Includes Suffolk County.

Health District No. 6. Includes the cities of Cambridge, Everett, Malden, Medford, Melrose and Somerville, and the towns of North Reading, Reading, Stoneham and Wakefield.

Health District No. 7.- Includes the cities of Beverly, Gloucester, Lynn and Salem, and the towns of Danvers, Essex, Ipswich, Hamilton, Lynnfield, Manchester, Marblehead, Middleton, Nahant, Peabody, Rockport, Saugus, Swampscott, Topsfield and Wenham.

Health District No. 8.- Includes the cities of Haverhill, Lawrence and Newburyport, and the towns of Amesbury, Andover, Boxford, Georgetown, Groveland, Merrimac, Methuen, Newbury, North Andover, Rowley, Salisbury and West Newbury.

Health District No. 9. Includes the cities of Lowell and Woburn, and the towns of Acton, Arlington, Ayer, Bedford, Billerica, Boxborough, Burlington, Carlisle, Chelmsford, Concord, Dracut, Dunstable, Groton, Harvard, Lexington, Lincoln, Littleton, Maynard, Pepperell, Shirley, Stow, Tewksbury, Townsend, Tyngsborough, Westford, Wilmington and Winchester.

Health District No. 10. Includes the cities of Marlborough, Newton and Waltham, and the towns of Ashland, Belmont, Brookline, Dover, Framingham, Grafton, Holliston, Hopedale, Hopkinton, Hudson, Medfield, Medway, Mendon, Milford, Millis, Natick, Needham, Northborough, Sherborn, Shrewsbury, Southborough, Sudbury, Upton, Watertown, Wayland, Wellesley, Westborough and Weston.

Health District No. 11.- Includes the city of Worcester, and the towns of Auburn, Brookfield, Charlton, Douglas, Dudley, Leicester, Millbury, Northbridge, North Brookfield, Oxford, Southbridge, Spencer, Sturbridge, Sutton, Uxbridge, Warren, Webster and West Brookfield.

Health District No. 12. Includes the city of Fitchburg, and the towns of Ashburnham, Ashby, Athol, Barre, Berlin, Bolton, Boylston, Clinton, Dana, Gardner, Hardwick, Holden, Hubbardston, Lancaster, Leominster, Lunenburg, New Braintree, Oakham, Paxton, Petersham, Phillipston, Princeton, Royalston, Rutland, Sterling, Templeton, Westminster, Winchendon and West Boylston.

Health District No. 13. Includes all of Franklin County, and all of Hampshire County excepting the towns of Huntington, Middlefield and Worthington.

Health District No. 14.- Includes all of Hampden County, and, in addition, the towns of Huntington, Middlefield and Worthington.

Health District No. 15. — Includes all of Berkshire County.

APPOINTMENT OF STATE INSPECTORS OF HEALTH.

On the tenth day of July, 1907, the following were appointed by the Governor to be State inspectors of health:

District No. 1. - Dr. Charles G. Morse, Wareham.

District No. 2.- Dr. Adam G. MacKnight, 355 North Main Street, Fall River.

District No. 3. - Dr. Wallace C. Keith, 237 North Main Street, Brockton.

District No. 4.- Dr. Elliott Washburn, 50 Broadway, Taunton. District No. 5.- Dr. Harry Linenthal, 327 Blue Hill Avenue, Roxbury.

District No. 6.- Dr. Albert P. Norris, 728 Massachusetts Avenue, Cambridge.

District No. 7. Dr. J. William Voss, 108 Cabot Street, Beverly. District No. 8.- Dr. William Hall Coon, 70 Newbury Street, Law

rence.

District No. 9. Dr. Charles E. Simpson, Lowell Hospital, Lowell. District No. 10. - Dr. William W. Walcott, 32 West Central Street, Natick.

District No. 11.- Dr. Melvin G. Overlock, 91 Chandler Street, Worcester.

District No. 12. - Dr. Lewis Fish, 7 Highland Avenue, Fitchburg. District No. 13. - Dr. Harvey T. Shores, 177 Elm Street, Northampton.

District No. 14. — Dr. Richard S. Benner, 10 Chestnut Street, Springfield.

District No. 15.- Dr. Lyman A. Jones, 170 Main Street, North Adams.

Under the rules, consideration was postponed until July 17, when the appointments were severally confirmed by the Council.

"COMMERCIAL" BACTERIOLOGICAL INSPECTION OF MILK.

For more than three years the Board of Health of the city of Boston has enforced a regulation requiring that milk sold in the city shall have a temperature not higher than 50° F., and shall contain not more than 500,000 bacteria per cubic centimeter. This regulation, adopted as a

result of the general demand of physicians and the more intelligent of the public for improved milk supply, has provoked much discussion concerning the value of sanitary milk inspection and the best methods of carrying it out. The establishment of the bacterial and temperature standards seemed at the outset to inflict particular hardship upon the small producer of milk, and caused some uneasiness among those engaged in its sale.

The results of the examinations by the Boston Board of Health during the first year in which the regulation was in force showed that about 28 per cent. of the samples examined did not conform to the bacterial requirement, while a much larger proportion of them revealed higher temperatures than are permitted. The succeeding years showed a marked improvement, however, indicating clearly that inspection of this sort is of great value in the improvement of the general supply.

In attempting to meet the new requirements squarely and in a practical way, even at considerable expense, one of the firms selling milk in the city began, in 1905, a system of what may be called the "commercial" bacteriological inspection, to distinguish it from that officially made by the Board of Health, and because of the fact that it has been carried on in a systematic manner, and not by making an occasional laboratory test of a few samples. On the results of the bacteriological examinations has depended to a considerable extent the policy of the firm in its dealings with its producers, as will later be shown.

This systematic inspection has now been carried on for more than two years, and a brief account of the plan and a statement of the results obtained may be of some interest, for the firm has made an earnest attempt to bring the milk to such a condition that it will more than satisfy the regulation, and thus secure for the Boston market, at least in part, a pure, safe and in every way satisfactory quality of milk.

The firm concerned is not a large one, as compared with the leading companies; it controls, approximately, 200 farms, situated in a district within 40 miles of Boston. The milk is brought from the farms to two central collecting stations, where it is appropriately handled and bottled; and thence it is shipped to the city, where it reaches the consumer within twenty-four hours of production.

At the outset, the services of a trained bacteriologist from one of the professional schools of Boston were secured, and he was given free rein to devise and conduct in his own way a systematic scheme of bacteriological inspection and control of the contributing farms. The plan which was entered upon tentatively became the established system of inspection. It includes veterinary inspection of the cattle, sanitary inspection of the farms, and examination of samples of milk collected

by a trained man as the product is brought to the central collecting stations. The samples are examined bacteriologically by the plate method, to determine the number of bacteria; and microscopically to determine the leucocytes and to detect pathogenic or suspicious types of bacteria. It includes, moreover, instruction of all those engaged in the production or handling of milk as to its nature, as to the rapidity of its decomposition through bacterial action, and concerning the possibility and danger of infection with the exciting causes of human disease.

In the farm-inspection work every farm is visited; the barn, milk house and appliances for the cooling of the milk are examined; and hints and advice are given, wherever possible or necessary, as to the best methods of securing the proper handling of milk. The reasons for the inspection work are explained carefully to the farmer, and his methods and appliances are criticised or approved, as occasion demands. In other words, an attempt has been made to carry out a thorough, intelligent, sympathetic but rigid inspection and supervision of the farms. The information thus derived from this source supplements that obtained by direct examination of the milk itself.

For the veterinary inspection, a trained man, a graduate of the Harvard Veterinary School, is employed, who makes frequent examinations of the cattle, looking for evidence of tuberculosis or other diseases, and notes the condition of general cleanliness of the barns. Any criticism of conditions on the farms is made to the farmer directly by one of the inspectors, either the bacteriologist or the veterinarian, and not through the office of the firm, as it seems most desirable that no restriction shall be placed upon the work of the inspectors, and that they alone shall judge as to the character and desirability of retaining the individual farms on the list of contributing sources. This inspection of the farms and barns takes place frequently, and without warning to the farmer.

The bacteriological examination of the samples of milk from the different farms has been and is carried out according to the methods employed by the Boston Board of Health, so that the results of the "commercial" inspection and of the "official" city inspection are comparable. Milk from each of the farms has been examined, on an average, twice or three times each month, about 9,000 samples having been examined during the first two years of the work. The samples are collected by a bacteriologist as they are brought from the farm to the central stations, and the temperature of the milk is carefully noted. As soon as possible after collection, the samples, carefully iced, are taken to the laboratory and plated upon the standard culture media; and the numbers. of bacteria per cubic centimeter of milk are ascertained after the proper period of incubation. As no regular order of collection is maintained.

there is no opportunity for a farmer to be especially careful on the day his milk is sampled, for his may be selected for examination on any day or on any number of successive days. The microscopical examination of the milk, in which process the standard method is employed, and the bacterial count, are performed at the same time.

An arbitrary method of grading the milk according to the number of bacteria was adopted early, and has been found very satisfactory for inspection purposes. Six grades of milk are recognized:

Grade A, containing not more than 10,000 bacteria per cubic centimeter;

Grade B, ranging from 10,000 to 50,000 bacteria;

Grade C, ranging from 50,000 to 100,000;

Grade D, ranging from 100,000 to 250,000;

Grade E, ranging from 250,000 to 500,000;

Grade F, containing more than 500,000 bacteria, or milk which unmixed cannot legally be sold in Boston.

The percentages of the total number of samples examined for each month during the two years are graphically represented upon the accompanying chart. It will be noted especially that there has been a great falling off in the number of illegal samples, i.e., those exceeding 500,000 bacteria per cubic centimeter; and a corresponding decided increase in the percentage of the samples of the higher grades, especially of A and B. It has been possible by this system of grading to separate the whole number of farms into groups, and to eliminate from the "bottle" milk that coming from the poorer farms. Any farmer who sends milk containing more than 500,000 bacteria per cubic centimeter at once receives a warning, in the form of a card sent directly by the inspector, a copy of which is reproduced below:

Owing to the regulations of the board of health the company is liable to fine if it sells milk containing more than 500,000 bacteria per c.c. A large majority of the dairies are sending milk which meets this requirement. The temperature must be kept low if these results are to be attained. Examination of milk from your farm on showed bacteria to

The company will be forced to exclude milk from your farm unless improvement takes place at once.

Cleanliness and greater care in handling and cooling the milk will probably remove the difficulty.

Repeated offence in this direction, or failure to produce satisfactory milk after two or three warnings have been given, results in the exclu