TUBERCULOSIS AS AN ECONOMIC AND SOCIOLOGIC FACTOR 195 



become taxpayers and return to the state more than it expended in 

 their care. 



About 50,000 tuberculous workmen pass every year [in Germany] through 

 these sanatoria, of whom, on an average, 75 per cent return "cured"; i.e., able 

 to support their families for a long time to come. This represents an enormous 

 social progress, the ultimate extent of which can hardly as yet be estimated.^ 



There are now twenty-seven states where sanatoria are author- 

 ized by law. In some of the states the county officials have authority 

 to erect and operate sanatoria without submitting the question to 

 the voters; in other states sanatoria can be erected only when a bond 

 issue has been voted for the purpose by the people. The following* 

 have state-supported institutions: Arkansas, Connecticut, Georgia, 

 Indiana, Iowa, Louisiana, Maryland, Massachusetts, Michigan, 

 Minnesota, Missouri, New Hampshire, New Jersey, New York, 

 North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South 

 Dakota, Vermont, Virginia and Wisconsin. In Maine such an 

 institution is maintained by the State Sanatorium Association, a 

 quasi-public corporation, and in Nebraska there is an arrangement 

 by which indigent patients may be cared for at public expense in 

 certain hospitals designated by the State Board of Health. 



In communities where the establishment of sanatoria has not been 

 secured because of objections on the ground of expense, it is probable 

 that money could be obtained for public dispensaries. Indeed, many 

 cities have such institutions and are operating them with great success. 

 The small outlay of funds brings large returns in economic gains to 

 the community.^ 



Appropriations have been made by some of the legislatures for 

 an educational campaign by means of advertising, public lectures, 

 dissemination of pamphlets, and by the maintenance of a tubercu- 

 losis exhibit to be carried from place to place, especially in the larger 

 cities. 



' Professor Gotthold Pannwitz, in a lecture reported in the Transactions of the Sixth International Congress 

 on Tuberculosis, at Washington, D.C. (special volume), p. 59, Philadelphia, 1908. 



' Information on these points was secured by correspondence with every state board of health in the 

 country. 



3 An interesting discussion of this subject is given in Public Health (London, Vol. XXIV, pp. 172-73, 

 1911), in connection with an article by Dr. William Robertson on "A Scheme for the Municipal Control of 

 Pulmonary Tuberculosis." 



