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Looking After Ohio Soldiers Discharged
SYSTEM of following up cases of tuberculosis in
men discharged because of the disease from the military service, made possible by the co-operation of the military authorities in giving notifications of such discharges, was installed just before the beginning of the year by the Division of Public Health Education and Tuberculosis of the State Department of Health.
Notifications of tuberculosis discharges from Camp Sherman, Chillicothe, received direct from the disability board at the camp. Reports from other camps and posts reach the department through the National Association for the Prevention of Tuberculosis, which receives and classifies the army reports.
Follow-Up Methods If a reported case is within the jurisdiction of a public health nursing center, a notice, with an investigation blank for each case in the district, is sent to the public health nurse or superior officer. If the case cannot be reached by a public health nurse, a letter is sent from the department direct to the discharged man, offering advice and assistance.
It is hoped that the direct letter will elicit a reply from the subject and place the department in position to give such general advice as may be possible and to recommend consultation with a physician of known worth in tuberculosis cases.
It is also desired that physicians,
in case the discharged man is in poor circumstances, will agree to render free service. In some cases where it may appear advisable, representatives of the department's nursing service will probably visit the subjects.
Investigation By Nurses
are referred to public health nurses, it is presumed that their investigations and visits will obviate any further direct action in the case on the part of the department until the subject becomes a patient in an institution for the public care of tuberculosis.
The investigation blank used in connection with this new branch of the department's work is the regular form used by the bureau of admissions and discharges, with the addition of questions bearing upon the industrial occupations of the subject, practically identical with the questions to be found on the certificate of industrial disease used by the department's Division of Industrial Hygiene.
Replies Come In Several replies were received shortly after the first letters to discharged men were sent out. It is believed that the department's offers of assistance will in general meet with a cordial reception.
Information regarding draft rejections on ground of tuberculosis infection was not at first available, an early order of Provost Marshal General Crowder making it available having been revoked. More
recently, however, authority to in- to getting well. Where this is not spect the draft records has been
possible, he should know how to granted the United States Public regulate his life, his work and his Health Service and by it delegated habits, and where to get such to the Commissioner of Health. medical advice as will give him the No detailed plan of collecting this best chance to get well, even if he information has yet been worked has to continue at his usual work. out.
“If you will write us, telling us Camp Sherman Discharges 27
what your circumstances are, we
will put you in touch with a good In December Camp Sherman doctor, and give you every assistmedical authorities recommended ance in our power in getting you discharge of 27 Ohio men because started the road to health. of tuberculosis. Twenty-three of There is no charge for anything these cases were referred by the we may be able to do for you, as Department of Health to public the state of Ohio has established health nurses and letters were sent this department and pays all the to the other four men. Notifica- expense of running it, so that we tions from all sources in Decem- may help to promote the health of ber gave information of 88 cases,
every citizen of the state. of which 67 were referred to pub- "Anything you may write us will lic health nurses and 21 were the
be considered as confidential, and subject of direct letters.
you need have no hesitancy in tellThe letters sent to men whose ing us just how you are situated, cases cannot be handled by public and just what you need in way of health nurses read as follows:
advice and assistance." Department's Services Offered
"In co-operation with the military authorities, this department is
CENSUS BUREAU ISSUES anxious to be of service to the men
WEEKLY DEATH FIGURES who have been discharged from As a health index, the Bureau the army because of lung trouble. of the Census is publishing each To the man with a touch of lung week mortality reports from 44 of trouble, nothing is as important as the largest cities in the United getting proper treatment immedi- States. ately. If taken in time, a large There are given for each city proportion of these cases can get the total number of deaths reabsolutely well, while, if neglected, ported (stillbirths excluded), the many will go down hill rapidly, death rate, the number of deaths and in a relatively short time be under one year of age, and the bevond the chance of final cure. proportion of infant deaths to total
"We are writing you, therefore, deaths. Where the data are obin the hope that we may be of
tainable for the previous five years, service to you in advising you as averages for the corresponding to what you should do to restore weeks are given for each city. yourself to full health and strength. These totals, rates, and percent
“If it is possible, a man who has ages permit valuable comparisons this trouble should give up his and serve as a ready health index business and give all his attention for health officers and others.
Control Venereal Diseases
Memorandum Relative to the Control of the Venereal Diseases 1. Epidemiology.
(a) Peculiar to the human species.
(e) Most prevalent in classes of low inhibition. 2. Control.
(a) Depends upon the control of infected persons.
titioners), name to be disclosed when infectious persons cease treatment. Case then followed up by health department which
enforces quarantine act. (2) Morbidity reports from venereal clinic and hospital. (3) Legal enactment necessary to secure morbidity reports. (4) Enact and enforce ordinance requiring pharmacists to keep
record (open at all times to health department) of sales of drugs for the prevention and treatment of gonorrhea and
syphilis. (c) Object of this control is to prevent contact between infected and
(1) Quarantine of infected persons.
tact with persons infected or presumably infected. 3. Quarantine of infected persons.
(a) Those who desire cure and can afford treatment.
(1) These are instructed by their physicians and theoretically are
(a) Accurate diagnosis.
(c) Hospital relief.
tions through promiscuity. (1) These for the most part are the ignorant or the criminal classes.
Careful physical examination of all persons entering jails or other public institutions, those found infected to be isolated either in a special hospital or under a probation officer who
enforces dispensary relief. 4. Cure of infected persons.
(a) Establishment of venereal clinics by health authorities.
(1) Federal, in zones in close contiguity to cantonments.
clandestine prostitution flourishes for the patronage of soldiers
but are beyond the authority of the Secretary of War. (4) Country, in thickly settled rural communities. (b) By the creation of new or the utilization of existing hospital
(1) Declaring the venereal infections to be quarantinable.
in the case of those convicted by courts and having venereal
infections. (3) By substituting remanding to a probation officer for the imposi
tion of fines. (4) To carry out 2 and 3 it is necessary that all persons arrested be
examined by the city physician or other authorized person. (5) By arrest of acknowledged and clandestine prostitutes by police
5. Public education. (a) Relieve problem of all moral and social issues and place campaign
solely on basis of control of communicable disease.
(1) Through public meetings addressed by forceful speakers.
venereal diseases and to recommend prompt treatment either
by competent physician or at the free venereal clinic.
(a) By physicians in private practice.
control of venereal diseases, provided for co-operation between state and city health officials and between these groups and the federal authorities, arranged for the installation in the state laborator
ies of facilities for Wasserman examinations and for free distribution of Salvarsan by the state if necessary appropriations could be obtained, and agreed that the state request municipalities to provide sufficient funds for their local other communicable infections. health departments' share of the This will permit the free and frank campaign.
discussion of this important ques
tion without offense to modesty. Civil Authorities' Responsibility “I shall be pleased to have your
"It is evident," said Surgeon views and suggestions as to the General Blue in his recent letter to prosecution of further work along state health officials, “that the pre
these lines. Whatever is to be vention of venereal infections in done must be initiated promptly if the military population is largely we are to prevent the next incredependent upon the degree with ment of the draft from having the which these infections are pre- high venereal rate of the last.” vented in the civil community. The accompanying “MemoranThis imposes upon the civil health dum Relative to the Control of the authorities the duty of forcefully Venereal Diseases" — the outline attacking the venereal problem referred to in the letted- was enupon the basis of the control of closed with the letter. communicable disease.
“There is forwarded you herewith an outline upon which it is ARMY SEEKING NURSES proposed to make this attack.
TO INCREASE CORPS BY Manifestly, no plan which can be
A THOUSAND PERCENT set forth at the present time can be complete in all its details nor
The Army Nurse Corps needs can a plan be devised which in all
37,500 nurses in addition to its its phases fits the requirements of
present strength of 3,800 to enable each state exactly. Therefore, in
it to meet the needs of an army of the plan which I am sending you
1,500,000 men. A call for this only the basic necessities have
number, which means a 1,000 perbeen stressed. Your co-operation
cent increase in the next year, was in putting this plan in force is re
issued just before New Year's
The supply of nurses at the NaImportance of Education tional Guard and National Army "The Public Health Service in
camps in the United States at that
time was 371 short of the number co-operation with the Red Cross and the Medical Department of
necessary to provide the minimum the Army is establishing venereal
necessary quota of 65 nurses per camp.
The need clinics in cities in immediate con
will be much tiguity to the Army cantonments.
greater when the troops get into
action in France. There is even greater need for the beginning of an active antivenereal
The nursing committee of the campaign in those cities which are
General Medical Board of the outside of the military zones but
Council of National Defense estiinto which soldiers go in search of
mates that there are from 80,000 recreation. Most important of all,
to 90,000 registered nurses and perhaps, is the thorough education
200,000 other grauate and pracof the general public to the end
tical nurses in the United States. that this disease group will be considered in the same light as are the Bad teeth bring bad health.