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 1929 > Part 8
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When thereto is added the absence of any follow-up work, per- haps the most important adjunct to such a clinic, it seems almost unnecessary to point out that a most unusual and undesirable con- dition exists.
I hope, however, that the new clinic schedule will in some way modify these defects.
Herewith are some figures:
Total number patients admitted to clinic.
19
Males treated for syphilis.
4
Females treated for syphilis.
5
Females treated for gonorrhoea.
2
Males treated for gonorrhoea ..
4
Old arrested cases re-examined.
2
For diagnosis only (dark field examination). Injections of mercury.
69
Injections of sulpharsphenamine
65
Irrigations for gonorrhoea ...
63
Smears examined for gonococci.
20
Wasserman tests
7
Urinalysis
11
Yours truly,
EDWIN E. SMITH, M.D.,
2
131
REPORT OF DEPARTMENT OF HEALTH
REPORT OF QUINCY DISPENSARY
JANUARY 1, 1930.
DR. EDMUND B. FITZGERALD, Health Commissioner :
DEAR DOCTOR :- During the past year we have made good prog- ress in our campaign against tuberculosis. Naturally this was more marked in our children's clinics than in the adult.
Treatment of adult tuberculosis without compulsory restraint in sanatoria will not be successful and, at present, we cannot get more than 50 per cent of our early cases to consent to sanatorium care. Home treatment at best, despite precautions, is a make- shift, and just so long as you have 50 per cent of your active cases at home, I doubt if we will make much progress.
Far different is the story in juvenile, or so-called hilum, tuber- culosis. Here we have a non-contagious disease, and one which responds well and reasonably soon to proper treatment.
As it is the source of most pulmonary tuberculosis, we are spending most of our time and effort at the dispensary with these cases and we are getting results.
During the past year we have increased our registration from three hundred and thirty-two to four hundred and fifty-two, more than 35 per cent, and our attendance during the past year at clinics was 1,734.
Our standby for nourishment is milk, of which we distributed 4,242 quarts, all of which was furnished without any expense to the city.
In previous years, we had much trouble in getting consent of the parents to allow juvenile cases to go to the sanatoria. This past year 75 per cent of the new cases were sent to sanatoria.
In fact, it is very noticeable in the treatment of tuberculosis that you not only get far better and more permanent results in the juvenile type of the disease, but you also get much better co-oper- ation.
From the economic phase, the logical conclusion is to spend your funds in this field. Furthermore, you need only expend $10 a week for the child, where it costs $30 a week for the adult. In addi- tion, the length of time needed for permanent cure in the child is a matter of months, whereas after years you can only promise "ar- rest" to the adults. Reckoned in dollars and cents, it has been found that $100 spent for the child produces more than $1,500 for the adult. It is hardly necessary to carry the analogy further.
As you know, as a part of our treatment, we sent our quota of children to the Norfolk County Health Camp for eight weeks' in- tensive open-air camp life. During the past year we had our usual good results.
But the great need in the past for holding the health benefits for these children was lacking, namely, the principle of an open-air school room. Now the fulfillment of this great need seems as- sured. During the past year I received wonderful co-operation from the school committee-unanimous consent was given-a sub- committee was appointed, made up of their physician members together with the school physician and the superintendent of schools. I have held conferences with this committee, and it seems assured that some working plan will be started this year in the schools for these children.
132
CITY OF QUINCY
This plan, developed and functioning, will give us a very effi- cient method of handling our juvenile tubercular problem in the city. That our problem is worthy is attested by the fact that from the school survey it seems there are some four thousand children that need treatment.
The detailed report of our clinics is included in a separate re- port.
In closing I wish to gratefully acknowledge the splendid co- operation I have received from the Mayor, City Council, School Committee, the nurses, the physicians and yourself.
Respectfully submitted,
C. J. LYNCH, M.D., Dispensary Physician.
REPORT OF DEPARTMENT OF HEALTH
133
REPORT OF TUBERCULOSIS NURSES
JANUARY 1, 1930.
DR. EDMUND B. FITZGERALD, Health Commissioner.
DEAR DOCTOR :- We herewith submit to you our annual report for the year ending December 31, 1929.
Cases of pulmonary tuberculosis in the city. 276
Active cases 118
Arrested cases 109
Hospital cases
49
Cases of hilum tuberculosis in the city
154
Active cases 97
Arrested cases
37
Hospital cases
20
T. B. Other cases in the city 30
New cases reported during the year
92
Pulmonary cases 69
Hilum cases 18
T. B. Other 5
13 of the Pulmonary cases were diagnosed Minimal Tuberculosis and 12 of these cases were admitted to sanatoria.
Disposition of New Pulmonary cases
Admitted to sanatoria 32
At home under treatment 10
Working 7
Died at sanatoria 4
Died at home
6
Died at Quincy City Hospital
2
Died at Massachusetts General Hospital.
1
Disposition of New T. B. Other cases
Died at Quincy City Hospital. 2
Admitted to sanatoria 1
Working 2
Disposition of Suspicious Pulmonary cases
Admitted to sanatoria on observation
3
Diagnosis Pulmonary Tuberculosis
3
Condition on discharge from sanatoria-Pulmonary
Arrested
4
Improved
4
Against advice
21
Dead
13
Absconded 3
21
Quiescent
2
Transferred to other hospital
1
Unimproved
All ex-sanatoria cases which could be located were visited in their homes by the dispensary nurses. All homes were visited after death of a patient, and all new cases were visited and pro- vided with sputum boxes, paper napkins and large paper bags free of charge so that all possible precautions could be taken. Advice was given.
/
134
CITY OF QUINCY
Deaths
45
At home 20
At Norfolk County Hospital. 14
At Quincy City Hospital 3
At Beth Israel Hospital 1
At Tewksbury 1
At Rutland 1
At Massachusetts General Hospital 1
At Boston Sanatorium 1
At Sharon 1
At Taunton 1
Transportation provided patients to sanatorium 11
Clinics held during the year for adults 52
Attendance at clinics 112
Registration at clinics 60
Visits made 1830
Referred to Welfare Department for aid 4
Referred to City Physician 4
Cases closed and addresses forwarded to State Department. 12
Visits made to X-San cases 262
Milk provided to patients by Norfolk County Health Assoc. (quarts) 4242
10
Cases reopened
6
Number of sputums examined during the year
557
Number of Contacts reported during the year 108
Contacts examined 54
Negative 35
1
Hilum
4
Suspicious 14
Cases referred to Norfolk County Hospital for X-ray exam-
ination
86
Negative 18
Hilum
13
Suspicious Pulmonary 1
Suspicious Hilum
16
Pulmonary
8
30
Undernourished and Contact Children's Clinic
Clinics held 103
Attendance 1734
Referred to Q. C. H. for tonsil and adenoids 65
Referred to school dentists and own dentists 180
Vaccinations done on city cases 6
Von Pirquet tests done 222
Negative 165
Positive 57
Registration of children for the year at North Reading and Westfield State Sanatoria
53
Registration of children at Westfield and North Reading at
end of year
24
Discharged as Latent Hilum 14
Discharged improved 2
Discharged against advice 1
Hilum 1
Pulmonary
1
Information received from doctors regarding private patients
Number of contacts examined during the year
Pulmonary
X-rays taken for camp
135
REPORT OF DEPARTMENT OF HEALTH
Readmitted 2
Unimproved 2
Discharged well-no disease 6
All X-ray cases referred to the Norfolk County Hospital were transported personally by the nurses from the dispensary, with the exception of male adult cases.
During the year extra clinics attended by Miss Russell were:
Toxin Anti-toxin Clinics 14
Child Welfare Clinics 4
Two days were spent at St. Joseph's and St. John's School as- sisting in the audiometer test.
Extra clinics attended by Miss Keeley were:
Audiometer test at St. John's and St. Joseph's School Child Welfare Clinics 25
Toxin Anti-toxin Clinics 32 Provided transportation for children going to Forsyth Den- tal Clinic seven afternoons
Contagious calls made:
Scarlet fever
45
Diphtheria 9
Cultures
12
Measles
20
Poliomyelitis
1
Whooping-cough
14
Both nurses attended a lecture on tuberculosis at the South End Unit, Boston-a medical meeting at the Norfolk County Hospital, where Dr. Chadwick, former superintendent of the Westfield State Sanatorium, gave a very interesting talk on our sanatorium cases and other children's cases. We visited the Prendergast Prevento- rium during the year, and also visited the smallpox cases at Mid- dleboro.
We wish to thank the personnel of the Health Department who have aided us in any way during the past year, and would espe- cially like to mention the Quincy Vincent Club which has so will- ingly aided two of our unfortunate tuberculosis cases, the North Quincy Catholic Club, the Quincy Catholic Club and St. Vincent De Paul Society for their willing aid in some of our less fortu- nate cases. Among others a Mrs. Russell of Marshall street, Norfolk Downs, who personally sheltered an unfortunate tubercu- losis case until we could make arrangements for further care, and Mrs. N. S. Hunting, who was directly responsible for our great increase in the milk fund during the past two years.
Respectfully submitted,
GERTRUDE T. RUSSELL, R. N., MARY E. KEELEY, R. N., Dispensary Nurses.
136
CITY OF QUINCY
REPORT OF CHILD WELFARE PHYSICIAN
JANUARY 1, 1930.
EDMUND B. FITZGERALD, M.D., Commissioner of Health, City of Quincy, Mass .:
DEAR DR. FITZGERALD :- It is my privilege to submit to you the report of the Child Welfare Clinics of Quincy for the year ending December 31, 1929.
Statistics
Total Clinic registration 3,259
Well Baby Clinics (ages 3 weeks to 3 years) 2,783
Pre-school Clinics (ages 3 years to 6 years) 222
Orthopedic Clinics (ages 3 weeks to 6 years)
254
Nutrition Clinics (all ages)
Number of Clinics 398
Well Baby Clinics 365
Pre-school Clinics
30
Orthopedic Clinics 12
Total Clinic attendance 7,154
Well Baby Clinics 6,795
Pre-school Clinics
155
Orthopedic Clinics
204
Average Clinic attendance daily
25
Well Baby Clinic
25
Pre-school Clinic
5
Orthopedic Clinic
17
Total Home Visits by Nurses
3,817
Babies
3,578
Pre-school
239
A more detailed analysis of these figures will be found in the report of the Child Welfare Nurses and the Orthopedic Clinic.
Comparative Figures of Well-Baby Clinics
Year
Registration New Enrollments Attendance
1926.
1,561
497
7,800
1927
1,752
622
7,047
1928.
2,130
693
7,293
1929
2,783
653
6,795
The increase in the number of children enrolled in the clinics and the number of new babies registered as shown in the compara- tive figures (above) for the past four years implies the coopera- tion and interest which the parents share in the service rendered by the clinic activities.
The clinic attendance is variable, fluctuating according to weather, season of the year, relation of clinic day to holidays, and the child or mother's need for clinic service. The clinic attend- ance varies inversely with that of the nurses' home visits. This past year the nurses have made 1,119 more calls in the homes than during the previous year. This fact, as well as the continued at- tempt to have the mothers return to clinic according to a schedule, has eliminated needless visits.
The decrease in clinic attendance should, therefore, be inter-
137
REPORT OF DEPARTMENT OF HEALTH
preted as the successful working out of a plan to promote the most intelligent use of the clinics.
Reference of Children
During the year 208 children have been referred from the clinics to their own family physicians or dentists. They were children who, at the time of clinic attendance, presented some evidence of disease. For this reason they did not qualify as well children and therefore were referred for treatment.
Forty (40) children have been referred from the clinics to other clinics or schools for advice or service.
A summary of these references appears in the report of the Child Welfare Nurse.
Nutrition Work
Through the generosity of the Quincy Chapter of the American Red Cross the Nutrition Demonstrations and Conferences started in the clinics last year have been extended into two clinics each week since May, 1929.
In endorsing the program of health instruction through the teaching of nutrition to the mothers of small children, the Quincy Chapter has taken an active part in one of their National Red Cross peace-time interests. The Red Cross Chapter paid the salary of the nutrition worker and provided the small expense of demon- strations.
Mrs. Mildred D. Burnham of Wollaston, a nutrition worker of experience, has been in charge of the nutrition work in the clinics.
With the volunteer assistance of Miss Marjorie Foster, Educa- tional Director of the New England Dairy and Food Council, Mrs. Burnham has directed a well-rounded educational program, which has met with the enthusiastic appreciation of the clinic mothers.
The details of the demonstrations have been illustrated each week by a short printed lesson-sheet which has been distributed to those interested in the subject.
The collection of material has been so arranged that it fits into a loose-leaf folder, enabling many of the mothers to compile in book form excellent nutrition material which they are using as guides in the care of their children.
The nutrition worker's report will give a review of the material which has been demonstrated and the subjects of conferences with the mothers. Over 1,000 mothers have been helped by this pro- gram.
Volunteer Help
Volunteer help in the form of service has been given in the Child Welfare Clinics this year by the following organizations:
The Junior Welfare League of Quincy
The Wollaston Mothers' Club
The Wollaston Woman's Club
The Girl Scouts
The Boston School of Physical Education
The Garland School of Homemaking
The Graduate School, Harvard Medical School
The New England Dairy and Food Council
The Junior Welfare League of Quincy has adopted an interest in the Child Welfare Program and has organized a volunteer serv- ice at several clinics. Their members serve as recorders for both doctors and nurses, and entertain the children of run-about age while the mothers are engaged with the Nutrition worker.
138
CITY OF QUINCY
This service has been greatly welcomed by the clinic mothers and the clinic staff. It has long been realized that such service was an essential part of a well-conducted clinic but until this year no arrangements had been made to make it possible.
The addition of small tables and chairs, balls and crayons, to the clinic equipment has facilitated the work of caring for the run-about age children according to an approved plan of health education.
Orthopedic Clinic
Quincy bears the distinction of leadership in having a preventive orthopedic program exist as a part of the Child Welfare program. Once each month a clinic has been held for the examination of children whose muscle tone was poor, whose posture of back or feet was faulty. The examinations have revealed conditions, which, with proper advice to the mothers, could be corrected at home.
Several serious deformities have been prevented by early advice or reference to the hospital for treatment.
The medical community in Quincy offers, at present no ortho- pedic service to its people. This fact may account for the welcome with which the clinic advice is received by parents and the diligence with which they follow the directions given.
The orthopedic clinic report gives a classification of the condi- tions found at the time of examination.
Recommendations
That the Child Welfare Clinics continue the full program of activities which this past year have contributed to the positive health of Quincy's community of children.
That the citizens' interest in an appropriate building for health- activities headquarters (A Health Center) be encouraged further.
That better housing be secured for the South Quincy Clinic. The present quarters for this clinic cannot be adequately heated for clinic work in winter.
That the clinics held at Woodward Institute on the second Thursday of each month be considered as material for a teaching- center, and welcome to visit the demonstrations be extended to per- sons interested in progressive public health programs.
Acknowledgments
The success of the Child Welfare Clinics is in a large measure due to the interest and help which you have given to the details of the service.
Your Child Welfare workers have considered it a privilege and a pleasure to work under your leadership.
Mrs. Fowler and Miss Marr have been enthusiastic and untiring in their service. They have been most helpful assistants to the doctors and excellent executives. They have carried into the homes more instruction than in previous years.
For their cooperation, appreciation is expressed to the personnel of the Health Office, other members of the staff, the Quincy Chap- ter American Red Cross, the Junior Welfare League of Quincy, the Wollaston Mothers' Club, the Wollaston Woman's Club, the Girl Scouts, the Fore River Club, the Presbyterian Church of South Quincy, the Council of the Knights of Columbus, and the Trustees of Woodward Institute.
Respectfully submitted,
RACHEL L. HARDWICK, M.D., Child Welfare Physician.
139
REPORT OF DEPARTMENT OF HEALTH
REPORT OF CHILD WELFARE NURSES
JANUARY 1, 1930.
DR. EDMUND B. FITZGERALD, Health Commissioner.
DEAR DOCTOR :- I herewith submit my tenth annual report of Child Welfare work during the year 1929.
There were 356 baby clinics held, with a total of 2,783 registra- tions, and 6,795 visits to clinics, and an average attendance of 19. At these clinics there were 653 new enrolments. There were 4,704 complete or partial examinations made by Dr. Rachel Hardwick and assisting physicians, who gave advice to mothers, and referred 208 to local physicians. During the year there were 464 babies who moved from the city, making a registration of 2,319 babies enrolled on December 31, 1929.
A Pre-School Clinic was held once a month, from January 1 to July 17, inclusive, From then on a weekly clinic was held. Chil- dren between the ages of 3 and 6 years were admitted to this clinic. The total attendance at these clinics for the year was 155 children.
There were 147 complete or partial examinations made by Dr. Rachel Hardwick. There were 92 new enrolments, making a regis- tration for the year of 194 children. Of these there were 40 re- ferred to the School Department, 42 moved from the city and one death, making a registration of 112 on December 31, 1929.
On the second Thursday of each month an Orthopedic Clinic was held by Dr. Miriam Katzeff. There were 12 children referred to local physicians or to hospitals for follow-up or corrective treat- ment. Eight of this number were over the age limit at the clinic. There was one child with tuberculosis of the knee sent to the Chil- dren's Hospital from this clinic, and from there to Massachusetts State School at Canton, Mass.
There were 3,578 visits made to babies and children between the ages of 3 and 6 years who were enrolled in these various clinics. Toxin-antitoxin was recommended at all clinics.
During the year there were 184 inspections made of 15 boarding houses for infants.
There were 9 children referred to the Children's Hospital for fur- ther corrective treatment or advice as follows:
Medical
3
Nerve
2
Orthopedic 4
There were 4 children referred to schools for speech training. One final examination made to admit a child to the Perkins Insti- tute for the Blind.
Thirteen babies were referred to the Quincy City Hospital:
Tonsilectomy
4
X-ray of chest 2
X-ray of thymus 3
X-ray of hip 2 X-ray of shoulder 1
X-ray of finger and chest 1
One child referred to the Massachusetts Eye and Ear Infirmary; 12 children were referred to the Habit Clinic in Quincy.
140
CITY OF QUINCY
Seven Intra-dermal tuberculin tests were made at the Pre-School Clinics.
Six appointments were made for dentistry at the Pre-School Dental Clinic which starts operations on January 2, 1930.
Baby Clinic Attendance
Ward 1 Woodward Institute.
1,063 Decrease since 1928
Ward 1 Houghs Neck.
572
Increase over 1928
Ward 2 Quincy Point. 951
Increase over 1928
Ward 3 South Quincy
1,162 Increase over 1928
Ward 4
West Quincy
561 Decrease since 1928
Ward 5
Wollaston
1,334 Decrease since 1928
Ward 6
Atlantic
1,152
Same registration
6,795 Decrease since 1928
Twice each week Mrs. Mildred Burnham, Nutrition Advisor, gave very helpful information and instruction on nutrition and the selection and preparation of foods. Mrs. Burnham's salary was paid by the Local Chapter of the American Red Cross.
From February to June, inclusive, Miss Frederickson, a physio- therapist, made follow-up home visits to orthopedic cases. She gave advice and instruction to mothers and children in corrective exercises.
During the year Child Welfare Nurses assisted at toxin-anti- toxin clinics when needed. Miss Mary Marr made six visits to Boston hospitals with babies; 3 visits to local physicians with children for nose and throat treatment and assisted at the Audi- ometer tests made at St. Joseph's Parochial School.
Deaths during the year of 1929 were:
Pneumonia
3
Cerebro-Spinal Meningitis
1
Acute Gastro Enteritis
2
Splenic Luekemia
1
Acrodynia
1
Of these deaths only the two gastro enteritis might possibly be considered as preventable.
Respectfully submitted, NETTIE DENTON FOWLER, R.N., MARY E. MARR, R.N., Child Welfare Nurses.
141
REPORT OF DEPARTMENT OF HEALTH
REPORT OF ORTHOPEDIC PHYSICIAN
JANUARY 1, 1930.
DR. E. B. FITZGERALD, Commissioner of Health, Quincy, Mass.
DEAR DR. FITZGERALD :- The following is the report of the Or- thopedic Clinic for the year 1929:
Number of clinics (one each month) 12
Number of visits to the clinics 208
Number of new cases examined 94
Follow up on examinations made in 1928 114
Classifications of conditions found in the new cases:
Abnormal feet
50
Rickets with mild deformities ..
9
Faulty posture with abnormal knees and feet.
9
Bow legs
7
Muscular atonia
4
Spastic paralysis
1
Infantile paralysis
1
Normal children (shoe advice given).
13
Interest in the orthopedic clinic is growing, as shown by the in- crease in registration of 44 cases over last year's figures.
A large measure of the success in this clinic is due to the co- operation of the Child Welfare Physician and the nurses of the Health Department.
It has been our good fortune to receive the service of a physio- therapist, Miss Dorothy Frederickson, of the Boston School of Physical Education. Miss Frederickson made 58 home visits in order to teach mothers how to carry out the directions given in the clinic. Unfortunately her volunteer services were limited to only three months. We are hoping to have a similar worker from the same school during February, March and April of this year.
We have had another volunteer, Mrs. Barbara Sears Rice, who has greatly added to the efficiency of the clinic by acting as re- corder. It is hoped that she may be able to continue this contri- bution during the coming year.
Respectfully submitted,
M. G. KATZEFF, M.D., Orthopedic Physician.
142
CITY OF QUINCY
REPORT OF QUINCY HABIT CLINIC
JANUARY 1, 1930.
EDMUND B. FITZGERALD, M.D., Health Commissioner, Quincy,
Massachusetts :
MY DEAR DOCTOR FITZGERALD :- I beg to submit the following report of the activities of the Quincy Habit Clinic from January 1, 1929, to December 31, 1929:
Number of weekly clinics held 44
Number of new cases referred 98
Number of children attending 211
Number of visits made by children 397
Number of visits made by social worker 737
The activities of the Habit Clinic in Quincy during the year nine- teen hundred and twenty-nine more than doubled those of previous years. In fact, both the clinic attendance and the demand for field work were greatly in excess of what were anticipated. It is of interest to note here that this one Habit Clinic outnumbered the attendance of any of the other State Habit Clinics.
The course followed by the clinic varied but slightly from that of other years in that its interests were chiefly confined to a two- fold purpose, namely, examination, diagnosis and treatment of pre- school cases referred and educational work in the community. This latter phase of the clinical program has been most gratifying in its results, and it is our impression that this year it has been more expansive and far-reaching in its effects than ever before.
The operating of the clinic at the Woodward Institute has markedly increased and facilitated the work since it identified the Habit Clinic as an integral part of the preventive work being done by the Health Department of Quincy and also because the Institute seemed to be the logical and most accessible site for a clinic of this kind, as it is one that coordinates well with a medical clinic and consequently the conjunction has meant an interchanging of clinical material between the Well Baby, Pre-School and the Habit Clinics.
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