These institutions are of a semi-public character, though they depend, to a great extent, on donations from various sources, the Crown support being private and not State funds.

Germany has found what seems to be one of the best solutions of the problem, judging from the literature on the subject, and from personal information. In the way of sanitoria, it has six of importance and eleven others which plan more or less for the care of phthisis. For the most part these are for pay cases, though some of them have an annex for the free care of the poor. Several have been established for a number of years, and the results are most gratifying. The following plan, which is in operation in Germany, is exceedingly interesting and its workings are said to be most satisfactory:

A Company, similar to an Insurance Company, is under the supervision and protection of the Government. The Government requires every laboring man, entering upon work in humbler paths, to be insured in this Company, against sickness, accident and old age. The employer must see to it that his employees are so insured. This Company, when insured persons require medical treatment, takes charge of them. Cases of phthisis are sent to a sanitorium at the Company's expense and are kept there until they are no longer a danger to the community at large. For this purpose the Insurance Company subsidized some of the sanitoria and later, finding it to their benefit, built resorts of their own. In this indirect way the Government brings aid to its phthisical subjects, protects the well, and secures a large number of cures, thus retaining bread winners in useful occupations.

The cures are said to be many, as the Company for its own protection sends the cases to sanitoria long before the patients would themselves think of going, and even earlier than physicians in private practice would recommend. It is a well established fact that a large number of cases, when taken early, can be cured permanently or for a length of time can enjoy good health.

As to the question of danger to the inhabitants in localities where sanitoria have been established the evidence is as follows: In the case of a sanitorium, where patients are collected and are under the supervision of a physician, carrying out hygienic and

prophylactic measures, there is no danger. In fact, in Germany the statistics indicate that tuberculosis in neighboring villages is actually diminished, as the people, by example and education, learn to care for themselves and protect each other. On the other hand, where phthisical cases are sent to localities for their health, living at large in the towns or districts with no prophylactic precautions, and no medical supervision and guidance, tuberculosis is spread and the natives suffer accordingly. In certain districts of the Austrian Alps where tuberculosis had been unknown, it began to show itself among the natives, we are told, shortly after the place had become a resort for phthisical patients.

The collecting of many tuberculous cases in a colony does not seem to endanger the cases themselves by auto-infection, so to speak, so long as proper hygienic conditions are maintained. If the expectoration is collected and destroyed, and the proper antiseptic precautions used, those in attendance seem to be exposed to no great danger.

Results.

Very interesting statistics have been secured as to the results of the treatment of consumptives in the German institutions.

In the sanitorium at Gaerbersdorf 5,440 patients were admitted during the eleven years-1876 to 1886 inclusive. Concerning 408 cases the records are missing, but the results in the remaining 5,032 have been carefully tabulated and are as follows:

A special inquiry made in 1890 as to the later history of cases discharged as cured showed that of 40 patients discharged in 1876 as cured, or nearly cured, 25 were living and in good health in 1890; 2 had died from phthisis and 13 from unknown causes. Other results were as follows:

At Falkenstein's Sanitorium, of a total of 1,022, 132, or 13 per cent., were discharged as cured, and 110, or 11 per cent., as nearly cured. Of 99 patients discharged as cured, 72 were living and in perfect health from three to nine years afterward. Of the 15 cases of a recurrence of the disease 12 were again restored to health.

At the Reiboldsgrün Sanitorium the following statistics are given as to the results of the treatment of 2,000 patients:

The statistics of these three institutions, covering more than 8,000 cases, show an average of about 13 per cent. of cures, and a still larger percentage of patients nearly cured or materially improved, these cases being often equivalent to complete recovery ultimately. When one remembers that only a short time ago consumption was held to be, under all circumstances, an in curable disease, such sanitoria must be regarded as remarkably successful. It is to be borne in mind that most of the patients were received in the second or third stages of the disease, only 1,390 of the 5,032 patients received at Gaerbersdorf being in the first stage. Of those received in the first stage, 58 per cent. were cured or nearly cured. It is stated that of all patients who remained more than a month in the sanitorium and were discharged 14 years ago or earlier, 8 per cent. were still in good health at the end of the 14 years.

The prices at Gaerbersdorf for first-class patients vary from $12.50 to $20 per week, according to size and location of room, and for second class patients from $8 to about $10 per week. At Falkenstein the prices vary from $20 to $25 per week, and at the other German sanitoria the prices are about the same.

COMMITTEE ON THE INSANE.

Under the provisions of Chap. 635, Laws of 1893, re enacted in the State Charities Law, Chap. 546, Laws of 1896, the annual reports of this Association upon institutions for the care of the insane are submitted to the State Commisson in Lunacy. Those of our readers who may be interested in the development of

the system of State care and maintenance of the insane are therefore referred to our annual reports to the State Commission in Lunacy, 1893-1898.

REPORT OF COMMITTEE ON PAUPER-DELINQUENTS.

The following report of the work of the Committee during the year has been submitted by the Chairman:

The Cumulative Sentences Law, after withstanding the open assaults of misguided but frank opponents, and overcoming the more insidious legislative attacks of political hostiles, and also after having been expressly declared constitutional by a decision of Judge Ingraham, has been practically abrogated by a judicial declaration of its unconstitutionality, and the old order of treatment of the misdemeanants affected by it has been resumed. This result, when the excellent working of the law was demonstrating its value to those most competent to judgeCity Magistrates and the Departments of Correction and of Charities can only be most seriously deplored.

Several bills amending the Tramp Laws of 1885 and 1891 were introduced in the last Legislature. These were, as usual, passed upon by your Committee, and, with the exception of two, those of Assembly men Nixon and Brennan, were approved.

The former bill, although valuable in its proposed discrimination between tramps and vagrants, as public charges, yet in its provision for the commitment of vagrants seemed to conflict with the Cumulative Sentences Law. Your Committee, therefore, suggested an amendment exempting cities of the first and second classes from the operation of the law. This was adopted by its introducer, and the bill passed.

Assemblyman Brennan's bill was very brief. It provided that all persons guilty of public intoxication, and disorderly persons in the Counties of Kings, Queens and Richmond, should be punished by fine or by imprisonment in the County Jail, or by both such fine and imprisonment, and all acts inconsistent were repealed. It will be seen that this bill proposed, though not in terms, to exempt the Counties of Kings, Queens and Richmond from the provisions of the

Cumulative Sentences Law, thus relieving Brooklyn from its operation, which had by the embodiment of the law in the new Charter, become amenable to its discipline. That this was the purpose of the bill seems reasonably clear from the opposition to the law shown by the Magistrates of Brooklyn early in the year and their expressed determination to secure its repeal. Their opposition was due, doubtless, as was the case in New York, mainly to the want of knowledge of the principles underlying the law, and also to the supposed loss of official prerogative resulting from it. Certain of the Brooklyn Magistrates, according to the newspapers, avowed their hostility and their intention to work for the early repeal of the law. Your Committee, hop

ing to allay this animosity and bring about a more reasonable view of the law, communicated with the Magistrates, explaining the origin of the measure, and offered to appear before their Board in its support. To this no answer was received, and soon after appeared the Brennan bill. As before stated, this bill was disapproved by the Committee. The bill, however, passed the Assembly unchanged and was sent to the Senate Committee on Internal Affairs. After some difficulty a hearing upon the bill in this Committee was obtained and was attended by two of your Committee. An interesting evidence of the favor gained by the existing law was had in the presentation by your Committee at the hearing, of letters approving it from seven out of ten of the Magistrates of the Borough of Manhattan, who for the most part deprecated any change in its provisions. The hearing terminated in a decision not to report, and this attack upon the integrity of the law thus failed.

Unfortunately the success of your Committee in resisting legislative attacks was practically nullified by proceedings in the Courts. In March, Mr. Justice Gaynor, in the case of Teresa Kenny, held that the act was unconstitutional, on the ground. that the offender was given no opportunity under the act to question or disprove the facts stated in the certificate of the Superintendent of the Workhouse, upon which his discharge by the Commissioner was based. Judge Gaynor's opinion suggested the propriety of an appeal, and an appeal was taken by the District Attorney of Kings County. Your Committee endeavored to confer with that official and obtain an in