other great sanitary improvements that have been effected in the last half century, and has taken place in the absence of any special precautions against the dissemination of the seed of the disease. Is it too much to hope that, now that we know this seed and can intercept and destroy it at the shoots by which it is discharged from its culture beds and granaries to be scattered broadcast, we shall be able still further, and more materially to reduce the tuberculosis death rate and the prevalence of the disease? Nay, further, is it too much to hope that by removing those who have contracted the disease from the impoverished, insalubrious and ill-regulated conditions of life that have invited and fostered it and by immersing them in pure air and unpolluted sunlight in restful and hopeful circumstances, with a liberal and welladjusted diet and under constant skilled medical supervision, so that untoward symptoms are dealt with as they arise and every bodily function is ordered, as far as may be, in the interests of health—and this is what sanatorium treatment consists in—is it too much to hope that we shall thus save many lives that would otherwise be lost, and prolong the days and alleviate the sufferings of those who are beyond hope of permanent recovery? Our sanatoriums in this country have not yet been in existence for a sufficient length of time to allow of the collection of wholly trustworthy statistics, but the returns as far as they go are highly encouraging, and confirmatory of the favorable verdict on sanatorial treatment arrived at by German institutions. Dr. Maudsley, himself, admits that so far the outcome of experience seems to be that many patients who are sent to sanatoriums in the early stage of the disease, recover if they are kept long enough, that most of those in a more advanced stage improve while they are there, frequently relapsing afterwards, and that those who are badly diseased ought not to be sent at all. And this, he calls a modest result. I am disposed to describe it as a result of which we may well feel proud and as one that, if properly presented to the public, should lead to the adoption on a larger scale than hitherto of this system of treatment at that stage of the disease when it may prove so efficacious. The benefits to be derived from sanatorial treatment have perhaps been exaggerated in prospect. It can not altogether supersede other forms of treatment, at high altitudes on sunny littorals, on the veldt, prairie or desert, or by sea voyages; it can not reconstruct a disorganized lung, but to those whose means do not enable them to command the best treatment under private care, and in whom the tubercular lesions are still of limited extent, and leave enough breathing space, it opens up new hopes of restoration to health. Even to the affluent, sanatorial treatment is profitable in the medical discipline it involves. The time may come when science will give us some tuberculin, or serum, or antitoxin, or antiseptic, that will kill the tubercle bacillus in its hidden lair, counter-
