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14
an old Middlesex Hospital man and at one time in practice in Queen Anne Street—
who deals with venereal disease, and a third who devotes his whole time to
tuberculosis, visiting the various State sanatoria.
The State in connection with infectious disease provides a laboratory at which
specimens are examined free of charge for diphtheria, malaria, etc. At another
laboratory, diphtheria antitoxin, vaccine against smallpox, and other materials of
this class are manufactured and supplied to the various authorities throughout the
State.
In regard to the work done in the department the only thing that really calls
for mention is that in connection with tuberculosis. This, as a matter of fact,
appeared to me to be the only one in which any particular activity was being shown,
the officer in charge being exceedingly energetic and enthusiastic, and the legislature
apparently less unwilling to spend money on this than on any other work. For
the reason that on at least three out of the ten days devoted to the State Board
we were sent to inspect State sanatoria we were able to form some sort of idea
of what was being done in this direction. One of these institutions (Essex County
Sanatorium) is by far the most magnificent I have seen, no expense whatever having
been spared in connection with its construction and equipment. Intended for 200
patients but at the time of our visit accommodating only 120, it cost 1,600,000
dollars, which works out at something like £1,800 per bed. Another most useful
sanatorium is that provided exclusively for children, where most excellent work
is being done. As a matter of fact, the question of tuberculosis in childhood is
one to which the Board, at the instigation of the tuberculosis officer, Dr. Remick,
is devoting much attention, and he is receiving every encouragement to seek out
all school children who are under weight, to have them examined for signs of
tuberculosis, and to have all such as appear to be the subject of or seriously
threatened with the disease put under treatment. In the experience of Dr. Remick
some 10 per cent. of children examined have been under weight and of this number
2 per cent. are in need of treatment. For the benefit of the remainder there is
attached to the staff an "expert on nutrition" or "dietician" (in the States specialization
is carried to great lengths) who tries to get into touch with the parents and to
give advice as to food and feeding by means of talks, leaflets, and so on.
Amongst other things visited were the metropolitan waterworks, which are
under the State, and the experimental station at Lawrence, some few miles out of
Boston. Much of the great reputation enjoyed by Massachusetts, so far as health
matters are concerned, has been built up on the work of the engineering department
of the Board, and all the members of the staff I met struck me as men of a very
high grade. Some of the works I saw, e.g., the Wachusett Dam, though I do not
pretend to be a judge, were stupendous and may safely be described as remarkable
engineering feats. The experimental station at Lawrence, known to water and
sewerage engineers all over the world on account of the researches and discoveries
made there in connection with sewage disposal, has been rather adversely affected
by the economy wave and presents rather the appearance of a place whose glory has
departed.
NEW BEDFORD (MASSACHUSETTS).
Having finished the programme of the State Board of Health, which, as
explained, consisted almost exclusively of tuberculosis and engineering, we left for
New Bedford, which had been chosen as the place in which the public health
administrative methods in a small town might be studied.
This city, with a population of 130,000, was formerly a great whaling centre,
but is now almost entirely industrial, its cotton mills providing employment for
thousands. The mixture of races in New Bedford is extraordinary, there being in
addition to many English—from Lancashire mainly—a great number of Portuguese
and French Canadians.