EPIDEMIOLOGY OF TUBERCULOSIS—PARR 489 
young men and women found to have tuberculosis will be adequately 
cared for. 
Tuberculin testing is time consuming and costly and, I regret to 
say, is sometimes omitted from the case-finding set-up. Celluloid 
films, 14 by 17 inches are also very expensive, and several substitutes 
have been worked out making it possible to examine the lungs of all 
members of a group (a good case-finding team can do 500 persons a 
All new students 
Minor focus of attention as long as 
healthy. X-ray half way through 
course and at graduation* 
Intradermal 
iTuberculin Test, 
using PeFsDe 
(a) 0.00002 mg 
(b) 0.005 mg 
Major focus of attention. Tuberculin 
retest each semester. Positives 
sent to X-ray at once and each 
term thereafter for at least two years, 
If found “not significant” follow 
closely with 
X-rays ,etc eas 
ordered. 
No 
lung 
pathology 
Full and 
careful study, 
diagnosis anc 
advice by Special- 
ized Chest 
Physician, 
Full 14 x 17 ins a, 
antero-posterior 
view,celluloid 
plate ,with expert 
interpretation, 
Suggestive 
Findings 
laboratory aid 
in making diag- 
nosis ,-sputum 
search,blood 
counts ,sedimen= 
tation tests, 
Significant 
#indings 
* In practice every 
student is tuberculin 
tested whether + or -, 
each semester the first 
three semesters but 
thereafter only if 
negative or weakly 
positive. 
at home or better 
in sanitorium 
until satisfacto 
arrest is at- 
tained, 
Figure 3.—Tuberculosis case-finding program at the School of Medicine, The 
George Washington University. 
day) at a reasonable cost. While this expedient works and is there- 
fore justified, from the epidemiological point of view it is distinctly 
faulty because the tuberculin test gives information we must have for 
the proper understanding of the disease, and the large plate provides 
a permanent record unequaled by most of the less costly substitutes. 
At George Washington University Medical School, through the in- 
terest and cooperation of the dean, a proper and complete case-finding 
program has been in progress almost 5 years. The organization and 
operation of this program are graphically indicated in figure 3. 
