EARLY PROBLEMS 37 



hand in hand to some degree with the problem of stimulation and 

 the developing of programs. In its organization effort, the Na- 

 tional Association gradually moved westward, developing first 

 the Atlantic Coast States, then the Middle Western and Southern 

 States, and finally pushing on to the Southwestern and North- 

 western States, confining itself for the most part to state 

 associations. It has always acted upon the theory that 

 dealings with local groups should come through the state asso- 

 ciation, and this practice has become more and more rigid as the 

 years have passed. In organizing state work, the Association 

 always considered the question of whether the new association 

 had funds available or in sight for carrying out a program. The 

 insistence upon fulltime paid executives as contrasted with 

 volunteer service has produced a machine in each of the states 

 that is working more and more effectively toward the desired 

 goal. At the present time each of the 48 states has an organiza- 

 tion and a fulltime secretary. A somewhat similar service has 

 also been secured for Porto Rico, the Philippine Islands, and 

 Hawaii. 



The fourth problem of the Association, to provide a clearing- 

 house for information and education, has been solved by the 

 gradual accumulation of knowledge and experience. As State 

 and local organizations developed and as institutions sprang up 

 apace, the National Association became more and more the 

 central clearing-house for providing literature, furnishing data, 

 gathering together groups in conference, etc. At the present 

 time the Association maintains elaborate machinery for the dis- 

 pensing of information through its executive office, through 

 correspondence, through its field service, through its three 

 monthly publications, through conferences and meetings and 

 in other ways. 



It will not be necessary in this part of the history to deal with 

 individual state problems nor even to record the development 

 of work in different parts of the country. These facts are re- 

 corded in a separate chapter. It will be necessary here simply 

 to call attention to this significant fact, that wherever State and 

 local tuberculosis associations have been formed there have 

 sprung into existence almost automatically, it would seem, 



