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17
latter being young women specially trained to carry out all forms of tooth work,
except actual extractions and stoppings. At the infirmary a special course of
instruction is arranged for dental hygienists of whom there are now a certain
number qualified and at work. In other parts of the building there are departments
in which extraction of teeth or removal of tonsils and adenoids is carried
out. The children in need of treatment are selected in the schools and a small
fee is charged to those who can pay it. In regard to dental work amongst
school children I may say that in most places I have visited more or less is done,
and a great deal of the inspiration undoubtedly comes from the Forsyth Dental
Infirmary.
Though quite a good deal of work appears to be done in connection with
tuberculosis in Boston, I am bound to say that what I saw did not greatly impress
me. So far as I could gather there is only one dispensary in the city, at which
clinics are held on five days in each week, one being an evening clinic. The staff
engaged at the clinic consists of five doctors—all part-time— and ten nurses. The
number of patients varies, and may be as many as 100, a great many, however,
are asthmatic and attend to receive injections. These are given by the nurses who
also take blood from every patient attending the dispensary for examination for
venereal disease. Wholesale examination of patients for this infection seems to be
quite a feature in American hospitals and dispensaries. The nurses attending the
dispensary are only part of the staff of tuberculosis nurses of whom there are in
all 32 engaged mainly in following up cases. The doctors do not visit the cases
in their homes. Apart from doctors and nurses there are several clerks, laboratory
workers, etc., at the dispensary. The laboratory is partly for the examination of
expectorations, but largely for research into problems connected with tuberculosis.
The cost of running the dispensary appeared to me to be very high, working out
at about 5s. per visit of each patient.
The hospital accommodation provided for the treatment of tuberculosis is in
the main intended for advanced cases. In all there are 422 beds, but in general
there are about 120 vacant. The patients are kept as long as they will remain
though they are allowed out one day per month to spend the money they can earn
in the workshop of the institution making rugs, baskets, etc. I was told that
since prohibition came into effect the patients appeared to be more contented to
remain though it was not at all unusual for those who are allowed out to return
to the hospital under the influence of drink. A statement of the nurses to the effect
that they had noticed great improvements in the homes they visited since prohibition
interested me very much as I had not been impressed by the sobriety of the population
of Boston. The same may be said of New York. In this connection, however,
it must be noted that both of these places are sea-ports and alcohol is more readily
obtainable. Moreover, they are large cities and the foreign populations are very
big. Back from the sea coast, and more particularly in the South, the effect of
the Act is much more pronounced. On inquiry at the City Hospital in Boston I
learned that the number of cases of alcoholism treated had definitely increased,
and in New York the number of deaths from this cause has also increased and is
considerable. The number of persons in prison has, however, I am told, very
markedly decreased. All the same, it would appear that the people who have been
accustomed to drink are still from time to time able to obtain alcohol, and it is
alleged that people who never would have taken alcohol do in fact take it now
when it is available and take it to excess. Most of the drinking which I have
seen openly or secretly on the street or in hotels or restaurants has not been
convivial, but almost entirely with the object of getting drunk. Since coming to
the Northern States I have seen more people completely and hopelessly inebriated,
at all hours of the day, than I have seen for years at home.
I had not intended to say anything with regard to prohibition and alcohol, and
you will note that I have expressed no opinion upon it. As a matter of fact, officially,