out the year; to the staff for their continued excellent service; to the friends of the hospital who have contributed to the entertainment of the patients; and to the Board of Trustees for their kindness in their direction of the policy of the hospital. Respectfully submitted, ALBERT H. GARVIN. PURPOSE OF THE HOSPITAL. The hospital was built for the treatment of incipient pulmonary tuberculosis, because it had been demonstrated that at least threefourths of the cases in this class can be cured. The definition of incipient tuberculosis is inserted on page 16. This definition is enlarged upon to state a little more clearly what cases are acceptable and what cases are to be positively excluded. The success in sanatorium treatment, in properly selected cases, is so remarkable that many physicians, not well acquainted with the limitations, flatter the sanatorium by thinking that it can do impossibilities, and send cases that are absolutely hopeless. Early cases, suffering from incipient pulmonary tuberculosis, in three out of four instances become apparently cured; moderately advanced cases, those suffering from infiltration of one lobe or a little more, will become apparently recovered once in five to twenty cases. Advanced cases will become apparently recovered, according to the experience in this hospital, once in 176 times. The rejection of an undesirable or an unsuitable patient is not an injustice. The hospital must restrict its endeavors to the purpose for which it was established, for the reason that it is not equipped in building or administrative staff to take care of bed or hospital cases, and also for the reason that it has been found by experience to be unsatisfactory to mingle hopeless cases with patients who have an opportunity to recover. It is not to be considered necessarily that the rejection of a case by the hospital means that the hospital authorities consider it incurable, although many patients, particularly those with health resort experience, labor under the delusion that the acceptance for admission is a guarantee of recovery, and that rejection means that the patient is a hopeless "chronic." As many patients are sent suffering from symptoms which indicate extensive disease, or have suffered from recent complications which require sus pension of judgment, a few definite symptoms are mentioned. It is not to be considered that the symptoms considered unfavorable mean invariably that the patient is unfavorable, but that the probability for cure with the presence of these unfavorable symptoms, or the incapacity that they necessitate, is such that the patient requires hospital rather than sanatorium treatment. It is taken for granted that patients in the sanatorium are able to be up and about, and at least come to the dining room for their meals, if they are on no other exercise. If the patient becomes ill in the sanatorium, or if his inflammation progresses while under treatment, he is placed in bed and properly treated, but no patient can be deliberately received as a bed patient. CASES NOT ACCEPTED. No bed-ridden patients. No patient confined to his room, or who has recently recovered from an acute infection and has convalesced for a shorter period than two weeks. No case of acute tuberculosis with high fever, or with temparature of about 100 degrees, which persists after two weeks of absolute rest. No case with tuberculous complications; laryngeal, ischio-rectal or bone. No patient with bubbling rales, indicating the breaking down. of lung tissue, especially if occupying the extent of one lobe. No cases with clinical signs of cavity. No cases with obstinate dyspepsia or malassimilation. If a patient cannot eat, he cannot get well. No patient who is expectorating more than one-half ounce of infectious sputum. No patient who is manifesting intense toxemia, with great weakness so great, for instance, as inability to get up one flight of stairs. No patient who has lost weight rapidly. No case with obvious dyspneoa while at rest. No case that is suffering from numerous or large hemorrhages. No case, in other words, that would fit the definition of moderately advanced tuberculosis, as stated on page 16, |