CITY OF BOSTON.

CITY PHYSICIAN'S OFFICE, January 1, 1870.

To the Honorable the City Council of the City of Boston: GENTLEMEN, — In accordance with custom, I have the honor respectfully to present the following

REPORT

of the doings of this office for the twelvemonth ending December 31, 1869:

One thousand seventy-nine visits have been made to persons. confined in the jail. I am happy in being able to add that during the past year there has been no prevalent disease among the inmates, and but one death has occurred from delirium tremens.

The City Prison and the Temporary Home in Chardon street have been visited whenever their respective inmates have needed my services.

In the latter institution two births and six deaths have taken place.

Under the direction of the chief of the police, examinations have been made of fifty-six appointed men, and certificates furnished them of their physical ability to serve on the force.

By the records of the City Registrar's office, the number of deaths from small-pox during the year has been five. This is not a large number when taken by itself, but it is large enough to suggest the inquiry whether, in a community where the means of protection by vaccination are provided gratuitously by the city, even such a number ought to appear.

By a canvass made in October, 1868, the number of persons unvaccinated within the then limits of the city was as follows:

By a canvass ordered this year, the number unvaccinated was

This number is largely in excess of the results obtained in the same way in former years, and ought not to be found in a community where the means of vaccination gratuitously fur

nished by the city enable all to avail themselves of it. The laws and ordinances existing, and in full force at the present time, are ample to prevent this undesirable state of affairs, but they are never enforced. The law is as follows:

VACCINATION.

SECT. 27. Parents and guardians shall cause their children and wards to be vaccinated before they attain the age of two years, and revaccinated whenever the selectmen or mayor and aldermen shall after five years from the last vaccination require it. For every year's neglect the party offending shall forfeit the sum of five dollars.

SECT. 28. The selectmen and mayor and aldermen shall require and enforce the vaccination of all the inhabitants, and, whenever in their opinion the public health requires it, the revaccination of all the inhabitants who do not prove to their satisfaction that they have been successfully vaccinated or revaccinated within five years. All persons over twenty-one years of age, not under guardianship, who neglect to comply with any such requirement, shall forfeit the sum of five dollars.

SECT. 29. Towns shall furnish the means of vaccination to such of their inhabitants as are unable to pay for the same.

SECT. 44. When a disease dangerous to the public health breaks out in any town, the board shall immediately provide such hospital or place of reception for the sick and infected as is judged best for their accommodation and the safety of the inhabitants; which shall be subject to the regulations of the board; and the board may cause any sick and infected person to be removed thereto, unless the condition of such person will not admit of his removal without danger to his health, in which case the house or place where he remains shall be considered as a hospital, and all persons residing in or in any way concerned within the same shall be subject to the regulations of the board as before provided.

SECT. 47. When a householder knows that a person within his family is taken sick of small-pox or any other disease dangerous to the public health, he shall immediately give notice thereof to the selectmen or board of health of the town in which he dwells. If he refuses or neglects to give such notice, he shall forfeit a sum not exceeding one hundred dollars.

SECT. 48. When a physician knows that any person whom he is called to visit is infected with small-pox or any other disease dangerous to the public health, he shall immediately give notice thereof to the selectmen or board of health of the town; and if he refuses or neglects to give such notice, he shall forfeit for each offence a sum not less than fifty nor more than one hundred dollars.

Were the provisions of the sections quoted above carried out, small-pox would become a matter of history rather than an existing fact; but the general indifference of the community at large to the presence of the disease, and the fact, that however much A, B, or C may desire that their neighbors should be circumspect and careful in regard to precautions against it, they themselves resent any infringement of their right to the largest liberty, when they become amenable to those same restrictions, makes it practically impossible to enforce them.

The city provides for a gratuitous vaccination of its citizens, without respect to age or condition, and a large number annually avail themselves of this charity. But the extension of the territorial area of the city, by the recent annexation of Roxbury and Dorchester, renders it more difficult than ever for all to come to this office for that purpose. The ferry, with its delays, also renders it less available for those who live at East Boston. I would respectfully suggest to the board the consideration of this point: to see if it may not be wise to establish branch offices for vaccination, in such localities as will accommodate those who are unable to bring their children to this office.

It is a noticeable fact that during the period, — twenty-six