Evening star. [volume] (Washington, D.C.) 1854-1972, 1906-11-20
SUBSTITUTE BILL FRAMED
Comment by Health Officer Woodward
Upon It's Provisions.
ISSUE WITH MEDICAL MEN
Does Not Agree With Contention That
Reports Regarding the Disease
Are Unnecessary.

The bill drafted by the citizens commit
tee on prevention OF tuberculosis in the
District. as a substitute for similar bill
introduced at the last session of Congress
BIZ Senator Alice of Delaware. and ap-
proved by the District Commissioners. has
bnen recommended by Health Oflcer Wood
ward and approved by the Commissioners
and referred to the corporation counsel of
the District for consideration to the
proper legal form. This substitute BILL like
Senator Allees, provides for the registra-
ton of all tuberculosis cases and the free
examination of sputum in accordance with
the legislation OF most Of the more pro-
gressive states in the Union.
Last spring. when the Alice bill was re-
ferred to the Commissioners for a report, a
public hearing was called by them at which
representative physicians protested against
the provision of the proposed law. which
would require them to register all cases of
consumption under their care They con-
tended that making such reports would be
violation of the professional obligation to
secrecy, and that in making such reports
work would be imposed upon them for
which they would not be compensated
They also offered as objections to the pro-
posed bill that in making such reports may
prejudice the patient in his social life and
In his ability to earn a livelihood. and that
the making of such reports would serve no
good purpose.
DR.. Woodward Dissents.
Health Officer Woodward does not agree
with the contentious of the members of the
medical profession. He says no question
can be raised as to the seriousness of the
ravages of tuberculosis In the District, nor
as to the Importance of preventing this dis
ease. He said in order that legislation de-
signed to prevent the spread of this dis
ease may be most effective 1t must embody
four features. which are, the compulsory
reporting of all cases; the instructing of
patients as to the means necessary to pre-
vent its spread: the compulsory disinfec-
ton of all rooms that have been occupied
by consumptives. the examination at pub
lie expense of specimens of sputa from per-
sons suspected of having the disease. mas
much as the proposed bill submitted by the
citizens committee for the prevention of
consumption embodies these features 1t is
worthy of approval, he says.
This proposed bill specifically provides that
II shall be the duty of every physician at
tending case of consumption to report
the same as soon as IL is brought to his at
tention. to the health office within one
week after the disease is recognized. This
is required of the authorities of all hos
pitfalls, dispensaries, asylums and other
public institutions. The bill further PRO-
vides that it shall be duty of the
health officer to make microscopical exam
nation of the sputum of the persons re-
ported, and shall make a report to his
findings to the physician or officer who re-
recorded in the health Office along with the
name and address of the patient which has
been registered.
He is instructed by the proposed bill
TO keep this record of consumption cases
strictly private. and shall not allow the
identity of the persons suffering with
this disease to be disclosed. 1t shall be
his duty to supply each patient. or those
in charge of patients, with printed in
structions as to the methods to be en-
ployed to prevent the spread OF the dis
ease. He shall see that after the death
or recovery of a tuberculosis patient the
apartment used by the former Is thor
oAghly disinfected.
The bill provides that any person vio-
lating any of the provisions shall upon
conviction, be deemed guilty of a misde-
meauor. and shall be punished by fine
not exceeding $25.
Due to Growth Of Bacilli.
In recommending the proposed draft
Of the citizens committee to the Commits
sioners Health Officer Woodward said:
tuberculosis is disease due to the
growth of tubercle bacilli within the
body. The only primary foci from which
tubercle bacilli are disseminated are To-
Gated within the bodies of animals suf-
fering from tuberculosis. For present
purposes animals other than men can be
disresarded as not coming within the
scope of the pending legislation From
a medical ST. dpoint the prevention of
tuberculosis depends upon one or both of
two factors: ID The establishment of
maximum bodily vigor; CD the proven
ton or the dissemination of tubercle ba-
GILL.
In order that the government may act
directly to prevent the spread of tubercle
bacilli from infected individuals 1t Is neces-
sary that II be informed as to the identity
and whereabouts of such individuals. And
In order that the government may know
whether any measures Of prevention that
II has adopted are are net effective 1t il
necessary to know the number of infected
individuals In the community from time
to time. while preventive measures are In
operation This brings sQuarely In ISSUE
therefore. the questions whether any SUBJ
stantial harm can come from reporting
cases of tuberculosis to a designated gov
ernment officer.
Regarding the claim of the physicians at
the public hearing last spring that the re-
porting OF all cases of tuberculosis would
serve no good purpose. Health Officer
Woodward made the following statement:
Conclusion Not Justified
Figures that have been presented to
show that the compulsory reporting of
tuberculosis does no good are too scant.
and the facts that accompany them to aid
in their Interpretation are too few to JUS
nfy the conclusion that has been drawn
from them. The prevention Of tuberculosis
depends largely upon individual effort; ac-
ton TO originate and to maintain such ef-
fort may be either educational or coercive,
and II such effort IL necessary for the pub
IL good responsibility for the taking of
such action should be definitely placed and
the responsible party or parties held ac-
countable therefor
1T Is. however important that all cases
of tuberculosis be reported in order that
the community may know the degree Of
success with which preventive measures
are meeting and may modify such meas
ures from time to time indicated. The
fact that such a limited system of re-
ports as has been suggested for this Dis
trict was adopted In New York and SO
soon abandoned for q system of uniformly
compulsory reports IL very good evidence
10 favor Of the insuficiency Of the original
method and argues against its adoption
elsewhere"
Submarines Out Of Commission.