enforcement. If the Kent measure fails of passing, the Association should then, after careful study of the situation, see that another measure or measures be introduced in the near future, which may WHAT WE Certain people have a notion that because it has been ascertained that tuberculosis is a germ disease and because the tubercle bacillus has been isolated and certain facts with reference to the treatment and prevention of this disease are known, therefore little more knowledge on this disease is ascertainable and that we know all there is worth while about it. A moment's reflection, however, will convince one that, after more than twenty-five years of study and research in tuberculosis and after ten years of very active and intensive campaigning in the control of this disease, we know very little indeed about it. For example, neither the pathologists nor the clinicians can tell us just how tuberculosis works in the human body, that is, what the germ does after it gets there, where it goes and how it lies dormant in the human system for months or years at a time. True, there have been theories and speculations about these things, but exact scientific knowledge on many of these points is lacking. As to infection itself, we know that the tubercle bacillus gets into the body somehow and we are of the opinion that it enters largely through the respiratory tract for the most part. Where does it go after that and how much infection enters the body through other channels or in other ways? provide a constructive basis for federal participation in the problem. For the purpose of considering all of this legislation, a committee of the Association has been appointed. DON'T KNOW On the social side of the disease, we are pretty well convinced that there is some relation between bad housing and tuberculosis, but the mere fact that a certain number of people have died of tuberculosis in a dirty tenement or filthy rooms does not prove a correlation, nor does it prove that there is a sequence of cause and effect. The whole problem of the exact scientific relation between housing and living conditions in connection with tuberculosis is still unsolved. There are mines of social data lying around in the files of sanatoriums throughout the United States which have never been touched and which are awaiting the skilled hand of the statistician, the investigator and the social worker. As to the whole field of immunity and specific treatment in tuberculosis we know practically nothing. In fact we know less than we thought we did five years ago, as certain theories which seemed well founded then have been more or less upset since. There is hardly a worker in the field of tuberculosis who does not hope that some day a vaccine or some sort of agent will be discovered that will have the same effect upon this disease as antitoxin has upon diphtheria or vaccination on smallpox. Immense amounts of research, however, are necessary before these results can be obtained, and research demands men and money. Tuberculosis research, both on its social and pathological sides, requires much more patience, much more perseverance, and much longer periods of work to secure results than do investigations in most acute infectious diseases. On this account the number of men that are work ing in the field of tuberculosis research is all too small and the amount of money available is pitiably lacking. Readers of the JOURNAL OF THE OUTDOOR LIFE, therefore, who have the future of the tuberculosis movement at heart can do nothing better than to rally to the support of such foundations for research and study as the Trudeau Foundation, the initial appeal for which we made in the last number of this JOURNAL, Up to date contributions of $375.00 have been received to the JOURNAL'S fund. How much will you give? The following have contributed since the last announcement: Continued from page 234 registration in the office of the State Board of Health of every case of tuberculosis in Virginia. Tuberculosis was made a reportable disease in 1910 by a rule of the State Board of Health, passed pursuant to an act authorizing the Board to promulgate a list of communicable diseases, and requiring the reporting of all cases so listed. The Board has endeavored to secure a strict observance of this rule. The appropriations above noted total $189,500 for the two years. This is an increase of $99,500 over the appropriations for 1914 and 1915. The members of the Commission which made the report to the Assembly were: W. L. Andrews, Chairman; I. E. Spatig, A. T. Lincoln, Miss E. Strudwick, and Harry T. Marshall. Agnes D. Randolph, R. Ñ., acted as Secretary for the Commission. Miss Randolph is Secretary of the Virginia Anti-Tuberculosis Association. A TUBERCULOSIS QUESTION BOX Suitable questions will be answered on this page each month. No treatment will be prescribed nor medical advice given for specific cases. Such advice can be given intelligently only by the patient's own physician. Address all communications to "Question Box Editor," JOURNAL OF THE OUTDOOR LIFE, 289 Fourth Avenue, New York City. Please write only on one side of paper. Questions received before the 10th of the month will be answered, if possible, the following month. 1. The National Association defines the three stages of tuberculosis as follows: Incipient Slight or no constitutional symptoms (including particularly gastric or intestinal disturbance, or rapid loss of weight); slight or no elevation of temperature or acceleration of pulse at any time during the twenty-four hours. Moderately Advanced No marked impairment of function, either local or constitutional. Marked infiltration more extensive then under incipient, with little or no evidence of cavity formation. No serious tuberculous complications. Far Advanced Marked impairment of function, local and constitutional. Extensive localized infiltration or consolidation in one or more lobes. Or disseminated areas of cavity formation. 2. The question of cure or apparent cure must be determined by a physician. 3. We presume that you mean fibrous or scar tissue. This begins to form immediately around the diseased area in the lung in which activity of disease has subsided. The rate at which this fibrous tissue forms is extremely variable. 4. This depends upon many other factors than the hemorrhages themselves. 5. Creosote used to be given very largely in the treatment of tuberculosis. Most authorities now agree that it has no direct effect upon the disease. TO THE EDITOR: 1. What are the symptoms of tuberculosis of the stomach? of the intestines? 2. Would a frequent movement of the bowels be due to either T. B. of the stomach or intestines? Would the vomiting of streaks of blood suggest either? C. B. U. Tuberculosis of the stomach is a very rare disease, scarcely ever occurring. Tuberculosis of the intestines, on the other hand, is quite com mon. Frequent movements of the bowels, with or without blood and mucus in the stools and oftentimes with abdominal pain, are the more common symptoms. Such symptoms, however, often occur from intestinal disturbance which is not tuberculous. TO THE EDITOR: Will you kindly advise me if it would be right for a young lady with an "apparently cured" case of tuberculosis to marry? E. G. B. The question of marriage is often a very difficult one to decide. If a case is really apparently cured, there is often no objection to marriage. Each case, however, is to be decided on its merits and we would strongly advise that you have skilled medical advice before making a final decision. TO THE EDITOR: I. Is it possible for a T. B. to become a cure in one year or less? 2. Would a certain class of incipient cases of T. B. be exempt from the definition of a "cure," as given by the National Association? (a) Or is it a definition made to cover all classes of T. B.? 3. Can a man return to an Eastern climate after he is cured in the Southwest? 4. Is the danger of relapse any greater in the East than in the Southwest after cure? 5. What per cent. of cured incipient cases relapse? 6. Is the climate of Cleveland, Ohio, against one who is cured of T. B.? 7. What is the altitude of Cleveland, Ohio. 8. Is the precentage of deaths from T. B. any greater, in one state than any other health-resort states excepted? 9. What should a man weigh who is six foot and three inches? (a) Would 198 lbs. be about the right weight? 10. Would mine be called a hemorrhagic case, having spit about two teaspoonfuls of blood at two different times? C. N. M. It 3. This depends upon the individual case. is often done without risk. Frequently, however, it is undesirable. Only your medical adviser can determine in the individual case. 4. Conditions of life in the East, particularly in the cities, are less favorable than in the Southwest. In some cases the climatic factor is also important. If a patient has reached the stage of apparent cure, most authorities believe that the method of living has more influence than climate. In other words, a proper method of life in a poor climate is better than an improper method with good climate. 5. This depends upon many factors, particulariy the opportunity for living the right kind of life after apparent cure. In general the percentage of relapse varies between 25 and 40. 6. There is nothing particularly unfavorable about the climate itself, but it would not be fair to say that it is especially favorable. 7. About 800 feet above the sea level. 8. Yes. If you mean the death rate, that is the number of deaths per thousand living population. No, if you mean the percentage of deaths caused by tuberculosis from all causes. The latter figure remains fairly constant, the former varies greatly in different parts of the United States from a very low rate in such a state as Utah or Michigan to a comparativley high one in a state like Tennessee or Massachusetts. 9. This depends upon the age. At 20 the average weight for this height according to the Nylic Scale is 177, at 40 it is 195. 10. These would be classified as slight hemorrhages. HELPING YOURSELF A DEPARTMENT FOR CONVALESCENT PATIENTS Contributions from readers of the JOURNAL for this department are earnestly requested. If you know of any plan whereby you or someone else has made money in the sanatorium or out of it, tell us about it, so that others may profit by your experience. If you like this department, help it along. Without your help, it will die. Making Your "Helping Yourself" column is very interesting, and so now I am going to offer what perhaps will be of help to the women who would like to make money. At the Sanatorium where I spent the winter one woman made little caps, and these proved quite a success. These caps were pretty and attractive and every girl wanted one or two to wear there or take home with her. Any woman who can handle a crochet-needle and do neat work will have no trouble of dispoing of her goods. These were made as follows: A crocheted circle about six inches in diameter serves as a crown and is finished with a small edging on which is attached brocaded ribbon (shirred on top and same color as crown) about five and one-half inches in width, and then on this comes a crocheted beading about two or two and one-half inches wide, finished with narrow ribbon drawn through the beading and finished with a ribbon rosette and ribbon ends Caps hanging down one side, upon which are placed little crocheted medallions at ends of ribbon. When the cap is drawn up it can also serve as a little bag. Another young woman who was a hairdresser and beauty specialist had a tremendous business shampooing the girls' hair and manicuring. It was always very hard to find any one to shampoo hair, and it would usually be a barber from a neighboring city, who would charge so much that his services weren't sought often. This is a splendid chance to make money for one who can go at it. This young woman also carried a complete line of very fine toilet articles and was greatly patronized. Trusting someone else can use and profit by these suggestions, and wishing the column luck. Sincerely, A. H. H. South Chicago, Ill. AN ILL WIND WITH SUNSHINE AFTER FOLLOWING A tuberculosis patient's story of a storm that brought a Tuberculosis Sanatorium to Columbia, S. C. The summer of 1915 was one of intense heat in Columbia, (S. C.), and the site of the small tuberculosis tent colony being maintained by the Anti-Tuberculosis Committee of the Associated Charities, the first of its kind in the State, afforded scant shade. It grew so hot that the dismissal of the patients was even considered, but the little band bore the discomfort, and by September cooler weather had brought relief. This experience, however, served to convince the directors of the necessity of a new site and of permanent buildings in place of the few tents then in use. Preliminary plans were outlined, but funds were scarce, and the raising of the necessary amount to provide a new site and the desired enlargements presented a hard problem. Encouragement was given just at this moment by L. T. Wilds, who furnished a pleasant surprise by donating a new site in the midst of a grove of pines. Surveys were made, a deed was drawn, and work was commenced. Then came the storm. The story of the ill wind that "blew good," has been well told by Gerald Edmunds, a patient at the Sanatorium, who has written a brief history of the camp, which was printed in the Columbia State. It is in part as follows: "While this new work was progressing the colony remained on the original site, and on the night of November 18th encountered a wind-storm of such severity that nearly all of the tents were blown down and many were completely wrecked. All of the patients, however, were promptly cared for by nurses and physicians in charge, and no one was exposed to the weather, and, indeed, the only discomfort which they experienced was the subsequent crowding together, due to a shortage in tents. "The storm had its bright side no less than its dark one. Messages of sympathy poured in, many of them being supported by substantial contributions. Attention was drawn to the new camp in building, and several societies offered to bear the expenses of a sleeping-shack each. The city electric company and the local telephone authorities made valuable concessions, which, with the kindness of individuals, enabled both electric lights and telephone connection to be installed at only nominal cost. The slight discomforts incident to the storm were soon lost sight of in the newly awakened interest and enthusiasm attending the birth of the new camp. "Work was rushed at the new site and November 29th the move was made to the present quarters, three of the shacks and the dining-room being ready for occupancy. Difficulty was experienced, however, in boring a well, the height of the knoll and its rocky soil proving serious obstacles, and for a time all water was hauled to the camp in barrels. At length, though, at a depth of 125 feet a stream of pure water was struck, and a pump installed. "By this time all of the shacks had been completed. Every building at the new site represented the generosity of society or individual. The dining-room was erected from combined contributions, and the four shacks were donated respectively by the Ladies' Aid Society of the First Baptist Church, the Fraternal Order of Eagles, D. A. Pressley, and the Ladies' Aid Society of the First Presbyterian Church. The dining-room is a commodious and well-ventilated building 20 feet by 35 in size, and the shacks are each 20 feet square, and comprise a sleepingporch amply large for four beds and a comfortable dressing-room in the rear. All buildings are thoroughly screened and fitted with electric lights. "No sooner were these buildings completed than plans were made for the erection of an administration building to serve for officers' and nurses' quarters, and arrangements were perfected to purchase an additional acre of land to permit further enlargement. Again the Daughters of the Holy Cross came to the fore, and generously raised and donated money sufficient for erecting the administration building, which was completed in February. "Two other buildings followed in rapid succession. The Graduate Nurses' Association of Columbia erected a shack to be occupied by sick nurses, and J. M. VanMetre contributed a combination sun-parlor and recreation-room, which filled a long-felt want. The Goodwill Society has raised a sufficient sum with which to build a special hospital shack, to be used for patients so critically ill as to require especial attention, and this building will be erected in the near future. "Through the kindness of Mr. Baldwin, the landscape gardener, the grounds of the camp were neatly laid off in walks and about 75 shrubs and young trees were set out. Although planted but a little over a month ago, these are already budding, and in a few cases preparing to bloom, adding much to the general attractiveness of the new camp. A new road has just been completed leading to the camp, and automobile travel to and fro has thereby been greatly facilitated. "The past winter proved exceptionally mild, save for a cold spell of brief duration occurring in late February, when the thermometer here one morning registered 18 degrees. The sheltered position of the shacks, however, together with warm covering and hot-water bottles when necessary, prevented any of the patients from experiencing discomfort. 'With the advent of spring the camp has been transformed into a veritable scene of rustic loveliness. Added to the natural beauties of the site, the flowers and foliage of spring-time have completed a perfect picture. Approaching the grounds, one sees to the right a rare view. Far away are rolling hills and winding valleys, clothed in the azure hue of distance, and the mind leaps with the eye across the intervening miles and one is impressed with a sense of breadth and depth as sky-line and earth-line blend in one. In striking contrast to this far-away glimpse is the picture of woodland beauty on the left. The ridge slopes sharply down to a valley of quiet and peace, where in early March the first violets of spring may be found, and the yellow jasamine, and the trailing arbutus, and the wild honeysuckle vie with each other in a riot of color. Here also may be heard the mocking-bird's carolling, the wren's clear flute notes, and the bell-like call of the thrush, the whole forming a woodland symphony of unrivalled beauty. "Such is the home of the little fresh-air colony, and to those who commune with nature she speaks indeed a various language. She whispers of the calm beauty of the quiet places and bespeaks meditation; she sings of the chattering brook, denoting energy and perseverance; she tells of the harmony of the feathered songsters and makes her plea for love of music; and she also speaks of the budding leaf and the rising sap, and bids the weary invalid learn the lesson of renewed vitality, and proffers him the ineffable gift of the hope that begets life, and that of the greater hope that lies beyond life's veil." NOTES, NEWS AND GLEANINGS Six Hundred Acres for T. B. Sanitarium Members of the Sociological Congress were enthused at the recent New Orleans meeting by the announcement of a splendid gift made by a Southern woman, Mrs. D. B. Safford, to be used in the realization of some of the important ambitions. Mrs. Safford announced the donation of seven hundred acres of North Carolina land, ideally located for a tuberculosis sanitarium, to be used by the Southern Sociological Congress in its battle of health against the white plague. Several thousand dollars also will accompany the gift to form a nucleus for the fund which must be raised to erect suitable buildings for the great sanitarium. It is believed that other philanthropic men and women of the South will contribute to a |