AND ENVIRONMENT 33 



which stands in my way. To begin with there is now 

 a large capital involved in sanatoria, there are big 

 staffs employed, and much of their income depends 

 on appeal to the public. The result is that hardly a 

 single sanatorium in this country publishes a report 

 from which it is possible to extract information of 

 scientific value as to their efficacy. You must either 

 get data behind the reports — and this is often very 

 difficult because in nine cases out of ten there exist no 

 proper records, even unpublished — or you must seek 

 material from foreign sources. Owing to the labours 

 of two well-known actuaries — Mr. W. Palin Elderton 

 and Mr. S. T. Perry — we are now in a position to give a 

 first report on both English and American experience. 

 The only scientific method of investigating the problem 

 is to obtain the mortality rate in each age-group of 

 those admitted into sanatoria, and then to compare 

 this mortahty rate with (i) that of the corresponding 

 age-groups in the general population, and (ii) that of 

 the corresponding age-groups of the tuberculous in 

 pre-sanatorium days. 



Now the patients may be classified by their state on 

 admission as : 



I. Incipient Cases, 



II. Moderately Advanced Cases, 



III. Far Advanced Cases; 



or, by their condition on discharge as : 



I. Apparently Cured, 



II. Arrested, 



III. Active. 



In the case of the EngHsh data Messrs. Elderton 

 and Perry had 7-8 years of post-sanatorium expe- 

 rience to judge by; in the case of the American 



c 



