almshouse any person infected with small-pox or other disease dangerous to the public health, or any other sick person whose health would be endangered by removal; but all such persons liable to be maintained by the Commonwealth shall be supported during their sickness by the city or town in which they are taken sick, and notice of such sickness shall be given to the state board, which may examine the case and order the removal of the patient if it deems it expedient: provided, that the notice herein required, in cases of sick persons whose health would be endangered by removal, shall be signed by the overseers of the poor, or by such officer as they may see fit by special vote to appoint, and they or he shall certify, after a personal examination, that in their or his opinion such removal of the person named in such notice, at the time of his application for aid, would endanger his health."

It is further provided (Acts of 1898, chapter 391) that "The reasonable expense incurred by a city or town under the provisions of the preceding section, within five days next before notice has been given as therein required, and also after the giving of such notice and until said sick person is able to be removed to the almshouse shall be reimbursed by the Commonwealth. The bills for such support shall not be allowed unless they are endorsed with the distinct declaration that, after full investigation, no kindred able to pay the amount charged have been found, and that the amount has actually been paid from the city or town treasury, nor unless they are approved by the state board or by some person designated by it; and not more than five dollars a week shall be allowed for the support of a person in a city or town hospital."

It is also provided (Acts of 1887, chapter 440) that “ No city or town officer or agent having the care and oversight of a sick pauper shall remove or cause to be removed or attempt to remove, either by himself or by an agent, such pauper to the state almshouse unless there shall be reasonable cause to believe that such removal will not injure or endanger the health of such pauper.

No city or town officer or agent having the care and oversight of a sick pauper shall remove or cause to be removed

or attempt to remove such pauper to the state almshouse, unless so ordered by the state board of charity, until he shall have first procured a certificate of some competent physician setting forth that he has at the request of such officer examined such pauper and that in his opinion such pauper can be removed to the state almshouse without injury or danger to his health.

Any city or town officer or agent violating the provisions of this act, or any physician who shall falsely certify as provided in the second section of this act, shall be punished by fine not less than twenty-five nor more than one hundred dollars or by imprisonment for not less than three months nor more than twelve months, or by both fine and imprisonment."

The number of sick State poor notices received during the official year was 5,539. These 5,539 notices were sent by the Overseers of the Poor of 184 cities and towns, and covered 7,705 persons, of whom 5,638 were represented as being too ill to be removed. This number of notices shows a decrease of 268, or about 4 per cent., as compared with the previous year; and, as compared with the official year 1897-98, a decrease of 257, or about 4 per cent. The largest number of notices received in any one month was 760, in January; and the smallest, 352, in November. The number of persons supported shows a decrease of 305, as compared with the previous year; and of persons actually sick and requiring medical attendance, a decrease of 268, as compared with the previous year. Of these 5,539 notices, 2,376, or about 43 per cent. of the whole number, were from Boston, viz.: 2,137 from the City Hospital, 84 from the Carney Hospital, 120 from the Institutions Department, 16 from the Boston Lying-in Hospital, and 19 on account of persons supported at their homes.

The number of visits made by the officers of the Board, in the investigation of these 5,539 notices, was 8,568. As a result of their investigations, the Overseers of the Poor were directed to discontinue aid in 284 cases, in 275 on account of the recovery of the patient sufficiently to permit of his removal, and in 9 for other reasons manifest to the visitor. In 263 cases all aid was refused; in 252 because, at the time

the application for aid was made, the patient could have been removed without danger; and in 11 for other evident reasons. There were 4,295 cases investigated by the visitors of the department; and in 550 cases settlements were found, covering 767 persons. Among those reported as sick there were 327 deaths.

Cases of Dangerous Diseases.

Of the 5,539 notices previously stated as received in regard to the sick State poor, 980 were on account of "smallpox or other disease dangerous to the public health,” covering 1,258 persons and 1,037 patients. These 980 notices. were from 45 cities and towns; 615 being for cases of diphtheria, 209 for scarlet-fever, 86 for measles, 64 for smallpox, 3 for whooping-cough, 2 for mumps, and 1 for spinal meningitis. In 169 cases settlements were found, covering 181 persons.

The following table is an abstract of the sick State poor notices received during the year:

Notices by Months and Counties. Sick State Poor.

December.

January.

February.

March.

Cases of Wife Settlement.

It is provided by Public Statutes, chapter 86, section 30, and section 31, as amended by Acts of 1885, chapter 211, that "When the operation of any provisions of law in relation to poor and indigent persons might cause a separation of husband and wife by reason of her having a legal settlement in some place in the Commonwealth, he being a state pauper, both parties shall be supported by the place where she has a legal settlement.

The expense of thus supporting the person who is a state pauper, written notice having been given to the state board within sixty days from the time when such aid shall be first given, shall be paid by the Commonwealth, reference being had to the expense of supporting such person at the almshouse, if thereto committed."

The number of notices received under this law, during the official year, was 761, from 94 cities and towns, covering 3,362 persons, of whom 351 were sick. These figures show a decrease in the number of notices, as compared with the preceding year, of 109, or about 12 per cent.; and, as compared with the year 1897-98, a decrease of 248. Of these 761 notices, 335, or about 44 per cent., were from the city of Boston. There were 314 cases investigated by the agents of the Board; 3 settlements were found, and 2,601 persons were acknowledged as settled, so that the whole number aided by the State was 758, of whom 242 were sick. The number of visits made in these cases was 1,014. As a result of these visits, the local authorities were advised to render no aid in 2 cases, and to discontinue aid in 15 cases.

The following table is an abstract of the wife-settlement notices received during the year: