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DEPARTMENT OF HEALTH.
Report for Week Ending April 5, 1913.
NEW HOSPITAL FOR CONTAGIOUS DISEASES IN THE BOROUGH OF QUEENS, In the calendar of the Board of Estimate and Apportionment for Thursday, March 27, 1913, under the heading of public improvements, appears the following:
"Report of the Corporate Stock Budget Committee, recommending that the resolution adopted June 17, 1910, which recommended to the Board of Health the abandonment of the 'Haacke Farm property' in the Borough of Queens as a site for a contagious disease hospital, and further, that another site or sites be selected for the same purpose, be rescinded, for the reason that in a matter so vital as the preservation of the public health, the advice of those who are charged with the duty of protecting the public health should be followed."
This would seem to mark the successful termination, for the time being at least, of the efforts of the Department of Health to establish a hospital for contagious diseases in the Borough of Queens. It is indeed a matter of great satisfaction that this subject has finally been brought to a successful conclusion, for the benefits which will accrue to the inhabitants of the Borough of Queens will undoubtedly be very great. The history of the department's efforts to obtain this hospital, with its successive victories and defeats, is rather interesting.
Acquisition of "Haacke Farm” Site.
On December 19, 1902, the Board of Estimate and Apportionment adopted a resolution approving the selection of property in Jamaica, known as the "Jack's Farm," as a site for a hospital for contagious diseases, and authorized the Department of Health to purchase the property at a price not to exceed $18,000. The owners of Jaek Farm refused to dispose of it for the amount appropriated, and on March 18, 1903, the Board of Estimate was requested to permit the purchase, at the same price, of the premises on the east side of Jamaica and Flushing avenues, 22.9 acres in extent, and known as the "Haacke Farm.". The property was accordingly acquired and almost immediately a disinfecting station was established thereon. At this time no specific appropriation was made for the construction of the proposed hospital. On June 11, 1909, the Board of Estimate and Apportionment authorized the issue of corporate stock in the amount of $230,000 for the construction of buildings upon the Haacke Farm. On June 10, 1910, the Comptroller recommended the selection of another site, on an island or on the water-front of the Borough of Queens, and further recommended that the suggestion be made to the Department of Health to turn over the Haacke Farm to the Commissioners of the Sinking Fund, and that the Board of Health request authority from the Board of Estimate to purchase new sites when selected. The Department of Health accordingly made every effort to secure another site for a contagious disease hospital in the Borough of Queens, but were unable to locate any property that would be suitable for the erection of any kind of a hospital. No island suitable for the purpose exists in Jamaica Bay. Under the circumstances, the Board of Health was compelled to urge upon the Board of Estimate and Apportionment the necessity of rescinding its action of June 10, 1910, and permitting the retention of the Haacke Farm property for the purposes for which it was originally acquired.
Proper Location of Contagious Disease Hospitals.
The recommendation of the Comptroller that some other and more distant site be selected was made on account of objections raised by persons residing in the vicinity of the Haacke Farm, and these objections seemed to be based upon two assumptions. first, that the establishment of a hospital for contagious diseases in the Borough of Queens itself would result in danger to the community, and, secondly, that the establishment of such a hospital would cause a marked depreciation in real estate values. Each of these assumptions is without foundation. The proper place for a hospital for contagious diseases is in the heart of congested population, and, if not at the very centre of the areas congested, at the nearest possible points to these centres.
In European cities, hospitals for contagious diseases are almost invariably situated, if not in congested districts, at least without any regard to the possible or rather impossible dissemination of contagion. In our own country, the Boston Hospital for Contagious Diseases, the Philadelphia Hospital for Contagious Diseases, and, in New York City, the Willard Parker Hospital, are so situated. The advantages of such an arrangement are only too obvious. We have long passed the age when children desperately ill with scarlet fever, diphtheria or membranous croup, shall be moved in intensely cold weather seven or eight miles to a water-front, transferred to a boat, carried across the river or bay, and transferred again to a ward, the whole process occupying, perhaps, three or four hours, an experience for which any child perfectly well might pay a severe penalty. To refer again to the supposed danger to the surrounding community, it can be affirmed most positively that when the hospital is once established and in operation no one will for a moment give it a second thought, any more than now those who protested against its establishment consider themselves in any way endangered by the presence of a case of scarlet fever or diphtheria in the next house.
Effect on Property Values.
In regard to the possible depreciation of property, the department is by no means prepared to admit that this depreciation would take place. This has not been the experience of other cities, and the parking of the surrounding area which has been suggested by the Board of Health would not only remove the sentimental objections and prejudices of the surrounding property owners, but would probably result ultimately in a greatly increased value of the surrounding property. In order to care properly for cases of contagious disease, The City of New York seriously needs additional hospitals located in the areas of developing population, and the fundamental need of more numerous and scattered contagious disease hospitals is a matter of such demand and importance that it would seem to be unwise to allow sentimental reasons or dubious property considerations to stand in their way.
THE NEW SEA VIEW HOSPITAL.
As a location for a hospital to care for the tuberculosis cases which must be treated in New York City, no finer site could have been chosen than that on Manor Road, Staten Island, where the great Sea View Hospital of the Department of Public Charities, with over one thousand beds, is soon to be opened.
This project was conceived and undertaken several years ago. The acquirement of the property, planning and erection of so large a hospital, with the delays attendant on the provision of funds, have naturally consumed much time; but at last the City has ready for use probably the finest, and certainly the most beautiful plant in this country, and one of the finest in the world.
Although no definite policy can be outlined now as to the class of cases which will be received, it is planned at first to take patients in not later than the second stage. A requirement, however, which will be strictly enforced is that patients shall be of the respectable, self-supporting class, not vagrants nor alcoholics, and preference will be given to those with families, who might become infected by their continued stay at home.
It is hoped to make every day a visiting day at Sea View, if possible, so as to give ample opportunity for the patients to see their friends, and for every member of a patient's family to get to know this great institution, which the City has erected at a cost of $3,500,000, so as to give every one with tuberculosis in New York City an opportunity to get well in beautiful and comfortable surroundings, where everything which science has evolved has been provided to hasten their recovery. E. S. McSweeny, M. D., formerly Resident Physician at the Otisville Sanatorium of the Department of Health, is the Medical Superintendent.
THE VON PIRQUET TEST FOR TUBERCULOSIS.
Unless especially contraindicated, the Von Pirquet tuberculin test is performed on every child attending the children's classes of the tuberculosis clinics of the Department of Health. This test, when positive, in the absence of a localized reaction, is of little if any service in adults, for it has been shown that about 90 per cent. of all adult bodies coming to autopsy present lesions of either healed or active tuberculosis. In children under five years of age, however, a positive reaction is of considerable diagnostic importance in a case presenting doubtful clinical symptoms. It may be said, in addition, that the test is of value when negative, both in adults and children.
Von Pirquet's test, in so far as a reaction denotes the presence of tuberculosis somewhere in the body, appears to be exceedingly reliable, and from the ease of its performance and the practical absence of constitutional reaction, is to be preferred in dispensary practice to the test by subcutaneous injection. The diagnosis of tuberculosis in children is frequently so difficult that no means should be neglected which promises to assist the examiner.
Von Pirquet's test is best performed as follows:
Three points of scarification are made upon the upper part of the left arm and separated from each other vertically by about 3 or 4 c. m. The scarification should be small and should not draw blood in any considerable quantity. The uppermost scarification serves as a control. Into the second is inoculated a 25 per cent. solution of crude tuberculin, while the third or lowest scarification receives an inoculation of 50 per cent. tuberculin. The inoculation may be made in a number of ways. One, which is simple and satisfactory in its results, consists in placing a drop or two of the solution upon the skin and then performing light scarification through it. It is necessary to dilute the tuberculin. The crude tuberculin, as furnished by the department, is a glycerine extract and contains no water. In consequence, when placed upon a scarified surface, absorption may fail to occur and disappointment result. It is true that the scarification may liberate enough blood serum in certain cases to make a solution which will be satisfactorily absorbed, but this is not to be relied upon. A successful "take" manifests itself in from twenty-four to forty-eight hours. At the point of control there will be no reaction, whereas at the two points of inoculation a zone of inflammation more marked at the lowest point of scarification will be evident. The "takes" are slightly elevated and light pink or red in color and are sometimes accompanied by swelling of the surrounding tissues. In a few days all signs disappear save except some temporary discoloration of the skin. The reactions at the points of inoculation vary considerably in severity, from slight redness and superficial infiltration, to a lesion somewhat resembling the earlier stages of a smallpox vaccination.
Summary for Week Ending Saturday, 12 M., April 5, 1913.
Corrected according to borough of residence.
The presence of several large institutions, the great majority of whose inmates are non-residents of the city, increases considerably the death-rate of this Borough. Deaths by Principal Causes, According to Locality and Age.
Total...... 1,534 1,991 1,933 1,991 2,127 1,790 1.773 2,090 2,462 2,509 2,610 2,634 2,674 2,508