50 SMITHSONIAN MISCELLANEOUS COLLECTIONS VOL. 63 



of age a child with tuberculous disease is often past cure. Aluch 

 can be done with a tuberculosis case if " caught young." 



After serious operations, the surgeons at the seaside sanatoria note 

 that progress is much more rapid when patients can live in the open 

 air and the practical point has been discovered that subsequent dress- 

 ings of a much more simple character are permissible under the open 

 air regime. For instance, m Metropolitan hospitals the practice of 

 packing and draining wounds has untold terrors for the unfortunate 

 patients. Dr. Charlton Wallace found that at " Sea Breeze " tuber- 

 culous sinuses heal more rapidly and permanently when all packing 

 and drainage are omitted and only a sterile absorbent dressing is 

 applied. As the general instability of these patients is- such as to 

 cause them almost to collapse at the thought of having their wounds 

 probed and packed, it led him to believe that they would gain 

 strength and local resistance if they were not nervously upset at the 

 time of each dressing. In the beginning, in order to ascertain 

 whether there would be full drainage, comparisons were made of 

 the amount of discharge, with and without the full dressing, and as 

 there was no diminution he concluded that packing or tubing was not 

 essential to drainage. Not only was the danger of infection less, 

 no infected wound being observed, but he found that no sinus healed 

 which still contained pus. This certainly simplifies the treatment of 

 surgical wounds and the credit is given to the favorable atmospheric 

 conditions. 



At Sea Breeze the children receive from one to two hours instruc- 

 tion daily, the teachers being furnished by the Brooklyn Board of 

 Education. It has been noted that the educational training given at 

 this Sea Breeze Hospital has a most happy effect on the morals of 

 the patients and at this early age much more can be accomplished 

 in combating vice and ignorance, which constitute the greatest ob- 

 stacles in dealing with the tuberculosis problem. 



(For open air schools for tuberculosjs children, Waldschule, etc., 

 see pp. 103-107). 



In estimating the value of sea air in non-pulmonary tuberculosis 

 in children, we naturally look to France for some data based on the 

 enormous experience now extending over a period of nearly fifty 

 years. During the last twenty years in France alone 60,000 children 

 have been treated in these sanatoria and Dr. Brannan is authority for 

 the following statement : 



Cures, 59 per cent. Decidedly improved.. 25 per cent 



Total of favorable results 84 per cent 



Cures in Pott's Disease 32 per cent 



Cures in glandular tuberculosis 74 per cent 



