No.

is granted a license to remove from the city, bones, grease and refuse matter (house offal excepted) for one month from April 1, 187, upon compliance with the following rules:

1st. All vehicles and vessels for the transportation of the abovenamed substances shall be inspected on the first day of each month. They shall be made and kept in such condition as will prevent the escape of any of their contents, or the odor thereof, and entirely conceal the same from view.

2d. Every vehicle so used shall have the name of the owner, and number of the wagon, in letters and figures two inches in size, painted thereon, in some conspicuous position.

3d. When the holder of this license discontinues the business for which it is granted, he shall return it to this office.

4th. Any violation of the above rules will cause a revocation of this license, and subject the offender to prosecution.

This license will be renewed only upon application at the yard of the City Stable, North Grove street, on the morning (between 8 and 12 o'clock) of the first day of each month, or the following day when the first day comes on Sunday.

No.

And for fish peddling, as follows:

to sell

from April 1, 18

is granted a license within the city limits for one month

This license will be renewed only upon application at the yard of the City Stable, in North Grove street, in the afternoon (between 1 and 4 o'clock) of the first day of each month, and upon compliance with the following rules:

1st. This license is not good for any other person than

and must be carried by him whenever selling such articles. 2d. All vehicles and vessels for the transportation of the abovenamed substances shall be made and kept in such condition as will prevent the escape of any of their contents, or the odor thereof, and entirely conceal the contents from view. They shall be inspected the first day of every month, at the City Stable in North Grove street.

3d. Every vehicle used for the above purpose shall have the name of the owner, and number of the vehicle, in letters and figures two inches in size, painted thereon, and also the number on the box, in some conspicuous position.

4th. The holder of this license is prohibited from crying his wares in the street to the disturbance of the inhabitants, and when he discontinues the business he shall return it to this office.

5th. Any violation of these rules will cause a revocation of this license, and subject the offender to prosecution.

The number of licenses issued for removing grease, etc., ; for peddling fish

was

HOUSE OFFAL, FILTH, ETC.

The ordinance relating to throwing dirt, or filth of any kind, into the streets, alleys, etc., not being comprehensive enough to cover some cases that we had, or at least such having been the decision of one of our courts, and as we thought it as necessary to restrain the negligent and careless dropping, as

the wilful or malicious throwing of filth in the street, on the 8th of May we made and published according to law, the following regulation:

Ordered, That no person removing manure, house-offal, swill or filth of any kind, shall suffer it to leak or escape from any vehicle, by him owned or driven, in or upon any street, court, square, lane, alley, wharf or public enclosure, in the City of Boston.

The following table shows nuisances abated during the year:

The number of complaints for violation of health laws and ordinances was 87. The amount paid in fines and costs was $982.91. In this number and amount, however, are included the cases reported by the Inspector of Provisions, which are given elsewhere in this report.

MORTALITY RETURNS.

A matter of the first importance in making up statistics of mortality is the physician's certificate. The statute upon this subject reads as follows:

*This does not include those that were voluntarily entered to be cleaned.

Any physician having attended a person during his last illness shall, when requested within fifteen days after the decease of such person, forthwith furnish for registration a certificate of the duration of the last sickness, the disease of which the person died, and the date of his decease, as nearly as he can state the same.

Then follows the penalty for neglect or refusal.

In a criminal case brought under the above section of the statute, there would be no question as to what "any physician" meant, inasmuch as the term would include any person who held himself out as such.

But for the purpose of gathering reliable data under this statute, this all-embracing method of defining the word physician does not give the highest satisfaction or the best statistics. The art of healing may be promoted, but the science of reasoning by induction is not, by acquisitions to the medical profession of men and women, who would return a certificate similar to the following, which is a verbatim copy of one received at this office during the year:

"This certifies that A beby boy died on the bornday of Febberiy, 1876. Cause of death, "Born."

her

M-XR

mark.

Or who would ascribe as among the causes of death the following:

The "lung diess" turned out to be upon investigation lung disease.

To say that a person died of "canker and spasms," "snuffles" or "lack of villality," gives us but little knowledge of the true cause of death; while "lung diess" may, to those who understand its meaning, show the location but not the nature of the disease. Correct classification of diseases is difficult under such circumstances, and the city physician has been of great assistance to us in examining and determining the true cause of death in these and similar cases.

The question who is a physician within the meaning of Sect. 3 of Chap. 21 of the G. S., still comes back to us and

ought to be settled. Is every person, who holds himself or herself out as such, attending another in his last illness, a physician within the meaning of the statute? Are we to take the certificate of every soi-disant physician, and, upon that alone, give a permit for burial? Is he or she a physician who has no degree, no diploma, who has never studied medicine, who has had little or no experience, who cannot spell the name of a disease so that it can be read or understood, and who cannot write his or her name at all, but who simply makes a mark? If so, what weight shall we give to such certificates? Of what possible value are they? And if not, where shall we draw the line? Ought there not to be some legislative enactment defining "any physician," or fixing the qualifications he shall possess, who undertakes to give this important certificate?

In the present report the Board is able to present for the first time the results of a mortality registration conducted under its immediate supervision. The statistics given in the following pages embrace only a part of the facts which have been gathered in this important department of sanitary work during the past year. Very much more might have been added, but the purpose has been kept in view to present in this portion of the report those matters only which possess obvious interest and value for the general reader, extensive statistical tables and detailed facts, appropriate in a registration report, but less acceptable here, having been omitted. The Board is not unconscious of the fact that important elements are lacking, whose presence is needed for statistical accuracy. Chief among these is a correct knowledge of the population of various sections of the city, whereby mortality rates might be calculated satisfactorily with reference to age-distribution, nationality and parentage. Other shortcomings will, it is hoped, be found easy to correct in the future working of this department of the Board's functions.

The immense assistance which this mortality registration has afforded to the Board during the year in its endeavors to promote the sanitary welfare of the city can hardly be overestimated. Without delay or obstruction the direct return of deaths has placed the Board in a position to investigate, and in many instances to remove, conditions inimical to life and health. Preventable local causes of mortality have thus been repeatedly discovered, which else might have escaped detection, to work further mischief in homes already bereft. The desolating inroads of diphtheria, of scarlatina, of cholera infantum, and of other maladies included in the group of zymotic or filth discases, have had in this manner

immediate recognition and, as far as lay in the power of the Board, energetic resistance. Without entering even an indirect claim that the diseases alluded to or any others are under the full control of sanitary authority, the Board feels confident that it has secured, in the registration of mortality, in the promptly reported information concerning the locality and causes of deaths, an immediately available and effective reinforcement in the prosecution of sanitary work.

It is to be remarked concerning the comparatively high death-rate of the city during the past year that it is open to a double interpretation. In the first place, it means, in accordance with common sense, that Boston is below the average as regards its public health, that imperfect sewerage and other conditions, remediable or inevitable, are impressing themselves upon our people in effects which are to be deplored. But, in the second place, lest there should be a temptation to exaggerate to a sensational degree the notion that Boston, judged by its death-rate, is an unfit place to visit, or to inhabit, it is further to be remarked that our relatively high rate of mortality means also that the registration of deaths is more accurate and complete than in cities which unduly exalt the estimated number of their inhabitants, while they fail to record the entire number of those who have died. This view of the case should not be lost sight of, when comparisons are made to the disparagement of Boston.

The whole number of deaths returned for the year ending April 30th, 1876, not including still-births, was 9,154.

This gives a death-rate of 26.77 per thousand of a population of 342,000.

If we include the still-births, of which there were 452, the whole number of deaths will be 9,606, and the death-rate 28.08 per thousand.

By Zymotics is meant those diseases which are due to contagion, filth, or miasma, and are known as preventable by, or amenable to, sanitary force. Small-pox, scarlatina, diphtheria, and typhoid fever are examples.

By Constitutional Disease is meant those not dependent upon influences coming from without, but are largely inherited. Consumption, cancer, and scrofula are examples.

In the class of Local Diseases are included affections of the various organs or groups of organs in the body, considered distinctively. Many of the inflammations illustrate this class, as, for example, pneumonia, pleurisy, and peritonitis.

Developmental Diseases are those which depend for their cause upon accidental or other interference with the nutrition or growth of the body. Premature birth, cyanosis, teething, old age and debility are examples.