summary of the statistics on page 212. The Sewerage of Nahant. pp. 227-248 A plan for a sewerage system. It contains sketches of various devices used for cleaning sewers, such as mirrors, hinged rakes, etc. 400 STATE SANITATION 1883 Supplement Supplement to the Fifth Annual Report of the State Board of Health, Lunacy and Charity Tubular Wells and Wells in General as a Source of Water Supply for Domestic Purposes. /. C. Hoadley, C.E., pp. 1-36 A paper describing the geology and hydraulics of underground waters, with an account of experiments made at Maiden, Mass., on the lines of flow and the circles of influence around a driven well. References are also made to the well supply of Berlin. The Sanitary Condition of SomerviUe. Dr. John F. Couch. An account of the sanitary conditions of Somerville as found by the local board of health. Trichinosis. pp. 177-189 A summary of recent investigations of the subject. Certain Questions Relative to the Sewerage and Sanitary Condition of Nantucket. pp. 191-209 Containing a report by Ernest C. Bowditch, C.E. Arsenic as a Domestic Poison. Professor Edward S. Wood, pp. 211-267 An extended study of the prevalence of arsenic in articles intended for domestic use, the form in which it is present, its danger to health and measures of prevention. In particular a study was made of wall paper, actual samples of which are to be found in the report. An important contribution to a subject, not now considered to be of great moment. 1884 Supplement Supplement to the Sixth Annual Report of the State Board of Health, Lunacy and Charity Sanitary Conditions of School Buildings in Massachusetts. Dr. D. F. Lincoln, pp. 1-94 Results of a detailed study of school buUdings in twenty-five cities and towns, illustrated by twenty-two plans. The Relation of Illuminating Gas to Public Health. Dr. Samuel W. Abbott, pp. 247-274 This paper treats of the composition of illuminating gas, the dan- gerous character of carbonic oxide, and remedies for the prevention of accidents. There are several tables showing the numbers of deaths from illuminating gas in different cities. A Study of the Relative Poisonous Effects of Coal and Water Gas. Professor William T. Sedgwick and Professor William Ripley Nichols, pp. 275-313 An important contribution to the subject embodying the results of experiments upon animals. Parts of this paper are reprinted on page 47. SCIENTIFIC ARTICLES AND REPORTS 401 Epidemic Cholera. Dr. Samuel W. Abbott, pp. 315-340 A statistical study of the occurrence of cholera in Massachusetts from 1847 to 1884, and an account of the epidemic in Boston in 1849. Reference is made to Koch's discovery of the comma-bacillus, the cholera germ in July, 1884. This is one of the earliest references to the modern germ theory of disease to be found in the reports of the Board. Rules are given for the prevention of the disease. Disinfection. pp. 341-354 Reprint of a report on the subject made by a committee of the American Public Health Association. Sanitary Relations of Taunton. Dr. E. V. Jones, pp. 335-369 A brief sanitary survey. Unimportant. 1885 Supplement Supplement to the Seventh Annual Report oj the State Board of Health, Lunacy and Charity Malaria in Eastern Massachusetts. Dr. Z. B. Adams, pp. 1-25 Description of an epidemic of malaria in Framingham in 1885, and a discussion of prevailing ideas as to the cause of the disease. A map is given showing standing water and its relation to the occurrence of the disease. An interesting article in the light of modern knowledge on the subject. Disposal of Sewage at the Massachusetts Reformatory, at Concord. William Wheeler, C.E., pp. 193-208 Description of the project proposed, which included tankage, sludge pits, and broad irrigation. Case of Lead Poisoning. Dr. Frederick W. Jones, pp. 209-213 A case at South Ashburnham said to be due to use of water delivered through lead pipe. Reports of the Water Boards, Commissioners, and Companies of Massachusetts. pp. 215-282 Third triennial report of statistics of Water Works. General Index of the Health Supplements to the Annual Reports of the State Board of Health, Limacy and Charity, pp. 283-348 General Index of Chapters and Other Material Relative to Public Health Contained in the Seven Annual Reports of the Board. PP- 349-357 402 STATE SANITATION 1886 Eighteenth Annual Report Transmission of Infectious Diseases through the Medium of Rags. Dr. Charles F. Withington, pp. 1-69 The following section headings will give an idea of the scope of this paper: i. Introductory. 2. Commercial and Industrial. 3. History of Sanitary Regulations. 4. The Recorded Evidence as to the carry- ing of Disease by Rags. 5. Personal Investigations. The author concluded that a few diseases, such as smallpox, could be conveyed by rags, that on the whole, not many diseases were thus spread, that domestic rags were more dangerous than foreign rags, and that in any event seasonal precautions shoiild be taken. Manual for the Use of Boards of Health of Massachusetts. PP- 233-322 Contains a codified list of the statutes relating to the Public Health and the Decisions of the Supreme Court of Massachusetts relating to the same. Rules and Regulations Relative to the Inspection of Food and Analysis of Food and Drugs. pp. 323-327 1887 Nineteenth Annual Report Sewage Disposal at Medfield, Mass. Frederick Brooks, C.E., pp. 97-110 Treatment of trade wastes at a straw factory by application to land. Report on Oleomargarine. pp. 197-289 A general view of the subject, inspection of establishments where oleomargarine was being made, protection afforded by laws, national, state, and local. The Healthfulness of Oleomargarine as an Article of Food. Dr. Elliott G. Brackett, pp. 248-279 A comprehensive discussion of the scientific aspects of the subject. The general conclusions were favorable to the use of oleomargarine as food, but as a food distinct from butter and made recognizable. The Ventilation of Schoolrooms Heated by Stoves. Dr. J. D. Pinkham, pp. 313-361 Contains diagrams of many schoolrooms in Lynn, and results of ventUation tests. The latter included temperature, humidity, and carbonic acid determinations made at different hours through the day. The results are shown by diagrams. SCIENTIFIC ARTICLES AND REPORTS 403 1888 Twentieth Annual Report Trichinae in Swine. Professor E. L. Mark of Harvard University, pp. 111-134 A paper describing the results of a study of the cause of infection of swine with Trichinae. It is of interest in that the most probable causes are said to be uncooked garbage containing swine flesh and rats. Of two the former is regarded as the more important. The Sale and Use of Opium in Massachusetts. Dr. B. H. Hartwell, pp. 135-158 A report of an investigation undertaken in compliance with a legis- lative act passed in 1888 after there had been an expose of opium joints in Boston. Data are given for the imports of opium, together with the opinions of many physicians as to the use of the drug, and the forms in which it appears. The Number and Distribution of Micro-organisms in the Air of the Boston City Hospital. Greenleaf R. Tucker, pp. 159-229 This was one of the earliest bacteriological investigations published by the State Board of Health. It is interesting not only for the results obtained, but from the use of the " aerobioscope," devised in con- junction with Professor William T. Sedgwick. An abstract of this report is given on page 65. Returns of Water Boards and Water Companies of Massachusetts. pp. 301-3 1 1 A summary of statistics in continuation of previous reports. 1889 Twenty-first Annual Report Report of Investigations of the State Board of Health upon the Pollu- tion of Ice Supplies. pp. 143-223 This investigation was made in compliance with a legislative act (Chap. 84 of the Resolves of 1888). It was a comprehensive study of the subject, with the latest and best analytical methods used. The tables of water and ice analyses (pp. 155-223) are given in a form which is still used and in addition to the determinations made several years before we now find statements as to turbidity and sediment, a mmieri- cal statement of color, and quantitative studies of algae, fungi, animal forms and bacteria. This report, except the tables, is printed in full on pages 77-85. Intermittent Fever in Massachusetts. Dr. C. H. Cook, pp. 245-284 A study of the occurrence of malaria in the state, based on the replies to circulars received from the physicians of the state. 404 STATE SANITATION Physique of Women in Massachusetts. Professor H. P. Bowditch, pp. 285-304 A continuation of the author's investigation on the growth of chil- dren. Among the data collected were records of height and weight, rates of sitting height to total height (average = 53 per cent), stretch of arms in per cent of total height (average = 100.54 per cent), etc. This paper is especially valuable for the statistical methods used. The " percentile grades " are employed to illustrate certain facts. The Influenza Epidemic of 1889-go. Dr. Samuel W. Abbott, pp. 305-383 This paper contains a history of the disease and the prevailing opinions as to its cause, as well as a statistical study of the epidemic in Massachusetts. Apparently it started in Russia in October, 1889. In November, it was prevalent in Berlin, Vienna and Paris; in December, in London. It appeared in New York about December 20, and in Massachusetts soon afterwards. It was a very severe epidemic, the death-rate for the state from this cause being estimated (1889-90) as 120 per 100,000. About 25 per cent of the population of the state was attacked (there were 850,000 cases) . Bronchitis and pneumonia followed in the train of " la grippe." The conclusion was that while aerial transmission may have been a factor a more important factor was " human intercourse." This today would be called " contact." The paper is of great value, but is too long to be reproduced. An Inquiry Relative to the Conditions which Attended an Unusually High Rate of Mortality in Lawrence in 1889, with Special Refer- ence to Diphtheria. Dr. Samuel W. Abbott, pp. 387-415 The chief interest in this paper today lies in the mortality statistics of the city, from 1848 to 1889, given on page 395, and the remarks appended to the table. Apparently the death-rates as given in the Registration Reports were computed on the basis of census populations, no estimates being made for the populations in the intermediate years. A table of corrected figures is therefore given. The paper should be consulted by students of water filtration in connection with the pos- sible influence of filtration on the general death-rate. Lawrence, like other cities of the state, suffered from influenza in 1889, which was just before the water filter was installed. Reference is made to the various insanitary conditions existing in the city. 1890 Twenty-second Annual Report Suggestions as to the Selection of Sources of Water Supply. Frederic P. Stearns, pp. 333-371 This paper relates especially to the quantity of water to be obtained from catchment areas under various circumstances. It covers both SCIENTIFIC ARTICLES AND REPORTS 405 surface waters and ground waters. It outlines the general principles used in balancing rainfall, stream-flow, storage, evaporation, and such factors and because of its importance is reprinted in part on page 106. The topics discussed are as follows: Quantity of Surface Water (p. 336), Quantity of Ground Water (p. 352), QuaUty of Surface Water (p. 364), Quality of Ground Water (p. 366). The Growth of Children, Studied by Galton's Method of Percentile Grades. Dr. H. P. Bowditch, pp. 477-522 This is an application of a new statistical method to the data of the growth of children obtained by the author in 1877. A portion of the paper, without the tables and with only a few of the many diagrams, is given on page 119. Typhoid Fever in its Relation to Water Supplies. Hiram F. Mills, C.E., pp. 523-543 Historically this is an important paper as it shows the relation between the occurrence of typhoid fever and polluted water. It relates the events that led up to the improvements of the water supplies of Lowell and Lawrence. An abstract of this paper is given on page 131. 1890 Part I of Report on Water Supply and Sewerage The Chemical Examination of Waters and the Interpretation of Analyses. Dr. Thomas M. Drown, Chemist of the Board, pp. 516-578 The first section of this paper describes the methods of water analyses under the following heads: Collection of samples (p. 519), Free and albuminoid ammonia (p. 523), Organic Nitrogen (p. 526), Nitrogen as Nitrites (p. 527), Nitrogen as Nitrates (p. 528), Chlorine (p. 528), Residue on Evaporation and Loss on Ignition (p. 529), Hardness (p. 531), Odor (p. 531), Color (p. 531), Turbidity and Sediment (p. 532). In the second section the principles of the interpretation of water analyses are discussed, first in a general way and then as related to each determination. The general principles are set forth at length. The paper should be consulted for these details, but a more condensed report, published in the 1892 report, is given in full on page 218. The topics in the remainder of the paper were these: — Normal and polluted surface waters (p. 539), chlorine (p. 542), albuminoid am- monia (p. 545), free ammonia (p. 550), nitrogen as nitrites and nitrates (p. 556), residue on evaporation (p. 564), turbidity and sediment (p. 566), color (p. 566), odor (p. 567), ground waters (p. 569). 4o6 STATE SANITATION Report upon the Organisms, Excepting the Bacteria, Found in the Waters of the State, July, 1887 to June, 1889. G. H. Parker, Biologist, pp. 579-620 This paper is interesting historically as being the first attempt to show by quantitative methods the relation between microscopic organisms and odors in drinking waters. The methods of enumeration were crude, but the general conclusions were nevertheless sound. The following topics were discussed: Methods of examination (p. 583), The relation of organisms and odors in Natural Waters (p. 583), Organisms found in the Water supplied to Boston, Charlestown and Cambridge (p. 587), Seasonal Distribution of Organisms (p. 597), Distribution of Organisms in Waters variously situated (p. 601), Purification of Water rendered Impure by Organic Growths (p. 609), Growth of Sponges in Water Supplies (p. 614). Summary of Water Supply Statistics, also Records of Rainfall, Flow of Streams, and Temperatures of Air and Water. Frederic P. Stearns, C.E., pp. 621-676 The first portion of this report comprises statistics of rainfall, etc., in Connection of previous records. On page 660 temperatures of the water in various reservoirs are given, on page 663 there is a compari- son of air and water temperatures at different seasons, and on page 665 a detailed study of the temperatures of the water in Jamaica Pond at different depths. On page 67 1 there is a section on the temperature of ground waters and on page 673 a record of the temperature of the water as delivered to consumers. A Classification of the Drinking Waters of the State, pp. 677-716 This is a most important paper: it shows the application of Dr. Drown's principles of the interpretation of chemical analyses to the water supplies of the state. The use of the normal chlorine map is described. (This part of the report is reprinted on page 139.) The surface waters of the state are grouped first according to the excess of chlorine above the normal and second according to the al- buminoid ammonia. The relation between these substances and the other items of the analyses to the known conditions as to the pollution of the watersheds is then shown. The ground waters are then considered and grouped not only according to excess of chlorine, but to the excess of total nitrogen above a certain average quantity (namely 0.221 parts per million) found in the unpolluted ground waters. The ratio between the chlorine excess and the nitrogen excess is also computed. The paper is one which may very profitably be consulted by students of water analysis. Unfortunately it is too long to be reproduced in the present volume. SCIENTIFIC ARTICLES AND REPORTS 407 Discussion of Special Topics Relating to the Quality of Public Water Supplies. Frederic P. Stearns and Dr. Thomas M. Drown, pp. 717-782 This paper is virtually a study of the storage of water and the influence of storage on quality. The influence of storage in open reservoirs on surface water is discussed on page 720, and that on ground waters on page 725. Then follows a section on the storage of ground waters in open reservoirs and tanks. On page 734 the effect of long storage in large reservoirs or ponds is treated, color and organic matter receiving particular attention. The section on the effect of storage upon the taste and odor of sur- face waters is reprinted on page 144. On page 749 begins a discussion of deep ponds, with an elaborate account of stagnation phenomena. The conditions in Jamaica Pond were described and illustrated by tables and diagrams. Interesting characters of certain water supplies of the state are given on page 767, et seq. and finally on page 773, there is a section on the filtration of water in filter galleries and an account of troubles with Crenothrix. The Pollution and Self-Purification of Streams. Frederic P. Stearns, pp. 783-802 The first part of this paper is printed on page 156. The second part relates to the changes in the condition of certain rivers, such as the Blackstone and Merrimack above and below some of the more important points of pollution. Index. pp. 803-857 Attention is called to this as an unusually complete index. 1890 Part II of Report on Water Supply and Sewerage Filtration of Sewage and Water. Hiram F. Mills, C.E., pp. 1-704 Without question this is the most important paper on the purifica- tion of sewage and water ever published in the United States. It describes the original investigations made at the Lawrence Experi- mental Station. On account of its length a part only is reprinted (p. 172). After describing the experimental plant and the object of the work (p. 5) an account of the methods of recording the analyses and inter- preting the results is given. Then follows an elaborate discussion of the results obtained from the various tanks, with elaborate tables. As an example a partial index is given of the headings which relate to one tank, i. e., Filter Tank No. i, started January 10, 1888, and still in operation (191 5). 4o8 STATE SANITATION Physical characteristics pp. 14 First application of sewage 15 Beginning of nitrification 18 Progress of sewage through sand indicated by chlorine 18 Effect of frost upon the effluent 21 First effects of nitrification 22 General results of filtration through the first winter 22 Purification by nitrification continued 23 Effect of increased quantity 23 Condition of the surface 24 Regimen essential to success 25 Nitrification in winter 27 Increased nitrification in the spring 29 More complete nitrification the second year 29 Relation of suspended matter to matter in solution 34 Mineral constituents of sewage and effluents 37 Comparison of winter result with that of year 38 Comparison of results of two years 39 Storing of nitrogenous matter in sand 40 Removal of stored nitrogen by nitrification 43 Quality of efiiuent at different hours of the day 45 Microscopical examinations of efiiuent 47 Bacteria in efiiuent 51 Proof that bacteria came down through the sand of this tank 56 The greatest number of bacteria came through with the sewage first applied after an intermission 57 General conclusions in regard to management 58 Bacteria found in sand at different depths 59 More than five hundred pages of the report are devoted to similar records of the other tanks, and to the tables and diagrams. On page 577 is a summary of the results reprinted in part on page The experiments on the intermittent filtration of water are described on pages 601-665. These are of less interest than the experiments on sewage purification. On pages 666-669 is an account of experiments on purification of sewage by chemical precipitation by Allen Hazen, Chemist in charge. Pages 670-704 contain a record of additional results of filtration of sewage and water obtained in 1890. Rainfall and evaporation records are given on pages 702-704. A Report of the Chemical Work of the Lawrence Experiment Station, Including Methods of Analysis and Some Investigations of the Process of Nitrification. Dr. Thomas M. Drown and Allen Hazen, pp. 705-734 Critical studies of the methods of determining nitrogen in its various forms, total residue and loss on ignition, chlorine, oxygen consumed, dissolved oxygen, alkalinity are given. SCIENTIFIC ARTICLES AND REPORTS 409 Then follows (p. 724) a study of nitrogen in filters, nitrification and the factors which influence it. The following is a resume of the results. In the foregoing comparisons and experiment, showing the effect of the storage of surface and ground waters in distributing reservoirs and tanks, we find that surface waters may be so stored without deteriorat- ing in quality; and at one place (Lawrence) there is a marked improve- ment in the quality of the water, owing to the storage and subsequent passage through pipes to the consumers. The state does not contain any good examples of surface waters stored in covered reservoirs; but it seems probable that, under such conditions, water containing many algae might become worse owing to their death when deprived of Ught. With ground waters the case is entirely different, as the water at the source is free from organisms, and it only needs to be kept so in order to be delivered to the consumer in satisfactory condition. The com- parisons show that the ground water does not deteriorate when the light is excluded; ^ but that it does when exposed to the light, except in some instances where the water is stored in iron tanks which receive only a limited amount of light. It seems hardly safe, however, in view of the unfavorable effect of storing ground water in the high-service tank at Brookline, to rely upon these apparent exceptions to the rule; and it is better in all cases to keep a ground water in the dark. Report of Experiments upon the Chemical Precipitation of Sewage. Allen Hazen, pp. 735-791 This paper gives the results of a series of carefully prepared experi- ments. A part of the paper is printed on page 188. A Report of the Biological Work of the Lawrence Experiment Station. Professor William T. Sedgwick, pp. 793-862 This report comprised the following sections: Micro-organisms pp. 796 Methods of microscopical analysis 799 New methods (Sedgwick-Rafter Method) 803 Methods of bacteriological analysis 811 The microscopical organisms in sewage 815 The bacterial organisms in sewage 819 Certain species of bacteria in sewage (Jordan) 821 Biological phenomena observed in the intermittent filtration of sewage 845 Variations in bacterial composition of certain effluents after an application of sewage 849 The passage of bacteria through certain sand filters 850 Effect of application of bouillon, peptone, salt, sugar, ammo- nium chloride, and sulphuric acid upon the bacterial discharge from the filters 855 1 These statements are not true of imperfectly filtered surface waters, as they are frequently affected by growth of Crenothrix which thrives better in the dark than in the light. 4IO STATE SANITATION Micro-organisms in the filtration of water and in the chemical purification of sewage pp. 859 Biological aspects of the theory of intermittent filtration 859 Investigations upon Nitrogen and the Nitrifying Organism. Edwin 0. Jordan and Mrs. Ellen H. Richards, pp. 863-881 An important bacteriological study incident to the main work at Lawrence. Index. pp. 885-910 Attention is called to the complete index. 1891 Twenty-third Annual Report Examination of Spring Waters. pp. 351-369 A report upon the quality of the spring waters publicly sold in the state. Each spring is described. Analyses are given and the springs are grouped according to the excess of chlorine above the normal. On the Amount of Dissolved Oxygen Contained in Waters of Ponds and Reservoirs at Different Depths. Dr. Thomas M. Drown, pp. 371-381 A study of stagnation in Jamaica Pond, Lake Cochituate and else- where. The data are valuable. The Effect of the Aeration of Natural Waters. Dr. Thomas M. Drown, pp. 383-394 A series of laboratory experiments from which the following con- clusions were drawn: 1. The oxidation of organic matter in water is not hastened by vigorous agitation with air or by air under pressure. 2. The aeration of water may serve a useful purpose, by preventing stagnation, by preventing the excessive growth of algae, by removing from water disagreeable gases, and by the oxidation of iron in solution. The Microscopical Examination of Water. Gary N. Calkins, pp. 395-421 A description of the Sedgwick-Rafter method with a discussion of sources of error. The Differentiation of the Bacillus of Typhoid Fever. George W. Fuller, pp. 635-644 A bacteriological investigation from which the following conclusions, important at the time, were drawn: 1 . After prolonged investigation, it has been found that it is possible to separate the bacillus of typhoid fever from all other bacteria hitherto encountered in the water of the Merrimack River. 2. The potato method of differentiation is for this organism of no diagnostic value. SCIENTIFIC ARTICLES AND REPORTS 411 3. The three tests which have been found to be highly characteristic of the bacillus of typhoid fever are (after non-liquefaction): (i) non- coagulation of milk ; (2) non-formation, or formation of a very slight amount, of acid in milk; (3) production of a turbidity, without gas, in the Smith test. On Uroglena. Gary N. Calkins, pp. 645-657 A carefully made and valuable study of an organism that has caused much trouble in Massachusetts water supply. The article is illustrated with three beautifully colored plates. On the Geographical Distribution of Certain Causes of Death in Massachusetts. Dr. Samuel W. Abbott, pp. 757-874 An elaborate and very thorough study of the distribution of measles, scarlet fever, diphtheria, smallpox, typhoid fever, cholera infantum, phthisis and pneumonia. The following important topics are considered: 1. Population of the state, its distribution and density by counties (pp. 765 and 769). 2. Vital statistics of the state (p. 768). 3. General death-rates of counties, cities, and towns (p. 771). 4. Statistics of measles (p. 780). 5. " " scarlet fever (p. 789). 6. " " diphtheria and croup (p. 798). 7. " " smallpox (p. 8ic). 8. " " typhoid fever (p. 819). 9. " " cholera infantum (p. 83c). 10. " " consumption (p. 844). 11. " " pneumonia (p. 855). 12. Conclusions (p. 866). The influence of the following conditions were considered: 1 . Natural Conditions. — Such as the conditions of climate (tem- perature, rainfall, humidity, prevailing winds), elevation above sea level, distance from sea, character of the soil (dryness of moisture). 2. Artificial Conditions. — Density of the population, purity of water supply, efficiency of sewerage system and sewage disposal, sufficiency and purity of food supply, and especially of milk, protec- tion from accidents, management and prevention of infectious diseases, freedom of intercommunication, especially among children, efficiency of municipal sanitation. 3. Character of the Population. — Race and nationality, distribu- tion by sexes and ages, occupation, education, social condition as to poverty or wealth, habits, size of families, etc. The paper is illustrated by maps. The tables are given in details. It may be well taken as a model for students to follow in studying vital statistics. 412 STATE SANITATION 1892 Twenty-fourth Annual Report The Interpretation of Water Analyses. Dr. Thomas M. Drown, pp. 317-330 This is one of the classic papers on the subject. It is printed in full on page 218, et seq. On the Amount of Dissolved Oxygen Contained in the Water of Ponds and Reservoirs at Different Depths in Winter, Under the Ice. Dr. Thomas M. Drown, pp. 331-342 A continuation of the study of stagnation begun the previous year. The data are valuable. On the Mineral Contents of Some Natural Waters in Massachusetts. Dr. Thomas M. Drown, pp. 343-351 Analyses are given for various ground waters and waters naturally filtered. The data are valuable. A Study of Odors Observed in the Drinking Waters of Massachusetts. Gary N. Calkins, pp. 353-379 A statistical study of the causes of the odors of the drinking waters of the state, with special reference to the effect of microscopic organ- isms. The following conclusions were drawn: We have now arrived at certain definite theories concerning the causes of odors in drinking waters, namely, that they may be produced by the putrefactive decomposition of the body plasm through the agency of bacteria; by the excretion of certain products of growth, or by the liberation of products by the physical disintegration of the body or breaking down of the enclosing cell walls. These three causes give rise to three classes of odors, as follows: (i) odors of chemical or putrefactive decomposition, (2) odors of growth and (3) odors of physical disintegration. In regard to the specific cause of an odor of growth or disintegration, all evidence seems to point to the importance of oil globules, it being assumed that these are odorous, as are the odor-giving oils of some of the higher plants. In Uroglena, Bursaria and Cryptomonas we notice a difference in the quality of the odor, just as we do in the case of the violet, rose and heliotrope. The paper is illustrated by a colored plate. The Seasonal Distribution of Microscopical Organisms in Surface Waters. Gary N. Calkins, pp. 381-390 A discussion of the subject illustrated by diagrams. Some Physical Properties of Sands and Gravels, with Special Refer- ence to Their Use in Filtration. Allen Hazen, pp. 539-556 This paper is printed in full on page 232. . SCIENTIFIC ARTICLES AND REPORTS 413 Report upon Artificial Ice. pp. 589-598 A study of the chemistry of the artificial freezing of water, from which the following conclusions were drawn: 1. Artificial processes of freezing concentrate the impurities of the water in the inner core or the portion last frozen. 2. The impurities are reduced to their lowest terms by the use of distilled water (condensed steam) for the manufacture of ice. 3. The number of bacteria in artificial ice is insignificant, under the prevailing methods of manufacture. 4. The amount of zinc found in the samples of melted artificial ice under observation is insufficient to injure the health of persons using such ice. Investigation of Recent Epidemics of Tjrphoid Fever in Massa- chusetts. Professor William T. Sedgwick, pp. 665-704 This is an elaborate report of the famous typhoid fever epidemics which occurred in the Merrimack valley in 1890-91. Lowell and Law- rence were the principal cities concerned. The length of the paper and its frequent mention in the modern literature of sanitation preclude its publication in full in this volume. The following topics illustrate the breadth of the investigation: The Lowell epidemic in 1890-91 pp. 668 Five systems of water supply in LoweU 671 Conditions to be fulfilled by any water-infection theory of the epidemic 678 Discovery of the probable cause of the epidemic 679 The canal-water theory 685 The milk supply of Lowell 687 Results of the investigation 688 The Lawrence epidemic in 1890-91 692 Typhoid fever in the cities of the Merrimack vaUey during five years, 1888-93 694 An outbreak of typhoid fever in Lowell, Lawrence, and New- buryport in 1892-93 701 An Investigation of an Outbreak of Tjrphoid Fever in Chicopee FaUs apparently due to Infected Water Supply. George V. McLauthlin, pp. 705-714 An interesting study of a small typhoid outbreak by a brilliant young scientist made shortly before his untimely death. An Investigation of an Epidemic of Typhoid Fever in the City of Springfield in July and August, 1892, due to Infected Milk. Professor William T. Sedgwick and Dr. Walter H. Chapin, pp. 715-725 An important report, — one of the earliest investigations of a "milk epidemic." 414 STATE SANITATION An Investigation of an Epidemic of Typhoid Fever in Somerville, due to Infected Milk. Professor William T. Sedgwick, pp. 726-731 An important example of a well studied " milk epidemic." Investigations of Epidemics of Typhoid Fever in Bondsville, Province- town, and MiUville, apparently due to Secondary Infection. Professor William T. Sedgwick, pp. 732-742 An interesting study of a phase of the subject new at the time. 1893 Twenty-fifth Annual Report On the Amount and Character of the Organic Matter in Soils and its Bearing on the Storage of Water in Reservoirs. Dr. Thomas M. Drown, pp. 383-398 This study was made in anticipation of the construction of the great storage reservoir above Clinton. Its object was to determine whether the organic matter in the soil was likely to injure the quality of the water, and if so the extent to which it should be removed. After drying the loss on ignition, the carbon, nitrogen, albuminoid ammonia, free ammonia, and oxygen consumed were determined. Extraction experiments were also made. The methods are described and the results given in a series of tables. The general conclusions were as follows: " It may be said that the effect of the organic matter in these various soils on the water in contact with them is simply a question of its amount, and that its origin and composition seem to be without marked influence. The watershed from which the samples were taken is very sparsely populated, and the organic matter in aU cases is mainly of vegetable origin. It is probable, therefore, that we need only concern ourselves with the amount of organic matter in a soil of this character in determining the necessity of its removal, and as a provisional standard we may perhaps fix 1.5 to 2 per cent of organic matter as determined by the loss on ignition of the sample dried at 100° C, as the permissible limit of organic matter that may be allowed to remain on the bottom and sides of a reservoir." The Filter of the Water Supply of the City of Lawrence and its Results. Hiram F. Mills, C.E., pp. 543-560 This was the first scientifically designed filter in the United States. In several respects it was unique and not aU of the ideas have been followed in later works. It was an open filter of the slow sand type, and was put in operation September 20, 1893. This paper describes the filter and contains a plan of it. It also gives typhoid statistics for Lawrence before and after the filter was started. The concluding paragraph is interesting, as it shows the con- fidence resulting from the experimental work and this first installation. SCIENTIFIC ARTICLES AND REPORTS 415 The study of this problem and its solution have estabUshed with more of certainty than ever before three important points in sanitary science : 1. The insufficiency of the self -purification of streams. 2. The ready conveyance of typhoid fever down a stream by sewage-polluted drinking water. 3. The practicability of protecting a community against an infected drinking water supply by natural sand filtration. Chemical Precipitation of Sewage at the World's Columbian Exposi- tion, Chicago, 1893. Allen Hazen, pp. 595-624 Mr. Hazen, having been granted a leave of absence from the Law- rence Experiment Station went to Chicago and made the investigation here described. The sewage of the exposition grounds amounted to about 2.5 million gallons per day. As a protection of the lake shore, as an object lesson to visitors and as a scientific experiment the sewage was treated chemically in large iron tanks. The chemicals used were copperas, lime, alum and ferric sulphate. It was found that copperas and lime produced a sludge more easily pressed than that resulting from the use of alum. The paper gives the analytical data, the cost and efficiency of the processes used. Isolation Hospitals for Infectious Diseases. Dr. Samuel W. Abbott, pp. 689-737 This paper was written in response to a demand for information in regard to the advantages of isolation hospitals and the best methods of arranging them. An appendix contains data relating to European practice. 1894 Twenty-sixth Annual Report The Composition of the Water of Deep Wells in Boston and Vicinity. Dr. Thomas M. Drown, pp. 421-431 A paper giving the chemical analyses of samples of deep well waters, some of them more than one thousand feet deep. The Bacterial Contents of Certain Ground Waters Including Deep Wells. Professor William T. Sedgwick and S. C. Prescott, pp. 433-443 Contains chemical analyses and bacterial counts of well waters. Physical and Chemical Properties of Sands with Special Reference to the Filtration of Water. H. W. Clark, pp. 701-710 The studies here described were made in continuation of those of Allen Hazen (24th report, p. 539). The conclusions were that cal- culations of rates of flow and losses of head should be made after the sand had been compacted. Values of the coefficient c are given for different conditions. 41 6 STATE SANITATION Reports upon Experiments in Feeding Hogs at a State Institution where Trichinosis among the Swine had been Unusually Preva- lent. Professor E. L. Mark, pp. 757-762 A short paper showing the effect of feeding uncooked swine flesh to hogs. On an Epidemic of Typhoid Fever in Marlborough apparently due to Infected Skimmed Milk. Professor William T. Sedgwick, pp. 763-774 An important epidemiological study, showing a method of trans- mission of this disease hitherto unsuspected, namely, the use of infected skimmed milk. 1895 Twenty-seventh Annual Report The Hardness of Water and the Methods by which it is Determined. Mrs. Ellen H. Richards, pp. 433-442 A description of Clark's " Soap Method," and Hehner's " Acid Method," with tables of the hardness of some Massachusetts waters as determined by both methods. Methods Employed at the Lawrence Experiment Station for the Quantitative Determination of Bacteria in Sewage and Water. George W. Fuller and William R. Copeland, pp. 583-598 The topics treated are: 1. Collection and storage of samples. 2. Preparation of culture media. 3. Sterilization and storage of culture media. 4. Technique of plating. 5. Technique of counting colonies of bacterial on plates. 6. Effect of length of period of cultivation and of temperature at which cultivation takes place. 7. Comparison of the relative values of gelatine and glycerine agar for quantitative bacterial work. 8. Roll cultures in four-Uter bottles. Report upon the Production and Use of Antitoxin. pp. 687-708 A series of circulars describing the advantages of the use of anti- toxin and the extent to what it was being used in the state. A labora- tory had been established in October, 1894 in charge of Dr. J. L. Goodale, but as the work became more extended Dr. Theobald Smith was appointed pathologist in charge of the department. 1896 Twenty-eighth Annual Report A Comparative Study of the Toxin Production of Diphtheria Bacilli. Dr. Theobald Smith and Ernest L. Walker, pp. 647-658 This paper is given in full on page 274, et seq. SCIENTIFIC ARTICLES AND REPORTS 417 Comparative Study of Forty-two Cultures of Diphtheria Bacilli and of Four Cultures of Pseudo-Diphtheria Bacilli from Different Localities in Massachusetts. Dr. Theobald Smith and Ernest L. Walker, pp. 659-672 A very careful bacteriological study of the cultural characteristics and their toxin-producing power. The toxin-producing power of bacilli persisting in the throat after recovery was also studied. The Vital Statistics of Massachusetts, 1856-95, — a Forty-Years' Summary. Dr. Samuel W. Abbott, pp. 711-829 A very valuable paper prepared in Dr. Abbott's customary thorough manner. The headings of the paper will assist the reader in finding the facts reported. On the accuracy of the material collected for pubhcation in the Massachusetts registration reports pp. 714 Population of the state 716 Interstate and international vital statistics 722 Marriages 724 Fecundity of marriage 731 Births (still-births, illegitimacy) 733 Deaths 742 Infant mortality 752 Cause of deaths 757 Summary of special causes of death 772 Typhoid fever 779 Consumption 785 Cancer 802 Childbirth 804 The balance of mortality 812 The returns of medical examiners 817 Vital statistics of cities, 1894 and 1895 821 1897 Twenty-ninth Annual Report (No special articles were published in this report.) 1898 Thirtieth Annual Report An Investigation of the Action of Water upon Lead, Tin, and Zinc. E. W. Clark, pp. 539-585 This is a detailed report of an investigation extending over two years to learn the nature and extent of the action of various waters on lead- pipe and the relation between this action and lead poisoning. Many analyses are given showing the relation between the presence of lead and the color of the water, chlorine, hardness, nitrogen in its 41 8 STATE SANITATION various states and oxygen consumed. Experiments were also made with waters containing various chemical substances. On page 565 the relation is shown between lead and carbonic acid and dissolved oxygen. This was the most important feature of the paper. On page 577, methods are described for the determination of lead, tin, zinc, and copper. This portion of the paper was prepared with the assistance of Mr. F. B. Forbes. The Vital Statistics of Massachusetts for 1897, with a Life Table Based upon the Experience of the Five-year Period, 1893-97. Dr. Samuel W. Abbott, pp. 797-827 The important part of this paper is the life table, which is reprinted in full on page 300, et seq. 1899 Thirty-first Annual Report The Occurrence of Iron in Ground Water and Experiments upon Methods of Removal. H. W. Clark, pp. 535-553 The tables of water analyses in this paper are especially valuable from the fact that they give for many ground water supplies the car- bonic acid and dissolved oxygen. On pages 539-553 are given the results of experiments made at Provincetown, Watertown, Marblehead, and Reading. The different treatments required to remove iron present in the forms of carbonate and sulphate are well shown. Aeration, filtration through sand, coke and iron strips, and chemical treatment with potassium permanganate and lime were the methods tested. 1900 Thirty-second Annual Report Continuation of an Investigation on the Action of Water upon Metallic or Metal-lined Service Pipes, and Methods for the Separation and Determination of Metals in Water. H. W. Clark and F. B. Forbes, pp. 485-506 This paper contains the results of determinations of lead, zinc, copper and tin in water flowing through pipes in ordinary use and after standing in the pipes. On pages 498-506 are given the results of studies made to deter- mine the accuracy of the methods of analyses, with suggestions as to how certain errors may be avoided. An Investigation in Regard to the Retention of Bacteria in Ice, when the Ice is Formed imder Different Conditions. H. W. Clark, pp. 507-524 This is a valuable contribution to the study of the freezing of water. Experiments were made by freezing sewage and sewage diluted with water in tanks. Many samples of ice from the Merrimack River were SCIENTIFIC ARTICLES AND REPORTS 419 analyzed chemically and bacteriologically, as well as samples of ice from various ponds. A summary of the results is given on page 521. It was found that in the still freezing of water practically all impurities are excluded from the ice, but that the freezing of river waters does not always offer adequate safety of the ice and the same is true of snow ice, or ice formed by the freezing of water which has flowed over the ice sheet. Studies of the Efficiency of Water Filters in Removing Different Species. Stephen de M. Gage, pp. 525-535 A study of the removal of B. coli and B. typhi by sand filters. It was concluded that B. coli was the more hardy of the two organisms. Examination of Spring Waters. pp. 537-585 A continuation of the examination made in 1891. Ninety-nine springs were examined. Descriptions and analyses are given for each one. They are grouped according to excess of chlorine. Great fluctua- tions were found in the numbers of bacteria. Consumption of Water in Cities and Towns in Massachusetts. pp. 587-616 An important tabulation by cities and towns of these facts: Year; population; average daily consumption; daily consumption per capita; number of services; per cent of metered services; length of distributing pipes. The influence upon consumption of the following factors was studied: Age of works, introduction of sewers, introduction of meters, extent of manufacturing hot and cold weather. Fluctua- tions in consumption are also considered. Statistics of Cancer in Massachusetts. Dr. W. F. Whitney, pp. 731-753 Statistics are tabulated by sex and ages for each five-year period from 1850 to 1895 for Massachusetts, and in somewhat less complete form, for other states. 1901 Thirty-third Annual Report Report on the Experimental Filtration of the Water Supply of Spring- field at Ludlow, Mass., from December 21, 1900 to January 31, 1902. H. W. Clark, pp. 323-369 Ludlow Reservoir water had been notorious for its summer growths of Anabaena. These experiments were undertaken to ascertain whether it was feasible to filter the water and, if so, how. The follow- ing topics were discussed: Condition of the water during the experiments pp. 325 Filtration of the reservoir water 334 Refiltration of reservoir water 346 Aeration, dissolved oxygen 351 Experiments with canal water , , 354 420 STATE SANITATION The following is a summary of the work as given by Mr. Clark. Studying the general results of the investigations made upon the feasibility of sand filtration of the Ludlow canal water, we find that all three filters were entirely successful in removing the organisms present in the water applied. The odor of the effluents of all three filters was generally very slight, and at times the effluents were entirely odorless, although during the last week in July, after the break in the canal bank by the side of Belcher town Reservoir and the consequent flow from this reservoir into the canal of water containing Anabaena, the effluent of each filter had the odor of this organism. Double filtration, however, would probably remove this odor as successfully as it did in the case of the reservoir water. The removal of color and organic matter, while not equal at all times of the year to that obtained in the filtration of reservoir water, was very good, and as great as usually expected with sand filtration of surface waters resembling this canal water. The small amount of suspended matter in the canal water passed to these filters is shown by the few scrapings of the surface needed during the period of operation. A Study of the Stability of the Effluents of Sewage Filters of Coarse Materials, Including Investigations upon Putrefaction and Secondary Decomposition. H. W. Clark, pp. 371-393 Bottles of sewage effluents were kept for many days and analyzed at frequent intervals, these analyses being quite complete. The data are given in detail. The results are critically discussed and summarized on pages 389-393. Bacteriological Studies with Special Reference to the Determination of B. coli. Stephen de M. Gage, pp. 395-420 This report includes the following studies: 1 . Changes in the methods for the detection of B. coli in water pp. 398 2. Review of routine B. coli studies 400 3. Methods for the differentiation of bacteria 407 4. Proposed classification of bacteria 415 5. Description of species 419 1902 Thirty-fourth Annual Report On the Value of Tests for Bacteria of Specific Types as an Index of Pollution. H, W. Clark and Stephen de M. Gage, pp. 243-281 Contains summaries of tests for B. coli in the Merrimack River and Lawrence water supply, with comparisons of results in summer and winter; effect of storage on B. coli; tests for B. coli in ground waters. Summaries of B. coli tests in sea water and shellfish are given. There is also a discussion of the significance of B. coli and other bacteria and a comparison of B. coli and B. typhosus as affected by cold, freezing, heat and sunlight. The general conclusion was that the two organisms behave very much alike under adverse conditions of living. SCIENTIFIC ARTICLES AND REPORTS 421 1903 Thirty-fifth Annual Report (There were no special articles in this report.) 1904 Thirty-sixth Annual Report (There were no special articles in this report.) 1905 Thirty-seventh Annual Report Materials Used for Service Pipes in Massachusetts. pp. 195-205 A statistical summary of the materials used for service pipes, i. e., wrought iron, galvanized iron, cement-lined, lead, lead-lined, and tin- lined, the number of services in each case being given. Experiments upon the Removal of Organisms from the Waters of Ponds and Reservoirs by the Use of Copper Sulphate. X. H. Goodnough, pp. 207-287 The experiments were made at the Arlington Reservoir, the Belcher- town Reservoir, the Lexington Reservoir, the Quincy Reservoir, Jamaica Pond, Crystal Lake in Newton, and Massapoag Lake in Sharon. The success of the copper treatment of water containing certain blue- green algae and protozoa is shown; its failure in the case of other organism is pointed out. Caution is urged in regard to this method of treatment on account of the danger to fish and the poisonous character of the chemical. Investigations in Regard to the Use of Copper and Copper Sulphate. H. W. Clark, pp. 289-338 The experiments described are of considerable interest. Among the topics treated are: Description of Method of Determining Copper, Copper Existing Naturally in Massachusetts Waters, Destruction of Algae by Copper Sulphate, Absorption of Copper Sulphate by Organic Matter, Copper and Copper Sulphate as a Bacteriacide, Experiments with Metallic Copper, Comparison of Copper Salts with other Salts. Examination of Sewer Outlets and of Tidal Waters and Flats from which Shellfish are Taken for Food. X. E. Goodnough, pp. 411-426 This is an interesting study of the pollution of the waters and flats of Boston harbor by the sewage of Boston and vicinity discharged at Moon Island, Deer Island, and Paddocks Island. Maps are given showing results of chemical analyses (free and albuminoid ammonia) at various places and at different depths. Another map shows the bacteriological findings. The conclusions, being of especial interest to the people of Boston, are printed in full on page 322. 42 2 STATE SANITATION Studies at the Lawrence Experiment Station on the Pollution of Shellfish. H. W. Clark, pp. 427-457 The following topics were treated: Studies of Clams; Examination of the various portions of Shellfish for the Detection of Infection; Studies of Digestion, Sterilization by Heat; Studies of Oysters; Destruction of Bacteria in Oysters by Cooking; Studies of the Joppa Clam Flats at Newburyport; Viability of B. coli in Salt and Fresh Waters. Inspection of Dairies. Dr. Charles Harrington, pp. 517-526 This report, except the tables, is printed in full on page 333, ei seq. A Description of the New Antitoxin and Vaccine Laboratory, together with a Ten Years' Retrospect of the Production and Distribution of Diphtheria Antitoxin. Dr. Theobald Smith, pp. 527-546 The first part of the paper is a detailed description of the laboratory, located on the grounds of the Bussey Institute of Harvard University, near the Forest Hills Station, illustrated with plans and photographs. There follows an account of the work of the department during the first ten years of its existence. The topics specially amplified relate to diphtheria antitoxin, tetanus antitoxin, and vaccine lymph. The iatter, in particular, is referred to in detail. 1906 Thirty-eighth Annual Report Significance of the Numbers of Bacteria in Water and Sewage Devel- oping at Different Temperatures. Stephen de M. Gage, pp. 325-349 Comparisons are made between bacterial counts at 20°, 30°, 40° and 50° C. Ratios between these counts are found for different waters, some polluted and some not polluted. Ratios between bacteria and B. coli are given for the Merrimack River. The influence of Temperature, Oxygen and Dilution upon the Bacterial Contents of the Merrimack River are considered. The bacterial counts at different temperatures are used to show the efficiency of water filters. Acid-producing bacteria are compared with B. coli. The results of incubation tests are given. A Comparison of Methods for the Determination of the Alkalinity of Ash. Hermann C. Lythgoe, pp. 41 1-4 14 A brief statement of Method. Report on the Sanitary Condition of Factories, Workshops, and Other Establishments. Dr. Charles Harrington, pp. 449-619 An important report, being an account of the first work done by the Board in accordance with the legislative act of 1905. It describes in detail various industries from the sanitary standpoint. The textile industries, the boot and shoe industry, machinery, the chemical industries, and slaughtering come in for long descriptions. SCIENTIFIC ARTICLES AND REPORTS 423 1907 Thirty-ninth Annual Report Report upon the Chemical Examination of Drawn and Undrawn Poultry Kept in Cold Storage. Dr. William F. Boos, pp. 263-282 A chemical investigation of the subject of ptomaines, Bacillus botulinus, as well as a practical study of the subject. The results of many experiments are given in detail. The general conclusions were as follows: 1. In cold storage itself no chemical changes occur. This is shown by: (a) The absence, after nine months and more of cold storage, in both drawn and undrawn cold-storage fowl of ptomaines and decomposition products in general, except such as are formed by bacteria and auto- lytic changes occurring before the birds are placed in cold storage and after they are thawed. {h) The negative results of animal inoculations with extracts obtained from the two kinds of poultry. 2. When fowl are taken out of cold storage and exposed to a tem- perature of 68° F., the conditions of exposure being the same, the undrawn birds show better keeping qualities. 3. When freshly killed fowl are exposed at 68° F. under conditions constant for all the birds exposed, the birds drawn according to the method described above show perfect keeping qualities, while the undrawn fowl undergo a rapid process of decomposition. Under these conditions the ordinarily drawn birds show fair keeping qualities, although they are not free from bacterial decomposition. It may be concluded, therefore, from these results that it is best to draw fowl in a different manner from that usually followed, before they are placed in cold storage. After removal from cold storage, the fowl should never be contaminated by soaking in watei', but should thaw in the air. Ordinary drawing is worse by far than no drawing at all. Report upon the Bacteriological Examination of Drawn and Undrawn Poultry. Herbert R. Brown, pp. 285-336 A detailed bacteriological study. The following conclusions were drawn: 1. Poultry kept at temperatures ranging from + 5° to — 14° F. undergo no decomposition as a result of bacterial activity. 2. Freezing destroys the red and some of the white blood corpuscles. 3. Freezing temperatures as low as — 14° F. destroy a large per- centage of the bacteria present, but do not affect the more resistant ones. 4. When the tissues are thawed, they become moistened by the melting ice crystals, and in this condition bacterial growth is facili- tated and decomposition of the tissues and contents of the cells is promoted. 424 STATE SANITATION 5. In the drawn chickens placed in cold storage aerobic conditions prevailed throughout the pleuroperitoneal cavities. The undrawn chickens showed much smaller numbers of bacteria in the pleuro- peritoneal cavities. On account of the closed cavity, partial anaerobic conditions prevailed in these birds. In decomposing meats, putrefactive aerobic bacteria may possibly produce the primary stages and prepare the way for anaerobes which possibly control the intermediate stages of decomposition. By the combined action of both, decay is brought about, but it is probably finished by aerobic bacteria. From these facts it appears that, given the aerobic conditions and the larger numbers of bacteria growing on the moist surfaces and tissues of a thawed drawn chicken, decomposition will proceed at a more rapid rate than with an undrawn one containing fewer bacteria existing under partial anaerobic conditions. 6. In freshly killed, unfrozen drawn chickens, the surfaces and tissues become dry within a very short time, and, although aerobic conditions prevail, the bacteria cannot grow because of lack of moisture. 7. In freshly killed, unfrozen and undrawn chickens, on account of the closed pleuroperitoneal cavities there is no drying of the tissues and surfaces, and facultative aerobic and anaerobic bacteria from the intestines rapidly cause decomposition. 8. By the removal of the viscera without the spilling of the contents of the alimentary tract decomposition can be prevented absolutely. The operation requires about two minutes. 9. Briefly stated, decomposition depends largely upon the presence of moisture in the tissues, for moisture is absolutely essential to bac- terial growth. In freshly killed birds, ordinarily or properly drawn, the surfaces quickly become dry. In cold-storage birds, no matter how they are drawn, the tissues will be moist, because of the melting of the crystals of ice. If properly drawn, there would be but few bacteria present capable of causing decomposition. The Infantile Mortality of Boston, June i-November 30, 1907. Dr. Donald Gregg, pp. 401-413 A study of the deaths of infants distributed by wards, by season, by feeding, etc. Report upon the Growth of Pathogenic Bacteria in Milk. Herbert R. Brown, pp. 415-437 A study of the growth of B. typhosus, the paratyphoid bacillus, the hog-cholera bacillus, the bacillus of dysentery, the diphtheria bacillus, etc., under different conditions. The folio-wing conclusions were drawn: I. Bacillus typhosus, paratyphoid, hog cholera, bacillus dysenteriae (Shiga) and bacillus diphtheriae can all grow in milk, but the last grows the poorest of the five when placed under the optimum conditions of temperature. SCIENTIFIC ARTICLES AND REPORTS 425 2. All species grow less luxuriantly at room temperature than at 36° C. 3. Exposure to low temperatures (5.6° to 6.7° C.) causes no appre- ciable destruction of bacteria during the first forty-eight hours, and there may even be some multiplication of the more vigorous individuals of all five species. Continued exposure for three weeks causes a rapid destruction of the individual bacteria most susceptible to the low temperature. 4. Bacillus typhosus produces an acid reaction in milk early in its development. The milk remains normal in appearance. 5. Bacillus hog cholera and the paratyphoid bacillus produce an initial rise in acidity, which is followed by alkali production as an end product. The milk assumes a primary opalescent appearance, which later on is changed to a translucence due to alkaline reaction and probable peptonization of the proteids present. 6. Bacillus dysenteriae produces a slight initial rise in acidity, which is followed by a return to a slightly alkaline reaction. The milk remains normal in appearance. 7. Exposure of bacillus typhosus to — 1.1°, — 12.2°, 17.8° and 21.1" C. for fourteen days did not kill all the bacteria of any one tube, for growth always ensued when the culture was placed in favorable environment. 1908 Fortieth Annual Report A Review of Twenty-One Years Experiments upon the Purification of Sewage at the Lawrence Experiment Station. H. W. Clark and Stephen de M. Gage, pp. 251-538 A most important paper. The subject matter is indexed under the head of the Lawrence Experiment Station in the third volume. A part of this Review is reprinted on page 341. 1909 Forty-first Annual Report Disposal and Purification of Factory Wastes or Manufacturing Sewage. H. W. Clark, pp. 339-403 An important paper giving the result of much experimental work. The subject matter is indexed under the head of the Lawrence Experi- ment Station, The Collection and Disposal of Mtmicipal Refuse. X. H. Goodnough, pp. 405-421 An important paper which treats of the following topics: Classifica- tion of municipal refuse (p. 407), sources, separation, methods of collection (p. 408), quantity of refuse (p. 410), methods of disposal (p. 412), cremation (p. 419). 426 STATE SANITATION A Study of Some of the Spore-bearing Anaerobic Bacteria in Market Milk. Herbert R. Brown, pp. 632-667 An extended bacteriological study of samples of milk purchased from small stores in Boston and vicinity. The methods used are first described (pp. 633-643), and then are given descriptions of seven- teen different organisms studied. On page 666 is given a long list of references. 1910 Forty-second Annual Report Studies of the Relative Corrosion of Metal Pipes by Waters, especially before and after Purification. Review of Literature on Corrosion. H. W. Clark and Stephen de M. Gage, pp. 287-310 The results of a series of experiments relating principally to " rusty water troubles." The effect of hot and cold water is discussed (p. 291), and that of dissolved oxygen on page 292. A review of the literature is given on page 295. Theories of corrosion are discussed on page 299, and methods of prevention on page 307. 191 1 Forty-third Annual Report Experiments upon the Disinfection of Sewage and Effluents from Sewage Filters. H. W. Clark and Stephen de M. Gage, pp. 339-364 This paper is indexed under the head of the Lawrence Experiment Station. 1912 Forty-fourth Annual Report Studies of Fish Life and Water Pollution. H. W. Clark and George O. Adams, pp. 336-345 The results of experiments to show the effect on small fish of sewage, diluted sewage, and various sewage effluents. The effect of dissolved oxygen, nitrates, iron, etc., is referred to (p. 341). The consumption of oxygen by fish life (p. 342), the solution and diffusion of oxygen in water (p. 343) and the liberation of oxygen by algae (p. 344) are studied. A Study of the Efficiency of Certain Methods for the Sanitary Control of Swimming Pools. H. W. Clark and Stephen de M. Gage, pp. 346-367 A general study of various swimming pools, notably those at An- dover and Lawrence (p. 351), Worcester (p. 365), and Cambridge (p. 366). Bacterial counts and B. coli results are given. A Study of the Hygienic Condition of the Air in Textile Mills with Reference to the Influence of Artificial Humidification. H. W. Clark and Stephen de M. Gage, pp. 659-692 The following topics were considered: Influence of the condition of the air upon health and comfort (p. 662), respiratory diseases in textile cities (p. 664), factors influencing the health of textile operatives SCIENTIFIC ARTICLES AND REPORTS 427 (p. 667), artificial humidification (p. 670), air in spinning and weaving rooms (p. 676), air in picker and carding rooms (p. 681), air in other wool manufacturing processes (p. 684), effect of humidifiers on bacteria and molds (p. Fecal Contamination of Roller Towels. Henry N. Jones, pp. 549-552 A brief statement giving results of tests for B. coli, Staphylococci and other organisms. The Occurrence of Infantile Paralysis in Massachusetts. Dr. Mark W. Richardson, pp. 555-561 Certain facts and observations of an unusual nature in the experi- ence of Massachusetts with infantile paralysis are here set forth, to- gether with a discussion of their possible significance. This article is published in full on pages 350-365, and with it an article by Dr. M. J. Rosenau and one by Dr. John F. Anderson and Dr. Wade H. Frost on the agency of stomoxys calcitrans in the spread of infantile paralysis. 1913 Forty-fifth Annual Report Further Experiments on Poliomyelitis. Dr. M. J. Rosenau, pp. 535-557 Experiments with the stable-fly described in detail. Experiments to Determine Paralyzed Domestic Animals and those Associated with Cases of Infantile Paralysis may Transmit that Disease. Dr. Carl Ten Broeck, pp. 558-577 The experiments are described in detail, the results showed that " in no case do the monkeys inoculated from any of these animals show any signs of a paralysis or symptoms which would indicate that they were infected with poliomyelitis." A Study of an Epidemic of Infantile Paralysis Occurring in the South- em Connecticut Valley during the Year 1912. Dr. James V. W. Boyd, pp. 578-601 An epidemiological study. Refers to paralysis among birds and horses. The cases are classified in various ways. 1914 Forty-sixth Annual Report Disposal of Sewage in the South Metropolitan Sewerage District, including report of the Chief Engineer. X. H. Goodnough, pp. 361-400 This report relates chiefly to an extension of the system so as to include the sewage of Wellesley and Needham, but various data are given for other places in the Charles River Valley. 428 STATE SANITATION The Suppression of Tuberculosis, an Address to the State Inspectors of Health of Massachusetts. Hiram F. Mills, pp. 701-722 A valuable statistical summary, with map, showing the decrease in tuberculosis between igo8 and 191 2 in different parts of the state. The Protection and Maintenance of the PubUc Health during and subsequent to a Great Conflagration. Dr. William C. Hanson, pp. 739-743 An account of the measures taken to safeguard the public health at the time of the Salem Fire. The Early Diagnosis of Lead Poisoning. Dr. Harry Linenthal, pp. 743-749 A critical study of thirteen cases of lead poisoning. II. ABSTRACTS OF SPECIAL REPORTS 1889 Sewerage of the Mystic and Charles River Valleys Report of the State Board of Health upon the Sewerage of the Mystic and Charles River Valleys. Dr. Henry P. Walcott, Chairman, January, 1889, pp. 1-36 In 1887 the legislature had asked the Board to report on the general drainage and sewerage of the Mystic and Charles River Valleys, including the best method of disposal. This comprehensive study resulted. Abstracts of the report are printed at some length on pages 86-105. The general scheme here recormnended was adopted and is now in use under the name of the North Metropolitan Sewerage System. The portions of the report not reprinted included additional experiments on the flow of water and sewage through peat and detailed statements relating to the cities and towns to be included in the district. The report contains maps and profiles. Report of Consulting Engineer. Joseph P. Davis, pp. 37-40 A general report approving the project recommended. Report of the Engineer. Howard A. Carson, C.E., pp. 41-84 Contains the results of the surveys and estimates of cost. Report upon Disposal by Chemical Precipitation. Charles H. Swan, C.E., pp. 11 2-1 20 The best location for works of this type was on the estuary of the Mystic River. Detailed estimates of cost were given. Report of the Chief Engineer. Frederic P. Stearns, pp. 85-1 11 This report covered the following points: The capacity of the Boston Main Drainage Works (p. 85), Operation of the Main Drainage Works with reference to the Outlet (p. 97), Methods of providing sewerage systems for each city and town within the district (p. 99), Independent systems for cities and towns (p. 106), Estimates of cost (p. no). Report on Absorption of Water upon Saugus Marshes. Frederick Brooks, C.E., page 121 Detailed descriptions of the experiments referred to in the main report. Interesting as showing the impossibility of using peat for sewage filtration. 430 STATE SANITATION 1894 Improvement of Charles River Report of the Joint Board Consisting of the Metropolitan Park Com- mission and the State Board of Health upon the Improvement of the Charles River from the Waltham Line to the Charles River Bridge. Dr. Henry P. WalcoU, Chairman, April, 1894, pp. i-xxii This report because of the importance of the subject to the people of Boston and the Metropolitan District is printed in full, with a few details omitted, on pages 249-259. The project of the Charles River Basin had been considered in 1891. There were many advocates and opponents. This report carried great weight and led to the immediate undertaking of the project. Report of the Engineer. Frederic P. Stearns, pp. 1-32 The following topics which were considered indicate the compre- hensiveness of the investigation upon which the report was founded: Present condition of the river (p. i), sanitary examination (pp. 6 and 14), methods of improvement (p. 9), proposed dam (p. 12), effect upon navigation (p. 17), effect upon the harbor (p. 18), effect upon sewerage systems (p. 23), effect upon ground water in filled lands (p. 26), effect upon marshes (p. 28), relation to storm water (p. 28), possible shoaling (p. 30), and cost (p. 30). Report of the Landscape Architects. Messrs. Olmstead and Eliot, pp. 33-43 A general discussion followed by statements concerning three sec- tions of the project. The Fresh Water Section, from the Waltham line to the Watertown Bridge, the Marsh Section, from the Watertown Bridge to Cottage Farm, and the Basin Section, from Cottage Farm to the Craigie Bridge. Appendix i. Freshet Flow of the Charles River. Appendix 2. Charles River Bridge. Appendix 3. Ground water in filled lands. 1895 Metropolitan Water Supply Report of the State Board of Health upon a Metropolitan Water Supply. Dr. Henry P. Walcott, pp. 9-21 This report is reprinted in full on page 260, et seq. Report of the Consulting Engineer. Joseph P. Davis, C.E., pp. 34-36 A short report approving the plan recommended by the Board. Report of the Chief Engineer. Frederic P. Stearns, pp. 1-148 A comprehensive report giving the results of the investigations made and a description of the works recommended for a Metropolitan SCIENTIFIC ARTICLES AND REPORTS 431 supply of water. The Metropolitan District was taken to be the cities and towns within ten miles of the State House. The following were the main subjects considered: 1. Statistics and estimates relating to the water supply of the Metropolitan District as a whole. pp. 3 2. A statement of the present condition of the water supply of each of the cities and towns in the district, prefaced by some remarks regarding sources of water supply in general. 14 3. An outline of the plan recommended for taking an ad- ditional water supply from the Nashua River. 67 4. A financial statement with regard to the existing water works of the district. 80 5. A statement with regard to each city and town in the dis- trict, as to whether it should obtain its water supply independently or as a part of the district. 85 6. A statement regarding sources investigated but not recom- mended. 103 7. A detailed description of the works recommended, both for bringing water to the Metropolitan District, and for distrib- uting it to the cities and towns within the district, including estimates of cost. 125 As is now well known, the Nashua River was selected as the source of the Metropolitan Supply. Among the sources studied but not recommended were the Merrimack River (p. 103), Lake Winnipisogee (p. 108), Charles River (p. in), Shawsheen River (p. 113), Ipswich River (p. 114), Assawompsett Pond (p. 115), and Sebago Lake (p. 117). Sources available for future additions to the Nashua River supply were: Tributaries of the Assabet River (p. 117), Ware River (p. 118)^ Swift River (p. 120), Deerfield River (p. 121), Westfield River (p. 122), Squannacook River (p. 122). The report is illustrated with maps and general plans, including sections of the main dam and dykes at the Wachusett Reservoir. A very important report. Appendix No. i Growth of Population in the Boston Metropolitan District. pp. 1 51-156 A statistical study of the populations of the cities and towns within the Metropolitan District, with a graphical estimate of future popu- lation. Appendix No. 2 Present and Future Consumption of Water in the Metropolitan District. Dexter BrackeU, C.E., pp. 157-175 A detailed study of the water consumptions in Boston and suburban cities and towns. Contains average per capita consumptions, quan- 432 STATE SANITATION titles used for domestic purposes, mechanical trade and manufacturing uses, public uses, and waste; also fluctuations in consumption. Esti- mates were given for the probable future consumptions. Appendix No. 3 Improvement of the Quality of the Sudbuiy River Water by the Drainage of the Swamps upon the Watershed. Desmond FitzGerald, pp. 176-187 Contains records of colors of various waters in the small feeders of the Sudbury River, with estimates of the probable improvements resulting from swamp drainage. Appendix No. 4 On the Amount and Character of Organic Matter in Soils and its Bearing on the Storage of Water in Reservoirs. Dr. Thomas M. Drown, pp. 188-201 Reprinted from the Annual Report of the State Board of Health for 1893. Appendix No. 5 Chemical Analyses of Water from the Sources Investigated. Made under the direction of Dr. Thomas M. Drown, pp. 202-216 Appendix No. 6 Water Supply of Different Qualities for Different Purposes. Dexter Brackett, C.E., pp. 217-221 A study of a possible dual supply, — a spring or ground water supply for domestic uses, and a supply of water of inferior quality, not suit- able for drinking, for mechanical, manufacturing, and other purposes. Appendix No. 7 Sanitary Examination of Nashua River Watershed. Chester W. Smith, pp. 222-223 A sanitary survey with results expressed in tabular form. 1896 Improvement of Upper Charles River Report of the Joint Board Consisting of the Metropolitan Park Com- mission and the State Board of Health upon the Improvement of Charles River from the Line between Watertown and Waltham to Mother Brook, May, 1896. Dr. Henry P. Walcott, Chairman, pp. i-io This work was practically a continuation of the work of a similar joint board in 1894. It covered that portion of the river above that formerly considered, and recommended a control of the water level, SCIENTIFIC ARTICLES AND REPORTS 433 arrangements for the transfer of boats past the dams, the acquisition of land for parks, along the stream, and public control of the area secured. Report of the Landscape Architects. Messrs. Olmstead and Eliot, pp. 1 1-20 Contains data of an engineering character. Intermittent Fever in the Charles River Valley. Dr. John Jenks Thomas The care of low lands and swamps is emphasized as a necessary measure, but no mention at this date was made of the mosquito in connection with malaria. 1897 Improvement of Neponset River Report of the State Board of Health upon the Sanitary Condition and Improvement of the Neponset Meadows. Dr. Henry P. Walcott, pp. 5-10 This investigation was undertaken in accordance with a legislative act (Chap. 8^ of the Resolves of 1895). Drainage of the meadows was recommended, largely in order to protect the region against malaria, but with an incidental increase in the usefulness of the land. This report is printed in full on page 293. Engineer's Report. X. H. Goodnough, pp. 1-27 The general conditions are first described, the sanitary condition of the river, its pollution by manufacturing waste; next the condition of the meadows (p. 14) and the feasibility of improving them (p. 17). The plan is described on page 20, and estimates of cost given. Finally the probable effect of the work upon the meadows. Report of the Chemist. H. W. Clark, pp. 28-33 A chemical investigation of the pollution and a study of the pos- sibility of purifying the manufacturing wastes. Filtration experiments were made. 1898 Cerebro-spinal Meningitis. Dr. W. T. Councilman, Dr. F. B. Mallory and Dr. J. H. Wright, page 178 This report covers the general nature and history of the disease, its epidemic occurrence in Massachusetts, and detailed medical descrip- tions of many cases. The bacteriology of the disease is also discussed. The paper is illustrated with colored plates. 434 STATE SANITATION 1898 Restoration of Green Harbor Report of the Joint Board Consisting of the Harbor and Land Com- missioners and the State Board of Health upon the Restoration of Green Harbor in the Town of Marshfield, Mass., January, 1898. Dr. Henry P. Walcott, Chairman, pp. 1-24 The report of an investigation made to determine the advisability of removing a dike so that the tidal waters might overflow certain marsh lands in the town of Marshfield and restore the harbor of Green Har- bor. Estimates of the relative amounts of damages and betterments were considered. It was concluded inadvisable to remove the dike. The report contains some interesting local historical statements and a statement as to the effect of applying salt water to a fresh water marsh. Appendix No. i Report of the Engineers. Frank W. Hodgdon and X. H. Goodnough, pp. 29-60 The report contains the engineering data required for the investiga- tion, a study of the saltness of the water above the dike, the effect of reflooding the meadows with salt water and suggestions for improving the harbor without removing the dike. Appendix No. 2 Report of the Engineer. Frank W. Hodgdon, pp. 61-63 On the cost of removing the dike and of improving the harbor without removing the dike. Appendix No. 3 Report of the Chemist. H. W. Clark, pp. 64-67 Contains the results of analyses of soils from the marshes and dike lands and experiments upon sections of soil. 1898 Sewerage of Salem and Peabody. {House No. 1301.) Report of the State Board of Health upon the Sewerage of the City of Salem and the Town of Peabody. Dr. Henry H. Walcott, Chairman, pp. 3-16 Made in accordance with the Resolves of 1895 and 1896. The existing nuisances caused by the discharge of sewage about Salem, the condition of the North River and the shores and flats have warranted the recommendation for improvement and change. Dis- posal by discharge into the sea is recommended. The report contains a description of various experiments and investigations made to determine the most suitable point of outlet. A description of the proposed sewerage system and its design, together with cost data, are given. SCIENTIFIC ARTICLES AND REPORTS 435 Engineer's Report. George A. Kimball, pp. 19-48 This report describes the complete situation, the topography, popu- lation and estimated increase, water supply, present sewerage facilities, industries, nuisances caused by the sewage and quantity of sewage in both places. The various methods of disposal available about Salem are enumerated and the disposal by dilution in sea water is recommended. Detailed accounts of the float experiments are given in order to find the proper location for the outfall sewer and in conclusion recommen- dations relating to the entire system, trunk sewer, pumping station, and estimates of cost are given. 1900 Discharge of Sewage into Boston Harbor Report of the State Board of Health upon the General Subject of the Discharge of Sewage into Boston Harbor. pp. 5-7 This special report was prepared in accordance with an act of the legislature (Chap. 65 of the Resolves of 1899). It was written by Dr. Henry P. Walcott, Chairman of the Board. It is printed in full on page 317, c^ seq. Engineer's Report. X. H. Goodnough, pp. ia-87 This report contains the fundamental data upon which the report of the Board was based. It describes briefly the existing works, their capacity and the necessity for relieving the Boston Main Drainage System (p. 20). The proposed method of relief, namely the construc- tion of the South Metropolitan System, is then described in detail. Certain areas are recommended for inclusion in this district and other areas were excluded because local disposal was more advantageous. These latter areas were in the upper parts of the Charles and Neponset drainage areas. On page 64 are given estimates of population and quantities of sewage, and on page 69 a description of the proposed harbor outlet for the high-level sewer. Finally, mention is made of the relief needed in Braintree, Weymouth and Hingham. An appendix gives populations of sewer districts from 1850 with estimates to 1940. 1901 Sanitary Condition of Sudbury and Concord Rivers Report of the State Board of Health upon the Sanitary Condition of the Sudbury and Concord Rivers. Dr. Henry P. Walcott, Chairman, pp. 1-9 The results of a sanitary survey of the river are here given. The recommendation was that certain pollutions be excluded, but that the efficacy of lowering the river's bed be left for future study. Report of the Chief Engineer. X. H. Goodnough, pp. 10-37 The statistics of pollution are given, with water analyses and statements as to the conditions of the rivers. 436 STATE SANITATION Report upon the Disposal of Manufactural Wastes from the Mills at Saxonville, Mass. H. W. Clark, Chemist, pp. 38-46 The wastes considered are from the processes of wool-scouring, washing yarn and dyeing. Various experiments were made. Sanitary Conditions in the Towns Bordering the Sudbury and Concord Rivers. Dr. Frank L. Morse, Medical Inspector, pp. 47-55 Malaria in Concord. Dr. Theodore Chamberlain, pp. 56-57 1904 Investigation of the Business of Undertaking and Embalming. PP; 1-4 The business is being satisfactorily carried on under the supervision of local health authorities. 1904 Dumping of Garbage and Rubbish in the Harbors and along the Sea Coast of Massachusetts Bay. {Senate, No. 277.) The Report of the State Board of Health upon the Dumping of Garbage and Rubbish into the Harbors and along the Sea Coast of Massachusetts Bay. Dr. Henry P. Walcott, Chairman, pp. 3-5 This report considers the general subject of dumping of refuse into the sea and along the shores. From observations made in the harbors of several cities there is believed to be little objection to the practice of dumping at sea providing it is done at a sufficient distance from the shore. Very little garbage or other putrescible matter is disposed of along shores — chiefly ashes, house dirt, street sweepings and rubbish. The enclosing of such dumping areas by walls is recommended. Report of the Chief Engineer. X. H. Goodnough, pp. 6-25 This report treats of the disposal of refuse matters in the City of Boston, Lynn, and Hull and the dumping of such materials into the harbor and along the shores. Observations were made relative to dumping from scows and disposal along shores. Appendix. pp. 26-27 Results of observations of dumping of Boston Refuse scows in Boston Harbor, also the dumping of Hull garbage. Appended is a map showing location of dumping grounds. 1906 Mystic River and Alewife Brook. (Senate, No. 363.) The Report of the State Board of Health on the Purification of Mystic River, Alewife Brook and the Adjacent Water Courses, Ponds and Drainage Areas. Dr. Henry P. Walcott, Chairman, pp. 2-18 The report states that the Mystic River, Alewife Brook and their tributaries are most seriously polluted by sewage and manufacturing SCIENTIFIC ARTICLES AND REPORTS 437 wastes. The drainage areas are largely swampy low lands suitable for breeding mosquitoes and giving rise to the malaria existing in the valley. The construction of a dam on the Mystic River at Craddock's Bridge, equipped with tide gates; the deepening and widening of channels; and the exclusion of storm sewage was recommended. 1907 Water Supply of Lynn. (Senate, No. 239.) An Act Relative to Increasing and Improving the Water Supply of the City of Lynn (Approved, June 21, igo6). page 3 A Report by the State Board of Health and the Water Board of the City of Lynn Relative to the Increase and Improvement of the Water Supply of the City of Lynn. Dr. Henry P. Walcott, Chairman, pp. 4-5 A joint report by the State Board of Health and the Water Board of the City of Lynn. It consists of a description of the present supply and the conditions which make a new supply necessary. Possible methods for the improvement and increase of the supply are given. Sand filtration is recommended as a means of purification. Report of Engineers. X. H. Goodnough, Chief Engineer, State Board of Health and George I. Leland, City Engineer of Lynn. pp. 7-26 This joint report outlines the present system of water supply and the existing conditions and character of the present polluted sources. Plans for an additional supply from several unpolluted sources are given together with details of the required works and the estimated costs. Sand filters were recommended. Maps are included in the report. 1908 Sanitary Condition of the Merrimack River Report of the State Board of Health upon the Sanitary Condition of the Merrimack River. Dr. Henry P. Walcott, Chairman, pp. 1-4 A special study made at the request of the legislature (Chap. 114 of the Resolves of 1908). It was concluded that while the condition of the stream was not injurious to the public health, more complete regulation of the pollution, especially pollution by trade wastes, was desirable. Particular mention is made of the possible recovery of wool grease. Report of the Chief Engineer. X. H. Goodnough, pp. 6-36 The details of the investigation are given in this report, as follows: Description of the river (p. 7), sources of pollution (p. 8), manufactur- ing wastes (p. 13), stream flows (p. 18), comparisons with other rivers (pp. 16, 22), analyses of the water at various points (pp. 22 and 37), sewer outlets (p. 28), summary (p. 34). 438 STATE SANITATION 1908 Pollution of Boston Harhor by the_ Discharge of Sewage at Moon Island. {Senate, No. 65.) Report of the State Board of Health on the Pollution of Boston Harbor by the Discharge of Sewage at Moon Island. Dr. Henry P. Walcott, Chairman, pp. 2-5 An investigation as to the extent to which the water of the Boston Harbor was polluted by the discharge of sewage at Moon Island. Bacterial and chemical examinations showed that the waters of the inner harbor were more polluted than the waters of the outer harbor, except in the immediate vicinity of the sewer outfall. The results indicated that the pollution of the inner harbor was not due to the dis- charge of sewage at Moon Island or at the other main outlets. 1909 Green Harbor Report of the Joint Board Consisting of the Harbor and Land Com- missioners and the State Board of Health upon the Improvement of Green Harbor, in the Town of Marshfield, Mass. Dr. Henry P. Walcott, Chairman, pp. 1-15 A further study of the problem reported on by a similar joint board in 1898, but with substantially no change in opinion. Report of the Engineers. Frank W. Hodgdon and X. H. Goodnough, pp. 6-21 Contains the engineering data, including estimates of cost. 1909 Lake Quannapowitt. {Senate, No. 208.) Report of the State Board of Health upon the Flooding of Lands Bordering Lake Quannapowitt and its Tributaries, and the High- water Elevation of the Lake. Dr. Henry P. Walcott, Chairman, pp. 2-10 A report by the State Board of Health investigating the condition of lands adjacent to Lake Quannapowitt in the vicinity of Wakefield and Reading, due to inadequate drainage. The drainage of the low lands in question by the removal of the dam at Vernon Street on the Saugus River, and the construction of drainage channels of sufl&cient size are recommended by the Board. No legal high-water mark for the lake has ever been established. SCIENTIFIC ARTICLES AND REPORTS 439 1909 Sewage Disposal for Worcester Insane Hospital. (House, No. 197.) Report of a Commission to Investigate the Advisability of Establishing a System for the Disposal of Sewage from the Worcester Insane Hospital in the City of Worcester. Dr. Henry P. Walcott, Chairman, pp. 2-10 This is a report of a Joint Commission composed of members from the State Board of Health and the Board of Health of the City of Worcester. It consists of a brief statement of the past and present con- ditions and the method of sewage disposal practiced, leading up to the recommendation that hospital sewage be discharged into the sewerage system of the City of Worcester. 191 1 Water Supply of Salem, Beverly, and Peahody and the Use of the Ipswich River Preliminary Report of the State Board of Health. pp. 1-2 1 Final Report of the State Board of Health. pp. 22-37 A consideration of the water supply needs of these communities and the way in which Ipswich River may be used to furnish a supply. 1913 Sanitary Condition of the Merrimack River. {House, No. 2050.) Report of the State Board of Health upon the Sanitary Condition of the Merrimack River. Dr. Henry P. Walcott, Chairman, pp. 3-6 This report is the result of investigations into the sanitary condition of the bed, banks, and waters of the Merrimack River, and of streams tributary or adjacent thereto in cities and towns bordering upon the river. Recommendations for the improvement of the sanitary con- dition of the river and the removal of objectionable conditions there- from are given. Report of the Engineer and Chemist. X. H. Goodnough and H. W. Clark, pp. 7-45 This report details the general condition of the river along its course, particularly at Lawrence, HaverhUl, and Lowell, aided by charts showing the averages of monthly analyses of samples taken at these points. The causes of the excessive pollution below the City of Law- rence are the sewage from several cities and towns, manufacturing wastes from the process of wool scouring and wastes from other con- cerns. The wool scouring wastes are very objectionable and their effect upon the river condition furnishes the basis for the recommenda- tions as to the further treatment of wool scouring wastes. Objection- able conditions caused by the discharge of sewage near the banks of 440 STATE SANITATION the river and plans by which objectionable conditions can be removed from the river at Lowell, Lawrence, and Haverhill are designated. Suitable maps of explanation are included as well as analyses of waters at various points in the river. An important contribution to the subject of the disposal of wool scouring wastes. 1913 Danvers River and its Estuaries. {House, No. 2201.) Report of the State Board of Health upon an Investigation of the Danvers and its Estuaries. Dr. Henry P. Walcott, Chairman, pp. 1-6 An investigation made in accordance with (Chap. 84, Resolves of 191 2), to ascertain whether it would be feasible and safe to construct a dam at Beverly Bridge and what changes in methods of sewage dis- posal of cities and towns in the watershed would be necessary to maintain a sufficient degree of purity in the basin. The report includes a sanitary survey of the Danvers River, its tributaries and of towns within the watershed, together with an account of the objectionable conditions contributing to the serious pollution now prevailing therein. Remedies are suggested for the elimination of the gross pollution and for the general improvement of the river and basin. It was thought advisable to construct a half-tide dam allowing free flow of the tide into and out of the basin, and to make certain improvements in sewage and waste disposal methods. Report of the Engineer. X. H. Goodnough, pp. 7-27 In this report are given in detail a complete description of the Danvers River and its tributaries, the existing conditions of sewerage, methods of sewage disposal employed within the watershed and existing conditions giving rise to the serious pollution of the river and basin. Measures necessary for the prevention of the present objec- tionable pollution are stated, and the practicability of improving the sanitary condition of the river by means of a dam at Beverly Bridge is discussed. The impracticability of a fresh water basin was shown. Chemical Examinations of Water. pp. 30-32 1913 Dorchester Bay. {House, No. 1840.) Report of the Joint Board on an Investigation as to the Advisability and Cost of Improving the Shores of Dorchester Bay. Dr. Henry P. Walcott, Chairman, pp. 1-3 This report, which was made jointly by the State Board of Health and the Directors of the Port of Boston, treats of the nuisances caused along the shores of Dorchester Bay mainly by the dumping of large quantities of refuse of various kinds, but in part by the discharge of SCIENTIFIC ARTICLES AND REPORTS 441 sewage at times of storms from sewer overflows along the shore. Filling in a portion of the bay was advised as a remedy for the existing nuisance and moreover it would add twenty-five acres of land to the area already filled at the upper end of the bay. Report of the Engineers. Frank W. Hodgdon and X. H. Goodnough, pp. 4-9 This report details the principal causes of nuisances and the practi- cable means of remedying the existing conditions; with estimates of cost, maps, etc. 1914 The Addition of the Town of Reading to the North Metropolitan Sewerage District. {House, No. 6.) A Joint Report by the Metropolitan Water and Sewerage Board and the State Board of Health Relative to the Addition of the Town of Reading to the North Metropohtan Sewerage District. Dr. Henry P. Walcott, Chairman for the Joint Board, pp. 1-3 A report of an investigation of the conditions affecting the disposal of the sewage of the town of Reading, the expediency and cost of dis- posing of the sewage of the town into the North Metropolitan Sewerage System, It was recommended that the town of Reading should be made a part of the North Metropolitan Sewerage District. An Act to Provide for the Addition of the Town of Reading to the North Metropolitan Sewerage District. pp. 4-6 A proposed act. Report of the Chief Engineers. Messrs. Frederick D. Smith and X. H. Goodnough, pp. 4-1 1 A report by the chief engineers of the two boards giving details and estimates. INDEX INDEX Abattoirs, see Slaughtering. Abbajona River, 225. Abbott, Dr. Samuel W., 300, 399-401, 411,415, 417,418. Acushnet Reservoir, 222. Adams, Charles F., 259. Adams, George O., 342. Adams, Dr. J. F. A., 385, 388, 394, 398. Adams, John Q., 64. Adams, Dr. Z. B., 398, 401. Aeration of sewage beds, 177, 178; of waters, 410. Aerobioscope, 68-70, 403. Air, determination of organisms in, 66-71, 200; Frankland's, Hesse's and Petrie's methods, 67; Tucker's method, 67-71; in textile mills, 426. Air, micro-organisms outdoors, 71-73; in hospital wards, 65, 66, 73, 75, 76, 403; in houses, 74, 76; in schools, 74, 76. Air and its impurities, 380. Alcohol, use of, 12; efJects of, 13-16, 379, 383. Aldrich, P. Emory, 11, 383. Alewife Brook, pollution, 436. Algae, 32-36, 42-45, 144, 146, 154, 196, 199, 397, 406. Alkalinity of ash, 422. Alster Basin, Hamburg, 255, 257, 258. Alum as a coagulant, 188, 189, 191. Ames, Dr. Azel, Jr., 386, 399. Amherst College, 395. Anderson, John F., 362. Antitoxin, 416, 422. Appleton, Julius H., 85, 105. Arsenic, 380, 400. Asylums, 387. Babcock, Professor James F., 384. Babington, Professor C. C, 41. Bacillus coli, 420. Bacteria in air, 71, 72, 74-76. Bacteria in ice, 78, 79, 81-84. Bacteria in milk, 426. Bacteria in sewage and sewage efl3uents, 172-174, 176, 178-185, 343, 345, 347. Bacteria in water, 166, 192, 193, 209-213, 329-332, 416, 422. Bacterial pollution, 420. Ball, Phineas, 90, 383. Bates, Theodore C, 105. Beer-shops, 383. Beverly Water Supply, 439. Billings, Dr. F. S., 305, 312, 396. Birch Pond, Lynn, 211. Births surviving in Massachusetts, 307, 310, 311; in foreign countries, 310, 311- Blackstone River, 58, 162, 164-168, 171, 221, 225, 398. Boardman, Dr. A. E., 386, 387. Boardman, A. W., 399. Boos, Dr. WiUiam F., 423. Boston City Hospital, 65. Boston Harbor, garbage, 436. Boston Harbor, pollution, 438. Boston Harbor, sewerage, 435. Boston main drainage system, 90, 102, 318, 322, 429. Boston water, 210, 212, 222, 223, 229, 260-273, 397; consumption, 262, 263, 268, 419, 431. Boston Water Board, 108. Bowditch, Ernest W., 397, 398. Bowditch, Dr. Henry I., 3, 11, 12, 16, 17, 25, 378, 381, 384, 387, 391- Bowditch, Dr. H. P., 119, 393, 395, 404, 405- Boyd, Dr. James V. W., 427. Brackett, Dexter, 261, 402, 432. Bradford, Laurence, 322. 446 INDEX Brighton abattoir, 385, 387. Brooks, Frederick, 94, 402, 429. Brown, Dr. Francis H., 396. Brown, Herbert R., 423, 424, 426. Brues, Charles T., 350, 358. Burial, 388. Calkins, Gary N., 207, 230, 410-412. Cambridge, sanitary condition, 395; Niles case, 395. Cambridge water supply, 396. ;v Cancer, 419. Capillarity in sand, 243. Carnelly, Professor Thomas, 73. Carruth, H. S., 249. Carson, Howard A., 90, 429. Car ventilation, 388. Cerebro-spinal meningitis, 351, 386,433. Chapin, Dr. Walter H., 413. Chapin, William C, 11. Charbon, 377. Charles River basin improvement. Re- port of Joint Board, 249-259, 430, 432, 433- Charles River Improvement Commis- sion, 249. Charles River valley, drainage, 58, 64, 86, 89, 317, 318, 320, 324, 429. Chase, Philip A., 259. Chase, WiUiam, 259. Chemical precipitation of sewage, 188- 191, 344, 346, 429- Chesborough, E. S., 392, 399. Chestnut Hill Reservoir, 113, 116, 146, 269, 270. Children, growth of, 1 19-130, 393, 395, 405- Chlorine in sewage, 140-143, 158-160, 183, 218. Chlorine in water, significance of, 218, 219, 227. Chlorine, normal, in Massachusetts, 139- 142, 227. Cholera, 19, 401. Cholera morbus, 398. Clark, Harry W., 341, 342, 415, 417-422, 425, 426, 433, 434, 436, 438. Clarke, Eliot C, 61, 395, 397. Clouston, Dr. T. S., 395. Coachlace Brook, 162. Coal and water gas, poisoning, 47-54, 385; passage through soil, 54-57. Cochituate Lake, 108, 146, 268. Cogswell, Dr. Edward R., 395. Cohn, F., 196. Cold storage, 423. Color bUndness, 394. Color in water, 106, 147, 148, 220, 221, 229. Colrain, Mass., epidemic of infantile paralysis, 35 1, 352. Concord, malaria, 436; sewage disposal, 401. Concord River, sanitary condition, 435. Consumption, 384, 427. Contact filters, 346-349. Converse, Edmund W., 64. Cook, Dr. C. H., 403. Copeland, W. R., 342, 416. Copper sulphate, use in reservoirs, 421. Corrosion of pipes, 426. Couch, Dr. John F., 400. Councilman, Dr. W. T., 433. Cows, care and condition, 336, 337. Craigie's Bridge and dam, 253. Cremation, 388. Curtis, Dr. Josiah, 312. Dairies, inspection of, 333-340, 422. Danvers River, 439. Davis, Joseph P., 261, 398, 429, 430. Davis, Robert T., 11. Death-rates, from typhoid fever in Mas- sachusetts, 133-137; infantile, and milk, S33- See Vital Statistics. Deaths in Massachusetts by age periods, 301, 305-308, 310, 312-316. Deerfield River, 397. Deer Island, sewage discharge, 90-92, loi, 104, 317, 318, 322-324, 326-331. de las Casas, William B., 259. Derby, Dr. George, 11, 377, 381, 382, 383, 386. Dibden, W. J., 157. Dilution of sewage in streams, 156, 157, 160-161, 163, 165-167. INDEX 447 Diphtheria, action of bacilli in, 275; antitoxin, 422; in Lawrence, 404. Diphtheria bacilH in hospital wards, 75. Diphtheria bacilli : experiments on toxin production, 278-284, 416, 417; mor- phology, 284-286; pseudo forms, 290- 292; virulence, 276, 281; toxicity, 276, 277, 288, 289. Disease prevention, 377. Disinfection, 401. Disinfection of sewage, 426. Dissolved gases in water, 164, 410, 412. Dorchester Bay, 440. Drainage, 383, 391-393, 395, 398. Draper, Frank W., 85, 105, 259, 273, 299, 321, 379, 380-384- Drown, Dr. Thomas M., 144, 218, 261, 342, 405, 407, 408, 410, 412, 414, 415, 432. Drug inspection, 369-373. Dual water supplies, 431. Effective size, 238-241, 245-248. Eliot, Charles, 249. Elliott, E. B., 307, 310, 312. Elutriation of sand, 234-235, 239, 240. Emerson, Dr. Herbert C, 350. Erysipelas bacteria, 75. Evaporation from water surfaces, 113, 114, 118. Eye-strain, 399. Factories, sanitary condition, 422. Factory waste, 425. Farlow, Dr. W. G., 39, 144-397. Farm-houses, 386. Farm Pond, 146. Farmers, health of, 385. Farr, Dr., 5, 300, 303, 306. Filtration experiments, 419. Filtration of sewage, 94-100, 172-187, 191, 296, 320, 342-349. Filtration of water, 26-38; history of, 29; practice of, 29, 41; object and results of, 30-31, 36-37; at Springfield, 419. Fish Ufe and pollution, 426. Fisher, Dr. Theodore W., 388. FitzGerald, Desmond, 113, 204, 261, 432. Fixed residue, interpretation of, 219, 230. Folsom, Dr. Charles F., 387, 390-393, 396, 398, 399. Food adulteration, 367-369, 381, 383, 384, 396, 399- Food and drug inspection in Massa- chusetts, 366-373, 402. Food laws, 367. Foot and Mouth Disease, 380. Forbes, Fred B., 342. Frankland, Grace, 214. Frankland, Percy F., 214. French, Henry F., 383. Fresh Pond, 41. Frictional resistance in sand, 243-247. Frost, Wade H., 362. Frothingham, Richard, 11. Ftely, Alphonse, 397. Fuller, George W., 342, 410, 416. Gage, Stephen de M., 341, 342, 419, 420, 422, 425, 426. Galton's method of percentile grades, 1 19-130, 405. Galvanized iron, effect on water, 386. Garbage, disposal, 425, 436; in Boston Harbor, 435. Gas poisoning, 47-54, 400; experiments on, 47-53; sources of danger, 54. Glen Lewis Pond, Lynn, 221, 223. Goodnough, X. H., 322, 421, 425, 427, 433-438, 440, 441. Great ponds, 383. Green Harbor, 434, 438. Greenleaf, Dr. Robert W., 249, 252. Gregg, Dr. Donald, 424. Grippe, 404. Ground atmosphere, 387. Ground water, 106, 107, 118, 143, 220, 221, 223-231, 415,419. Growth of children, 1 19-130, 393, 395, 405. Hammond, Dr. J. W., Jr., 350. Hanson, Dr. Wilham C, 428. Hardness in water, 27, 228, 416. 448 INDEX Harrington, Dr. Charles W., 333, 422. Hartwell, Dr. B. H., 403. Hassall, Arthur Hill, 194. Hastings, Joseph W., 85, 259, 273. Hayden, Edward D., 64. Haynes reservoir, 220, 221. Hazen, Allen, 188, 215, 232, 342, 408, 409, 412,415. Health, value of, 387. Heights of children, 1 19-130. HenneUy, Dr. Thomas P., 350. Hm, Dr. Henry B., 381, 384. Hirt, Dr. L., 197. Hitchcock, Professor Edward, 395. Hoadley, J. C, 387, 400. Hodgdon, Frank W., 434, 438, 441. Holmes, Dr. Oliver Wendell, 398. Holyoke, sanitary conditions, 398. Homes of the poor, 384. Horn Pond, Woburn, 222, 225, 226. Hospitals, 386, 387, 394, 395, 396, 415; air of, 403. Hotels, drainage, 397. House drainage, 391, 395. Housing, 378. Hull, James W., 259, 273, 299, 321. Hulwa, Dr. Franz, 197. Hydrolytic tanks, 347. Ice, 413; analyses, 78-83; investigation of supplies, 77; pollution of supplies, 77-85, 403. Index, general, 396, 401, 407, 410. Infant mortality, 333, 383, 424. Infantile paralysis in Massachusetts, 350-365, 427- Infantile paralysis, epidemiology, 350- 352, 356; prognosis, 357; transmis- sion, 353-356, 358-365- Influenza, 404. Insane, 381. Intemperance, letter on, 12-16. Intermittent fever, see Malaria. Interpretation of water analyses, 218- 231, 405,412. Iron in water, 196, 224, 229, 418. Iron salts as coagulants, 188-191. Isochlors, 139-142, 227. Jamaica Pond, 223. Jarvis, Dr. Edward W., 381, 383, 386. Jeffries, Dr. B. Joy, 399. Johnson, Dr. A. H., 394. Jones, Dr. E. V., 85, 105, 401. Jones, Dr. Frederick W., 401. Jones, Henry N., 427. Jones, Dr. Lyman A., 350. Jordan, Edwin O., 208, 210, 410. Kean, Alexander L., 200, 201. Kimball, George A., 435. Kirkwood, James P., 29, 388, 390. Lawrence, diphtheria in, 404; water supply, 414. Lawrence Experiment Station, 137, 172, 193, 199, 203, 206, 215, 232, 341-349- Lead in water, 417. Lead poisoning, 377, 401, 428. Leland, George T., 436. Leprosy, 399. Life tables, English, 300, 302, 304; limitations of accuracy, 301-305; value of, 312, 316. Life tables for Massachusetts, 300-316. Lime and iron as coagulants, 188-191. Lincoln, Dr. D. F., 261, 394, 400. Linenthal, Dr. Harry, 428. Liquor, intoxicating, 12, 13-16, 379, 383. Live stock, transportation, 387. Local Boards of Health, 386. London water supply, 194. Loss on ignition, interpretation of, 219, 231. Lothrop, Thornton K., 85, 105. Lovett, Dr. Robert W., 350. LoweU, health of, 391. Lucas, Dr. WiUiam P., 350. Ludlow Reservoir, 148, 154, 211, 220. Lynn, sanitary condition, 393; water supply, 436. Lythgoe, Hermann C., 366, 422. Macdonald, J. D., 198. McLauthlin, George V., 413. Malarial fever, 19, 252, 295, 296, 298,398, 401, 403, 433, 436. INDEX 449 Mallory, Dr. F. B., 433. Manual of Public Health Statutes, 402. Mark, Professor E. L., 403, 416. Marlborough, 416. Martin, A. C, 379. Massachusetts Drainage Commission, 90, 91, 294. Massachusetts State Census, 304, 306. Massachusetts State Registration Re- port (1857), 307, 312. May, Dr. Arthur W., 350. Mead, Henry E., 322. Mead, Julian G., 299, 321. Meat supply, 387. Medfield, sewage disposal, 402. Meriam, J. N., 387. Merrimack River, 164, 165, 266, 267, 396, 437, 438. Metal pipes, corrosion of, 426. Metals in water, 417, 418. Metropolitan Sewerage, 86-105, 317- 321, 322-332, 379, 399, 427, 429, 435, 436, 440, 441. Metropolitan Water Supply, cost figures, 269, 272; report upon, 260-273, 430, 431- Micro-organisms in air (see also Air), 65- 76. Microscopical analysis of water, 192- 207, 410; old methods, 194-198; new methods, 199-207. Microscopic organisms in ice, 79. Microscopic organisms in water and sewage, 32-36, 42-4S, i44, 146, i54, 192, 193, 196, 218, 224, 230, 406, 412. Middleton Pond, 226. Milk, adulteration, 384; bacteria in, 424, 426. Milk, production and handling, 333- 340. Milk and disease, 333-336, 339. Mill dams, 381. Millers River, 397. Mills, Hiram F., 85, 105, 131, 172, 199, 232, 259, 273, 299, 321, 342, 405-407, 414-428. Mind, diseases of, 393. Moon Island sewage discharge, loi, 102, 104, 317-319, 322, 323, 325-327, 330- 331- Morse, Dr. Frank L., 435. Morse, Professor John L., 350. Mystic Lake, 108, 222, 225, 380, 397. Mystic River, pollution, 435. Mystic River valley, drainage, 58, 64, 86, 89, 92, 324, 397, 429. Nahant, sewerage, 399. Nantucket, sanitary conditions, 400. Nashua River, 163, 267-269, 271, 432. Naukeag Pond, 155. Neponset Meadows, sanitary condition and improvement, 293-299, 433. Neponset River, 225, 294, 295, 297, 317, 318,320,324,330. New Bedford water, 220, 221. Nichols, Dr. Arthur H., 377, 381, 384, 391- Nichols, WilUam Ripley, 26, 47, 144, 380, 382, 385, 387-391, 394, 396, 397, 400. Niles Case, Cambridge, 395. Nitrification and the nitrifying organism, 208-217, 219, 344, 410. Nitrification in water, 208-213, 219, 225-227. Nitrification of sewage, 172-178, 181- 183, 343-346, 348, 408. Nitrogen, in water, 154, 155, 208-212, 219-226. Nut Island, sewage discharge, 319, 324. Odors and tastes in water, 33, 35, 42, 106, 144-155, 162, 163, 218, 230, 295, 406, 412. Oleomargarine, 402. Oliver, Dr. F. E., 381, 391. Oliver, Dr. Henry K., 383. Ohnstead and Eliot, 430, 433. Olmsted, Frederick L., 249. Opium, 381, 403. Organic matter in sewage, 343-349. Organic matter in soils, 432. Organic matter in water, 219, 251, 295, 325- Osgood, Dr. Robert B., 350. 450 INDEX Oxygen consumed, interpretation of, 219, 228. Oxygen dissolved, 410, 412. Parasites, 382. Parker, Professor G. H., 199, 200, 406. Peabody, sewerage, 434, 435. Peabody, water supply, 439. Peat in sewage filters, 173, 174, 343- Peddock's Island, sewage discharge, 319, 324, 326, 327, 330. Pegan Brook, 162. Percentile grades, 1 19-130. Philbrick, Edward S., 391. Physical education, 395. Physician of the future, 17, 21, 23, 24. PiUing's Pond, 154. Pinkham, Dr. J. D., 402. Pinkham, Dr. J. G., 393. Plague, 19. Plunkett, Mrs. Thomas F., 386. Poisons, 377. Poliomyelitis, see Infantile Paralysis. Political economy of health, 386. Pollution of drinking-water, 139-142, 146, 153-155, 165, 166, 187, 221. Pollution of streams, 89, 156-171, 250, 25s, 256, 294-296, 298, 299, 396, 407, 420; of Boston Harbor, 91-93, 100- 105, 317-319. 322-331, 438. Population of Massachusetts by age periods, 301, 313, 314; of Boston, metropolitan district, 431. Porter, Charles H., 259, 273, 299, 321. Poultry, cold storage of, 423. Prescott, S. C, 415. Preservatives in food, 369. Preventive Medicine, 17-25, 377, 3^4; growth, 18; results, 20, 21; for Massachusetts, 22 {see also State Medicine). ProbabiUty of life, 308, 313-315- Prudden, Dr. T. M., 79. PubUc Health, letter on, 9-1 1. Quannapowitt, Lake, 438. Radlkofer, Ludwig, 195. Rafter, George W., 204-207. Rags, infection, 402. Rainfall, 107, 108, 113, 114. Reading, sewage of, 440. Refuse, disposal of, 425. Registration, 391, 393. Reservoirs, storage of water in, 144- 147. Residue on evaporation, 230. Richards, Abraham L., 259. Richards, Mrs. EUen H., 208, 210, 396, 409, 416. Richardson, Dr. Mark W., 350, 359, 360. Roberts, Charles, 119. Rosenau, Dr. Milton J., 350, 354, 358, 427. Royal Commission on Metropolitan Sewage Discharge, 157. Salem fire, sanitation, 428, Salem, water supply, 439. Sand and gravel analysis, 232-248, 412, 415- Sand for microscopical analysis, 206. Sands and gravels, physical properties of, 232-248, 344. Sands and gravels in filters, 172-175, 179, 243-248, 344. Sanitary hints, 391. Saugus marshes for sewage disposal, 92, 94, 98, 100, 429. Sawyer, Warren, 11. Saxonville, trade wastes, 436. Scarlet fever, 394. School hygiene, 386. School sanitation, 394, 398, 400, 402. Sedgwick-Rafter method, 199-207. Sedgwick, Professor William T., 47, 65, 192, 342, 400, 409, 413-416. Self-purification of streams, 166-171,407. Septic tanks, 346, 347. Service pipes, 421. Sewage analyses, 158-160, 174, 178-185, 188, 220, 345. Sewage and shellfish, 322-332. Sewage disposal, 89-92, 100-105, 156- 164, 317-326, 378, 382, 383, 389, 390, 393, 401. Sewage, effect of freezing, 84. INDEX 451 Sewage effluents, 172-183, 343, 348, 349, 412; compared to drinking-water, 183- 187. Sewage purification at Lawrence Experi- ment Station, 341-349, 425. Sewage sludge, 345-347- Sewage treatment, 90-92, 94, 172-191, 296, 320, 341-349, 408, 409, 4iS> 420, 425, 426, 429. Sewage volumes, 158, 164, 317, 318, 322- 324- Sewerage, 392, 393, 397. Sewing machines, 381. Sharpies, Professor S. P., 399. Shellfish and sewage polluted water, 322- 332, 421, 422. Sheppard, Dr. Philip A. E., 350. Slaughtering, 377, 382, 384, 385. Smallpox, 19, 382. Smith, Chester W., 432. Smith, Frederick D., 440. Smith, Dr. Theobald, 274, 350, 416, 417, 422. Soil analysis, 414. Soil moisture, 19, 295. Soil stripping, 147, 148, 155. Soils, organic matter in, 432. Somerville, sanitary condition, 400. Spectacle Island, 325, 327. Spot Pond, 269, 270, 272, 273. Spring waters, 410, 419. Springfield, water purification, 419. Stable fly and infantile paralysis, 354, 358-365. Stables, conditions at dairies, 336-338. Stacy's Brook, 162, 226. State Board of Health, duties, 6, 7, 9, 10. State Medicine, address on, 3-8; in Great Britain, 4-6; in Massachusetts,6. Statutes, manual, 402. Stearns, Frederic P., 106, 144, 156, 249, 253, 260, 265, 271, 404, 406, 429, 430. Stebbins, Solomon B., 64. Storage of water, 110-112, 116, 117, 144- 155, 269, 396. Storer, Professor Frank H., 380. Stream flow, 107-109, 112, 116-118, 157, 161, 164, 166. Sudbury River, 108-111, 113, 114, 117, 118, 140, 146, 164, 169, 261, 267-269, 432. Sudbury River, sanitation, 435. Sulphur organisms, 45. Surface water, 106, 107, 118, 208, 210- 213, 220-223, 225-231. Swamp drainage, 432. Swan, Charles H., 90, 429. Sweeping, effect upon organisms in air, 74- Swimming pools, 426. Swine, trichinosis, 416. Taunton, sanitary conditions, 401 . Ten Broeck, Dr. Carl, 427. Textile mills, air in, 426. Thames River, 194. Thomas, Dr. J. J., 433. Tidal waters, 421. Tin in water, 417. Tobey, Gerard C, 259, 273, 299, 321. Towels, contamination, 427. Trade wastes, 164, 165, 225, 295-297, 345, 348, 349, 425, 436. Trichina, 377, 396. Trichinosis, 400, 403, 416. Trickling filters, 343, 345-349. Tubercle bacillus in hospital wards, 75. Tuberculosis, 384, 428; among cattle, 336. Tucker, Greenleaf R., 65. Tuckerman, Leverett S., 64. Turbidity in water, 218. Typhoid bacillus, 131, 410; in air, 132; in milk, 321; in water, 132, 133, 136- 138. Typhoid fever, 377, 413, 414; and milk, 339, 414, 41:6; and water supplies, 131-138, 262, 339, 405. Undertaking, 435. Uniformity coefiicient, 238-241, 245- 248. Upham, Dr. J. Baxter, 386. Uroglena, 411. 452 INDEX Vaccination, 398. Vegetable growths, 32-36, 39-46, 192, 218, 220, 224, 226, 230, 295. Vegetable parasites, 382. Ventilation, 74, 396; cars, 388; school- houses, 379, 402. Vital statistics, 300-316, 379, 380, 391, 393, 404, 411, 417-419- Voids in sand, 242. Wachusett Reservoir, 268. Walcott, Dr. Henry P., 58, 85, 105, 249, 259, 260, 273, 293, 299, 321, 350, 398, 399, 429, 430, 432-436- Walden Pond, Lynn, 220. Walker, Ernest L., 274, 416, 417. WaUing, H. F., 383. Ware River, 268, 272. Waring, George E., Jr., 398. Warington, Robert, 214. Wastes, manufacturing, 164, 165, 225, 295-297, 345, 348, 349, 425- Water analyses: ground waters, 185, 211, 221, 223-231, 415, 419; micro- scopical, 192-207; polluted waters, 103, 161-163, 167-171, 221, 225, 322, 326-331, 389, 397; ponds and reser- voirs, 149-153, 220-223, 225-231, 397, 43 2 ; possible Metropolitan sources,43 2 . Water analyses, interpretation of, 218- 231, 405, 412. Water consumption, 262, 263, 268, 419, 431- Water pollution, problems, 58-61; legal control in Massachusetts, 60, 61 {see also Pollution). Water, properties of, defined, 27, 28. Water purification, 26-38, 394, 407, 419. Water softening, 27. Water supply, classification of Massa- chusetts waters, 139-143, 406; effect of storage, 144-155, 407; of towns, 382, 389; report upon Metropolitan, 260-273; selection of sources, 106- 118, 404; statistics, 406, 419; well water, 400. Watersheds, 108, no, 112, 114, 117, 266, 267. Waters of Massachusetts classified, 139- 143- Water weeds, 40-42. Waterworks, 399, 401, 403, 419. Watuppa Lake, 222. Weights of children, 1 19-130. Wenham Lake, 229. Westfield River, 396. White, Dr. James C, 382. Wigglesworth, Dr. Edward, 309. WUIiston, Professor S. W., 205. Winnipiseogee Lake, 265, 266. Winogradsby, 214-216. Winsor, Dr. Frederick, 386, 390, 395. Withington, Dr. Charles F., 402. Women, physique of, 404. Wood, Dr. Benjamin, 350. Wood, Dr. Edward S., 396, 400. Woodman, Miss C. A., 203. Worcester, sewage disposal, 383, 398; at Insane Hospital, 439. Wright, Dr. J. H., 350, 433. Zinc in water, 386, 417. PRINTED AT THE HARVARD UNIVERSITY PRESS CAMBRIDGE, MASS., U. S. A. COLUMBIA UNIVERSITY This book is due on the date indicated below, or a(. the expiration of a definite period after the date of borrowing, as provided by the rules of the Library or l>y special ar- rangement with the Librarian in charge. DATE BORROWED DATE DUE DATE BORROWED DATE DUE I C2a(638)M50 llDV 1 5 w