TUBERCULOSIS 179 



the medical profession, however influential and numerous, can- 

 not grapple with this problem unless they have the hearty support 

 of the people and the administration of the city. They must 

 have generous appropriations for carrying on the work for the 

 provision of medical inspectors and disinfectors, for educational 

 measures, for the establishment of dispensaries and sanatoria for 

 the care of incipient cases, and of homes to which advanced 

 cases may be removed, and where they may be made comfortable 

 until the inevitable fatal termination comes. We must remem- 

 ber, in this connection, that every incipient case and every ad- 

 vanced case of tuberculosis which is removed from its home and 

 surroundings and placed in a properly equipped and conducted 

 institution is, in this way, not only given a fair chance for recovery 

 of health, but is educated as to the means to be taken to prevent 

 further extension of infection, and, at the same time, one focus of 

 infection is removed from the city. On the average, every case of 

 tuberculosis infects at feast one other case, and if removed to a 

 hospital early enough, the infection of this second case would be, 

 in each instance, prevented, and thus the total number of cases 

 would be reduced. 



" It is in an educational way that lay organisations for the pre- 

 vention of tuberculosis may be of the greatest service. They 

 serve to arouse interest in and to disseminate knowledge of the 

 nature of tuberculosis; they form compact bodies of public-spir- 

 ited citizens, whose influence is of the greatest value in so mould- 

 ing public sentiment that funds shall be forthcoming to erect 

 and maintain dispensaries, sanatoria, and homes for the consump- 

 tive poor. Through their assistance, and that of the public press, 

 we may hope eventually to obtain State and municipal appropria- 

 tions for the suitable care of the consumptive poor. New York 

 State has made a small beginning in this way, and it is hoped 

 that the State sanatorium, now in course of erection in the Adi- 

 rondacks, may lead to very much larger appropriations for this 

 purpose. The State is spending many millions of dollars annu- 

 ally for the care of the insane, and while this is absolutely neces- 

 sary, for humanitarian reasons, I have no hesitation in saying 

 that far greater returns would be obtained from the expenditure 



