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Journal of the

OUTDOOR LIFE

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POPULARIZING THE DOUBLE RED CROSS

IN ITALY

BY J. DEAN HALLIDAY, PUBLICITY SECRETARY,
NATIONAL TUBERCULOSIS ASSOCIATION

To make the meaning of the double-barred tuberculosis cross known to nearly forty million people is a task of no small magnitude, as years of anti-tuberculosis work in America have proved. But to make its meaning clear to a people, largely composed of the peasant class, a people just emerging from a desperate participation in the world war is a problem even more bewildering in magnitude and one bristling with difficulties.

That, however, was the task which confronted the American Red Cross Tuberculosis Unit to Italy when, in October, 1918, it undertook the launching of an educational program for the prevention of tuberculosis in the latter country in cooperation with Italian authorities.

The Commission headed by Dr. William Charles White, of Pittsburgh and Dr. R. H. Bishop, Jr., of Cleveland, was not the first to introduce the tuberculosis cross to Italy. It had been used for some years by several Italian organizations interested, in some degree, in anti-tuberculosis work and to some extent by the Italian Red Cross. As a symbol, however, it was known only to the comparatively small group of workers actively engaged in caring for and attempting to cure those actually suffering from the disease. It did not shine before the masses as a sign of prevention. In other words it had not been popularized. This the American Unit undertook to do.

Entering Italy during what proved to be the last few weeks of the war and at a time when the general commission of the American Red Cross in Italy was already beginning to curtail its work, the Tuberculosis Unit had to undertake to set in motion within a few months' time a popular public health campaign which, it is hoped, will develop into a permanent national movement.

In the weeks immediately preceding and following the armistice, field workers were

* Mr. Halliday served as director of Publicity with the American Red Cross Tuberculosis Unit in Italy. -THE EDITOR.

busy surveying and outlining plans to be put into execution by provincial committees organized for the purpose. These committees were composed entirely of Italian personnel but were assisted by the staff of the Tuberculosis Unit. First application of the final working plan was undertaken simultaneously in the province of Liguria, with headquarters in Genoa; in Umbria, with headquarters in Perugia; Sardegna, with headquarters in Sassari, and in Sicily with headquarters in Palermo. To acquaint the people with the undertaking and to arouse them to united cooperation an intensive educational program was launched. Posters, pamphlets, folders and newspaper publicity were used to supplement the efforts of lecturers and the use of American motion pictures dealing with health subjects. These last were exhibited by means of portable projection machines operated on the roofs of motor-truck dispensaries, ten of which completely equipped, had been taken to Italy by the Unit. Almost a million pieces of printed matter were prepared.

To herald the Italian committees operating under the guidance of the American health experts an official or symbolical poster was first prepared from a painting by Professor Emilio Lazzaro, a Roman artist of note. This poster, printed on opposite page, was lithographed in eight colors. The figure used is a reproduction of the bronze statue of the archangel Michael which crowns the Castle of St. Angelo in Rome. A legend concerning this angel figure is as follows:

"In the year 590, while a votive procession for the staying of a great plague then sweeping Italy was being led by Pope Gregory the Great, across the Aelian bridge which spans the Tiber in front of the Castle, the archangel Michael was seen hovering on the summit of Hadrian's tomb. The angel was in the act of returning his sword to the scabbarda sign that the heavenly wrath was appeased. Soon after this the plague miraculously ceased."

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CON QUESTE ARMI VINCIAMO LA TUBERCOLOSI

WITH THESE WEAPONS WE CONQUER!

An educational poster, in four colors, appealing to the Italian people's appreciation of the dramatic. Designed and distributed by the American Red Cross Tuberculosis Unit in Italy.

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MORE DANGEROUS THAN ENEMY AEROPLANES!

An anti-fly poster, in two colors, which takes advantage of war terrors to drive home the truth about the disease-bearing fly. Designed and distributed by the

American Red Cross Tuberculosis Unit in Italy.

This legend is known the length and breadth of Italy. Even to those who cannot read, the angel figure stands for the stopping of the plague. For these reasons, as well as for its artistic merit, the figure was chosen to represent and interpret the meaning of the tuberculosis cross as used in the program for the control of Italy's modern day plaguetuberculosis. On the poster the figure is silhouetted against a brilliant, yellow sky with swirling clouds, which gives a wonderfully effective feeling of sunshine and fresh air. Across the top of the poster is the declaration, "In Hygiene is Victory." The line across the bottom calls for "War on Tuberculosis." On the first printing two hundred thousand copies of this poster, in various sizes, were struck off for distribution. The Italian government cooperated in this distribution through its Bureau of Internal Propaganda.

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The Italian people as race relish the dramatic and this trend of mind was catered to in the educational poster, reproduced on page 162, a lithograph in four colors. In it tuberculosis is represented by a figure of death, broken sword in hand. It has been beaten back by the combined onslaught of swords representing "Fresh Air," "Sunlight,” "Rest," "Temperance," "Good Food," "Cleanliness," "Perseverance," and "Hygiene." Across the bottom one reads the declaration, "With These Weapons We Conquer Tuberculosis."

The picture dramatizes the fight against the disease and with the aid of a very few words conveys all the fundamental principles of prevention.

The anti-fly poster, reproduced on page 163, was designed to take advantage of the impressions left by the terrors of war. In it the fly is represented as an aeroplane driven by death. From it drop germ-filled bombs which upon bursting, scatter disease among the people.

Other types of posters also were used to emphasize the pleasanter side of health. One reproduced in ten colors shows a mother and her children silhouetted against an open window through which one glimpses a bit of picturesque Italian landscape flooded in brilliant sunshine. This bears the proverb, (popular in Italy although rarely put into practice), which reads, "where sunshine and fresh air enter the doctor does not."

In so far as the program of the American Red Cross Tuberculosis Unit to Italy has progressed to date the types of posters used seem to be accomplishing their purpose. Posted in the public square of small towns as well as on the walls of cities as busy as Genoa, they caught the eye and held the attention of a people who have shunned the disease for ages more from superstitious fear than from any knowledge of the scientific facts concerning it.

THE TALE OF LANKY JOE*

Here's the tale of Lanky Joe, who, a month

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He would very often choose to get filled right up with booze

And he made the doctors wish he'd never come,

He would stay out half the night, and, get mixed up in a fight,

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And that sort of thing puts lungers on the bum.

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ESSAYS OF TUBERCULOSIS

XVII. SOME PHASES OF RESISTANCE.

PART I: THE

BIOLOGICAL BASES OF PROTECTIVE REACTIONS

BY ALLEN K. KRAUSE, M.D.

EDITORIAL NOTE

At the close of the May essay, Dr. Krause announced his intention of making Koch's observations on tuberculous reinfection of the guinea pig the theme of the present essay. Upon further reflection it has seemed best to him to lead up to this discussion by a presentation of some fundamental data that pertain to our concept of resistance,—data which apply directly to an interpretation of the "Koch phenomenon" and which may contribute to a better appreciation of its significance. This phase of the subject will be developed through the next two or three essays of the series.

From a physical point of view the animal body is a mechanism of extreme complexity yet exquisitely adjusted for the performance of certain functions. Several-one or twoof these functions are elementary and fundamental: indeed, it has been patly said that in the scheme of nature the basic and primal business of an animal is "to get and beget." Like all other things in the universe animals also have their place. Exactly what may be the place or the purpose of man or any other animal species we must leave to the philosophers to dispute. But over and above all controversy one fact stands out. This is, that whatever may be our ideas of first causes, whatever may be the interpretation that anyone of us puts upon the riddle of creation, the cycle of life is uninterruptedly maintained in the animal kingdom by and through the act of the individual yet by and through no design on the part of the individual. Thoroughly conscious of a relatively few exceptions to this rule, all of which occur among the human species, we would nevertheless lay it down as a general proposition.

When it comes to breaking the threads of the continuity and perpetuity of their own species volitionally, man in general and every animal are helpless. In the plan of the universe the individual may "bulk" large or he may shrink to insignificance. Again we shall leave the matter of his relative size to the theologians and philosophers. Yet no matter what dimensions they shall finally hit upon as fitting the individual, we can at once proceed and safely affirm that these measurements must be vastly smaller than those that bound the individual's species. This reflection must surely be platitudinous, yet it allows us a peep into the universal plan. It teaches anew

what has so often been said, namely, that Nature is comparatively "careless of the individual." To the point of every expense to the latter it lays insistence on a perpetuation of life-a burden that at his inception the individual was mercifully spared in the sense of exhibiting immortality in his own person; and it does this by endowing the animal with the power of reproduction. To make certain that this capacity will be exercised nature makes it instinctive in the individual. Moreas we proceed higher in the animal scale we find that it has become appetitive until at the apex, in man, it makes up a remarkably large part of emotional or passional life. As we go into the matter further and further, as we proceed upwards from the amoeba and paramoecium to man, we are continually struck by the fact that checks and balances to the fulfilment of reproduction are continually being met by an intensification of the springs of action.

To reproduce, therefore, to beget, must surely be an animal's primal, basic and highest function. But between the birth of an animal and the time that it is capable of transmitting the spark of life there is in mostcases a longer or shorter interval. During this period it cannot support its existence on materials that were stored up in its tissues at its birth. It maintains the integrity of its tissues and provides for their growth and orderly development only by the ingestion of proper foodstuffs. This necessity at once demands that the individual's first duty is to acquire to itself everything that may be requisite to its physical upkeep. Thus comes into being the fundamental function of "getting." To get becomes as imperious and as much beyond the individual's volition as to

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