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 1943 > Part 5
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Deaths from Reportable Diseases. There were no deaths from typhoid fever, infantile paralysis, diphtheria, measles, scarlet fever or whooping cough during the year 1943. Among the deaths in this group were, 30 from tuberculosis, all types, 18 from lobar pneumonia, and 3 from cerebrospinal (meningococcus) meningitis.
Infant Mortality. During 1943 there were 64 infant deaths, indicating the infant mortality rate as 35.3 per 1000 live births, as against 48 deaths in 1942, and a rate of 28.3 in that year. The 1942 rate was the lowest ever obtained in Quincy; however, the 1943 rate was better than any year previous to 1938. Of these 64 deaths, 44 or 69% were under 1 month of age. The leading cause of death was prematurity, claiming 24 or 371/2% of the total infant mortality, and 55% of those deaths of less than 1 month of age. Table 2 classifies the infant deaths by age and cause; while the rates for the past ten years are included in Table 5.
Maternal Mortality. For the first year in the City's history there were no maternal deaths. Table 5 shows the rates for the past ten years.
Births
There was a total of 1,815 births credited to Quincy in 1943. There were 1,672 that actually occurred in the city. When we subtract 339 of these that were non-resident births, and add 482 resident births that occurred outside of Quincy, we get the above mentioned figure of 1,815 resident births. This gives us a birth rate of 23.6 per 1,000 population, the highest rate since 1920. These 1,815 births are the greatest number ever recorded in Quincy
86
CITY OF QUINCY
for a calendar year; and the excess of births over deaths (958) is the greatest in our history. Only 22 of the total births occurred in homes; the balance occurring in hospitals. For birth rates since 1934 see Table 4.
Recommendations
Following up a recent letter to you, I urge the full cooperation with the state in mosquito control work within the city. Last summer, because of the prevalence of these pests it was unbearable to remain out of doors in the early morning or evening for either recreation, rest or work in gardens or around the homes. Aside from the possible sickness, in case some of these mosquitoes were of the anophales group, the proportionally small expenditure in ratio to the benefits derived make the effort a "must project." To get the best results this work should be started early in the spring.
Again, I urge that when any licenses are applied for to the License Commission for any business requiring equipment in accordance with State Health Laws, or the regulations of this department, that the Health Department be notified of the appli- cation in time to see that the full requirements are met before the license is issued. This would eliminate much extra effort on the part of our inspectors and eliminate court action.
Rabies in animals continue to occur in communities nearby. While we had no cases reported in 1943, the only insurance for safety of families and animals is the annual innoculation of dogs by their veterinarian.
In closing I must mention the splendid cooperation by the Quincy Patriot Ledger in affording us real publicity in all of our projects. Only by acceptance of the public can our various endeavors be successful; and newspaper assistance is a most valued asset.
Respectfully submitted,
RICHARD M. ASH, M,D., Health Commissioner.
87
REPORT OF DEPARTMENT OF HEALTH
TABLE 1 Resident Deaths According to Cause, 1943 (International List of Causes of Death)
All, CAUSES .857
I Infectious and Parasitic Diseases. 41
6. Cerebrospinal (Meningococcus) Meningitis 3
13. Tuberculosis of Respiratory System 27
13c. Tuberculosis of unspecified site .. 1
14. Tuberculosis of the meninges and central nervous system 2
30. Syphilis 3
33. Influenza 2
44b. Hodgkin's disease 3
II Cancer and Other Tumors 118
45. Cancer of the buccal cavity and pharynx ....... 4
46. Cancer of the digestive organs and peri- toneum 48
47. Cancer of the respiratory system 12
48. Cancer of the uterus 9
49. Cancer of other female genital organs 3
50. Cancer of the breast 12
51. Cancer of the male genital organs
8
52. Cancer of the urinary organs 3
53. Cancer of the skin. 4
55. Cancer of other and unspecified organs. 13
57. Tumors of unspecified nature 2
III Rheumatism, Diseases of Nutrition and of the
Endocrine Glands, Other General Diseases and Avitaminoses 12
61. Diabetes mellitus 8
52. Diseases of pituitary gland. 2
63. Diseases of the thyroid and parathyroid glands 1
64. Diseases of the thymus gland 1
IV Diseases of the Blood and Blood-Forming Organs 6 73. Anemias (except splenic anemia) 2
74. Leukemias and aleukemias 4
V Chronic Poisoning and Intoxication 1
77. Alcoholism 1
VI Diseases of the Nervous System and Sense Organs 93
80. Encephalitis (non-epidemic) 1
81. Meningitis (not due to meningococcus) 1
82. Diseases of the spinal cord (except locomotor ataxia and disseminated sclerosis) 5
83a. Cerebral hemorrhage or effusion 70
83b. Cerebral embolism and thrombosis. 8
83c. Cerebral softening 1
88
CITY OF QUINCY
83d. Hemiplegia and other paralysis of unspeci- fied organs 1
85. Epilepsy 2
86. Convulsions (under 5 years of age). 1
87. Other diseases of the nervous system 1
89. Diseases of the'ear and mastoid process ..
2
VII Diseases of the Circulatory System 341
91. Acute endocarditis 1
92. Chronic affections of the valves and endocar- dium 17
93. Diseases of the myocardium 141
94. Diseases of the coronary arteries and angina pectoris 115
95. Other diseases of the heart 35
97. Arteriosclerosis 29
99. Other diseases of the arteries 3
VIII Diseases of the Respiratory System 60
105. Diseases of the larynx 1
106. Bronchitis 2
107. Broncho pneumonia 24
108. Lobar pneumonia 18
109. Pneumonia (unspecified) 8
111. Hemorrhagic infarction, thrombosis, edema and chronic congestion of the lungs 2
112. Asthma
3
114. Other diseases of the respiratory system (ex- cept tuberculosis) 2
IX Diseases of the Digestive System. 42
115. Diseases of the buccal cavity, pharynx, ton- sils and adnexa 1
117. Ulcer of stomach or duodenum 5
118. Other diseases of the stomach 1
119. Diarrhea, enteritis and ulceration of the intestines (under 2 years of age) 4
121. Appendicitis 2
122. Hernia and intestinal obstruction 8
123. Other diseases of the intestines 1
124. Cirrhosis of the liver 15
125. Other diseases of the liver. 3
127. Other diseases of the gall bladder and bili- iary duct 2
X Diseases of the Genito-Urinary System 34
130. Acute nephritis 1
131. Chronic nephritis 27
132. Nephritis, unspecified 2
133. Other diseases of the kidneys and ureters. 2
137. Diseases of the prostate 2
XIV Congenital Malformations 13 157a. Congenital malformations 13
89
REPORT OF DEPARTMENT OF HEALTH
XV Diseases Peculiar to the First Year of Life. 31
159. Premature birth 24
160c. Other injuries at birth 3
161a. Asphyxia, atelectasis 4
XVI Senility 1
162. Senility
1
XVII Violent or Accidental Deaths 63
163. Suicide by poisoning 2
164a. Suicide by hanging or strangulation. 3
164c. Suicide by firearms 1
164d. Suicide by cutting or piercing instruments. 1
164f. Suicide by crushing 1
166. Homicide by firearms
1
168. Homicide by other means 2
169. Railway accidents 1
170c. Automobile accidents 6
171. Street car and other road-transport accidents 1
173. Air-transport accidents 2
176. Other accidents involving machinery 2
178. Accidental absorption of poisonous gas. 2
182. Accidental mechanical suffocation 2
183. Accidental drowning 6
186a. Accidental injury by fall 21
186b. Accidental injury by crushing 2
195. Other and unspecified accidents 7
XVIII Ill-Defined and Unknown Causes
1
.. 200. Ill-defined and unknown cause 1
90
TABLE 2 Infant Deaths by Cause and Age, 1943 (Corrected for Residence)
Age
Under 1 day
1-6 days
7-13 days
14-20 21-29 days days
Total under 1 month
1-6 7-11 months months
Total under 1 year
14. Tuberculosis of the Meninges and Central Nervous System
89a.
Otitis and Other Diseases of the Ear
0
0
0
0
0
0
1
0
1
95c. Other Diseases of the Heart ..
107. Broncho Pneumonia
0
0)
0
1
0
1
109.
Pneumonia (unspecified)
114e. Other and Unspecified Diseases of the Respiratory System ..
0
()
0
0
0
0
1
0
1
119.
Diarrhea, Enteritis and Ulceration of the Intestines
0
0)
0)
2
0
2
2
0)
4
3
4
0
2
0)
9
3
1.
13
157.
Congenital Malformations
14
5
2
3
0
24
0
0)
24
159. Premature Birth
1
2
0
0)
0
3
0
0
3
160c. Other Injuries at Birth
2
2
0
0
0
4
0
0
4
161a. Asphyxia, Atelectasis
0
()
0)
0
0
1
0
1
182. Accidental Mechanical Suffocation
0
0)
0
0
0
0)
0
1
1
186. Accidental Injury by Fall
0
0)
0
0)
0
0
1
0
1
195e. Other and Unspecified Accidents
....
. .
20
14
2
8
0
44
13
7
64
Total
.....
0
0
0
0
0
0
1
1
2
0
1
0)
1
0
0
0
1
3
2
0
()
0)
0
0
2
3
CITY OF QUINCY
.
..
91
REPORT OF DEPARTMENT OF HEALTH
TABLE 3 Resident Deaths by Age Groups
Deaths
Per Cent of Total
1943 1942 1941 1940 1939
1943 1942 1941 1940 1939
Under 1 yr.
64
48
47
35
34
7.5
5.7
6.3
4.8
4.5
1-4 yrs.
5
8
5
6
8
.6
.9
.7
.8
1.1
5-9 yrs.
6
7
3
4
4
.7
.8
.4
.5
.5
10-19 yrs.
11
10
5
10
15
1.3
1.2
.7
1.4
2.0
20-29 yrs.
15
33
16
21
16
1.7
4.0
2.1
2.9
2.1
30-39 yrs.
34
39
28
27
25
4.0
4.7
3.7
3.7
3.3
40-49 yrs.
62
67
59
76
78
7.2
8.0
7.9
10.4
10.4
50-59 yrs.
150
113
98
104
98
17.5
13.6
13.1
14.3
13.1
60-69 yrs.
179
188
198
164
149
20.9
22.6
26.5
22.5
19.9
70-79 yrs.
183
187
167
175
190
21.4 22.4
22.3
24.0
25.4
80-89 yrs.
129
115
110
92
121
15.0
13.8
14.7
12.6
16.2
90 yrs.
and over
19
19
12
15
11
2.2
2.3
1.6
2.1
1.5
857
834
748
729
749
100.0 100.0 100.0 100.0 100.0
TABLE 4 Births and Deaths with Rates per 1,000 Population (Corrected for Residence)
Year
Births
Rate
Deaths
Rate
1934
1,247
16.9
740
10.1
1935
1,109
15.0
731
9.9
1936
1,113
15.0
735
9.9
1937
1,121
15.0
777
10.4
1938
1,134
15.1
750
10.0
1939
1,117
14.8
749
9.9
1940
1,174
15.5
729
9.6
1941
1,398
18.3
748
9.8
1942
1,694
21.9
834
10.9
1943
1,815
23.6
857
11.2
TABLE 5 Infant Deaths, Maternal Deaths, and Stillbirths (Corrected for Residence)
Infant Deaths Maternal Deaths
Stillbirths
Year
Number Rate
Number Rate
Number
Rate
1934
54
43.3
8
6.3
30
24.1
1935
40
36.1
8
7.1
24
21.6
1936
48
43.1
10
8.8
27
24.3
1937
41
36.6
6
5.2
28
25.0
1938
44
38.8
3
2.6
26
22.9
1939
34
30.5
1
.9
24
21.5
1940
35
29.8
2
1.7
20
17.1
1941
47
33.6
2
1.4
23
16.4
1942
48
28.3
7
4.1
28
16.5
1943
64
35.3
0
0.0
19
10.5
Note-Infant death rates and stillbirths rates are per 1,000 live births.
Maternal death rates are per 1,000 total births.
92
CITY OF QUINCY
REPORT OF DISPENSARY PHYSICIAN
January 1, 1944.
Like other problems war has interferred very much during the past year with the Tuberculosis problem. The State estimates an increase of 30 per cent in the death rate. New cases, are undoubt- edly from two sources-the anxiety on the part of the patient to make more money through defense work and the non-realization of the tax and over-strain to his health by the defense work. We will have to hope for better success after the war.
Of course, the same problem indirectly affects our children's clinic. Here the children have extra money and spend it for pleasure and movies rather than for their health. Consequently, our educational propaganda which we were able to send into the home through the clinics ,will be diminished.
Some new sources of discovering Tuberculosis have been afforded through rejectees from military service. As you know the final status of these cases is determined by the county sanatoria-and thus we get our quota of new cases.
A resume of the costs of Tuberculosis in the early days and at present might be interesting. In 1908 the small sum of $800 was expended for Tuberculosis. Today we spent from $30,000 to $35,000.
In 1904, the death rate was 208 per 100,000. Since then the death rate has gradually decreased to less than 100 in 1923. Another interesting thing in the fight in childhood Tuberculosis- Quincy has made a yearly appropriation of over $2,000 and is probably the only city of its size in the state that appropriates so much money in this field of Tuberculosis. Many additions have been added in the fight in the so-called follow-up work. For the past two years we have added a full time social worker and re- habilitation worker. These agencies together with the field nurse- make the problem of the discovery of new cases much more thorough; and naturally decrease our general costs in overcoming the Tuberculosis problem.
I trust that we may take up the work after the war in the thorough way that we adopted in peace time.
I wish to thank you for your cooperation and the different nurses of the Health Department. Also Miss Russell who has done very well in coordinating all these different agencies for the general success in overcoming Tuberculosis. Also Mr. Ivan Poole, our efficient statistician, who has spent much time during the year for me in looking up health data.
Sincerely yours,
C. J. LYNCH, M.D., Dispensary Physician.
-
93
REPORT OF DEPARTMENT OF HEALTH
REPORT OF THE TUBERCULOSIS DISPENSARY NURSE
January 1, 1944.
I herewith submit to you my annual report for the year ending December 31, 1943.
Total number of all kinds of Tuberculosis in the city 450
Active pulmonary cases 107
Arrested pulmonary cases 286
Pneumothorax cases 15
Extra pulmonary cases 34
Quiescent pulmonary cases
8
New cases of Tuberculosis reported during the year 57
Pulmonary cases 51
Extra pulmonary cases 6
Diagnosis revoked during the year 2
Disposition of New Pulmonary Cases :
Admitted to Norfolk County Hospital 17
At home under own physician 6
Admitted to Rutland State Sanatorium 5
Admitted to Saranac Lake Sanatorium 1
Admitted to Tewksbury State Infirmary 1
Admitted to North Reading State Sanatorium 1
Admitted to Veterans' Sanatorium, Rutland
4
Admitted to Mattapan Sanatorium
1
Reported by death certificate 5
Working not having active disease 6
Moved away .. 4
Disposition of New Extra Pulmonary Cases :
Reported by death certificate 2
Admitted to Lakeville State Sanatorium 4
Norfolk County Hospital
Registration of patients at the end of the year 44
Cases admitted during the year 23
Cases readmitted during the year 9
Cases discharged during the year 38
Condition of patients on discharge:
Dead 13
Arrested pulmonary tuberculosis 14
Discharged "Improved" 4
One of the "improved cases" was transferred to another hospital for disciplinary reasons; Case not active but condition improved-discharged to report for check-ups every 2 months; left against advice (2) Discharged "Quiescent"-(1) against advice 4 Indefinite leave of absence to return to hospital for pneumothorax treatment 3
94
CITY OF QUINCY
North Reading State Sanatorium
Registration of patients at the end of the year 2
Cases admitted during the year 1
Cases discharged during the year 1
Condition of patient on discharge:
"T.B. Pleurisy with Effusion"-Arrested
Lakeville State Sanatorium
Registration of patients at the end of the year 4
Cases admitted during the year 5
Cases discharged during the year 5
Condition of patients on discharge:
T.B. knee and Hilum T.B .- "Arrested" 1
T.B. Tenosy novitis 1
Discharged-"Non Tuberculous" 1
T.B. Cervical Adenitis Arrested 1
T.B. Nephritis right-T.B. Epidididymitis left- -
Arrested 1
T.B. Epididymitis right-Quiescent
Rutland State Sanatorium
Registration of patients at the end of the year 5
Cases admitted during the year 8
Cases discharged during the year 3
Condition of Patients on Discharge:
Dead 1
Lung Abscess "well"-non tuberculous. 1
Left against advice-"Improved" 1
Tewksbury State Infirmary
Registration of patients at the end of the year 3
Cases admitted during the year 5
Cases discharged during the year
Condition of patients on discharge:
Dead
1
Left against advice "Unimproved" 1
Deaths
Total number of deaths reported during the year
30
Pulmonary Tuberculosis 27
Extra pulmonary cases 3
Dispensary Clinics-Adult
New patients examined 47
Old patients examined 141
Diagnosis of pulmonary tuberculosis made 8
Children's Clinic
New patients examined 63 Old patients examined 277
95
REPORT OF DEPARTMENT OF HEALTH
Sent to camps for 2-3 week periods 5 Referred for dentistry 14
Referred for T. & A. operation 6
X-rays taken on cases referred to Norfolk County Hospital through the clinics 297 Total number of visits to and in behalf of Tuberculosis patients 1,178
X-ray patients were transported to the Norfolk County Hospital Out-Patient Department every Tuesday A. M. and to Lakeville State Sanatorium Out-Patient Department three times during the year.
Transported four patients to and from Tewksbury State In- firmary.
Transported three patients to Rutland State Hospital.
Total Number of visits to communicable disease cases 297
Gave two lectures to the training school seniors at the Quincy City Hospital on Tuberculosis Work in Quincy at the request of Miss Potter.
Conducted a "Home Nursing Course" at the Cranch School every Monday afternoon for 12 weeks.
Am serving on the Procurement and Assignment Board for Nurses at the Quincy City Hospital.
Have also assisted at Well Baby Conferences when called upon.
Respectfully submitted,
GERTRUDE T. RUSSELL, R.N., Dispensary Nurse.
96
CITY OF QUINCY
THE REPORT OF THE CHILD WELFARE PHYSICIAN
January 1, 1944.
The birth rate of Quincy still rises-23.6 for 1943 as compared to 21.9 for 1942.
The infant mortality was 35.3 (Quincy residents only) as com- pared to 28.3 for 1942. Dr. Leona Baumgartner of the New York City Health Department states that even in New York where medical and health standards are unusually high, there has been an unexplained lull in progress in combating infant deaths. Dr. Baum- gartner also says, "It may be caused by the fact that a larger per- centage of mothers are having their first babies and are inexperi- enced in their care." Family breakdowns she felt, has more to do with adverse conditions, since many young wives are carrying heavy war-time burdens, many are obliged to work and their babies may be suffering as a result.
Provisional figures reported by the U. S. Bureau of the Census for the first four months indicated a tentative rate of 54.8 deaths per 1,000 live births in New England, as compared with 46.5 in the same period of 1942.
Dr. Louis Dublin of the Metropolitan Life Insurance Company pointed to several possible reasons-"Overcrowding in our major industrial areas-The severe strain on hospital facilities for the care of mothers and newborn infants and the increasing shortage of doctors and nurses, all are contributing factors."
Commenting on congestion in maternity wards and hospital nurseries, Dr. Martha Eliot, Associate Chief of the U. S. Children's Bureau, has suggested opening convalescent homes near hospitals to which mothers and babies could be moved as soon as it was con- sidered safe.
Approximately 69% of the infant deaths occurred under the age of 1 month. This is a decrease from the previous year. The per- centage of hospital deliveries is slightly higher than in 1942 (98.8).
There were no deaths from Whooping Cough, Scarlet Fever, Diphtheria or Poliomyelitis. There were only 3 deaths among the total registration of 1,885 Clinic Children-but this group includes children to the end of the second year and also includes a small number of children registered in the pre-school clinic. Two of these deaths were T.B. Meningitis and one from a fractured skull.
The attendance at the Well Baby Conferences has dropped slightly-from 2,966 visits to 2,889 for 1943. The attendance at the pre-school clinic dropped from 88 to 49-largely due to the fact that no clinics were held during the first four months of the year (because Woodward Institute was closed).
The Atlantic Conference still remains the largest one-in fact, there was a slight increase.
Valiant work is being done by the Quincy Visiting Nurses. Working in cooperation with the Department of Health Nurses, the Visiting Nurses make certain that adequate care is provided to bridge the gap between hospital and home and to insure a good start in life for the infant.
Very truly yours,
E. B. FitzGerald, M. D. Child Welfare Physician.
.
97
REPORT OF DEPARTMENT OF HEALTH
REPORT OF CHILD WELFARE NURSES
January 1, 1944.
Report of the Child Welfare Nurses for the year ending Decem- ber 31, 1943.
Total clinic registration during year
1,885
Total clinic registration active December 31st
895
Total new registration during year
650
Total clinic attendance
2,889
Number of clinics held
223
Well baby clinics
206
Pre-school clinics
7
Orthopedic clinics
10
Number of deaths
3
T.B. Meningitis
2
Fractured skull
1
Clinics Held
Day
Station
Attendance
Examined
New Cases
Monday
South Quincy
386
370
84
Monday
Woodward (Pre-school)
49
49
11
Tuesday
Wollaston
464
430
103
Wednesday
Quincy Point
356
340
71
Thursday
Houghs Neck
275
265
56
Thursday
Woodward
546
520
151
Thursday
Woodward (Orthopedic)
54
54
21
Friday
Atlantic
759
740
153
2,889
2,768
650
Due to the closing of Woodward Institute. from January to April-no preschool clinics were held.
The Houghs Neck Clinic is held twice a month. Pre-school and Orthopedic clinics are held once a month, and all other clinics are held weekly.
Clinic Registration
Clinic
Active Dec. 31st Inactive 1 year
Reg. in 1943
South Quincy
110
189
299
Wollaston
154
134
288
Quincy Point
96
89
185
Houghs Neck
74
63
137
Woodward
157
187
344
Pre-school
39
76
115
Orthopedic,
35
85
120
Atlantic
230
167
397
895
990
1,885
Boarding homes registered
15
Boarding homes not registered
4
Children now in boarding homes
50
98
CITY OF QUINCY
Boarding home inspections
36
Total number of visits made 1,305
Number of visits made to babies under 1 year 903
Number of visits made to babies between 1-2 369
Number of visits made to pre-school group
33
Referred to L.M.D. by doctor or nurse
200
Referred to private or clinic dentist 69
Referred to Habit clinic 41
Each Monday and Wednesday morning was spent at St. Joseph's School and St. Mary's School.
Assisted Contagious Nurse on calls.
Respectfully submitted, EVELYN R. KELLY, R.N., PHYLLIS OLSON, R.N., Child Welfare Nurses.
REPORT OF ORTHOPEDIC CLINIC FOR 1943
January 1, 1944.
Below is a report of the Orthopedic Clinic from January 1, 1943 to December 31, 1943:
Number of clinics held
10
Attendance
54
New cases
21
The following is a classification of conditions found in these patients :
Pronated feet
19
Flat feet and knock knees
7
Bow legs
4
Curvature spine
2
Flat feet
4
Hammer toes
1
Club feet
1
Respectfully submitted,
F. RAMON BURKE, M.D., Orthopedic Physician.
REPORT OF THE CHILD GUIDANCE CLINIC
January 31, 1944.
To the Health Commissioner, City of Quincy:
It is with pleasure that I present the seventeenth annual report of the Quincy Child Guidance Clinic for the year December 1, 1942 through November 30, 1943.
99
REPORT OF DEPARTMENT OF HEALTH
You will recall that our President, at the last White House Con- ference on Children in a Democracy, stated that all Americans want this country to be a place where children can live in safety and grow in understanding of the part they must play in our nation's future. If anywhere in our country, any child lacks the opportunity for home life, for health protection, for education, for moral or spiritual development, the strength of our nation and its ability to cherish and advance the principles of democracy' are thereby weakened.
During the past year, the Quincy Child Guidance Clinic has brought service to 194 children of all economic levels, needing special assistance in dealing with problems of home, school or community adjustments. They ranged in age from one year through fourteen years. There was no single cause for any of their difficulties.
Many parents find it hard to understand how some children resist so well the unfavorable factors of their environment, such as the influence of bad companions, the temptations of unlocked auto- mobiles, emotional tension from exciting or sensual books and movies, discontent and boredom with school, while others are such easy preys to these allures. It is only through study of the individ- ual child that we can learn the reasons for these reactions and how they can be prevented.
A child has a mental life that is far more delicate and complex than his physical body, far more difficult to keep in order and much more easily disrupted in functioning. It is very unfortunate that many parents, who would insist on the best medical advice avail- able when their child manifests the faintest symptoms of illness, overlook symptoms of serious personality difficulties in the form of bad habits and behavior problems that we know will influence keenly the future life of the child.
A large number of children studied were in the pre-school group, ranging from one to six years. Poor habits of eating, sleeping and elimination as well as thumb sucking, food dislikes, temper tan- trums and jealousy were among the problems of chief concern to parents. In treatment of these difficulties, one of our greatest concerns was the particular needs of the parents, because younger children, far more than we may realize, sense the underlying thoughts and feelings of those they love best.
The greatest number of children studied were in the school-age group from six through twelve years of age. This was due partly to the fact that the Child Guidance Clinic works so closely in con- junction with the School Guidance Department and that this service is well understood by the school staff.
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