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conditions but little, if any, better than does the gives hope for a cure. To such, admission and city. The average ranchman came here as treatment are free, without regard to race or poor man, and is still struggling for a sure foot creed. While a medical staff is provided, the ing. His house, built under hard pioneer con chief means of cure relied upon, in addition to ditions, is small and ill suited for the accommo. the pure air and sunshine, are good food and dation of guests. As for help, he must seek abundance of it, with strict sanitary and dietary the ruggedest kind,—men who at need can regulations. A gift of thirty thousand dollars wade in rubber boots through the miry, irri from M. Guggenheim's Sons, of New York, in gated fields for long hours, under a sun which 1901, made possible the erection of a pavilion glows with fierce heat from the cloudless sky. for the accommodation of seventy-five addi. There is scant room here for "lungers."
tional patients. This building is provided with SOME INSTITUTIONS FOR CONSUMPTIVES. The realization of the foregoing facts has led to a number of projects for the benefit of consumptives. As early as 1891, an organization of public-spirited Jews in Denver began raising funds for a consumptives' hospital. A building costing forty thousand dollars was begun a year later, and was nearing completion when the panic of '93 came. In the ensuing wreck of fortunes the leaders of this noble enterprise found themselves unable to proceed, and the doors of the hospital were closed. Strenuous efforts were made to secure help outside the State, but without success until 1899, when the national order of B'nai B'rith raised funds to equip the building, and pledged five thousand dollars a year toward its support. In recogni. tion of this aid the institution was named the National Jewish Hospital for Consumptives.
Admission is restricted to patients who are ORIGINAL BUILDING, NATIONAL JEWISH HOSPITAL FOR unable to pay for care, and whose condition
“porch rooms," having glass tops and sides, Admission is restricted to persons of good where patients resort on cold days, while in character whose condition gives promise of their pleasant weather open-air life is prescribed for being benefited.
being benefited. Under the same management, but admitting only persons of limited means, is an admirably equipped building erected by Mr. Charles L. Adams, of Chicago, as a memorial to his wife. The total capacity of “The Home” is one hundred and twenty patients.
Another institution, to be called the Agnes Memorial Sanatorium, is to be built during the coming year just outside of Denver, by Mr. Lawrence C. Phipps, of Pittsburg, in memory of his mother, Mrs. Agnes Phipps. In its conduct it will be similar in many respects to “ The Home,'' but is designed particularly for persons of limited means. Also, a staff of specialists in tuberculosis will be provided, with a view to progress in the treatment of the disease. The buildings as planned will cost about two hundred and forty thousand dollars, and will accommo.
date eighty patients. THE GUGGENHEIM PAVILION, NATIONAL JEWISH HOSPITAL
The idea of tent life for consumptives, which
has been advocated by many physicians, was most cases. The reports of the institution show taken up in Denver, some five years ago, by Dr. highly satisfactory results.
A. Mansfield Holmes. He experimented first in For persons able to pay for their care, an in the thickly settled parts of the city, with unused stitution called " The Home” was established lawns for tent-sites ; then in the suburbs and in within the city, some six years ago, under the rural districts, where the results were more satdirect ownership and management of the Episco- isfactory. Within the past year he has secured a pal Church of the Diocese of Colorado. It aims sheltered mountain tract, near Wellington Lake, to provide sanitary quarters and home comforts, Colo., where it is proposed to establish a tent the patients choosing their own medical advis colony, with industrial features for the benefit
of needy patients. Dairying, cattle - raising, the Young Men's Christian Associations of the poultry-keeping, gardening, and numerous small State for aid in securing employment. enterprises to meet the needs of colony life, are
A NATIONAL SANATORIUM NEEDED. expected to furnish light and diversified employment; while a magazine, published by the It is the belief of well-informed persons that patients and medical staff, will acquaint the out if the enterprises now planned in Denver for the side world with interesting phases of the col care of incipient cases are carried out, they will ony's life and work.
by no means provide for all of this class needing Another tent colony, to be conducted along assistance, while for the large class in the later similar lines, was projected three years ago by stages of consumption nothing of a special kind Colorado Young Men's Christian Associations. has been done. The Secretary of the Denver With funds already raised a farm has been Charity Organization Society, Mrs. Izetta George, purchased near Denver, and strong efforts are who during many years' work has had unusual being made to provide it with the administra opportunities for becoming acquainted with the tion buildings and other necessary equipment. actual conditions, has held the belief that a sanaHere it is planned to offer light employment, torium or system of sanatoria, planned on a chiefly in market gardening, to young men in scale which only the national government could the incipient stages of consumption,-of whom undertake, is required to adequately meet the many hundreds apply in the course of a year to needs of the time. This idea has also been in
dorsed by most of the physicians with whom I have discussed it. It is true, as one prominent physician has said, the most important work is not the cure of consumption, but its prevention, by the elimination of those unhealthful conditions of life which particularly favor its development, such as a bound in the slum districts of cities. But this is a work of hygienic and civic education, and our generation can at best hope for only a moderate reduction of the consumptive class through these means.
The estimate of Vaughan, that at the present death rate from tuberculosis ten million or more of the seventy-five million people now liv. ing in the United States will die of this disease,
points to a problem of national importance. (On three sides are double-canvas walls, which may be
The disease claims its victims in early manhood opened by raising the upper half of outer wall like an and womanhood, in the beginning of what should awning, and dropping the inner wall, thus making a be the period of their greatest usefulness, so pavilion tent. When closed, a space just above wain
that the economic loss alone to the nation is a scoting of outer wall admits air, which enters the tent at the eaves.)
matter equaled in importance by few public
THE HOLMES TENT COTTAGE.
questions. Very many consumptives are per burden upon the community. It would be so, sons of high intellectual powers who, through indeed, if the community should undertake to exposure or overtaxing labor, have invited dis.
care adequately for all those coming who need ease, but who with proper care might be re care and aid. As it is, the money expended on stored to health and usefulness.
this class by the local poor authorities and the A number of States have taken a commend charity organization goes principally to the reable step by the establishment of sanatoria for lief of distress rather than to provide means of consumptives. It is the judgment of some rec aid toward recovery. The community is reimognized authorities that when these sanatoria bursed in good part, at least, for this outlay by are properly conducted, even though they are the number of recovered patients who remain located in regions with no special climatic ad and, with their money or labor, help to build vantages, the results obtained will be as satis up the State. Colorado owes a great deal to the factory in the end as in institutions situated in
energy of this class. typical climatic resorts.* Still, so long as the Nor can it be said that the presence of conbelief is widely prevalent that the high, semi sumptives constitutes a serious menace to the arid regions are especially favorable to recov health of the community, provided the patient ery, consumptives will continue to come in and those about him observe the few common. numbers too great to be cared for by private sense rules for guarding against infection. The charitable or semi-charitable institutions.
problem is mainly one of providing favorable
conditions for the consumptive in his battle for THE COMMUNITY AND THE CONSUMPTIVE.
life. For, as some one has well expressed it in I am not able to agree with the assertion a homely way, “It takes independence and frequently made, that the presence here of a bread and butter and shelter as well as climate large class of semi-invalids constitutes a great to restore health."
IV.-NEW YORK'S FIGHT AGAINST TUBERCULOSIS.
BY CHARLES H. JOHNSON
York, the president of the health depart. from thirty to forty thousand ; and many of ment said : “During the calendar year 1902, these are undoubtedly infecting their associates, 7,571 persons died of tuberculosis of the lungs and thus adding to the extent of the disease. in New York City, while 1,312 died of other New York has been fortunate in having had, forms of tuberculosis. In 1901, the deaths from for many years, as its medical officer, a physipulmonary tuberculosis numbered 8,135." The cian who has added to his other qualifications a reduction in the mortality from tuberculosis in special interest in the subject of tuberculosis. New York City since 1886 has been about 40 His reputation in this particular is international, per cent., which means, if applied to the greater and Dr. Robert Koch, the celebrated discoverer city, a decrease of more than six thousand in the of the
which causes tuberculosis, recently, number of deaths annually caused by it. What in a London address, highly commended Dr. such a reduction means economically to the com Hermann M. Biggs for his splendid work in the munity will be better understood when it is re. combat of tuberculosis. The health department called that to a very large extent these deaths has required since 1893 that all public institutake place in the working period, between fifteen tions in the city shall report to the department and fifty-five years of age,—the years when a every case of pulmonary tuberculosis ; and all person is worth most in a productive way to so physicians in private practice in the city were ciety. This decrease must be gratifying ; and requested, and since 1897 required, to do the yet it does not mean that there is no tuberculosis
In 1894, only 4, 263 cases were reported ; problem among New York's many other prob in 1897, 9,572 were reported ; and in 1901, lems. The disease remains the greatest single 17,588 reports were sent in. This does not mean cause of deaths in this city, and the number of that the disease increased in this ratio, but that
compliance with the request of the department * See, for instance, "Tuberculosis as a Disease of the increased. The department has also made proMasses, and How to Combat It," by Dr. S. A. Knopf, of New visions for the free examination of sputum in York. This essay, which won the prize offered by the International Congress to Combat Tuberculosis, is peculiarly
doubtful cases, and for the gratuitous treatsuited for popular instruction regarding consumption. ment, at their homes, of those afflicted with
consumption who are not financially able to em ing under the care of the Sisters of Charity. ploy a physician. Provision is also made for a The maximum accommodation is two hundred, free disinfection of bedding, clothing, and prem. and the institution is always filled and has a ises. It is now further proposed to erect next long waiting list. It stands on an eminence overdoor to the department's building a tuberculosis looking the Hudson, and contains all the modern dispensary especially adapted and equipped for appliances for sanitation, one of its chief attracthe free treatment of the various forms of tuber tions being a large solarium filled with growing culosis, and to follow up this treatment by visits plants, where in cold or stormy weather the pato patients' homes of trained nurses in the em tients delight to congregate. But what are two ploy of the city.
hundred beds to twenty thousand consumptives, Early in the present year, the Committee on many of whom require hospital treatment? On the Prevention of Tuberculosis, a committee February 1, 1902, therefore, some of the buildconnected with the Charity Organization Society, ings formerly occupied by the Manhattan State had plans of a sanatorium and tent colony Hospital for the Insane, on Blackwell's Island, drawn, and submitted them to the department. were opened by the commissioner for the use of The officials were much impressed with these consumptives. Its first occupants were collectplans; but fearing that it would not be possible ed from Bellevue and other hospitals. In the to undertake it as a whole, the commissioner de. men's building are 297 patients, and in the cided to inaugurate a tent system at some dis women's building, 97. The men are met, upon tance from the city. Various sites were inves. their entrance, by the deputy superintendent, tigated, and finally a site which seemed ideal Mr. Easton, who is a college-bred man and has was offered to the city for this purpose. There made a special study of sociology. He has preamong the hills the commissioner planned to es pared a set of questions which he tries, with contablish a tent colony where New York's poor siderable tact, to have answered, and which bear consumptives could inhale the life-giving air and on the sociological aspects of the disease. Mr. be restored, if not wholly, yet almost so, to Easton attempts to secure personal relations with health again. It is now admitted by physicians the patients, and has done much to persuade men generally that fresh air and nourishment consti to prolong their stay in the infirmary, so that tute the principal factors in the successful treat they may be permanently benefited by it. The ment of this disease. Phthisisophobia in a rabid temperature of the hospital is seldom above 60 form, however, developed among the surround degrees ; there are nine hours of sleep, and the ing property-owners, many of whom were wealthy patients eat nine times a day : and influential, and they decided that New York's
At 6 A.M., a breakfast of cereals, bread and butter, consumptive poor should not have the benefit of
coffee and beefsteak or poached eggs. the air in that vicinity.
At 8 A.M., cod-liver oil, with whiskey or sherry. It is estimated that half the tenement-house
At 10 A.M., eggnog. population of New York are more or less af
At 12 M., dinner, consisting of soup, beef, or mutton, fected by tuberculosis. Thousands become con
potatoes, another vegetable, and bread.
At 2 P.M., cod-liver oil and plenty of sherry. sumptive by reason of their weakened powers
At 3 P.M., beef tea. of resistance, due to improper nourishment, un At 4 P.M., eggnog. sanitary conditions in their homes, and too long At 5 P.M., supper of pudding, a soft-boiled egg, bread hours of labor. The result is that the number and butter, tea. of those actually dependent upon public and pri
At 8 P.M., hot or cold milk. vate charity is greatly increased by the presence The results for the first year, just ended, are of this lingering disease in the family. What most encouraging. Of the 1,431 cases admitted this prevalence of consumption among the poor in the course of the year, all of which were conof the city costs the city of New York has been siderably advanced, having been brought thither worked out by Dr. Biggs, who shows an annual from Bellevue and other city hospitals, 378 were loss of $23,000,000 to the municipality, and a discharged as improved, 77 as much improved, loss to the country as a whole of $330,000,000 and 27 as practically cured. There were 394 9, year.
deaths, 37 were transferred elsewhere for surgi. The Department of Public Charities, since the cal operations, and 67 were sent home after it advent of the present commissioner, has attempted was found that their coughs were not tubercu. to cope with this problem in an intelligent way.
lous. It has sent, for several years, its consumptive ap The commissioner has now decided to try the plicants to Seton Hospital, located on Spuyten experiment of a camp in connection with this Duyvil Parkway. Here the patients are sent as hospital. In the early part of April, one tent city charges by the department, the hospital be was put in operation, and it is intended to have