plumbing and trapping about houses, in my judgment contribute largely to the violence and spread of this very fatal disease.

Lisbon- C. H. BOYNTON, M. d.

Typhoid Fever. — Have seen no well-marked cases during the year 1888. From past observation believe unsanitary conditions to be the most common cause of the disease.

Diphtheria. None during the year.
None during the year. Consider this disease to

be largely the result of unsanitary conditions.

Littleton-F. T. MOFFETT, M. d.

Typhoid Fever. - Five cases; three in Littleton, one in Dalton, one in Bethlehem. Drinking-water contaminated in two cases by sink-drain, in one by decomposing vegetable matter, and in two others by cesspools. My past observation has been to the effect that where we have good sanitary conditions there is little or no fever. In the case in Dalton, the spring from which the drinking-water was obtained was lower than the sink-drain, and about ten feet from it; on the other side, at a distance of about twenty feet, was a large cesspool.

Diphtheria. One well-marked case.

Am of the opinion that this case was caused by a lot of decomposing vegetable matter in the house. Believe that unsanitary conditions influence diphtheria as they do typhoid fever.

Littleton T. E. SANGER, M. d.

Typhoid Fever. — Fifteen cases, one fatal; nine in town, six in Bethlehem and Franconia. Drinking-water polluted in about 50 per cent of these cases; in others, could not trace the cause. Believe unsanitary conditions are to typhoid fever as C to 100, although not always discernible, but believe they always exist.

Diphtheria. None during the year. Am of the opinion that unsanitary conditions bear a close relation to the disease.

Londonderry-F. B. PERKINS, M. D.

Typhoid Fever. None observed during the year.
Diphtheria. None.

Manchester- CHARLES E. DODGE, M. D.

Typhoid Fever. None observed during the year.

Diphtheria. — Three cases, one fatal. Could not discover

that unsanitary conditions influenced the disease, but consider them the cause frequently.

Manchester. H. B. BURNHAM, M. D.

Manchester-C. M. DODGE, m. d.

Typhoid Fever. - Two cases, both recovered.

was used for all purposes.

City water

Have observed that when the system is run down and depraved, unsanitary conditions bear an intimate relation to the disease.

Diphtheria. - About twenty-five cases, two fatal. Am unable to state the cause. My opinion is very flexible in relation to the influence of unsanitary conditions. Have often seen this disease appear without warning in the very best conditioned homes. Undoubtedly (if it could be ascertained) there is some certain condition of the system united with some atmospheric contamination at the bottom of all this evil.

Manchester

Typhoid Fever. - One case.

There were cesspool, vaults, and sink-drains within ten feet of the well; sandy soil; but an analysis showed the water to be pure. It is my opinion that unsanitary conditions are the chief cause of the disease.

cases.

Diphtheria. - Twelve cases, one fatal. Had no reason to suppose that unsanitary conditions had any connection with these Believe that unsanitary conditions bear the same relation to diphtheria that they do to any other grave sickness; do not consider their relation to diphtheria peculiar. There has been no epidemic of diphtheria in this city for the past twelve years; it has been endemic, and, like the poor, we have it always with us.

Typhoid Fever. Have not seen a case during the past year. From my past experience believe unsanitary conditions favor the development of the disease.

Diphtheria.

Two cases, both recovered. In one case there was bad sewerage, and stagnant water near the house.

Do no

consider that unsanitary conditions are to diphtheria as cause to effect, but think such conditions may help its development.

Manchester-GEORGE D. TOWNE, M. D.

Typhoid Fever. Three cases, none fatal. Believe unsanitary conditions are present in 90 per cent of all cases of this disease. Diphtheria. Eleven cases, three fatal. Bad sanitary conditions were a factor of nearly every case, and from past experience believe they influence more than 95 per cent of all cases.

Marlborough - W. H. ALDRICH, M. D.

Typhoid Fever. Seven cases, none fatal; two in Swanzey, five in Harrisville. The two cases in Swanzey were contracted away from home, the disease being caused by a hidden cesspool. The five cases in Harrisville occurred four in one family and one in an adjoining house. The family had been in the neighborhood but a short time. Upon investigation I found the well from which the drinking-water was obtained to be situated in the cellar, and the cellar was covered with six inches of surface water, and also leaching into this, on the back side of the house, was the foul sink-water, which the family had supposed was carried a safe distance from the house, but which had drained back through the subsoil into the cellar, the land back of the house being ascending. From my past experience believe the disease is nearly always contracted through some unsanitary condition.

Diphtheria. None during the year; have had quite a number of cases of diphtheritic sore throat. I believe that genuine diphtheria is due to unsanitary conditions, together with debility of patient.

Marlow MARSHALL PErkins, m. d.

Typhoid Fever. - None observed.

Diphtheria. None.

Merrimack - WARREN W. PILLSBURY, M. D.

Typhoid Fever.

-Two cases, one in Merrimack and one in Bedford. The Bedford case was probably due to contact with clothing of another patient which was washed in the house where the above-named patient lived. The well-water, however, was

in a bad condition, and might produce typhoid. (Have at this date, January 11, 1889, another case in the same family, who became ill about one week after the first case, and am told that a young man sixteen years of age, who visited this family the last of November, died some four weeks since at Penacook of typhoid fever, after being confined to his bed eight days. It was during his visit that the infected clothing was washed in the house.) The case in this town was contracted in Nashua while attending a sister who was suffering from a severe attack of typhoid. Unsanitary conditions, in my opinion, are the cause in almost all cases of this disease.

Diphtheria. Two cases, both recovered. The well where these cases occurred was about fifteen feet from the sink-spout. The spout, a lead pipe, did not protrude from the house more than an inch, and everything that would pass through the pipe was poured into the sink. Filth was everywhere about the house. The water was polluted to such an extent that a greasy scum was upon it. Cases have occurred in the same house in years gone by. Unsanitary conditions no doubt have inuch to do with diphtheria, but, in my opinion, not so much as is ascribed to them. If the individual is ripe for the disease, he will take it from contact with the germ wherever found.

Milford-H. S. HUTCHINSON, M. d.

Typhoid Fever. One case, recovered. This patient came from a neighboring town while already ill with the disease. He had been in attendance upon two other cases, in the capacity of nurse, and doubtless contracted the fever in that way. Basing my opinion upon past experience, should say that unsanitary conditions bear a causative relation to the disease.

Diphtheria. Six cases, none fatal. Nearly every case has been, in my opinion, unfavorably influenced by unsanitary conditions. At least two of my cases could be traced to contagion, one coming from a locality in Massachusetts where the disease was prevailing, and where one other member of the same family succumbed to the disease just before said case removed to New Hampshire, where it developed in severe form. The second case was communicated from a patient while convalescing, the patient falling ill shortly after. Diligent search failed to reveal any other

source of the disease; the conclusion, then, of contagion seems tenable. Believe unsanitary conditions bear a causative relation to this disease.

Milford-A. W. Smith, м. D.

Typhoid Fever.

None observed during the year. I consider unsanitary conditions a very fruitful means of the spread of typhoid fever.

Milton CHARLES D. JONES, M. D.

Typhoid Fever. - None.

Diphtheria. None.

Milton Mills M. K. COWELL, M. D.

Typhoid Fever. Two cases, neither fatal; one in town, the other in Acton, Me. Drinking-water polluted in both cases. Consider unsanitary conditions largely the cause of the disease. Diphtheria. One case, recovered. Unsanitary conditions were the whole cause in this case, as I believe them to be in nearly every case.

Moultonborough - WILLIAM H. H. MASON, M. D. Typhoid Fever. - None during the year. I believe typhoid fever to be caused by a direct poison from exposed decomposition, from polluted wells, sink-drains, cesspools, back door slops, and from the sick-room. I believe covered drains more dangerous than open ones, and either, at best, is dangerous. I believe with proper sanitary care the disease can be avoided. Diphtheria. - None observed during the year. itary conditions bear the same relation to diphtheria that they do to all other diseases.

Think unsan

Moultonborough - F. S. LOVEring, m. d.

Diphtheria. None observed during the year. From past experience consider unsanitary conditions the direct and most common cause of the disease.

Mont Vernon - F. CHANDLER, M. D.

Typhoid Fever. One case, recovered. Obscure etiology.
Diphtheria.

None observed.