1913 Journal of the American Medical Association (JAMA)  
The discovery of the tubercle bacillus has changed all of our definitions of the disease. The discovery of a specific cure may change many of our methods of control, or our attempts at control. Ultimate control is the aim of all new methods or measures. The last fight against the disease will be made by the public health workers of the world. Changes have occurred both in treatment and in administrative methods; but always there has been progress. The question of control, of prevention rather
more » ... an cure, naturally appeals to the public health worker. Minnesota has had some legislation on tuberculosis. It has been defined as a contagious and infectious disease and made reportable. A state sanatorium was erected about five years ago. The legislature authorized the appointment of a state advisory commission for this institution. These are some of the things which have been done looking toward control. Two years ago the legislature passed a bill authorizing counties to issue bonds for the purpose of erecting tuberculosis sanatoriums. This, ¡I was thought, would stimulate interest which would result in the erection of sanatoriums in. various parts of the state. It failed of its purpose. At Hie last session, therefore, the legislature passed another county sanatorium hill with the entirely new feature of state aid added. The hill also carried with it, an appropriation of $500,0(H) fo make the measure effective. Some of the features of the hill may be of general interest. It provides that any county or group of counties, through their hoards of county commissioners, shall bave the power, with the advice and approval of the advisory commission of the Minnesota Sanatorium for Consumptives, to establish and maintain sanatoriums for the treatment, and care of persons affected with tuberculosis. These sanatoriums may be established by a majority vote of the commissioners (if any one county or group of counties, whenever the cost of construction fo he paid by the county or group of counties shall not exceed such a sum as may he raised by a tax levy of not to exceed one mill on Hie dollar of. the taxable properly of any such county or group of counties. Whenever the cost of construction shall exceed the amount thai mighl lie raised by a one-mill lax. then the two questions of (I) whether or not such sanatorium shall he established and (2) whether or not such bonds shall be issued to defray any county's portion of the cost thereof shall lie submitted to the voters of such county, and the sanatorium shall not be established unless ¡i majority of I he voters of such county shall vole in favor of each of the two propositions submitted lo them. If the county commissioners of any county shall refuse to construct such a Si.loriiitn, then, on a petition of not less than 5 per cent, of I he freeholders of such county, such question shall be submitted lo the voters, and if a majority of the voters of such county, voting thereon, shall vote in favor of constructing such a sanatorium, then such a sanatorium shall he erected. On the decision to establish and maintain a tuberculosis sanatorium, tbe county commissioners shall appoint a commission consisting ol' three members, at least, one of whom shall he a licensed physician, and whose appointment, before becoming effective, shall be approved by the State Board of Health. Such county sanatorium commission shall have full charge and Control of all moneys received for the credit of the tuberculosis sanatorium and have full charge and control of the location, establishing, and maintenance of any sanatorium. But no site shall be secured and buildings erected or equipped without the approval and consent, of the Advisory Commission of the Minnesota Sanatorium for Consumptives. Before final action is taken the plans and specifications shall be submitted to the State Board of Health for approval. The State Board of Control shall have full power and control over the construction and equipment of any such sanatorium. A county or group of counties desiring to erect a sanatorium shall through their boards of county commissioners appropriate one half the necessary funds and deposit the same with the state treasurer. The hill furl her provides that the amount contributed by the state shall not exceed $50,000 to any one county, and that no sanatorium shall he constructed of smaller capacity than twenty beds. After their construction these sanatoriums shall he under the charge and control of the county sanatorium commission. Preference is to be given to the patient with an advanced case and to the resident of the local county, but no person is to be turned away for lack of means if there is an available bed for his care. In case there are no relatives who should lie responsible for the care of the patient, the state will pay to the county treasurer of (he particular county the sum of live dollars pel' week. In counties in which a contract has already been let, or in which a sanatorium has already been built, the state shall refund to the particular county a sum equal to five hundred dollars for each available bed. To carry out the provisions of the bill an appropriation of $500,000 was made. Besides Ibis county sanatorium hill the legislature passed a hill for the better control of tuberculosis. It requires the reporting of all cases of the disease by physicians. This is provided for in a former law. The law further says that it shall be unlawful for the authorities in charge of any penal or charitable institution to care for any person a 111 ici ei I with tuberculosis in the same room or ward with other inmates. Another seel ion provides that the health officer may report to the hoard of county commissioners any person afflicted with tuberculosis whom he considers a menace to his family or the public, and, oil the approval of the hoard of county commissioners, the health officer shall have the power to remove such person and place him in a public hospital or sanatorium in which he shall remain until discharged by the superintendent of such institution. This is another way to protect the public by compulsion in case protection by education has failed. This wise law would he without effect unless sonic place were provided where the vicious consumptive could he restrained. This is met" however, in the provision by the state for county sanatoriums. Another provision of this hill is that no teacher, pupil; or employee about a school building who is afflicted with tuberculosis shall remain in or about such building, without a certificate from the hoard of health, or an agent duly authorized by the board of health, that such person is in no sense a source of danger fo others. It is a pool' rule that, does not work both ways,' so teacher and pupil are treated alike linder this act. It provides for the proper disinfection of the premises following death ol removal and for placarding the premises with a warning notice lo the public until this has been done.. This is thought to be the first bill providing state aid in the consli notion of county sanatoriums. How well it is to wot»
doi:10.1001/jama.1913.04350180032011 fatcat:tbskbmpcxncathhe6oohowqnrm