THE FRAMINGHAM DEMONSTRATION 73 



veloped in support of the campaign; and all conditions are favorable to its 

 success. 



"15. CONTINUATION VITAL 



"These statistical calculations have led us to the conclusion that the Fram- 

 ingham Demonstration should be continued for a period of at least five years 

 in order to render the attainment of definite results of reasonable certainty. 

 It would furnish for the first time a definitely established working program for 

 the practical control of tuberculosis." 



The Framingham Demonstration endeavors as one of its dis- 

 tinct aims to show to other communities how tuberculosis may be 

 controlled. Framingham is, in other words, a community labo- 

 ratory where methods that can be universally applied are tested. 

 Dr. Armstrong in a recent article has emphasized this phase of 

 the work under the pertinent title "Framingham Yardsticks." 

 Since this article shows in brief some of the most significant 

 achievements of the Demonstration from the point of view of 

 methods, it is quoted in full as follows: 



"I. HOW MUCH TUBERCULOSIS IS THERE? 



"The examination of thousands of men, women and children in Framing- 

 ham shows that approximately I per cent, were suffering from active tu- 

 berculosis. 



" In a city of 100,000 people this would mean, therefore, about 1,000 active 

 cases. 



"II. HOW MANY CASES SHOULD BE UNDER CARE? 



"In Framingham intensive medical work among infants, in schools, in 

 factories and elsewhere, brought to light 9 or 10 active cases for every annual 

 death. 



" In a city of 100,000, therefore, with a death-rate, say, of 100 per hundred 

 thousand, or 100 deaths a year, there should be 900 or 1,000 active cases 

 under care. (Variations in the death-rate may, of course, affect this ratio.) 



"III. WHAT PERCENTAGE OF CASES SHOULD BE REPORTED IN 



THE EARLY STAGE? 



"Before the Demonstration started in Framingham, the physicians of 

 Framingham reported only 45 per cent, of the cases in the early stage; now 

 about 75 per cent, of the cases are being reported as early-stage tuberculosis. 



"IV. WHAT ARE THE MINIMUM INSTITUTIONAL NEEDS? 



"In Framingham the minimum bed requirement has been from one to two 

 beds for every annual death in the community. This hypothetical city of 

 100,000, with 100 deaths a year, will need, therefore, at least 100 hospital or 



