DR. J. L. HUNTIXGTOX'S PAPER 437 



to report at the clinic should be traced by the nurse. 

 All patients when applying to the pregnancy clinic 

 should be given a complete physical examination. In 

 the clinic the urine examination should include an 

 examination of the sediment in every specimen show- 

 ing albumin by the heat test. Such an ideal 

 pregnancy clinic must be associated with a hospital 

 providing beds and adequate obstetrical care for the 

 graver complications of pregnancy and for operative 

 obstetrics. It should also be associated with an out- 

 patient service providing care for patients in their 

 own home. What would be the estimated cost of such 

 an institution, exclusive of the care of confinement 

 and puerperium or the services of the physician during 

 pregnancy ? We have found the rental of the neces- 

 sary quarters to house such an institution would be 

 8300 per year ; the initial expense of fittings and 

 office furniture $100. This clinic would require 

 three nurses to make the necessary visits. If living in 

 the hospital provided, such nurses could be obtained 

 in Boston for $500 a year. Car fares for one nurse in 

 1912 amounted to $40.10; gas for heating water and 

 lighting in winter cost $38.80; the services of a 

 maid to clean the rooms cost in 1912 $42 ; stationery, 

 drugs, and instruments cost $120.75. So t^ 6 tota l 

 cost of such an institution caring for 2,000 cases 

 annually would be 2321.55 for the first year and 

 82221.55 for subsequent years, as the wear and tear 

 of office fittings is slight. Thus with each patient 

 paying $1.16 the thing could be accomplished. It 

 would seem that for a practically nominal cost to the 

 individual the hygiene of pregnancy could be super- 

 vised intelligently in any community offering over 

 500 pregnancies for observation annually. 



Dr. R. GREEN (United States) said he was more inclined 

 to look at the question from the mother's point of view. 

 He could see that there were certain important things which 

 supervision of pregnancy could do for the mother, and by 



