Medicine: Chronic Disease Hospitals

Because the profession as well as the laity has a fuzzy conception of what a chronic disease is, there exist only two special private hospitals for chronic diseases in the U. S.—Montefiore Hospital for Chronic Diseases in New York City and Robert Breck Brigham Hospital in Boston. Last week the recently resigned medical director of Montefiore, Dr. Ernst Philip Boas and his chief assistant published a meaty, precise book on the subject.* Special hospitals exist for insane and tuberculous chronics, but no hospitals, except at New York and Boston, for the vast number of those otherwise affected. The great plurality of chronics are grudgingly and inadequately maintained at general hospitals, homes for incurables, almshouses,† city infirmaries, homes for the

Dr. Boas urges that all.large communities establish special chronic disease hospitals, that states create them in rural districts. Precise-minded, he specifies that such hospitals should have connecting pavilions for the three types of chronics, 1) patients requiring medical care for diagnosis and treatment, 2) patients requiring chiefly skilled nursing care, 3) patients requiring only custodial care. As a patient improves or declines he can be shifted to where he gets specific treatment. As for the smaller details, every three patients should have two wheel chairs at their disposal. Preferably not more than two should occupy a room. They should have hand rails in rooms, corridors and washrooms to cling to.

*THE CHALLENGE OF CHRONIC DISEASES-Ernst P. Boas & Nicholas Michelson-Macmillan ($2.50). †U. S. almshouses contain 85,000 inmates, three-fourths of whom need constant medical attention, get little.