Antall József szerk.: Orvostörténeti közlemények 87-88. (Budapest, 1979)

TANULMÁNYOK - Birtalan Győző: Adatok a két világháború között Magyarországon végzett szervezett egészségvédelmi munkáról, különös tekintettel az OKI tevékenységére

The NIPH was subordinated to the Ministry of the Interior, i. e. to the assigned undersecretary of state. This post was held first by Kornél Scholtz, then from 1935 on by Béla Johan (first director of the National Institute of Hygiene). Well equipped and well functioning model-districts were established, unfortunately only a few in the country. Organized sanitary work in the period between the two world wars ranged over about 1 /5th of the population. At its largest compass, the organization having the green cross as a symbol, included 1100 medical officers and 1400 general nurses (dealing mostly with mother and infant, and T. B. care). The rural health centres formed the basic units of the organization. A district nurse had to look after an average of 6000 people. The study deals with the factors that hindered the work of the NIPH : economic problems, especially during the crisis of 1929, furthermore the resistance of local charities preventing the good coordination of work. There were overlappings of authority especially with the Stefánia Association which had dealt with mother and infant care on a national scale since 1917. To solve the conflict, the Stefánia would work in town and the Green Cross in the country, and in 1941 with the nationalization of public health in Hungary, the two organizations fused. The nationalization of medical officers took place in 1936. We try to illustrate the results of sanitary work in the given period by some representative data. There was a fall of 50 per cent in the mortality rate of tuberculosis in the first half of the 20th century. Between 1901—1910, out of 10,000 inhabitants 38, by 1936 16 died of diseases of tuberculotic origin. This tendency was characteristic of all Europe and the first period of improvement cannot be connected with measures of epidemic control. Calmette's vaccination was introduced in Hungary in 1935 with the vaccine prepared by József Tomcsik. Only half of the patients who would have needed hospital treatment could be placed in hospitals. This situation did not change until the end of the war. Internationally outstanding results were obtained in Hungary in the prevention of dyphteria. Ramon's anatoxin immunization began to come into practice in 1928, later it was developed by Tomcsik for a single-vaccination method. In 1937 dyphteria morbidity in Hungary was 100,000/81.6, this rate was better than Chechoslovakian, Austrian or German data from the same period. By 1939 ancylostomiasis, very frequent disease in Hungarian mines, was eliminated. Out of 25 thousand screen examinations 768 positive cases were recognized. Expensive efforts were made in the whole country to cease the malaria seats. Despite all that, the morbidity rate was rising from the mid-3os on. Approximately 6500 cases were registered in 1938. Emphasis was put on the development of school hygiene that had been quite neglected earlier. School dentistry was introduced as a novelty. In 1932, 14 mobile out-patient departments of school dentistry were in function. The urgent need for this is proved by the fact that 90 per cent of the examined children had some sort of dental trouble. The NIPH carried out regular water examinations and insisted on setting up good wells to which it provided expert advice. In the beginning 15—30 wells were established a year, in 1936—159. By the end of 1937, a total of 644 new village wells were established in the country. Annual infant mortality was 50,000 in 1920, 24,000 in 1938; annual mortality of infectious diseases was 16,000 in 1920, 5,000 in 1938; but the annual number of births was 250,000 in 1920, 182,000 in 1938. We may say after all that in the period between the two world wars, the organized work of public health in Hungary could develop and could obtain outstanding results in many fields in spite of the unfavourable economic conditions, half-feudal, under-developped social