6 A HISTORY OF NATIONAL TUBERCULOSIS ASSOCIATION 



disease dates back even further than Dr. Janeway's paper. Dr. 

 Stephen Smith, that venerable Nestor of the medical profession 

 of the United States, now in his ninety-ninth year, wrote the 

 author, in an autograph letter dated July 2, 1920, as follows: 

 "When a Commissioner of Health from 1868 to 1875, I en- 

 deavored to have tuberculosis reported as contagious, but failed." 



It was not until 1889 that the communicability of tubercu- 

 losis was officially recognized by the New York City Health De- 

 partment. Thus the year 1889 marks the most important epoch 

 in the control of tuberculosis in New York city, as well as in the 

 United States, if not in the entire civilized world. In that year 

 Dr. Hermann M. Biggs, Dr. T. Mitchell Prudden, and Dr. H. P. 

 Loomis presented to the Health Department of New York city a 

 communication calling attention to the communicability of tu- 

 berculosis and recommending that measures be taken to prevent 

 the spread of this disease and outlining these measures. The 

 Department of Health submitted this communication to 12 

 prominent physicians and asked for their suggestions and recom- 

 mendations. The only ones of this group who favored the 

 recommendations of Drs. Biggs, Prudden, and Loomis were Dr. 

 Edward G. Janeway and Dr. Frank P. Foster, at that time editor 

 of the New York Medical Journal. The Department of Health, 

 however, considered the matter with more or less favor, and in 

 that same year, 1889, published a leaflet giving the essential 

 facts with regard to the nature, causation, and prevention of 

 tuberculosis, and distributed the leaflet in large quantities, 

 particularly in the tenement houses of the city. The leaflet 

 was^also placed in the hands of every family where a death from 

 tuberculosis had occurred. So far as we are able to ascertain, 

 this is the first leaflet ever published for distribution among the 

 general public. It is certainly the first one published and dis- 

 tributed by a health department, and as such marks an epoch 

 in tuberculosis education. 



On account of its historic interest a copy of this leaflet is re- 

 produced herewith: 



