Public Document No. 34 Cf)e Commontoealtfr of ®®a$mib\xmt8 ANNUAL REPORT DEPAfiTMENT OF PUBLIC HEALTH Year ended November 30, 1925 Publication of this Document approved bt the Commission on Administration and Finance 1200 7-26 Order 5793 CONTENTS. Report of the Public Health Council Report of the Commissioner of Public Health Dr. Eugene R. Kelley .... Disease Prevalence .... The Ten-Year Juvenile Tuberculosis Program The Tuberculosis Sanatoria . New Tuberculosis Legislation Boards of Health and Physicians . Antitoxin and Vaccine Laboratory The Health of the Child Sanitary Problems .... Transfer of Board of Examiners of Plumbers Changes in Personnel .... New Legislation ..... Appropriations and Expenditures for the year ended November 30, 1925 Special Appropriations and Expenditures for the year ended November 30, 1925 Expenditures from Balances of Special Appropriations of Previous Years Expenditures of Tuberculosis Sanatoria for the year ended November 30, 1925 Report of Division of Sanitary Engineering Oversight and Care of Inland Waters The Sanitary Protection of Water Supplies Examination of Public Water Supplies Analyses of the Water of Public Water Supplies Consumption of Water .... Rainfall ....... Flow of Streams ...... Examination of Rivers .... Examination of Sewage Disposal Works Examination of Sewer Outlets Discharging into the Sea Sewerage and Sewage Disposal for the Cities of Salem, Beverly and Peabody and the Town of Danvers and for Certain Public Institutions Sewage Disposal of the City of Lynn Sewage Disposal of the City of Gloucester Water Supply of Lawrence and Methuen Shellfish Investigation . Sanitary Condition of the Aberjona River Improvement of Spy Pond in the Town of Arlington Disposal of Garbage and Refuse Condition of Stony Brook, Boston Water Supply of State Sanatoria Neponset River Improvement Nuisances from Noisome Trades Report of Division of Water and Sewage Laboratories Iodine in Massachusetts Water Supplies Examination of Shellfish ..... Water Purification ...... Lawrence City Filters ...... Treatment of Sewage ...... Studies of the Oxygen Consumed Test . Report of Division of Food and Drugs Summary of Prosecutions ... Variation in Samples of Liquor submitted by Police Departments Bakeries Cold Storage Slaughtering Arsphenamine List of Prosecutions Summary of Liquor Samples examined during 1925 Summary of Milk Analyses for the year 1925 Composition of Average Milk not declared Adulterated Summary of Food Analyses for the year 1925 Summary of Drug Analyses for the year 1925 Cold Storage Statistics ..... Report of Division of Communicable Diseases . Outline ........ General Remarks ...... Changes in Personnel ...... Activities of District Health Officers Regulations for Reporting Venereal Diseases Changed Diagnostic Laboratory ..... Outbreaks Traced to External Agencies ; Special Remarks on Certain Communicable Diseases Distribution of Arsphenamine, Sulpharsphenamine and Bichloridol, by Years Cases and Deaths from Certain Communicable Diseases in Massachusetts from 1920 to 1925 Cases and Deaths, with Case and Death Rates per 100,000 Population for All Reportable D during the year 1925 ........... Cases and Deaths from Communicable Diseases by Months, 1925 .... Cases and Deaths from Diseases Dangerous to the Public Health, 1925 ii CONTENTS PAGE - 98 Report of Division of Biologic Laboratories . Antitoxin and Vaccine Laboratory ........... 98 Distribution of Products ............. 98 Expenses ............... 98 Stocks on Hand .............. 99 Improvements .............. 99 °» Personnel . • • • • • • 99 Educational Activities . Inspection by U. S. Public Health Service . 100 , Wassermann Laboratory ............. 100 102 Report of Division of Hygiene . • • • Maternal and Infant Hygiene ............ 102 School Hygiene • 103 Nutrition 104 Mouth Hygiene 105 105 Health Education , Activities against Cancer and Other Diseases of Middle Life ....... 107 Report of Division of Tuberculosis ............ 108 Sanatoria ..........•••• 108 Hospitalization of Children ............. 108 Non-Pulmonary Tuberculosis ............ 109 Hospitalization of the Adult ............ 109 Dispensaries . • • • • ' Tuberculosis ?> * Consultation Clinics . • • • * „ The Ten-Year Program 110 Subsidy Ill Recommendations ............... HI 112 Lakeville State Sanatorium . • • • 119 North Reading State Sanatorium . 125 Rutland State Sanatorium . Westfield State Sanatorium ............. 132 Report of the State Examiners of Plumbers 140 Index I 42 MASSACHUSETTS STATISTICS FOR 1925. Estimated population 4,158,103 Death rate per 1,000 population 12.5 Infant Mortality 73.1 per 1,000 live births Cf)e Commontoeaitf) of Q&azwtbumtg Department of Public Health, State House, Boston, January 20, 1926. To the General Court of Massachusetts. In accordance with the provisions of Section 32 of Chapter 30 of the General Laws, I have the honor to submit herewith the annual report of the Department of Public Health for the year ended November 30, 1925. Respectfully, GEORGE H. BIGELOW, M.D., Commissioner of Public Health. ELEVENTH ANNUAL REPORT OF THE Department of Public Health of Massachusetts REPORT OF THE PUBLIC HEALTH COUNCIL. At the end of the fiscal year closing November 30, 1925, the State Department of Public Health was constituted as follows: Commissioner of Public Health .... George H. Bigelow, M.D. Public Health Council. George H. Bigelow, M.D., Chairman. Richard P. Strong, M.D., 1926. Warren C. Jewett, 1925. 1 James L. Tighe, B.A.Sc, C.E., 1926. Sylvester E. Ryan, M.D., 1928. Roger I. Lee, M.D., 1927. Francis H. Lally, M.D., 1927. During the year fifteen formal meetings of the Department were held, as well as meetings of standing committees and special boards. The standing committees cf the Council are as follows: Sanitary Engineering (including Housing and Rural Hygiene). Mr. Tighe, Dr. Bigelow and Mr. Jewett (deceased) Preventive Medicine and Hygiene. Drs. Lee, Bigelow, Lally, Ryan and Strong. Food and Drugs. Drs. Lally and Ryan and Mr. Jewett (deceased). Laboratory Work and Research. Drs. Strong and Bigelow and Mr. Tighe. Publications. Drs. Lally and Ryan and Mr. Tighe. In accordance with its usual custom, the Committee on Sanitary Engineering has met regularly prior to the meeting of the Public Health Council and considered in detail all matters coming before the Department having to do with water supplies, sewage disposal and sanitation generally, subsequently submitting recommenda- tions thereon to the Public Health Council. As provided by statute the Public Health Council has held hearings on plans for water supplies, sewage disposal systems and contracts pertaining to the use of county tuberculosis hospitals, has considered and approved appointments sub- mitted to it by the Commissioner as required by law, and has discharged other miscellaneous statutory duties. From time to time the Commissioner has also submitted to the Council for its consideration and advice proposed developments in policy and extensions of ac- tivity in the various fields of public health effort with which the Department concerns itself, especially in the control of tuberculosis and venereal disease, in maternal and infant hygiene, and in the new field of health education. Under Chapter 28 of the Resolves of 1925 the Public Health Council and the Commissioner have served as a Joint Board with the Lawrence Committee on New Water Supply and the Methuen Water Commissioners to extend a study begun in 1924 under Chapter 61 of the Resolves of 1924. A report based on this study will be submitted in January. In accordance with the second paragraph of Chapter 16 of the Resolves of 1925 the Department studied matters relating to the pollution of the Aberjona River and legislation thereon, and has made its report. Under Chapter 19 of the Resolves of 1925 the Department has studied the problem of correcting objectionable conditions arising from Spy Pond in Arlington and has so reported. In accordance with Chapter 23 of the Resolves of 1925, methods of garbage disposal have been studied by the Department and report has been made to the Legislature, which will be published as a separate document. 1 Deceased November 28, 1925. v\ 2 1^*2, b P.D. 34. Under authority contained in Chapter 300 of the Acts of 1925 a study of con- ditions existing in the shellfish industry has been made and a report will be made to the Legislature containing recommendations in regard to further legislation on this matter. Under Chapter 20 of the Resolves of 1925 this Department and the Department of Public Welfare have studied the cancer situation in Massachusetts and made a report thereon which will be printed as a separate document. At a meeting of the Public Health Council on January 18, 1926, the Commis- sioner of Public Health presented to the Council a report of the activities of the Department for the fiscal year 1925, and it was voted that this report, together with the foregoing brief summary of the doings of the Public Health Council, be approved and adopted as the report of the State Department of Public Health for the year 1925. ELEVENTH ANNUAL REPORT OF THE COMMISSIONER OF PUBLIC HEALTH. To the Public Health Council: Gentlemen: — I have the honor to submit herewith my annual report for the fiscal year ending November 30, 1925. Dr. Eugene R. Kellet. The sudden tragic death of the Commissioner, Dr. Eugene R. Kelley, has pro- foundly affected the Department. The extent of his loss has even yet not been fully realized. The accomplishments and plans presented in this report should,