(a) State Sanatoria. (b) County Sanatoria.

(c) Local Sanatoria.

(Granted that arrangements have been made whereby data is submitted to central authority at stated intervals.)

Applications: (When data is received note whether names given have been indexed. For instance, the first name on the list may be Isaac Smith from Manchester, his physician making application on January 9. The Manchester file is consulted, and we find that Isaac Smith was reported to the local board of health on January 1, and that between January 1 and 8 was sent to Springfield waiting admission to a State sanatorium. On this same Manchester card of Isaac Smith will be placed information as follows:)

Manchester, January 1, 1919.

Pul. Tb., Smith, Isaac, age 36, 100 Arlington Street,

Also reported to Springfield board of health, January 8, 1919, from city hospital. Application made by Dr. John Brown, Manchester dispensary, January 9, 1919.

(If, upon looking in the index, we do not find the name of Isaac Smith of Manchester, a pink card will be used to record this application, viz., name of person, city or town, address, application made by whom. This would show that the first knowledge of the case came through the application to other State board.)

an

Application by Dr. John Brown, Manchester Dispensary, January 9, 1919. Admissions to state, county or local sanatoria:

(Notices of patients admitted to hospitals may be forthcoming with certain data in regard to each.)

(Consult files to see if name in question is indexed, if so, additional information may be placed on the card. For instance Isaac Smith may have been admitted to C

Sanatorium March 19, 1919. We find upon consulting the files that Isaac Smith was reported to the local board of health on January 1, 1919, application for admission to one of the Sanatoria on January 9, 1919, and we now have the additional information that Isaac Smith was admitted to CSanatorium on March 19, 1919, a moderately advanced case.)

Manchester, January 1, 1919.

Pul. Tb.; Smith, Isaac, age 36,

100 Arlington Street.

Also reported to Springfield board of health, January 8, 1919, from city hospital.

+ Or other institutions housing tuberculosis patients.

Smith, Isaac,

100 Arlington Street.

Manchester,

CSanatorium, Admitted March 19, 1919, Mod. Adv. Discharges from State, County or Local Sanatoria:

(Likewise, when a discharge notice is received the files are consulted. And if we find that Isaac Smith has been discharged from CSanatorium on June 26, 1919,

we add this information to that already recorded, and also record the condition on discharge, and any recommendation which may be made by the superintendent. The following shows information given at discharge :)

Manchester, January 1, 1919.

Pul. Tb.; Smith, Isaac, age 36,

100 Arlington Street.

Also reported to Springfield board of health, January 8, 1919. Application made by Dr. John Brown, Manchester Dispensary, January 9, 1919.

C

Sanatorium. Admitted March 19, 1919, Mod, adv. Discharged June 26, 1919, "Improved." Recommended that patient shall report to the dispensary or physician from time to time.

(If a first knowledge of the case comes through discharge from a sanatorium white card is used:)

a

Sanatorium. Admitted March 19, 1919, Mod, adv. Discharged June 26, 119, "Improved." Recommended that he shall report to the dispensary or physician from time to time.

(Note that the discharge notice will always give the admission notice.)

(A different colored card may be used for county hospital and local hospital if desired, for instance, blue.)

5. Deaths Reported:

(It sometimes may happen that on the report made to the local board of health forwarded by them to the State, the following statement appears: "Not reported until after death." In this case make a report on a brown card, instead of green, showing that first knowledge of case came through a death report.) (See 1.)

(As information is received or obtained through cooperative regulations in regard to deaths, the deaths should be checked off with the cases on file, and if there is no case

on record a brown card used to record the death, with particulars, as given on the list received from local or other authority. The following card illustrates :)

White, Maynard,

136 Haymarket Street.

Manchester,

Died from pulmonary tuberculosis January 17, 1919. Age 40.

6. Sputum examinations:

Bacteriologists may send names of positive sputum examinations and these may be checked with the cases, and if they are not found in the index, the name may be jotted down on another colored card for reference in case the case is subsequently reported. If the case is on file the note may be added when the positive sputum result was found.) (If not on file as follows:) Lewis, James, Springfield,

14 Albion Street. Positive sputum January 16, 1919, age 21, carpenter.

7. Aliens with defects:

The names and addresses of aliens destined for a State, showing disposition to tuberculosis, may be available. These may be indexed on a yellow card, and filed according to city and town and alphabetically. Elmo, Joseph, Springfield,

2 Princeton Street. Steamship M

January 22, 1919, to

son, same address. "Poor physical development."

8. Special temporary boards:

(Examining boards)

au

(Through arrangement with local thorities and examination boards, men exempted because of tuberculosis or suspected tuberculosis could be forwarded to central authority. If, after files were consulted, they were not found another colored card may be used and name, etc., recorded.)

cards. In other words, the object as stated before, is to centralize all data received in regard to one person on one card. For instance, if a detailed report of Isaac Smith is received on the special printed card, we refer to the information on file, and check it with that contained on the printed card filled in, and destroy the card on file, putting in its place the detailed investigation card, being sure that all information not contained in the field report is transferred to it.) (See also III.)

I. State Department of Health: (Green detailed history card) July 16, 1919

ILL WITH TUBERCULOSIS Manchester

(Town)

Jan. 1, 1920

(Date report is made out)

Pul.

(Form of disease)

Age: 36

Reported Jan. 1, 1919, (to local board)

(Date)

37

Also reported to: Springfield, 1/8/19.
Name of patient: Smith, Isaac.
Sex: M. Residence: 100 Arlington St.
Birthplace: Chicago. Parentage: Irish-Am.
How long in U. S.: Always.

In this town: 26 years.

Where is the patient at this date: Home. Syndicate: S.

Occupation: at present, Carpenter.

Occupation: when first rep. tb., Carpenter.

If not working, how does patient spend time: Out-of-doors; but at work.

Home Sanitation: Good.

Personal Hygiene, (including care of sputum): Careful.

Occupation sanitation :-(Reverse Side). Sputum examinations:

Positive-Jan. 1, 1919.

Negative-June 26, 1919-Dec. 31, 1918. How long ill: June, 1918.

Application to S. S.: 1/9/19, by Dr. J. Brown, Manchester Dis.

Has patient ever been to a State San. or Tb. Hospital: Yes.

Condition of other members of the household: (4 adults) Good.

Condition of patient: "Says he feels good."
Supervision of patient: Dispensary.
Family history: Neg. for tb.

Personal history: Always well until recently. Remarks: Patient doing well. Will report to dispensary soon. Reports at dispensary once a month.

Latest visit to home: 6/27/19. Dec. 31, 1918.

(Nurse or T. B. Worker)

(Continued on page 118)

The war is over. There is still before us the great work of reconstruction in which we must all take part and your part in that reconstruction must be the reorganization of your forces in your warfare against tuberculosis. Our experiences in the warfare against the Hun suggest to us many things which will be useful in our never-ending battle against the tubercle bacillus.

Before the war, all of our states had their state militia. The militia had uniforms and military caps, full-sized knapsacks and formidable looking muskets and, as they marched by, they looked like soldiers and acted like soldiers and we thought they were soldiers. When they were taken to France, it was found that they lacked just one thing-the one essential thing in the making of soldiers—and that one thing was discipline.

There are thousands of persons in the army engaged in the warfare against tuberculosis who look like real fighters. They have sleeping porches and wear hoods and fleece-lined bed shoes and, to all appearances, they are real soldiers. But the vast majority of these persons lack the great essential that makes the soldier. They are sadly lacking in discipline.

Over in France, it was found that discipline was not so essential in the face of an emergency. Fear or enthusiasm or the spirit of adventure, or whatever it may be, carried the men over the top and across "no man's land" without a thought of rules or regulations. The man who fights tuberculosis does not need his discipline when the bombs of hemorrhage or the shrapnel of pneumonia are falling about him. In an emergency most red-blooded men develop the spirit of the soldier.

It was in the trenches over in France, in the endless waits for something to happen, that discipline was found imperative. Among the fighters against tuberculosis, it is the long, monotonous rest period and the days and weeks and months of inactivity in which discipline is most essential.

It was during this time of inactivity that the soldiers were most inclined to gossip and were discontented. They were known to criticize their superior officers and there were even words of impatience and disloyalty against their whole organization. These things arise in the monotonous watches of the antituberculosis army.

The Hun, who is almost as relentless in his methods of warfare as the tubercle bacillus, introduced new and barbaric things into warfare. Among them, he introduced poison gases which did great damage among the opposing forces. Even here among you I have sometimes seen the haze and smoke of those

poison gases. The most dangerous of these are known as gossip and discontent.

In France, when gases were detected, officers ordered their men to put on their gas masks. For your own protection and for the sake of the whole organization, I am going to urge upon you that, when you notice the first traces of these gases of gossip and discontent, you put on your face masks, stuff cotton in your ears and keep your lips tightly closed. If you will do this, these gases will prove entirely harmless.

Out of the war, with all its horrors, there have developed many splendid things; but nothing more splendid than the development of the brotherhood of man, a spirit of unselfishness, a willingness for self-sacrifice. Life in the army established a new kind of human affection which illustrated itself in the soldier dividing his last bit of tobacco with the trenchmate beside him and which manifested itself more heroically when men vied with each other to take their lives in their hands to go over the top to save a fellow who was but recently a stranger, but who had become a real brother in arms.

Fighting together shoulder to shoulder, with the same common enemy, the same aims and hopes and purposes, that same spirit of selfsacrifice, that same element of human affec(Continued on page 118)

Everyone interested in the campaign against tuberculosis will welcome the announcement that a Red Cross Christmas Seal campaign is to be held again this year. Definite arrange

ments have been made between the American Red Cross and the National Tuberculosis Association and by the time this number of the JOURNAL OF THE OUTDOOR LIFE reaches its readers rapid progress in the manufacture of seals and other supplies will have been made

The wisdom and expediency of the method of financing required by the exigencies of the war for the current year cannot be denied. On the other hand, the outstanding value of a Red Cross Seal campaign not only as a means of financial support, but more particularly as a means of education. and organization, has been so clearly demonstrated in past years that tuberculosis workers would look with great reluctance upon any permanent withdrawal of that method of campaign.

While details of the plans of campaign for this year cannot be announced, we are permitted to give a few important and interesting facts. In the first place the campaign will be

for a higher goal than has ever before been set. Five hundred million seals is the aim of the campaign. As an initial printing order, the National Association is starting with 600,000,000 seals and will probably produce a billion or more before the campaign is over. In the second place, the campaign will probably be of a more intensive nature than any heretofore conducted. The experience of the last two years in war drives has taught much that can well be incorporated in the Red Cross Seal campaign. An effort will be made to interest in the tuberculosis movement the pennies, nickels, dimes, dollars and thousands of dollars of every man, woman and child in the United States. From national headquarters special assistance in highly intensified campaign. organization will be given to every state and local community that needs. it. Every effort will be made to conduct a campaign upon a bigger, broader and better basis than ever before.

Tuberculosis workers and others interested in the campaign are urged thus early to reserve their time, energy and money for the Red Cross Seal campaign.