COLUMBIA LIBRARIES OFFSITE 
 
 HLAL IH SCILNU '■ \ A 41. A H 
 
 HX641 22638 
 RC309.N48 N48 The Association oi t 
 
 RECAP 
 
 , 
 
 ' 
 
 ■H 
 
 * ■/ 
 
 of ■ ork.' 
 
PC 30<lN4-g 
 
 Columbia (Hnttier^ftp 
 
 mtljeCtfpirflltogork 
 
 COLLEGE OF 
 
 PHYSICIANS AND SURGEONS 
 
 LIBRARY 
 
Digitized by the Internet Archive 
 
 in 2010 with funding from 
 
 Open Knowledge Commons 
 
 http://www.archive.org/details/associationoftubOOnewy 
 
8 L— 1911 21-392, 11, 5,000 (P) 
 
 THE ASSOCIATION 
 
 OF 
 
 TUBERCULOSIS CLINICS 
 
 OF THE 
 
 CITY OF NEW YORK 
 
 ISSUED BY THE DEPARTMENT OF HEALTH FOR USE 
 BY THE ASSOCIATION OF TUBERCULOSIS CLINICS 
 
 1911 
 
yV *- <-* v f* " 
 
 /Vff 
 
 THE ASSOCIATION OF TUBERCULOSIS CLINICS 
 
 OF THE CITY OF NEW YORK 
 
 DIRECTORS AND OFFICERS 
 
 JAMES ALEX. MILLER, M. D., President 
 
 JOHN H. HUDDLESTON, M. D., Vice-President 
 
 LAWRENCE VEILLER, Secretary 
 
 MRS. HERMANN M. BIGGS 
 
 F. MORRIS CLASS, M. D. 
 
 MRS. J. BORDEN HARRIMAN 
 
 AUSTIN W. HOLLIS, M. D. 
 
 A. JACOBI, M. D. 
 
 MISS BLANCHE POTTER 
 HENRY L. SHIVELY, M. D. 
 ANTONIO STELLA, M. D. 
 
 B. H. WATERS, M. D. 
 
 FRANK H. MANN, Assistant Secretary 
 
 F. ELISABETH CROWELL, Executive Secretary 
 
The Association of Tuberculosis Clinics 
 
 The Association op Tuberculosis Clinics is the outgrowth 
 of an experiment undertaken by the Committee on the Preven- 
 tion of Tuberculosis of the New York Charity Organization 
 Society to demonstrate the possibilities of effective home treat- 
 ment of tuberculosis in New York City. The experiment was 
 conducted by a special committee consisting of the chiefs of 
 several of the tuberculosis clinics in the city and representatives 
 of the Charity Organization Society. The close association of 
 these chiefs of the tuberculosis clinics and the co-operation 
 between them and the social and benevolent organizations in the 
 city led, at the conclusion of the experiment in January, 1908, 
 to the formation of a separate organization, composed of the 
 representatives of nine special tuberculosis clinics, having as its 
 purpose the further organization and development of tubercu- 
 losis clinics looking toward the ultimate dispensary control of 
 the disease. 
 
 MEMBERSHIP. 
 
 Clinics eligible for membership in the Association must be pro- 
 vided with : (a) a separate class for tuberculosis cases ; (b) a 
 graduate nurse assigned to this class for the purpose of main- 
 taining supervision over the homes of these tuberculosis cases; 
 (c) a district within which the work of the class is limited for 
 new cases. 
 
 Members are elected, and there are no dues. 
 
 The number of active members corresponds to the number of 
 clinics in the Association, each active member being the repre- 
 sentative of a particular clinic. 
 
All physicians engaged in the treatment of tuberculosis, and 
 representatives of all associations interested in tuberculosis work, 
 are eligible for associate membership. 
 
 PURPOSES OF THE ASSOCIATION. 
 
 First. — To organize dispensary control of pulmonary tuber- 
 culosis in New York City. 
 
 Second. — To develop a uniform system of operation of such 
 dispensaries as are organized for this purpose. 
 
 Third. — To retain patients under observation until they are 
 satisfactorily disposed of, and to prevent them drifting from one 
 dispensary to another. 
 
 Fourth. — To establish and maintain a district system of dis- 
 pensary treatment. 
 
 Fifth. — To facilitate the attendance of patients at the dispen- 
 sary most convenient to their homes. 
 
 Sixth. — To facilitate the work of visiting nurses in the homes 
 of patients. 
 
 Seventh. — To provide for each patient requiring it, assist- 
 ance by special funds or benevolent organizations, and proper 
 hospital or sanatorium care. 
 
 Eighth. — To co-operate with, and assist as far as possible, 
 the Department of Health in the supervision of pulmonary tuber- 
 culosis. 
 
 WHAT HAS ALREADY BEEN ACCOMPLISHED. 
 
 Medical Care and Home Supervision Combined. 
 
 Twenty-two special clinics for the treatment of pulmonary 
 tuberculosis have been established in Manhattan, The Bronx and 
 Richmond. At each of these clinics facilities are provided to sep- 
 arate tuberculosis from other diseases and to treat these patients 
 more carefully and skilfully than is possible in a general dispen- 
 sary. Visiting nurses follow up the patients in their homes and 
 thus insure the execution of the instruction and advice given at 
 
the clinic. Other members of the family are seen and all 
 suspicious cases are sent to the clinic for physical examination. 
 Thorough and repeated instruction educates the patients and their 
 families in the essentials of the prevention and treatment of 
 tuberculosis. Assistance in the form of clothing, payment of rent, 
 extra nourishment or general charitable relief is rendered either 
 by special funds administered by the clinic nurse or through 
 proper benevolent organizations. Hospital or sanatorium care is 
 secured for those who need such treatment. 
 
 A District Plan and Its Advantages. 
 
 For more than two years a plan has been in operation by which 
 the city has been apportioned by districts between the various 
 tuberculosis clinics. Patients are required to attend the clinic in 
 the district of their residence, and whenever application is made 
 to the wrong clinic the patient is promptly referred to the clinic 
 in the district in which he lives. 
 
 This scheme enables the visiting nurse to supervise the patients 
 much more effectively by facilitating frequent visits, and insures 
 treatment for the patient within convenient distance of his home. 
 It thus makes for greater efficiency of service by an economy of 
 time and energy. Theoretical objections to this district system 
 have not materialized in practice. 
 
 Co-operation Between the Various Clinics. 
 
 By means of the Association the various physicians have been 
 brought closely together and much has been accomplished toward 
 a harmonious and effective system of management of pulmonary 
 tuberculosis. A remarkable unity of purpose, the satisfaction of 
 better accomplishment and an enthusiasm for the future have 
 resulted. Acquaintance and comparison have tended to the gen- 
 eral adoption of approved methods of education, supervision, 
 relief and treatment of patients. 
 
 CO-OPERATION WITH SOCIAL AND CHARITABLE ORGANIZATIONS. 
 
 Through its associate membership the Association endeavors 
 to interest all the various organizations in the city which come 
 in contact with this disease. Physicians thus widen their horizon 
 in accordance with the comparatively recent recognition of the 
 
large social factor concerned in the study of this, as well as many- 
 other diseases. Social workers, on the other hand, are assured 
 of competent advice and a reliable medical basis for their work. 
 
 The following list of societies and institutions represented in the 
 associate membership shows to what extent such co-operation 
 has been secured: 
 
 Association for Improving the Condition of the Poor, Amer- 
 ican Red Cross, Bellevue and Allied Hospitals, Bellevue Hos- 
 pital Auxiliary, Brooklyn Association of Tuberculosis Clinics, 
 Charity Organization Society, Department of Education, Depart- 
 ment of Health, Department of Public Charities, Federation of 
 Catholic Charities, Federation of Churches, Gouverneur Hos- 
 pital Auxiliary, Health Department Auxiliaries, Italian Benev- 
 olent Association, Loomis Sanatorium, New York Diet Kitchen 
 Association, Nurses' Settlement, Nurses' Association, Otisville 
 Sanatorium, Riverside Hospital, St. George's Tuberculosis 
 Class, St. Joseph's Hospital, Societe Francaise de Bienfaisance, 
 State Department of Labor, Society of St. Vincent de Paul, 
 Stony Wold Sanatorium, Union Settlement, United Hebrew 
 Charities, Vanderbilt Clinic Women's Auxiliary, Visiting 
 Nurses' Association of Presbyterian Hospital, Women's 
 Auxiliary of Morgagni Clinic, Women's Auxiliary of St. Bar- 
 tholomew's Clinic and Women's Committee Civic Federation. 
 
 CO-OPERATION WITH GENERAL DISPENSARIES. 
 
 A complete canvass of all the dispensaries in the city has been 
 made to ascertain their attitude toward the work of the Asso- 
 ciation. The results show a general approval of its methods and 
 plans. 
 
 The method of co-operation proposed by the Association in its 
 campaign to secure active affiliation with those dispensaries 
 offered two alternatives: 
 
 Either, That the general dispensary establish a special tuber- 
 culosis clinic, with a visiting nurse, assume responsibility for a 
 district and join the Association, subject to its rules and regula- 
 tions ; 
 
 Or, If this be not feasible, that the general dispensary decline 
 to treat cases of pulmonary tuberculosis but refer such patients to 
 the proper clinic of the district of their residence — maps and 
 cards for this purpose to be furnished by the Association. 
 
Establishment of Children's Clinics. 
 
 Believing that the early recognition of tuberculosis in children, 
 followed by careful observation and adequate treatment, is one 
 of the strongest factors in the ultimate control and eradication 
 of tuberculosis, the Association has strongly urged the establish- 
 ment of special children's clinics in connection with the tubercu- 
 losis clinics for adults. Four of the dispensaries are now main- 
 taining these special tuberculosis clinics for children. 
 
 Formation of Women's Auxiliaries. 
 
 Nine dispensaries have organized Women's Auxiliaries whose 
 chief function is to make possible and thorough an efficient 
 social service for the tuberculosis cases who are under the clinic 
 care. Destitute cases are helped from a special fund. Assistance 
 is given by paying rent, furnishing outfits, and if necessary pay- 
 ing carfares to and from sanatoria. Special diet is provided. 
 When necessary, the work of the clinic is supplemented by pay- 
 ing the salaries of additional nurses and by contributing toward 
 the expenses of the day camps. 
 
 Establishment of Day Camps. 
 
 Connected with five of the clinics are day camps for the use 
 of incipient and moderately advanced tuberculosis cases who have 
 the time and are willing to spend a certain part of the day in 
 taking the rest cure in the open air but who are unable to leave 
 the city. Three of these day camps are on ferry-boats. An- 
 other is on the roof of one of the dispensaries. Nurses are in 
 immediate charge of the patients, and regular visits are made 
 by physicians in attendance. In connection with these day camps 
 there are conducted fresh air schools under the charge of teachers 
 appointed by the Department of Education for those tuberculosis 
 children who have been excluded from the public schools. Ap- 
 plicants for admission to the day camps are admitted through 
 any of the clinics belonging to the Association. 
 
 Four of these day camps also make provision for caring for 
 patients at night. 
 
 One clinic maintains in winter a special night camp. 
 
Organization of Nurses Engaged in Clinic Work. 
 
 A Nurses' Association of the Association of Tuberculosis 
 Clinics has been organized, the object of which is to secure co- 
 operation and promote uniformity of the nurses' work in con- 
 nection with the tuberculosis dispensaries, and by regular monthly 
 conferences to keep the nurses informed of the best methods by 
 which such co-operation and uniformity may be secured. 
 
 In addition, by means of short talks by the heads of various 
 philanthropic agencies, frequent opportunity is afforded for the 
 nurses to become acquainted with the best methods of co-oper- 
 ating with the various relief agencies in the city. 
 
 Sanitary Supervision of Cases of Pul- 
 monary Tuberculosis at Their Homes by 
 Nurses of the Department of Health. 
 
 All registered tuberculosis cases, except those in hospitals, sana- 
 toria, or other institutions, or those under the care of a private 
 physician, are supervised in their homes. Responsibility for this 
 supervision is divided between the tuberculosis clinics and the 
 Department of Health. All clinic cases are supervised by clinic 
 nurses. All "at home" cases, that is, cases not regularly attend- 
 ing the clinic, not in an institution, or under a private physician's 
 care, are under the immediate supervision of the Department of 
 Health, and are visited at least once a month. 
 
 For the information of the members of the Association, a 
 description is here given of the work of the district tuberculosis 
 nurses of the Department of Health. 
 
 In each clinic district a staff of district nurses is maintained, 
 charged with the sanitary supervision of cases of pulmonary 
 tuberculosis in that district. These nurses report daily at the 
 tuberculosis clinic of their district, and there receive all assign- 
 ments. One nurse is detailed as "Captain" of the district, and 
 acts as the official intermediary between the tuberculosis clinic 
 and the Department of Health. Each morning she telephones to 
 the Department of Health the daily report of the clinic, and 
 receives in the same manner all information received at the 
 
Department of Health during the preceding twenty-four hours 
 regarding all cases of tuberculosis in the district. This latter 
 information is at once reported to the tuberculosis clinic. 
 
 In case of death or removal of tuberculosis patients, the dis- 
 trict nurses order the necessary disinfection of the premises 
 and bedding; they make arrangements for the admission of ad- 
 vanced cases to hospitals and incipient cases to sanatoria ; they 
 investigate all complaints made by citizens, see that the sanitary 
 regulations of the Department of Health regarding the care of 
 expectoration are observed, and use their authority to induce 
 "delinquent" cases to resume attendance at the clinic ; they visit 
 the families of patients in hospital at stated intervals; and each 
 nurse maintains a complete and correct index of all cases of 
 pulmonary tuberculosis living in her district, which is at all times 
 accessible to the nurses and physicians at the clinic. Every effort 
 is made to secure complete and harmonious co-operation between 
 the district nurses of the Department of Health and the tuber- 
 culosis clinics. 
 
 RULES OF THE ASSOCIATION. 
 
 I. — Maintenance of the District System. 
 
 i. — Each applicant for admission, who has already been 
 admitted to the dispensary of the district in which he or 
 she lives, shall be refused admission to any other dis- 
 pensary, and referred back to the dispensary of his or 
 her district. 
 
 2. — Patients removing from one dispensary district to 
 another shall be considered transferred cases. 
 
 All cases so transferred are at once reported through 
 the district "Captain" to the Department of Health, which 
 notifies the proper clinic by telephone within twenty-four 
 hours. All such transferred cases are immediately visited 
 by a Department of Health nurse and urged to attend the 
 proper clinic ; should they not do so within one week they 
 are again visited for the same purpose, but are not re- 
 visited by the Health Department nurse while they are in 
 attendance at the proper clinic. (See Rule VI, Sec. B.) 
 
 9 
 
Where patients have been under observation at the 
 original clinic for some time, the results of diagnostic 
 tuberculin tests, sputum test and temperature, pulse and 
 weight observations and a brief description of the loca- 
 tion of lesion are to be forwarded by mail to the proper 
 clinic on a special card for that purpose. 
 
 3. — Each applicant who lives outside the district shall 
 be examined, and if positive or suspicious, shall be trans- 
 ferred at once to the proper dispensary. 
 
 4. — Cards containing address and hours of the clinic to 
 which the patient is being transferred shall be given to 
 him, and a careful explanation made of the reason of the 
 transfer. 
 
 Except : When by reason of employment certain hours 
 of attendance are impossible, or in certain exceptional 
 instances approved by the physician in charge of the dis- 
 pensary, a patient may be treated in other than his proper 
 district dispensary. 
 
 5. — Not later than one week after the first visit of 
 every new or transferred tuberculous patient, the nurse 
 of the clinic shall visit the patient. 
 
 Except : That dispensary patients who, in the judgment 
 of the physician in charge, would suffer loss of position or 
 other hardship by reason of the nurse's visit, may be re- 
 ported to the Department of Health as private cases by 
 the physician in charge who will assume all responsibility 
 for such action, supervising the home conditions, and sub- 
 mitting monthly reports to the Department of Health, as 
 required by law. 
 
 II. — "Not Found" Cases. 
 
 Should the patient be not found, this fact shall be re- 
 ported the following morning to the Department of Health 
 "Captain" for the district, who will endeavor to obtain the 
 correct address from the dispensary of original applica- 
 tion, and will report the same to the clinic. 
 
 10 
 
III. — LODGING-HOUSE CASES. 
 
 All cases (except those living in licensed lodging-houses) 
 whom for any reason it is impossible for the clinic nurse 
 to visit in their homes, shall be reported to the Depart- 
 ment of Health, Division of Communicable Diseases, 
 which will supervise these patients by its inspectors. Such 
 cases, however, shall not be considered "delinquent" cases 
 unless they fail to attend the dispensary, as provided in 
 Section IV (A). 
 
 IV. — "Delinquent" Cases. 
 
 A. Each patient for any reason omitting to return to 
 his or her proper dispensary for a period of one month 
 (except while a resident in hospital, sanatoria or out of 
 town) shall be reported to the Department of Health Cap- 
 tain as a "delinquent" case. 
 
 Except : When a case is well known and supervised by 
 the visiting nurse, and for reasons sufficient and satisfac- 
 tory to the physician in charge, cannot come regularly to a 
 dispensary. 
 
 B. Should any patient, except those found to be under 
 the care of private physicians, refuse for any reason to 
 attend his or her proper dispensary, such patient shall then 
 be considered a "delinquent" case. 
 
 C. Responsibility for "delinquent" cases will be as- 
 sumed by the Department of Health, and all such cases, 
 except those found to be under the care of physicians as 
 private patients, will be kept under observation by a De- 
 partment nurse, who will endeavor to secure the patient's 
 return to his or her proper dispensary. 
 
 V. — Applicants for Hospitals and Sanatoria. 
 
 As far as possible, each patient shall be furnished with 
 medical and other assistance, through the agencies of the 
 dispensary district in which he or she lives. 
 
 n 
 
All applicants for hospital or sanatorium care are to be 
 referred to the Tuberculosis Hospital Admission Bureau 
 at 426 First Avenue, Borough of Manhattan. Hours, 9 
 A. M. to 6 P. M. daily, except Sundays. Through this 
 Bureau must pass all cases of tuberculosis admitted to 
 Bellevue and Allied Hospitals (except emergency cases), 
 the hospitals of the Department of Charities and the De- 
 partment of Health, and Otisville and Ray Brook Sana- 
 toria. (Including cases of forcible removal.) 
 
 Applications for admission to Riverside Hospital must 
 be accompanied by a voucher that tubercle bacilli have 
 been found in the sputum within at least two weeks of 
 the date of application. 
 
 Otisville Sanatorium of the Department of Health, and 
 the New York State Hospital for Incipient Tuberculosis at 
 Ray Brook, are primarily for non-complicated first stage 
 cases of pulmonary tuberculosis. Patients must be in 
 favorable physical condition, of good character and disposi- 
 tion, and residents of New York City for at least one year; 
 citizens of the United States are given preference over non- 
 citizens. Patients are required to furnish a suitable outfit 
 of clothing, etc. Every suitable case is to be referred to 
 the Tuberculosis Hospital Admission Bureau, by means of 
 the special reference cards (71 L) furnished for that pur- 
 pose. These cards must be forwarded in duplicate, and 
 must give the essential data regarding the case, at least 
 two records of the temperature and pulse, and the results 
 of examinations of sputum and urine. These cards are * 
 to be mailed to the Admission Bureau, at 426 First 
 Avenue. When vacancies occur, the applicants are notified 
 to call for final examination. If found to be suitable for 
 admission, each case is placed upon the waiting list in 
 the order of its original application at the clinic from 
 which it was referred. Each patient after completion of 
 the examination and observation required, shall return, 
 pending action in his case, to the proper dispensary. 
 
 12 
 
VI. — Co-operation With the Department of Health. 
 
 A. Each dispensary shall furnish daily to the Depart- 
 ment of Health "Captain" the names and addresses of all 
 new cases of tuberculosis diagnosed at its last session; 
 all discharges for non-attendance or as cured ; all cases 
 transferred as not living in the clinic district; all changes 
 of addresses within the district; and cases not found by 
 the clinic nurses at the address given. 
 
 B. No case of tuberculosis reported as being under 
 treatment is visited by Department of Health physicians 
 or nurses, except for the following reasons: complaint 
 made by citizens or inspectors; investigation as to exclu- 
 sion from school ; investigation as to suitability for dis- 
 charge from Otisville Sanatorium or other institutions; 
 and in cases of removal or death, in order that the neces- 
 sary disinfection of the premises may be ordered. 
 
 C. Each dispensary shall endeavor in every possible 
 way to assist in the prevention of tuberculosis, to conform 
 to the requirements of the Department of Health, to prop- 
 erly manage and dispose of the patients coming under its 
 observation, and to further the development of an ade- 
 quate, efficient and uniform system for the care of 
 pulmonary tuberculosis. 
 
 VII. — Reports to the Association. 
 
 Each dispensary shall furnish the office of the Associa- 
 tion with such monthly reports of its work as may be 
 required by the Association. 
 
 VIII. — Circulars of Information. 
 
 All information which is of general interest to the clinics 
 belonging to the Association, and all rulings concerning 
 the method of procedure recommended by the Association, 
 shall be transmitted by the Executive Secretary to each 
 clinic in the form of a Circular of Information, two copies 
 being sent to each clinic, one to the physician-in-charge 
 and a duplicate to the supervising nurse, who shall keep 
 such circulars on file in a binder furnished for this purpose. 
 
 13 
 
CLINICS AND DISTRICTS 
 
 H DETT 
 
 MANHATTAN 
 
 Bellevue Hospital Clinic (12) Foot E. 26th 
 
 St. Daily, 1 to 3 p. m. Children's Clinic, 
 
 Tuesday and Saturday, 1,30 to 3 p. m. 
 Flower Hospital Clinic (15) Eastern Bou- 
 levard and 63rd St. Monday, Wednesday 
 
 and Saturday, 2.30 to 3.30 p. m. 
 German Hospital Clinic (17) 76th St. and 
 
 Park Ave. Daily, 3 to 4 p. m. 
 Good Samaritan Clinic (10) Essex and 
 
 Broome Sts. Daily, 2.30 to 4.30 p. m. 
 Gouverneur Hospital Clinic (9) Foot Gou- 
 
 verneur Slip. Monday, Wednesday and 
 
 Friday, 2 to 4 p. m. Tuesday, Thursday 
 
 and Saturday, 4 to 6 p. m. 
 Harlem Hospital Clinic (2) 136th St. and 
 
 Lenox Ave. Daily, 2.30 to 3.30 p. M. 
 Health Department — East Side (11) 81 E. 2d 
 
 St. Daily, 10 a. m. to 4 p. m. Thursday 
 
 and Saturday, 8 to 9 p. m. 
 Health Department— Italian (19) 339 E. 109th 
 
 St. Daily, 10 a. m. to 12 m. Tuesday, 
 
 Thursday and Saturday, 2 to 4 p. m. 
 
 Tuesday, 8 to 9 p. m. 
 Health Department— West Side (4) 307 W. 
 
 33d St. Daily, 2 to 4 p. m. Thursday, 
 
 8 to 9 P. M. 
 Tuberculosis Hospital Admission Bureau 
 
 (20) 426 First Ave. Daily, 9 a.m. to 5 p.m. 
 Morgagni Clinic (7) 169 VV. Houston St. 
 
 Tuesday, Thursday and Saturday, 2 to 
 
 4 p. M. 
 Mt. Sinai Hospital Clinic (18) Madison 
 
 Ave. and 100th St. Daily, 10 to 11 A. m. 
 
 Children's Clinic, Saturday, 2 to 4 p. m. 
 New York Dispensary (8) 145 Worth St. 
 
 Daily, 11 a. m. to 12.30 p. m. 
 New York Hospital Clinic (s) 8 W. 16th St. 
 
 Daily, 1 to 3 P- m. 
 New York Throat, Nose and Lung Hospital 
 
 Clinic (14) 229 E. 57th St. Daily, 3 P. M. 
 
 and 8 p. m. 
 Presbyterian Hospital Clinic (16) 70th St. 
 
 and Madison Ave. Daily, 1.30 to 3 P. M. 
 St. Bartholomew's Clinic (13) 209 E. 42nd 
 
 St. Tuesday, Thursday and Saturday, 
 
 2 to 4 P. M. 
 
 St. Luke's Hospital Clinic (1) Amsterdam Ave. and 113th St. Monday, Wed- 
 nesday and Friday, 2 to 3 p. m. 
 
 St. Vincent's Hospital Clinic (6) 149 W. nth St. Monday, Wednesday and 
 Friday, 10 to n a. m. 
 
 Vanderbilt Clinic (3) Amsterdam Ave. and 60th St. Daily, 1 to 2.30 p. m. 
 Monday, Wednesday and Friday, 9 to 10.30 a. m. Children's Clinic, Saturday, 
 
 THE BRONX 
 
 Daily, 2 to 4 p. m. 
 Daily, 10 a. m. to 12 m. Tues- 
 
 Health Department— Northern (1) 3d Ave. and St. Paul's PI 
 
 Thursday, 8 to 9 p. m. 
 Health Department — Southern (2) 493 E. 139th St 
 
 day, 8 to 9 p. m. 
 
 RICHMOND 
 
 Health Department, Bay Street, Stapleton, S. I. Tuesdays, Thursdays and 
 
 Saturdays, 2 to 4 p. m. 
 Note :— All applicants should apply to the tuberculosis clinic of the district in 
 
 which they live. 
 
COLUMBIA UNIVERSITY LIBRARIES 
 
 This book is due on the date indicated below, or at the 
 expiration of a definite period after the date of borrowing, 
 as provided by the rules of the Library or by special ar- 
 rangement with the Librarian in charge; - 
 
 
 
 DATE BORROWED 
 
 DATE DUE 
 
 DATE BORROWED 
 
 DATE DUE 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 C28(l 140) Ml 00 
 
 
 
 
EC 509 .1143 
 
 IT4S 
 
 Li. 
 
 New York ( ity) Dept. of health.