THE STATE TUBERCULOSIS ASSOCIATIONS 103 



The work of the Massachusetts Tuberculosis League during 

 its early history was conducted through the cooperation of the 

 Boston Association, the League having no independent paid staff 

 or offices of its own. Since 1918 the League has assumed full 

 responsibility for state-wide activities, and has organized a large 

 portion of the state on the county and district unit plan, and 

 has increased its local Seal Sale Committee from 91 to 350. 



At the present time there are in Massachusetts 4 state sana- 

 toria, 6 county hospitals, 40 municipal and private institutions 

 with a combined bed capacity of 4,356, which will be increased 

 to approximately 5,000 when the county hospital program is 

 completed. The county hospital law is mandatory and must be 

 complied with not later than 1925. There are 56 tuberculosis 

 dispensaries, I preventorium, 35 open-air schools registering 

 3,120 pupils, and about 800 public health nurses. 



The passage of legislation making it mandatory for communi- 

 ties with a population of 10,000 or over to establish tuberculosis 

 dispensaries, the provision of 4 state hospitals, the establish- 

 ment of the Framingham Demonstration, and the reorganiza- 

 tion of the State Department of Health are among the high 

 lights of achievement to which the campaign against tuberculosis 

 in Massachusetts has contributed very largely. 



The mortality from tuberculosis in Massachusetts has been 

 declining in recent years. In 1905 the death-rate was 192.7; 

 in 1910 it was 162.7; in 1915 it was 141.6, and in 1920 it was 

 113.8. 



The headquarters of the Massachusetts Tuberculosis League 

 are located at 80 Boylston Street, Boston, Massachusetts, and 

 the executive secretary is Mr. R. V. Spencer. 



MICHIGAN TUBERCULOSIS ASSOCIATION 



In February, 1908, the Michigan Association for the Prevention 

 and Relief of Tuberculosis was formed, a group of physicians 

 headed by Dr. Victor C. Vaughan, Jr. and Dr. A. S. Wharton of 

 the University of Michigan Medical School being the leaders in 

 the formation of the new organization. 



As early as 1905 the Grand Rapids Tuberculosis Society had 



