Evening star., 1935-05-12
Health Outlay Held Lou
tuberculosis Situation Here Cited as
Result of Limited Budget.
BY THOMAS r. HENRY.
.HE District Of Columbia spends
approximately 80 cents a per-
son a year for public health
activities.

hurdle in the road to the ideal in the
mind of DR.. George c. Rutland,
Washington's new health officer. of
making the National Capital the
Nations model health city. 1t would
go for the employment of more public
health nurses. the conducting of more
specific health campaigns and demon
strations, and the education of the
public. There is no mystical formula
for public health and there are no
miracle workers. It is all a matter of
applying certain tested and proven
principles-and the application re-
quireS time, effort and money.
tuberculosis Toll High.
Take, for example, tuberculosis,
Washington. as cities go. is not un-
healthy on the whole. But, in respect
to this one malady, it presents a bad
picture. There are 600 deaths year
Among the colored population the rate
is approximately 800 per 100000. The
white death rate is about one-sixth of
that. 1t is fact that the white race
is less susceptible to tuberculosis than
the colored, on the whole, and condi-
tions of living are better. But for the
country as a whole the ratio Is only
about three to one. In the neighboring
city of Baltimore, where the colored
population lives under similar condi-
tionS, the tuberculosis rate Is ap-
preciably lower
Such is the picture confronting Dr.
Ruhland today.
Why is WaShington's colored popu-
lation so ravaged by tuberculosis and
what can be done about it?
Upon the answer to these two
questions depends the answer to many
others.
First, it may be taken for granted
that Washington hasn't population
supernormally susceptible to the dread
malady.
Again. statistics give no basis for
the assumption of some hidden physi-.
cal condition here-climate or lack
of sanitation-by which the discrep-
ancy can be explained. The only an
swer is that tuberculosis here is be-
ing allowed to get better foothold
than in other cities through the
failure of preventive measures.
Cause Well Known.
tuberculosis happens to be a dis
ease of which the cause is well known.
1t is due to infection by the tubercle
bacillus. Nearly everybody gets some
of these bacilli in their systems at
one time or another. Some dispose
of them naturally, without any
treatment whatsoever. and never
know they have been infected.
Throughout childhood, in the great
majority of cases, the disease may
persist without doing much damage.
The system may encase the bacilli
with walls of calcium and prevent
them from doing any further damage.
They do not ordinarily attack the
lungs.
Then comes adolescence. Something
happens in the physiological system
that makes the germs much more
virulent If they haven't been dis
posed of before they start to cause
LESSONS in the lungs. Right here. at
the threshold of adult life, is the time
to strickland strike hard. This is the
excuse for DR.. Ruhland's first major
demonstration of public health meth
ods in Washington.
There is no wand-waving trick about
it. The disease cannot be cleared up
by some far-reaching but inexpensive
sanitary measure-Such as screening
houses in campaigns against malaria.
The only way is patiently to locate
every adolescent case and bring it
Immediately under proper medical
care, to find out the source Of in
fection, and to prevent the infection
from spreading further. This is the
objective of the great anti-tuber-
culoSis drive DR.. Rutland has
launched in the District high schools,
both public and parochial.
Individual Study Needed.
The campaign deals with indi-
viduals. It demands that each pupil,
right at the dangerous age, be ex-
amined individually. There are three
steps. First is the tuberculin test
relatively simple and easy to admin
lister. 1t shows whether the indi-
vidual ever has had tuberculosis, and
nothing else. The case may long
very active.
For those who show a positive re-
action the next step is the X-ray pic
ture of the lungs. This, taken at
high school age, shows whether the
bacilli actually have invaded the
lungs. It does not show ordinarily
whether the case is active or closed.
Where the lung invasion is shown,
further tests must be undertaken to
show the status of the malady. But
even this is but part of the story.
Once the victim has been located
trained workers must trace down the
source of the infection, determine
whether others in the same family
are infected and decide what pre-
ventive measures are necessary. It
is all matter of intensive, thorough
attention to details.
But it is the only way in which
tuberculosis can be materially re-
duced. It requires time, work and
money. The results are certain.
They have been demonstrated over
and over again. Scores of lives would
be saved every year.
Other Diseases Similar.
There is much the same story to
be told in connection with most Of
the other bacterial diseases. They
can, for the most part, be brought
under control. The death rate can
be greatly reduced But it is q mat
ter of patient, thoroughgoing work
with individuals. The public health
is, in sense, misnomer. It Is the
health of the individuals making up
the public. The City Of Washington
hasn't any lungs to be invaded by
the tubercle bacillus. It hasn't any
heart to be weakened by diphtheria
or scarlet fever. A doctor can't shoot
an injection of serum into the arm
of the old gentleman pictured in Mr..
Berryman's cartoons as "the District
of Columbia" He never has been
located.
Upon the clear realization of this