No special diseases prevailing at present outside the above. Diagnosis verified by the three oldest physicians of the town, Dr. Ellison, Dr. Frank Buck, Dr. E. H. Asher and myself. 'Number of cases, six (6); began about a month ago; type, "Discrete;" precaution, have already isolated and quarantined. Issued orders because I did not hear from you to the contrary.

12-INSPECTION AT BIRDSBORO, BERKS COUNTY.

By W. H. BOARDMAN, Engineer Inspector, on account of Pollution of Public Water Supply.

PHILADELPHIA, July 20, 1892.

To the Secretary of the State Board of Health:

SIR: I have the honor to report that I visited Birdsboro on July 20, 1892, and found the following conditions to exist:

The supply of water, which I found to be at present much better than it has been for some time, is obtained from several small streams formed by the numerous springs on the hillsides and impounded in a large reservoir formed by an earthen dam built across the ravine.

The dam is excellently located and well designed; the reservoir thus formed affords an abundant supply of water by gravity to the inhabitants of Birdsboro and the adjacent towns.

The nuisance complained of is caused by a large number of old stumps, roots, muck and other debris in the bottom of the reservoir, and by the building of a brick wall laid in cement mortar across the spillway. The safety of the dam has been much endangered, and the water forced out of its original limits back into the surrounding woods; also the absence of a fence around the reservoir allows cattle to contaminate the water. In order to protect the water from pollution and the dam from serious damage I recommend:

That the brick wall and all other obstacles in the spillway be entirely removed so that nothing will prevent the waste water from escaping without overflowing the breast of the dam.

All the land that is covered by water when the dam is full should be entirely cleared of all stumps, roots, sods or other perishable material, the same to be either burned or removed to a point below the dam.

That in connection with the present supply pipe a branch pipe be provided extending upward to a height of about five feet above the present pipe and inside the screen chamber, this pipe to be used as the regular supply pipe, the present pipe to be used only when the water is below the top of the other pipe, or when it is desired to draw off the water from the dam.

A good substantial fence should be built entirely around the reservoir.

The fire hydrants on all dead ends of the distribution pipes should be opened frequently to clean out the pipes.

It is also recommended that an engineer experienced in this kind of work be employed to supervise the repairs to the dam, as such work must be very carefully done, and the work should be performed only by experienced men.

If this reservoir is properly cared for there is no doubt that the inhabitants of Birdsboro will obtain a bountiful supply of good, wholesome water, as I have examined the water-shed and found no source of pollution.

13.-INSPECTION AT NORWOOD, DELAWARE COUNTY.

By WILLIAM B. ATKINSON, Medical Inspector, on account of complaint of drain age standing in gutter.

To the Secretary of the State Board of Health:

August 10, 1892.

SIR: I have the honor to report that I visited Norwood, on this day, and found the following conditions to exist: The entire drainage of one or more houses flows into the road gutter, and as there is no means of exit, it remains and stagnates in front of the door of the complainant. These people have provided for the drainage from their own premises by means of a sewer pipe running beneath their premises to a rear street, thence into the road gutter. As their premises are located at a distance from the next cross street any gutter continued from their house on the road would require a further expense to carry the drainage into the cross roads on property known as a public park. Therefore they claim that the houses from which the drainage issues should be provided with a pipe on the premises similar to that on their own. This can easily be laid and will obviate all cause of complaint. This is the only proper plan which should be adopted, and I would recommend that this be urged upon the owner of the property in fault.

14. INSPECTION AT CHADD'S FORD, ETC.

By Wм. B. ATKINSON, Medical Inspector, on account of Diphtheria in a malig

nant form.

To the Secretary of the State Board of Health:

August 5, 1892.

SIR: I have the honor to report that I visited Chadd's Ford on August 5, and found the following conditions to exist:

The population of this town is about one hundred and fifty. It has no organization. It is located on a flat piece of ground with a substra

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tratum of clay. This is say three feet below the arable soil, and extends about six to eight feet to a porous water bearing gravel. All the drainage is on the surface save in one instance. The water supply is abundant but in many cases it has been decided to be non-potable. At least two householders, one the hotel have provided good water from an artesian well with a windmill to pump it into the reservoir. There has been very little sickness until June 26, when a child of Dr. Heyward was attacked with diphtheria and died in four days. An interval of eighteen days occurred, and a third case occurred at a short distance and to the rear of the others. Death ensued in about four days. On the 2d of July a child of the next neighbor was attacked and died in four days. On July 29 the fourth case occurred and died suddenly when apparently convalescent on the 3d of August. Two other cases of mild sore throat occurred and during my visit I saw a colored woman with an ulcerated throat. The first three cases were children under ten years, all appeared malignant from the outset. The fourth was a man about twenty-five years. His death appeared due to the passage of detached tissue into the air passage, producing asphyxia almost immediately. The circulation continued for an appreciable time after breathing had ceased. After a very careful inspection of the infected houses, I found that every precaution had been taken to disinfect the premises, the other children were removed, and efforts made to prevent further attacks. A singular feature that but one in a household with a number of others only should be attacked and in such a malignant form.

The drainage is poor owing to the flat condition of the surface, and the water has been condemned in several instances. As one house connects its cess pool, etc., with an abandoned well, it is extremely probable that this pollutes all the underlying water basin, this rising after a heavy rainfall in at least two houses, comes into the cellar, and it is reasonable to believe that the air of these places is rendered dangerous. I found a large collection of recent oyster shells which had been allowed to putrefy in the hot sun.

Every one who met me expressed a willingness to do what they could to prevent a continuance of the disease.

The remedy is that all drains be frequently flushed and kept in good condition. The oyster shells to be removed. This was promised me by the owner of the place. The cellars to be made tight and where any evidence of a leak is shown, that must be stopped. The connection of the hotel with the old well must be removed.

With these precautions, I think there will not be any more cases of the disease, and perhaps a typhoid epidemic may also be prevented. After the abandonment of the water pollution, every one, particularly those near to the hotel, should pump out their wells thoroughly in order to secure pure water.

I enclose a map furnished me by Dr. Johns.

15.-INSPECTION AT NORRISTOWN, MONTGOMERY COUNTY.

By W. B. ATKINSON, M. D., Medical Inspector.

PHILADELPHIA, August 3, 1892.

Subjects of complaint.-An establishment for boiling refuse, fat, grinding bones, etc.

2. Condition of fish market belonging to the borough.

3. Condition of bridge belonging to the borough.

4. Collection of drainage on an unopened street.

In the case of the boiling establishment of J. S. Long, on visiting the stores and residences on Main street to the north of this place, each person assured me that when in full operation, and the wind in the direction, the odor was such as to sicken everyone, to compel the closing of windows, and in short to cause all who could get out of the range of the smell to do so quickly. I was promised a list of the names of those so annoyed, but I may mention the proprietor of the Hartranft House on Main street, Dr. Eisenberg, whose office is adjoining; an ice cream saloon, etc. All assured me of the sickening odor and a loss of business owing to the unwillingness of customers to encounter this horrible stench.

I went to the place and found that owing to an accident to the boiler the works were just starting up. Mr. Long acknowledged that as he had not expected a visitor, his place was not as clean as he would have had it. There was a quantity of rotten fat in the press which was full of maggots and giving forth a horrible stench. When in full blast it is impossible for such a place to be otherwise than highly objectionable, and although the proprietor was using the best kind of boilers, yet he cannot prevent the odor from escaping in every direction. Such a place should not be permitted in the built up portion of any inhabited place. I would recommend its removal.

2. The fish market is about as well kept as such places can be. It should have been located at the other end of the market for convenience

of pouring the drainage directly into the sewer. Where it is requires all the foul matter to flow the whole length of the street to reach the inlet. The lower wood work is rotten, the foul drainage soaks into the places beneath and there continues to putrify and add to the nuisance.

The remedy is to remove the fish market to the other end, or to build the sewer up to reach it. If the latter, the old rotten wood must be torn away, the places beneath disinfected and the nuisance will be relieved for a time.

3. The bridge is filthy. It is covered, and boarded in, so that the wind and rain cannot act to aid in keeping it clean. I was informed that no sprinkling is done when it is swept, what dirt (largely drop

pings of horses) is gathered, is placed in open barrels on each side of the driveway, and there it remains weeks at a time. I saw at least 50 full barrels, with many others part full. Beneath the walk in the center the sweeping appears to be done very imperfectly. Every ledge and crevice is loaded with this dirt, to be blown about by what air passes through, and all who use the bridge must take with them a liberal supply in their lungs, clothes, etc.

The remedy is thorough and frequent cleansing, first sprinkling the place, then the immediate removal of the sweepings.

It would aid greatly in keeping this bridge clean if the roof and sidings were removed, leaving the bridge itself free to the rain and winds. 4. Drainage on the unopened street, while not much of a nuisance yet, must accumulate and form a foul place, and if more houses are erected in its neighborhood will become a disease breeder.

The remedy is to require a drain to be carried through to permit the flow to pass off.

In conclusion, I would urge that the above remedies be applied. The first, by the owner of the boiling establishment. In the other two instances, the borough itself is the party to act. In the last, unless the street is opened the parties on each side should join in making the drain.

16.—INSPECTION AT TRAINER, DELAWARE COUNTY.

By WM. B. ATKINSON, M. D., Medical Inspector, on account of epidemic of Diphtheria.

To the Secretary of the State Board of Health:

August 20, 1892.

SIR: I have the honor to report that I visited Trainer, Delaware county, on August 17 and found the following conditions to exist:

The population of Trainer is about 900. The people are largely employed in the ticking mills, and are located in houses owned by the Trainer Company. The place has no government other than a township. The drainage is almost wholly on the surface. The water supply is abundant and of good quality. Diphtheria began here in March, when one child died. No other cases occurred till July; since then it has prevailed with great mortality-some fifteen cases with ten deathsas follows:

1. McFadden, March 5, on the Main street east of the railroad; only child died.