conditions but little, if any, better than does the city. The average ranchman came here as a poor man, and is still struggling for a sure footing. His house, built under hard pioneer conditions, is small and ill suited for the accommodation of guests. As for help, he must seek the ruggedest kind,-men who at need can wade in rubber boots through the miry, irrigated fields for long hours, under a sun which glows with fierce heat from the cloudless sky. There is scant room here for "lungers."

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 recognition of this aid the institution was named the National Jewish Hospital for Consumptives.

Admission is restricted to patients who are unable to pay for care, and whose condition

gives hope for a cure. To such, admission and treatment are free, without regard to race or creed. While a medical staff is provided, the chief means of cure relied upon, in addition to the pure air and sunshine, are good food and abundance of it, with strict sanitary and dietary regulations. A gift of thirty thousand dollars from M. Guggenheim's Sons, of New York, in 1901, made possible the erection of a pavilion for the accommodation of seventy-five additional patients. This building is provided with

ers. Admission is restricted to persons of good character whose condition gives promise of their 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 idea of tent life for consumptives, which has been advocated by many physicians, was taken up in Denver, some five years ago, by Dr. A. Mansfield Holmes. He experimented first in the thickly settled parts of the city, with unused lawns for tent-sites; then in the suburbs and in rural districts, where the results were more satisfactory. Within the past year he has secured a sheltered mountain tract, near Wellington Lake, Colo., where it is proposed to establish a tent colony, with industrial features for the benefit

of needy patients. Dairying, cattle raising, poultry-keeping, gardening, and numerous small enterprises to meet the needs of colony life, are expected to furnish light and diversified employment; while a magazine, published by the patients and medical staff, will acquaint the outside world with interesting phases of the colony's life and work.

Another tent colony, to be conducted along similar lines, was projected three years ago by Colorado Young Men's Christian Associations. With funds already raised a farm has been purchased near Denver, and strong efforts are being made to provide it with the administration buildings and other necessary equipment. Here it is planned to offer light employment, chiefly in market gardening, to young men in the incipient stages of consumption, of whom many hundreds apply in the course of a year to

THE HOLMES TENT COTTAGE.

(On three sides are double-canvas walls, which may be opened by raising the upper half of outer wall like an awning, and dropping the inner wall, thus making a pavilion tent. When closed, a space just above wainscoting of outer wall admits air, which enters the tent at the eaves.)

the Young Men's Christian Associations of the State for aid in securing employment.

A NATIONAL SANATORIUM NEEDED.

It is the belief of well-informed persons that if the enterprises now planned in Denver for the care of incipient cases are carried out, they will by no means provide for all of this class needing assistance, while for the large class in the later stages of consumption nothing of a special kind has been done. The Secretary of the Denver Charity Organization Society, Mrs. Izetta George, who during many years' work has had unusual opportunities for becoming acquainted with the actual conditions, has held the belief that a sanatorium or system of sanatoria, planned on a scale which only the national government could undertake, is required to adequately meet the needs of the time. This idea has also been indorsed 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 abound 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 living in the United States will die of this disease, points to a problem of national importance. The disease claims its victims in early manhood and womanhood, in the beginning of what should be the period of their greatest usefulness, so that the economic loss alone to the nation is a matter equaled in importance by few public

consumption who are not financially able to employ a physician. Provision is also made for a free disinfection of bedding, clothing, and premises. It is now further proposed to erect next door to the department's building a tuberculosis. dispensary especially adapted and equipped for the free treatment of the various forms of tuberculosis, and to follow up this treatment by visits to patients' homes of trained nurses in the employ of the city.

Early in the present year, the Committee on the Prevention of Tuberculosis, a committee connected with the Charity Organization Society, had plans of a sanatorium and tent colony drawn, and submitted them to the department. The officials were much impressed with these plans; but fearing that it would not be possible to undertake it as a whole, the commissioner decided to inaugurate a tent system at some distance from the city. Various sites were investigated, and finally a site which seemed ideal was offered to the city for this purpose. There among the hills the commissioner planned to establish a tent colony where New York's poor consumptives could inhale the life-giving air and be restored, if not wholly, yet almost so, to health again. It is now admitted by physicians generally that fresh air and nourishment constitute the principal factors in the successful treatment of this disease. Phthisisophobia in a rabid form, however, developed among the surrounding property-owners, many of whom were wealthy and influential, and they decided that New York's consumptive poor should not have the benefit of the air in that vicinity.

It is estimated that half the tenement-house population of New York are more or less affected by tuberculosis. Thousands become consumptive by reason of their weakened powers of resistance, due to improper nourishment, unsanitary conditions in their homes, and too long hours of labor. The result is that the number of those actually dependent upon public and pri vate charity is greatly increased by the presence of this lingering disease in the family. What this prevalence of consumption among the poor of the city costs the city of New York has been worked out by Dr. Biggs, who shows an annual loss of $23,000,000 to the municipality, and a loss to the country as a whole of $330,000,000 9 year.

The Department of Public Charities, since the advent of the present commissioner, has attempted to cope with this problem in an intelligent way. It has sent, for several years, its consumptive applicants to Seton Hospital, located on Spuyten Duyvil Parkway. Here the patients are sent as city charges by the department, the hospital be

ing under the care of the Sisters of Charity. The maximum accommodation is two hundred, and the institution is always filled and has a long waiting list. It stands on an eminence overlooking the Hudson, and contains all the modern appliances for sanitation, one of its chief attractions being a large solarium filled with growing plants, where in cold or stormy weather the patients delight to congregate. But what are two hundred beds to twenty thousand consumptives, many of whom require hospital treatment? On February 1, 1902, therefore, some of the buildings formerly occupied by the Manhattan State Hospital for the Insane, on Blackwell's Island, were opened by the commissioner for the use of consumptives. Its first occupants were collected from Bellevue and other hospitals. In the men's building are 297 patients, and in the women's building, 97. The men are met, upon their entrance, by the deputy superintendent, Mr. Easton, who is a college-bred man and has made a special study of sociology. He has prepared a set of questions which he tries, with considerable tact, to have answered, and which bear on the sociological aspects of the disease. Easton attempts to secure personal relations with the patients, and has done much to persuade men to prolong their stay in the infirmary, so that they may be permanently benefited by it. The temperature of the hospital is seldom above 60 degrees; there are nine hours of sleep, and the patients eat nine times a day:

Mr.

The results for the first year, just ended, are most encouraging. Of the 1,431 cases admitted in the course of the year, all of which were considerably advanced, having been brought thither from Bellevue and other city hospitals, 378 were discharged as improved, 77 as much improved, and 27 as practically cured. There were 394 deaths, 37 were transferred elsewhere for surgical operations, and 67 were sent home after it was found that their coughs were not tubercu lous.

The commissioner has now decided to try the experiment of a camp in connection with this hospital. In the early part of April, one tent was put in operation, and it is intended to have