SREGIMINE DONATA A.D.1

City Document No. 53.

FOURTH ANNUAL REPORT OF THE BOARD OF HEALTH OF THE CITY OF BOSTON.

MAY 1, 1876.

TO HIS HONOR THE MAYOR, AND THE CITY COUNCIL OF BOSTON :

We herewith present the annual report of the Board of Health, for the year ending April 30, 1876, and including that day.

APPOINTMENTS, ETC.

On May 1, 1875, Charles E. Davis, Jr., was again chosen clerk of the Board, and on the 29th of April, subject to the Mayor's approval, we reappointed Samuel A. Green, M. D., City Physician, Alonzo S. Wallace, M. D., Port Physician, and George W. Forristall, Superintendent of Health, for the ensuing year.

The reports of the City Physician, the Port Physician, and the Superintendent of Health, accompany this report.

Thomas Kittredge, M. D., was reappointed Assistant Port Physician by Dr. Wallace, with our concurrence.

Our sanitary inspectors are the same as last year. Particular attention was paid throughout the hot weather to disinfecting all the lanes, courts, and by-places in the city, and this work was continued up to November, as appears in a table which follows later in this report.

REGISTRAR OF DEATHS AND BURIALS.

The office of Registrar of Deaths and Burials, created by us in 1874, with the approval of the Mayor, was, with like approval, abolished May 3, 1875, on which date, also with the approval of the Mayor, we adopted the following regulation:

BOSTON, May 3, 1875.

Voted, That after May 4, 1875, no human body shall be buried in, or removed from, the city without a written permit from the Board of

Health, nor until the facts required by the first clause of Sect. 4, Chap. 21, of the General Statutes, shall have been returned to and recorded by said Board.

Voted, That in case the physician's certificate, required by the abovementioned chapter, cannot for good and sufficient reasons be obtained, report thereof shall be made to this Board in season to obtain from the City Physician the certificate required before burial.

SMALL-POX.

At the date of our last report, as therein stated, there was but one case of small-pox in the city, that being in the hospital. The patient recovered and was discharged May 10. The next case was discovered in South Boston, on the 17th of June, and the patient was on that day taken to the hospital. This was a woman who had been in the city but a few days, having brought the disease with her from another State. On the 25th of June she recovered and was discharged. The next case was reported to us on the 1st of July. This was also in South Boston, and arose from the case last mentioned. The patient was a woman, who was too sick for removal, and who died the following day. Special pains were taken to guard the house, which was a tenement house. All the inmates were cared for, lest they should communicate the disease, and after the death of the patient the house was thoroughly fumigated. Fears were entertained that other thoroughly_fumigated. cases would arise from this, as such a result seemed almost inevitable; but this one was all. On the 23d of July, a woman from the West, stopping at a hotel in the city, where she had been but a few days, was found to have the small-pox. She was removed to the hospital the same day, and was discharged on the 30th of July, fully recovered.

No other case, to our knowledge, occurred in the city until February 24th of the present year, when one was reported in East Boston. Upon visiting the place, the city physician was unable to find the patient, as he had wandered out about the city, bringing up the next day in the office of the Board of Health, whence he was taken to the hospital. He recovered, and was discharged on the 6th of March.

The next case, also in East Boston, was reported on the 18th of March. This was traced directly to the case last mentioned. The patient, a man of fifty, being too sick to be removed, the house was placed in quarantine, and such other measures were taken as we thought necessary for the public safety.

The next case, also in East Boston, was reported on the 27th of March. This was the case of a man forty-seven years of age, and was traced directly to the case of February 24th. He was removed to the hospital, and died April 2d.

Another case arose on the 18th of April from that of the 18th of March, in the same house; and still later in April a third case was discovered in the same house, all of whom have now fully recovered, and there is now, so far as we know, no case in the city.

There has been a number of reports of cases of this disease, but the city physician, who has examined all such, found none genuine, except those mentioned; and the only deaths from this cause during the year were the one of July 20, 1875, and that of April 2, 1876.

On the 24th of November we received the following communications, and deemed it proper thereupon to address to the Committee on Public Buildings the paper that follows:

[COPY.]

CITY OF BOSTON.

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IN THE BOARD OF ALDERMEN, Nov. 22, 1875. Ordered, That the Committee on Public Buildings be and they are hereby authorized to take possession of the estate on Marcella street, owned by the city, and now held for the purposes of a small-pox hospital, and to make such repairs and alterations therein as may be required to fit the same for the accommodation of minors committed under the truant and vagrant acts; the expense, estimated at ten thousand dollars, to be transferred for that purpose from the reserved fund.

IN BOARD OF ALDERMEN, Nov. 22, 1875.

Ordered, That the Board of Health be and they are hereby authorized to fit up on Gallop's Island a suitable hospital for the treatment of contagious and infectious diseases; or whenever they deem it necessary may purchase, with the approval of His Honor the Mayor, a suitable lot of land and buildings, within the limits of the City of Boston, for the location of a hospital for contagious and infectious diseases; the expense, not to exceed the sum of twenty-five thousand dollars, to be charged to the appropriation for small-pox hospital.

To the Committee on Public Buildings of the City Council of Boston: GENTLEMEN, In accordance with the expressed wish of the City Council, as communicated to us, we hereby respectfully surrender to you the Marcella-street Hospital.

In doing so, we recommend the most thorough disinfection of the entire building. the floors, walls, ceilings, and all interstices therein; and that they be so changed as to be absolutely free from any danger of communicating small-pox to future occupants.

For the Board of Health,
(Signed,)

A. W. BOARDMAN,

Chairman.

YELLOW FEVER.

On September 7, schooner N. J. Miller, from San Domingo, arrived in quarantine, with two cases of yellow fever on board. They were removed to Gallop's Island, recovered in a short time, and were discharged. The schooner, after being properly disinfected and remaining a reasonable time in quarantine, was released.

On the 17th of December, the brig Elba, from Cuba, arrived in quarantine, about 9 A. M., with yellow fever on board. Some of the crew had been sick with this disease at Havana, and had recovered. But the captain was sick with it on entering port. He was removed without delay to the quarantine hospital at Gallop's Island. He was very sick, but recovered, and was discharged on the last day of the year. The Elba was thoroughly fumigated, and let out of quarantine on the 21st of December. There has been, to our knowledge, no other case of this disease.

QUARANTINE.

We have had no other case of quarantinable disease than those already mentioned. Early in April Capt. Wm. H. Sampson resigned as captain of the quarantine steamer, and Geo. T. Ranlett, former captain of the boat, was appointed to fill the vacancy. Capt. Sampson proved himself a faithful and competent officer. Capt. Ranlett's acceptance created a vacancy at Gallop's Island, which was filled by the appointment of Jacob Severance as overseer.

On the 15th of Sept., upon the resignation of Dr. C. Irving Fisher, as Port Physician, we appointed Alonzo S. Wallace, M. D., in his place. Dr. Fisher held the office for nearly three years, and was a conscientious, faithful and efficient officer.

SEWERAGE.

Upon this subject so much has been said by us in former reports and communications, and it has been so thoroughly gone over by the commission appointed by His Honor the Mayor, that we deem it proper now only to submit the following, which is the substance of a communication we have already prepared, to be presented at an early date:

To the Committee on Improved Sewerage: The subject of sewerage

is one to which the attention of the Board of Health has been called almost daily since its organization. We have necessarily witnessed its defects and consequent evil results in almost all parts of the city, and have from time to time called the attention of the City Council to the necessity of a radical change in our whole system of sewerage. Year after year has passed, and the complaints of citizens have increased as the

evils have grown worse. In our report of 1873-74, the Back Bay was alluded to. (See page 49 of that report.)

In our annual report to the City Council for 1874-75, we alluded to the same thing. (See page 10 of that report.)

In a special communication of the Board to the City Council, in December, 1874, we referred to the Roxbury canal, Stony-brook sewer, Muddy-brook sewer, and sewerage in general. (See page 11 of that report.)

The population of Boston at the time of the taking of the last census was, in round numbers, 342,000. Since the year 1820, the population of the district, within the circle of six miles radius from City Hall, has doubled every eighteen years. At the same rate of increase, in thirtysix years from the date of the last census, Boston would contain a population of 1,368,000.

There can be no reason to doubt but that at the end of this period Boston will at least have doubled her present population.

That some provision should be made to correct the present bad condition of our sewerage, and meet the requirements of the immediate future, must, as a matter of economy, be apparent to every one. What that provision should be but few are competent to determine. Acting under this conviction, the Mayor and City Council appointed three skilful men, of well-established reputation, to consider the subject, and devise some plan which would utilize the present system, correct its defects, and meet the requirements of generations to come. If the plan recommended by the commissioners should not be adopted, to whom shall we look for a plan more practicable? It seems to us to meet the case completely. The strongest argument brought against it is its cost. The citizens of Boston have not been slow to adopt other improvements, and we cannot believe that, when their health is in question, they will hesitate because of the expense.

If it is borne in mind that it will be a number of years before the works can be completed, and that the expense of construction will be divided over those years as the work progresses, it will be seen that the burden upon the tax-payers will not be felt as some would have us believe.

If it be further borne in mind that to carry out the propositions to extend the Stony-brook sewer a distance of three miles; to divert the filth in the Roxbury canal; to extend the mouths of sewers into deep water in Charles river; to dredge the flats in the river and South bay, and other expensive measures, will necessitate the outlay of a large sum of money, affording but partial and temporary relief, and which will be rendered unnecessary by the commissioners' plan, it will be seen that the difference in the cost of the two schemes will be very small; not so, however, with their results. We believe that it has been clearly shown that our sewers are largely in a stagnant and filthy condition; that their inability to discharge their contents, before putrefaction takes place, is a great source of nuisance and danger to the health of the people. Sanitarians, the world over, are agreed that the foul gases emanating from decomposing sewage are among the most fruitful sources of disease and death. We believe it has been clearly shown that the average death-rate in Boston, for many years, especially from preventable causes, has been far above the normal rate. In some parts of the city, where the soil-water stands much of the time near the surface of the ground, and the sewers are ineffectual, the mortality is alarming.

The houses in that section of the South-cove District lying between Troy street and the Boston and Albany Railroad, we consider unfit for habitation. There can, we think, be no question but that the large amount of sickness prevailing there is due in a great measure to imperfect drainage. From May 1, 1875, to April 30, 1876, in that small