No restriction of diet, and podophyl, given every night or Seidlitz powders in morning. The patient has never been unable to get out of bed and walk across the floor.

BENJAMIN LEE, M. D.,

PITTSBURGH, July 30, 1886.

Secretary State Board of Health of Pennsylvania:

DEAR DOCTOR: I have the honor to report that of ten samples of well water furnished me by your inspector, Mr. L. H. Hunter, two of the samples, when subjected to Nessler's test, exhibited decided evidences of organic matter. Eight of the samples exhibited no traces of organic matter when subjected to the same test.

I have to report further that by direction of your inspector I, on Thursday, July 29, visited the town of West Elizabeth, and, in presence of Drs. Pierce, McGrew, Welsh, Shaffer, Fife, Riggs, Van Kirk, of East Elizabeth, and Van Kirk, of McKeesport, examined the body of Graham, aged thirty-five years, R. R. street. The attending physician, Dr. Pierce, stated that his illness was of twenty-two days. duration, but could furnish me with no clinical record of the case. Autopsy twenty-two hours after death. The characteristic lesions of typhoid fever were demonstrated to the satisfaction of all the physicians present.

The ileum was the only portion of the small intestine examined. I demonstrated the lesions (ulcerations of Peyer's patches) in different stages, but farthest advanced and most numerous as ileo-cæcal valve was approached. The liver weighed three and three-quarter pounds. The spleen weighed nine ounces. Stomach found partially filled with liquid containing fæcal matter and much corroded. Damage evidently not all due to post mortem causes.

Yours truly,

V.

W. SNIVELY.

NOTE ON AN EPIDEMIC OF TYPHOID FEVER AT SOUTH
PITTSBURGH.

By BENJAMIN LEE, M. D., Secretary.

Previous to the outbreak at West Elizabeth the Board had, at the urgent request of Crosby Gray, Esq., the efficient and energetic health officer of Pittsburgh, made an investigation into the condition of certain bone-boiling establishments, known in the dialect of that region as "schinderies," which it was feared might pollute the Monongahela river, from which what is called South Pittsburgh draws its water supply. This is the region of the city alluded to by the Secretary as so faulty in its drainage arrangements, in his paper before the sanitary convention entitled "An Epidemic of Diphtheria Traced to its Source." There was reason to fear that it was likely again to afford a text for

a sanitary sermon. The result of the inspection was decidedly condemnatory, and the occurrence of the above-described pestilence farther up the stream evidently intensified the risk. Scarcely had the necessary orders for the abatement of these nuisances been issued when their importance was made apparent by the simultaneous occurrence of several cases of undoubted typhoid fever in South Pittsburgh. Two cases of the same disease were discovered on a "shanty-boat," on the Allegheny river, lying not far from the influent pipe of the Allegheny water works. The aspect of affairs thus became so threatening that the Secretary requested Dr. Germer, the President of the Board, to proceed to Pittsburgh and confer with Dr. McClelland, of the Board, Mr. Hunter, the inspector and the local health authorities as to the best means to adopt to stamp out the infection. Much public interest was awakened in the matter. The daily press of Pittsburgh took up the question most energetically, one paper causing elaborate analysis to be made of the water, and seconding the Board in all its efforts. The full report has not yet been received.

VI. REPORT ON AN EPIDEMIC OF TYPHOID AND CONTINUED FEVER AT GLASGOW IRON WORKS, NEAR POTTSTOWN, MONTGOMERY COUNTY.

By BENJAMIN LEE, M. D., Secretary, AND WILLIAM B. ATKINSON, M. D., Medical Inspector.

In the month of August the Board found it necessary to investigate an alarming outbreak of fever among the employés of the Glasgow Iron Company and their families near Pottstown, Montgomery county. This place was visited by the Secretary, accompanied by the inspector of the Delaware district, Prof. William B. Atkinson, Thursday, July 29. This company employs about one hundred and thirtyfive hands, and nearly half of them were then reported as on the sick list. Besides these, members of the families of those residing quite near the works were also ill. Twelve of them were seen in various stages of a low fever which is thus well described by Dr. H. Y. Nieman, of Pottstown, in summing up his report of sixteen cases under his care: All these cases had typhoid symptoms, and, with few exceptions, diarrhoea. One had hemorrhage from the bowels. All commenced in the same way, with chills, pain in the back and limbs very severe, at times fearful pain over the entire cranial region, loss of appetite, delirium, dry and coated tongue, nausea and often vomiting, pulse hard and full, generally averaging from 80 to 90, except in those of true typhoid fever, where it ran considerably higher.

All of these cases are convalescent; some of them got well in six