In 1901, tuberculosis was the leading cause of death in Ohio. One in every four Ohioans was affected by tuberculosis.[i]
What is “dirt”? We don’t usually ask ourselves this question. At least I don’t. We wash regularly and we instruct our children to cover their mouths when sneezing, but these aren’t habits we’ve always had. In the 1914 “Proceedings First Ohio Conference of Tuberculosis Workers,” Sarah Halbert, School Nurse of the Cincinnati Anti-Tuberculosis League, described a talk on health and sanitation she gave at a mother’s club. Prior to her presentation, one of the mothers complained that her children refused to eat from dirty dishes after attending Halbert’s school course on hygiene. The busy mother wasn’t thrilled about her children’s new habits. Yet, Halbert claims that this same mother became the leader in cleaning up her block after she attended Halbert’s talk at the mother’s club.
Identifying germs with “dirt” became more widespread in the late 19th century and contributed to preventing disease by encouraging personal hygiene and strengthening the public health movement. We see this in past campaigns against tuberculosis. In 1880, Dr. Robert Koch in Germany discovered the tuberculosis bacillus. Koch’s research showed that tuberculosis, also called ‘consumption’ and the ‘White Plague,’ was not inherited but contracted. This meant it could be prevented. The American Lung Association of Ohio (ALAO), or the Ohio Society for the Prevention of Tuberculosis (as it was first called), took on this cause in Ohio. The Society was initiated by the Director of the Ohio State Board of Health, Dr. Charles Oliver Probst, in 1901. He envisioned a society that would not just help combat tuberculosis, but one that would work toward public health and an improved quality of life.
ALAO disseminated information on tuberculosis in several ways, including advertisements, school programs, and seminars. Their Christmas Seal campaign not only raised money for hospitals and educational programs, it also spread awareness about tuberculosis and other respiratory diseases. The campaign posters encouraged family safety through communal health and prevention. Catch phrases like “Tuberculosis Robs You, Public Health Protects You” and “A Fine Body May Conceal Tuberculosis, But Modern Methods Uncover it Before it Does Harm,” underscore ALAO’s work on both prevention and diagnosis. ALAO wanted to change health and sanitation habits in the home and in the work place. Probst mentioned how dusty work floors should be washed rather than swept, and machinery should be used to prevent workers from breathing in too much dust. ALAO also found ways to encourage sick people to seek treatment and helped provide for tuberculosis hospitals and tuberculosis professionals, such as visiting nurses.
Visiting nurses provided information directly to their patients. Charlotte Ludwig, Supervising Nurse of the Bureau of Tuberculosis, Division of Health in Cleveland, insisted that patient follow-ups should take place in their own home where the public nurse sees “that the instructions given at the dispensary are carried out, and that he [the patient] may be taught the necessity of cleanliness and ventilation.” After the patient saw the benefit of the nurse’s instructions “he repeats the instructions to his neighbor and recommends that he call upon the nurse.”[ii] In this way, the Association also spread information via the patients themselves. They introduced personal health and hygiene habits to patients who, they hoped, would then encourage others to do the same.
Visiting nurses also helped report cases of tuberculosis to health officials. This was significant because the public was generally hesitant to report such cases. Probst himself took note of the opposition to requiring physicians to report tuberculosis cases. Patients were worried that it would restrict their liberty. Probst, however, suggested that it was not necessary to “give public notice of the case.”[iii] While reporting cases gave medical professionals the opportunity to provide information and disinfect the rooms occupied by patients, it was important not to instill fear. The Association did not want the public to feel hopeless or to panic. In 1914, Ludwig described how the common perception of tuberculosis:
“… exaggerated the hopelessness of attaining health, once the disease has manifested itself. Many patients are prone to accept a positive diagnosis only as a death warrant. Friends and neighbors visit the unfortunate to express their sympathy.”[iv]
Schools became a battle front against demystifying tuberculosis and teaching children health and hygiene. Testing and educational programs in schools informed children who then shared the information with their parents. The 1936 Christmas Seal campaign is one example. School children were asked to participate in a Health Day Program that partly involved interviewing different people about their roles in keeping them healthy.
By 1964, 750,000 chest X-rays and 300,000 tuberculin tests were provided to Ohioans annually.[v] Tuberculosis rates also began to drop dramatically. Consequently, fewer tuberculosis hospitals were needed and the ALAO began to look at implementing new programs to deal with non-infectious lung diseases. Today, the ALAO continues to hold awareness campaigns on lung related diseases and conditions.
How does public health affect your everyday life? For more information on the American Lung Association of Ohio Collection visit our manuscript catalog and come see the collection at the Ohio History Center.
Adria Seccareccia, Processing Assistant
[i] “The American Lung Association of Ohio: The Christmas Seal People.” American Lung Association of Ohio, MSS 1556. Box 3, Folder 16. Ohio History Connection, Columbus, Ohio.
[ii] “Proceedings First Ohio Conference of Tuberculosis Workers.” American Lung Association of Ohio, MSS 1556. Box 3, Folder 8. Ohio History Connection, Columbus, Ohio.
[iii] Probst, C. O., Dr. “Association for the Prevention of Tuberculosis.” American Lung Association of Ohio, MSS 1556. Box 3, Folder 20. Ohio History Connection, Columbus, Ohio.
[iv] “Proceedings First Ohio Conference of Tuberculosis Workers.”
[v] “The American Lung Association of Ohio: The Christmas Seal People.”