"Carrying ointments and even pills!" Medicines in the work of Henry Street Settlement visiting nurses, 1893-1944.

We turned into Sufolk Street and walked south several blocks. . . . The tenement was an uncommonly clean one . . . the sickroom was crowded with sympathetic neighbors. . . . The first case was a four year old girl with grave pneumonia. She was at a stage of the disease where absolute quiet would have been demanded in the hospital. The sight of the nurse was the signal for a weak scream and a wailing that never ceased until the nurse finished her work. . . . Meanwhile the nurse, calm and unruffled, bathed the sick child, rubbed its hot little body with alcohol, remade the bed and administered medicines and a half glass of milk. The child took the medicines and the nourishment, too terrified to resist. She had refused them from the hand of the mother.1 Sufolk Street, on the Lower East Side of New York City, was in the heart of the tenement district inhabited by German, Polish, Greek, Italian, and Irish immigrants in the late nineteenth and early twentieth centuries. It was in this setting that, in 1893, Lillian Wald, a well-to-do young graduate nurse from the elite New York Training School for Nurses, established the Henry Street Settlement (HSS) house with the financial support of philanthropist Jacob H. Schiff. Decades later, in her 1922 radio speech, Wald spoke of its origins: A sick woman in a squalid rear tenement, so wretched and so pitiful that, in all the yean since, I have not seen anything more appalling, determined me within an hour to live on the East Side. That was in 1893. Before that time I had spent two years in a New York Training School for Nurses and supplemented the education I had received there by study at a medical college. . . . I induced my friend Mary Brewster [also a trained nurse], to come with me, and we two together made up our minds not only that we would give our services as nurses, but that we would live in the neighborhood in order to participate in its life and its problems.2 From its inception in 1893 until 1944 when the social and nursing activities were separated, the Henry Street Settlement (HSS) linked nursing, social welfare, and the public.3 One of its unique aspects was that in addition to providing social services such as kindergartens, playgrounds, boys' and girls' clubs, and summer camps, the HSS operated a visiting nurse service (VNS). These nurses provided skilled, professional nursing care to the thousands of European immigrants who crowded into ethnic ghettos in New York City.4 According to Wald, the needs of these New York City residents were limitless: There were nursing infants, many of them with the summer bowel complaint that sent infant mortality soaring during die hot months; there were children with measles, not quarantined; there were children with opthalmia, a contagious eye disease; there were children scarred with vermin bites; there were adults with typhoid; there was a case of puerperal septicemia, lying on a vermin-infested bed without sheets or pillow cases; a family consisting of a pregnant mother, a crippled child and two others living on dry bread . . . ; a young girl dying of tuberculosis amid the very conditions that had produced the disease.5 It is clear that the Henry Street nurses responded to these needs. A report from die HSS Record Office for March 1923 notes that the nurses made 34,240 home visits that month, caring for patients with a wide variety of acute illnesses. These included patients with "pneumonia, typhoid fever, dysentery, thrush, colitis, scarlet fever, whooping cough, polio, influenza, diphtheria, measles, mumps, bronchitis, enteritis, tonsillitis, nephritis, burns, rheumatism, alcoholism, meningitis, tuberculosis, cardiac problems, and those with ulcers and eye diseases. In addition, the HSS nurses visited obstetrical cases, following both mother and baby over several weeks post-partum."6 Initially run by Wald and Brewster, by 1924 the VNS employed 253 nurses, each averaging eight visits a day, and by 1926 was making over 300,000 visits each year. …