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306 come the present ambulance system of the world—for Europe copied us in this matter.

The putting to sleep of Lemuel Shattuck's noble report by apathetic legislators did not prevent progressive minds from pursuing the subject, and there was a knot of men in Boston who kept up interest in the work by stated meetings among themselves, and occasional public meetings, at one of which Edward Everett delivered one of his most brilliant addresses; but when they ascended Beacon Hill and took the practical steps of asking for the organization of a State Board of Health, it was sure to be defeated by the rural legislator from "way back," typified by the one who said, "Them boards don't do no good, and they cost a sight o' money." Just before the war the prospect became hopeful, and then came the imperative "Halt!" to all the lines of forward-marching progress. During the four-long, bitter years of contest the whole land had taken a lesson in the value of organized action, and as soon as we had caught our breath the march was resumed with a quickened step. Meantime England had made great strides in practical sanitation, and it had begun to be stoutly held that some of the most destructive diseases are not the visitations of an angry God for the moral derelictions of people, but are the direct and palpable outcome of the neglect of sanitary laws. Especially was it believed in England that typhoid fever, the decimating scourge of young manhood and young womanhood, can be averted; and on this side the water Dr. Bowditch had instituted an inquiry looking to discovering the preventable causes of consumption. The results, printed only for private circulation, made a great impression in medical circles—for bacteriology with its tubercle bacillus had not been even heard of. The phrases Preventive or State medicine had begun to be used, when, in 1869, a remarkable concatenation of circumstances, consisting of two distinct lines of action, resulted in the establishment of the Massachusetts Board of Health. Repeated repulses at the State House had completely disheartened the advocates of State medicine in Boston, but unexpected help was coming to their aid from the extreme western part of the State. Those familiar with the annals of sanitation will recall a fearful visitation known as the Maplewood Fever, which occurred in the year 1864 in Pittsfield, at the Young Ladies' Institute, in which out of seventy-seven pupils fifty-one had typhoid fever of a virulent type, and thirteen died—as the result of purely local causes, the direct result of ignorant sanitary neglect. The outbreak occurred in August, and in September, at the instance of Thomas F. Plunkett (husband of the writer), three of the professors, who had come to give their annual courses of lectures in the Berkshire Medical College, undertook a