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 1938 > Part 9
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The money appropriated yearly for this clinic is a good invest- ment and health dividends in abundance result. Reviewed as a tax problem, it is said that it costs $100 to prevent and $1500 to treat and cure Tuberculosis. Expressed as a survey problem, we esti- mate one year to prevent and from three to five years to cure. The
165
REPORT OF DEPARTMENT OF HEALTH
right thing to do is obvious, and the City of Quincy is doing it in a very thorough manner.
As a corollary, I believe the State should re-establish the "Chad- wick Clinics" in the cities and towns. Originally these clinics dis- covered many Hilum cases among the children and stressed the importance of carrying on the so-called "Ten Year Program."
Many of the cities and towns, since the depression, are unable to stand the expense of this work. Hence, the work is not being done. It is my belief, that the State should again do the work, and spread the expense to general taxation. After all, this problem is really a State problem and all should share in the expense. Otherwise, these primary cases will later become active Pulmonary cases and thus Tuberculosis will rapidly increase, and naturally, Tuberculosis con- trol will be retarded. Briefly, it's the old story, prevention is al- ways the best and cheapest method in solving all disease, and this is doubly so in Tuberculosis. During the last few years there seems to be a laxity in the reporting and handling of the primary and glandular Tuberculosis cases. Such excuses, as a refusal by insurance companies to take these cases are sad indeed, when you realize that these same children are to be the future citizens and home makers of the community. Their health should be para- mount and neither expense nor commercialism should obstruct their progress. We should also remember, that usually, the most successful communities are also the healthiest.
The story of this clinic in Quincy since the beginning, has been one of progress, and a definite increase in its registration has been noted yearly. It has many times brought favorable com- ment from the authorities of the State Preventoria. The constant flow of cases to these institutions, has convinced them, that Quincy is very sincere in its fight to control Tuberculosis, and will not spare. expense when the health of the community is at stake. Of course, all communities believe in this policy but few do so thorough a job as Quincy. Intensive fight against active cases seems to be her slogan in Tuberculosis control and let's hope that Quincy will never change it until full control is obtained.
Along this trend of thought it is certainly worth while record- ing, that during the past year five new cases of pulmonary tuber- culosis were diagnosed in the clinic, of which four were minimal cases. This is very fortunate for the welfare of the cases, and very creditable for the dispensary.
Also, out of 163 possible contacts during the past year 147 were brought into the clinic by the nurses. This is getting 85 per cent, whereas 65 per cent has been the average of the county sanator- ium. Naturally, the full regime of testing is used in these cases, that is, all are given the Mantoux skin test and are X-rayed. All our diagnosed cases are hospitalized within 48 hours to two weeks after reporting to the clinic.
"Camp Norfolk Preventorium"
Surely one of the chief reasons for the success of this clinic is Camp Norfolk. Here carefully selected contact groups are given intensive health training and come back to their homes fully re- stored to health. These children are not only specimens of good health on their return but they also become crusaders for good
166
CITY OF QUINCY
health among their less fortunate play mates. Many a new family becomes registered in the clinic, because they see the good re- sults obtained in the camp by their neighbor's child. Hence, as an educational source, this camp is certainly worth while in the solution of Tuberculosis control. Quincy has always supplied more than half of the camp's quota, and last year, we sent an over supply of ten children to the Prendergast Preventorium.
Quincy is certainly doing a good job in the Tuberculosis prob- lem and should serve as a model for all other cities wishing to do the right thing for their community health.
Sincerely yours, CORNELIUS J. LYNCH, M.D., Dispensary Physician.
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REPORT OF DEPARTMENT OF HEALTH
REPORT OF THE TUBERCULOSIS DISPENSARY NURSES
JANUARY 1, 1939.
RICHARD M. ASH, M.D.
Health Commissioner.
Dear Dr. Ash :-
We herewith submit to you our annual report for the year ending December 31, 1938.
Total number of all kinds of tuberculosis on record in the city 571 Pulmonary tuberculosis 324
Childhood type tuberculosis 215
Other forms 32
New cases of tuberculosis reported during the year. 81
Pulmonary tuberculosis 65
Childhood type tuberculosis 7
Other forms 9
Disposition of New Pulmonary Tuberculosis cases: Admitted to sanatoria 44
Reported by death certificate 2
Taking treatment at home and working 10
Died at Quincy City Hospital 1
Waiting for admission to sanitorium
2
Died at home 2
Diagnosis revoked 2
Children diagnosed minimal pulmonary tuberculosis and were admitted to North Reading State Sana- torium 3
Disposition of New Childhood Type Tuberculosis :
Admitted to North Reading Sanatorium 3
At home under clinical follow-up 4
Disposition of New Other Forms:
Admitted to Lakeville State Sanatorium 6
Discharged from Peabody Home against advice- Diagnosis being made upon discharge 1 At home and under care of Mass. General Hospital 1
On waiting list at Lakeville State Sanatorium 1
"Norfolk County Hospital"
Cases admitted to Norfolk County Hospital during the year . . 53
Cases discharged from Norfolk County Hospital during the year: Arrested Pulmonary T. B. . 14
Indefinite leave of absence to report regularly to the hospital for refills and examinations 6
Left against advice "Unimproved" 5 Left against advice "Improved"-hemo-pneumothorax 1
Left against advice to take home treatment "Im- proved" 1
Discharged in "Improved Condition" 3
2
Quiescent
No Disease "Admitted on 60 day observation" 1 Bronchiectasis "Unimproved" 1
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CITY OF QUINCY
Empyema "Unimproved"-Non T. B. 1
Carcinoma "Unimproved"-Non T. B. 1
Dead 15
Pulmonary and Silicosis deaths 3
Inactive Pulmonary T. B. but active Silicosis 1
Discharged against advice and readmitted-later dis- charged to Wellington Home, negative sputum 1
.... Cases who had been discharged on "leave of absence" but readmitted during the year 3
"North Reading State Sanatorium"
Number of cases listed at sanatorium at beginning of year ....
6
Cases admitted during the year 7
Pulmonary tuberculosis in children 3
Childhood type 4
Cases discharged during the year-"Arrested Hilum" ...
1
Number of cases at sanatorium at end of year 12
"Lakeville State Sanatorium"
Cases at sanatorium at beginning of year
4
Cases admitted during the year 7
Cases discharged during the year 4
Condition on discharge:
Dead 1
T. B. Hips "Arrested condition" with braces on 1
T. B. Kidney "Quiescent" 1
T. B. Hip "Arrested condition" attending school 1
Cases at sanatorium at end of year 7
"Deaths"
Total number of deaths reported during the year 26
Died at home 9
Died at Quincy City Hospital 1
Died at Norfolk County Hospital 14
Died at Boston City Hospital-auto accident 1
At Lakeville Sanatorium 1
"Adult Clinic"
Attendance 298
New cases added to clinic register 97
Number of contacts examinations made 89
Number of sputum examinations made. 209
Patients X-rayed at Norfolk County Hospital 147
Number of Mantoux Tests done 112
"Children's Clinic"
Attendance 1388
New cases added to clinic register 238
Number of contact examinations made. 618
Mantoux Tests done 225
Number of children admitted to Norfolk County Pre-
ventorium for eight weeks during the summer 43
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REPORT OF DEPARTMENT OF HEALTH
Number of children admitted to Prendergast Camp
for two, three and four weeks during the summer- not eligible for Norfolk County Preventorium Vaccinations done
8 10
Cases referred to Quincy City Hospital for T & A operations 24
Cases referred to nose and throat specialist
Cases referred for dentistry 2
14
Cases examined before admitting children to Farring- ton Memorial, Lexington (For Family Welfare) 20
Number of X-rays taken 142 Total number of visits made to and in behalf of tuberculosis patients
1849
Respectfully submitted,
GERTRUDE T. RUSSELL, R.N. KATHERINE J. WISEMAN, R.N., Dispensary Nurses.
170
CITY OF QUINCY
REPORT OF THE CHILD WELFARE CLINIC
JANUARY 1, 1939.
DR. RICHARD M. ASH Health Commissioner.
Dear Dr Ash :-
The last year has seen both an increase in the attendance and in the registration at the Child Welfare Clinics.
The attendance at some of the clinics has been less, but there has been an increase in the registration in every case except the Orthopedic and the Squantum Clinics.
It is only a question of time, however, before registration at Child Welfare Conferences will become less on account of the marked drop in birth rate all over the United States. Of course, this may be completely offset if there is an industrial boom in Quincy along with the usual influx of families.
Among the registered babies, there were no deaths from nutritional diseases or other conditions that are usually considered preventable.
During the year the first Child Welfare Nurse for the City of Quincy, Mrs. Nettie Fowler, resigned. It was the writer's privilege, as Child Welfare Physician, to start work with Mrs. Fowler approximately sixteen years ago. All during that time, and for some years before, her untiring industry and cheerful tact was a welcome help to the mothers attending the Child Welfare Con- ferences.
Truly yours, EDMUND B. FITZGERALD, M.D., Child Welfare Physician.
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REPORT OF DEPARTMENT OF HEALTH
REPORT OF CHILD WELFARE NURSES
JANUARY 1, 1939.
DR. RICHARD M. ASH,
Health Commissioner.
Report of the Child Welfare Nurses for the year ending De- cember 31, 1938.
Total clinic registration during year
1594
Total clinic registration active December 31 1243
Total new registrations during year
724
Total preschool registration (1938)
161
Registered over 6 years in Othopedic clinic
56
Total clinic attendance
6148
Removed from file for reason given below
351
Deaths
6
Broncho pneumonia
3
Suffocation
1
Lobar pneumonia
1
Drowning
1
Inactive 12 months and over
Entered school
Moved from city
Number of clinics held
307
Well baby clinics
286
Preschool clinics
10
Orthopedic clinics
11
Clinics Held
Day
Station
Attendance 1246
989
101
Monday
Woodward (preschool)
138
117
45
Tuesday
Wollaston
785
718
97
Tuesday
Houghs Neck
448
324
48
Wednesday
Quincy Point
1287
859
124
Thursday
Woodward
1002
853
152
Thursday
Squantum
67
67
8
Thursday
Woodward (orthopedic)
158
158
41
Friday
Atlantic
1017
827
108
6148
4912
724
Examined New Cases
Monday
South Quincy
The Houghs Neck clinic is held twice a month; preschool, Squantum and Orthopedic clinics are held once a month, and all others are held weekly.
172
CITY OF QUINCY
Clinic Registration
Clinic
Active' Dec. 31st Inactive 1 year
Reg. in 1938
South Quincy
196
34
230
Wollaston
167
18
185
Houghs Neck
68
38
106
Woodward
226
37
263
Preschool
113
48
161
Orthopedic
103
53
156
Quincy Point
184
49
233
Atlantic
169
64
233
Squantum
17
10
27
1243
351
1594
Boarding homes registered
19
Boarding homes not registered
4
Children now in boarding homes
32
Boarding home inspections
114
Number of visits made to babies under 1 year
1536
Number of visits made to babies between 1 and 2 years
975
Number of visits made to preschool group
401
Number of visits made to boarding homes
114
Total number of visits made
2912
Referred to local doctor by clinic doctor or nurse
125
Referred to private or clinic dentist
50
Referred to habit clinic
56
Respectfully submitted,
MARY MARR McLENNAN, R.N., HAZEL G. KERR, R.N.,
Child Welfare Nurses.
173
REPORT OF DEPARTMENT OF HEALTH
REPORT OF ORTHOPEDIC CLINIC
FEBRUARY 16, 1939. Health Department,
DOCTOR RICHARD ASH, Health Commissioner,
1305 HANCOCK STREET, QUINCY, MASSACHUSETTS.
Dear Doctor Ash:
Enclosed is a report of eleven Orthopedic Clinics attended by me during the year 1938.
With kindest regards, I am
Sincerely yours,
JOHN L. DOHERTY.
JLD:MY
Report of Orthopedic Clinic
The following is a report of eleven clinics attended by Dr. John L. Doherty from January, 1938, to December, 1938, inclu- sive.
171 children were examined-63 were new admissions and 108 were follow-up examinations.
Classification of Conditions Found in New Patients
Pronated feet
25
Knock knees
12
Bow legs
4
Flat feet
18
Poor posture
1
Curvature
1
Congenital valgus
1
Infantile
1
63
One hundred eight children reported for follow-up examination.
174
CITY OF QUINCY
REPORT OF THE HABIT CLINIC
RICHARD M. ASH, M.D., Health Commissioner, CITY HALL, QUINCY, MASSACHUSETTS.
FEBRUARY 25, 1939.
MY DEAR DOCTOR ASH :
You will please find enclosed the annual report of the Quincy Habit Clinic for the year 1938.
I trust this report will be satisfactory. If you feel that further information should be included, please do not hesitate to request it.
Sincerely yours, EDGAR C. YERBURY, M.D., Director.
ECY : MF Enc.
Annual Report of the Quincy Habit Clinic
The twelfth annual report of the activities of the Quincy Habit Clinic for the fiscal year ending November 30, 1938 is herewith submitted.
This clinic has been functioning efficiently throughout the year, continually stressing the quality of work rather than the quantity.
There has been no change in the aim, service and procedure of the clinic. The policy has been to continue to give intensive treat- ment consistent with highest therapeutic standards to a limited number of children needing prolonged study and treatment. Every case referred has been accepted for appraisal at least, and recommendations have been made to the referring agencies as to the most practical course to pursue.
There have been minor changes in the clinic personnel, as well as changes in the manner of referring cases through the School Department. The primary change in the latter method of re- ferring cases was brought about by the establishment of a Guid- ance Department in the School System. This Department has taken over the active responsibility of dealing with the problems of the children in the School System. In the past, all referrals to the Habit Clinic had been made directly by the individual school principal. Any case now needing advice or treatment is first re- ferred to the Guidance Department by the school principal. This Department then decides whether the child is in need of study by the Habit Clinic. With the organization of the Guidance Depart- ment fewer cases have been referred by the School System, as many problems are treated by the Guidance Department.
Following this change in policy, the clinic staff was reduced and at the present time there is only the service of one psychiatrist. The case load became somewhat lighter. However, the surrounding communities have referred their problems directly to the clinic in increasing numbers, so that the actual number of new cases has not dropped as much as would be anticipated.
175
REPORT OF DEPARTMENT OF HEALTH
During the year a number of conferences were held between the clinic staff and the School Department. This service has been a very valuable one as mental hygiene education has proved helpful to those persons dealing directly with children.
The modus operandi is briefly described so that interested per- sons may be better acquainted with the procedure. Children are referred to the Habit Clinic for numerous reasons by various sources. These reasons and sources will be found in the tables em- bodied in this report. The clinic assumes that a child will require detailed study in order to determine the real cause of the difficulty.
This full study begins with a careful checkup of the child's physical condition, excepting where recent and adequate physical examinations have been made and results of the same reported to the clinic. In some cases where definite physical factors are presented and without doubt are the etiological bases for the child's mental problem, the Habit Clinic acts only in an advisory capacity to the pediatrician or proceeds with a cooperative thera- peutic program.
The next step is the psychological study of the child and the interpretation of the results by the psychologist. An evaluation of the child's intellectual endowment, his school achievements, special aptitudes and educational possibilities is made. The psychologist's observation of the child during his period of study offers a definite contribution in a better understanding of the child's personality.
A study of the child's home, school and play environments is made by the psychiatric social worker. This information is ob- tained from all those having a contact with the child, as the parents, relatives, teachers, physicians and others familiar with the child's environment. A complete report of the family situation, personal and developmental histories of the child, along with a record of his adjustment in school completes the picture of his environmental background.
The clinic psychiatrist then makes contacts with the child and his parents. The psychiatric study begins with an observation of the child's behavior and reactions. This procedure is then followed by a general summarizing and coordinating of all the information and impressions obtained by the members of the staff. The case is reviewed at a conference of the staff members, a diagnostic summary is made and the treatment outlined, pointing out to the parents and other interested persons the probable causes of the child's difficulties and the mode of proceeding with treatment.
During the year, the educational program has been continued, keeping in mind the importance of interesting the community (parents, teachers, physicians and public health nursing groups) in the field of mental hygiene. The staff of the Habit Clinic has cooperated with various clubs and organizations in giving talks and lectures on the principles of mental hygiene.
The Director of the Division of Mental Hygiene and the Habit Clinic Staff wish to express their appreciation to the Health Com- missioner, the School Department and the various agencies in the community who have so willingly cooperated with the clinic dur- ing the past year.
ECY :MF
176
CITY OF QUINCY
QUINCY HABIT CLINIC STATISTICS, 1938
Total Number of Clinics Held 47
Total Number of Cases Carried 205
Total Number of New Cases 128
Total Number of Old Cases 77
Total Number of Visits by Children
1035
Sources from Which Cases Were Referred
Schools
64
Relatives and friends
28
Health agencies
16
Physicians
8
Clinic Staff
5
Nursery Schools
3
Family Agencies
3
Children's Agencies
1
Total Number of New Cases referred 128
REASONS FOR REFERRAL TO 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 persons to describe maladjusted children.
177
REPORT OF DEPARTMENT OF HEALTH
REPORT OF PART TIME PAROCHIAL SCHOOL NURSE
DR. RICHARD M. ASH,
Health Commissioner.
Dear Sir:
I hereby submit my report for part time Parochial School Nurse from September 26, 1938 to December 31, 1938.
Number of visits made to schools 42
Number of children given vision tests 799
Number of children weighed and measured 464
Number of children examined in nurses room for various causes
42
Number of dental appointments made
Number completing dental work
6
Sanitary inspection of each school.
Class room inspection of first three grades in each school.
Records.
Chadwick Clinic.
Assisted Dr. Jenkins with Mantoux Test.
96
Number of children tested
Number of arm readings 96
Moving Picture of "Behind the Shadows" was given for the seventh grade students in each school by Miss Nevers.
Relief Work.
Assisted Dr. Ash at Immunization Clinic - Number of children 13
Released scarlet fever case
1
Posted scarlet fever case
1
Respectfully submitted,
KATHERINE WISEMAN, R.N.
REPORT OF PART TIME PAROCHIAL SCHOOL NURSE
DR. RICHARD M. ASH,
Health Commissioner.
Dear Sir :-
I hereby submit my report for part time Parochial School Nurse from January 1, 1938 to October 1, 1938.
Number of visits to Parochial Schools 125
Number of children given vision examinations 1117
Number of children weighed and measured 500
Number of children examined for various causes, in nurses room 243
Number of children given health inspection 2000
Pupils were instructed in healthful living, both in groups individually.
and
Number of class talks given
80
JANUARY 1, 1939.
JANUARY 1, 1939.
Office hours.
10
178
CITY OF QUINCY
All pupils were given health inspection after vacations, when returning to school after an illness, and at request of teacher.
Number of children referred to family doctor 106
All class rooms were inspected where a communicable disease had been reported.
Suspicious looking cases were excluded from school .
Number of house calls made to pupils absent for three days or more 210
Number of follow-up calls made 180
Approximately 75 per cent of all defects of the pupils were cor- rected.
Sanitary inspection of school buildings.
ยท Respectfully submitted,
HAZEL R. KERR, R.N.
REPORT OF INFANTILE PARALYSIS COMMISSION
300 Longwood Avenue, Boston, Massachusetts. JANUARY 25, 1939.
DR. RICHARD M. ASH, Health Commissioner, CITY HALL,
QUINCY, MASSACHUSETTS.
My dear Dr. Ash :-
During 1938 there were fifty-five active infantile cases in the Quincy district. Forty-one of these attended the local Clinic which is held each Monday at the Quincy Dispensary on High School Avenue.
There were forty-four Clinics held during the year and six hun- dred and twenty-six treatments were given.
Four new cases were added to the enrollment-two from Quincy and two from Braintree.
Five cases were operated upon, four of them at the Children's Hospital and two cases were sent to the Wellesley Convalescent Home of the Children's Hospital. Two cases have been for some time at the Lakeville State Sanatorium in Middleboro.
May I take this opportunity to express my appreciation of the splendid cooperation extended to the Harvard Infantile Paralysis Commission workers at the Quincy Clinic.
Sincerely, ARTHUR T. LEGG, M.D.
REPORT OF DEPARTMENT OF HEALTH
179
REPORT OF COMMUNICABLE DISEASE NURSE
JANUARY 1, 1939.
DR. RICHARD M. ASH,
Health Commissioner.
Dear Doctor :-
I herewith submit my annual report as Communicable Disease Nurse for the year ending December, 1938.
One thousand, eight hundred and five cases of notifiable diseases were reported as follows:
Anterior Poliomyelitis
1
Chickenpox
400
Cat Bite
2
Dog Bite
160
Epidemic of Cerebro Spinal Meningitis
2
Encephalitis Lethargica
1
German Measles
17
Influenza Meningitis
2
Lobar Pneumonia
82
Malaria
1
Measles
205
Mumps
52
Para Typhoid
2
Scarlet Fever
824
Septic Sore Throat
3
Suppurative Conjunctivitis
1
Typhoid Fever
5
Undulant Fever
1
Whooping Cough 44
Total number of visits
Scarlet Fever- 1933
By other nurses- 739
2672
Measles
355
Typhoid Fever (Cultures 89) Widals 3
130
Whooping Cough
52
Anterior Poliomyelitis
3
Influenza Meningitis
2
V. Disease
10
Cases sent to hospitals
150
To Haynes Memorial
140
Scarlet Fever
133
Measles
2
Whooping Cough
3
Chickenpox
1
Strept. Throat 1
10
Typhoid Fever
Para Typhoid
2
Anterior Poliomyelitis
1
Influenza Meningitis
2
Anterior Poliomyelitis
One case was reported, a decided decrease as compared with eleven cases reported in 1937. This patient died at the Quincy City Hospital.
3224
To Quincy Hospital
..
180
CITY OF QUINCY
Diphtheria
For the second consecutive year, no diphtheria was reported. During the year 16 clinics for immunization were held .A total of 327 children were immunized. The various age groups are as follows:
Under 1 year 72
1 year
148
2 years
55
years 32
4 years
13
5 years
8
6 years
5
7 years
4
Measles
Two hundred and five cases were reported, five less than in 1937. Two cases were hospitalized.
Scarlet Fever
There were over twice as many cases reported this year than were reported in 1937. One hundred and thirty-three cases, of the eight hundred and twenty-four cases reported, were sent to the John Haynes Memorial Hospital.
Typhoid Fever
Five cases of Typhoid Fever, as well as two cases of Para Typhoid, were reported and sent to Quincy City Hospital.
As the State Department of Health recommends, home visits were made on patients having had the disease. These visits were made monthly for one year. Specimens were obtained and sent to the State Laboratory. Four contacts of Typhoid Fever were given the inoculations by the Commissioner, Dr. Richard Ash, at the Health Department Office.
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