APPENDIX C.

TO

ANNUAL REPORTS OF CITIES AND TOWNS.

1. Third Annual Report of the Board of Health of the City of Altoona. Mr. Charles W. Kephart.

2. Annual Report of the Health Officer of Erie. W. E. Allen, M. D.

3. Mortuary Tables. W. B. Atkinson, M. D., Philadelphia.

4. Report of the Health Department of Erie for the months of April, May, June, July, August, September, October and November, 1888. A. A. Woods, M. D. Health Officer.

I. THIRD ANNUAL REPORT OF THE BOARD OF HEALTH OF THE CITY OF ALTOONA.

DEPARTMENT of the Board of Health, ALTOONA, PA., January 24, 1888. To the Select and Common Councils of the City of Altoona, Pa.: GENTLEMEN: The third annual report of the board of health of the city of Altoona, for the year ending December 31, 1887, with suggestions relative to improving the sanitary condition of the city, is respectfully submitted herewith.

Pursuant to the election held by the city councils April 4, 1887, the following members of the board of health met at the mayor's office on the morning of April 5, 1887, namely: Dr. J. Wesley Allen, Mr. Frederick S. Ball, Dr. M. J. Buck and Dr. Charles B. Dudley, and Hon. Samuel J. Breth, who called the meeting to order.

The oath of office was administered by Hon. Samuel J. Breth. The members then proceeded to organize by the unanimous election of Hon. Samuel J. Breth as permanent president.

The election of a secretary was next in order, and Mr. Charles W. Kephart was unanimously elected to fill the position.

On May 4, 1887, the election of a health officer having been announced, it was resolved that the election be by ballot. The organization was then completed by the election of Mr. William McGough as health officer.

By resolution duly enacted, the health officer's salary was fixed at $50 per month, and also, it was resolved that the mayor be requested to appoint the health officer as a sanitary policeman, which was subsequently done.

Considerable time and study was given to the preparation of a code of rules for the government of the board and its officers, as well as for preserving the health of the city and for maintaining the records of marriages, births and deaths and interments. After being adopted, a copy of these rules, together with a copy of the act of Assembly approved May 30, 1887, authorizing the establishment of a board of health, a copy of city ordinance No. 173, passed September 8, 1887, relating to the government of the board of health and districting the city, and a copy of the city solicitor's opinion, dated September 26, 1887, upon the rules, were published in the Altoona city daily papers and printed in circular form and distributed throughout the city, a copy of all of which is herewith enclosed.

It will be observed that the rules on privy cleaning compel persons cleaning privies to take out a license therefor and to obtain a permit. for each privy cleaned, the amount charged for each. license being $25 and the amount charged for each permit being twenty-five cents, creating an income to the city, which for the next fiscal year is ap proximated at $200, as noted in a letter to your honorable bodies dated November 22, 1887. This amount may be increased considerably by fines imposed for the violation of any of the rules of this board, but to what extent we are, of course, unable to say.

During the year there were 401 nuisances abated upon verbal orders of the health officer and there were 11 which required the action of the board, all of which were abated with the exception of one, which was finally canceled; making a total of 411 nuisances abated. This number, compared with that of 1886, shows an increase of 144 nuisances abated, the total number of nuisances abated in the year 1886 being 267.

The following is a statement of the number of marriages which occurred within the city during the year 1887:

All of these people married were white.

The following number of births occurred within the city, according to our records, during the year 1887:

Of the above total number, 763 were white and 11 colored; 418 males, 352 females and 4 premature.

Owing to the failure of some of those, from whom information is required, to make returns of deaths and burials at which they were in attendance, the mortuary record is believed to be incomplete, the total number of deaths and burials being but 396, which we think falls about 80 short of the actual total number; but from the information at hand, the death rate is estimated at 17 per 1,000 for the year 1887, assuming that the total number is 476 and the population 28,000.

Owing to the change in the law governing cities like Altoona, the board was practically without any means of compelling obedience to its desires until the new rules were established in October. We take this opportunity of explaining that the board of health is now investigating this matter of non-compliance with its wishes, and as fast as the necessary information can be obtained, to convict the persons not complying with the rules and regulations in regard to reporting deaths and burials, suits will be instituted against them and the persons brought to justice.

The records show that during the year 1887, there were 115 cases of contagious diseases reported in the city. The number of cases of each disease which occurred per month is given below:

It should be stated that the premises on which a portion of these cases occurred required sanitary inspection, which inspection was performed immediately upon the receipt of the report, and all precautions taken against the spread of any disease.

A member of this board made chemical analyses of samples of the various waters supplying Altoona. which samples were taken about the middle of November, before the rains had any perceptible influence on the streams, so that the samples may be fairly supposed to represent the condition of these sources of supply in dry weather.

The water from Canan Station is fairly good, the amount of objectionable matter not being sufficient to cause serious anxiety; it is, however, poorer than any of the other samples mentioned below.

The water from Kittanning Point can fairly be regarded as a moderately healthy drinking water.

The water from Burgoon's Run is good in every respect. This is the station where some pumping was done by the Vigilant engine into the main pipe supplying the city from Kittanning Point.

In the water from Pottsgrove reservoir, the organic impurity is larger than was expected, although the danger limit is not passed.

Suggestions Relative to Improving the Sanitary Condition of the City.

Open Sewers. We desire to again bring before you, for early consideration and action, the matter of the open sewers running from the outlets of the covered sewers in the city, and which, in the opinion of this board, are dangerous to the lives and health of the citizens; this is especially so where the course of the open sewers is close to the public school house in the Fifth ward.

These open sewers have been inspected by members of this board at different times during the summer season and found to be in a very filthy condition, liable at any time to breed sickness and disease. There is a very urgent necessity that these open receptacles for a vast amount of filth, be so covered that no gases or offensive smells arise from them, and we would respectfully urge upon your honorable bodies, that you take such speedy action as will remove the danger mentioned before the heated term of the year 1888 comes upon us.

The best remedy to overcome the whole trouble, that we can recommend at this writing, is to have covered sewers put down as shown on the plan of the city sewerage system prepared by the Pennsylvania Railroad Company's officials and adopted by city councils some time since.

Sewer Traps. In regard to sewer traps, we would say that there is plenty of room for improvement, the traps being defective in many, if not all, the sewer inlets in the city. It is very important that these defects should be corrected, and your board would recommend that all the sewer inlet traps be put in proper shape as rapidly as possible. City's Sewage.-With regard to the disposal of the city's sewage, your board of health is unable as yet to recommend any definite method. The matter has been studied somewhat during the year, and correspondence had with the State Board of Health over the matter, but the difficulties connected with disposing of large amounts of sewage per day and rendering it practically unobjectionable are so great, as well as the knowledge on the subject available so small, that at present it is impossible to recommend to your honorable bodies any scheme.

It should be stated that experiments are being made on a large scale by the city of London, England, by the city of Worcester, Mass., and by the city of Providence, R. I., to demonstrate whether it is feasible to dispose of the sewage of large cities by means of precipita tion, and the precipitation scheme seems to be the the most feasible one now known. Your board hope to be able to recommend a definite scheme by the time the Fifth ward sewer is finished.

Material Removed from Sewer Inlets.-The material taken from the sewer inlets is not hauled away as promptly as it should be. The filth and dirt which accumulates in the gutters are washed into the inlets during the rains, and taken out and piled up at the side of the inlets and allowed to remain there for a long time; in some instances for weeks. The gases arising from this material is offensive and unhealthy, especially so in the hot season of the year. Your board would recommend that strict orders be given to those in charge of this work, that when an inlet is cleaned out the contents must be hauled away at the time the work is being done, or immediately afterwards on the same day.

Low Places in Alleys.-There are a number of alleys in the city which are not properly graded, being high at both ends and low towards the middle; after rains, these low places become pools of stagnant water and are receptacles for a vast amount of drainage from stables and adjoining properties. This board would suggest that the subject of grading all the alleys in the city be taken up, and the work on the grading be commenced as soon as possible.

Gutters. The earnest attention of your honorable bodies is respectfully called to the condition of the gutters.

This subject has received careful consideration, and it is the opinion of this board that the gutters, especially of the unsewered portion of the city, and the open sewers, are things which most seriously threaten the public health. As is well known, the gutters in many portions of