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diff --git a/.gitattributes b/.gitattributes new file mode 100644 index 0000000..d7b82bc --- /dev/null +++ b/.gitattributes @@ -0,0 +1,4 @@ +*.txt text eol=lf +*.htm text eol=lf +*.html text eol=lf +*.md text eol=lf diff --git a/LICENSE.txt b/LICENSE.txt new file mode 100644 index 0000000..6312041 --- /dev/null +++ b/LICENSE.txt @@ -0,0 +1,11 @@ +This eBook, including all associated images, markup, improvements, +metadata, and any other content or labor, has been confirmed to be +in the PUBLIC DOMAIN IN THE UNITED STATES. + +Procedures for determining public domain status are described in +the "Copyright How-To" at https://www.gutenberg.org. + +No investigation has been made concerning possible copyrights in +jurisdictions other than the United States. Anyone seeking to utilize +this eBook outside of the United States should confirm copyright +status under the laws that apply to them. diff --git a/README.md b/README.md new file mode 100644 index 0000000..347208c --- /dev/null +++ b/README.md @@ -0,0 +1,2 @@ +Project Gutenberg (https://www.gutenberg.org) public repository for +eBook #62116 (https://www.gutenberg.org/ebooks/62116) diff --git a/old/62116-0.txt b/old/62116-0.txt deleted file mode 100644 index 6bd65cb..0000000 --- a/old/62116-0.txt +++ /dev/null @@ -1,903 +0,0 @@ -The Project Gutenberg EBook of A Working Plan for Colored Antituberculosis -Leagues, by C. P. Wertenbaker - -This eBook is for the use of anyone anywhere in the United States and -most other parts of the world at no cost and with almost no restrictions -whatsoever. You may copy it, give it away or re-use it under the terms -of the Project Gutenberg License included with this eBook or online at -www.gutenberg.org. If you are not located in the United States, you'll -have to check the laws of the country where you are located before using -this ebook. - - - -Title: A Working Plan for Colored Antituberculosis Leagues - -Author: C. P. Wertenbaker - -Release Date: May 13, 2020 [EBook #62116] - -Language: English - -Character set encoding: UTF-8 - -*** START OF THIS PROJECT GUTENBERG EBOOK COLORED ANTITUBERCULOSIS LEAGUES *** - - - - -Produced by hekula03 and the Online Distributed Proofreading -Team at https://www.pgdp.net (This book was produced from -images made available by the HathiTrust Digital Library.) - - - - - - - - - - - TREASURY DEPARTMENT - Public Health and Marine-Hospital Service of the United States - - A WORKING PLAN FOR COLORED - ANTITUBERCULOSIS LEAGUES - - BY - - C. P. WERTENBAKER - - _Surgeon, United States Public Health and - Marine-Hospital Service_ - - [Illustration] - - WASHINGTON - GOVERNMENT PRINTING OFFICE - 1909 - - - - -A WORKING PLAN FOR COLORED ANTITUBERCULOSIS LEAGUES. - -Reprint No. 39, from the Public Health Reports, Vol. XXIV, No. 36, -September 3, 1909. - -By C. P. WERTENBAKER, Surgeon, United States Public Health and -Marine-Hospital Service. - - -There was published in the Public Health Reports of May 28, 1909, Volume -XXIV, No. 22, a plan for the organization of colored antituberculosis -leagues, which contemplated the organization of a league in each State, -with a branch in every colored church. - -Experience has shown that after such leagues are formed difficulty -arises in getting to work in an effective way, because the work is -new in character and those engaged in it have had but little, if any, -experience. It is to meet this difficulty and supply a practical guide -for the work of the leagues that this is written. - - -ORGANIZATION OF A STATE LEAGUE. - -The object of the state league is to organize the church leagues, to -bind them together and render more effective their work. The caring for -patients and work of a similar character are properly the function of the -church leagues. - -There need be but little ceremony in organizing a state league. A few -leading colored men and women, preferably from different parts of the -State, but not necessarily so, meet and proceed to organize the state -league. - -The constitution and by-laws for state leagues should be adopted, -followed by the election of a president, a secretary, and a treasurer. - -It is desirable that the constitution and by-laws recommended in “The -Plan” be adopted in all essential particulars, so that there will be -uniformity in organization and work. They have been adopted in all -the States that have organized thus far, and it is believed future -organizations should also adopt them. - -The president then appoints a committee, the president and secretary -being members of it, to select a vice-president for each county in the -State. (The plan contemplates that there shall be a vice-president for -each county, whose duty it is to organize a branch league in each colored -church in the county.) - -The selection of the county vice-presidents should be made with a good -deal of care. Suitable persons who will actively carry on the work should -be chosen for these positions. The vice-presidents should be authorized -to appoint one or more representatives in each community to help them -organize the leagues in the churches and arouse interest in the work. - -It can not be impressed too strongly on the vice-presidents that the -success of the church leagues in their districts will depend upon the -amount of attention given the work. The organization of a branch league -in a church is merely the starting point; the real work is done after the -organization is completed. - -The president and secretary of the state league should call for regular -reports from the county vice-presidents, showing the number of church -leagues in their respective counties and a statement of the work done in -each. - -If any of the church leagues are not prospering, the president or the -secretary of the state league should visit or write to them and learn -what is the trouble, and give needed advice and encouragement. Officers -of the state league should consult frequently and freely with their state -board of health and enlist its sympathy and aid in their work. The closer -the leagues keep in touch with the health authorities the better will be -the results obtained. Both the state and local health officers will be -glad to give their best efforts to help along this work. They are in a -position to do a great deal to assist both state and church leagues, and -the leagues should work in harmony with them. - - -CHURCH BRANCH LEAGUES. - -_Organization._—In order that the members of the church in which it is -proposed to organize the branch league may understand thoroughly the -objects of the league, the minister or other competent person should -explain clearly the purpose of the league and what it is expected to -accomplish. He should inform them that relatively many more colored -people die of consumption than white people; that very few colored -people get well of the disease, partly because they do not know how to -take care of themselves and partly because many neglect to do so; and -that the object of the league is to teach the well how to preserve their -health and prevent their contracting consumption and other diseases, and -the sick how to regain their health. If too poor to take the necessary -treatment, it is the purpose of the league to help its members to do so. - -After the foregoing has been thoroughly explained, the church branch of -the state league should be formed by the adoption of the constitution and -by-laws given for church leagues in the plan of organization published -in the Public Health Reports of May 28, 1909. After this has been done, -the officers required by the by-laws should be elected. - -The secretary then takes the name and address of each of the members, -and as soon as a member has paid his dues he is given the certificate -of membership, properly filled out, and signed by the president and -secretary of the church league. - -The certificate of membership given to each person joining the league has -printed on it information and instructions which, if followed, will tend -to protect the individual from consumption. - -An attempt has been made to make the certificate large and attractive, -and it is expected that the members will value it to such an extent that -they will frame and hang it in a prominent place in the home, where it -can be frequently seen, and that the sanitary maxims that it contains -will be learned and followed. - -In organizing the church league it is well to have a number of the -certificates on hand to supply the members as soon as they pay their -dues. The form of the certificate will be found in the plan of -organization for these leagues. The certificate can be printed at a local -printing office, but if this is not practicable, or it is preferred to -buy them, very handsome certificates printed in black and red, with a -large red seal, and the name of the state and church branch league, can -be bought for about 6 cents each, by the hundred. - -The amount of the annual dues to be paid by each member can be changed by -each league to suit the necessities of the community. The dues should be -so small that no one will be kept out of the league by not being able to -pay them. However, as the dues will be the chief source of revenue with -which the league expects to do its work, they should not be made smaller -than is actually necessary. - -The money paid into the league as dues goes to form a fund that is -disbursed by the church league collecting it to help those of its -members who contract consumption. How much this help will be will depend -upon the amount of money the league has at its disposal and the needs -of the individual. But whether this help is much or little the having -the certificate of membership and belonging to the league will give -information that will teach one to protect himself and his family from -disease. This means less sickness, consequently less loss of time from -work, therefore more money, more comforts, and more happiness for all -concerned. - -The vice-presidents and organizers should see that the four standing -committees required by the by-laws of the church leagues are promptly -appointed and that they understand their duties. - -As the work of each church league will at first consist largely of -educating its members as to the cause of tuberculosis and the way to -live to keep from getting it, the committees, and especially the ones -having charge of “sick,” “sanitation;” and “information” should be -especially active. They should learn all that is possible about their -respective subjects so that they can teach the other members. - -In joining the church league one also becomes a member of the State -Colored Antituberculosis League. Members of the state league and church -branch leagues wear a button showing their connection with the leagues. - -_Membership._—Membership in the church leagues should not be confined to -the members of the church organizing the league. As a rule it is better -that the members of each church join their own church league, but if for -any reason their church has no league there should be no objection to -their joining the league of some other church. Those who are not members -of any church should also be allowed to join the league. - -_Details of the work of a church league._—As soon as the church league -is organized the president should appoint the four standing committees -required by the by-laws to serve for one year, viz: “Finance,” -“Information,” “Sick,” and “Sanitation.” The details of the work to be -done may then be considered. One of the first of these is to ascertain -how many of the members have or are suspected of having tuberculosis. -This duty devolves upon the committee on the sick, which should get from -the secretary a list of the members, giving the name and address of each. -This list should be gone over and every member carefully considered. It -is probable that the greater number of the members are personally known -to the committee, and thus it can be told at once whether they are sick -or well. - -The committee is not expected to decide whether these members have -tuberculosis. Their duty is to make out the list of the sick and ailing. -The physician will decide the nature of the sickness. - -It is desirable to find cases of consumption in the earliest stages, for -these may be cured, and if all members who are not strong and healthy are -examined by the physician it is possible that cases of early consumption -will be found. - -Each ailing member should be visited by some of the committee and more -careful inquiry made as to the nature of the trouble and the member urged -to go to a physician or a dispensary for examination. This is especially -true if the member has been losing flesh, or has had a cough for some -time, or has throat trouble, or is sickly and frail. If upon examination -the physician finds that the member has consumption, the patient should -get a certificate stating that fact. The physician will also tell the -patient what treatment is necessary. - -The certificate will be presented to the committee by the patient, and -the committee will make more careful inquiry into the condition of -the patient, the treatment considered necessary by the physician, the -patient’s means, the number of people he has depending upon him, etc., so -that the facts may be presented to the executive board in accordance with -the requirements of Article VII of the by-laws. - -The list of the sick should be most carefully guarded and no one allowed -to see it but the officers of the league and the health officers. This -knowledge should be regarded as a sacred confidence that should not be -divulged except to the persons mentioned above, as many might object to -having it known that they have tuberculosis. - -Under no circumstances should the list be allowed to fall into the hands -of “patent medicine” concerns which might urge their nostrums on the -patients, much to their annoyance and also to their detriment, if they -become induced to take the “patent medicines.” - -The measures necessary for the treatment of a patient who has -tuberculosis must be determined by the physician, but it is the duty of -the executive board to decide how much and what kind of help the league -can give the patient in carrying out this treatment. - -It is not proposed to discuss here the question of treatment in a -sanatorium which is the ideal way of handling all cases of tuberculosis, -for in a sanatorium the sick cease to be a menace to the community and -can be under supervision and treatment all the time. Unfortunately, at -present sanatoria are not available for the great mass of the people; and -even if they were, many would be unable to go to them. - -There is a class of patients who have to depend upon their daily labor -for the support of themselves and their families. If they stop work, -their support is cut off. For such as these treatment in a sanatorium -is out of the question, and any treatment they can get must be given -in their homes and frequently while they are working. To this class -belong the great majority of the negroes; therefore the work of the -church leagues must be directed to such help as can be given under these -circumstances. What is necessary in each case will depend upon the -condition of the patient, the stage of the disease, and the financial -circumstances of the individual. - -For the purposes of the league, consumptives may be divided into three -classes: - -First. The patients who are in the earlier stages of the disease and are -able to go about their work while taking treatment. - -Second. Cases in which it is necessary to stop work and remain quiet if -they are to get well. - -Third. Cases in which the disease has progressed so far that it is -hopeless to attempt a cure, but for which much can be done to make the -patients comfortable and prevent them from scattering the germs of the -disease. - -As stated above, what is necessary in each case will depend upon the -condition of the patient and his surroundings. Much also depends upon the -means the league has at its disposal to help the individual. Most church -leagues find that they have very little money; therefore the help given -must be limited. However, there are certain things that can be done even -by the poorest leagues. - -Information as to the way in which the disease is spread; the means to -prevent it; what is necessary to get well if one has it, etc., is all -printed on the certificate. When the member gets the certificate and has -learned all that is printed on it, the first step has been taken in the -education of the individual in regard to tuberculosis, so it should be -the aim of the officers of the leagues to get the certificates in the -hands of the members. - -The officers of the league can see that the instructions on the -certificate are understood and carried out. Many individuals are careless -and must be constantly watched to see that they do not neglect important -precautions. Probably the most difficult thing the league will have to do -will be to induce its members to keep their windows open and let fresh -air and sunlight into their rooms. - -The officers and committees of the league should urge the members to -keep the windows of their rooms open, especially at night, and to avoid -overcrowding their sleeping rooms. Whenever a dark room or closed window -which should be open is found, the danger should be pointed out, and the -member urged to correct it. - -The practice of sleeping with the head and face covered is so deeply -rooted in the negro race that it seems almost hopeless to attempt to -eradicate it in the present generation. It is a most pernicious habit. -The dangers of the practice should be pointed out, and the members urged -to abandon it. Children should not be allowed to contract the habit. - -The careless spitting of consumptives in their homes is a practice -dangerous to others. The careless at times spit on the floor, the -walls, the hearth of the open fire, or on the stove if one is used. The -sputum of the consumptive dries and is carried into the air as dust. -This is drawn into the lungs when one breathes. The dangers of this -should be emphasized, and the proper way to dispose of sputum shown. The -consumptive should catch all of his sputum and burn it. There are cheap -cups made of paper that can be had at small cost, and these should be -used to spit in, and when they are full they should be burned. The better -cups have covers to them, so that the flies can not get at the sputum. -While consumption is a dangerous disease, the careful consumptive is not -dangerous to live with. The careless consumptive, however, is dangerous -to live with and a menace to those around him. - -The minister and the officers of the leagues should consult frequently -with the health officer of their community. Working together they can -accomplish much more than by working alone. - -The minister and officers of the league can teach their people to be -careful and not produce unsanitary conditions, and the health officer can -remedy conditions that the people can not correct. The leagues should -urge the members to beautify their homes, no matter how humble they may -be. If the home is made more attractive, interest in it will grow, and -an improvement in the sanitary conditions will naturally follow. Teach -the members to have grass and flowers in their yards. See that there -is no dirt, trash, or litter scattered about; that the loose paling -of the fence is nailed on, and the sagging gate has a new hinge. Pull -the dirty rags from the broken window pane and burn them. Let them put -their bed-clothing out in the sun occasionally, and sweep the dust from -under the bed and furniture. Open the window and door and let air and -sunlight into the rooms. All of these things tend to improve the sanitary -conditions, which means health and happiness. - -Members should be taught that remedies advertised as cures for -consumption are not to be relied upon, and that the only known way to get -well is to live in the open air as much as possible, both day and night, -and to eat nourishing food at regular intervals. The consumptive when -possible should go to a physician or a dispensary and follow exactly the -instructions given. - -Aside from the help that can be given the individual consumptive, which -will be discussed later on, there is much that the leagues can do by -concerted action to improve the conditions under which the negro lives. -Probably one of the most important factors in the spread of tuberculosis, -aside from his habits, is the manner in which the negro is housed. The -negro as a rule is a renter. The houses that he can rent are usually -located in the poorest and most unhealthy part of the city. They are -often poorly constructed, badly lighted and ventilated, and frequently in -bad repair. The rooms are usually small and dark, having but one window, -and the top sash is seldom arranged to be lowered. Many houses are built -on poorly drained ground, and water stands under them after each rain, -making the rooms damp and cold. These houses are seldom provided with -bathing arrangements or water-closets, thus necessitating the use of -privies, or the back alleys, with all the dangers attendant upon such -conditions. For such houses, or more frequently for one or two rooms in -such a house, the negro pays proportionately more rent than the white -race does for better houses in the same community, either because better -accommodations are not available, or because he can not, or will not, -pay for better. The family, usually consisting of father, mother, and -several children, and often friends or relatives, all live, eat, and -sleep in these two or three rooms, frequently with the windows and doors -tightly closed, and in winter a stove going at full blast. - -In the negro section of the city the streets are usually either badly -paved or not paved at all. The sidewalks are either in bad repair or -missing. The streets are badly lighted at night, garbage cans are not -emptied regularly, and the scavenger service is poor. - -“There is a reason for these things,” say the landlords, the municipal -authorities, and others who have dealings with the negro. The landlord -says: “Negroes are destructive; they pull down, but they never improve -property. A house rented to negroes will depreciate from 25 to 50 per -cent in a year. If you put in plumbing they break it, they deface the -walls, they tear off the shutters and the doors, they break and burn the -fences. It is useless to give them good houses as they neither appreciate -them nor take care of them.” - -The municipal authorities say that negroes make no effort to keep their -surroundings clean and sanitary. They throw things into the street, choke -the plumbing, drains, and sewers with old rags, trash, and dirt, and make -no effort to help the authorities keep things in order; therefore it is -useless to try to help them until they learn to help themselves. They say -that there are exceptions to these statements, but that they are true so -far as the great mass of the negroes is concerned. Reference is made to -the subject here to draw attention to the fact that the leagues can do -much to change these conditions, thereby bettering the condition of the -race. - -If the things that are said about the negro by the landlords, the -municipal authorities, and others are true, then it is necessary for -the negro to change these conditions before there can be hope for much -betterment. If they are not true, steps should be taken to convince the -landlords, municipal authorities, and others that they are false. - -It is in this way that the leagues, though aimed at tuberculosis, may be -the means of bettering the conditions along many lines. If the negro can -demonstrate that he is not destructive, and that he can and does take -care of the house in which he lives; if he will keep his surroundings -neat and clean; if he shows that he is clean and sanitary in his -practices, and that he feels his responsibility as a citizen by trying -to keep up the sanitary conditions and the appearances of his home and -his city, he will find that many of his troubles will disappear. If a -landlord finds that his property is being cared for by his negro tenant, -the yard, fences, etc., being kept in order, the rent promptly paid, and -tenant is desirable, he will be only too glad to keep him, and to make -such alterations in his house as he may desire. If it is demonstrated to -the municipal authorities that the negro is as careful of his section -of the city as the whites, his wants will receive consideration. The -educated negroes succeed in getting surroundings that are far better than -those of the average because they have learned to appreciate the above -facts, and have put them into practice. - -When the leagues have taught their members that it is not healthy to live -in dark, damp rooms, with bad sanitary surroundings, and have educated -them to the point where they will refuse to live under such conditions, -then the landlords will build proper houses for them. The leagues working -in conjunction with the health officer can get the city authorities to -so frame the building ordinances that only sanitary dwellings will be -erected in the city. - -_What a church league can do for the individual consumptive._—In addition -to supplying the members of the league with information in regard to -tuberculosis and sanitation, which is the work of the committees, and -trying to induce the members to follow the instructions given them, there -are other things that the league can do for the individual consumptive. - -The chief difficulty that will be encountered by the leagues is the -lack of money to help their sick members. It is hoped, however, that as -the league demonstrates its value to the community more money will be -available, and the work of helping the sick members can be extended. -This work contemplates the “class method” of treating patients at their -homes, the establishment of dispensaries, and ultimately sanatoria and -“tuberculosis farms,” where a patient can earn a living by working on the -farm and at the same time be under medical supervision. It is realized -that these things are for the future, but it is well to keep them in mind -as one of the ultimate aims of the leagues. - -Now let us consider what can be done for the members who have -consumption. The league should buy a number of the paper spit cups -mentioned above, and distribute them to their consumptive members, -and urge their use. These cups are cheap and therefore can be burned -after being used. If every consumptive can be induced to use these cups -and then burn them much will be done toward stopping the spread of -consumption. - -Whenever a case of consumption is discovered the officers of the league -should apply to the health officer to disinfect the rooms occupied by the -consumptive, in order to protect the other people in the house from the -disease. Then if the consumptive is careful he is not likely to reinfect -them. Also when a consumptive dies the health officer should be asked to -disinfect the rooms. - -Consumptives should spend most of their time out of doors, and if -possible should sleep on a porch, or in a shed, or tent. All one needs is -something to protect against the weather and keep off the rain and snow, -but let in a great deal of fresh air. Patients live out of doors all -winter in the north, with the thermometer below zero, and many have been -cured of consumption in this way, including negroes. The league may help -to provide the shack, shed, or tent, or it may furnish sleeping bags, -blankets, etc., and in this way help the patient. - -If the patient is very poor it may be that the league can see that he -gets proper food which he might not otherwise have. The committees of the -league will doubtless find many other means for helping the patient at -small expense. The minister in making his pastoral calls can be of the -greatest help both to the patient and to the community by seeing that the -patient is properly carrying out his instructions, and that he has the -proper facilities for doing so. - -_Dispensary._—As soon as the church league is formed, some physician -should be designated who will examine all members referred to him, to -decide if they have consumption. Usually there will be found one or more -physicians who are members of the league, who will probably act in this -capacity. If practicable a tuberculosis dispensary might be established -at some convenient point, possibly in one of the rooms in the church, -where the physicians could be found on certain days at stated hours, -say, twice a week. Here they could see the consumptives, and examine and -advise them as to the treatment necessary. They could also examine other -members referred to them to decide whether they had consumption or not. -Records of the dispensary work should be kept. - -It is not practicable at this time to go more minutely into the details -of the work of these leagues, which are now in their formative stage. - -The writer will be glad to lend any aid in his power to any state or -church league that may desire it, and all persons who are interested in -this movement are invited to write to him, expressing any views they may -have for the advancement of the work. He will be glad to have any aid, -advice, or criticisms that may be offered. - - - - - -End of the Project Gutenberg EBook of A Working Plan for Colored -Antituberculosis Leagues, by C. P. Wertenbaker - -*** END OF THIS PROJECT GUTENBERG EBOOK COLORED ANTITUBERCULOSIS LEAGUES *** - -***** This file should be named 62116-0.txt or 62116-0.zip ***** -This and all associated files of various formats will be found in: - http://www.gutenberg.org/6/2/1/1/62116/ - -Produced by hekula03 and the Online Distributed Proofreading -Team at https://www.pgdp.net (This book was produced from -images made available by the HathiTrust Digital Library.) - - -Updated editions will replace the previous one--the old editions will -be renamed. - -Creating the works from print editions not protected by U.S. copyright -law means that no one owns a United States copyright in these works, -so the Foundation (and you!) can copy and distribute it in the United -States without permission and without paying copyright -royalties. 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Thus, we do not -necessarily keep eBooks in compliance with any particular paper -edition. - -Most people start at our Web site which has the main PG search -facility: www.gutenberg.org - -This Web site includes information about Project Gutenberg-tm, -including how to make donations to the Project Gutenberg Literary -Archive Foundation, how to help produce our new eBooks, and how to -subscribe to our email newsletter to hear about new eBooks. - diff --git a/old/62116-0.zip b/old/62116-0.zip Binary files differdeleted file mode 100644 index 30f057f..0000000 --- a/old/62116-0.zip +++ /dev/null diff --git a/old/62116-h.zip b/old/62116-h.zip Binary files differdeleted file mode 100644 index 45780a7..0000000 --- a/old/62116-h.zip +++ /dev/null diff --git a/old/62116-h/62116-h.htm b/old/62116-h/62116-h.htm deleted file mode 100644 index d5b14a2..0000000 --- a/old/62116-h/62116-h.htm +++ /dev/null @@ -1,1054 +0,0 @@ -<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN" - "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd"> -<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en"> - <head> - <meta http-equiv="Content-Type" content="text/html;charset=utf-8" /> - <meta http-equiv="Content-Style-Type" content="text/css" /> - <title> - The Project Gutenberg eBook of A Working Plan for Colored Anti-Tuberculosis Leagues, by C. P. Wertenbaker. - </title> - - <link rel="coverpage" href="images/cover.jpg" /> - -<style type="text/css"> - -a { - text-decoration: none; -} - -body { - margin-left: 10%; - margin-right: 10%; -} - -h1,h2 { - text-align: center; - clear: both; -} - -hr { - margin-top: 2em; - margin-bottom: 2em; - clear: both; - width: 65%; - margin-left: 17.5%; - margin-right: 17.5%; -} - -p { - margin-top: 0.5em; - text-align: justify; - margin-bottom: 0.5em; - text-indent: 1em; -} - -.center { - text-align: center; - text-indent: 0em; - margin-bottom: 2em; -} - -.figcenter { - margin: auto; - text-align: center; -} - -.larger { - font-size: 150%; -} - -.pagenum { - position: absolute; - right: 4%; - font-size: smaller; - text-align: right; - font-style: normal; -} - -.smaller { - font-size: 80%; -} - -.smcap { - font-variant: small-caps; - font-style: normal; -} - -.titlepage { - text-align: center; - margin-top: 3em; - text-indent: 0em; -} - -.top-box { - margin: auto; - max-width: 35em; - border-bottom: double black; -} - -@media handheld { - -img { - max-width: 100%; - width: auto; - height: auto; -} -} - </style> - </head> -<body> - - -<pre> - -The Project Gutenberg EBook of A Working Plan for Colored Antituberculosis -Leagues, by C. P. Wertenbaker - -This eBook is for the use of anyone anywhere in the United States and -most other parts of the world at no cost and with almost no restrictions -whatsoever. You may copy it, give it away or re-use it under the terms -of the Project Gutenberg License included with this eBook or online at -www.gutenberg.org. If you are not located in the United States, you'll -have to check the laws of the country where you are located before using -this ebook. - - - -Title: A Working Plan for Colored Antituberculosis Leagues - -Author: C. P. Wertenbaker - -Release Date: May 13, 2020 [EBook #62116] - -Language: English - -Character set encoding: UTF-8 - -*** START OF THIS PROJECT GUTENBERG EBOOK COLORED ANTITUBERCULOSIS LEAGUES *** - - - - -Produced by hekula03 and the Online Distributed Proofreading -Team at https://www.pgdp.net (This book was produced from -images made available by the HathiTrust Digital Library.) - - - - - - -</pre> - - -<p><span class="pagenum"><a name="Page_1" id="Page_1">[1]</a></span></p> - -<div class="top-box"> - -<p class="titlepage">TREASURY DEPARTMENT<br /> -Public Health and Marine-Hospital Service of the United States</p> - -</div> - -<p class="titlepage larger">A WORKING PLAN FOR COLORED<br /> -ANTITUBERCULOSIS LEAGUES</p> - -<p class="titlepage">BY<br /> -<br /> -C. P. WERTENBAKER -<br /> -<span class="smaller"><i>Surgeon, United States Public Health and<br /> -Marine-Hospital Service</i></span></p> - -<div class="figcenter titlepage" style="width: 85px;"> -<img src="images/marine-hospital-logo.jpg" width="85" height="85" alt="Logo of the Marine-Hospital Service" /> -</div> - -<p class="titlepage">WASHINGTON<br /> -<span class="smaller">GOVERNMENT PRINTING OFFICE</span><br /> -1909</p> - -<p><span class="pagenum"><a name="Page_2" id="Page_2">[2]</a></span></p> - -<hr /> - -<p><span class="pagenum"><a name="Page_3" id="Page_3">[3]</a></span></p> - -<h1>A WORKING PLAN FOR COLORED ANTITUBERCULOSIS LEAGUES.</h1> - -<p class="center smaller">Reprint No. 39, from the Public Health Reports, Vol. XXIV, No. 36, September -3, 1909.</p> - -<p class="center">By <span class="smcap">C. P. Wertenbaker</span>, Surgeon, United States Public Health and Marine-Hospital -Service.</p> - -<p>There was published in the Public Health Reports of May 28, 1909, -Volume XXIV, No. 22, a plan for the organization of colored antituberculosis -leagues, which contemplated the organization of a -league in each State, with a branch in every colored church.</p> - -<p>Experience has shown that after such leagues are formed difficulty -arises in getting to work in an effective way, because the work is -new in character and those engaged in it have had but little, if any, -experience. It is to meet this difficulty and supply a practical guide -for the work of the leagues that this is written.</p> - -<h2>ORGANIZATION OF A STATE LEAGUE.</h2> - -<p>The object of the state league is to organize the church leagues, -to bind them together and render more effective their work. The -caring for patients and work of a similar character are properly the -function of the church leagues.</p> - -<p>There need be but little ceremony in organizing a state league. -A few leading colored men and women, preferably from different -parts of the State, but not necessarily so, meet and proceed to organize -the state league.</p> - -<p>The constitution and by-laws for state leagues should be adopted, -followed by the election of a president, a secretary, and a treasurer.</p> - -<p>It is desirable that the constitution and by-laws recommended in -“The Plan” be adopted in all essential particulars, so that there will -be uniformity in organization and work. They have been adopted -in all the States that have organized thus far, and it is believed future -organizations should also adopt them.</p> - -<p>The president then appoints a committee, the president and -secretary being members of it, to select a vice-president for each -county in the State. (The plan contemplates that there shall be -a vice-president for each county, whose duty it is to organize a branch -league in each colored church in the county.)</p> - -<p><span class="pagenum"><a name="Page_4" id="Page_4">[4]</a></span></p> - -<p>The selection of the county vice-presidents should be made with -a good deal of care. Suitable persons who will actively carry on the -work should be chosen for these positions. The vice-presidents -should be authorized to appoint one or more representatives in each -community to help them organize the leagues in the churches and -arouse interest in the work.</p> - -<p>It can not be impressed too strongly on the vice-presidents that -the success of the church leagues in their districts will depend upon -the amount of attention given the work. The organization of a -branch league in a church is merely the starting point; the real work -is done after the organization is completed.</p> - -<p>The president and secretary of the state league should call for -regular reports from the county vice-presidents, showing the number -of church leagues in their respective counties and a statement of -the work done in each.</p> - -<p>If any of the church leagues are not prospering, the president or -the secretary of the state league should visit or write to them and -learn what is the trouble, and give needed advice and encouragement. -Officers of the state league should consult frequently and freely with -their state board of health and enlist its sympathy and aid in their -work. The closer the leagues keep in touch with the health authorities -the better will be the results obtained. Both the state and -local health officers will be glad to give their best efforts to help along -this work. They are in a position to do a great deal to assist both -state and church leagues, and the leagues should work in harmony -with them.</p> - -<h2>CHURCH BRANCH LEAGUES.</h2> - -<p><i>Organization.</i>—In order that the members of the church in which -it is proposed to organize the branch league may understand thoroughly -the objects of the league, the minister or other competent -person should explain clearly the purpose of the league and what it -is expected to accomplish. He should inform them that relatively -many more colored people die of consumption than white people; -that very few colored people get well of the disease, partly because -they do not know how to take care of themselves and partly because -many neglect to do so; and that the object of the league is to teach -the well how to preserve their health and prevent their contracting -consumption and other diseases, and the sick how to regain their -health. If too poor to take the necessary treatment, it is the purpose -of the league to help its members to do so.</p> - -<p>After the foregoing has been thoroughly explained, the church -branch of the state league should be formed by the adoption of the -constitution and by-laws given for church leagues in the plan of<span class="pagenum"><a name="Page_5" id="Page_5">[5]</a></span> -organization published in the Public Health Reports of May 28, 1909. -After this has been done, the officers required by the by-laws should -be elected.</p> - -<p>The secretary then takes the name and address of each of the members, -and as soon as a member has paid his dues he is given the certificate -of membership, properly filled out, and signed by the president -and secretary of the church league.</p> - -<p>The certificate of membership given to each person joining the -league has printed on it information and instructions which, if followed, -will tend to protect the individual from consumption.</p> - -<p>An attempt has been made to make the certificate large and -attractive, and it is expected that the members will value it to such -an extent that they will frame and hang it in a prominent place in -the home, where it can be frequently seen, and that the sanitary -maxims that it contains will be learned and followed.</p> - -<p>In organizing the church league it is well to have a number of the -certificates on hand to supply the members as soon as they pay their -dues. The form of the certificate will be found in the plan of organization -for these leagues. The certificate can be printed at a local -printing office, but if this is not practicable, or it is preferred to buy -them, very handsome certificates printed in black and red, with a -large red seal, and the name of the state and church branch league, -can be bought for about 6 cents each, by the hundred.</p> - -<p>The amount of the annual dues to be paid by each member can be -changed by each league to suit the necessities of the community. -The dues should be so small that no one will be kept out of the league -by not being able to pay them. However, as the dues will be the -chief source of revenue with which the league expects to do its work, -they should not be made smaller than is actually necessary.</p> - -<p>The money paid into the league as dues goes to form a fund that -is disbursed by the church league collecting it to help those of its -members who contract consumption. How much this help will be -will depend upon the amount of money the league has at its disposal -and the needs of the individual. But whether this help is -much or little the having the certificate of membership and belonging -to the league will give information that will teach one to protect -himself and his family from disease. This means less sickness, consequently -less loss of time from work, therefore more money, more -comforts, and more happiness for all concerned.</p> - -<p>The vice-presidents and organizers should see that the four standing -committees required by the by-laws of the church leagues are -promptly appointed and that they understand their duties.</p> - -<p>As the work of each church league will at first consist largely of -educating its members as to the cause of tuberculosis and the way<span class="pagenum"><a name="Page_6" id="Page_6">[6]</a></span> -to live to keep from getting it, the committees, and especially the -ones having charge of “sick,” “sanitation;” and “information” -should be especially active. They should learn all that is possible -about their respective subjects so that they can teach the other -members.</p> - -<p>In joining the church league one also becomes a member of the -State Colored Antituberculosis League. Members of the state -league and church branch leagues wear a button showing their -connection with the leagues.</p> - -<p><i>Membership.</i>—Membership in the church leagues should not be -confined to the members of the church organizing the league. As a -rule it is better that the members of each church join their own -church league, but if for any reason their church has no league there -should be no objection to their joining the league of some other -church. Those who are not members of any church should also be -allowed to join the league.</p> - -<p><i>Details of the work of a church league.</i>—As soon as the church -league is organized the president should appoint the four standing committees -required by the by-laws to serve for one year, viz: “Finance,” -“Information,” “Sick,” and “Sanitation.” The details of the work -to be done may then be considered. One of the first of these is to -ascertain how many of the members have or are suspected of having -tuberculosis. This duty devolves upon the committee on the sick, -which should get from the secretary a list of the members, giving the -name and address of each. This list should be gone over and every -member carefully considered. It is probable that the greater number -of the members are personally known to the committee, and thus -it can be told at once whether they are sick or well.</p> - -<p>The committee is not expected to decide whether these members -have tuberculosis. Their duty is to make out the list of the sick and -ailing. The physician will decide the nature of the sickness.</p> - -<p>It is desirable to find cases of consumption in the earliest stages, -for these may be cured, and if all members who are not strong and -healthy are examined by the physician it is possible that cases of -early consumption will be found.</p> - -<p>Each ailing member should be visited by some of the committee -and more careful inquiry made as to the nature of the trouble and -the member urged to go to a physician or a dispensary for examination. -This is especially true if the member has been losing flesh, or -has had a cough for some time, or has throat trouble, or is sickly and -frail. If upon examination the physician finds that the member has -consumption, the patient should get a certificate stating that fact. -The physician will also tell the patient what treatment is necessary.</p> - -<p>The certificate will be presented to the committee by the patient, -and the committee will make more careful inquiry into the condition<span class="pagenum"><a name="Page_7" id="Page_7">[7]</a></span> -of the patient, the treatment considered necessary by the physician, -the patient’s means, the number of people he has depending upon -him, etc., so that the facts may be presented to the executive board -in accordance with the requirements of Article VII of the by-laws.</p> - -<p>The list of the sick should be most carefully guarded and no one -allowed to see it but the officers of the league and the health officers. -This knowledge should be regarded as a sacred confidence that should -not be divulged except to the persons mentioned above, as many -might object to having it known that they have tuberculosis.</p> - -<p>Under no circumstances should the list be allowed to fall into the -hands of “patent medicine” concerns which might urge their nostrums -on the patients, much to their annoyance and also to their detriment, -if they become induced to take the “patent medicines.”</p> - -<p>The measures necessary for the treatment of a patient who has -tuberculosis must be determined by the physician, but it is the duty -of the executive board to decide how much and what kind of help -the league can give the patient in carrying out this treatment.</p> - -<p>It is not proposed to discuss here the question of treatment in a -sanatorium which is the ideal way of handling all cases of tuberculosis, -for in a sanatorium the sick cease to be a menace to the community -and can be under supervision and treatment all the time. -Unfortunately, at present sanatoria are not available for the great -mass of the people; and even if they were, many would be unable to -go to them.</p> - -<p>There is a class of patients who have to depend upon their daily -labor for the support of themselves and their families. If they -stop work, their support is cut off. For such as these treatment -in a sanatorium is out of the question, and any treatment they can -get must be given in their homes and frequently while they are -working. To this class belong the great majority of the negroes; -therefore the work of the church leagues must be directed to such -help as can be given under these circumstances. What is necessary -in each case will depend upon the condition of the patient, the stage -of the disease, and the financial circumstances of the individual.</p> - -<p>For the purposes of the league, consumptives may be divided -into three classes:</p> - -<p>First. The patients who are in the earlier stages of the disease -and are able to go about their work while taking treatment.</p> - -<p>Second. Cases in which it is necessary to stop work and remain -quiet if they are to get well.</p> - -<p>Third. Cases in which the disease has progressed so far that it is -hopeless to attempt a cure, but for which much can be done to make -the patients comfortable and prevent them from scattering the -germs of the disease.</p> - -<p><span class="pagenum"><a name="Page_8" id="Page_8">[8]</a></span></p> - -<p>As stated above, what is necessary in each case will depend upon -the condition of the patient and his surroundings. Much also -depends upon the means the league has at its disposal to help the -individual. Most church leagues find that they have very little -money; therefore the help given must be limited. However, there -are certain things that can be done even by the poorest leagues.</p> - -<p>Information as to the way in which the disease is spread; the -means to prevent it; what is necessary to get well if one has it, etc., -is all printed on the certificate. When the member gets the certificate -and has learned all that is printed on it, the first step has been taken -in the education of the individual in regard to tuberculosis, so it -should be the aim of the officers of the leagues to get the certificates -in the hands of the members.</p> - -<p>The officers of the league can see that the instructions on the -certificate are understood and carried out. Many individuals are -careless and must be constantly watched to see that they do not -neglect important precautions. Probably the most difficult thing -the league will have to do will be to induce its members to keep -their windows open and let fresh air and sunlight into their rooms.</p> - -<p>The officers and committees of the league should urge the members -to keep the windows of their rooms open, especially at night, and to -avoid overcrowding their sleeping rooms. Whenever a dark room -or closed window which should be open is found, the danger should -be pointed out, and the member urged to correct it.</p> - -<p>The practice of sleeping with the head and face covered is so deeply -rooted in the negro race that it seems almost hopeless to attempt to -eradicate it in the present generation. It is a most pernicious habit. -The dangers of the practice should be pointed out, and the members -urged to abandon it. Children should not be allowed to contract the -habit.</p> - -<p>The careless spitting of consumptives in their homes is a practice -dangerous to others. The careless at times spit on the floor, the -walls, the hearth of the open fire, or on the stove if one is used. The -sputum of the consumptive dries and is carried into the air as dust. -This is drawn into the lungs when one breathes. The dangers of this -should be emphasized, and the proper way to dispose of sputum -shown. The consumptive should catch all of his sputum and burn it. -There are cheap cups made of paper that can be had at small cost, -and these should be used to spit in, and when they are full they -should be burned. The better cups have covers to them, so that the -flies can not get at the sputum. While consumption is a dangerous -disease, the careful consumptive is not dangerous to live with. The -careless consumptive, however, is dangerous to live with and a menace -to those around him.</p> - -<p><span class="pagenum"><a name="Page_9" id="Page_9">[9]</a></span></p> - -<p>The minister and the officers of the leagues should consult frequently -with the health officer of their community. Working together they -can accomplish much more than by working alone.</p> - -<p>The minister and officers of the league can teach their people to -be careful and not produce unsanitary conditions, and the health -officer can remedy conditions that the people can not correct. The -leagues should urge the members to beautify their homes, no matter -how humble they may be. If the home is made more attractive, -interest in it will grow, and an improvement in the sanitary conditions -will naturally follow. Teach the members to have grass -and flowers in their yards. See that there is no dirt, trash, or litter -scattered about; that the loose paling of the fence is nailed on, -and the sagging gate has a new hinge. Pull the dirty rags from -the broken window pane and burn them. Let them put their bed-clothing -out in the sun occasionally, and sweep the dust from under -the bed and furniture. Open the window and door and let air and -sunlight into the rooms. All of these things tend to improve the -sanitary conditions, which means health and happiness.</p> - -<p>Members should be taught that remedies advertised as cures for -consumption are not to be relied upon, and that the only known -way to get well is to live in the open air as much as possible, both -day and night, and to eat nourishing food at regular intervals. The -consumptive when possible should go to a physician or a dispensary -and follow exactly the instructions given.</p> - -<p>Aside from the help that can be given the individual consumptive, -which will be discussed later on, there is much that the leagues can -do by concerted action to improve the conditions under which the -negro lives. Probably one of the most important factors in the -spread of tuberculosis, aside from his habits, is the manner in which -the negro is housed. The negro as a rule is a renter. The houses -that he can rent are usually located in the poorest and most unhealthy -part of the city. They are often poorly constructed, badly -lighted and ventilated, and frequently in bad repair. The rooms -are usually small and dark, having but one window, and the top -sash is seldom arranged to be lowered. Many houses are built on -poorly drained ground, and water stands under them after each rain, -making the rooms damp and cold. These houses are seldom provided -with bathing arrangements or water-closets, thus necessitating -the use of privies, or the back alleys, with all the dangers attendant -upon such conditions. For such houses, or more frequently for one -or two rooms in such a house, the negro pays proportionately more -rent than the white race does for better houses in the same community, -either because better accommodations are not available, or -because he can not, or will not, pay for better. The family, usually<span class="pagenum"><a name="Page_10" id="Page_10">[10]</a></span> -consisting of father, mother, and several children, and often friends -or relatives, all live, eat, and sleep in these two or three rooms, frequently -with the windows and doors tightly closed, and in winter a -stove going at full blast.</p> - -<p>In the negro section of the city the streets are usually either badly -paved or not paved at all. The sidewalks are either in bad repair or -missing. The streets are badly lighted at night, garbage cans are -not emptied regularly, and the scavenger service is poor.</p> - -<p>“There is a reason for these things,” say the landlords, the municipal -authorities, and others who have dealings with the negro. The -landlord says: “Negroes are destructive; they pull down, but they -never improve property. A house rented to negroes will depreciate -from 25 to 50 per cent in a year. If you put in plumbing they break -it, they deface the walls, they tear off the shutters and the doors, -they break and burn the fences. It is useless to give them good -houses as they neither appreciate them nor take care of them.”</p> - -<p>The municipal authorities say that negroes make no effort to -keep their surroundings clean and sanitary. They throw things into -the street, choke the plumbing, drains, and sewers with old rags, -trash, and dirt, and make no effort to help the authorities keep things -in order; therefore it is useless to try to help them until they learn to -help themselves. They say that there are exceptions to these -statements, but that they are true so far as the great mass of the -negroes is concerned. Reference is made to the subject here to -draw attention to the fact that the leagues can do much to change -these conditions, thereby bettering the condition of the race.</p> - -<p>If the things that are said about the negro by the landlords, the -municipal authorities, and others are true, then it is necessary for -the negro to change these conditions before there can be hope for -much betterment. If they are not true, steps should be taken to -convince the landlords, municipal authorities, and others that they -are false.</p> - -<p>It is in this way that the leagues, though aimed at tuberculosis, -may be the means of bettering the conditions along many lines. If -the negro can demonstrate that he is not destructive, and that he -can and does take care of the house in which he lives; if he will keep -his surroundings neat and clean; if he shows that he is clean and -sanitary in his practices, and that he feels his responsibility as a citizen -by trying to keep up the sanitary conditions and the appearances -of his home and his city, he will find that many of his troubles will -disappear. If a landlord finds that his property is being cared for -by his negro tenant, the yard, fences, etc., being kept in order, the -rent promptly paid, and tenant is desirable, he will be only too glad -to keep him, and to make such alterations in his house as he may -desire. If it is demonstrated to the municipal authorities that the<span class="pagenum"><a name="Page_11" id="Page_11">[11]</a></span> -negro is as careful of his section of the city as the whites, his wants -will receive consideration. The educated negroes succeed in getting -surroundings that are far better than those of the average because -they have learned to appreciate the above facts, and have put them -into practice.</p> - -<p>When the leagues have taught their members that it is not healthy -to live in dark, damp rooms, with bad sanitary surroundings, and -have educated them to the point where they will refuse to live under -such conditions, then the landlords will build proper houses for them. -The leagues working in conjunction with the health officer can get -the city authorities to so frame the building ordinances that only -sanitary dwellings will be erected in the city.</p> - -<p><i>What a church league can do for the individual consumptive.</i>—In -addition to supplying the members of the league with information -in regard to tuberculosis and sanitation, which is the work of the -committees, and trying to induce the members to follow the instructions -given them, there are other things that the league can do for -the individual consumptive.</p> - -<p>The chief difficulty that will be encountered by the leagues is the -lack of money to help their sick members. It is hoped, however, -that as the league demonstrates its value to the community more -money will be available, and the work of helping the sick members -can be extended. This work contemplates the “class method” of -treating patients at their homes, the establishment of dispensaries, -and ultimately sanatoria and “tuberculosis farms,” where a patient -can earn a living by working on the farm and at the same time be -under medical supervision. It is realized that these things are for -the future, but it is well to keep them in mind as one of the ultimate -aims of the leagues.</p> - -<p>Now let us consider what can be done for the members who have -consumption. The league should buy a number of the paper spit -cups mentioned above, and distribute them to their consumptive -members, and urge their use. These cups are cheap and therefore -can be burned after being used. If every consumptive can be induced -to use these cups and then burn them much will be done toward -stopping the spread of consumption.</p> - -<p>Whenever a case of consumption is discovered the officers of the -league should apply to the health officer to disinfect the rooms occupied -by the consumptive, in order to protect the other people in the -house from the disease. Then if the consumptive is careful he is -not likely to reinfect them. Also when a consumptive dies the health -officer should be asked to disinfect the rooms.</p> - -<p>Consumptives should spend most of their time out of doors, and -if possible should sleep on a porch, or in a shed, or tent. All one -needs is something to protect against the weather and keep off the<span class="pagenum"><a name="Page_12" id="Page_12">[12]</a></span> -rain and snow, but let in a great deal of fresh air. Patients live out -of doors all winter in the north, with the thermometer below zero, -and many have been cured of consumption in this way, including -negroes. The league may help to provide the shack, shed, or tent, -or it may furnish sleeping bags, blankets, etc., and in this way help -the patient.</p> - -<p>If the patient is very poor it may be that the league can see that -he gets proper food which he might not otherwise have. The committees -of the league will doubtless find many other means for helping -the patient at small expense. The minister in making his pastoral -calls can be of the greatest help both to the patient and to the community -by seeing that the patient is properly carrying out his instructions, -and that he has the proper facilities for doing so.</p> - -<p><i>Dispensary.</i>—As soon as the church league is formed, some physician -should be designated who will examine all members referred to -him, to decide if they have consumption. Usually there will be -found one or more physicians who are members of the league, who -will probably act in this capacity. If practicable a tuberculosis dispensary -might be established at some convenient point, possibly in -one of the rooms in the church, where the physicians could be found -on certain days at stated hours, say, twice a week. Here they could -see the consumptives, and examine and advise them as to the treatment -necessary. They could also examine other members referred -to them to decide whether they had consumption or not. Records of -the dispensary work should be kept.</p> - -<p>It is not practicable at this time to go more minutely into the -details of the work of these leagues, which are now in their formative -stage.</p> - -<p>The writer will be glad to lend any aid in his power to any state or -church league that may desire it, and all persons who are interested -in this movement are invited to write to him, expressing any views -they may have for the advancement of the work. He will be glad to -have any aid, advice, or criticisms that may be offered.</p> - - - - - - - - -<pre> - - - - - -End of the Project Gutenberg EBook of A Working Plan for Colored -Antituberculosis Leagues, by C. P. 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