So much has already been written about tuberculosis that most people are thoroughly bored with the subject, while those who are not, already know so much about it that there seems little more to add, all of which makes the writing of this paper difficult. As conducted in most states, the campaign against tuberculosis is an educational one. The public has been educated during the past five years on an enormous scale, accomplished by means of the press, open lectures, lantern slide exhibitions, expositions, and countless talks of an informal nature given to various clubs and other organizations. All of this has been of the greatest assistance in bringing to the layman a fuller knowledge of the causes and nature of the disease and of the methods necessary for its prevention. In Maryland this campaign has been a particularly active one. This education or molding of public opinion is, however, for the most part, for the benefit of those who have not tuberculosis,-it is the education of the top, although of course some of it filters downward into the lower and poorer strata of society where tuberculosis flourishes by natural right. The education of this lower layer, however, is not left to time and the chance of penetration of information into the places where it is most needed, but is accomplished directly and without loss of effort by means of the special tuberculosis nurses. These nurses bring instruction as to the nature and prevention of the disease directly into the homes where the consumptive himself lives. There are four of these nurses at present in Baltimore, who are to-day visiting in over eleven hundred families where tuberculosis exists. This association (the Maryland State) supported one of them for fifteen months, and I think we may well congratulate ourselves upon the undertaking. This house to house teaching, as done by nurses, may be called education along the bottom, or from the bottom upward. The combination of these two methods of instruction, teaching the upper and the lower levels of society, the well and the sick, must in time have its effect upon the community, though it is of necessity slow.
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