SURGKONS' REPORTS — MASSACHUSETTS FOURTH DISTRICT. 203 



Number of chest measuremeuts 1, 92G 



Average age 30=} years. 



Average height (57^ inches. 



Greatest height, (native of Irehuid) 74 inclies. 



Least height 59 inches. 



(Three of tliese from Massachusetts, England, and New BriinswicJv.) 



The iourth district of Blassachnsetts embraces five wards in Boston jjroper, also East Boston, 

 Chelsea, North Chelsea, Winthrop, and Cambridge. Save one ward in the center of the city, all 

 these idaces are bathed by the salt-water coming iu from Massachusetts Bay, or by rivers flowing 

 toward the ocean. All, without exception, experience the full influence of the cast winds and of 

 the inevitable changes that arise from the clashing of the land and ocean climates. 



Thoracic diseases undoubtedly prevail extensively in all New England. Phthisis is said by 

 Keith Johnston* to be endemic in New England to so great an extent that he marks the spot for 

 this peculiarity ; but it has been proved by Dr. C. W. Parsons t and myself | that iu proportion to 

 the moisture in the soil on which a village is situated will be the prevalence of consumption. Dr. 

 A. A. Gould, of Boston, § 1ms added another element, which he deems indispensable, viz, coldness, 

 and this is severer, perhaps, in our district than in most others. It is found, moreover, that a resi- 

 dence near the coast is somewhat more liable to cause consumption than a residence in the interior.!! 

 Hence it will be perceived that this district might, a priori, be considered peculiarly liable to con- 

 snmptive tendencies. 



Iu Massachusetts, 20.69 per cent.H of all the deaths, annually, are from consumption. Iu this 

 district we have exempted 4.45 per hundred, or 44.50 per thousand, from military service during the 

 existence of the board of enrollment, (August, 1863, to May, 1SC5,) in consequence of their having 

 some pulmonary disease of a chronic nature; a large majority having tubercular disease. In Table 

 5, of Report from Provost-Marshal-Geueral,** the rate of rejection is 44 50 per thousand, or 4.45 per 

 cent. This does not seem to me a large ])roportioii, when we take into consideration the various 

 influences at work iu our district tending to diminish the powers of life, viz, the position of the 

 district above alluded to, and the fact that a very large proportion of our recruits and drafted men 

 have come from our ill-ventilated workshops, and have been subject to the generally bad hygienic 

 influences of the city. • 



It is true that the city of Cambridge has more of the advantage of country life. Never- 

 theless, its situation is low, ami it is washed by the Charles River iu its sinuous course to the sea; 

 and, moreover, a very hirge number of the inhabitants transact their daily work within the limits of 

 this city, returning to their suburban homes only at night. Hence they, too, are much influenced 

 by the same causes of disease as those to which city residents are subjected. 



Epilcpsii. — From Table 5, it appears that there has been a less proportion exempted in Mass- 

 achusetts than in the States generally ; 8.38 per thousand belonging to the States, and 7.02 per 

 thousand from Massachusetts. Notwithstanding the fact that in one of my former reports I drew 

 the attention of the Provost-Marshal-General to what I deemed an unusual number of exemi)tions 

 in this district, from this cause, I again call his attention to the tact that the whole number exempted 

 during the war sustains the statement. During the jieriod of the existence of the board, 10.90 per 

 thousand have been sufferers from this complaint, and hiive been exempted for that cause. 



Acute and ovfjanio diseases of the brain or spinal cord, heart, lunejs, liver, spleen, kidneys, or blad- 

 der. — The fact that a vast proi)ortion of our population whence the dralt is made are mechanics, 

 working in ill-ventilated apartments and living in the most crowded and filthy parts of our city; 

 iu a word, the fact that they and their families are crowded iijto the worst district in the State, 

 must be tiie reason for the large pro()ortion exemi)ted for acute and oiganic internal disease. I 



'The Physical Atlas, by A. KiciTii Jounstox. Folio, Ediuburtjli, 1856: Map 35, The geoijraphival distribution of disease. 

 iBhode Island ref/istralion of births, deaths, and marriages. 



iConsuiiq/tion in Alaasuchusctts ; on locality, one of its chief causes. Annual adUiess before the Massachusettsi Medical 

 Society, 18G2. 



estate rcyistration of births, deaths, and marriayes. 



Wlbid., la(J3,jiO(7(;03. 



H/ftid. 



"Annual vejwrt of the rrorost-Marxhal-General, November 15, 1804. 



