The Health bulletin [serial] - University of North Carolina at Chapel Hill

1PUBLI5AED 6YTAE N^RTA CAROLINA STATE B°A R D >/ AEALTAVol. 66 JULY, 1951 No. 7J. W. R. NORTON, M.D., M.P.H., State Health Officer JOHN H. HAMILTON, M.D., EditorINTO THE HILLS(Case Finding Services of the Official Agency)Robert F. Young, M.D., M.P.H., F.A.P.H.A.Halifax County Health DepartmentHalifax, North CarolinaCould it be that there is a need for achange in the attack against the ageold enemy, tuberculosis, from that of asweeping, motorized maneuver on the"vast plains" where tuberculosis at onetime rode rampant to that of a gorillatype of warfare fought In The Hills,where this clever enemy possibly hasretreated and where he must be foughtand literally dug out from every rockycrevice. If so, then this gorilla warfarewould require a new plan, new maneuversand new techniques along with amore dogged patience and perseverancethan has ever been demanded in thepast.Could it be that the once proud andhaughty "Captain of the Men of Death"has now degenerated into an outlaw.Could it be that the Giant who onceslew our stars of literatvire such asThoreau, Brown, Keats and many otherfamous men of history, is now contentto "bump off" his victims in the lowerincome brackets by sniper fixe, underthe cover of ignorance and from behindthe rocky crags of superstition andthereby to reduce himself to a cormnonrenegade who seeks refuge by retreatingInto The Hills.There was a time when there seemedto be no defense against this relentlessenemy, tuberculosis, imtil from out ofthe Harz Mountains of Germany, Godgave us Koch, and through him, revealedto us this redheaded killer, thetubercle bacillus, for the first time inhistory; until Roentgen gave us thex-ray and demonstrated to us directlythe deadly work of this bacillus in thelung tissue; until Trudeau gave us theLittle Red Cottage at Saranac andtaught the value of rest; and until themany other weapons against this marauderof the microscopic world hadbeen provided through the years withthe adding of the modern Sanatoria, thepresent surgical techniques and judgment,and now the armamentarium ofthe modern miracle drugs.It seems to the writer that the OfficialAgency in Halifax County has battledtuberculosis on the vast plains and nowInto The Hills through four rather distinctphases of case finding procedures:(1) Tuberculin testing or relatively smallgroups of the population followed byx-raying of the positive reactors; (2)The opening broad attack in 1946 whenthe first mass x-ray survey (the fourthin the state) was made available to us;(3) An epidemiological type of x-raysurvey of a selected group of the populationin a selected area of the county;(4) The recent mass x-ray survey ofJanuary, February and March, 1951, our