EDITORIAL.

Contributions of original articles, correspondence, etc., should be sent to the publishers, Otis Clapp & Son, Boston, Mass. Articles accepted with the understanding that they appear only in the Gazette. They should be typewritten if possible. To obtain insertion the following month, reports of societies and personal items must be received by the 15th of the month preceding.

THE STATE SANITARIUM AT RUTLAND.' It is now between four and five months since the State sanitarium for those suffering from incipient tuberculosis opened and began its practical work. Although it is altogether too soon to draw any conclusions, yet sufficient time has elapsed to indicate the trend and to furnish sufficient data to enable one to form some idea as to how this experiment is received by the people for whose benefit especially it was established. While the necessity and ultimate success of this institution was most firmly believed in by its originators, and indeed by all those most conversant with modern ideas in the treatment of tuberculosis, there was no little doubt as to how kindly the idea of hospital treatment, with its necessary discipline and removal from home and friends for a long period, would be received and to what extent its advantages would be embraced by the public. The result has more than filled the expectations of its creators; already has the male ward for some time had its quota of patients filled and on the female side are not more than half a dozen vacancies. All these, it must be remembered, are selected cases to a certain extent, only those being admitted in whom the disease is beginning and those for whom there is a reasonable hope of improvement and practical recovery. It should never be lost sight of for a moment that the object of this institution is cure, not care; it is not intended as an asylum for the euthanasia of those upon whom the disease had acquired a firm hold, but a sanitarium for the application of the most advanced knowledge tending to the cure of those in whom the disease is beginning to be evident. That ad

1 For the facts and ideas which led to the writing of this editorial, the Editor is indebted to an informal but very interesting talk upon the subject before the Hughes Medical Club by Dr. Vincent Y. Bowditch, one of the attending physicians at the Rutland sanitarium.

vanced knowledge to-day consists of the most perfect hygienic surroundings possible, in absolutely fresh air at all times, night and day, obtained by keeping the patient outdoors during the day and by bringing the outdoors into the patient during the night; in making available all the sunshine which our somewhat stingy New England climate furnishes, by the most nutritious diet known, by the conservation of animal heat, by abundance of warm and suitable clothing, and by the administration of as little medicine as possible, and that directed mainly to the relief of intercurrent or accessory symptoms.

But why not do this at home?" "why the necessity of all this expense just for the application of such simple and well-known remedies?" some one cries out; and why not, indeed? Simply because at home the patient will not submit to it, the family will not and the doctor cannot enforce it. The discipline which is an integral and necessary part of the life in any institution where a number of people are gathered for any purpose is in general accepted by the inmate as a usual, ordinary, and necessary condition to which he must accommodate himself, and to which he does as gracefully as his temperament will permit. While under his own roof, where he is master of his own castle, or where he has acquired the position of an autocrat by virtue of his invalidism, he will have none of it. And his position is reinforced rather than antagonized by family and friends in whom the popular fallacy that the "consumptive" should be coddled is still rampant.

And in the exposure of this fallacy and in the substitution in the minds of the people of undeniable truths regarding the care and treatment of this unfortunate class, is suggested the secondary object of the institution at Rutland, an object more far-reaching, indeed, and important in its ultimate results than the primary object itself. Primarily, it is established for the cure of tuberculosis; secondarily it will disseminate broadcast among the citizens of the commonwealth knowledge most vital. It will demonstrate by facts not only that tuberculosis in its incipience is a curable disease, and that, too, by means available to all, but that, while in unsanitary surroundings, without any or insufficient antiseptic meas

ures, it is a very contagious disease, that under proper conditions of cleanliness and caution in the disposal of sputum large numbers may be segregated without injury to themselves or attendants. Every individual that goes out from that institution cured of his disease, or so far improved that he can complete the cure himself, will go forth an automatic "fresh air crank" that will turn and keep turning wherever it goes until it has turned out of the minds of family and friends the old ideas of housing and heat and delicacies and coddling for consumptives, and turned in the knowledge and the truth of fresh air and sunshine. Thus it may be seen that indirectly this sanitarium of the State is a practical educational institution of no mean order whose influence on the welfare of its inhabitants will be inestimable. That tuberculosis could be practically eliminated from the number of prevalent diseases within a reasonably short time, is in the minds of those most capable of judging not without the bounds of probability, and as the whole people become cognizant of this fact, undoubtedly steps in that direction will be taken; indeed, the establishment at Rutland is the first step, and a long one, too, but it is only the first. Every large city and every county should have a similar place where those cases unable in the beginning to care for themselves could go and be cared for and instructed how to cure themselves; and in addition to these, other places more in the nature of hospitals should be built where those so far advanced in the disease as to be incurable could be made comfortable until their release came. By these means alone a vast decrease in the spread and mortality of this scourge could be achieved in the space of one generation; in two or three it could be eradicated. Do not let any one raise the objection of expense; the productive power of the lives of its citizens. saved would far more than recompense the commonwealth for the cost.

Every physician throughout the State should feel it his constant duty to make known throughout the community in which he lives these truths regarding this most common and fatal disease.

EDITORIAL NOTES AND COMMENTS.

We sincerely hope it may be possible for many of the readers of the GAZETTE to go to Paris in 1900 and accept the following kind invitation to be present and take part in the Congress :

INTERNATIONAL HOMOEOPATHIC CONGRESS, 1900.

Esteemed Colleague: At the London Congress of 1896 it was decided that we should meet next time in Paris, and that the quinquennial gathering should be ante-dated one year, so as to make it coincide with the Exposition Universelle which is to be held in that city in 1900. The Société Francaise d'Homoeopathie has accepted the task of organizing the Congress, and has appointed the undersigned a Commission for the purpose. It has also obtained from the management of the Exposition a place among the Official Congresses meeting in connection therewith.

We therefore beg to inform you that the Sixth Quinquennial International Homoeopathic Congress will assemble in Paris, at a date hereafter to be determined, but lying between July 20 and August 19, 1900; and we earnestly solicit your coöperation in our work of preparation for it. We need essays for our discussions, and the presence of representatives of our system to conduct these to advantage. Will you be good enough to take such measures as you deem most suitable for interesting in our projected gathering the readers of the NEW ENGLAND MEDICAL GAZETTE?

All information regarding the Congress will be published in good time in the French Homœopathic journals.

With our fraternal regards, we remain, dear Colleague, yours most truly,

P. JOUSSET, President.

R. HUGHES, Permanent Secretary.

LEON SIMON, Secretary.

VICTOR CHANCEREL.

A. GONNARD.

MARC JOUSSET.

J. Love.

J. P. TESSIER.

P. S. All essays and papers should arrive by January 1, 1900, at the latest, and should be addressed to

DR. LEON SIMON,

24, Place Vendôme, Paris, France.

A letter from the editor of the "Coming Age" desires us to call the attention of our readers to an article by Prof. John Uri Lloyd in the forthcoming April number, entitled "Do Physicians and Pharmacists Live on the Misfortunes of Humanity." It would seem from the title that physicians would be interested.

DIABETES.

Editor of New England Medical Gazette:

November 20 last I was called to see a robust man aged fifty with a severe and sudden attack of grip, which developed rheumatism. It was worse in the arms, occasionally below the elbows; at times twinges of pain in other parts. It was so severe he could not lie in bed nights. He had previously had a severe rheumatic fever. I asked if he had any kidney trouble; he said no. It was nearly four weeks before he was really happy. Then he said he was obliged to get up three or four times each night, and said upon questioning him that he probably passed three or four quarts, but he did not think anything of that, for he was a great hand to drink water. His wife said if any got on the woodwork of the closet it was so sticky it was very hard to wash it off. The urine was very clear, nearly neutral. Specific gravity 10.30, containing 3 per cent sugar. Argentum nitricum diminished the quantity somewhat and lowered the specific gravity to 10.25, but it soon increased again, and slightly diminished the amount of sugar. As he had one symptom that called for phaseolus nana, and knowing it had a direct effect upon the kidneys, I gave the 5 x four No. 35 globules every four hours. In eight days there was scarce a trace of sugar and he was feeling first class.

Springfield, Mass.

A. M. CUSHING.