inflammations and organic destruction. These are the conclusions that cannot be avoided. Beyond a doubt, unsanitary water is one important cause of the "chronic invalidism" in New England. Then, again, it needs but little argument to prove that the prolonged use of such water does produce actual disease,-active, acute disease. Perhaps this can not be mathematically demonstrated, yet circumstantial evidence is not wanting to prove it beyond a doubt. Our board of health reports are filled with cases confirming this opinion. There is a large class of diseased conditions best represented by diphtheria and erysipelas (which, in my opinion, are one and the same disease in all essential particulars). They are characterized by diffused inflammations, purulent formations, and finally septic poisoning. Unsanitary water

is not the only, but one of the causes of these diseases. But all these causes operate upon precisely the same general principles, and physicians endeavor to cure them by exactly the same remedies. It is also held with good reason that scrofulous and tubercular diseases are originated, or certainly rendered more intense, or run their course more rapidly, from this cause. Then, again, the most important particular of this matter is the fact that the water of our wells may become infected with the germs of diseases, such as typhoid fever, diphtheria, anthrax, and perhaps some other diseases, and then, when used for drinking, will communicate the parent disease to those drinking the water. Thus these diseases may go on repeating themselves indefinitely. Typhoid fever is thus propagated beyond a doubt. The epidemic at Plymouth, Penn., is a most striking and indisputable instance. The same does occur repeatedly in New Hampshire year after year. No well-informed person will deny the possibility, nor the probability, nor even the common occurrence of such a communication of typhoid fever. Now, then, this fact being granted, we must admit that the possibilities of unsanitary wells are immense, and that there is no excuse for the ignorance, and no pardon for the crime, that permits the neglect of proper and sufficient sanitary measures to prevent the increase of such diseases.

During the last three years there have been in this state 497 deaths from typhoid fever, and 358 from diphtheria, making in all 855 deaths from preventable diseases. But more yet; if we

estimate in the usual ratio, there have been in the same time not less than 10,000 cases of painful diseases that could have been prevented by means already within human knowledge.

The cost of these diseases in cash actually paid on account of physicians, nurses, and other help must be fully $50,000; and the loss by death would amount to nearly $1,000,000 for the three years. Probably there is a yearly loss to the state and to individuals of at least $50,000 per year on account of diseases that could be prevented by proper sanitary precautions, and a great part of this should apply to our water supply. This cost, according to excellent authorities, might be avoided to a degree. To accomplish this, demands the services of the keenest intellects, almost superhuman perseverance and energy, and perhaps most radical means and measures. But why not employ them? Had there been 8,550 cases of small-pox with 855 deaths during the last three years in the state, there would have been a vigilance mittee in every county, a smoke-house in every village, and a line of soldiers extending from the Atlantic to the Pacific. Why not do as much for the arrest of diphtheria and typhoid fever? There are as many facts to justify such action in the one case the other.

the state.

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Now one line of such action is in the direction of our wells. When public opinion is more fully informed upon this matter all old wells near dwelling and out houses will be abandoned and no new ones dug, excepting in suitable and sanitary locations; and these must be protected by the most perfect sanitary precautions. Another necessity is the chemical examination of every well in There is as much reason for this as for posting senti nels on our borders to repel small-pox. Eight hundred preventable deaths and ten thousand preventable cases of disease demand this, or we must abandon our belief in the preventability of these diseases. Of course public opinion is not up to that point of action; yet it is time to advocate such action. This is correct if the prevailing idea of preventability. of certain diseases

correct.

is

Finally, suppose we had no proof that any specific diseases were caused by the so-called unsanitary waters, there is sufficient reason for their being abandoned on account of their well-known

condition and surroundings. When we remember that the body is only a mass of delicate cells, and that every function is but the growth, life, and destruction of these cells; and when we know that these cells are composed of the most delicate membrane, and that all life is but the passage of fluids in this membrane; and when we also know that all this is directed and controlled by a certain force called vitality, and more yet, that this very vital force depends upon proper cell action, and then when we comprehend that all this vital action could not go on for one moment only that water renders it a possibility, then, I say, we can partially understand the absolute necessity of a water supply of a standard sanitary purity to a creature perfect in body and mind. It is perfectly certain that in the beginning God created water of this standard purity. If so, what must be the result when this fluid is allowed to fall below this standard purity? There can be but one general result, and that is confusion of mind and destruction of body. And who shall dare to say that the soul's salvation may not in some degree depend upon the sanitary purity of this all important fluid?

SCHOOLHOUSES OF MERRIMACK COUNTY.*

BY IRVING

BOARD
A. WATSON, M. D., SECRETARY STATE

HEALTH.

OF

About one year ago the State Board of Health decided to investigate the sanitary conditions and surroundings of the schoolhouses of the state. In order to carry out this idea in the most practical way and to obtain the most reliable information at the least expense, a blank-book containing numerous questions bearing upon the subject was prepared. It was deemed best to carry out the work through the assistance of the teachers, as far as pos sible, chiefly because they, being in daily association with all the conditions, would have a superior knowledge of the situation, and could give an accurate report without feeling the weight responsibility that would naturally rest upon a member of the school board or upon the prudential committee. The questions were prepared with great care, and whenever necessary to exact understanding explanatory notes accompanied them. The blanks contained fifty questions, besides a page printed in small squares for the purpose of rendering it easy to draw a

an

good

of

plan of the buildings upon such a scale as the teacher might choose, and without rule or measurements. An illustration how the plan was to be drawn accompanied the page mentioned. The only questions requiring any labor on the part of the teacher beyond the ordinary answer, were those asking

the

length, breadth, and height of the schoolroom, size of glass, etc. The work was commenced by sending a letter to all the superintending school committees in the state, asking them to forward to

Read at the April meeting of the board.

the board, upon properly printed postal cards sent with the letters, the names of all the persons teaching in their respective towns, with number of district, post-office address, etc. Upon receipt of the names a copy of the blank-book above described was sent to each teacher, with a letter asking each to interest himself and to assist in the important work which the State Board of Health had inaugurated. The promptness, willingness, and courtesy with which the teachers responded cannot be too highly commended. Indeed, not a few expressed in strong terms their high appreciation of the importance of the work. In many towns the superintending school committees did a great deal toward completing the survey within their respective jurisdictions. It is to be said, with regret, that in a few instances no interest has been manifested in the attempt to improve the condition of either the schools or the houses. Happily such evident lack of interest has been the exception.

Reports have been received from about two thirds of the schoolhouses in the state, and it will probably take another year to complete the survey. From the reports already received, some fifteen hundred, we are able to gain a very general knowledge of the schoolhouses throughout the state. Not a few districts have houses unused for want of pupils; these houses are not included in the survey, for the reason just mentioned.

The work of examining and transferring these reports to blanks, that will show at a glance the sanitary conditions and situation, is so great that at this time only a small part of it has been completed. That some general knowledge of the existing state of our schoolhouses and their condition may be comprehended, we have taken all the schools of Merrimack county that have been reported up to the present time, one hundred and seventy-six. These reports, we are confident, will represent a fair average for other counties. The first and most important subject is that of

VENTILATION.

In the construction of a very large majority of our schoolhouses this vital consideration has been entirely ignored, in others a feeble attempt at ventilation has been made, but generally without any knowledge of the natural laws involved in the