It seems to me that in recent years the crusade against tuberculosis has been, indeed, a most difficult task and that there is a decided lack of public interest in the problem. This may be due to the fact that our energies have been directed toward war-time activities or perhaps that we have nothing new or sensational to offer or to add to our present methods of handling the tuberculous as has been the case in other infectious diseases of shorter duration. But the fight against tuberculosis is still the world's conflict and there is none comparable to it in magnitude or fatality. The tubercle bacillus is still the same unrelenting, uncompromising enemy of both man and beast, working every conceivable form of misery, poverty, sorrow, destruction and death. Tuberculosis is potential dynamite acting without the "bang," and its destruction is not so spectacular.

The recent world-war has revealed to us that from humanitarian and economic viewpoints we must readjust and reconstruct all our armaments in the fight against the great white plague. Untoward post-war conditions can only be compensated for by sincerely taking advantage of everything science really knows of recognized methods of treatment.

The post-mortem table has never perhaps given more decided proof of the curability of a disease than it gives of tuberculosis of the lungs. Specific therapy should logically form the basis of treatment and cure, but it has as yet shown no results that would entitle it to this advanced position. "No single element in the cure, neither air, nor food, nor medicine affords any guarantee of success; it is only the satisfaction of all the physiologic and hygienic demands of the organism, from the greatest to the least significant that can bring about this result." We must pin our faith on the leucocyte-the scavenger of the blood-and no chemical nor pharmaceutical laboratory, no mechanical nor electrical appliance has, as yet, succeeded in producing a single one. food, fresh air and the proper regulation of one's living are the factors that will place one in the most favorable position for the manufacture of his own anti-bodies with which to combat the disease.

Rest,

Ofttimes the saddest story one hears is the story of patients "chasing climate" instead of "chasing the cure" which is within his grasp. It is not a question of where you are, but what you do. Did you ever stop to think how certain reputed climates would be teeming with millions if there were any virtue per se in such climates as a panacea for tuberculosis? As stated before, there is no specific for tuberculosis. Present methods, while not ideal, will bring about results if skillfully administered and intelligently received, and are not to be despised because they are homely

and devoid of the spectacular and are not taken out of a bottle.

The nature of the disease is such that we cannot expect an improvement in a few days or weeks, or sometimes even months, and ofttimes a patient must necessarily become worse before he can begin to improve. Success comes to him only who devotes himself to his task with unceasing patience, to him who strives with an iron determination toward the goal, and to him who is able to minimize the import of temporary discouragements, which qualifies are, in truth, necessary for success in any department of human endeavor. There must exist between physician and patient a mutual bond of sympathy and implicit obedience. Directions in detail should be followed most religiously. This is easy when the patient knows he needs these things, but not so easy when he imagines he does not, for an apparently insignificant indiscretion then may overthrow all that has been accomplished in months past.

Food is one of the most important factors in our fight against tuberculosis, and yet it is the object of most bitter attack by many in sanatoriums and hospitals. Institutional food is often described by all kinds of uncomplimentary adjectives, but if patients will eat it, it will do the work. I have never yet heard of a sanatorium that did not supply an abundance of the best food that judicious and conservative buying could purchase. I recently met hundreds of persons who in no uncertain manner repeatedly showed their derision and contempt for most delicious pink roast beef with all the regulation "trimmin's," preferring salt pork, beans, corn bread and molasses-a typical pellagra diet. The reason for all this adverse criticism of institutional food is quite apparent. The patients are ill, there is undoubtedly a toxic psychosis in many, a distorted viewpoint, and many have gastro-intestinal disturbances. As a rule most patients give a history of great loss of weight while at home, living and eating almost as they pleased. This argues all the more in favor of the simple diet of institutions where many after entering almost immediately gain in weight. Best tasting foods are not necessarily the best for body-building and blood-making. Eating should not be regarded as a palate-satisfying recreation, but as one of the best medicines we have in both treatment and prevention.

The fight against tuberculosis is not an easy task, but there is no such word as "can't." It is the duty of everyone to take an active interest, on the one hand, in restoring the sick to health and, on the other hand, in protecting the general public-a protection the absence of which may very well spell death itself. (Continued on page 311)

judicial procedure; and provided further that where the regularly constituted health authorities have reasonable ground to believe a person is afflicted with a contagious, infectious, or venereal disease and such person, or those in control of him, is notified thereof, then nothing in this Act contained shall exempt such person from quarantine regulations where the quarantine laws of the State are applicable, or from submission to examination by a regular licensed physician or surgeon selected by him or in case of a minor by his parents or guardian, whereupon a certificate by such physician or surgeon showing the results of such examination shall be furnished to said health authorities."

Attention is directed to the phrase in italics.

No one denies that the Christian Scientist has rights, the same as any other American citizen, but everyone will agree that he has no rights that are different inherently from those of a member of any other religious sect or a' man who has no religious affiliation whatever. It must be apparent to anyone that if in the enforcement of the quarantine laws for infectious diseases the health officer is dependent upon his action for a report from a physician selected by the suspected case, a person who has no responsibility whatever under law to the community or to the individual, the possibility of securing quarantine is extremely remote. The JOURNAL OF THE OUTDOOR LIFE has no

evidence to prove or disprove the statement of Mr. Gilmore that "there is not a record of a case where the spread of contagion could be taxed to their negligence." We do believe, however, that unless well established principles of health regulation by means of exercise. of the police power in the quarantine of dangerous or suspectedly dangerous persons is upheld and furthered, there is every likelihood that epidemics of infectious diseases will be spread.

Mr. Gilmore stated to the editor: "Christian Scientists have no conflict with the work of the anti-tuberculosis associations." When, however, he was asked what he meant by continually opposing public health legislation such as that for the creation of a health department in New Mexico, or the establishment of a county nursing bill in South Dakota, he replied: "Of course, we want to do the work in our own way."

The JOURNAL OF THE OUTDOOR LIFE has no conflict with the religious tenets of the Christian Science Church. It does believe that this continuous propaganda against matters that relate to the improvement of the community and public health is vicious, anti-American, and will lead, if it is allowed to continue, to serious consequences, particularly in some of the Western states.

the animal's general health, while very large doses will invariably kill within a day or two. This is in marked contrast to what happens when we similarly inoculate a non-tuberculous animal. We have already seen that not the least symptom of illness follows as the direct result of primary infection: and, to add emphasis to this statement, I would say that I have yet to find a quantity of bacilli sufficiently large to cause illness in a guinea pig treated in this way. I do know that for days after the intravenous inoculation of a first large dose of a milky suspension of living bacilli, the animal remains as well as before it was infected.

Now we do know that under these circumstances the animals that fall acutely and violently ill are highly resistant or immunized animals, while those that remain well for a while are animals with only their native reacting capacity, with which is associated only a modicum of defense to the invading bacillus. We have, therefore, no other recourse than to link fulminant and acute symptoms of illness with heightened powers of resistance and acute, inflammatory reaction of tissues. We thus catch up with the statement made a few pages back that the sickest animal may be the most resistant; that it is ill because it is resistant; and that to view severity of illness in terms of lack of resistance is altogether fallacious and not borne out by the plain facts of the case. And we think once more of the possibility "of an acme of resistance resulting in the exhaustion and annihilation of the defender."* For we know that those experimental animals that survive their acute illness will go on and far outlive the controls which do not at once fall sick and that they may indeed successfully resist their virulent infection.

Thus we have, on the one hand, animals receiving their first infection. And we find: in general, reactions delayed and slow-no early deviation from health or limitation of function, no immediate reaction of inflammation, a comparatively late development of focal tuberculous changes, a tendency to progression of lesion and disease, and death.

In direct contrast we have the already tuberculous animal experimentally reinfected. And here we find: immediate and even fatal acute illness, immediate inflammatory response of tissues, accelerated and abortive development of tuberculous changes that tend to be

See August number, p. 250

more diffuse, retrogression, and evidences of healing.

One of the youngest of our subdivisions of biological science, allergy, is one of the most fundamental and has rapidly grown into one of the broadest and most far-reaching. In tuberculosis its ramifications, insinuate themselves everywhere; to such an extent, indeed, that we can hardly think of a single phase without being obliged to reckon with allergy. Whenever we discuss the conversion of benign tubercle into manifest disease, whenever we wrestle with the obscurities of pathology, of symptomatology, of tuberculin in diagnosis and treatment, of general treatment, of prevention, of resistance, of prognosis, so far as these are a part of tuberculosis, we must pay attention to the remarkable circumstance that tubercle changes the native reactions of the normal body to tubercle bacilli.

The present essay has aimed to set before the reader only a very few of the numerous phases and applications of allergy. It has studiously avoided selecting and displaying any features that were not strictly necessary to the purpose at hand. This purpose has been to lay bare as concisely, yet as clearly as possible, how and under what conditions the body and particularly its tissues vary their methods of reacting to the tubercle bacillus. Other manifestations and functions of allergy must await description and discussion until we arrive at a more advanced stage of our journey. For the present our concern is to prepare the ground for an analysis of such questions as the fruition of childhood infection into adult tuberculosis and the healing and disappearance of lesions. In such an analysis a consideration of the finer details of allergy will have their place. Here it would tend only to confuse the reader, who should carry away from a reading of this essay only two or three important truths: an appreciation of the actuality of changed reactions to irritation by tubercle bacilli, a conception of what features characterize these reactions, and a knowledge of what event in an animal's experience brings them about.

In this essay, too, we have implied, rather than urged or attempted to demonstrate, any relations other than coincidental association between the state of allergy and that of increased resistance. To go further than this is unjustifiable until we have examined those conditions that give immunity to tuberculous infection its being as well as those that govern it, which are matters that will form the burden of the next essay.

"Before this disease came upon you, you professed a religion or philosophy of life that spelled 'cheerfulness.' Was it only a fairday religion? Can it not meet its Calvary with trust? Is there no to-morrow of the ages when that character developed through the trials of to-day will mean a blessing richer to you for the buffeting? The sculptor breaks and mars the block of fair marble.

That is only the apparent failure which must precede the figure of the Angel."

"Life's attar of roses is as rare as it is precious, and it takes the sunshine of many summers and the braving of many thorns to produce a single drop. But that drop when once produced is worth all that it costs and the perfume of it will last forever."

TO THE EDITOR:

One of the most important problems confronting the discharged sanatorium patient is, I believe, the problem of suitable employment. This being especially true of those who find it necessary to earn their own support and with involvement limiting the nature and amount of work they can perform.

I am, fortunately, well on the way toward solving this difficulty in my own particular case, and it has been suggested to me that my experience might be helpful as a guide to fellow "cure chasers" in similar circumstances. If this be the case I shall be very glad to pass my experiences on to others.

Some two years ago, with 9/8's involvement -so a doctor who tried to pass the matter off lightly told me—and a bank account frantically struggling to keep on the proper side of the ledger, I was summarily consigned by a sanatorium to my family. The necessity for earning something pronto with which to combat the H. C. of L. became immediately apparent. After carefully considering the few possibilities that offered I decided to make a try at magazine subscribtion work by mail.

After two years of endeavor in this field I find it admirably suited to persons able to exercise but little or none and that it affords possibilities for a great many persons disabled for other work. Publishers of the many publications pay annually to agents in commissions a sum that runs well into the millions of dollars, practically all of this amount going to

abled-bodied newsdealers and canvassers who are physically able to do other work, and other vast sums are lost to any agent by the subscriptions being sent direct to the publishers by the subscriber. Invalids and partly disabled persons have an equal or better chance in this field for one reason if no other, that being that all disabled persons who make an effort to earn their support have the sympathy of the public. My experience is very few people are unwilling to help those who honestly try to help themselves.

In beginning this work I first arranged to handle subscriptions for all magazine, jorunals and city newspapers published and secured from a large agency a few hundred catalogs listing all current Club and Special Offers. Then I made a list of all my friends and acquaintances, mailing to each a catalig together with a letter explaining my situation and the work I had taken up, asking them to order their magazines through me and to give me a list of the names and addresses of their reading friends. They were very generous in this, and on receipt of these lists I immediately mailed to each address a catalog and letter making the same request. My third month in this work netted me $125. After two years I have a mailing list about as large as I can take care of.

I may as well state here that I have done practically all of this work in bed, as I have been rigidly "on the cure" and now have only one hour exercise daily. A few weeks ago I