Aufiust, '12) BRLEft AND SiHEPPARD: INFANTILE PARALYSLS 317 



Only two cases occurred here, giving an incidence of .07 per 1,000, 

 one in a very unsanitary house in the yard of which many Stonioxys 

 were seen ten days after the patient became parah^zed. 



Tewksbury. Population approximatelj^ 6,000. 



Tewksbury is in Middlesex County between the Merrimack and 

 Concord rivers, five miles southeast of Lowell and 22 miles northwest 

 of Boston. It is connected with Boston by the Boston and Maine 

 Railroad, and with the surrounding towns and villages b}' trolley. The 

 population of the town proper, which is about 4,000, is principallj' 

 engaged in agricultural pursuits and the manufacture of cotton machin- 

 ery, l)ut the State Infirmary with 200 inmates is also located in Tewks- 

 bury. 



Six cases occurred here giving an incidence of 1 per 1,000; or 2 in 

 the infirmary and 0.50 in the population of the town. One death 

 occurred, in the infiimary, that of a child, a state ward. No sickness 

 could be discovered among the animals on the Institution grounds, 

 although several fowls died after the first case occurred. The cause 

 of death of these fowls could not be ascertained. A child trans- 

 ferred from the institution to the Children's Institution, Boston, 

 reported well at the time, boarded out in a family in ]Malden, later 

 developed acute epidemic poliomyelitis. In this family another ward, 

 a probable secondary' case, developed a facial paralysis. 



At the time of our visit on September 16th, all the cases reported 

 from the institution had occurred. The usual domestic insects were 

 observed, also an unusual abundance of Stomoxys, some of which 

 were seen upon a screened enclosure in the grounds in which the chil- 

 dren had frequently been placed before they were attacked. 



WiNTHROP. Population approximately 10,000. 



Winthrop is in Suffolk County, five miles northeast of Boston, 

 situated on a peninsula in ]\Iassachusetts Bay. It is a summer resort 

 and to some extent frequented by transient visitors to an ocean beach, 

 which borders the town on the east. It is connected with Boston by 

 the Revere Beach and Lynn Railroad, and also by trollej'. 



Three cases occurred here, giving an incidence of .30. They were 

 associated with the usual household insects, in addition to Avhich 

 small horse flies (Tahanus) were common along the beach frequented 

 by the children and also reported in one house where a case occurred. 



WoBURN. Population approximately 15,000. 



Wol^urn is a small manufacturing town in Middlesex County, ten 

 miles northwest of Boston, whence mam' trains of the Boston and 



