This subject was prominently considered by Dr. H. P. Walcott, of Boston,
in his address on state medicine, at the meeting of the American Medical
Association recently. The vital statistics of Massachusetts, he said,
showed a declining death rate for the last thirty-six years, under the
influence of state sanitation. The most marked decrease had been observed
in the mortality from zymotic diseases; there had been a less decided
reduction of that from constitutional diseases; that from local diseases
had increased; and that from mental diseases and from violence had
remained stationary. In 1876 there was not a single death from small-pox.
Typhoid fever had diminished most in cities having a good system of
sewerage and water supply, and least in towns without such improvements.
Diphtheria, which reached its maximum in 1877, had since declined, until
it now caused only one per cent. of the total mortality. Ovariotomy saved
more lives than any other surgical operation, but, taking Somerville as a
basis of calculation, the ascertained results of preventive medicine had
saved more lives in ten years, among thirty thousand people, than
ovariotomy would save in the same time among two millions. Great attention
was given to small-pox, which had killed but 5,500 persons in
Massachusetts in thirty-six years, and to cholera, which had destroyed
only 2,000; but too little heed was given to scarlet fever, with its
mortality of 37,000, and to typhoid fever, with its mortality of
45,000.--_N. Y. Med. Jour._