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SCHOOLHOUSES.

The attention which this Board has hitherto given to the subject of schoolhouse sanitation has, we believe, resulted in much benefit to the State. The law of 1885, adopting the town system, necessitated the building of many new schoolhouses, and the remodeling and reconstruction of old ones; and in this work in many places we have observed the results of the teachings of this Board, while not a few towns have applied for specific instructions in building.

The subject of ventilation has been especially considered by building committees, and even in some very small district schoolhouses, some system of ventilation, of more or less utility, has been adopted. The importance of proper ventilation, lighting, heating, etc., of our schoolhouses is better understood and better appreciated by the public at the present time than formerly, hence we have, as a State, made considerable progress in schoolhouse sanitation, which, although not as marked as it ought to be, is, perhaps, as much as we could expect under the circumstances. The small, unventilated schoolroom, heated by an airtight stove, and with pupils facing the windows, is still to be found in more than one locality, and perhaps will be until the millennium; nevertheless, the fine school buildings which are now in process of erection in Concord, Portsmouth, and many other towns that might be named, indicate that schoolhouse construction and sanitation are making creditable advance in this State.

In comparing the present state of public health interests and practical sanitation with that which existed even five years ago, we are able to record very marked progress; and we have reason to expect that sanitation will accomplish more in the next few years than it has in the past, because the subject is being more generally and thoroughly understood by the public from year to year.

There is nothing more essential to the advancement of public health interests than that the entire people thoroughly understand the possibilities of sanitary science. When every family in the State possesses that amount of sanitary knowledge which may become common to all, and which is now well understood by many, we shall expect an advancement in the restriction of

disease, the lessening of mortality, and the general prosperity of the community. Our people are well on the road to such knowledge, and it seems to this Board, that through a continuation of the practical teachings of sanitation which are presented by executive work of efficient health officers, and through a general diffusion of sanitary knowledge, our State may reap substantial. benefit, which will be demonstrated by practical results in every town. We are, to-day, surely advancing toward such results.

CO-OPERATION OF THE MEDICAL PROFESSION IN SANITARY WORK.

The medical profession in New Hampshire as a profession are thoroughly interested in sanitary work, and are doing much good by educating the people in the restriction and prevention of dis-ease. The physicians of the State support and supplement, in a very large degree, the work of the State Board of Health, and many communities are under deep obligations to the philanthropic labors they are performing in addition to the actual practice of their profession. We can call to mind many intelligent members of the profession who lose no opportunity to impress upon the people the importance of sanitary work, and who instruct and educate them in the measures necessary for the prevention of disease or the restriction of its spread. Such efforts as these are to be commended from every standpoint, and especially so when it is remembered that such a course is in direct opposition to the financial interests of the physician. They take the most active measures possible to prevent the spread of an infectious or contagious disease, using disinfectants and germicides in a rational and scientific manner, isolating the patient, and performing many other duties in the line of preventive medicine which, even a few years ago, were not in vogue in medical practice. There are many in the practice of medicine, it is true, who give no attention to these matters, but they are among that class that can be found in every quarter, several years behind the times; but the intelligent, progressive men of the profession are as much interested in sanitary progress as in medical and surgical advancement.

REPORT.

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LOCAL BOARDS OF HEALTH.

The majority of the towns in the State have local boards of health or health officers, while in the remaining towns the selectmen are ex officio a board of health. Many of the latter class are complete failures as boards of health, for two reasons: First, they are totally unfitted for the performance of the duties devolving upon a health officer; and second, they have no interest in the work. We believe that the law should be changed so that it shall be compulsory upon every town to provide a board of health or health officer, and such board or officer should be appointed rather than elected. If such a course were followed, more or less work in the interest of public health would be accomplished in every town. An efficient health officer is as necessary as a board of selectmen; the work to be performed in the restriction and prevention of contagious diseases alone, warrants this assertion. In many of our towns the health authorities are active, vigilant, intelligent, and ready to perform every duty that may come to them; in these towns we have witnessed a very marked sanitary advancement; infectious and contagious diseases are controlled, and the towns are cleaner and more healthful. These boards cooperate with the State Board of Health in every measure proposed for the good of the locality, and many of them inaugurate and carry out improvements without the order or advice of the State Board. A much better health service is being secured in most of our cities than heretofore; Concord, Manchester, and Keene have efficient health departments, while Dover and Nashua are already taking action to secure better health service in those cities.

PUBLIC WATER SUPPLIES.

The increase in the number of public water supplies in this State during the last five years has been very noticeable. At each session of the Legislature, charters have been secured for new water-works; at the last session charters were obtained, or old ones amended, for public water supplies in the following towns: Berlin, Derry, Boscawen and Penacook, Hampton, Portsmouth, Canaan, and Tilton and Northfield. The water supplies of several cities and towns have also been enlarged and improved.

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STATE BOARD OF HEALTH.

Among such operations worthy of special mention are the extension of the water supply at Dover and the introduction of a very abundant supply into Tilton.

In no way can the health of the people of the State be better guarded than by securing an abundant supply of uncontaminated water. An improved condition of the general health of the people has frequently been observed in towns, immediately following the introduction of a public water supply and the abandonment of surface wells. This Board has constantly urged upon the public the importance of a good water supply for every town, and pointed out the dangers arising from shallow wells; the result of such teaching may be observed to-day in many towns. The Board has caused the analysis of well waters in many sections of the State, the results of which have plainly shown their great dangers; so that our wells are to be looked upon with suspicion, and, indeed, many of them are perilous to the health of the persons using the water from them. These facts have been very forcibly brought to the attention of the people in the localities where the examinations have been made, thereby greatly enlightening the public in respect to the dangers of water pollution. A more detailed account of this work is to be found in the report of Prof. E. R. Angell, in another part of this report.

SEWERAGE AND DRAINAGE.

The sewerage and drainage of towns is a subject which is closely connected with the introduction of a public water supply, and one which, after an abundant water supply has been brought into a town or city, demands immediate attention. Many towns have made a very respectable beginning in this direction, with a view to finally completing a system ample for the needs of the locality. A majority of them do not feel able to construct a complete system of sewers in one year, hence it is built by piecemeal. Most of the towns have commenced this work upon a systematic plan, and when finished a perfect system will be secured; other towns, with less foresight, have constructed short sewers to meet the immediate demands of the locality, without any reference to a regular system.

The work of sewering our towns as a whole is probably in

keeping with the general sanitary progress that has been made in the last few years, although there are some noticeable exceptions to this rule. The construction of sewers occasions a considerable outlay, from which no money dividends will be received; hence it is sometimes impossible to secure a vote of the town for an appropriation sufficient to carry on the work. Among the larger towns of the State which sadly need such a system are Laconia and Rochester, particularly the latter.

ALMSHOUSES.

The Board has made an inspection and examination of all the county almshouses in the State during the year, and detailed reports upon these institutions may be found elsewhere. In a general way we would say that the county almshouses have been very much improved so far as their sanitary appointments are concerned, since the Board first commenced this kind of work. It is a pleasure to state that in most of the counties the board of county commissioners has cordially co-operated with the State Board of Health in its efforts to better the condition of these institutions. In some counties these improvements have been very marked, and their almshouses are now in a condition that may be classed as excellent; while in some other counties, although more or less work has been done from year to year, there is yet need for further action. As a matter of course, in all these institutions there must be some repairs and changes each year; but when they are once placed in the best possible condition, the annual expenditures for repairs and alterations are reduced to the minimum. Work that is well and substantially done requires but a slight annual outlay; but a defective construction, as plumbing without traps, or sewers imperfectly laid, or steamheating with insufficient boiler capacity, etc., will, as a result, demand large expenditures each year. Some have had this very experience, and it has proved very expensive; one or two others have this problem yet in hand, and will of necessity be obliged to expend considerable money in the next year or two for repairs. On the whole, our almshouses are ample to meet the wants of their respective counties, are well managed, and make most excellent homes for this unfortunate class.

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