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 1934 > Part 7
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(4) I recommend the employment of a restaurant inspector in order to supervise the handling of food in the large number of restaurants and taverns situated in Quincy.
(5) The dental program should be instituted as soon as possible. A gap of two years (with no dental work for the school children) at a time when the usual family has had a sharp drop in their budget, has created a situation that will take time and considerable money to improve.
(6) The establishment of a Health Council which would co-ordi- nate the work of the Quincy Visiting Nurses, School Department, the Society for the Prevention of Cruelty to Children, Quincy Hos- pital, Family Welfare Society, Health Department and the Welfare
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CITY OF QUINCY
Department of the City, would be a desirable thing. This is be- cause of the fact that at the present time there is necessarily some confusion and some duplication of effort. * * * *
The Health Department has the sad duty of reporting the death of Mr. Francis Driscoll, who had been connected with the Health Department as Statistician for two years before his very sudden death. He was a faithful worker and died in the prime of life.
The Quincy Health Department again wishes to thank the State Department of Health, Quincy Visiting Nurses, Quincy Physicians, Quincy School Department, both the "Quincy Patriot Ledger" and the "Quincy Evening News," and the President and members of the City Council.
Mayor Ross has shown an active and continued interest in the work of the Health Department. The Health Department em- ployees have also shown that they are interested in making their department better and better each year.
For this year's motto for the Health Department, let us choose this paragraph from the "Children's Charter," written by Presi- dent Hoover. "For every child a community which recognizes and plans for his needs, protects him against physical dangers, moral hazards and disease; provides him with safe and wholesome places for play and recreation and makes provision for his cultural and social needs."
Any community which can satisfy the requirements in the pre- vious paragraph must be a healthful community, and I think Quincy is healthful.
Very truly yours,
E. B. FITZGERALD, M.D., Health Commissioner.
113
REPORT OF DEPARTMENT OF HEALTH
REPORT OF THE QUINCY HABIT CLINIC
It is of interest as well as satisfaction to note the statistics of the Quincy Habit Clinic for the year 1934. These results are a source of even greater satisfaction when one appreciates that the prevailing economic conditions have meant increased demands on clinic services which were fulfilled, in spite of the fact that the budget did not permit an increase in the clinic personnel, beyond obtaining the services of one additional psychiatrist, which seemed imperative in order to maintain the efficiency of the clinic and to answer the community's needs.
The general outline of the clinic program has not differed from that of the previous year, in that its two main objectives have been clinical and educational.
There has been a weekly clinic held on Thursday afternoons in the Woodard Institute. The aim of the clinic's program has been to relieve children from those emotional handicaps (whether orig- inating in the child on in his environment), to check the beginning of undesirable traits and unacceptable behavior, to assist in direct- ing his potentialities, at the same time appreciating whatever limi- tations he may have and to construct in him wholesome attitudes and patterns of behavior that will enable him to competently meet the complexities of every-day life. To this end the Division of Mental Hygiene has not only provided Quincy with clinical facili- ties for the study of the whole child but has also provided it with an organization that coordinates other agencies and arouses their interest in the mental health of the child through the prevention and correction of personality and behavior problems. Averting difficulties rather than waiting until they have become real prob- lems is the essence of Mental Hygiene.
The psychiatric and psychological and social investigations have continued to improve year by year, but the outstanding improve- ment has been the intensive therapy accomplished in a large num- ber of cases in parents as well as children. The number of chil- dren seen is not the measure of success and real accomplishment comes only after complete and thorough study and treatment of the smaller number of cases.
Clinics maintaining such aims as do the Habit Clinics cannot undertake to study in detail all the cases referred; to do so would not only reduce the clinic's opportunities to deal with the increas- ing intake of cases, but would also embarrass progress in those cases where service is most needed. Therefore, in order to operate efficiently, as well as to maintain the quality of the work, it has been imperative to avoid the jeopardy of conventrated effort on those cases which were organically, socially and intellectually irremediable. The clinics might easily defeat their purpose of usefulness by attempting to do more than they can do well by concentrating on cases in which little benefit could possibly result or by doing with its own staff work which might be done equally well by other agencies. To give intensive study and treatment to other than a practically selective group would be economically as well as physically impossible. Therefore, in considering the mat- ter of accepting cases, it becomes necessary to practice a reason- able amount of selection, and one justly asks the following ques- tions: Firstly, does the case warrant the kind of service we have to offer. If so, is the environmental situation such as could be directed (assuming, of course, that the causative factors in the case are environmental), and are the parents intelligent and dis- posed to cooperate sufficiently to make this service worth while
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CITY OF QUINCY
to them. If the answer to these questions are in the negative, while we do not make a complete study of the case, we either give a consultation service, in which a diagnosis or recommendation may be made, or we refer it to some other agency whom we feel is adequately equipped to deal with the situation.
The monthly conferences with the Schools have been of material benefit and have tended toward a further diffusion of the Mental Hygiene point of view. The school and the clinics are concerned with the education of the child both as regard to personality and capacity. Because of the close relationship between the child's mental life and his education, the Division of Mental Hygiene has always had a keen appreciation of the fact that the school was a pivotal point for furthering Mental Hygiene. A teacher has a definite psychiatric function in the education of the child, not only is she in a strategic position to aid and direct in the growth of his personality, but she is also in an excellent position to recognize the beginning development of psychiatric problems. The person- nel lay just claim to having aided many teachers in developing a new and broader concept of the aim of education. In situations where a teacher's attention was directed solely to the child's ac- quiring the prescribed amounts of subject matter with little or no regard for his development as a whole and where as a result of her restricted perspective, problems of maladjustment and even failure were manifest, a fuller appreciation of the meaning of education was given by the clinic with subsequent benefits to the child.
Educational activities have continued as an outstanding phase of the clinic's program. Lectures and formal courses of instruc- tion have been used as the medium of educational efforts to the public. Lectures were given to various types of social agencies- Parent-Teacher Association, Teachers' Groups and Mothers' Clubs. The educational program has been an aid in influencing community thinking as well as contributing to their social welfare. It has made for a better appreciation of the value of prevention and increased awareness of early signs of behavior difficulties and has led to a recognition on the part of parents and others of the neces- sity for early guidance. It has been axiomatic of our educational program to urge prevention of emotional difficulties and malad- justments of children, and that guidance directed toward preven- tion is more successful, as well as economical, than efforts with problems of long standing. For the most part, every opportunity for contact with groups interested in child welfare was accepted, since it is an established fact that this is one means of promoting community relationships which are beneficial to the furtherance of the clinic's aims. The acceptance of a psychiatric clinic as an integral part of the community depends on the relationships which the clinic has established. The clinic accomplishes its purpose only in proportion to its ability to give parents, schools and community agencies a greater understanding of the individual child and the best methods of directing him. Then, too, the actual performance of the clinic is better understood by other agencies and they are ready to assume their responsibility for their cases, and conse- quently tend to become more discriminating in their requests for service, recognizing as they do the clinic's capacity and essential function.
The fact that the Quincy Habit Clinic reports the largest attend- ance of any of the clinics under the direction of the Division of Mental Hygiene is a real tribute to Quincy's interest and progress in the matter of mental health.
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REPORT OF DEPARTMENT OF HEALTH
The personnel of the clinic wish to extend their sincere appre- ciation to the Health Commissioner, the School Department, and the Community for their invaluable cooperation during the year.
QUINCY HABIT CLINIC STATISTICS 1934
Boys
Girls
Total 44
Total number of clinics held.
Total number of cases carried.
108
55
163
School age, 107-pre-school age, 56
Total number of new cases
68
41
109
School age, 70-pre-school age, 39
Total number of old cases.
40
14
54
School age, 37-pre-school age, 17
Total number of visits by children.
362
157
519
Sources from Which Cases Were Referred
Health agencies
17
Schools
46
Friends and relatives
25
Children's agencies
2
Physicians
12
Community Education Newspapers
0
Speeches
1
Family. agencies
2
Referred by Clinic Staff.
4
REPORT OF BACTERIOLOGIST
JANUARY 1, 1935.
DR. E. B. FITZGERALD, Health Commissioner.
DEAR SIR: During the past year examinations were made in the laboratory as follows:
Plate counts (milk)
656
Pus and streptococci (smears)
656
Chemical examinations (milk)
720
Ice cream (chemical)
40
Ice cream (plate counts)
40
Total examinations
2,012
Respectfully submitted,
EDWIN E. SMITH, M.D.
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CITY OF QUINCY
REPORT OF VENEROLOGIST
JANUARY 1, 1935.
Male Clinic
Treated for gonorrhoea (patients)
16
Discharged cured
5
Left town
1
Lapsed treatment
4
Remaining under treatment
6
Visits for gonorrhoea
250
Treated for syphilis (patients)
32
Contacts and observation
8
Died
1
Transferred to Taunton
1
Lapsed treatment
8
Remaining under treatment
22
Visits for syphilis
619
Total visits by males
877
Female Clinic
Treated for gonorrhoea (patients)
6
Visits for gonorrhoea
33
Contacts and observation
28
Treated for syphilis
20
Referred to private physician
1
Left town
2
Lapsed treatment
6
Remaining under treatment
11
Visits for syphilis
431
Total visits by females
492
Respectfully submitted,
EDWIN E. SMITH, M.D.
117
REPORT OF DEPARTMENT OF HEALTH
REPORT OF INSPECTOR OF ANIMALS
FEBRUARY 13, 1935.
DR. EDMUND B. FITZGERALD, Health Commissioner.
DEAR DOCTOR: The following is my report for the year 1934:
I have inspected 82 cows, all in good condition and under state control for tuberculin testing.
I have quarantined 232 dogs for biting human beings; of this number 13 positive cases of rabies were found. I consider the above information serious and a menace to public health and safety. To emphasize the above danger we have had eight positive cases of rabies since January 1, 1935. I believe and recommend, in spite of its drawbacks, that a quarantine order should be issued stating that every dog be given vaccine or be quarantined for a period of sixty days.
As a matter of illustration, our neighboring town, Milton, Mas- sachusetts, immediately issued orders to vaccinate or to quarantine all dogs after three positive cases were reported. Since then there have been no further cases.
Respectfully yours,
EDWARD A. DEVARENNES, V.S., Inspector of Animals.
PRE-SCHOOL HYGIENE
Number of pre-school children in city (estimated)
7,556
Number of pre-school children (ages 1-5 inclusive) regis-
tered at pre-school conferences 479
Number of visits to conferences
2,759
Number of nurses' visits to and in behalf of children 1,861
Number of baby boarding houses 15
Number of inspections made
269
GENERAL SANITATION
Number of sanitary inspections
768
Per cent of dwellings connected with street sewers (est.) 67
FOOD AND MILK
Number of inspections of food-handling establishments 1,580
Per cent of milk supply pasteurized 98.7
Number of farms producing milk 56
Number of inspections made of such farms
511
Number of pasteurizing or distributing plants 4
Number of inspections of such plants 97
Per cent of milk supply before pasteurization showing a plate count less than 500,000 per c.c. 100
Per cent of total pasteurized supply showing a plate count less than 50,000 per c.c. 95
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CITY OF QUINCY
REPORT OF ORTHOPEDIC CLINIC
FEBRUARY 14, 1935.
DOCTOR E. B. FITZGERALD, Commissioner of Health, Quincy, Mass.
DEAR DOCTOR FITZGERALD: I am attaching my report of the Or- thopedic Clinic for the eight months ended December 20, 1934.
In the past year corrective measures have replaced palliative ones in all the new cases and in the old cases whenever it was pos- sible to convince the parents of the advisability of them. That this has been beneficial is demonstrated by the marked improvement seen in individual cases in a short period of time.
Because of the nature of the cases seen in a children's Ortho- pedic Clinic, the period over which these patients must be treated is necessarily longer than in an adult clinic. However, with cor- rective treatment established as a fundamental in this clinic, I believe that we can look forward to reduction in the number of secondary deformities seen here, together with reduction in the period of convalescence and the end result should be an increasing number of patients discharged as cured.
Very truly yours, JOHN L. DOHERTY.
The following is a report of eight clinics attended by Dr. John L. Doherty from May, 1934, to December, 1934, inclusive:
152 children have been examined-64 were new admissions, 88 for follow-up examination.
Classification of Conditions Found in the New Patients
Pronated feet
38
Pronated feet and knock knee
4
Bow legs
6
Faulty posture
3
Flat feet
12
Spastic paralysis
1
64
Classification of Conditions Found in Old Patients
Pronated feet
43
Pronated feet and knock knee
5
Bow legs
4
Faulty posture
3
Flat feet
32
Spastic paralysis
1
88
119
REPORT OF DEPARTMENT OF HEALTH
The personnel of the Health Department consists of: Health Commissioner Plumbing Inspector Milk Inspector
Sanitary Inspector
Child Welfare Physician
Assistant Child Welfare Physician
Tuberculosis Physician
Venereal Disease Physician
Bacteriologist
Orthopedic Physician
Inspector of Animals
Two Child Welfare Nurses
One Contagious Disease Nurse
One full-time Tuberculosis Nurse
One temporary part-time Tuberculosis Nurse
One part-time Parochial School Nurse
One Clerk
One Custodian for the Dispensary
REPORT OF CHILD WELFARE PHYSICIAN
JANUARY 15, 1935.
DR. EDMUND B. FITZGERALD, Commissioner of Health, Department of Health, City Hall, Quincy, Massachusetts.
DEAR DOCTOR FITZGERALD :- It is my privilege to submit to you the report of the Child Welfare Clinics of Quincy for the year end- ing December 31, 1934.
Statistics
Total Clinic Registration
2,022
Well Baby Clinics
1,744
New Registrations, 1934 814
Preschool Clinics
113
New Registrations, 1934
112
Orthopedic Clinics
165
New Registrations, 1934
137
Total New Registrations 1,063
Number of Clinics
300
Well Baby Clinics
278
Preschool Clinics
9
Orthopedic Clinics
12
Total Clinic Attendance
8,276
Well Baby Clinics
7,834
Preschool Clinics
187
Orthopedic Clinics
255
Total Home Visits by Nurses
4,257
Babies under 1 Year
2,127
Babies 1 to 2 Years
1,464
Preschool Children
397
Boarding Homes
269
The Child Welfare Clinics were held weekly in South Quincy, Quincy Center, Quincy Point, Atlantic, Wollaston; bi-monthly in Houghs Neck; monthly at Squantum.
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CITY OF QUINCY
Figures for attendance at Clinics are as follows:
Station
Day
Attendance New Cases
South Quincy
Monday
1,378
81
Wollaston
Tuesday
1,518
90
Houghs Neck
Tuesday
531
54
Quincy Point
Wednesday
1,502
115
Quincy Center
Thursday
1,499
157
Squantum
Thursday
34
13
Atlantic
Friday
1,372
137
The Preschool Clinic was started again on April tenth and has been held once each month on the second Tuesday afternoon at Woodward School.
The Orthopedic Clinic was held monthly on the third Thursday afternoon at Woodward School. Dr. Miriam Katzeff, who has been associated with this Clinic since it was first started in 1927, re- signed in April, 1934. It has been our good fortune to have had for seven years the advantage of Dr. Katzeff's special interest in the correlation of growth and development with the prevention of orthopedic defects in very young children. Since May the Ortho- pedic Clinic has been in charge of Dr. John L. Doherty.
The Statistics for 1934 compared with those of 1933 show an increase of 451 cases in clinic registrations, an increase of 265 new cases, an increase of 465 calls made by the Child Welfare Nurses. There were 75 more clinic sessions than in 1933. The clinic attend- ance was 267 less than during the previous year. This figure de- crease is a logical corollary to the increase in home visits made by the nurses, since good teaching visits by the nurses in the home substitutes many times for the clinic visit by the parent. This is a most helpful form of service in the homes where there are three or four small children and visits to the clinics are difficult for the mother to arrange.
Reference of Children
During the year 282 children have been referred from the clinics to the care of local physicians, dentists, or hospital.
Referred for Medical Care
211
Referred for Dental Care
61
Referred for Hospital Care
10
The re-establishment of a clinic for dental care for preschool children is filling a need which was becoming serious. In our ef- forts to prepare the children with sound health for school entrance dental care is a major problem. The addition of a Dental Hygien- ist to the staff has been helpful in extending to parents the teach- ing of nutritional needs in relation to dental health.
Volunteer Help and Acknowledgments
The volunteer service as recording secretaries given by the mem- bers of the Junior Welfare League in the Quincy Center and Wol- laston Clinics has been exceedingly helpful. We are grateful for their enthusiastic interest in the clinic activities.
Miss Alice G. Thompson has been for the past four years a vol- unteer as Recorded in the Atlantic Clinic. Her trained assistance and generosity have made this large clinic one of those most easily conducted.
Members of the Wollaston Woman's Club have assisted in the recording of weights of babies in the Wollaston Clinics each week.
121
REPORT OF DEPARTMENT OF HEALTH
Throughout the year there have been at several clinics demon- strations of food products and their value in diets for children.
We appreciate the privilege of holding clinics in Woodward School, Wollaston Branch of the Thomas Crane Public Library, Knights of Columbus Hall at Atlantic, Italian Hall, South Quincy, Methodist Church at Squantum, and the City School Buildings at Quincy Point and Houghs Neck.
The efficiency with which the very large weekly clinic attendance is satisfied depends largely upon the experienced planning of the nurses. Both Mrs. Nettie D. Fowler and Miss Mary Marr have an unusually good understanding of the problems which require help at clinics and have correlated their home visits with clinic activities in such a way that much has been accomplished for the children which would not have been possible in the short period of time allowed for the clinic conference.
I wish to thank you as Commissioner of Health, and the mem- bers of your Health Department Staff, for your understanding and co-operation in all the activities of the Child Welfare Clinics.
Respectfully yours,
RACHEL L. HARDWICK, M.D., Child Welfare Physician.
.
122
CITY OF QUINCY
REPORT OF DISPENSARY PHYSICIAN
JANUARY 1, 1935.
DR. EDMUND B. FITZGERALD, Health Commissioner.
DEAR SIR :- Though dispensary records show a substantial in- crease in the total number of tuberculosis cases in the city-734 for 1934 as against 573 for 1933-a further analysis reveals many hopeful signs in the fight against tuberculosis.
For example-there were less new pulmonary tuberculosis cases. More cases are appearing at the dispensary in the early stages of the disease. We had six minimal cases during the past year-and this is a record for any one year at the dispensary. Usually they appear hopelessly advanced. Another good sign is that physicians are referring more indigent cases in the earlier stages of the dis- ease for diagnosis and hospitalization. More cases appear volun- tarily at the clinic for chest examination. Also, patients readily respond to advice to enter the hospital for treatment and readily give consent for needy childhood types to enter preventoria.
Of course, some of this increase in the number of tuberculosis cases is due to economic conditions, that is, the depression has forced into the clinic cases previously cared for by their relatives at home during prosperity. However, there is another important reason and that is the increased hope and confidence the people have in the new treatment offered by the many surgical pro- cedures for lung collapse. This inspired confidence is truly justi- fied in many cases.
In some cases surgical procedure cuts the time for an arrested case from 2-3 years under the old regime to eight months. After a "rib operation" cough is often quickly suppressed and sputum is free from bacilli, and hence the spread of the disease is checked. Almost all suitable cases are benefited and many are cured. Above all, it inspires confidence and promotes and encourages the tuber- cular patient to undergo treatment early, and this is the key to success in tuberculosis control.
We are fortunate in the fact that our county hospital is at pres- ent doing by far the greatest amount of surgical work so that we not only directly benefit, but also indirectly because more active cases seek treatment; thus hospitalization checks the spread of tuberculosis.
Another good feature noticed as a result of the confidence in- spired in these patients is that they insist upon the family and relatives being examined. Thus new contacts and other cases are discovered and early treatment started.
In a word, it begins to look as if a "New Day" is at hand in the treatment and solution of the tuberculosis problem-and the tax- payers may expect some relief in the cost of tuberculosis control.
"Undernourished Clinic"
This clinic still remains our most important source of education for the prevention of tuberculosis. Here most of the "contacts" are examined and direct contact with the family results.
Thus a two-fold advantage obtains-early infection and disease pathology are discovered-and prophylactic advice given to the whole family. To carry on the pioneer work of the state the cities must depend upon dispensary clinics to control the spread of tu- berculosis and as in all disease problems "prevention is the best policy." For better results upon prevention lines I would again
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REPORT OF DEPARTMENT OF HEALTH
recommend rest periods and forced nourishment for undernour- ished school children and have all active hilum cases enrolled at the dispensary clinic.
"Norfolk Preventorium"
Through the agency of the Federal Government, ERA funds were obtained and a fine outdoor swimming pool and a large rec- reation building were added during the past year to the camp equipment.
This project added much enjoyment to the camp regime and also did away with the necessity of weekly swimming trips to Nan- tasket Beach. Thus more time for sun treatments was gained for the children and this new addition makes the Norfolk Preventorium one of the best in the state. Another good feature was that the city appropriated the usual $2,000 so that we could send 50 instead of 30 children to the preventorium for intensive treatment. This appropriation should be continued because the more children we send to camp means a larger clinic attendance and consequently educational propaganda for tuberculosis prevention will be more widespread in the community.
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