USA > Massachusetts > Norfolk County > Quincy > Inaugural address of the mayor, with the annual report of the officers of the city of Quincy for the year 1923 > Part 14
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There were 14S cases of diphtheria in the city during the year. This number includes the "carriers."
All members of the families, and as far as possible all contacts, are cultured in each case.
In this way many carriers are found.
These cases were scattered over the different sections of the city.
There were 4 deaths resulting, in each case the child being five years old or under.
Scarlet Fever
There were 314 cases of scarlet fever reported, with only 1 death.
Most of the cases were of a very mild type, and for this reason in many instances the first case was not recognized until a second or third case appeared.
There were probably others that were never recognized.
Failure to obey quarantine rules was due in most cases to this light type of the disease.
The cases were well scattered over the city, no one section being affected.
Measles
Only 152 cases of measles (a marked decrease over the year 1922) with no deaths for 1923, against 3 deaths for the year previous.
215
REPORT OF DEPARTMENT OF HEALTH
Whooping Cough
Two hundred and twenty-one cases reported, with 1 death. This is a much better record than 1922, when we had 5 deaths.
Whooping cough is one of the most difficult diseases to control, as it is transmitted so often before it is recognized; and, as many people do not consider it dangerous, they do not observe even the mildest quarantine.
Mumps
There were 162 cases reported, with 1 death.
Chicken Pox
There were only 53 cases reported. As a matter of fact, there were many times this number of cases in the city. Because children are not generally sick enough to have a physician the cases are not reported until they come to the Health Department for certificates to return to school.
Typhoid Fever
This year we had a marked increase in typhoid, there being 13 cases reported.
In one instance 5 cases was the result of contact in one family.
In another instance 3 cases became infected from the same source.
The five other cases could not be traced.
Venereal cases reported by the State Department and local board were followed up and investigated.
Thirty cases of diphtheria and 45 cases of scarlet fever were taken to the Homœopathic Hospital at Brighton.
Over 1,077 cultures for diphtheria, and 2 Widals, were taken.
Convictions were obtained in two instances of failure to obey quaran- tine restrictions. Both cases were placed on file.
Approximately 2,392 home visits were made.
The report of the Schick clinics, which were started in October, on Wednesdays and Saturdays, at the Quincy Dispensary, is as follows:
Schick Clinics
Number of clinics held
23
Total attendance
868
Average attendance
33
Number of different persons in attendance
324
Number of persons receiving immunizing treatment without first having
Schick test
81
Schick test given
243
Result of tests:
Positive
136
Negative
47
Combined
10
Pseudo
14
To be read 1/2 or 1/6/24
23
Persons who failed to report for reading after lapse of three weeks . 13
216
CITY OF QUINCY
Number who have received one immunizing dose Number who have received two immunizing doses
42
. 30
Number who have received three immunizing doses Total number of immunizing doses given
. 154
564
Failed to report for further treatment:
For reading
13
For first immunizing dose
1
For second immunizing dose
6
For third immunizing dose 2 Total 22
Percentage found susceptible
70
Percentage found not susceptible
30
No retests have been made as a six-month has not elapsed.
I wish to extend a word of appreciation to Dr. M. T. Sweeney, the Health Commissioner, and all members of the Health Department for their kindly assistance during the year; also a word of thanks to the physicians of Quincy, and to Dr. M. E. Drew, school physician, and the school nurses, for their co-operation.
Respectfully submitted,
RUTH W. BEAN, Contagion Nurse.
REPORT OF QUINCY DISPENSARY
Dr. M. T. SWEENEY, Health Commissioner.
DEAR DOCTOR: - The following is the report of the Quincy Dispen- sary for the year ending December 31, 1923.
Cases of tuberculosis
. 228
Arrested
49
Active
120
Hospital
59
New cases in 1923
. 96
Pulmonary
Other forms
88 8
Admitted to hospitals .
43
Discharged from hospitals
30
Arrested
3
Against advice
15
Improved
12
Cases closed, addresses forwarded to state
46
Cases opened
30
Clinics held
51
Attendance to tuberculosis clinics
425
Visits by tuberculosis nurse
570
Examinations of contacts of tuberculosis
140
Moderately advanced
1
Suspicious
10
.
·
.
.
217
REPORT OF DEPARTMENT OF HEALTH
The moderately advanced cases were sent to Norfolk County Hospital and were discharged arrested.
The suspicious cases were returned periodically for examination until lungs were negative.
Deaths
46
At home
. 30
In hospitals
16
Fourteen of these cases came to our attention by death reports.
Undernourished Clinic during Year ending December 31, 1923
Clinics held
52
Attendance
403
Referred to Quincy City Hospital for treatment and advice 31
Referred to Dr. Harkins
7
Vaccinations
24
Medications provided
8
Milk tickets were freely supplied until weight increases were noted.
On comparing attendance at clinics one is struck by the increase, - 403 for 1923 compared with 276 in 1922. At first one might conclude that this indicated increase in tuberculosis cases in the city, but it may well and probably does mean the public realization of the necessity of early examination and treatment for conditions of "loss of weight," "general debility," etc., rather than wait for telltale cough, night sweats, etc., hence resulting in an early restoration to health rather than a later classi- fication in the realm of pulmonary tuberculosis.
Of course the more generally the attendance is assumed the better from a health standpoint will be our results, and consequently the sooner we will stamp out the rightfully dreaded but equally preventable disease of tuberculosis.
In other words the more "suspects" and "contacts" we can enroll at the Tuberculosis clinic the sooner will obtain a permanent improvement in the health of the community.
Along this line very good results are being reached in the so-called undernourished clinic.
Here many undernourished and underweight children gather Saturday mornings, are examined, given advice and instruction, free milk and free medicine when indication tends to discovery of pretubercular conditions.
Any special eye, ear or throat defects are noted and referred to their proper channels for correction, and then the children return to clinic for further observation.
A new and very important feature has been added this past year, and that is, being able to refer all doubtful cases to Norfolk County Hospital for X-ray.
In this way hilum tuberculosis and other tubercular and pretubercular conditions are ascertained before other clinical signs are present.
Such children are classified, sent to Westfield or similar places, where the child's health and education are jointly looked after, and eventually restored to a condition of health and general usefulness.
Thus it is, - their birthright certificate of health is restored, - a con- dition given to most of us and desired by all.
.
·
21S
CITY OF QUINCY
In closing I wish to thank most cordially the willing effort of Miss Coleman, the Dispensary nurse, the physicians of Quincy and yourself for generous co-operation which tends to make the clinic more efficient in eradicating consumption and thus promoting the general welfare of the community.
Yours very truly, C. J. LYNCH, M.D., Dispensary Physician.
REPORT OF CHILD WELFARE NURSE
JANUARY 1, 1924.
Dr. M. T. SWEENEY, Health Commissioner.
DEAR SIR: - It is with pleasure that I, as child welfare nurse, submit my fourth annual report for the year ending December 31, 1923.
There were four clinics held weekly. as follows:
On Monday afternoons, at the Methodist Episcopal Church. Hall Place. West Quincy, there were 48 clinics held. with a total attendance of 498 babies being weighed. and an average of 11 babies weekly.
On Tuesday afternoons, at the Methodist Episcopal Church, Corner of Newbury Avenue and East Squantum Street, Atlantic, there were 51 clinics held, with an attendance of 932 babies weighed, an average of 18 weekly.
On Thursday afternoon. at the Quincy Dispensary. there were 50 clinics held, with a total attendance of 1,517 and an average attendance weekly of 30 babies.
On Friday afternoons at the Community Church, corner South and Washington Streets. Quincy Point, there were 48 clinics held, with a total attendance of 739 babies weighed, and an average attendance of 16 babies weekly.
The total number of clinics held were 197, and the total attendance was 3.656 babies weighed.
The attention of Dr. Edmund B. Fitzgerald was given untiringly to the Thursday afternoon clinics at the Quincy Dispensary, on High School Avenue, who made 705 examinations.
Of those examined, 28 were referred to family physicians or to other physicians for special treatment: 2 to the Boston Dispensary for surgical correction: 3 for X-ray and treatment of thymus; and 18 to the medical clinic for out-patient treatment. There were 26 sent to the Quincy City Hospital, tonsil and adenoid clinic, and 1 for X-ray of neck: 2 were sent to the venereal clinic at the Quincy Dispensary and 2 referred to the Overseers Department.
There were 395 visits made to babies, and 115 prenatal visits made.
There were 5 homes inspected for the boarding of infants, and 2 homes found for babies.
There were 8 deaths while under the supervision of the Child Welfare Department: 5 were from pneumonia, 1 from congenital syphilis, 1 from ileocolitis. and 1 from malnutrition.
The Wednesday afternoons and Saturday mornings since October 13, 1923. were spent at the Schick clinics, held at the Quincy Dispensary.
Below I will give you a record of the clinic increase since 1920.
219
REPORT OF DEPARTMENT OF HEALTH
CLINICS HELD
1920
1921
1922
1923
Ward 4, Monday, from 2-5 P.M.
47
385
498
Ward 6, Tuesday, from 2-5 P.M.
.
No clinics No clinics 539
166
702
932
Ward 1, Thursday, from 2-5 P.M.
1,220
1,011
1,517
Ward 2, Friday, from 2-5 P.M. .
No clinics
71
659
739
Total attendance
539
2,504
2,757
3,686
.
I wish at this time to thank for their many courtesies and their kindly assistance extended to me and to the child welfare clinics, the Health Department, Quincy City Hospital and other hospitals, physicians and private organizations, Public Welfare Department, and the pastors who gave us space in their churches in which to carry on the Monday, Tuesday and Friday clinics.
I also wish to thank Dr. Fitzgerald for the kindly interest in every baby, and the many hours spent so untiringly in their behalf, and I also extend my thanks to you for your interest in the Child Welfare Department and in those, our future citizens.
Respectfully submitted, NETTIE H. DENTON, R.N.
220
CONTAGIOUS DISEASES REPORTED BY MONTHS, 1923
January
Feb- ruary
March
April
May
June
July
August
Septem- ber
Octo- ber
Novem- ber
Decem- ber
Total
Diphtheria .
9
9
21
10
10
7
6
7
13
15
21
20
148
Scarlet fever
34
53
66
55
33
29
14
2
3
3
8
14
314
Typhoid fever
4
5
32
25
20
37
9
4
4
8
4
152
Measles
7
6
7
4
7
6
5
8
7
14
5
8
84
Pulmonary tuberculosis
10
Tuberculosis, other forms
5
15
16
21
41
35
11
7
3
2
2
4
162
Mumps ·
.
14
6
1
2
5
2
1
1
-
7
14
53
Chicken pox
2
Ophthalmia neonatorum Whooping cough . ·
12
27
55
41
33
9
10
19
4
7
4
221
Lobar pneumonia
17
18
17
3
5
4
2
1
3
1
2
73
.
.
4
3
2
1
-
-
-
I
1
11
Influenza .
.
.
1
-
-
-
-
.
.
6
Septic sore throat
.
Anterior poliomyelitis .
.
-
-
-
1
-
-
-
-
1
Total
.
.
118
135
219
160
161
137
62
52
35
52
57
66
1,254
-
1
4
3
1
2
2
1
-
-
-
.
.
·
1
-
1
-
1
2
1
1
2
-
.
-
2
-
-
-
-
-
.
2
Encephalitis lethargica
4
-
2
-
-
-
2
-
-
CITY OF QUINCY
-
-
-
1
-
.
.
14
2
CONTAGIOUS DISEASES REPORTED BY WARDS, 1923
Ward 1
Ward 2
Ward 3
Ward 4
Ward 5
Ward 6
Total
Diphtheria
29
29
17
50
12
11
148
Scarlet fever
.
1
5
1
1
3
3
14
Typhoid fever
32
38
12
3
45
22
152
Measles
84
Pulmonary tuberculosis
4
-
1
3
1
1
10
Tuberculosis, other forms
30
18
5
5
72
32
162
Mumps
·
12
15
5
3
15
3
53
Ophthalmia neonatorum
23
39
6
6
77
70
221
Whooping cough
15
15
17
7
8
11
73
Lobar pneumonia
.
3
1
-
1
4
3
11
Influenza .
2
Encephalitis lethargica
2
2
-
-
-
2
6
Septic sore throat
2
2
Anterior poliomyelitis
212
275
129
118
319
201
1,254
.
18
15
14
23
8
0 6
Chicken pox
.
-
-
1
1
-
-
-
-
1
1
-
.
-
-
-
Total .
.
·
REPORT OF DEPARTMENT OF HEALTH
221
.
97
50
17
73
34
314
43
.
1
2
222
COMPARATIVE MORBIDITY CONTAGIOUS DISEASES REPORTED LAST TEN YEARS
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
Septic sore throat
Diphtheria
82
125
60
88
78
94
167
122
95
148
Scarlet fever
185
66
249
47
58
141
164
88
135
314
Typhoid fever
31
15
9
19
9
15
9
4
8
14
Measles
170
474
91
124
979
23
163
722
867
152
Cerebrospinal meningitis
48
57
91
104
79
86
77
61
79
84
Tuberculosis, other forms
-
-
-
-
-
-
-
11
15
10
Smallpox
·
13
7
9
16
7
3
3
4
6
Whooping cough ·
19
25
49
42
88
33
115
42
189
221
Chicken pox .
26
19
52
73
84
82
68
116
83
53
Anterior poliomyelitis
1
3
66
2
1
12
4
2
2
Mumps
83
5
34
118
21
21
47
13
118
162
Lobar pneumonia .
-
-
-
12
8
29
47
56
59
73
861
615
245
5
93
11
Influenza
-
-
-
-
-
-
1
2
2
Tetanus
.
Total
658
826
710
617
2,275
1,150
1,124
1,250
1,751
1,254
-
-
-
-
-
-
-
-
.
1 Figures for yours 1914 to 1920 include all forms.
CITY OF QUINCY
-
-
-
-
2
2
6
7
1
-
-
-
-
-
-
-
-
1
-
-
-
-
-
-
.
.
.
.
Pulmonary tuberculosis 1
2
-
Ophthalmia neonatorum
.
Encephalitis lethargica
.
6
223
REPORT OF DEPARTMENT OF HEALTH
LIST OF CAUSES OF DEATHS, 1923
I. GENERAL DISEASES
Scarlet fever
1
Cancer of the female genital or- gans
10
Diphtheria
4 Cancer of the breast 4
Influenza
9
Cancer of other organs .
16
Erysipelas
2
Diabetes . 9
Other epidemic diseases
1
Anæmia
5
Septicemia 3
Alcoholism
3
Tuberculosis of the lungs
23
Other malignant tumors
1
Cancer of stomach and liver
10
Cancer of peritoneum, intestines
and rectum .
10
Total
117
II. DISEASES OF THE NERVOUS SYSTEM AND OF THE ORGANS OF SPECIAL SENSE
Simple meningitis . 3
Encephalitis lethargica . 2
Other diseases of the nervous
system .
3
Locomotor ataxia
2
Cerebral hemorrhage, apoplexy
.
43
Total
.
54
Epilepsy
1
III. DISEASES OF THE
Pericarditis 2
Acute endocarditis ?
Organic diseases of the heart
95
Angina pectoris
6
Diseases of the arteries, atheroma,
Total
147
aneurysm, etc.
32
IV. DISEASES OF THE RESPIRATORY SYSTEM
Chronic bronchitis 3
Broncho-pneumonia
39
Lobar pneumonia .
21
Other diseases of the respiratory
system .
Pulmonary œdma
6
Total
72
V. DISEASES OF THE DIGESTIVE SYSTEM
Diseases of the mouth and annexa 1 Appendicitis and typhlitis 4 Diseases of the liver 4 Other diseases of the digestive 2 system (cancer and tubercu- losis excepted) 4
Diarrhea and enteritis (over two years) 1 Total 17
Diseases of the stomach (cancer and ulcer excepted) · Diarrhea and enteritis (under two years) 1
CIRCULATORY SYSTEM
Embolism and thrombosis
.
9
Diseases of the lymphatic sys-
tem
1
Tuberculosis of other organs
4
Syphilis
1
Whooping cough
1
3
224
CITY OF QUINCY
VI. NON-VENEREAL DISEASES OF THE GENITO-URINARY SYSTEM
Acute nephritis 6 Diseases of the prostate .
1
Bright's disease 14
Other diseases of the kidney and
Total
. 22 .
annexa
1
VII. THE PUERPERAL STATE
Puerperal hemorrhage . 1 Puerperal embolism 1 .
Puerperal septicemia .
1
Miscarriage
1
Puerperal albumina and convul-
sions
1
Total
5
VIII. DISEASES OF THE SKIN AND CELLULAR TISSUE
Carbuncle
1
Pemphigus
1
Total
2
IX. DISEASES OF THE BONES AND ORGANS OF LOCOMOTION
Diseases of the joints
2
x. MALFORMATIONS
Congenital hydrocephalus .
3
Congenital malformations of the heart
3
Total
6
XI. EARLY INFANCY
Premature
10
Injuries by forceps at birth .
1
Other causes peculiar to early infancy
15
Total
26
XII. OLD AGE
Senility
3
XIII. EXTERNAL CAUSES
Suicide by poison 1 Traumatism by railway 2
Suicide by asphyxia
1 Traumatism by other crushing 1
Suicide by hanging
1
Effects of heat 1
Suicide by firearms
2
Other external violence 3
Burns (conflagrations excepted) .
2
Traumatism by fall
5
Traumatism by auto
. 12
Total
31
.
225
REPORT OF DEPARTMENT OF HEALTH
XIV. ILL-DEFINED DISEASES
Unknown
Summary
I. General Diseases 117
II. Diseases of the Nervous System and of the Organs of Special Sense 54
III. Diseases of the Circulatory System
147
IV. Diseases of the Respiratory System
72
v. Diseases of the Digestive System
17
VI. Non-venereal Diseases of the Genito-urinary System
22
VII. The Puerperal State
5
VIII.
Diseases of the Skin and Cellular Tissue
2
IX.
Diseases of the Bones and Organs of Locomotion
2
X.
Malformations
6
XI. Early Infancy
26
XII. Old Age
3
XIII. External Causes
31
XIV. Ill-defined Diseases
6
Total
510
1923
1922
Total deaths .
510
452
Death rate per 1,000 (estimate population 53,368) .
9.56
9.04
Stillborns
26
50
RETURN OF DEATHS, 1923 [Stillborns excluded]
SEX
NATIONALITY
Males
Females
American
Foreign
Provincial
Unknown
January
28
22
29
16
5
-
February
29
33
30
24
7
1
March .
23
26
30
14
5
-
April .
19
25
24
17
3
-
May
15
29
29
10
5
-
June
.
24
23
19
21
7
July
17
21
23
14
1
August
14
24
23
7
8
September
15
17
21
9
2
October
22
20
21
17
4
November
16
17
19
9
5
-
December
6
25
23
8
-
-
Total
228
282
291
166
52
1
6
226
CITY OF QUINCY
/ DEATHS BY AGES, 1923
Under 1 day
14 15 to 19 years
7
1 to 2 days
4
20 to 24 years
9
2 to 3 days
2
25 to 29 years
13
3 days to 1 week
5 30 to 34 years
8
1 to 2 weeks
4 35 to 39 years
14
2 to 3 weeks
2 40 to 44 years
25
3 weeks to 1 month
-
45 to 49 years
27
1 to 2 months
8 50 to 54 years
33
2 to 3 months
4 55 to 59 years
31
3 to 6 months
9 60 to 64 years
48
6 to 9 months
2
65 to 69 years
59
9 months to 1 year
7
70 to 74 years
51
1 year
6
75 to 79 years
39
2 years
6
80 to 84 years
26
3 years
2
85 to 89 years
15
4 years
3 90 to 94 years
8
5 to 9 years,
10
95 to 99 years
2
10 to 14 years
7
Total
. 510
CHILDREN'S DEATHS
1921
1922
1923
Under 1 year
56
66
61
Between 1 year and 2 years
12
14
6
Between 2 and 3 years
7
5
6
Between 3 and 4 years
4
5
2
Between 4 and 5 years
2
6
4
From 5 to 9 years
7
11
10
Total
88
107
89
REPORT OF VENEREAL DISEASE PHYSICIAN
JANUARY 15, 1924.
Dr. M. T. SWEENEY, M.D., Health Commissioner.
DEAR SIR: - Since the clinic was transferred from the City Hospital to the Dispensary in March, I have records of 152 visits to this clinic. I have tabulated the work done as follows:
Total number patients
18
Total number patients receiving treatment for gonorrhœa
2
Total number patients for Wassermann test only . 4
Total number patients for diagnosis of gonorrhœa only
1
Total number patients discharged (no venereal disease)
2
Total number patients who have lapsed treatment
3
Total number patients receiving treatment for syphilis 11
Total number arsphenamine ("606") injections
102
·
·
Respectfully submitted, EDWIN E. SMITH, M.D.
227
REPORT OF DEPARTMENT OF HEALTH
REPORT OF BACTERIOLOGIST
JANUARY 28, 1924.
Dr. M. T. SWEENEY, Health Commissioner.
DEAR SIR: - Since March, 1923, the work of the bacteriologist has been limited to the bacteriological and chemical examination of milk and ice cream.
During this time there have been 35 collections of milk of from 8 to 20 (average, 15 each) samples, and 6 collections of ice cream (4 to 6 samples each).
I have tabulated the work done as follows:
Chemical examinations of milk . 455
Bacteriological examinations of milk 412
Bacteriological examinations of ice cream 32
Chemical examinations of ice cream . 32
B. Coli determinations on "tonics" .
6
Total number of examinations made
937
Yours truly,
EDWIN E. SMITH, M.D.
REPORT OF TUBERCULOSIS NURSE
JANUARY 8, 1923.
To Dr. M. T. SWEENEY, Health Commissioner, Quincy, Mass.
Report of Quincy Dispensary, Year ending December 31, 1923
Cases of tuberculoses in city
228
Arrested cases
49
Active cases
120
Hospital cases
59
New cases reported in 1923
96
Pulmonary tuberculosis
88
Tuberculosis, other
8
Admitted to hospitals .
43
Discharged from hospitals
30
Arrested
3
Improved
12
Against advice
15
Cases closed, addresses forwarded to State Department
46
Cases opened
30
Clinics held
51
Attendance at tuberculosis clinics
425
Visits, tuberculosis
570
Examination of contacts of tuberculosis
140
Moderately advanced
1
Suspicious
10
.
.
The moderately advanced case was sent to Norfolk County Hospital, and was discharged "apparently arrested.". The suspicious cases re- turned at periods for examination until their condition improved and lungs were negative.
228
CITY OF QUINCY
Deaths · At home
. 30
In hospital
.
16
Fourteen of these cases came to our attention by the death report. Personal attention of Dr. Lynch at clinics.
Report of the Undernourished Clinic, Year ending December 31, 1923
Clinics held
52
Attendance
403
Referred to Quincy City Hospital for treatment and advice 31
Referred to Dr. Harkins
7
Vaccinations
24
Medication provided
8
Milk tickets supplied to children until results were noted in weight increase.
Children sent to summer camps 6
Attention of Dr. Lynch at clinics.
Respectfully submitted, LILLIAN T. COLEMAN, R.N.
REPORT OF CHILD WELFARE PHYSICIAN
JANUARY 1, 1924.
Dr. M. T. SWEENEY, Health Commissioner.
DEAR DOCTOR: - During the year 1923, of 590 babies registered in the care of the Quincy baby clinics there were 8 deaths; 5 of these, due to pneumonia, were presumably not preventable; 1 from congenital syphilis; 1 from a fulminating infection (death certificate gave "ileo- colitis" as the diagnosis); and 1 from "malnutrition," this last baby not directly under the care of the clinics.
This figure gives an infant (babies under two) mortality of a little less than 16 per 1,000, in contrast with the figure that you have in your office of the general infant mortality of Quincy. This last figure as compared with that of the previous year may be due in part to the work of the clinics.
Twenty-three children, because of financial reasons, were sent to Boston out-patient clinics. There were many others who the writer feels did not attend a private physician because of expense, and failed to attend clinics in Boston because of the distance.
During my work I have made 708 complete or partial physical examina- tions. The total attendance of the clinics increased 34 per cent. The increase by wards was as follows:
Per Cent
Ward 4
29
Ward 6
. 32
Ward 1
. 50
Ward 2 .
. 12
·
46
I should recommend the establishment of a separate clinic for children from the ages of two to five, such clinic to be kept distinct from any clinic for "pretubercular children."
229
REPORT OF DEPARTMENT OF HEALTH
I should advise the elimination of prenatal work by the present child welfare nurse, such work to be conducted possibly by the district nurse.
I should recommend as far as possible the use of schoolhouses or other public buildings for clinics, because under the present arrangements it is sometimes impossible to correctly weigh the babies on account of insuffi- cient heat. The designation of these clinics and their time by suitable signs would be of some value.
Publicity, perhaps by means of a weekly health column in a local paper, would benefit the work. In this way it might be possible to enlist some volunteer workers to assist Miss Denton in weighing the babies.
This is being done now by Miss Denton.
It has been the custom of Miss Denton to refer all babies who were not progressing satisfactorily to the clinic physician in the central clinic for examination. Because of distances to be traveled many babies have not been seen at all or only when in a very poor state of nutrition. The situa- tion might be improved if more or all of the clinics had a physician in attendance.
I can give no reason why Wards 4, 6 and 2 should not increase at about the same rate. The marked increase in Ward 1 might be repeated in all wards if a physician were in attendance at all clinics. Ward 2 may have diminished somewhat in population because of lessened employment at the Fore River Ship Yard.
There were 101 children over the age of two years registered at the clinics, and during the year there were 54 transferred to school nurses and health stations of other cities.
Recommendations for Future Expansion
The following table will show that two fairly populous wards have no clinics.
WARD
Population (1920)
Clinic
1
9,185
Thursday afternoon
2
8,415
Friday afternoon
3
8,450
No clinic
4
5,834
Monday afternoon
5
9,161
No clinic
6
6,927
Tuesday afternoon
I should recommend that clinics be established for Wards 3 and 5. In the case of Ward 3 it is particularly necessary because of the high Italian population.
I should request the use of another full-time nurse trained in baby welfare work, even if no further increase in the number of clinics is possible. By the report of the child welfare nurse, Miss Nettie Denton, it is seen that 517 visits were made during the course of the year besides conducting four clinics weekly and attending two other clinics. It is obviously impos- sible to do efficient follow-up work and to carry out an educational pro- gram with one nurse as the sole worker.
These recommendations are many and perhaps expensive, but carried to their logical conclusion cannot but mean lowered infant morbidity and mortality, with the ultimate result of fewer dependents on the city and county because of physical and mental defects.
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