NO. I AIR AND TUBERCULOSIS HINSDALE 45 



Ocean, ten miles from New York City. This was undertaken by the 

 New York Association for Improving the Condition of the Poor. 

 Ten tents were erected on the beach and were opened to children 

 between the ages of two and fourteen on June 6, 1904. These 

 tents had a capacity of fifty patients. In the autumn permanent 

 buildings were occupied and have since been used. While the 

 main reliance has been on fresh sea air and good food, the very best 

 surgical aid has been employed, and for all major operations the chil- 

 dren were temporarily removed to hospitals in New York City. 

 This co-operative arrangement is a great advantage to the seashore 

 institution, as the distance is not great and avoids the necessity of 

 enlarging the surgical staff and at the same time provides the highest 

 surgical skill. To avoid mistakes most of the cases admitted are 

 seen by at least one other surgeon besides the attending surgeon. 

 While pulmonary cases are refused the staff admits severe, desperate, 

 and even hopeless cases. 



In a recent report by two of the members of the staff ' there are 

 histories of forty-two cases and illustrations of the methods of 

 treatment ; but the noteworthy feature of the report is the prominence 

 given to residence at .the seashore as the chief means of cure. The 

 conclusions from seventy-six histories which form a basis of the re- 

 port are as follows : 



(i) The seashore is the best place for treating children with tuberculous 

 adenitis. The children make a better recovery here than elsewhere. Those 

 with adenoids and enlarged tonsils should be submitted to an operation as a 

 start of the cure. Sea air does not permit us to dispense with this. 



(2) The seashore is probably the best place for children with tuberculous 

 joints, provided they can have there the same skilled orthopedic care as else- 

 where. Their disease runs a somewhat milder and probably a shorter course, 

 and the functional results are better than those obtained elsewhere. 



(3) Our results have been largely due to the careful attention (including 

 feeding and nursing) which has been given the children. 



(4) Our results justify pushing the work. 



(5) A hospital such as this does better work than a public hospital under 

 control of the municipality. 



(6) Many cases of co-called bone tuberculosis are in reality syphilis. 

 We do not know whether there is anything " specific " about the seashore. 



'Leonard W. Ely and B. H. Whitbeck, Medical Record, March 7, 1908. 

 See also Charlton Wallace, Medical Record, July 22, 1905; John Winters 

 Brannan, Trans. American Climatological Association, 1905, P- 107; John 

 Winters Brannan, Trans. National Association for the Study and Preven- 

 tion of Tuberculosis, 1906. Roland Hammond: Heliotherapy as an Adjunct 

 in the Treatment of Bone Disease, Amer. Journ. Orthopedic Surgery, May 

 and October, 1913. 



