As you

Being a reader of your Journal, "The Outdoor Life," I am greatly interested in the comments of other readers, especially in the inmates of a sanatorium and I generally read their letters and find great pleasure in doing so. say that any suggestion made would be welcome, I would venture to suggest that you, having readers in almost every san in this country should organize a correspondence exchange, which I am sure would be a great pleasure and benefit to many isolated ones who may have to spend some years taking the cure, and I am sure a letter of encouragement and hope from a fellow sufferer would greatly cheer and help him on his fight for health. Experience in a sanatorium myself has taught me what a letter of cheer and hope means to any one there, and how it helps to break the monotony of each day, and I have seen so many who have vainly looked for a letter for week after week, so I think if you could see your way, to do this I am sure you, as well as all concerned, would derive great benefit from it. I would suggest that it should be merely for the inmates of a sanatorium taking the cure at the present time.

Wishing you all success I remain yours truly, A READER.

NOTE: The Editor will gladly further such a suggestion as this if somebody will start the ball a-rolling.

Burlesquing the Cure

TO THE EDITOR:

Herewith I enclose 3 amusing photographs, one where "Pneumothorax" is being administered, another where the "Tuberculin" treatment is being given and the other one where an "examination" is being given.

These are all patients at the Muskoko Free Hospital Sanatorium and were taken in No. 3

for 120 were given to me to be printed for the various patients in residence here. The Pneumothorax machine in the picture consists of the Fire Extinguisher and an alarm clock on top, and the percussion hammer in the examination

I. Is a mouth temperature of 98 4-5 to 99 I-5 indicative of active process in the lung? Temperatures not present except at night.

2. Do you think benefit would be derived from a stay at a sanatorium if the patient was nervous and discontented the greater part of the time?

3. How soon after the temperature is normal may the patient take any form of exercise? What would you advise in case the doctor left this to the patient's judgment?

4. How often should a patient see a doctor for lung examination? M. E. C.

1. A regular mouth temperature over 99 in the afternoon, if other causes than tuberculosis are excluded, shows a little absorption from the point of disease, although the disease may not be acutely active.

2. Too many factors are involved for us to give advice in this matter. It is common experience, however, that the discontented patients can school themselves to the régime, and in that way get the benefits of a sanatorium. Sometimes, however, a change seems necessary. 3. We do not believe that it is wise to leave this important matter to the patient's judgment, nor are we willing to give advice.

4. It depends entirely upon the character of the case and the conditions under which he is living.

TO THE EDITOR:

With all physical and constitutional symptoms absent for the past two years, a streak of blood

has appeared in the expectoration twice within the past two months.

If we assume that the blood comes from a brittle blood vessel near the healed lesion, could this case still be classed as an apparent cure? EX-PATIENT.

You should consult a physician to determine the exact cause of such bleeding. Cases with such bleeding, if it comes from the old lesion, would not be kept in the class of apparent cures.

TO THE EDITOR:

Can you give your readers any information on the iodine treatment which has proved so successful in either the army or navy tubercular sanitarium? I may be mistaken as to the name of the drug used with such marked success at one of these institutions.

I read a news article on the matter some time ago, but have lost the clipping. A. F.

Iodine in various forms and preparations has been suggested often for the treatment of tuberculosis. The subject has recently been reopened, but there is no definite proof available that it has any real value.

TO THE EDITOR:

1. Are any cases of T. B. kidneys cured? 2. If so, about how long does it take? 3. Should medicines give relief or just outdoor treatment? E. R.

1. Yes, but frequently operation is necessary. 2. This varies greatly, but it takes a long time.

3. No drugs are known to be of any value. General outdoor and rest treatment is the most important, but the possibility of surgical treatment should always be carefully considered.

TO THE EDITOR:

I believe it is a scientific fact that postmortems on people dying from any and every cause show conclusively that 90% of people have been affected with the tubercle bacillus. Does this mean that 90% of people react positively to tuberculin? Please indicate wherein lies the limitation of tuberculin as a conservative diagnostic agent. SUBSCRIBER.

It has been pretty definitely proved that somewhere around 90% of adults show evidences of having been infected with tuberculosis, and also that about the same percentage of adults react to tuberculin, and, therefore, it is now generally accepted that a positive tuberculin reaction is

of significance only in children and particularly young children. Most authorities place very little reliance upon it above the age of five. A negative reaction is, of course, significant.

TO THE EDITOR:

1. Why is the temperature taken at 3 P.M. in most sanitariums? Is this standard?

2. What significance, if any, has a late rise in temperature? Say between 5 and 6 P.M.? 3. What effect, if any, does heat have on temperature? A SUBSCRIBER.

1. Probably for convenience. As a rule if fever exists, the higher temperature comes a little later in the day, but they vary greatly in different individuals, coming usually between 4 and 8 P.M.

2. The rise between 5 and 6 is not at all unusual. It has the same significance as a rise any other time in the afternoon.

3. In hot weather, particularly on exertion, the body temperature rises. After very active exercise this rise may be 2 or 3 degrees, and if a person is resting it is rarely more than from 1⁄2 to I degree, and the weather must be very hot to produce this.

TO THE EDITOR:

1. Is there any injurious effect possibly produced by the daily use for months of verocolate as a cathartic?

2. If a patient, lying perfectly quiet in bed, hold his thermometer in his closed lips for twenty minutes, might it register a "false" temperature, provided he was not nervous and excited about his temperature?

3. Is it possible for blood ever to come from the lungs or bronchial tubes unless there is a tubercular lesion there? I am told by a nurse slight hemorrhage may come from the lungs during menstrual periods when there is no tuberculosis in the lungs. R. C.

1. It is, of course, undesirable to get dependent upon any cathartic, but vercolate is as harmless as any.

2. All mouth temperatures may be unreliable, particularly if taken out of doors, but when taken for twenty minutes they usually are fairly accurate. If there is any reason to doubt this accuracy, a rectal temperature should be taken to check it up.

3. Yes, but such hemorrhages are due to tuberculosis in at least nine cases out of ten. There is such a thing as bleeding from the lungs or other mucous membranes at the time of menstruation. This is called vicarious menThe struation, but it is comparatively rare. diagnosis can usually be fairly easily made by a competent physician.

TO THE EDITOR:

Kindly give me your opinion whether or not I will ever regain the use of my leg after having it in a splint for a year for a tubercular hip? Could anything be done to tear the adhesions loose and limber up the joint? If so, how long would it take? A READER.

We can give no opinion about cases we have never seen. Every case differs from another, but it is certainly unusual for a tubercular hip to become so stiff that its use is permanently lost.

TO THE EDITOR:

My doctor in reply to my inquiry about a window-bed, for sleeping outdoors the year around, advised me to write to you.

A window-tent is not what I require. I always sleep with my head as near to an open window as I can put my bed. What I want is to have my head actually out of doors. What can you tell me of beds for this use?

M. L. C., Mass.

We would refer you to advertisements of American Furniture Co., The Cabinet Window Tent Company, and The Korff Mfg. Co., appearing in this and October numbers.

TO THE EDITOR:

Can you tell me where to get pattern or design or some instructions for making a canvas hood for protection of head of bed mentioned in a pamphlet by Dr. T. S. Carrington and sent out by the National Association for the Study and Prevention of Tuberculosis? M. A. H., Pa.

In the JOURNAL for November, 1912, you will find a good article by Dr. Cummings on 'Sleeping Out with Comfort" which contains an illustration somewhat along the line you have in mind. The price of this number is 10 cents.

TO THE EDITOR:

I have been a victim of tuberculosis for the past eighteen months. The last six weeks I have been taking Microbe Killer and it has improved my condition considerably. I therefore would like to ask you what the ingredients are or if it will result in a cure. J. W., Wisc.

We are inclined to believe that the benefit you speak of is imaginary or temporary. We do not know anything of this "cure," but we do know that anything that will kill the germs inside of your body will kill you first.

Tuberculosis Week December 3rd to 10th

Tuberculosis Week from December 3rd to 10th will be more widely observed this year than in any previous year, according to preliminary information reaching the National Association.

It is strongly urged that those who have not already made plans for the observance of this week do so at once.

The success of the three feature days of the week last year has warranted similar plans for this year. Wednesday, December 6th, will be National Medical Examination Day. Children's Health Crusade Day will be observed on December 8th. Two dates, December 3rd and 10th, have been designated for Tuberculosis Sunday in order that churches may choose the one which will best fit in with their program of services. For those worshipping on Saturday, December 2nd or 9th, has been set aside. The fact that Tuberculosis Sunday is an undenominational and non-sectarian movement is emphasized in order that all possible religious groups may be reached.

The literature furnished by the National Association, especially for the week, includes the following:

A one-page circular describing the movement, which will be useful for general distribution; a four-page folder, "Some Talking Points About Tuberculosis," which will prove valuable to those who expect to lecture about tuberculosis; the Tuberculosis Day Prayer by Dr. Walter Rauschenbush; a talk for school-children for use on Children's Health Crusade Day; a pamphlet on "Periodic Medical Examination' " which gives reasons why every one, sick or well, ought to be examined at least annually; a sermon on "Indifference to Tuberculosis," written for those who do not wish to prepare their own talk. Single copies of any of the above literature will be sent free of charge upon request to the National Association.

Two New State Associations Formed

The Vermont Association for the Prevention of Tuberculosis was formally organized at a public meeting in Rutland on August 4th. The officers elected are: President, Thomas Magner, Burlington; Honorary Vice-Presidents: Hon. C. W. Gates, Franklin; F. C. Partridge, Proctor; Vice-Presidents: Dr. H. D. Holton, Brattleboro; Mrs. R. E. Smith, White River Junction; Rev. A. H. Bradford, Rutland; Secretary, H. W. Slocum, Burlington; Treasurer, A. W. Hill, Burlington; Assistant Secretary-Treasurer, Dr. Grace W. Sherwood, St. Albans.

The organization of the New Hampshire Association for the Prevention of Tuberculosis was completed on September 12th at a meeting in the Y. M. C. A. at Manchester. The officers elected are: President, J. Brodie Smith, Manchester; Honorary Vice-Presidents: Henry W. Keyes, Haverhill; Bishop E. M. Parker, Concord;

Mrs. L. M. French, Manchester; Vice-Presidents: Col. George B. Leighton, Monadnock; Mrs. James W. Remick, Concord; Dr. Herbert L. Smith, Nashua; Secretary, Dr. Thomas Chalmers, Manchester; Treasurer, A. H. Hale, Manchester; Assistant Secretary-Treasurer, Mrs. A. H. Harriman, Laconia.

Charles M. DeForest, field secretary of the National Association, assisted in the organization of both societies.

Tennessee Association Reorganized

Under the direction of Frederick D. Hopkins, Field Secretary of the National Association for the Study and Prevention of Tuberculosis, The Tennessee Anti-Tuberculosis Association was formally reorganized at a meeting in Nashville on September 21st. A new constitution and bylaws was adopted and the following officers were elected: President, Bolton Smith, Memphis; Vice-President, Henry Teitlebaum, Nashville; Secretary, Mrs. Claude D. Sullivan, Nashville; Treasurer, John Stagmaier, Chattanooga. In addition to the President and Secretary ex officio the members of the executive committee are: Dr. Max Goltman, Memphis; Mrs. K. P. Jones, Maryville; William R. Pouder, Johnson City; J. H. Allison, Nashville, and Dr. W. N. Lackey, Gallatin. James P. Kranz, formerly secretary of the Memphis Associated Charities, was elected executive secretary. Mr. Kranz has had several years' experience in social and public-health work, and has been in charge of the anti-tuberculosis work carried on in Memphis.

"The Great Truth"

A new two-reel motion picture to be known as "The Great Truth" is being produced for the National Association for the Study and Prevention of Tuberculosis by the Plimpton Epic Pictures, Inc. It will be released for use on November 15th.

The scenario for this picture was written by Mrs. Elsie Williamson Phifer, secretary of the Mississippi Anti-Tuberculosis Campaign Committee. Many of those who have read a synopsis of the story have spoken with great enthusiasm of the dramatic and the educational possibilities of the picture. It promises to be one of the most attractive films on tuberculosis and should prove of great value to the anti-tuberculosis campaign. The National Association will be pleased to furnish further information about the picture upon request.

"Tuberculous" or 66 Tubercular

Distinctions between the words "tubercular,” "tuberculous" and "tuberculosis" when used as adjectives are pointed out by the National Association for the Study and Prevention of Tuberculosis, in a bulletin issued recently.

Of the various words used to designate some phase or other of the tuberculosis movement, says the bulletin, the word "tubercular" is most frequently misapplied. The term "tubercular" may be used correctly only to describe conditions resembling tubercles, but not necessarily caused by the tubercle bacillus, the germ of tuberculosis.

Thus, if one says a certain individual is tubercular, he really indicates that the person has a disease process manifesting itself by tubercles or little lumps, but it is not necessarily tuberculosis. To say that the person has tuberculosis, the adjective "tuberculous" is the correct word. It refers directly to diseased conditions caused by the tubercle bacillus. Thus, when an institution for tuberculosis recently labelled itself as a "tubercular sanatorium," it not only indicated that the sanatorium was sick, but that it was sick with something resembling tuberculosis. The adjective "tubercular" should be used very infrequently.

The word "tuberculosis," the bulletin holds, may be used correctly as an adjective, modifying sanatorium, hospital, nurse, etc. This is in accord with the common usage of such phrases as "typhoid hospital," "smallpox infirmary," etc. "Tuberculosis" may also be used, as it commonly is, as a noun, but the use of "tuberculous" or "tubercular" as nouns without a modifying definite article, "the," is extremely doubtful.

Since the anti-tuberculosis campaign is developing with such great rapidity, The National Association for the Study and Prevention of Tuberculosis is urging all newspapers and other publications, as well as its own affiliated associations, to make proper use of the words "tuberculosis," "tuberculous" and "tubercular."

Health Insurance

Those who desire to familiarize themselves with the subject of health insurance, which is being widely discussed at present, will probably find no better single source of information than the "Brief for Health Insurance" issued by the American Association for Labor Legislation, 131 East 23d St., New York City. This brief was issued in the June number of the American Labor Legislation Review. . The price is one dollar.

In addition to the brief itself, the pamphlet contains a tentative draft of a health-insurance act, a select critical bibliography on the subject, and the following special articles: Is Health Insurance "Paternalism"? by William Hard; Compulsory Health Insurance in Great Britain, by Olga S. Halsey; Tendencies in Health Insurance Legislation, by Margaret A. Hobbs; and Voluntary Health Insurance in New York City, by Anna Kalet.

Under a system of Health Insurance, which would necessarily presuppose regular examinations at periodic intervals of all workers, both the employer and the employee, as well as the state, would be interested to see that tuberculosis was discovered before it had developed too far. The proposed bills provide for participation of the worker, the employer, and the state in the in

surance fund and also provides for the adaptation of the scheme to already existing benefit agencies under state supervision. The health-insurance laws will be compulsory for every worker earning $100 a month or less.

Virginia Hospital Site Abandoned

Announcement has been made by the Virginia State Board of Health that, in deference to the desires of the citizens of Ivor, Southampton county, it has been determined to abandon the proposed purchase of the demonstration farm of the Norfolk and Western railroad, near that place, as a location for the colored sanatorium for the treatment of tuberculous patients. The committee in charge of the selection of a new site has a number of places under consideration.

Boy Scouts at Sanatoriums

An organization of Boy Scouts has been formed at the South Mountain State Sanatorium, Mont Alto, and the Cresson State Sanatorium, two of Pennsylvania's tuberculosis institutions. They have had regular drills under a scout master for some time past.

The Mont Alto Sanatorium is situated in the midst of a State Forestry Reserve, and the Cresson Institution has several hundred acres. of forest land immediately surrounding it. In both places there is splendid opportunity to study woodcraft. This is a suggestion for other sanatoria, although not a new one, for many institutions have Scout troops.

Dust and Tuberculosis

In a recent issue, Popular Mechanics had the following to say regarding the use of water sprays in the prevention of dust from miners' drills:

"The prevalence of pulmonary disease among miners, due to continual breathing of dust in the mines, has resulted in employing various devices which are attached to drills for the purpose of laying the dust caused by drilling in the rock. These devices have been found necessary in addition to fans and ventilators, which cannot carry off the dust before it is breathed by the men. One of these attachments employs compressed air which draws water through a hose from a pail and throws it in a fine spray about the hole where the drill is working. Such a spray is particularly needed when miners are drilling upward and the dust ordinarily sifts down into their faces. Drills of another type are hollow, allowing water to pass through the drill to the far end of the hole. Not only does it lay the dust, but it keeps the end of the drill clean and cool, and makes possible more rapid work. Miners also follow the practice of wetting ore or coal before handling it, to prevent raising a dust."

Two Important Articles

In the Survey for July 22 there were two interesting articles of special value to anti-tuberculosis workers. One article, by Dr. Philip.