THE PENNSYLVANIA SOCIETY FOR THE Prevention of Tuberculosis ORGANIZED APRIL 10, 1892 INCORPORATED 1895 REPORT FOR THE YEAR ENDING APRIL 13, i8g8 “It is in the power of man to cause all parasitic maladies to disappear from the world.”—Pasteur PRESIDENT _ MAVRENCEJL-KLFCKt 7‘-tA Pin,. — H. S. ANDERS 1836 Wallace Street, Philadelphia. J. SOLIS COHEN, 1431_ Walnut Street, Philadelphia. GUY HINSDALE v 3943 Chestnut Street, Philadelphia. VICE-PRESIDENTS BENJAMIN LEE Health Officer, Philadelphia. MISS E. W. REDFIELD, 117 No. 34th Street, Philadelphia. TALCOTT WILLIAMS 916 Pine Street, Philadelphia. ' S. A. KNOPF, 955 Madison Avenue, New York City, SECRETARY A. H. DAVISSON, 2024 Pine Street, Philadelphia. TREASURER (MRS.) HELEN C. JENKS, 920 Clinton Street, Philadelphia. SOLICITOR JAMES L. STANTON, 412 Drexel Building, Philadelphia. BOARD OF DIRECTORS A. H. DAVISSON 2024 Pine Street, Philadelphia. MRS. HELEN C. JENKS, 920 Clinton Street, Philadelphia. JAS. L. STANTON, 412 Drexel Building, Philadelphia. MAZYCK P. RAVENEL, Univ. of Penna., Philadelphia. TTHOMAfi W. SPARKS,—„ Waln.it Sfrp^f| Philadelphia^ MISS E. H. CARROLL, 1629 S. 16 St., Philadelphia. MISS E. W. REDFIELD, 117 No. 34th Street, Philadelphia. LAWRENCE F. FLICK, 736 Pine Street, Philadelphia. S. G. DIXON, The Acad, of Nat. Sciences of Philadelphia. GUY HINSDALE, 3943 Chestnut Street, Philadelphia. H. S. ANDERS, 1836 Wallace Street, Philadelphia. BENJ. LEE, 1632 Pine Street, Philadelphia. LEONARD PEARSON, Univ. of Penna., Philadelphia. GEORGE WOODWARD, Board of Health, Philadelphia. MRS. M. E. B. HAMPTON, 2010 Arch Street, Philadelphia. The Board of Directors meets monthly at the Academy of Natural Sciences, Logan Square, Philadelphia. PENNSYLVANIA SOCIETY FOR THE PREVENTION OF TUBERCULOSIS, The Society for the Prevention of Tuberculosis has worked quietly with but one end in view—namely, the education of the community in a knowledge of the true nature of consumption and of the means now considered necessary to control or conquer this disease. The means by which this end is sought to be obtained are : 1st. by the publication and distribution of pamphlets; 2nd, by constant efforts to induce those in influential positions to use their earnest efforts to prevent the spread of the disease; and 3rd, by striving to obtain the requisite conditions whereby those early afflicted may be restored to usefulness, or for those far advanced, the safeguarding that will prevent the communication of infection to others. During the past year one new pamphlet has been published, Tract No. 4, “How Storekeepers and Manufacturers Can Help to Prevent the Spread of Tuberculosis,” 5000 copies of this have been issued and 20,000 copies of earlier tracts have been reprinted and extensively circulated and copied. The chief effort of the managers, however, has been directed towards the establishment of the greatly needed Municipal Hospital for Tuberculous patients, and also for a sanatorium in the high regions of the State. The former of these is needed for two reasons—iSt, the comfort and last retreat of the poorest members of our community who after months and years of struggle find themselves at last penniless, abso- lutely unfit for work and refused admission to the general hospitals of the city. The hospitals of the city cannot admit all the cases of tubercu- losis that apply to them; their wards would be crowded to the detri- ment of the acute cases of other diseases. The Home for Incurables is full and has always a long waiting list. The Free Hospi- tal Fund for Poor Consumptives has undertaken, as far as its means permit, to pay for consumptive patients who are received in a special ward of St. Agnes Hospital. The Rush Hospital will take cases for a limited time, and the City Mission, by a few beds at 411 Spruce Street and its fine Home at Chestnut Hill—this latter only for women—provides for a number of sufferers. At the Philadelphia Hospital certain wards are reserved for consumptives, but even with 3 these the accommodation is not nearly sufficient for the size of our city. For their own sake, such patients should have better air and sanitary conditions than are possible in an Almshouse hospital; for the sake of the community they should be treated by such methods as will not only tend to cure certain cases but will prevent the con- tagion from spreading. We feel convinced that a State Sanatarium in the highlands would save many valuable lives and also that a good City Hospital set apart for tuberculous patients would not only give comfort to them but add greatly to the safety of the (apparently) healthy part of the community. A most desirable location in Luzerne County has been offered the Society for the site of a sanitorium and strong efforts are being made to obtain state aid to erect the building. In December 1896, a committee was appointed by the Society to make a report on a suitable site for such an institution. This committee of four members visited White Haven, in Fuzerne County, Glen Summit and Bear Creek and neighboring localities within a radius of from twenty to thirty miles. The place which appeared to present the greatest advantages was situated quite near White Haven, a borough composed of educated and progressive people, and in touch with all the great railroad systems of the State. This is an important matter, as it would diminish the sense of isolation on the part of the patients, attendant upon removal to a wilderness or a dense forest remote from civilization and difficult of access. The point selected is about 1,225 feet above the level of the sea, and 250 feet above the Lehigh River. Green Mountain rises gently from the borough of White Haven until at an elevation of 100 feet above the town it forms a plateau, a few hundred feet in width, stretching westward indefinitely. It is on this plateau that it is proposed to locate the Sanatorium. The prevailing winds of this locality are northwest, and the Sanatorium would be protected from them by Green Mountain, which rises rather abrupt- ly from the plateau some 400 feet, and passes westward continuously with the plateau. It thus affords admirable shelter from the wind. The sun exposure is all that could be desired. The outlook is to the south and the plateau is bathed continuously with sunshine, from daylight to dark. The view is out over a wide stretch of wilderness, east, west and south. From the top of Green Mountain there is a charming prospect towards every point of the compass. The soil is 4 View of Green Mountain from the South showing plateau ani summit. View of the Valley of the Lehigh looking south from Green Mountain. 5 porous, and the drainage good. With the exception of a clearing on the plateau which is occupied as a farm, the mountain side is wooded. It is the natural home of the pine, though the extensive lumbering operations which brought White Haven into being, have long since caused an almost entire disappearance of this beneficent tree, whose varied products, by some strange chemistry of nature, have ever been found to be so healing in affections of the respiratory tract For purity of atmosphere the locality is up to a high standard, and is pronounced practically free from miasmic and malarial influences. The condition of dry atmosphere is fairly present. The fogs are not frequeut, nor are they extensive or continuous. They mostly originate in the condensation which takes place in the moisture arising from the river, but they do not last long nor do they usually reach to the plateau. The tract consists of several hundred acres, and it has been offered free of expense and encumbrance to the Society, on the sim- ple condition that they shall raise the funds for building and equip- ping the institution. The matter having been brought to the notice of the Board of State Charities, from the fact that it is intended to make this more especially a refuge for the consumptive poor of our large cities, that body recommended an appropriation of $30,000.00, provided a like amount could be raised by private subscriptions The Committee on Appropriations of the Legislature, however, re- ported the bill negatively. The movement having once been inau- gurated, will certainly not be suffered to drop. The first difficulty in carrying out the objects of the Society is the immense number of persons suffering from tuberculosis. Even if we consider those who actually die of this disease each year we find that for the State of Pennsylvania it is an army equal in num- bers to that ofits National Guard. What consternation would ensue, what measures would not be undertaken if we might suppose the disease to cease for ten years and then be restored in its full measure of mortality ! The second element of difficulty is the apathy of our people. They have not begun to grasp the idea that tuberculosis is one of the preventable diseases. They look upon the mortality from phthisis as a part of an inevitable tribute to death that must be paid because it always has been paid with such a remarkable regularity that one is able to fortell very closely just how many will die of phthisis in 6 the year. We know now, and we were morally certain at the open- ing of the year, that in Philadelphia about 2350 would die of phthisis in 1898. But happily in Philadelphia the rate has fallen gradually Chart Showing the Steady Reduction in Deaths from Consumption per thousand of Population, Philadelphia. 1870—1897. so that, whereas, fifteen years ago about fourteen per cent, of all deaths were from phthisis now only about ten per cent, are from that cause. The reason is that, as in other warfare, “To know the enemy is half the battle. ” So the fuller knowledge of the way in which the disease is propagated from the sick to the well enables us in some measure to avoid distributing broadcast the germs of the disease, and, on the other hand, to avoid receiving them with a strange indif- ference which does not seem to exist in our relations to other diseases. An institution for the scientific treatment of tuberculosis is a great object lesson on the means of prevention of the spread of the disease as well as its cure. The sanatoriums in the Adirondack Mountains, at Chestnut Hill in Philadelphia, in England, the Isle of Wight, and 7 Diagram Showing Comparative Mortality by Deaths from Thirteen Prominent Causes of Death in Philadelphia, for the Ten Years, 1884—1893, inclusive. on the continent of Europe, by exerting a strict supervision of their patients, teach how the disease can be managed and the dan- gers of its communication destroyed. So it would be with an insti- tution of this kind if established in any locality. Those who go out relieved or cured should aid in all measures calculated to diminish the disease. The Society has made a strong effort to limit the evil of expect- oration in public places. The Board of Health was requested by this Society to consider the advisability of issuing circulars or public notices to be properly distributed, warning against the uncleanly, unnecessary, unhealthful and reprehensible practice of spitting, es- pecially aby consumptives, in public places, thoroughfares and con- veyances. The Board of Health published “ The Spitting Habit ” and thousands of copies were widely distributed; now every street car in Philadelphia is provided with a sign authorized by the Board of Health forbidding the practice of spitting upon the floor. The State Live Stock Sanitary Board of Pennsylvania has been for about two and a half years and much of its work has been in connection with the suppression of tuberculosis of cattle. Since its establishment it has caused the condemnation and destruction of over 3500 tuberculous cattle. This work is justified both from the standpoint of public health and from the standpoint of agriculture. In the first place the ingestion of the meat or milk of tuberculous animals may produce tuberculosis in the consumer, and in the second place this disease is quite contagious among cattle and causes very great losses to farmers. Inspections of tuberculous herds have been made by the State Veterinarian in all parts of Penn- sylvania under the supervision of the State Live Stock Sanitary Board. Herds have been found in which the percentage of tuber- culosis has been extremely high. In one herd of fifty-six cattle re- cently examined fifty-three were afflicted with tuberculosis and killed. The average percentage, however, is steadily falling and while the proportion of infected cattle in infected herds was as high as 30 per cent, in the beginning of the work it has been reduced to about 10 per cent, showing that the herds in which infection is most exten- sive are being discovered and disposed of. In some parts of the State there is very little, if any tuberculosis of cattle, and the same condition prevails in many herds in districts in which tuberculosis is most abundant. The absence of tuberculosis seems to depend upon freedom from exposure and the prevalence of tuberculosis depends 9 upon care that the animals receive and the conditions to]which they are subjected and the length of time that the outbreak has remained undisturbed. Many cases have been observed in which calves and swine have become infected with tuberculosis through the consump- tion of skimmed milk from creameries supplied in part with milk from tuberculous cows. The danger of infection meat can only be avoided by obtaining these important foods fromjanimals that are known to be healthy, or by destroying by heat the germs that they may contain. Much progress is being made in the suppression of this import- ant disease of domestic animals and this progress is due to several lines of work. In the first place tuberculous herds are inspected and diseased animals are destroyed outright, thus removing all danger that may accompany their existence. The premises occupied by such animals are thoroughly disinfected. The owners of cattle are placed on guard and upon the first appearance of tuberculosis they take precautions to prevent its spread. Great attention is being paid to sanitary condition of stables and farmers are now enabled to pur- chase cattle that are proven free from tuberculosis by application of tub rculin test as a result of the enforcement of the new law requir- ing inspection of all dairy cows and cattle for breeding purposes com- ing into Pennsylvania from other States. The State Live Stock Sanitary Board is now engaged in some research work carried on for the purpose of discovering more as to the exact manner in which tuberculosis is transmitted from animal to animal, the infectiousness of the breath, saliva and secretions of tuberculous animals, the infectiousness of the milk at different stages of disease and the discovery of practical methods for the prevention of the spread of tuberculosis in infected herds. In the beginning of this work there was some opposition to it by farmers on the ground that it is not necessary and would cause them financial loss. That they now appreciate its importance and benefits is shown by the fact that the State veterinarin receives fully three times as many voluntary applications for examinations of herds as can be made with the funds at the disposal of the State Live Stock Sanitary Board. TREASURER’S REPORT. Helen C. Jenks, Treasurer, in account with the jPenna. Societ)' for the Prevention of Tuberculosis, from May 1st, 1897 to April 13th, 1898. Dr. Balance, May 1st, 1897 .... $179.17 Annual Dues, 1896 .... 12.00 “ “ 1897 47.00 “ “ 1898 .... 10.00 “ “ 1899 ..... 1.00 “ “ 1900 .... 1.00 Donation, T. W. Sparks, .... 10.00 “ Mrs. J. L. Welsh, . . . 5.00 “ .25 Interest on Deposits, .... 3.60 $269.02 Cr. Oct. 1897, D. J. Gallagher, Printing 100 cards, . . . $ 1.50 Nov. 1897, Lea Bros., 3,000 Tracts, . . . 48.39 Jan. 1898, 1100 penny newspaper wrappers, 12.10 Jan. 1898, Letter box, , 1.25 April 13, 1898, Balance, .... 205 78 $269 02 We the auditors appointed April 13, 1898, find the accounts of the Treasurer correct. (Signed) GUY HINSDALE, (Signed) SAMUEL G. DIXON. The Society has a donation of $100.00 from Dr. and Mrs. S. A. Knopf toward the erection a Sanatorium. 11 CONSTITUTION AND BY-LAWS. Art. I. The name of this Society shall be the Pennsyl- vania Society for the Prevention of Tuberculosis. CONSTITUTION. Art. II. The Society is formed for the purpose of preventing tuberculosis (consumption) : 1st, By promulgating the doctrine of the contagiousness of the disease; 2d, by instructing the public in practical methods of avoidance and prevention ; 3d, by visiting the consumptive poor and supplying them with the necessary materials with which to protect themselves against the disease, and instructing them in their use : 4th, tby furnishing the con- sumptive poor with hospital treatment; 5th, by co-operating with Boards of Health in such measures they may adopt for the prevention of the disease; 6th, by advocating the enactment of appropriate laws for the prevention of the disease ; 7th, by such other methods as the society may from time to time adopt. by-daws. Art. I. Members. Any person who shall pay one dollar or more into the treasury of the Society shall be enrolled as a member for the year in which such payment is made. Art. II. Officers and Their Duties. SECT. i. The officers of the Society shall be a President, three or more Vice-Presidents, a Secretary, a Treasurer, a Solicitor, and a board of Directors. Sect. 2. The President, Vice-Presidents, Secretary, Treasurer, and Solicitor shall preform the customary duties of their respective offices. Sect. 3. The Board of Directors shall consist of fifteen mem- bers. It shall have entire control of the business of the Society and of the expenditure of its funds, except where otherwise provided for by the By-Daws; and it shall appoint such subordinate officers and agents as shall be necessary to carry out the work of the Society. Art. III. Meetings. Sect. i. The Society shall meet annually on the second Wednesday in April. 12 Sect. 2. The Board of Directors shall meet regularly on the second Wednesday of every second month, beginning May 10, 1892. Sect. 3. The Secretary shall call a special meeting of the Board at the written request of three members. Art. IV. Elections. The officers and Board of Directors shall be elected annually at the meeting of the Society in May. All vacancies shall be filled by the Board until the next annual meeting. Art. V. Expenditures. Sect. t. At each regular meeting of the Board of Directors all money in the treasury beyond that which is necessary for defray- ing the general expenses until the next regular meeting of the Board shall be set aside to be used as a Hospital Fund. Sect. 2. When the money in the Hospital Fund shall amount to $150 or more, a tuberculous patient shall be placed in a hospital for every $150 in the Fund. Art. VI. Amendments and New By-Eaws. New By-Eaws may be adopted or amendments made by a ma- jority vote of the Board of Directors. MEMBERSHIP LIST. (Philadelphia, where no city is mentioned.) Anders, H. S., M.D., 1836 Wallace Street. Baker, Geo. C., Esq., 804 Market Street. Bell, J. E., Miss, Chestnnt Hill. Bissell, Mary Taylor, M.D. 142 West 44th St., New York City. Bissell, W. G., M.D., Health Department, Buffalo, N. Y. Brannan, John Winters, M.D., 11 W. 12th St., New York City Carrigan, Gordon S., P. O. Box 724 Carroll, Emma, Miss, 1629 S. 16th Street. Carruthers, Georgina H., Miss, 3000 Frankford Avenue. Castner, Samuel, Jr., 328 Chestnut Street. Cohen, J. Solis, 1431 Walnut Street. Conover, S. S., Miss., 1314 Pine Street. Cooke, Edwin S., M.D., 1616 Christian Street. 13 Cramp, David D. 804 Market Street. Crider, George A , 804 Market Street. Daland, Judson, M.D , 319 S. 18th Street. Davis, Theo. G., M.D., 118 Commerce St., Bridgeton, N. J. Davisson, A. H., M.D., 2024 Pine Street. Dixon, Samuel G., M.D., Academy of Natural Sciences. Dixon, Samuel G., Mrs. Dunn, Chas. B., Dunn Brothers, Bankers, Chestnut Hill. Engel, Joseph M., 804 Market Stteet. Eskridge, J. T , M.D., Equitable Building, Denver, Colo. Farr, Caroline, Miss, 2218 Trinity Place. Farr, W. W., M. D., 5800 Green St., Germantown. Farrelly, Stephen, 39 Chambers St., N. Y. Fisher, Henry M., M.D. 317 S. 12th Street. Flick, Lawrence F., M.D., 736 Pine Street. Flick, Lawrence F., Mrs., 736 Pine Street. Flick, Lawrence F. P., 736 Pine Street. Gilliams, E. Leslie, 806 Walnut Street. Girwin, A. J. 2002 Pine Street. Gonzaga, Sister, Carnegie Hospital, South Boston, Mass. Green, Maggie T., Miss, 503 Pine Street. Gryttenholm, K , M.D., Lumbrota, Minn. Hallahan, P. T., 759 Passayunk Ave. Hampton, M. E. B., Mrs., 2010 Arch Street. Haydon, Marie W-, M.D., 2215 Vine Street. Hinsdale, G., M.D., 3943 Chestnut Street. Hookey, A. C., 2464 Frankford Avenue. Jackson, Edward, M.D., McPhee Building, Denver, Colo. Jenks, Wm. F., Mrs., 920 Clinton Street. Johnson, F. C., M.D. Wilkes-Barre, Pa. Kromer, Louise, Miss, 1920 Mt. Vernon Street. Knopf, S. A., M.D., 955 Madison Avenue, New York. Knopf, S. A., Mrs., 955 Madison Avenue, New York. Landis, H. D. Mrs., Chestnut Hill. Landis, Henry, M. D., Reading, Pa. Lee, Benjamin, M.D., 1532 Pine Street. Levy, Max, 4508 Rubicam Avenue, Germantown. Lomb, Henry, Rochester, N. Y. McCullen, Joseph P., Brown Building. Moore, E. M., M.D., Rochester, N. Y. 14 Morse, Edwin F., 1105 Frankford Avenue. Moss, Wm., M.D., Chestnut Hill. Musser, J. H., M.D., 1927 Chestnut Street. Nolan, Edward J., M. D., 831 N. 20th Street. Otis, E. O., M.D., 308 Commonwealth Avenue, Boston, Mass Pearson, Leonard, M.D., University of Pennsylvania. Perkins, J., M.D., Providence, R. I. Preston, David, 511 S. 9th Street. Randall, M. N., Miss, 1724 Pine Street. Ravenel Mazyck, P. University of Pennsylvania. Redfield, Eliza W., N. 34th Street. Rhoads, J. Neely, M.D., 1610 S. 7th Street. Richards, J. Harvey, 4403 Spruce Street. Risley, Samuel D., M. D., 1722 Walnut Street. Roberts, John B., M.D., 1627 Walnut Street. Robb, Wm. H., M.D., 18 Grove Street, Amsterdam, N. Y. Ross, J. W , M.D., Clarksville, Tenn. Scully, Rev. J. J., S. J., 317 Willing’s Alley. Shattuck, Fred. C., M.D., Marlborough Street, Boston, Mass. Snellenburg, Samuel W., 5th and Passayunk Avenue. Sparks, Thos. W., T21 Walnut Street. Stanton, James L-, 412 Drexel Building. Stewardson. Thos. Chestnut Hill. Strittmatter, J. P., M.D., 999 N. 6th Street. Thomas, Geo. C., Mrs., 301 South 21st Street. Trudeau, E. L-, M. D., Saranac Lake, N. Y. Turner, Jas. P , Rev., 18th and Summer Streets. Turner, J. V. P., Board of Health, City Hall. Veale, Moses, Major, 727 Walnut Street. Vickery, Herman, M. D., 263 Beacon Street, Boston, Mass. Wanamaker, John, 13th and Market Streets. Welsh, J. Lowber, Mrs., Chestnut Hill. White, R. P., Mrs., 2024 Chestnut Street. Wightman, J. G., M. D., 2022 Wallace Street. Williams, Talcott, 916 Pine Street. Wilson, J. C., M. D., 1437 Walnut Street. Windrim, James H., Mrs., 817 North Broad Street. Wood, Albert, M. D., 67 Pleasant Street, Worcester, Mass. Any one desirous of becoming a member of the Pennsylvania Society for the Prevention of Tuberculosis can do so by sending his or her name and one dollar to the Treasurer, (Mrs.) Helen C. Jenks, 920 Clinton Street, Philadelphia, or to any of the officers or directors. A single payment of ten dollars entitles one to Life Membership. Members are urged to invite others to join the Society and to aid it by donations or subscriptions.