The San Francisco call., 1909-08-22
By Lucy B. Fisher

:" GENERAL. when planning an at
tack upon the enemy, selects a
vantage point. marshals his
forces and then gives his COM
mand to fire. A campaign against that
foe 10 the human race, the bacillus of
b tuberculosis, needs to be planned with
the same strategic skill if it is to win
decisive victory.
The San Francisco Association for
the Study and Prevention of Tuber-
culosis mapped out its campaign
against tuberculosis a year ago with
the same care that "a general would
give to his plan OF army maneuvers
The part Of the plan that required
much thought was the basis on which
70 organize the tuberculosis clinic.
Several forms Of organization were
carefully considered and men on the
Atlantic coast, who had made a ma
tional reputation for themselves on the
social study Of tuberculosis. were con-
suited. The wisest among them said:
You must be governed entirely by
your local conditions, and for this rea-
son no one can decide the question for
you" The basis of organization was
finally sifted down TO two definite plans,
which were submitted for consideration
10 the several medical bodies in the
city.
The first pfan was the establishment
p Of a tuberculosis clinic in each medical
college. which would be under the
jurisdiction Of the hospital and dis
pensaries committee of the tuberculosis
association. The second plan was the
formation Of a central clinic which
would have representatives from the
several universities as it's clinicians.
The latter plan was chosen, after care
ful deliberation by the medical depart
ment Of the University of California,
cooper medical college and Mt. Zion
hospital
One Clinic Best
The hospital and dispensaries com
mittee was greatly Influenced in its
final decision Of the basis on which to
establish the clinic by this choice of
three important medical bodies. 1t
was also convinced that the focusing
OF the tuberculosis work at its incep-
tion by the establishment of one rep
resentative clinic would attract more
public interest than the diffusion Of
the work by the organization of sew
eral clinics.
A circular letter presented to the
community the second week in jan
nary aunounoed +b. oDarsr- - a.
clinic January Is at the Telegraph Hill
neighborhood association. 1874 Stockton
street, and IL also definitely outlined
the plan Of structure on which the
clinic was to build its work in the fol-
lowing paragraphs:
The community has, for long period,
realized the necessity of centralizing
the tuberculosis medical work. The
reasons for this are obvious and the tu-
bercUlosls clinic will be started:
First-On the principle that concen-
tration OF effort and the centraliza ton
Of an enterprise will logically produce
greater results than the dissipation of
effort and the diffusion of an enter
prise in many directions.
Second-In order to establish an in
telligent system by which the ply
sician's directions to his patients may
be executed, as without such a system
the work Of a tuberculosis clinic is fu-
tile. This system will comprise in it a
STAFF OF nurses, who will not only full
i'll the function of visiting nurses, but
act as social workers by going into
the homes OF the patients and enforc-
ing sanitary regulations. which will
protect the patient, the family and the
community from the infection of tuber-
culOsis. The nurses will stimulate the
patients to fulfill the doctors instruc-
tfons and viii make every effort to
procure financial assistance for the
patients who otherwise could not carry
out the doctors orders. The nurses
will work in close cooperation with
fnsanitary surroundings and all cases
or tuberculosis and all removals of
patients so that the vacated premises
may be disinfected-
Tsaird-In order to have an educa-
fiOnal center for the prevention and
cure Of tuberculosis. This will be full
filled by personal interviews with the
patients in the clinic and in the homes
and the practical demonstration of the
use of sputum cups and paper nap
kins The patients will not only be
taught how to protect others from the
infection, but what means to take to
regain their own health. Leaflets of
instructions will also be distributed to
the patients and their families.
One Of the greatest factors of the tu-
berculosis clinic will be the combina-
ton team Of skilled physicians who
are able to diagnose early CASES of
tuberculosis. and the nurses acting as
scouts to send the possible -ases from
the homes they visit to the physicians
ct the clinic. These they will find
oronov~ced cases Of tuberculosis exist.