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 1937 > Part 11
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CITY OF QUINCY
of the child begins with a careful physical survey, except where recent and adequate reports of physical examinations are avail- able. Physical defects or disease must be carefully evaluated in any psychiatric program which is to be outlined. In some cases where physical factors are found to be acute and predominantly causative in the particular problem for which the case was referred, the clinic may act in an advisory capacity to the pediatrician; in others, the psychiatric program may proceed simultaneously and cooperatively with the medical program.
The psychological study of the child is the next step. This in- cludes an evaluation of his intellectual capacity, school achieve- ment (if the child is of school age), and special abilities and dis- abilities. The psychologist's contribution to our knowledge of the child's intellectual equipment is an important one that offers a basis for planning, his educational program and his school place- ment. In addition to this, the psychologist's observations of the child during his period of study aids appreciably in obtaining a better evaluation of his total personality.
A detailed study of the child's environment is made by a psychi- atric social worker. This information is obtained from one or both parents, from the physician, and from teachers and others familiar with the child and his total situation. It includes a complete pic- ture of the family situation; a detailed developmental and medical history; a picture of the child's adaptation to the school, both as regards his scholastic achievement and his adjustment to the teachers and the pupils, as well as a picture of his behavior in the play group. The completed study reveals all of the numerous environmental factors, and the child's relationship to his parents, teachers, siblings and others.
The psychiatrist then acquaints himself with the child and the parents, as well as with the data already collected by the other staff members cooperating in the case. The psychiatrist's study may vary from mere observation of the child's behavior in the examining room, to more intensive investigation of his emotions, drives, interests, attitudes, personal relations and mental content, obtained during several interviews.
In dealing with children of pre-school age, psychiatric inquiry frequently is directed more to the parent and the total situation, than to the child himself. We know that many of the difficulties of these younger children are but secondary to problems in the parents, or symptomatic of conflicts within the family group. It thus follows that treatment in such cases is directed toward the parents and the environment rather than directly to the child.
The next step in clinic routine is the summarizing and coordinat- ing by the psychiatrist of all the information and impressions ob- tained by staff members preparatory to a staff discussion. Physi- cians, teachers, social workers, and others interested are welcomed at the discussion. The case is reviewed, the observations of the various staff members reported and discussed, a diagnostic sum- mary made and plans for further study and treatment outlined.
Treatment varies with the individual case, and it is impossible in a report of this nature to adequately discuss the question of treatment of the social, educational, psychological and psychiatric problems revealed in these studies. However, one might roughly list treatment procedures as follows :
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REPORT OF DEPARTMENT OF HEALTH
1. Direct information and advice to parents and teachers.
2. Direct application of remedial procedures appropriate to spe- cific needs of the child.
3. Direct psychotherapy with the child.
4. Psychotherapy for the parent.
5. Social treatment for the environment.
Any one or several of the above approaches to a child's problem may be undertaken by one or more members of the clinic staff, frequently in cooperation with the school, or social agency inter- ested in the case. A large portion of therapy consists of parental education and environment reconstruction excepting in those cases where we are faced with a situation in which the problem is a fundamental one, involving the whole organization of the per- sonality and character of the child. We are all aware of the diffi- culties encountered in attempting to influence the fundamental per- sonality organization of an individual. However, with the knowl- edge which we now have about the nature of the influences that determine personality and character, we are able in certain cases to evaluate what is taking place in the mental development of these children. Not infrequently we see the gradual development of the potential neurotic, eccentric, delinquent and psychotic adult, and it is in these cases where one finds possibilities for fruitful preventive work. Some of our most interesting, as well as our most challeng- ing cases, fall within this group.
For these more serious personality problems, we have made a systematic and concerted effort at treatment. One goal has been our objective: to facilitate the child's emotional, intellectual and social development, so that he will attain a satisfactory adjustment to life inasfar as it is practicable and derive satisfaction from so doing.
In dealing with problems of childhood, parents definitely enter the picture. In a surprising number of cases, many of the prob- lems manifested in the child are imposed upon him by his parents, who obviously exert a powerful influence upon his emotional de- velopment. Many times parents are so preoccupied with the child's physical development and intellectual achievement that they overlook his emotional needs and their paramount influence upon his total development and later success. It is comparatively easy for a parent to evaluate the child as regards his physical and intellectual developments. Frequently, however, because the child's emotional problems are part and parcel of the parents' own emo- tional difficulties, the parents lose their objectivity and are often unable to give the sort of emotional guidance that is necessary or even imperative. Obviously then, a large part in the successful treatment of our cases lies in our ability not only to give parents a better understanding of their own problems and how they affect the child, but also to aid them to achieve a better adjustment themselves.
Parents should and must be reached because of their direct re- sponsibility. They should be impressed with the importance of early habit formation, character building, and behavior foundations in the life of their children. For this reason, we have devoted a reasonable proportion of our educational program to the task of parental education. There is a large number of intelligent parents
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CITY OF QUINCY
who feel the need of a better understanding and seek assistance in the mental guidance of their children. It is, therefore, impor- tant that parent education hold a substantial position in a mental hygiene program. The clinic has thus been keenly aware of its responsibility to assist and encourage parents insofar as it is possible.
The educational program has been sufficiently inclusive to reach not only parents, but also a wide variety of interested individuals, including physicians, teachers, public health nursing. groups and medical students.
The clinic through its educational activities has done much to influence community thinking along the lines of child welfare activities. It has succeeded in formulating more clearly the value of prevention in the field of mental health, and making for in- creased awarement of early signs of behavior difficulties in the minds of parents and others.
During the past year the clinic has added to its regular staff a volunteer worker, specially trained in the treatment of speech disorders. So many requests have been made for this type of service that it has been necessary to temporarily postpone further admission of speech cases.
The remedial teachers from Boston University have continued to give their beneficial assistance, on a volunteer basis at the Quincy Habit Clinic. They have dealt with various educational handicaps in the form of reading disabilities and associated diffi- culties, and the results obtained in these cases have been most gratifying. Not only has this specialized type of service been a means of aiding the child to a better adjustment in the classroom, but it has been a real aid in correcting personality and behavior problems closely related to the educational problem.
A better appreciation of the child's personality is sometimes gained in observing him at play, and child guidance clinics now recognize play technique as a valuable part of the study of certain cases. Occasionally one meets a child in whom there are such factors as fears, shame, anger, feeling of insecurity, etc., any one or all of which may tend to block the interview and prevent an expedient and satisfactory understanding of the case. Play fre- quently introduces a feeling of ease and naturalness in the child, as well as a great deal of spontaneity and, in this way, many of his underlying difficulties may be more clearly expressed than would be possible perhaps in a direct interview. Play may enable him to act out what he thinks and feels, and reveals much about his adaptability with other children. These observations are most valuable to the psychiatrist in his study of the child's personality and related behavior.
We have been fortunate in having the services of two volunteer workers at the Quincy Habit Clinic, who have demonstrated much initiative and ingenuity in the organization of a play group. This has been of inestimable value in three directions-one, in the as- sistance it has provided the staff by means of the observations made; two, in the interest and entertainment it has provided the children during their wait at clinic; three, through the benefits derived by contact with other children in an organized play group.
Mental Hygiene has continued to be accepted as a vital part of the educational program. Monthly conferences with the schools
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REPORT OF DEPARTMENT OF HEALTH
have done a great deal to promote a better understanding of the psychological needs of the child and the responsibility of the school in this matter. It is interesting to observe the widening scope of these conferences-not only have they considered the individual problem cases referred, but also have included general discussions of the broader aspects and implications of mental hygiene prin- ciples as they relate to the school.
The personnel of the clinic wishes to express its sincere apprecia- tion to the Health Commissioner, the School Department, and the Community for their invaluable cooperation during the year.
PROBLEMS DEALT WITH AT THE QUINCY HABIT CLINIC Personality and Habit Problems
Faulty eating
Stammering
Faulty sleeping
Fears
Thumb sucking
Jealousy
Nail biting
Selfishness
Bed wetting
Quarrelsomeness
Day wetting
Overactivity
Disobedience
Cruelty
Temper tantrums
Unpopularity with other children
Destructiveness
Listlessness
Day dreaming
Laziness
Nervous mannerisms
Showing off*
Conduct Problems
Stealing Truanting
Lying.
Sex misconduct
Scholastic Problems
Repeated school failure
Destructiveness
Reading disability
Poor teacher-child relationship
Refusal to attend school
Lazy child*
Inattention
Nervous child*
Listlessness
*Term frequently used by parents, teachers, and others to describe maladjusted children.
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CITY OF QUINCY
REPORT OF PART TIME PAROCHIAL SCHOOL NURSE
DR. RICHARD M. ASH.
JANUARY 1, 1937.
Health Commissioner.
Dear Sir:
I hereby submit my report for part time Parochial School Nurse from January 1, 1937 to December 31, 1937.
Number of visits to Parochial Schools 130
Number of children weighed and measured 1000
Number of children given vision examination 1110
Number of children examined for various causes in nurses room 330
Assisted Dr. Ash at physical examination.
Number of children examined
118
Chadwick Clinics.
Assisted Dr. Pillsbury with Von Pirquet Test
Number of children tested 69
Number of children X-rayed 18
Number of children given physical examinations 10
Number of children referred to family doctor 150
All pupils were given health inspections, after vacation, after returning to school, after an illness, and at the request of the teacher. Pupils were instructed in healthful living.
Number of house calls made to pupils absent for three days or more 180
Number of follow up calls made 200
Approximately 80% of all defects of the pupils have been corrected. Relief Work:
Assisted at T. A. T. Clinics, both in the Parochial and Public Schools. 20
Number of Clinics
Assisted at V. D. Clinics. Number of patients 68
Contagious Work. Number of house calls made 60
Respectfully submitted, HAZEL R. GIFFORD, R.N.
REPORT OF THE POLIO CLINIC
DR. RICHARD M. ASH.
JANUARY 10, 1938.
Health Commissioner.
CITY HALL,
QUINCY, MASSACHUSETTS.
My dear Dr. Ash:
Thank you for your letter of January 4. I am indeed glad that the Quincy Treatment Clinic is to be continued.
Inclosed is a bill for Quincy's share of the Clinic expenses. Wey- mouth is billed for $200.00, Braintree $175.00 and Milton $75.00- the same as last year.
During 1937 twenty-six Quincy Infantile cases made one hundred and forty-two visits to the Children's Hospital Clinic. Twenty-two of these cases received four hundred and thirty treatments at the local Clinic. There were three new cases and one operation was performed.
A total of forty-two individual cases received eight hundred and sixty-eight treatments during the year. Forty-nine treatments were given at Bumpkin Island.
If you desire any further information, I shall be glad to furnish it. Sincerely,
ARTHUR T. LEGG, M.D.
REPORT OF DEPARTMENT OF HEALTH
193
REPORT OF COMMUNICABLE DISEASE NURSE
RICHARD M. ASH, M.D.
JANUARY 1, 1938.
Health Commissioner.
Dear Doctor:
I hereby submit my annual report as Communicable Disease Nurse for the year ending December, 1937.
One thousand, five hundred and ninety-two cases of notifiable diseases were reported as follows:
Anterior Poliomyelitis
11
Chickenpox
418
Dog Bite
128
Epidemic Cerebro Spinal Meningitis
7
German Measles
17
Lobar Pneumonia
106
Malaria
1
Measles
210
Mumps
44
Para Typhoid Fever
4
Scarlet Fever
391
Septic Sore Throat
2
Supperative Conjunctivitis
1
Trachoma
1
Trichinosis
2
Typhoid Fever
3
Whooping Cough 246
Total number of visits
Scarlet Fever
1334
Measles
573
Whooping Cough
312
Typhoid Fever
107
(cultures 60)
(widals 12)
(immunizations 7)
Para Typhoid
40
(cultures 20)
Anterior Poliomyelitis
26
Conjunctivitis
1
Septic Sore Throat
1
Diphtheria Contact
2
(cultures 2)
V. Disease
10
Anterior Poliomyelitis
Eleven cases were reported, all of whom were hospitalized. Eight were cared for in the Haynes Memorial, two at the Quincy City Hospital, and one at the Massachusetts General. Two children died from the disease.
Diphtheria
No diphtheria reported in the city in 1937. The outstanding achievement of the year in communicable disease work, was the immunization of three thousand two hundred and twenty-nine chil- dren, including school and preschool, who were immunized at the
2406
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CITY OF QUINCY
clinics held in the various schools in conjunction with the school department and the State Department of Health.
Five teams, each consisting of a physician and three nurses, covered the various schools, so that all the clinics were held the same day for three weeks in succession.
Seven hundred and fifty-nine children immunized were under 5 years of age. Two thousand and thirty-one were in the age group from 5-10 years and four hundred and thirty-nine children were in the group of those 10 years of age and over.
Measles
There were two hundred and ten cases reported, a decided de- crease in numbers, as compared with the previous year when one thousand one hundred and seventy-seven cases were reported. One patient was sent to the Haynes Memorial Hospital.
Scarlet Fever
Forty-one cases of the total number, three hundred and ninety-one cases, were hospitalized.
Typhoid Fever
The three cases of Typhoid Fever, as well as the four cases of Para Typhoid Fever reported, were treated in the Quincy City Hospital.
Whooping Cough
Two hundred and forty-six cases were reported, a decided increase in numbers, as compared with the previous year. Five cases were sent to the Haynes Memorial Hospital.
Clinics
Fifty-six various clinics were attended during the year.
In the follow-up work 2406 visits were made, including placarding, revisiting, investigating complaints, checking quarantine regula- tions, taking cultures, examination of contacts and releases from quarantine.
Office hours were held daily.
Respectfully submitted, CATHERINE F. COLEMAN, R.N., Contagious Disease Nurse.
REPORT OF THE DENTAL CLINIC
JANUARY 1, 1938.
RICHARD M. ASH, M.D.
Health Commissioner.
Dear Doctor :-
As in the past year the attendance at the Dental Clinic has been very good. Clinics are held every school day from 9:00 o'clock to 1:00 o'clock, at the Coddington School, for the children of the first, second and third grades.
This year, the third grade was included and it was a great satis- faction to note the improvement in the children's mouths. More
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REPORT OF DEPARTMENT OF HEALTH
fillings of the permanent or six-year molars are done to the children of this grade, which I think is of the greatest importance, as these teeth hold the natural formation of the mouth until the following second teeth erupt.
The decidous or first teeth are just as important to the child as his permanent dentition. The child is growing physically, men- tally and structurally, and his teeth are needed to prepare properly the food necessary to carry on this growth. I cannot refrain from quoting Dr. Sweet in the November 1931 Dental Cosmos, in which he says-"An extremely loose decidous tooth, a cavity large or small, a pulp exposure, or an open pulpless tooth may prove such an aggravation to the child that he not only fails to eat the foods that need mastication, but refuses to eat almost everything and is known as a 'finicky eater' by the parents. Such children lose weight and prove a problem both at school and at play. They fail to show improvement until some one puts their mouths in such a condition that meal times are not approached with fear or pain."
Again I want to mention the able and efficient assistance I have received from Miss Katherine Wiseman and Mrs. Gladys Imray, Dental Nurses.
It is with pleasure I extend my thanks to you as Health Com- missioner and also to the members of the Health Department for the help and cooperation I have received during the past year.
Respectfully submitted, LOUIS E. SULLIVAN, D.M.D., School Dental Clinician.
JANUARY 1, 1938.
RICHARD M. ASH, M.D.
Health Commissioner.
QUINCY, MASSACHUSETTS.
Dear Dr. Ash:
I herewith submit to you my annual report for the year ending December 31, 1937.
Dental Program
Assisted Dr. Sullivan in examination of 2,298 school children- Grades 1, 2 and 3.
Number dental clinics
123
Number dental appointments 1922
218
Number different children treated 569
Number total attendance
1704
Number extractions
744
Number temporary teeth extracted
709
Number permanent teeth extracted
35
Number fillings 1007
Number permanent teeth filled
562
Number temporary teeth filled 445
Number prophylactic treatments
392
Number first grade children treated
209
Number second grade children treated
236
Number third grade children treated
38
Number dental appointments not kept
196
CITY OF QUINCY
Number children refusing treatment 28
Number emergency cases
86
Number children completing treatments
318
Number dental home visits
609
Number school visits
43
Clerical Work:
Tabulated appointments-Planned Dental Schedule-Diphtheria Prevention Program
Assisted Dr. Mahoney at twenty clinics
Number diphtheria prevention home visits 826
Tuberculosis Survey :
Assisted Miss Russell in preparing records for survey. Assisted at all X-ray examinations.
Number of home visits
65
Miscellaneous:
Assisted Dr. Costanza
South Quincy Baby Welfare Clinic 1
Assisted Dr. FitzGerald
Wollaston Baby Welfare Clinic 1
Assisted at Preschool Dental Clinics: Dr. Tobben 1
Dr. O'Malley 1
Number contagious home calls
5
Respectfully submitted,
KATHERINE WISEMAN, R.N.
REPORT OF SCHOOL DENTAL CLINIC Year Ending December 31, 1937
DR. RICHARD M. ASH
Health Commissioner.
QUINCY, MASSACHUSETTS.
Dear Dr. Ash:
The following is the report on the work done at the School Dental Clinic.
Number of first, second and third grade children examined
1397
Number dental clinics
85
Number total attendance at clinics
1290
Number different children attending clinics
291
Number extractions 627
43
Number temporary teeth extracted
584
Number fillings
589
Number temporary teeth filled
255
Number permanent teeth filled
334
Number prophylactic treatments
233
Number post operative treatments 5
Number examinations 5
Number permanent teeth extracted
197
REPORT OF DEPARTMENT OF HEALTH
Number completed cases
175
Number refused treatment
11
Number emergency cases
23
Number home visits
517
Number visits to schools
15
Number visits to school nurse
8
Number appointments cancelled
148
Number first grade children treated
129
Number second grade children treated
121
Number third grade children treated
41
Respectfully submitted,
GLADYS IMRAY, R.N.
REPORT OF PRESCHOOL DENTAL CLINIC Year Ending December 31, 1937
DR. RICHARD M. ASH,
Health Commissioner.
QUINCY, MASSACHUSETTS.
Dear Dr. Ash:
The following is the report of the work done at the preschool dental clinic.
Number of clinics
100
Number of total attendance
1017
Number different children treated
219
Number operations . .
982
Number fillings . . .
708
Number extractions
80
Number prophylactic treatments
126
Number treatments
45
Number examinations
23
Number refused treatment
10
Number cancelled appointments
62
Number home calls
341
Number referred for gas anesthesia and extraction .. 25
Respectfully submitted,
GLADYS IMRAY, R.N.
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CITY OF QUINCY
REPORT OF MILK INSPECTOR
JANUARY 1, 1938.
DR. RICHARD M. ASH,
Health Commissioner.
Dear Sir:
I herewith submit my report for the year ending December 31, 1937.
The following statistics refer to milk, cream, ice cream, chocolate milk, buttermilk and oleomargarine, produced and consumed in the City of Quincy.
Dairies in City of Quincy 1 dairy having 60 cows 1 37 „, 1 7
1 3
5 dairies having 1 cow each-5 cows
Total number of cows 112
Total number of quarts of milk produced by dairies in the City of Quincy 1,120
Total number of cows in nearby dairies 1,126
Total number of quarts of milk produced in nearby dairies and distributed in Quincy 11,260
Milk contractors' processing plants, storage and creameries doing business in the City of Quincy 10
Milk contractors' processing plants, storage and creameries who come from out of the City of Quincy 43
Teams, auto cars and trucks employed in distribution of milk, cream, ice cream, chocolate milk and buttermilk (All have been inspected)
205
Milk processing plants doing business in the City of Quincy 4
Amount of milk pasteurized in Quincy (quarts) 33,150
Milk consumed in the City of Quincy (quarts) 36,750
(All milk is pasteurized except certified milk)
Ice cream manufacturers in Quincy 13
Ice cream manufactured in Quincy (gallons) 611
Ice cream consumed in Quincy (gallons per day) 1,961
Ice cream manufactured outside of Quincy (gallons per day) 1,451 (All ice cream is pasteurized)
Certified raw milk consumed in Quincy (quarts) 141
Grade A milk consumed in Quincy (quarts) 2,673
Chocolate milk consumed in Quincy (quarts) 143
Cream consumed in Quincy-all grades (quarts) 2,673
Buttermilk consumed in Quincy (quarts) 451
Retail licenses issued in Quincy for sale of milk, cream, ice cream and oleomargarine 704
Milk samples collected 1,488
Milk samples taken from teams & trucks 850
Milk samples taken from stores & schools 218
Milk samples taken from dairies 420
1,488
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REPORT OF DEPARTMENT OF HEALTH
Milk samples taken before pasteurization
359
Milk samples below State standard for butter fats 3
Milk samples with high bacteria count 9
Cream complaints investigated
1
Cream and ice cream samples collected Samples taken for bacteria 56
112
Samples taken for chemical test 56
112
Number of stores visited and milk, cream and ice cream cabinets inspected and re-inspected 833
Number of milk rooms inspected and re-inspected 359 Number of milk processing plants inspected and re-inspected 291
Number of ice cream manufacturing plants inspected and re- inspected 71
The W.P.A. distributed 30,000 quarts of milk from their commis- sary, gratis, to needy families.
Respectfully submitted,
JAMES O'DOWD, Milk Inspector.
REPORT OF BACTERIOLOGIST
JANUARY 1, 1938.
Plate counts (milk)
688
Plate counts (ice cream) 56
Babcock tests (ice cream)
56
Smears for pus and streptococci (milk)
688
Chemical examinations (milk) 800
Total examinations 2,288
EDWIN E. SMITH, M.D.
200
CITY OF QUINCY
REPORT OF VENEREOLOGIST
JANUARY 1, 1938.
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