August, '12] BULKS AND .SHEPPAKD: IXFAXTILE PARALYSIS 321 



ciated with no other case in any way, although a later case reported 

 elsewhere may have originated in Marblehead. 



Insects, except mosquitoes, housefiies and Stomoxys, were not seen, 

 although an insect described as resembling a. tick had been seen on 

 the infant and had bitten it, liefore the sj'mptoms of poliomyelitis 

 developed. Stoinoxys had been killed in the patient's bedroom. 



Marlboro. Population approximately 14,000. 



Marlboro is in Middlesex County on the Fitchburg division of the 

 Boston and Maine Railroad, and also on the line of the New York, 

 New Haven and Hartford Railroad. It is engaged mainly in the 

 manufacture of boots and shoes, half of its 7,000 wage earners being 

 ■engaged in this industry. 



Three cases occurred in the town proper, in the families of which the 

 fathers were operatives in these factories. In one family in which 

 four cases occurred, the father was a farmer and the locality typically 

 rural and well removed from the town. In this latter family two 

 deaths occurred, and one of the cases, a girl 13 years of age, had suffered 

 a previous attack of poliomyelitis ten years ago, when an infant three 

 years of age. The question of second attacks will be treated of in 

 another paper. 



Sto77ioxys was unusually al:>undant about the premises and l^arn- 

 yard of this farm, and was also seen in the house and in the bedrooms 

 with the patients. 



Lowell. Population approximately 106,000. 



Lowell is in Middlesex County at the junction of the Merrimack 

 and Concord rivers. It is connected with Boston by the Boston and 

 Maine Railroad and by trolley lines, both passing through Somerville 

 and Winchester, and is also connected with Woburn by electric cars. 



It is a manufacturing town, engaged mainly in textile industries, 

 although it also contains many foundries and machine shops, and 

 some boot and shoe factories. Its population, therefore, consists in 

 great part of the lower working classes, living in rather closely settled 

 districts surrounded by more sparsely peopled rural communities. 



Fourteen cases occurred in this town, an incidence of approximately 

 . 13 per 1,000 of population. The usual series of domestic insects were 

 observed in the environment of these cases, including Stomoxys. In 

 one case a cat became paralyzed at about the same time that the 

 child was paralyzed, and this child had played with the cat intimately. 

 This cat was driven out of the neighborhood and could not be found at 

 the time of our visit. 



At least six cases in the city occurred later, several of which were in 



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