SANITATION IN MASSACHUSETTS.

This subject was prominently considered by Dr. H. P. Walcott, of Boston, in his address on state medicine, at the meeting of the American Medical Association recently. The vital statistics of Massachusetts, he said, showed a declining death rate for the last thirty-six years, under the influence of state sanitation. The most marked decrease had been observed in the mortality from zymotic diseases; there had been a less decided reduction of that from constitutional diseases; that from local diseases had increased; and that from mental diseases and from violence had remained stationary. In 1876 there was not a single death from small-pox. Typhoid fever had diminished most in cities having a good system of sewerage and water supply, and least in towns without such improvements. Diphtheria, which reached its maximum in 1877, had since declined, until it now caused only one per cent. of the total mortality. Ovariotomy saved more lives than any other surgical operation, but, taking Somerville as a basis of calculation, the ascertained results of preventive medicine had saved more lives in ten years, among thirty thousand people, than ovariotomy would save in the same time among two millions. Great attention was given to small-pox, which had killed but 5,500 persons in Massachusetts in thirty-six years, and to cholera, which had destroyed only 2,000; but too little heed was given to scarlet fever, with its mortality of 37,000, and to typhoid fever, with its mortality of 45,000.—N. Y. Med. Jour.