having an effect in raising the vitality of the people of the State and bettering public health generally.

The formation of the State Society for the Prevention of Consumption, October 13th in Indianapolis, it is expected, will have the result of organizing all of the converts to the fresh-air theory of treatment in this State and bringing about a general publicity of beneficial results that have been brought about by this method of treatment.

Many of those who have taken the fresh

refuses the use of her name. When she was accepted at the institution the disease had made considerable progress. She was discharged fifteen months ago seemingly in good health and is at her home just outside of the city at this time living the fresh air life. The Trudeau institution, however, does not make record of a cure until two years have passed.

"While Indiana is discussing this subject," she said, "and the possibilities of a sanatorium in this State such as Dr. Trudeau has erected at Saranac lake, and as

the States of New York, Massachusetts and Rhode Island have opened, it might be interesting for the people to know something about such an institution as seen through the eyes of a patient. In the first place, the Trudeau institution is a philanthropic institution, not a money-making enterprise, and its founder has given his life and his money to the people of this country. To us the institution is in reality a school. Those who enter it have learned this lesson: 'You cannot cheat nature.' While there they learn how to give nature a chance.'

"The regular term is six months, but if one proves too wilful, or if his previous lessons were too sadly learned, he is dismissed sooner. Hopeful pupils are often permitted longer terms. In the first month or two a most earnest and obedient pupil may perhaps learn enough to do a long sum in addition-may learn how to add scores of years to a life. Money cannot always buy this most valuable education that so many need. Only those of limited means receive the opportunity. The fee charged the pupils does not even cover the table expenses. Friends of humanitythe practical kind-provide for the most of the expenses.

"Patients are received from far and near-natives of China, Armenia, France, Spain and England. Many patients are of the highest intelligence and from the best class of society. The poet and novelist Stevenson spent a winter here. Ther Ther they learn the gospel of fresh air and lots of it. The mountain scenery, with the changing charms of the seasons, is a neverceasing source of delight.

"The sanatorium is a group of about twenty-four buildings, including eighteen dainty, well-furnished and well-kept cottages for the patients. Most of the cottages contain four bedrooms (one for each patient), a sitting-room, bathroom and a large porch partially protected by g'a s. Only those patients are accepted who are in the incipient stage of the disease, or whose conditions are such as would, in the opinion of the examining physicians, be sufficiently benefited by the treatment given there. If a patient becomes so sick as to be confined to his bed continuously he is removed to the infirmary, where there

are ample accommodations for twenty, and the charges there are doubled.

"All porches are supplied with reclining chairs or cots, and woe to the patient who makes a sitting-room of any room indoors, between breakfast and supper time. Not even may one go in to read or write a letter, and certainly never because of cold weather, without fear of a reprimand from one of the physicians in charge, and their eyes are wonderfully vigilant. Very little medicine is given for tuberculosis, though almost every morning or evening opportunity is given any patient to consult the physician for any ailment.

"As to diet, rare beef, eggs and milk are recommended as particularly helpful in enabling nature successfully to fight the tubercular bacilli. Milk is delivered daily at the cottages for all who wish it at other than meal times. than meal times. Many patients, at their own expense, have hucksters deliver to them fresh eggs, which they take raw, the most beneficial way. Individual regulations and attention are given the patients as to the amount of exercise allowed. Fatigue is much guarded against, especially in cases of fever or hemorrhage. Daily cold sponge baths are required. While no one is required to sleep out of doors, many of the patients prefer to, myself among them. I have continued the habit since returning to my country home near Indianapolis, fifteen months ago, even in the sixteen degree below zero weather of last winter, and it has seemed both benefic al and pleasant. In winter patients generally wear long fur cloaks.

"Very strict care is taken that there shall be no expectorating whatever, except into the paper sputum cups, which are provided free. These, after being carefully wrapped, are collected daily and burned in the crematory, for that purpose, to prevent infection. I should feel much safer from infection among those patients than among the people in most libraries, railroad stations or churches.

"Even after the patient is passed on favorably, he must often wait weeks before entering, as there are always many more applicants than can be accommodated. One hundred is about the number that can be provided for.

"The grounds and buildings are lighted

by electricity and the drainage and sewerage system is excellent. The general work of cleaning and arranging the cottages is done by maids who visit the cottages daily for the purpose. The patients have no work other than to keep them in order. The cottages have hardwood floors, and after each room is vacated, it is cleaned thoroughly with an antiseptic solution before another patient is given the room. There are good arrangements for ventilation.

"A large open-air pavilion is well equipped with provision for entertainment with croquinole, chess, billiards, pool and many other games. A library build.ng with open shelves,' is well stocked with attractive books and magazines, which may be taken to the cottages and kept for two weeks. In a beautiful boulder chapel ministers of various denominations hold services. Gala days are duly observed; Christmas with trees, and each one's stockings well filled with candy and toys; the Fourth of July with flags and hatchets; Easter with flowers.

"First-class concerts have been the gifts of Miss Rockefeller and others. There are always patients of some talent who often entertain informally of evenings in the large general parlor, and the patients sometimes give little plays. It is said that It is said that 'Home, Sweet Home,' is forbidden on any musical occasion. I never once heard it there. Cheerfuness is regarded an essential to a speedy recovery. Any depressing topic of thought or conversation is discouraged.

"Many patients leave the sanatorium in excellent health and remain so. These figures from the annual report of 1903 speak for themselves: Fifteen hundred cases treated during fifteen years. The resident physician, Dr. Lawrason Brown, has succeeded in tracing 1,066 of these. Of those traced 46.7 per cent. are still living, 31 per cent. of them well and 6.5 per cent. with the disease at least arrested. During the year previous to November 1, 1903, 298 persons were treated. Of these 160 had left after a stay of three to seventeen months; 75 per cent. of them either apparently cured or with the disease arrested. None of these 160 had died.

"Dr. Trudeau has always been the piesident of the board of directors, among the

members of which are Whitelaw Reid, Edward H. Harriman, Anson Phelps Stokes

and W. Seward Webb.

"In connection with the sanatorium is a laboratory for original research work on the subject of tuberculosis."

Dr. Knopf, of New York on Tuberculosis; Anti-Tuberculosis Society of Indiana Formed.

An assembly that filled every part of the assembly-room at the Claypool Hotel heard Dr. S. A. Knopf, of New York, the noted consumption expert, taik on "Tuberculosis, and Its Prevention," at 8 P. M.

October 13th.

After being introduced by J. J. Price, president of the Indiana Association of Life Underwriters, and Dr. W. H. Wishard, president of the Indianapolis Medical Society, Dr. Knopf acnowledged the reception given him by the audience, but declined to proceed with any lecture on tuberculosis unless the windows were opened and pure air admitted. He emphasized the importance of precautions regarding consumption by stating that one patient could expectorate seven billions of tuberculosis bacilli in one day. He stated that there were three methods of getting consumption-by inhaling the bacilli when the person is not in good health; by ingestion, or taking the bacilli into the stomach through infected milk or food; by inoculation, by which the bacilli are introduced through a scratch or wound through the skin.

Dr. Knopf declared that no consumptive or any one else had the right to spit on sidewalks or in public places, and victims of consumption should be provided with pocket cuspidors or else old handkerchiefs, which they could use and then burn. To prevent tuberculosis through the use of infected milk from a tubercular cow, the doctor advised the sterilization of the milk.

Dr. Knopf spoke strongly regarding coughing. He warned patients against swallowing sputum, which might cause the consumption to affect other organs of the body, and warned them against coughing at all. The speaker said coughing was simply scratching a tickling throat,

for tuberculosis in Indiana, and said that patients could be treated more successfully in their native atmosphere than in a strange one, if there were proper facilities.

"Insist on pure air, twenty-four hours in the day. Sleep with open windows at night, for the night air is purer and better than during the day. Bad air in a church is as foul as any place else. He declared that the pulpit, the school and the press could be the greatest factors in combatting tuberculosis successfully, by spreading the knowledge of its successful

treatment.

Surprise was caused by the speaker's remarks regarding child labor in Indiana, a fruitful source of tuberculosis in children. Dr. Knopf said that Indiana was far behind Illinois, Ohio and Michigan regarding this, and he read a letter from Florence Kelly, of New York. She stated that in the three adjoining States children were not permitted to work after 6 or 8 o'clock at night, but that in Indiana they were allowed to work for ten hours. writer said many children were so employed in the Indiana glass factories, and she had been unable to induce Factory Inspector McAbee to prevent this. Unless children were protected in their work, Miss Kelly declared, consumption was certain greatly to increase in Indiana.

The

Dr. Knopf closed his address with an eloquent plea for better sanitary conditions in cities and especially in the poorer quarters, and for the erection of a public institution for the treatment of tuberculosis. "Hundreds of poor victims of consumption are dying to-day in Indianapolis from consumption for want of pure air and sunshine, and suitable nourishing food.

Let the statesmen of Indiana hear the cry of the suffering and authorize the appropriation of money for a consumption hospital." With such an institution, the death rate from tuberculosis in the State would be reduced 50 per cent. within two or three years.

At the conclusion of the address the "Anti-Tuberculosis Society of Indiana" was organized, with Dr. Theodore Potter as secretary and treasurer and the following trustees: Albert Metzger, John C. Dean, Noman Peck, Dr. J. N. Hurty, of Indianapolis; George Shirts, Noblesville; Dr. W. J. Fairfield, Anderson; Dr. George

McCoy, Columbus; Dr. Hugh Cowing, Muncie, and Dr. G. W. Bence, of Greencastle. A meeting of the trustees will be held soon, when a president will be selected. and an active campaign started to combat the ravages of tuberculosis. Dr. Potter, the secretary, is the chairman of the special committee on tuberculosis appointed by the Indiana Medical Association.

The above report is from the Indianapolis News of October 14th, as is also the portrait of Dr. Knopf. The News is a powerful ally of prophylactic medicine. The article on the Adirondack Sanatorium is also from the News. It is written by a well-known lady of the city, who is doing much to advocate the arrest of tuberculosis by hygienic and sanitary methods. Her work is quite as valuable, coming from the laity, as the work of the medical specialist.

MISCELLANY.

Disease and Death in Indiana in September.

The regular monthly bulletin of the State Board of Health for September says: "Sickness in the State this September was less than in the same month last year and was also less than in the preceding month. Diarrhoeal diseases were most prevalent and then in regular order follow typhoid fever, rheumatism, tonsilitis, bronchitis, scarlet fever, erysipelas, malarial fever, pneumonia, diphtheria, influenza, whooping cough, measles, puerperal fever, cerebro-spinal meningitis. As predicted in the August Bulletin an increase in pneumonia appears as compared with the preceding month. Typhoid fever was reported present in all but thirteen of the 92 counties. There were 137 deaths and 702 cases of the disease reported. The number of deaths is accurate. The number of cases is probably twice as great as here given.

The total number of deaths was 2,658, annual rate per 1,000 is 12.2. In the corresponding month last year the deaths numbered 2,766, rate 13.4. There were 287 consumptive deaths, 20 fewer than in the corresponding month last year. Diphtheria deaths 12 as compared with 35 in the same month last year. The deaths by