7^ Hollinger Corp. P H8.5 408 1 Issued By~ STATE TUBERCULOSIS SANATORIUM sanatorium, Fom Green County.Texas H b ■I &%* m To the Teachers of Texas: The degree of success to be attained in the campaign against communicable diseases depends not so much upon the treatment of existing cases of tuberculosis, typhoid, smallpox and the like, as it does upon the PREVENTION of further spread of these diseases. A person suffering from a communicable disease may or may not get well, but with the application of proper methods the ten, hundred or thousand persons coming in contact with the sick one may and should be prevented from "taking" the disease from him. A knowledge of communicable diseases, and of preventive measures to be employed against their further spread, does not come of itself. It must be imparted. As it is possible to reach only a small per cent of grown people in an educational way and also, as it is difficult to change the beliefs and opinions of adults, we must exert our best efforts along this line upon the child. The schoolroom is undoubtedly the proper field of endeavor for this form of education. It is to assist the teachers of Texas, working as they are for the future and for the good of coming generations, that this little book has been prepared. It is assumed, without question, that no teacher in this Great State will fail to do his or her share of doing away with the great toll paid by humanity because of its present lack of knowledge of preventive measures to be taken against disease. Sincerely, J. B. McKNIGHT, Superintendent and Medical Director, State Tuberculosis Sanatorium, Carlsbad, Texas. LIBRARY 66.$QNQRI8B r.E^iivEO MAB181M1 DOCUMENTS DIVISION Protecting Youth the Man-ftWef oP the Future Never since the birth of our beloved nation has the import- ance of the protection of the health of our children been so vital as it is today. We are standing on the thresh- hold of the re-making of the world. We, the American people will be expected to do a large part in carry- ing on of the great work which has been begun at so ghastly a cost in blood and money. It is very important that the ideals we have fought for shall be maintained now that the war is won and it is the children in our care today upon whose shoulders this great task will fall. Shall we send these, our children of today, the men and women of tomorrow, into the fray half equipped, or shall we see that they are endowed with that neces- sary requisite for long and arduous labor — GOOD HEALTH? It is necessary to eradicate old false ideas. Parents must be taught (through their children) that it is wrong to expose children to measles or whooping cough in order to "get it over with." They must also be taught that if a child is sick, even though it has only a "cold," it must be kept at home and the services of a physician sought, if the occasion warrants. Superintendents of schools, teachers and others in- terested in child welfare should redouble their efforts and leave no stone unturned that the great work of protecting the health of our children, and instructing them concerning communicable diseases, shall have a first position in the many activities of the day. Ffesli Aii^ And Sunshine in Schools Badly ventilated, stuffy school rooms make chil- dren dull and listless. They become depressed, stupid and languid. Instead of bright, wide-awake studying, the task becomes boresome. Heads droop and a general apathy pervades the entire class. Nothing is more unnatural to children. There is something radically wrong when this condition exists. It is due to a lack of fresh air. It is inhumane to force study under these conditions. Poorly ventilated, overheated and closely crowded school rooms affect all children, especially the anemic and undernourished. Not only is study retarded, but the children are predisposed to colds, their growth is stunted and their general health endangered. Ample fresh air and sunshine, especially when em- bodied in the form of the OPEN AIR SCHOOL, have saved hundreds of children from lives of invalidism, de- pendency and inactivity by giving them healthy bodies and a good start in life. Measles Principal Early Signs and Symptoms Begins like a cold in the head, with fever, running nose, watery, inflamed eyes and sneezing. The rash appears about the third day and consists of small, irregular groups of dull- red, slightly raised spots. They are usually first seen on the forehead and face, and they rapidly spread over the entire body. The rash may almost disappear if the patient becomes chilled, but reappears if the patient again becomes warm. A positive sign of measles is the so-called Koplik spots. These are bluish-white specks upon a red ground, which are best seen in the inside of cheeks opposite the molar teeth. Strong sunlight may be necessary to see these. Source of Infection Discharges sprayed or thrown from mouth or nose in coughing, sneezing or spitting. Incubation Period 7 to 18 days; most often 14. Exclusion Exclude child with disease. Child may return to school five days after disappearance of rash if nose and throat are free from discharges. Exclude other children who are from same home unless there is a change of residence, in which case exclude for 14 days, and then readmit if there have been no symptoms of disease and if children do not return to infected house. Remarks Measles is infectious even before the rash appears, effects are often more serious than the disease. Measles After German Measles Principal Early Signs and Symptoms Illness usually slight. Onset sudden. The rash is gen- erally the first thing noted. Unlike measles, there is no cold in the head, although the eyes may be inflamed and slight fever and sore throat may accompany the attack. Source of Infection Discharges sprayed or thrown from mouth or nose in coughing, sneezing or spitting. Incubation Period 10 to 12 days. Exclusion Exclude child with disease. Child may return seven days after disappearance of rash. Well children from same home may attend school. Remarks German Measles is usually very mild. The danger from it is slight, although none of the usual precautions should be neglected. Almost no after effects. German Measles ■j- fitooorit SL* Mumps Chicken Pox tWwttr SL> Mumps Principal Early Signs and Symptoms The onset may be sudden or gradual, beginning usually with sight fever, nausea, pain and swelling about the angle of the jaw. The jaws may be stiff and the saliva sticky. Source of Infection Discharges sprayed or thrown from mouth or nose in coughing, sneezing or spitting. Incubation Period 2 to 3 weeks. Exclusion Exclude child with disease until all swelling has disap- peared. This usually requires a period of three weeks. Well children from same home may attend school. Remarks Mumps is very infectious. Early symptoms should there- fore be noticed and patient immediately excluded. Defective hearing may be a serious after effect. Chicken Pox Principal Early Signs and Symptoms Onset gradual. May be no symptoms. Usually there is feverishness, but this may be very mild. Rash appears on second day as small raised pimples which shortly become filled with clear fluid; later scabs form. There may be successive crops of this rash up to the tenth day. Source of Infection. Fresh or dried exudate from eruption. Incubation Period. 10 to 15 lays. Exclusion Exclude child with disease until all scabs have disap- peared. Well children from same house may attend school. Remarks When the child returns, examine the head for overlooked scabs and scales. A mild disease and there are seldom any after effects. Scarlet Fever g= TW* SL> Scarlet Fever Principal Early Signs and Symptoms The onset is usually sudden. Vomiting, sore throat, head- ache or fever may be first symptoms noted. Unlike measles, eyes are not watery or congested in beginning of disease. The rash usually appears within 24 hours and is seen first on the neck and upper part of the chest. It appears as fine spots, evenly diffused and bright red. Later the skin peels in scales, flakes, or large pieces. In the early part of the disease the tongue is usually whiteish, with bright red spots resembling a strawberry. » Source of Infection Discharges sprayed or thrown from mouth or nose in coughing, sneezing or spitting. Incubation Period 1 to 7 days; most often 2 to 4. Exclusion. Exclude child with disease for a minimum period of 35 days. Exclude other children who are from same home unless there is a change of residence, in which case exclude for 10 days and then readmit if there have been no symptoms of dis- ease and if children do not return to infected home. Remarks Scarlet Fever is dangerous, both during the attack and because of the after effects. Slight attacks are as infectious as severe ones. There is a great variation in the type of the disease, and many mild cases are not recognized, and are frequently re- sponsible for starting severe epidemics. The peeling may last from 6 to 8 weeks from the onset of the disease. Second attack is rare. When scarlet fever is occurring in a school, all children with sore throat should be sent home. MODERN HEALTH CRUSADERS SCHOOL 4 LEAGUE DFMODERN HEALTH CRUSADERS A Valuable Form of Health Education in the Schools. The Modern Health Crusader Movement had its origin in the annual Christmas Seal Campaign, but the manifest value of the active interest of children in public health has led to its extension throughout the year. In 1918 more than one mil- lion children in the United States were enlisted as Modern Health Crusaders. The ultimate hope for the prevention of tuberculosis and other communicable disease lies in the children. Teachers, nurses and others interested in health work in every city, town and rural school center are invited and urged to enlist Modern Health Crusaders and to organize leagues as a means of pro- moting health among children anl through them the entire community. Modern Health Crusaders are children between 6 and 16 years of age, who meet the requirements stated in the certifi- cate of enrollment published by the agencies fostering this movement. The certificate of enrollment is a handsome card, printed in a new design each year and sets out the requirements neces- sary for membership. The boy or girl agrees to keep the Cru- saders Health Rules to the end of the year; to do nothing that may hurt the health of any person; to help keep the home and town clean and to do at least 75 per cent of the 72 "Health Chores" in each of two weeks. The record of "Health Chores" is a folder on which the child and his parents may check off those hygienic tasks during a period of from one to fifteen weeks. These tasks cover simple hygienic matters, like washing the hands before eating, brushing the teeth, taking baths, sleeping with windows open, etc. Besides the certificate of enrollment, badges are provided as awards and marks of rank for Crusaders who meet the ad- vanced requirements. (See illustrations at top of page.) The Junior Red Cross has officially endorsed this most worthy movement and its members and others interested are urged to become affiliated. The Modern Health Crusader's Manual gives the full history and outline of the purpose and practical working of this move- ment and will be sent free on request to superintendents, teachers and others interested in child welfare. I RodCfoss So air- \0koi1FioyDoAncI How Children Can Help Red Cross Christmas Seals are the means whereby the American Red Cross combats the dreadful disease, tuberculosis. They are the medium whereby funds are raised each year to carry on a most essential work against this destructive disease which is one of the greatest enemies of our population. They make possible the carrying on of a noble work in Texas, where up to a few years ago very little had been done to educate the public as to the nature- cause, treatment and prevention of tuberculosis. The Texas State Tuberculosis Sanatorium does not itself sell Red Cross Seals, but it indorses the sale of the seals most heartily. The Sanatorium is supported by appropriations from the State Legislature. It is not an "institution" in the strict meaning of the word. It is in the nature of a great school. It has beds for three hundred and twenty-five patients, patients be- ing allowed to stay six months, though many stay a shorter time. It thus "turns out" from seven hundred to a thousand "graduates," with a working knowledge of tuberculosis, its treatment and prevention. The Bureau of Correspondence and Information of the Sanatorium is the Extension Department or Pub- licity Department, corresponding to the same establish- ment in a college or university. This Bureau furnishes people who are unable from any cause to attend the Sanatorium with literature on tuberculosis. It also fur- nishes articles to newspapers, sends bulletins to physi- cians, health workers, and so on. More about the work of the Bureau is told on another page. This little pamphlet is published by the bureau. Small Pox Principal Early Signs and Symptoms Onset likely to be sudden. Nausea and fever, accompan- ied by backache. Rash is seen first about the face and wrists. It consists first of small red spot, which quickly become ele- vated and hard like shot felt under the skin. Source of Infection All discharges from nose, mouth, sores and scabs convey infection. Incubation Period 9 to 15 days; most often 12. Exclusion Exclude child with disease until all crusts or scales have fallen off. Exclude other children from same home unless there is a change of residence in which case exclude for 14 days and then readmit if there have been no symptoms of disease and if children do not return to infected home. Children who have been successfully vaccinated need not be excluded, pro- vided there is a change of residence. Remarks Smallpox is particularly infectious. After the occurrence of a case, all persons in the school or in the vicinity of the home of the patient should be vac- cinated. Whooping Cough Principal Early Signs and Symptoms Early symptoms resemble those of a cold in the head. Later there is persistent cough which grows worse at night. The characteristic "whoop" does not develop until about a week or more after the onset of the disease. Spasms of cough- ing often end in vomiting. Source of Infection Discharges sprayed or thrown from mouth or nose in coughing, sneezing or spitting. Incubation Period 7 to 14 days; most often 10 to 14. Exclusion Exclude child with disease until one week after "whoop" ceases — usually a period of six weeks. Well children from the same home may attend school. Remarks Whooping cough is especially infectious during the first few weeks. There is great variation in the type of disease. Second attacks are rare. It may cause great debility. Small Pox Whooping Cough YWerit* SL> Tuberculosis *]-- Trachoma 8L> Tuberculosis Principal Early Signs and Symptoms Occurs in the pulmonary form (consumption) and is also frequently manifested by the enlargement of the glands of the neck or inflammation of the bones or joints. Its development is insidious and gradual, characterized usually by failure in nu- trition, cough, often with expectoration, fever and rapid pulse and marked impairment of energy and interest. The glandular and bone and joint forms are as a rule easily recognized, but any bone or joint swelling with pain, limping gait or faulty posture should be regarded with suspicion. Method of Infection By inhalation, by ingestion of the specific or pathogenic organism, the tubercle bacillus in milk or other foods. Rarely also by inoculation. Exclusion. To be excluded while the sputum contains the bacilli. Generally advisable to exclude until disease is apparently ar- rested. Remarks Very communicable while the sputum contains bacilli, unless adequate precautions are taken. Additional informa- tion on the prevention and cure of tuberculosis will be sent upon request. Trachoma Principal Early Signs and Symptoms Eyes feel sore at first as if foreign substance were present. Then become red and painful and discharge water. Some pus is also present. The eyelashes stick together in the morning. Later the inner surface of the eyelids become rough and gran- ulated. The lids become swollen and cause a drooping of the upper lid. Constant irritation causes the eyeball to become red and painful. Contact trachoma. with Method of Infection. from eyes discharges of person having Incubation Period Not known. Exclusion Child should be excluded until eyes are apparently cured. Other children from the same house may attend school. Remarks Trachoma frequently ends in total blindness or seriously impaired vision. • i Some of the Educational Material Offered By the Texas State Tuberculosis Sana- torium In the Fight Against Disease LITERATURE This association has prepared for general distribution a num- ber of pieces of educational lit- erature. A thirty-two page pamphlet prepared by medical specialists entitled, "What You Should Know About Tuberculosos" con- tains useful facts for the tuber- culous and those living with them. A pamphlet entitled "Sleep- ing and Sitting in the Open Air" presents a summary of the methods for obtaining fresh air and gives practical hints for the construction of shacks, sleeping porches and other fresh air ar- rangements. "A Tuberculosis Primer for School Children" is a booklet de- signed for the younger children. It is in the nature of a textbook, as its name implies, and at the end of each chapter is provided a set of questions for the use of the teacher who desires to make the "primer" a part of the regu- lar school work. Simply worded and attractively illustrated. The exposure of the dangers in patent medicines which are offered the public as "cures" for tuberculosis is given in a pamphlet entitled "Fake Con- sumption Cures." "What Everyone Should Know About Tuberculosis" is a pamph- let designed primarily for boys and girls in the intermediate and high school grades. Illustrated and contains much valuable in- formation. A folder entitled "Some Talk- ing Points About Tuberculosis" gives statistical facts and sugges- tions for lecturers, preachers, physicians and others who are called upon to speak on the pre- vention of tuberculosis. The Sanatorium publishes many other leaflets, folders and pamphlets. It issues a monthly bulletin to physicians consisting usually of articles by prominent tuberculosis specialists dealing' with the early detection, preven- tion and treatment of tubercu- losis. All of the publications of the Sanatorium are furnished free of charge to residents of Texas. HEALTH EDUCATION IN SCHOOLS No form of this Sanatorium activities is considered of greater value than the move- ment to encourage good health habits among the school chil- dren. Anyone interested in child- ren may accomplish great good in the schools at small sacrifice of time and effort by the proper use of material furnished by this institution. The Sanatorium co-operates with the Texas Public Health As- sociation, the state anti-tubercu- losis association of Texas, in all of its work. The Modern Health Crusader movement, fostered by the Texas Public Health Associa- tion, is a most commendable one. Its object is to arouse interest in better health among school child- ren. The Sanatorium considers this to be one of the most com- mendable health movements of the age, and one that will be pro- ductive of the most good. All in- quiries concerning this phase of the anti-tuberculosis campaign will be referred to the Texas Pub- lic Health Association, or an in- quiry addressed to the Headquar- ters of the Association at Austin, Texas, will receive prompt atten- tion. The Open Air School has proved to be one of the most valuable agencies in conserving the health of school children, especially those who have ten- dencies to tuberculosis. It is found that children make better progress in their studies in such schools because of improved health, and are benefitted both physically and mentally to a re- markable degree. The Sanatorium invites cor- respondence on this subject. Some of the Educational Material Offered By the Texas State Tuberculosis Sana- torium in the Fight Against Disease LANTERN SLIDES No time is so opportune and no means so certain to gain pub- lic attention as that furnished by the picture show. Between acts the patrons of the show are waiting for diverson, and shrewd advertisers everywhere are taking advantage of this op- portunity to give their message to the people through catchy slides. Anti-Tuberculosis associations and all societies engaged in the war against disease should make use, where possible, of this sure means of making a favorable im- pression on public opinion. We have prepared a series of eighteen slides, graphically and pointedly portraying the facts concerning tuberculosis and the best means of combatting and preventing it. A complete set of these slides will be loaned to Anti - Tuberculosis associations, women's clubs, or any other so- cieties interested in the public health. No charge is made for their use. Moving picture show proprie- tors are usually enterprising and public spirited citizens and are glad to serve the community's interests. Little difficulty should be met in arranging to run these slides, one series each two weeks. LECTURE SERVICE Another means of education employed by the Sanatorium has wide range of possibilities. This is the lecture service. A very interesting and care- fully planned stock lecture on tuberculosis has been prepared in such form that it can be pre- sented by any person who will read it carefully. A series of lantern slides which accompany the lecture add greatly to the in- terest and effectiveness of the text. Any organization desiring the use of this stock lecture should notify the Sanatorium of the date of the meeting well in advance of the time, and the lantern slides will be sent, together with the lecture itself. It is of great advantage though not absolutely essential, to have the lecture presented by some one who is posted on the subject of public health and can speak and add comment with some measure of authority. The introduction of features especial- ly pertaining to the community in which the lecture is delivered will add greatly to its interest and effectiveness. A circular letter has been sent to every picture show in Texas, with the request that the three series of slides, eighteen slides in all, be run by them, with inter- vals of two weeks between series. The great loss to moving picture show proprietors because of the closing down of their theaters when the influenza pandemic was at its height will undoubtedly serve to influence them to a fa- vorable consideration of our re- quest. Through an arrangement with the Extension Department of the University of Texas an elaborate lecture, prepared by the Sana- torium, illustrated by about fifty slides, is being presented through- out the State. An effort has been made to make this lecture truly illustrative of conditions in Texas and it is believed that it will play a considerable part in the work of arousing the people to the ne- cessity of fighting the Great White Plague. =a PEDICULOSIS OR HEAD LICE Light gray insects. Lay eggs or "nits" in the hair at the nape of the neck and about the ears. Symptoms are irritation and itching of the scalp. The usual treatment is to soak the hair in kerosene or in turpentine, wash thoroughly with soap and hot water. Repeat three successive nights. Scrupulous care and cleanliness are sufficient to prevent recurrence. Con- tagious. Exclude child until head is free from lice. RINGWORM OF THE SKIN Begins as a small, reddish, scaly patch about the size of a pea. Gradually increases in size until it may reach that of a silver dollar. Meanwhile central (oldest) part recovers and a characteristic ring like appearance results. Located on face, wrists, neck or hands. The usual treatment is to apply tincture of iodine. Mildly contagious. Exclude child until skin is healed. SCABIES OR ITCH An infectious eruption found most frequently on palm of hand and between fingers. The usual treatment is to wash affected parts thoroughly with warm water and soap and then anoint with a diluted sulphur ointment. Child should be kept separate until cured. Sleep alone. All clothing and bed linen should be boiled for one-half hour. Quite contagious, espe- cialy to others in same family. Exclude child until eruption has entirely disappeared. IMPETIGO OR "CONTAGIOUS SORE" Sores which soon form loose scales. Appear on face. The usual treatment is to apply some antiseptic ointment. Child should use separate towels. Very contagious, especially in the spring. Exclude child until sores have disappeared. Pediculosis or- Head Lice Ringworm of the Skin Scabies or Itch Impetigo ' 'Contagious Sore" fti/ocfrit 3L* What the State Tuberculosis Sanatorium Has Accomplished In addition to its routine work through its Bureau of Correspondence and Infor- mation the State Tuberculosis Sanatorium has accomplished these things: It has covered the state with hundreds of thousands of pieces of literature, describing the nature of tuberculosis and presenting the simple and effective methods for its prevention and cure. It has given state-wide help to organizations interested in child welfare by distributing a large amount of helpful literature. It has provided 5,000 doctors in Texas with monthly bulletins, consisting of arti- cles written by eminent specialists, on early detection and diagnosis of pulmonary and other forms of tuberculosis. It has furnished articles to 1,000 newspapers, secured the co-operation of mem- bers of 4,000 lodges, 517 Woman's Clubs, 140 Medical Societies, 36 Y. M. C, A. Organ- izations, 117 Public Libraries. It has furnished information on tuberculosis to 252 County Judges, 1400 Rotary Club Members, 380 Manufacturers, besides corresponding with thousands of tuberculous people, directly. It has prepared three series of lantern slides, six slides to the series, to be exhib- ited in as many of the 1000 picture shows in Texas as will show them. These slides present vividly the simple methods of prevention and treatment of tuberculosis. It has provided all discharged and returned soldiers whose names could be ob- tained with application blanks for admission to the Sanatorium. A number of soldiers have taken advantage of this service, and a still larger number have been placed in other sanatoria and supplied with information on home treatment. It has sold at cost hundreds of dollars worth of sputum cups and holders, and clinical thermometers. Everyone, regardless of whether or not he or she has tubercu- losis, should use a sputum cup. Clinical thermometers are indispensable in finding one's true condition of health. This feature of the Bureau's activities will be continued to the limit. It has conducted a training school for graduate nurses to prepare them especially for tuberculosis nursing. Nurses trained in t his school serve only in Texas cities. It will provide a corps of lecturers fo r local communities throughout Texas It will give illustrated lectures on tuberculosis, its cause, means of prevention and cure, throughout Texas. It has provided literature for co-operation with local home service sections, in car- ing for cases of tuberculosis among discharged and returned soldiers. What This Sanatorium Hopes to Accomplish in the Future. The Texas State Tuberculosis Sanatorium expects to enlarge on every one of its activities inaugurated through its Bureau of Correspondence and Information. It will put into effect a follow-up system of ex- patients, keeping a record of activities, occupations and physical condition of all who have passed through the Sanatorium and will send a visiting nurse to assist such ex-patients in continuing to keep up their treatment, when necessary. It will make provision for educating the Negro and foreign language speaking population of the State. It will encourage the providing of sanatoria for Negroes. It will continue to urge the use of sputum cups and clinical thermometers — selling these supplies at cost. It will co-operate, especially with physicians. The physician is the sick man's best friend. It will co-operate with every organization in the State to combat tuberculosis and other communicable diseases in order that Texas may be a better state to live in. LIBRARY OF CONGRESS 021 331 066 5 TWortt Preserve This Pamphlet. It Is Valuable