of the director of the dispensary and hospital. This would pre- 

 vent over lapping, expense, and lack of care for those who most 

 need attention. Since the county and city will probably event- 

 ually be one, it does not seem impossible for them to unite in this 

 public service. The county, for instance, might furnish the med- 

 ical attention and supplies, and the city pay the nurses. If pub- 

 lic funds are not available immediately for this purpose, some 

 private organization should pay for nurses, until public funds 

 are available. At -present the dispensary gives an average daily 

 service to nearly twenty persons, a good record for the length of 

 time it has been established. Clinics for different kinds of treat- 

 ment are given by physicians at different hours during the day. 

 Many minor operations are performed on Saturdays for school 

 children. A very great service is thus rendered to the city. It 

 would seem practicable for the city and county to unite at this 

 time in appointing a commission to plan a unification of the 

 whole public hospital and dispensary system. Such a consolida- 

 tion of interests has been effected in Cleveland. 



Tuberculosis 



In addition to the measures already mentioned against the 

 spread of tuberculosis, there is in San Diego a society for the 

 study and prevention of tuberculosis, which in spite of tremend- 

 ous odds has offered help to persons afflicted with the disease. 

 It deserves greater support and interest from the public^ 

 At present it maintains a small camp situated on the edge of 

 the city. This camp, if properly supported financially could help 

 much in relieving the County Hospital of real incipient cases, and 

 in providing for convalescents by giving them the benefit of out- 

 door living when they are able to do much for themselves, but 

 need some attention. Some dispensary service is rendered also, 

 which, again, if properly supported, might be developed to a 

 greater degree of usefulness. Either this should be done or such 

 service should be transferred to the County Dispensary. The 

 latter seems the better course. Such work, if successful, should 

 be built up about the personality of certain doctors and nurses. 

 Greater co-operation between this Society and the director of the 

 County Hospital is urged for the mutual benefit of both. The 

 work of this Society and that offered at the County Hospital are 

 the only provisions made for tubercular persons within the reach 

 of the working man and his family, or the small salaried person. 



Infant Mortality 



There is no infant hygiene work in San Diego at present, and 

 this in face of the fact that last year eighty-five babies died be- 

 fore they were a year old, or a total of one hundred and thirty- 

 five under five years of age. This is perhaps not large compared 

 with the infant death rate in eastern industrial cities, but it is far 

 too large for a city whose natural advantages and size should 

 make ideal conditions for babies. It was impossible from the fig- 

 ures available to find what proportion of these deaths were from 



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