GEOGRAPHICAL DISTRIBUTION OP CONSUMPTION IN MASSACHUSETTS. The following pages from* the 24th Registration Report, now in course of publication, are respectfully forwarded to the “ Fellows of the Massachusetts Medical Society,” in the hope that additional information may thus be obtained upon an interesting subject. The undersigned, by whom they were prepared, will receive with many thanks any facts or professional opinions bearing upon the endemic or other causes of consumption which may be sent to his address. GEORGE DERBY, M. D. 102 Charles St., Boston, April 20, 1867. The Geographical Distributidn of Consumption has in previous years engaged the attention of the medical profession in Massachu- setts, and has been a subject of frequent discussion in these reports. In 1854, Dr. Henry I. Bowditch addressed inquiries to the members of the Massachusetts Medical Society in every town of the State, asking replies to a series of questions of a broad and general character, as to the prevalence of consumption in their vicinity, the influence of soil, of the weather, of exposure to the various winds, of elevation above the sea, of proximity to the sea, of occupation of the people, Ac., &c. The result of these inquiries was reported to the Massachusetts Medical Society in a very original and instructive communication in which the author presented evidence for his belief that moisture, and particularly soil moisture, was prominent among the causes of consumption in many localities, and that removal from such places to dry and elevated ground was a remedial and preventive measure of the highest importance. Subsequently, the late Dr. A. A. Gould, published in the State Registration Reports for 1861 and 1862, an analysis of the United States census for 1850 and 1860, showing very clearly the greater 2 prevalence of consumption in the Northern than in the Southern States, and a regular series of declining percentages, correspond- ing with the degrees of latitude, from New England to the Gulf of Mexico. The subject is one which may well engage the atten- tion of the people of Massachusetts, and if by continued investi- gation in these reports, additional light can be thrown upon the causes of this terrible destroyer of life, and means suggested by which it may be in any degree averted, time and labor will be well spent. • The last table, showing the greater prevalence of consumption in the seaboard than in the interior counties, is striking in its result, and yet inconclusive. If the inland counties were all distant from the sea, and the Atlantic counties all immediately exposed to its influence, it would prove much ; but this is not the case. The division is as good a one as could be made by counties, yet it is obvious that large portions of Bristol, Essex and Plymouth are not under sea influences, while populous portions of Norfolk and Middlesex really are. Moreover, we have reason to believe from Dr. Bowditch’s investigations that certain localities of very limited extent supply a morbific influence, whatever it may be, which determines disease and death. It therefore seemed neces- sary to make smaller divisions of territory the subject of statistical comparison ; the smaller the better, provided the period included was sufficient to furnish significant numbers. With this view we have prepared the following table exhibiting the mortality from consumption in each town of the State for ten years, 185G-65, taking the census of 1860 as a basis for the calculatio.ur'of percen- tages, and for the number living annually to one death by that disease. In presenting this table it seems proper to make certain statements, that all who refer to it may form their own estimate of its value, and of the possible errors it may include. 1st. It does not correspond with the official reports of deaths by consumption in the several years. The official report is 46,018 persons ; our tabulation, including the State Almshouses, 45,561 persons; making a difference of 452, or about one per cent, of the whole. This discrepancy we can only explain by the general statement that the results are drawn from a careful examination of about seven thousand pages of original manuscript returns from the clerks of towns. These returns are not always clearly written, the nomenclature of disease is imperfectly under- 3 stood by the writers, and deaths are often credited to two distinct affections. For these reasons it does not seem possible that any two persons tabulating these records could arrive at precisely the same result. Our own examination shows a number slightly less than the official report in every year, and in almost every county for every year. 2d. Allowance may be made for incorrect diagnosis on the part of physicians. It is exceedingly probable that many deaths of children reported from consumption would have been more properly placed under some other -heading. It is also probable that a certain number of cases reported as “ disease of lungs,” should have been called consumption. “ Disease of lungs ” is intended only to comprise such diseases of those organs as are not otherwise mentioned in the very full statistical nosology furnished to the towns. As, however, the whole number reported under this head in ten years was only 493, the error from this latter source cannot be very great. 3d. The correctness of the reports of town clerks may be questioned. We can say on this point that, although often not clearly written, they almost invariably show that they have been drawn up with much labor and care, and with a conscientious desire to give all the information in the writers’ power. This is frequently attested by explanatory notes. Deaths by Consumption in each Town, 1856-65. w M U n w to p ~i * p 3 p CO o 3 3 cr P Er CD •sj P 1 w o H o JT- cs s* 3 » p 3 CD g£ w CO (► ~ co !/! H > 0 # w c H O 3 • *zj CO 03 ro co ro k—* *05 'h-4 Population, 1860. ro 0< 05 CO to 09 05 CO ro o CO CO Deaths from all C5 h-* Oi ►£* to causes In ten o CO CO CO H-4 CD years. CO 05 —I CO o 05 Deaths from Con- h-A Oi >-* O CO h-4 ro >—4 CO CO h-» >—* sumption In ten Oi Oi h-4 to 05 CO to years. Percentage of to tO tO ro ro t—» to Deaths by Con- CO Oi ro o oo CO ro sumption to CO CO 05 cb Deaths from all causes in ten yrs. Average No. of 221 234 251 05 O o 199 382 458 persons living each 3-ear to one Death by Con- sumption. CO ro tO h-» CO Order of Mortal- o CO 05 GO to 4* CO CO CO co co 05 to * This column represents the order in which the towns appear with respect to mortality from Con* sumption, No. 1 being least, and No. 333 greatest. 4 Stockbridge, Sheffield, . Savoy, © 0! 0 & to' © 2- Richmond, . Pittsfield, . Peru, .... Otis, .... New Marlborough, New Ashford, Mount Washington, . Monterey, . Lenox, Lee, .... Lanesborough, . Hinsdale, . Hancock, . Great Barrington, Florida, Egremont, . Dalton, Clarksburg, Cheshire, . Becket, Alford, Berkshire. Adams, Yarmouth, . Wellfleet, . Truro, Sandwich, . Provincetown, . Barnstable—Con. Orleans, CITIES AND TOWNS. to to k—4 00 l—4 V—4 Hi I-4 I—4 CO k~» l—4 k—4 l—4 05 to to ►—4 Ok CO M >—» 05 CO Cl co © Hi CO -4 to co *4 -4 CO Cl 00 00 05 © to Hi Cl © © © © Cl Hi- to 05 Population, 1860. CO to o 00 k— CO CO 00 CO IO Cl ►—4 to o k-4 I—4 -4 4* -4 4- to © -4 Hi to Ci to 00 © •*4 05 h-4 kk* On Hi Cl co 00 to CO k-4 00 k-4 o © k-4 © h-4 Cl © CO © co © to Hi to to CO © 05 © l—4 l—4 Deaths from all 05 © k—4 to k—4 "rfi k—4 CO ►—4 to no l—4 to 05 k-4 l—4 l—4 to lo k£* CO CO © 05 © CO k—4 05 k-4 to Cl 05 to CO Hi co 05 © co 05 co 4- CO © C1 k—4 © l—4 Cl CO o o CO 4k co Cl •4 ►—4 CO to Cl Cl ►+- © •*4 C5 k—4 Cl C1 CO -4 Cl CO to 00 00 © © © © Hi. 05 © -4 years. Deaths from Con- to kA 4 to k—4 k—4 Cl CO 05 05 k—4 CO k—4 k~4 Hi l—4 Cl CO to 05 l—4 o I—4 to CO ►—4 to k-4 ■4 © Hi Cl to 00 -4 co o 00 to 05 k"4 -4 k-4 H* to © CO CO co © 05 05 *■4 Cl Hi -4 © © CO CO © *4 CO Hi CO years. Percentage of k-4 k—4 to V-4 k-4 to v-4 k—4 k—4 k—4 to l-4 k-4 to 1—4 h-4 k-i ►—4 k--4 ►—4 k—4 k-4 ■h-4 4-4 to k-4 k-4 k—4 to 05 00 k-* 00 CO Cl o o to co Hi CO H-4 © CO CO 05 05 © 00 •4 © to 05 CO Cl to Cl CO © © sumption to do ►—* CO 05 do cb 05 05 to cb oo Cl © Hi w 05 05 to -4 Hi 05 k-4 © 05 >£■ © Deaths from all causes in ten yrs. k—4 k-4 Average No. of CO to 05 Hi -4 05 Hi Cl >5*. Cl C5 co CO © Hi to © © Hi 4^ M © © 05 © to © to CO to to k—4 persons living -4 GO © 05 Cl 00 co CO © co © CO Cl 05 © © Cl C1 © © — CO Cl CO CO Ci 00 Hi to k-4 -4 to Cl Hi -4 C1 C1 © © to h-4 © 05 Cl © © C1 © to “4 to *4 -4 © *4 © CO © Death bv Con- sumption. to k-4 k—4 k—4 l—4 to • k—4 to k—4 k—4 to © Order of .Mortal- 00 IO no Cl ►—4 o Hi ►—4 k-4 05 CO to Hi oo 00 © © © U-4 to CO © ci © Cl CO k-4 h-4 o Cl >—4 00 05 CO CO 00 k—4 © Hi Hi © M -4 to © © © © •4 to © © Cl © © to © tty- 5 Tisbury, Edgartown, Dukes. Chilmark, . Westport, . Taunton, . Swanzey, . Somerset, . Seekonk, . Rehoboth, . Raynham, . Norton, New Bedford, Mansfield, . Freetown, . Fall River,. *J 2. ►5’ o- p a> P Easton, Dighton, . • Dartmouth, Berkley, Attleborough, Bristot, Acushnet,*. Windsor, . Williamstown, West Stockbrid Washington, Berkshire— Tyringham, o H Q g H • • □Q O * * 9 3 S5 • . • 3 CD I—4 to I—4 h-4 to to cn M h-4 to h-4 h-4 >—4 to to I—4 co CO k-4 CO 05 I—4 to l—4 *05 "h-4 C5 “co *M *05 “co '■- 00 © “co 00 *05 “cn CO Population, 1860. CO h-4 cn 05 CO CO 05 CO © h-4 to to H-4 05 CO 00 K) 05 GO CO GO CO H-* 00 rf* —i 05 © CO to to 05 00 © t—4 05 GO CO OS cn 05 —~t CO h-4 co GO © . to CO l—4 Deaths from all co to oo h-4 CO to CO CO to H-4 CO to cn cn to 05 t—4 co h-4 to k-4 k-4 causes in ten Cn 00 GO 00 Of CO —4 H—4 CO cn k-4 co 05 05 05 to 05 CO cn 05 to 05 to o CO Cn CO 05 GO to CO OO CO co -4 CO 00 GO © to 05 © © 05 CO -4 05 © years. Deaths from Con- h-4 05 CO l—4 i—4 l—4 k—4 sumption in ten Cn »—4 © © cn •<1 05 ~4 •—4 to to to to to CO to to CO l-4 to k-4 to i—4 to CO Order of Mortal- to to to CO 05 cn co ~4 05 o co CO 05 to -1 -t -t © ►F* f—4 M cn CO © ity. CO CO H-4 k—4 cn h-4 h-4 cn co -4 © h-4 co © ~4 © oo k-4 © © to co Cn to * Six years only, t Included Acushnet four years. 6 Topsfield, . Swampscott, South Danvers, . Saugus, Salisbury, . GO £L 5T B Rowley, Rock port, . North Andover,. Newburyport, Newbury, . Nahant, Middleton, . Methuen, . Marblehead, Manchester, Lynnfield, . f B ta Lawrence, . Ipswich, Haverhill, . . Hamilton, . Groveland, Gloucester,. Georgetown, Essex, Danvers, . Bradford, . Boxford, Beverly, Andover, . Essex. Amesbury, . CITIES AND TOWNS. ro k—4 k—4 k—4 k—4 05 ro CO IO k—4 co to CO k—4 to -4 k—4 CO “4 co © k—4 © to k—4 © k—* k—4 05 4* oo To Ci “ci o "co ro "io Io *co 44 CO CO "ci 05 05 00 © 05 CO CO •4 44 CO © ‘U* 05 © T-4 ‘co Population, 1860. CO wU to >—4 Ci -t CO 44 © <44 00 05 CO 05 oo CO © CO CO w* © -I © k—4 (» ro Ci © to © CO 4* © to GO -1 CO ►—4 44 © © 05 05 OO 05 CO © © Cl CO CP 44 Cl k—4 © 00 © 44 Cl •4 44 to k—4 CO 44 k—4 to h-4 Deaths from all r\3 ro CO 05 *ci to 05 CO T-4 to k—4 CO "ci co k—4 *ci T—4 Ot 4* k—4 to *05 CO CO CO to k—4 © CO 05 causes In ten o 4- Cl to 44 Cl 05 Cl 05 Cl CO © OO co Cl 00 to 44 CO 4- “4 4* to © ro -4 CO © Cl 4* 05 to to 05 to CO ►4* CO 44 k—4 oo © 4^ ro © 05 •4 05 ►f* CO to CO CO uo k—4 © CO 4-* 00 years. Deaths from Con- ro ►—4 CO k—* 44 k—4 to 00 GO k—4 CO 44 k—4 to to k—4 CO Cl ro 05 05 Cl 44 Cl •4 05 Cl k—4 © © -i oo Cl k—4 uo to o CO Cl CO Cl to Ci © CO sumption in ten ci CO to co © CO k—4 -4 00 05 05 44 Cl co to © © Cl Cl © oo CO to k—4 *4 05 Cl CO CO 05 ci years. Percentage of k—4 to to k-4 to to k—4 to to to to k—4 to k—4 to to to k—4 to to k—4 V-4 k—4 to k—4 to to to to to to Deaths by Con- -I © © GO 4^- >—4 05 CO ►—4 k—4 k—4 “4 © 05 oo k—4 © CO CO k—4 Cl CO -4 Cl oo 00 k-4 o © co to © sumption to M -4 4* 44 to 05 cc ►4- Cl to CO CO 4*. 44 h-4 © -4 do 05 44 oo to K-4 05 -4 CO -4 to do © Deaths from all causes in ten yrs. Average No. of CO to NO CO to to CO NO co to to © 05 to to to to to to ro to to CO to to to to CO CO to to to 05 no CO ro o CO © o CO Cl C1 ro 05 4^ oo ro k—4 05 «^4 o ro CO 05 o Cl CO 00 CO 00 Or ►-4 IO to 05 © © 00 © ■4 CO to CO CO CO 05 k—4 to CP k-4 GO CO k—4 *4 to OS k—4 Death bv Con- sumption. to k—4 >—* CO ro >—4 CO >—4 rc to to to to to cc co to to to k—4 to co k—4 to k—4 k—4 to to to Order of Mortal- 00 o CO CO to CO Cl to oo © Cl »—4 CO 4* oo © © k—4 ro Cl CO 05 CO o 00 4^ 05 o -4 CO k—4 Ci 00 Ol CO to © 05 co C1 to © © © 44 CD © 05 CO CO CP © oo © 44 CO © CO © to CO CP ity. 7 S3 G e S oia? 'c3 CITIES AND TOWNS. Population, 18 Deaths from causes in 1 years. Deaths from C( sumption in years. Percentage Deaths by C< sumption Deaths from causes in ten. Average No. persons liv each year to Death by Cc sumption. Order of Mort ity. Essex—Con. Wenham, . 1,105 170 59 34-7 187 331 West Newbury, . • 2,202 374 104 27-8 212 316 Franklin. Ashfield, 1,302 226 39 17-2 334 120 Bernardston, 968 165 32 19-4 802 178 Buckland, . 1,702 344 43 12-5 396 70 Charlemont, 1,075 174 33 18-9 326 130 Colrain, * 1,798 304 79 26- 228 304 Conway, 1,689 307 60 19-5 281 224 Deerfield, . 3,073 579 95 16-4 323 137 Erving, 527 102 17 16-6 310 160 Gill, . 683 108 22 204 310 161 Greenfield, 3,198 600 105 17-5 304 175 Hawley, 671 94 25 26-6 268 237 Heath, 661 111 14 12-6 472 37 Leverett, . 964 190 40 21-1 241 282 Leyden, 606 108 12 111 505 30 Monroe, 236 29 2 6-9 1,180 2 Montague, . 1,593 258 55 21-3 290 203 New Salem, 957 195 33 16-9 290 204 Northfield, . 1,712 300 85 28-3 201 327 Orange, 1,622 306 64 20-9 253 266 Rowe, 619 84 8 9-5 774 9 Shelburne, . 1,448 278 43 15'5 337 117 Shutesbury, 798 143 31 21-6 258 257 Sunderland, 839 163 30 18-4 280 225 Warwick, . 932 165 27 16-4 345 109 Wendell, . 704 113 19 16-8 371 83 Whately, . •• 1,057 204 42 20-6 252 267 Hampden. Agawam, . 1,698 280 52 18-6 326 131 Blandford, . 1,256 203 27 13-3 465 39 Brimfield, . 1,363 273 53 19-4 257 262 8 Middlefield, Huntington, Hatfield, Hadley, Greenwich, Granby, Goshen, Enfield, Easthampton, Cummington, Chesterfield, Belchertown, Hampshire. Amherst, . Wilbraham, West Springfield, Westfield, . Wales, Tolland, Springfield, South wick,. Russell, Palmer, Montgomery, Monson,* . Ludlow, Longmeadow, Holyoke, . Holland, Granville, . Chicopee, . Hampden—Con. Chester, CITIES AND TOWNS. k—4 k—* k—4 to k-* k-* k—4 to co to to © 04 k—4 4* 05 k—4 k—4 4* k—4 -4 k—4 to CO >—4 05 CO k^- o CO o on -r to o k—4 o 05 © k—4 k—4 05 © 05 k—4 k—4 05 CO 4* 05 to •© Population, 1860. kfc* k—4 CO o CO © 05 to >—4 CJO CO o o 00 o Of CO CO GO © CJO 05 -4 -4 CO I—4 (JO 05 k—4 oo o M Of CO CO Of 05 Of CO 05 k—4 Of © 05 CO © 04 to k—4 ►4- 4* © --4 © Of k—4 4* k—4 05 k—4 — Deaths from all, k—4 to V-4 k-4 to co k—4 k-A k£* Cl co 4* k—4 k—4 Of to k—4 4* 4* k—4 to -4 to Of k—4 co Of Of 05 05 05 on 05 05 Of Of 05 05 o k—4 © (X) o © 05 M k^> © -4 k^* © 05 05 C5 kf* k+* to n* CO 05 «-t os --4 oo 05 oo k—4 05 Of k—4 CO *4 © 4* Of 4» © k—4 to © k—4 to years. Deaths from Con- k—4 k—* k—4 04 k—4 k—4 © k—* CO 4*. CO to to k—* 05 co 4* o o © 4i CO 05 k—4 C5 05 © k—4 © © k—* © k—4 k—4 sumption in ten | 00 co -4 co oo Of 4* CO -4 05 k—4 k£* co CO CO CO Of 04 © © CO © © to © GO Of © © years. Percentage of k—4 to k—4 to k—* k—4 k—4 to to to to k—4 k—4 k—4 k—4 to k—4 k—4 k—4 to to to to k-4 k—4 k—4 to k—4 Deaths by Con- 00 k—4 GO o Of Of k—4 CO to to 00 4*- k—4 00 00 05 Of CO © k—‘ k—* CO Of © 05 © to sumption to ►£*■ © to 05 ~4 00 CO 4* K* © 4>- © -4 CO 04 Of 05 © k-^4 to k—4 © © to -^4 Deaths from all causes in ten yrs. Average No. of CO to to to 05 co to © to to NO 05 CO 4» to to co to to to 05 to 05 to to 4- © 05 to ~4 persons living 05 00 to Of 05 o k—4 CO o 05 o CO 05 Of © CO 05 CO © co C5 CO 05 to CO 05 05 o 00 Of 05 o 05 05 CO oo 05 CO oo 00 05 o n- Of -4 © -4 to 4* to © 05 04 to w- 05 © © Death bv Con- - sumption. to CO to k—4 05 k—* CO to k—4 to CO to k—4 05 to to to to Order of Mortal- Of 00 k—-* o —1 CO Of to CO k—• 05 05 ~4 Of 05 to © 05 co to oo CO OO © 4- to 05 CO k—4 05 © ~4 to o © co -4 ~4 oo -4 k—4 to 4* 4* OO © © to Of CO © to CO © CO CO to ity. * Almshouse not included. 9 t-* CD HH HH a e o o o o or o o- n p o p « c w W o W w o w ro > > Ui 3 < W o w o Plainfield, . IzJ O * 3 °2. o -3 ?r 3* o p a* o 3 o o 3 So 3. 3* fi3 3 3 3 X S' 2 JET p n. 3 3 o o •-* p- o 3 X/i o> •-1 a- p -i rT Ui o 3 J3 pi jr 3 cr EJ 03 pi _ 3* 03 O 3 05 o 3 X cr o -i o 3 03 p- ?r 2. 3* p 3 o 3 ■'* a- o5 p* sT 3 a. o' cr o => g 3 c R 3* 03 o p p* 3 03 cr 3 aq Ui p 3 o 3 •-J p c a4 S3 3 ►3 O 3 3 P- HH P £ aT C/3 ri o *t S3 S3 3 ’-5 P* P 3 O 3 HH > CO 3 3 g CD tz5 O 03 H 69 i O -Con. >ZS OD ro IO ro 4* 05 CO 4* ro ro Cl o CO k—4 k—4 V—4 IO 05 k—4 ro Ci "OD 05 “co lo U- no 'to lo © Oi o 05 'co 4- 4 00 bi "o b "o o bi lo Ci Ci «<4 Topulation, 1860. 4- 05 CO IO 00 GO CO o IO o O o o 4^ Cl CD IO 4- CD o CO -4 CO 4- 00 CO o CO 05 -4 -4 k—* Ci c» k—4 o o Cl CO Oi 00 CO 4- k—4 Ci • k—4 c« CO o k—4 CD CO CO Ci Cl • * Deaths from all 4* Ci CO ci Oi ro CO CO o k—* k-4 vU ro k—* k—4 CO to CO k—* CO k—4 co ro CO k—4 4H causes in ten IO IO CX) o CO oo CO CO to ci IO -I CO -I -i -i ►—4 Cl CO Cl Oi ro -1 CD -4 k—4 CD CO years. •“4 CO 4- CO CO CO k—* Oi oo CO to CO H-4 Oi o k—4 k—4 oc IO -4 © 4*- to 4* o Ci CO CD to o k—* Deaths from Con- H-4 k—4 b> CO »—* ro sumption in ten ►—4 oc IO k—* o CO o k—* k—* k—* Ci k—* Cl k-H ro 4n Cl kU CO Ci >—4 Oi 4^ Ci k—4 t—4 to Ci ►4- CO oo 4* -1 —t to to 4- ci Ci to (X) 4- o CO Ci GO k—4 CO o 4- CD CO o -t -4 Ci CD 3’ears. Percentage of k—4 IO IO IO ro H-4 to to k—* ro k—1 U-4 k—4 k—4 ro k—* h-4 k—4 k—4 ro k—4 k—4 k—4 k—4 ro k—4 k—4 ro i » to k—4 Deaths by Con- ►—4 IO o Ci CO >—4 ►—* o ►—* CO CO 4n © oo k—* Ci Cl k—4 ci CD 4^ Ci o 4- -I k—4 Ci Cl CO sumption to 05 05 CO 4 bi cb Cl cb CO o to CO Ci CI 43* Cl Cl Ci CD ro at k^-4 Cl to •^4 GO Deaths from all causes in ten yrs. Average No. of CO CO CO ro to ro CO CO Ci ro CO ro Cl 4n ro CO Oi 05 CO ro CO CO CO CO IO ro CO CO Co IO to persons living each vear to one (X» Cl CO uo o CO Ci GO o CO . GO Cl 4- IO to Cl 4- CO IO CO 14— Ci -1 CD c?i c« H— CO oo CO Ci CO to 05 oi Ci 4- Cl OI GC Cl Cl 4- 4^ 4* CD oo o 4* to o o o IO Death by Con- sumption. >-* IO ro ro k—* ro ro ro k—* k—4 CO k—4 CO ro k-4 ro Order of .Mortal- ci Ci (JO -1 d k—* CO 00 CO CO k—* o k—4 CO CO CD o co IO CD 00 oo Ci Ity. k—4 o< -4 oo oi Ci o -1 05 1-1 05 CO k—4 IO © o 4^ Ci Ci Ci 05 Ci CO CD 4-* to Ci ro 4- -4 GO * Seven years only. 10 CITIES AND TOWNS. j Population, 1860. Deaths from all causes In ten years. Deaths from Con- sumption in ten years. Percentage of i Deaths by Con- [ sumption to Deaths from all j causesln tenyrs. Average No. of persons living each year to one Death by Con- sumption. Order of Mortal- ity. Middlesex—Con. Lincoln, 718 104 14 13-4 513 28 Littleton, . 1,063 217 38 175 280 226 Lowell, 36,827 6,961 1,554 22-3 237 289 Malden, 5,865 867 156 17-1 398 67 Marlborough, 5,911 868 165 19- 357 95 Medford, . 4,842 712 172 24-2 282 223 Melrose, 2,532 400 63 15-7 402 63 Natick, 5,515 894 177 19-8 311 159 Newton, 8,382 980 193 19-7 434 50 North Reading, . 1,203 166 37 22-3 325 134 Pepperell, . 1,895 354 .86 243 220 810 Reading, . 2,662 471 98 20-8 272 232 Sherborn, . 1,129 136 26 19-1 434 51 Shirley, 1,468 251 36 14-3 00 o 58 Somerville, 8,025 1,396 270 19-3 297 192 South Reading, . 3,207 493 98 19-9 327 128 Stoneham, . 3,206 591 109 18-4 294 198 Stow, .... 1,641 264 52 19-7 315 152 Sudbury, . 1,691 251 49 19-5 ' 345 110 Tewksbury,* 1,744 157 33 21- 528 24 Townsend,. 2,005 450 71 15-8 P 220 Tyngsborougli, . 626 122 30 24-6 209 319 Waltham, . 6,397 1,148 205 17-8 312 158 Watertown, 3,270 528 98 18-5 334 1«1 Wayland, . 1,188 180 34 18-9 O CO 104 West Cambridge, 2,681 455 71 156 378 78 Westford, . 1,624 302 47 15-6 345 111 Weston, 1,243 141 16 11-3 777 8 Wilmington, 919 151 32 21-2 IO 00 -4 212 Winchester, 1,937 229 41 17-9 472 38 Woburn, . 6,2S7 1,171 206 17-6 305 174 * Almshouse not included. 11 CITIES AND TOWNS. Population, I860. Deaths from all causes in ten years. Deaths from Con- sumption in ten years. Percentage of Deaths by Con- sumption to Deaths from all causes in ten yrs. Average No. of persons living each year to one Death by Con- sumption. Order of Mortal- ity. Nantucket. Nantucket,. 6,094 1,153 225 19-5 271 235 Norfolk. Bellingham, 1,313 194 53 27-3 248 275 Braintree, . 3,468 550 112 20-3 309 162 Brookline, . 5,164 709 116 16-3 445 46 Canton, 3,242 631 96 15-2 337 118 Cohasset, . 1,953 351 58 16-5 336 119 Dedham, . 6,330 1,233 215 17-4 294 197 Dorchester, • . 9,769 1,639 284 17-3 344 113 Dover, 679 96 14 14-6 485 33 Foxborough, 2,879 401 69 17-2 417 54 Franklin, . 2,172 321 65 202 334 123 Medfield, . 1,082 15S 34 21-5 318 143 Medway, . 3,195 610 121 19-8 264 245 Milton, 2,669 469 84 17-9 318 144 Needham, . 2,658 400 88 22- 302 179 Quincy, 6,778 1,129, 237 21* 286 216 Randolph, . 5,760 1,082 312 28-8 184 333 Roxbury, . 25,137 5,032 764 15-2 329 126 Sharon, 1,377 234 38 16-2 362 91 Stoughton, . 4,830 842 182 21-6 265 243 Walpole, . 2,037 327 66 20-1 309 163 West Roxbury, . 6,310 658 112 17- 563 20 Weymouth, 7,742 1,319 233 17-6 332 125 Wrentham, 3,406 493 84 17- 405 61 Plymouth. Abington, . 8,527 1,307 308 23.6 268 239 Bridgewater,* . 3,761 559 108 19-3 348 105 Carver, 1,186 205 46 22-4 258 259 Duxbury, . 2,597 463 82 17-7 317 146 E. Bridgewater,. 3,207 552 134 24-3 239 286 Halifax, 766 107 32 299 239 287 * Almshouse not included. 12 CITIES AND TOWNS. Population, 1860. Deaths from all causes in ten "ears. Deaths from Con- sumption in ten years. Percentage of Deaths by Con- sumption to Deaths from all causes in ten yrs. Averape No. of persons living each year to one Death by Con- sumption. Order of Mortal- ity. Plymouth—Con. Hanover, . 1,565 306 71 23-2 220 311 Hanson, 1,245 215 55 256 226 307 Hingham, . 4,351 810 164 20 2 265 244 Hull, . . . 285 88 6 6-8 475 34 Kingston, . 1,655 265 52 19-6 318 145 Lakeville, . 1,160 217 45 20-7 258 260 Marion, 918 156 37 23-7 248 276 Marshfield, 1,870 295 56 19- 334 122 Mattapoisett, 1,483 297 32 108 . 463 41 Middleborough, . 4,553 767 110 14-3 414 57 N. Bridgewater,. 6,584 1,180 249 211 264 246 Pembroke, . 1,524 305 48 15-7 317 147 Plymouth, . 6,272 1,164 240 20-6 261 251 Plympton, . 994 175 19 10 8 523 26 Rochester, . 1,232 176 36 20-5 342 114 Scituate, 2,227 393 74 18-8 301 181 South Scituate, . 1,774 302 59 195 301 182 Wareham, . 3,186 443 89 201 358 94 W. Bridgewater, 1,846 326 67 20-6 275 230 Suffolk. Boston, 177,840 42,592 7,767 18-2 229 300 Chelsea, 13,395 2,345 434 18-5 309 164 North Chelsea, . 921 76 9 11-8 1,023 4 Winthrop, . 544 57 17 29-8 320 140 Worcester. Ashburnham, 2,108 376 71 18-9 297 193 Athol, 2,604 456 69 15-1 377 79 Auburn, 914 112 15 13-4 609 16 Barre, 2,973 556 97 17-4 306 171 Berlin, 1,106 184 32 174 346 107 Blackstone, 5,453 899 178 198 306 172 Bolton, 1,348 250 45 18- 299 188 Boy 1st on, . 929 132 20 151 464 40 13 • CITIES AND TOWNS. Population, 1860. Deaths from all causes in ten years. Deaths from Con- sumption in ten years. Percentage of Deaths by Con- sumption to Deaths from all causes in ten yrs. Average No. of persons living each year to one Death by Con- sumption. Order of Mortal- ity. Worcester—Con. Brookfield,. 2,276 419 88 21- 259 253 Charlton, . 2,047 339 88 26- 233 294 Clinton, 3,869 765 125 16-4 308 168 Dana, 876 162 35 21-6 250 273 Douglas, . 2,442 331 85 25-7 287 213 Dudley, 1,736 321 58 18-1 299 189 Fitchburg, . 7,805 1,531 255 16-6 306 173 Gardner, . 2,646 410 66 161 401 64 Grafton, 4,317 700 121 17-3 356 97 Hardwick, . 1,521 263 53 20-2 287 214 Harvard, . 1,507 274 48 17-5 314 153 Holden, 1,945 360 79 21-9 246 278 Hubbardston, 1,621 308 55 17-8 295 196 Lancaster, . 1,932 298 61 20-4 317 148 Leicester, . 2,748 466 86 18-5 320 141 Leominster, 3,522 535 122 22-8 289 207 Lunenburg, 1,212 250 55 22- 220 312 Mendon, 1,351 213 53 24-9 255 263 Milford, 9,132 1,989 389 19-6 235 292 Millbury, . 3,296 670 158 23-6 208 321 New Braintree, . 805 114 17 14-9 473 36 Northborough, . 1,565 255 48 18-8 326 132 Northbridge, 2,633 366 62 16-9 425 53 North Brookfield, 2,760 502 99 19-7 279 227 Oakham, . 959 188 47 25- 204 325 Oxford, 3,034 571 127 22-2 239 288 Paxton, 725 152 30 19-7 242 281 Petersham, 1,465 220 55 25- 266 241 Phillipston, 764 149 29 19-5 263 247 Princeton, . 1,201 224 38 17- 316 149 Royalston, . 1,486 287 71 24-7 209 320 Rutland, 1,076 226 34 15- 316 150 Shrewsbury, 1,558 386 68 17-6 229 301 14 Worcester,. Winchendon, Westminster, West Brookfield, West Boylston, . Westborough, Webster, . Warren, Uxbridge, . Upton, Templeton, Sutton, Sturbridge, Sterling, Spencer, Southbridge, WORCKSTER—Con. Southborough, . o w CD £ o H o Jj CD 24,960 2,624 1,840 1,548 2,509 2,913 2,912 2,107 3,133 1,986 2,816 2,676 2,291 1,881 2,777 3,575 4 'bo Oi ►k* Population, 1860. 05 Deaths from all o 4*. CO to CO Ol Ch CO CO 4* CO CO Cl 05 to causes In ten 1 k-4 o k-4 CO CO o w- 05 05 05 05 k-4 k-4 CO CO 05 CO oo 00 -4 o 05 CO 05 CO 05 Ol to CO to Oi to years. k-4 Deaths from Con- © ►—4 k-4 >—4 k-4 k-4 k-4 -4 “4 cn Or o to 05 © o -4 00 -4 CO •4 ro 05 sumption in ten k-4 05 H-‘ o 05 k-4 CO H- cx> CO 4~ CO -4 •CO CO -4 years. Percentage of k-4 k-4 to k-» k-4 to to k-4 to to k-4 k-4 to k-4 k-4 k-4 to Deaths by Con- 05 00 ro 05 4*. o k-4 00 ro CO “4 00 o k-4 Oi CO sumption . to 03 05 cb cb k-4 to CO CO -4 6i k^ to oo 4» •4 c» Deaths from all causes in ten yrs. Average No. of to CO to 03 4* to ro CO to k-4 CO co co CO ro ro persons living k-* ►k- Oi ►k* CO CO ro CO CO OI *—4 o Oi CO Oi CO © 05 uo ■4 CO o 05 05 CO ►k* 00 k-4 k^ •4 Death by Con- sumption. ro k-4 to k-4 to to k-4 to CO k-4 k-4 k-4 to ro Order of Mortal- i -4 k-4 Oi CO k*. o CO to o CO CO 4- Cl ro o o ro to CO Ol CO © *4 oi to 05 to 4* CO CO k-4 co ity. To the above list of towns reporting 44,467 deaths by consump- tion add,— Monson Almshouse, 106 Tewksbury Almshouse, 327 Bridgewater Almshouse, ........ 550 Northampton Insane Asylum, (3 years,) 26 Pawtucket, before transfer to Rhode Island, .... 82 Gay Head and Gosnold, (1 year,) 3 And we have as total deaths from Consumption, in ten years, according to the original records, 45,561. The following table is intended to place before the eye two groups of towns in the order which they should occupy as having the least and the greatest mortality from consumption. Towns having less than one thousand inhabitants are not here recorded. 15 Least Mortality. Greatest Mortality. Cheshire, Randolph, Weston,. Upton, Chester,. Wenham, Chelmsford, . Orleans, Belmont, Fall River, Becket, . Chatham, West Roxbury, Nortlifield, Edgartown, . Rockport, Tewksbury, . Salisbury, Eastliampton, . Millbury, Sterling, Royalston, Brighton, West Newbury, Winchester, . Ware, Mattapoisett, . Ashby, Blandford, Lawrence, Barnstable, Hanover, Lanesborough, Lunenburg, Brookline, Pepperell, Holyoke, • # Harwich, Dighton, Lynn, New Marlborough, Hadley, Newton, Hanson, West Springfield, Raynliam, Nortlibridge, . Shrewsbury, Foxborough. . Georgetown. In the first list of twenty-five towns containing 67,289 inhabi- tants, there were in ten years 1,380 deaths from consumption. In the second list .of twenty-five towns containing 100,741 inhabi- tants, there were in ten years 4,812 deaths from consumption. In the first list one death occurred annually to 487 persons living. In the second list one death occurred annually to 209 persons living. This difference it will be seen is exceedingly great. The results seem equally remarkable when single towns are compared ; as for instance Northbridge and Upton, adjoining towns in Worcester County, of nearly equal size and with a similar population, or Weston and Wenham, not very distant from each other, and both occupied by farmers. We have earnestly endeavored to discover 16 in what respects each of the above groups of towns has common characteristics, and to find broad distinctions separating one group from the other. That we have failed to satisfy our own mind is perhaps not surprising, since the solution of such a question requires an intimate knowledge of a multitude of facts which we do not possess. That causes are in existence for the results above given seems certain, and we commend the comparison of towns and districts to observers throughout the State, confident that what is now obscure will, at some future day, which we hope and' believe to be not distant, be apparent to every one. One thing we cannot help regarding as proved by the foregoing analysis. Consumption is very unequally distributed throughout Massachusetts. This conclusion seems unavoidable unless we reject all death returns as valueless, since the disease in question is so marked and positive in its later signs that it seems impossible that it should be mistaken for anything else by observers of average intelligence. An examination of the reported deaths from consumption in Massachusetts in three periods of five years shows that this disease is becoming less destructive. Mortality from Consumption in Three Periods of Five Years. • 1851-55. 1850-00. 1801-05. Whole number, . * . 22,091 23,161 22,852 Percentage to all deaths, 22-62 21-46 17-54 If it should be objected to this view that the last period was one of war, when the mortality was excessive, thereby reducing the percentage of any disease, attention may be called to the fact that the whole number of cases in these last five years is only 761 (a little more than three per cent.) greater than in the first five years, and actually 301 less than in the middle five years, in spite of the increase of population within these periods. The cause of this diminished mortality is to be found chiefly in the advance of medical science! The intimate nature of the disease is better understood. Formerly, a patient with consump- tion was regarded as affected with a local disease of an inflamma- 17 tory character, and was kept in-doors, carefully protected from the air, and imperfectly nourished. In the light of the present day the disease is understood to be of a general and not of a local character, and to require the utmost amount of fresh and open air, daily moderate exercise out#of doors, except in very severe and stormy weather, and as much nourishing and stimulating food as can possibly be digested. By such means life is pro- longed, and in some instances the disease itself arrested. The prevention of consumption in those disposed to it by inheritance or otherwise, is in a still greater degree within our power. The free admission of sunlight to our dwellings, and an abundant supply of pure air both by day and by night, are real protections against consumption ; and we think it the duty of all who believe these to be established facts, to proclaim and publish them in every possible way. In this connection we venture to make another observation, which is, that one of the most important discoveries of modern times in its influence upon human life and happiness remains yet to be made in some simple and easily adjusted contrivance by which the fitness, or the degree of unfitness for respiration, of the air of buildings of all sorts, may be measured. The temperature we know, the degree of moisture is almost equally attainable, but the measure of purity, of freedom from the products of respiration and of the combustion of various kinds of fuel, and other noxious material with which the air we breathe is constantly mixed, these we have at present no means of indicating with any approach to accuracy. The temporary mental impressions made upon those who feed their lungs upon unwholesome air are utterly untrust- worthy, but the results are often distinctly seen in subsequent disease, and especially consumption.