USA > Massachusetts > Worcester County > Fitchburg > Address of the mayor, together with the annual reports for the city of Fitchburg, Massachusetts for the year .. > Part 22
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410
REPORT OF BOARD OF HEALTH
conditions of back yards and the unsanitary housing conditions in certain parts of the city. An effort will soon be made to take up a thorough sanitary inspection of the city and thereafter to make regular sanitary inspections and keep proper records of the same.
INSPECTION OF MEATS AND PROVISIONS.
May 6, 1911, a regulation concerning the exposure of food- stuffs was adopted, making it obligatory to protect them from dirt, flies, animals, and other contaminating substances and the Inspector was directed to enforce it. Our zeal was later some- what impaired by a decision of the courts that the law was un- constitutional. The Inspector of Meats and Provisions, Henry D. Clark, D. V. S., was in June named Inspector of Slaughter- ing in accordance with Chapter 534, Acts of 1911, and has per- formed his duties to our satisfaction.
INSPECTION OF MILK AND PLUMBING.
For the details of work of these departments you are referred to the report of Mr. John F. Bresnahan, Inspector of Milk and Plumbing. As regards milk inspection the quality of the work done meets the approval of the Board, but the quantity has been limited owing to the fact that the Milk Inspector has not the time to devote to the work that its proper performance requires. All farms should be inspected twice a year and more time spent in testing the cleanliness and quality of milk. The Inspector should devote his whole time to the duties and should be paid a commensurate salary. We believe however, that the milk supply of Fitchburg will compare favorably with that of other cities and that this is due in great measure to the efficient work done in this department. We have not felt justified in spending a large amount for milk inspection, while the policy of the state regarding the matter is in its present unsettled state, but believe the work done has been done in the right way and has accomplished much towards obtaining a clean milk supply for Fitchburg and towards diminishing the infant mortality of our city. The price paid the producer by the con- sumer, however, has much to do with the problem of cleaner milk. When the consumer is willing to pay more he will get a
411
REPORT OF BOARD OF HEALTH
better milk. Much could be done to diminish the infant mor- tality of our city by the employment of a district nurse and by the issue of a pamphlet to mothers regarding the care of milk after it is received in proper condition from the milkman and also regarding the care and feeding of the infant during the hot months. If births of infants were reported immediately and mothers were looked up and advised as suggested above, infant mortality during the first few months of infantile life would be materially lessened .* The. Board of Health will willingly co- operate with charitable persons or societies to carry out a plan of this sort if your honorable body is not willing to make an appropriation for this purpose.
TEMPORARY CARE OF PERSONS SUFFERING FROM MENTAL DERANGEMENT.
Chapters 394 and 395 of the Acts of 1911, provide that per- sons requiring public assistance who are suffering from insanity, mental derangement, delirium, except delirium tremens and drunkenness, placed or detained in a lockup, police station, city prison, house of detention, jail or other penal institutions, may be detained for twelve hours, but must be forthwith exam- ined by a physician and furnished suitable medical care and nursing. During this time such persons must be sent to some public or private hospital or provided for in some way. If this cannot be done during the twelve hours, they must be turned over to the Board of Health, who must provide for their admission to a state hospital and for their care temporarily if necessary at a general hospital, or in some private family. Boards of Health may make an agreement with municipal authorities to take care of all cases so placed or detained, but as any physician, police officer of city or town, or member of the district police may at once apply to a state hospital and send them there, provided it is done within twelve hours, it seems to us that the simpler way is the better way, and that Boards of Health should have the care of those only who cannot be sent away within twelve hours.
The chairman of the Board of Health has taken charge of four persons under this law and sent them temporarily to the Worcester State Hospital, entailing an expense of $24, which
*Since this was written a law has been passed requiring births to be reported within 48 hours.
412
REPORT OF BOARD OF HEALTH
has been paid out of the county treasury. Some defects have been found in this law which will no doubt be remedied at the coming session of the Legislature.
MEDICAL INSPECTION OF SCHOOLS.
May 1, 1911, the medical inspection of schools was assumed by the Board, of Health. Medical inspection of schools was first taken up by the School Committee in 1906; two school physi- cians were appointed for the examination of all school children referred to them by teachers for diseases and defects other than those of the eye and ear, and for the examination of working children between the ages of fourteen and sixteen. The ex- amination for defects of sight and hearing were made by teachers as provided in the law. A perusal of the yearly reports of the school physicians shows that very commendable work has been done and that a good beginning has been made in school inspection, but no comprehensive plan has yet been adopted whereby the full effects and intents of the school inspection laws shall be realized. What is the aim of school inspection ? To ascertain by physical examination the physical condition of each pupil entering school, together with his defects of vision, hearing, teeth, of development, etc., to make a record of the same, to advise the parent or guardian of the remedial treatment that should be adopted to perfect his physi- cal condition, and finally to endeavor to see as far as possible that this treatment is carried out, and thereafter to make a yearly examination of the pupil before he enters the next grade. It is not necessary to try to show the importance of this work. Public opinion realizes its importance and will support you in appropriating whatever sums of money are necessary to accomplish it. Although the law of 1908 provides that school committees and boards of health are not to be limited by appro- priations of municipalities in carrying out the provisions of the law regarding school inspection, we much prefer that your hon- orable body make a sufficient appropriation for this work.
This inspection to be complete should include all schools, public, parochial and private. There are in round numbers 6,800 pupils enrolled in these schools; it is believed that at least four school physicians would be necessary to do this work, allowing 1,700 pupils to each physician. Eventually a daily
413
REPORT OF BOARD OF HEALTH
inspection of every school in the city will be required ; this means about an average of two hours each day for the inspector besides additional time for keeping records, etc. School physi- cians are classified under the civil service, and a requisition has already been made for an eligible list from which three or four may be appointed. At first a regular bi-weekly examination will probably be made when the new physicians shall have been appointed and additional visits when necessary. To supple- ment the work of school physicians it has been found that school nurses are necessary, whose work shall be to visit the parents and guardians, to explain to them the nature of the diseases and defects from which pupils suffer, and to try to induce them to carry out the recommendations of the school physicians; to see that they consult their family physicians if they are able to pay them, or to guide them to some hospital or dispensary where they can get free treatment, if they are unable to pay. It has been found by actual experience that unless this plan is adopted very many parents neglect to carry out the recommendations of the school physician. Dr. Frederick H. Thompson, Jr., the present school physician, has for a long time advocated the employment of a school nurse. A committee from the Woman's Club, in conference with teachers of the public schools, sent a letter to the School Committee April 25, 1910, urging more complete medical inspection of schools and the employment of a school nurse. The Board of Health strongly endorses these recommendations and asks your honor- able body to make an appropriation sufficient to enable it to employ four school physicians and a school nurse. The exam- ination of all school children for defective teeth has been made possible through the liberality and public spiritedness of the Grammar School Athletic League, in co-operation with the dentists of Fitchburg. This work is more than half done, and to this league and to the dentists of Fitchburg belongs the credit of inaugurating the first comprehensive and systematic inspection for defects other than those of vision and hearing of school children of Fitchburg. We desire here to place on record our appreciation of and thanks for their free service in this work for the public welfare.
Dr. Frederick H. Thompson, Jr., was appointed school physician, by the Board of Health, last June, and has done the
414
REPORT OF BOARD OF HEALTH
work formerly performed by the two school physicians ap- pointed by the School Committee along the same general lines as has been followed since school inspection was first taken up in this city. His report is as follows :
REPORTS OF SCHOOL PHYSICIAN.
To the Board of Health of Fitchburg, Mass. :
The report of the School Physician of division No. 2 for the school year 1910-1911 is as follows :
Number of visits made from September, 1910, to June, 1911, 235.
Day street,
23
Edgerly,
20
Practical Arts,
18
Highland avenue,
11
Lunenburg street,
29
Goodrich school,
21
Maverick street,
9
South Fitchburg,
15
Salem street,
16
Hosmer,
18
Laurel street,
22
Rollstone street,
24
Pleasant street,
2
High school,
1
School street,
2
Academy street,
2
Ashburnham street,
1
St. Joseph's (Parochial),
1
235
Pupils examined, 1,242
Pupils advised, 506
Pupils excluded, 132
. Pupils not advised nor excluded, including all negative cases, 604
REPORT OF BOARD OF HEALTH
415
Summary of cases referred to the School Physician :
Negative examinations for cultures,
508
Cultures for diphtheria, 172
Negative examinations,
96
Enlarged tonsils with adenoids,
66
Impetigo contagiosa,
65
Pediculosis,
51
Adenoids,
46
Defective teeth,
40
Unvaccinated cases,
24
Enlarged tonsils,
21
Pharyngitis (colds),
14
Tonsillitis,
9
Eye strain,
8
Malaise,
7
Defective hearing (worst cases),
6
Scabies,
6
Internal Strabismus,
5
Nervousness,
5
Septic wounds of hand,
5
Conjunctivitis,
4
Diphtheritic sore throats,
4
Dermatitis,
4
Mentally deficient,
4
Otitis media catarrhalis,
4
Septic wounds of foot,
4
Defective sight (severe),
4
Whooping cough,
4
Septic wounds of finger,
3
Seborrhœic eczema,
3
Choreiform movements,
2
Curvature of spine,
2
Chicken pox,
2
Enlarged cervical glands, Epilepsy,
2
Granulating wounds,
2
Goitre,
2
Heart disease,
2
Herpes simplex,
2
2
27
416
REPORT OF BOARD OF HEALTH
Iritis,
2
Irritable bladder,
2
Ivy poisoning,
2
Stye,
2
Alveolar abscess,
1
Bruise of hand,
1
Bruise, of face,
1
Alopecia,
1
Bow legs,
1
Congenital dislocation hip,
1
Suppurating gland of neck,
1
Eczema of scalp,
1
Eczema of hands,
1
Furunculosis,
1
Frost bite,
1
Granular conjunctivitis,
1
Congenital hip disease,
1
Incised wounds of head,
1-
Incised wounds of hand,
1
Nasal hemorrhage,
1
Refused examination,
1
Rhinitis,
1
Suppurating wound of neck,
1
Suppurating wound of knee,
1
Sprain of wrist,
1
Urticaria,
1
Wen of hand,
1
Multiple warts,
1
Total,
1242
The past year has had the usual run of parasitic skin diseases. The greatest number of the pupils referred to the physician have had physical defects or abnormal conditions of the nose and throat.
In the latter part of January, owing to the prevalence of diphtheria and diphtheritic sore throats in the Cleghorn district among pupils attending the parochial schools, and because of the appearance of cases in the Lunenburg street school district, the Board of Health asked for the co-operation of the school
417
REPORT OF BOARD OF HEALTH
physicians in detecting cases among the pupils of the public schools of these districts. This work was done as recommended and four positive cases were found. The committee on school houses and hygiene voted the school physicians an assistant to carry on the systematic examinations of all school children in the other schools of their districts. It was further ordered that there be daily inspection made at the Lunenburg street school.
Out of 684 examinations made at the Lunenburg street, Goodrich street and Edgerly schools, 172 cultures from sore throats were taken and four were found positive. Two positive cultures were obtained from the Laurel street school.
The services of a school nurse are needed to follow up cases in the homes of children advised or excluded from school. By the co-operation of a nurse with the teachers and the school physician it will be possible to shorten the exclusion period in many of the diseases due to the lack of personal hygiene, and in other cases to hasten the time when the physical defects of the child will be given proper medical attention and the defects remedied. The nurse will educate the parent on matters of common sense hygiene and thereby help to stamp out many of the prevailing parasitic skin diseases that are due to poor hygienic surroundings and which form a large percentage of absences from school.
Since May, 1911, when the Board of Health assumed the duties, the work of medical inspection has been under the direction of this Board with one school physician.
Respectfully submitted,
FREDERICK H. THOMPSON, JR., M. D., School Physician.
Sept. 5, 1911.
To the Chairman of the Board of Health : -
The report of the School Physician for the months of Sep- tember, October, November and December, 1911, is given in detail, viz :
Total visits to schools, 154, as follows : -
418
REPORT OF BOARD OF HEALTH
Sept.
Oct.
Nov.
Dec.
Totals by Schools
Ashburnham street,
2
1
1
2
6
Academy street,
3
5
4
4
16
Clarendon street,
2
2
1
2
7
Day street,
7
5
4
1
17
Dean Hill,
0
0
1
0
1
Edgerly,
2
3
0
1
6
Goodrich street,
2
3
1
1
7
Highland avenue,
2
2
0
1
5
Hosmer,
2
4
2
2
10
High,
0
0
1
0
1
Lunenburg street,
3
4
3
2
12
Laurel street,
2
4
3
3
12
Maverick street,
2
1
0
0
3
Nolan,
1
1
1
2
5
Practical Arts,
2
2
0
1
5
Pleasant street,
3
1
4
2
10
Pearl Hill,
0
1
0
0
1
Rollstone street,
2
4
5
3
14
South Fitchburg,
1
3
1
2
7
School street,
2
2
1
2
7
Wachusett,
0
0
1
0
1
Woodbury,
0
0
1
0
1
Totals by months,
40
48
35
31
154
Total number of pupils examined,
735
Pupils excluded,
115
Pupils advised,
162
Pupils not advised, nor excluded,
160
437
Cultures for diphtheritic throats taken,
74
Throat examinations, no cultures taken,
182
256
Throat examinations for scarlet fever,
42
Total,
-
735
Pupils were referred to the School Physician for the follow- ing diseases and physical defects :
419
REPORT OF BOARD OF HEALTH
Pediculosis,
67
Adenoids.
38
Impetigo contagiosa,
37
Adenoids and enlarged tonsils,
24
Enlarged tonsils,
9
Unvaccinated,
8
Eye strain,
7
Internal strabismus,
7
Pharyngitis (colds),
7
Scabies,
7
Conjunctivitis,
4
Herpes simplex,
4
Septic wounds,
4
Seborrhæic eczema,
4
Laryngitis,
3
Mal-nutrition,
3
Nervousness,
3
Otitis media suppurativa,
3
Tonsillitis,
3
Acute bronchitis, .
2
Cervical adenitis,
2
Defective speech,
2
Dermatitis,
2
Furunculosis,
2
Indigestion,
2
Paronychia,
2
Stye,
2
Burn of face,
1
Bruise of hand,
1
Congenital dislocation of hip,
1
Chicken pox,
1
Defective sight (severe),
1
Defective hearing (bad),
1
Eczema.
1
Foreign body in eye,
1
Granulating wound,
1
Iritis,
1
Rhinitis,
1
Seborrhœa of scalp,
1
Tubercular ankylosed spine,
1
420
REPORT OF BOARD OF HEALTH
Pulmonary tuberculosis,
1
Tubercular adenitis,
1
Teneo-synovitis,
1
Ulcerated tooth,
1
Verruca,
1
Total,
276
Breaking quarantine,
1
Total, 277
Respectfully submitted, FREDERICK H. THOMPSON, JR., M. D., School Physician. Jan. 1, 1912.
To the Board of Health, Dr. F. H. Thompson, Chairman :
In accordance with Chapter 514 of the Acts of 1909, the medical inspection of working children between the ages of 14 and 16 for health certificates was begun in August, 1910.
The report for the year, August, 1910, to August 1, 1911, is as follows :
Number of minors examined, 333
Number of minors failed, 5
The number who failed, three girls and two boys, were refused certificates for the following reasons :
1910. Dec. 19-Evelina Brenconnier, 611 West Main street. Diagnosis: Cachexia, incipient pulmonary tuberculosis. Dec. 30 - Annie Desgrosseiliers, 38 Berry street. Diagnosis : Curvature of spine. Under treat- ment with apparatus.
1911. Jan. 30- Harry M. Lowe, 578 Main street. Diagnosis : Epilepsy. Feb. 24 - Fannie Malk, 5 Johnson street. Diagnosis : Cachexia, pulmonary tuberculosis. Has been under observation at the tuber- culosis clinic.
421
REPORT OF BOARD OF HEALTH
1911. July 24- Thomas Moriarty, 103 Pratt road. Diagnosis : Valvular heart disease,
Respectfully submitted,
FREDERICK H. THOMPSON, JR., M. D., School Physician.
Dec. 14, 1911.
HOUSE INSPECTIONS.
The total number of inspections for the year was 53. Thirty or 56 per cent. of the inspections were made in Ward Two, where there were a large number of contagious diseases during the year. In case a nuisance was found notice was sent to abate the same, and all have been complied with except one which is waiting for legal action.
A new form of inspection blank was used late in the year, which gives the number of sleeping rooms and occupants of the same. The idea of this being to find if any overcrowding occurs in tenements or lodging houses. No overcrowding has been found to date. Following is the tabulated statement of conditions found :
Ward' One, 5; Ward Two, 30; Ward Three, 2; Ward Four, 4; Ward Five, 1; Ward Six, 11.
Number of dwelling houses inspected,
47
dwelling houses and stores,
61
separate tenements inspected, 151
occupants over ten years of age, 595
occupants under ten years of age, 399
vacant tenements,
23
buildings with sewer connections,
41
buildings without sewer connections, 1
buildings on sewered street without sewer connections, 2
buildings having cesspools,
3
buildings having privies,
4
buildings having city water,
52
buildings having well water,
0
privies examined, 1
422
REPORT OF BOARD OF HEALTH
Number of privies well located,
1
privies in good condition,
1
privies in poor condition,
2
cesspools examined,
3
cesspools well located,
3
cesspools in good condition,
2
cesspools in poor condition,
1
yards in good condition,
21
yards in poor condition,
32
out-buildings in good condition,
18
out-buildings in poor condition,
6
houses with good disposition of swill,
32
houses with poor disposition of swill,
19
cellars in good condition,
27
cellars in poor condition,
24
water closets examined,
148
water closets in good condition,
121
water closets in poor condition,
27
water closets in good location,
129
water closets in poor location,
19
water closets with good ventilation,
134
water closets with poor ventilation,
14
sinks examined,
164
sinks well trapped,
157
sinks poorly trapped,
7
bath tubs examined,
19
bath tubs well trapped,
19
basins examined,
15
basins well trapped,
15
wash trays examined,
6
wash trays trapped,
6
buildings having good house drains,
48
buildings having poor house drains,
3
buildings with proper ventilation of house drain, 49
buildings without proper ventilation of house drain, 3
buildings with drainage to surface,
1
buildings with drainage direct to river, 2
423
REPORT OF BOARD OF HEALTH
QUARANTINE EXPENSES. DIPHTHERIA.
Twenty-nine patients were aided at home, detailed list of expenditures. below :
Coal and wood,
$7 90
Groceries and provisions,
121 06
Medical attendance and medicine,
79 25
Milk,
8 40
Nursing care,
38 40
Board and care,
24 65
Reimbursement of wages,
287 93
Amount paid for taking of cultures,
111 00
$678 59
Twelve diphtheria patients were aided in hospitals in other cities in Massachusetts, at an expense of 633 44
Total expenses paid out of Board of Health ap- propriation for aid extended in diphtheria cases,
1,312 03
TYPHOID FEVER.
Eight cases of typhoid fever were aided at the Burbank Hospital, all state cases for which this department was reim- bursed by the Commonwealth.
Expense for board and care at hospital was, $228 06
SCARLET FEVER.
Two cases of scarlet fever were aided at an expense of $10 50 For medical attendance.
MEASLES.
One case of measles was furnished medicine at an expense of $ 75
Total expenses of quarantine, $1,551.34
424
REPORT OF BOARD OF HEALTH
EXPENSES INCURRED DURING DIPHTHERIA EPI- DEMIC.
Services of physicians,
$1,131 00
Services of bacteriologists,
811 00
Groceries and provisions,
724 70
Coal and wood, ,
84 90
Milk,
2 56
Medicine,
8 72
Board and room,
42 13
Services of police officers,
78 39
Services of assistant to agent,
42 10
Culture tubes,
161 50
Incidentals,
3 10
$3,090 10
The above amount was not paid out of the Board of Health appropriation, but was paid out of the incidental account.
TUBERCULOSIS EXPENSES.
Board and care at farms in Ashby,
Mass.,
$535 44
Board and care at State Sanatoria,
2,480 31
Board and care at State Hospital at Tewksbury,
134 00
Board and care in other cities,
110 57
Transportation,
53 08
Groceries and provisions (furnished patients at homes), 66 06
Milk, (furnished patients at homes),
109 89
Eggs, (furnished patients at homes), 22 62
Medical attendance and medicine, (furn- ished patients at homes), 84 40
Nursing care, (furnished patients at homes) 219 20
Coal and wood, (furnished patientsathomes), 13 05 Clothing, 154 68
Blankets,
24 00
Overshoes,
64 32
Paid Burbank Hospital for one patient
treated for tuberculosis of knee, 76 00
Total, $4,147 62
425
REPORT OF BOARD OF HEALTH
Fifty-six patients were aided during the year: One at Burbank Hospital, four at Tewksbury State Hospital, 20 at Westfield Sanatorium, 10 at Rutland Sanatorium, one at North Reading Sanatorium, three at farms, two in other cities, and 15. at homes in this city.
EXPENSES INCURRED IN CARING FOR CEREBRO- SPINAL MENINGITIS CASES.
Medical attendance,
$126 00
Nursing care,
127 10
Amount paid to police department for
services of officers to guard house,
43 56
Medicines,
18 90
Supplies,
31 09
Groceries and provisions,
15 92
Meals for nurses,
27 25
Paid Directory for Nurses, Boston, Mass., for furnishing two nurses,
4 00
Ice,
40
Milk,
2 44
Trucking,
2 50
Wood,
1 00
$400 16
RECEIPTS.
Appropriation,
$10,000 00
Reimbursements from Commonwealth for contagious diseases, 487 57
Reimbursements from private person for tuberculosis case, 12 57
Check from J. R. Fallon for culture tubes, 16 50
Cash Receipts :
129 milk licenses,
64 50
11 oleomargarine licenses,
5 50
14 milk samples tested,
3 50
10 manicure and massage licenses,
10 00
5 undertaker's licenses,
5 00
3 stable licenses,
3 00
426
REPORT OF BOARD OF HEALTH
1 slaughter house license, $1 00
1 rendering license, 1 00
1 permit to collect butcher's waste, 1 00
$10,611 14
Debts receivable :
Amount due from Commonwealth, $460 19
Amount due from town of Concord, 72 44
Amount due from city of Lowell, 4 50
537 13
Total,
$11,148 27
EXPENDITURES.
Salaries, $5,486 87
Tuberculosis expenditures, 4,147 62
Quarantine expenses (diphtheria, scar-
let fever, typhoid fever and measles), 1,551 34 Quarantine expenses (cerebro-spinal meningitis, ) 400 16
Stationery, printing, advertising,
284 31
Automobile expenses,
1,309 64
Disinfectants,
187 20
Milk laboratory supplies,
46 26
Bacteriological laboratory supplies,
112 50
Telephone,
46 82
Ice,
47 04
Postage,
16 70
Express,
21 60
Car tickets,
8 80
Anti-rabic serum,
25 00
Incidentals,
183 52
$13,850 38
Deficit balance, Dec. 1, 1911, $2,702 11
Respectfully submitted, FREDERICK H. THOMPSON, M. D., JAMES BARR, D. S. WOODWORTH, M. D.,
Board of Health.
427
REPORT OF BOARD OF HEALTH
REPORT OF INSPECTOR OF MEATS AND PROVISIONS.
FITCHBURG, MASS., December 31, 1911.
To the Board of Health,
GENTLEMEN : - Herein is submitted the annual report of the Inspector of Meats and Provisions.
SLAUGHTER HOUSE REPORT.
The amount of work in this department is increasing, and it is gratifying to note that the loss from tubercular animals is less than in former years.
The state regulations requiring a tuberculin test on cattle brought into the state of Massachusetts, is doubtless one of the principal reasons for this improvement.
ANIMALS SLAUGHTERED, INSPECTED AND STAMPED IN 1911.
Beef
Swine
Veals
Sheep
January,
25
23
42
February,
23
10
28
March,
15
20
23
April,
8
12
50
May,
10
19
47
June,
8
16
48
July,
9
19
42
August,
22
14
62
September,
22
33
38
October,
29
64
43
November,
32
43
43
63
December,
39
80
55
Total,
242
350
521
63
In addition 12 beef were condemned as tubercular, and 20 veals were below the standard, total number of animals slaught- ered and inspected at the slaughter house and on farms in 1911, 1208 head.
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