Development of institutional Service

10. The further development of the institutional advisory service. Among the various possible features of such a service the following would be widely useful: (a) The preparation and publication of a book on the details of sanatorium construction. (b) Advisory and consulting service on sanatorium accounting and all that pertains thereto, with the preparation of a model and standard system. (c) Advisory and consulting service on the furnishing and equipment of sanatoria and other institutions, and the preparation of model and standard lists and specifications. (d) A study of the personnel requirements for modern sanatoria of various capacities. (e) Further study of institutional provisions for children, such as open air schools, preventoria, summer camps and children's units in sanatoria. Estimated cost, $10,000 a year. Training and Placement of Personnel

11. The personnel problem of tuberculosis organizations and institutions of the United States is a serious one and needs more adequate study and development. Associations, dispensaries, hospitals and other agencies are suffering for lack of the right kind of personnel. The problem divides itself into three phases-training, placement and standardization. The National Association can contribute greatly to the training and placement of workers in the tuberculosis field. It can co-operate with the workers themselves in developing higher professional standards. To do these things, however, requires additional funds for the conduct of institutes, for the extension of the employment service and for definite research that will tend to develop a higher professional status on the part of tuberculosis executives. Estimated cost, $6,000 for first year.

Accounting Advisory Service

12. The development of an accounting advisory service for our own Association and for our affiliated associations is needed. It is realized that there is a tremendous field for an advisory service in budget-making,

The

in the proper preparation and presentation of financial statements, and what would be termed in the business field a system of cost finding. We know too little about the actual cost of the various phases of our work, and furthermore, the amount that should be spent on such activities, as already worked out by other associations. There is a vast amount of material along such lines that can be made available. This would mean the employment of an expert on accounting who would familiarize himself thoroughly with the procedure in the executive office of the National Association, the relationship between the office and the affiliated associations, and a thorough study of the best business methods to be followed by state and local associations. Estimated cost, $7,000 a year.

Conclusion

In conclusion I wish to express to the members of the Association my personal appreciation of the loyal service rendered during the past year by all members of the staff. With cuts in budget to be arranged for on two separate occasions, with disappointments as to service and sudden calls for emergency work, the staff has proven equal to every demand placed upon it. It is no small gratification to be able to state to the Association that it has in this staff the most loyal and efficient and smoothly working organization that I personally have ever known.

Announcement was made yesterday of my resignation as Managing Director after a service extending over eight years. I take this opportunity to express to the Association my sincere pleasure and gratification in the development of the work and also in my associations with the many devoted workers who have brought about this development. I am happy in the consciousness that you will have Dr. Linsly R. Williams as my successor. You already know of Dr. Williams' experience and abilities and you will soon know more of his many fine qualities. I congratulate the Association on securing Dr. Williams as its chief executive, and I look forward with confidence to a future that in accomplishment will far exceed the past.

Trees

Silently the trees stand in a row,

Hands folded, fast asleep;

Waiting for Mother Snow to come And cover up their feet.

All summer long they gave their best, Beautiful leafy shade,

A safe retreat for little birds
Where they need not feel afraid.

Now Father Sun shines on us so cold,
Each bird has flown from its nest.
The trees' work is done; summer is o'er;
They are taking their well-earned rest.

TH

HREE significant statements were made at the annual meeting of the National Tuberculosis Association which may in themselves form a text for editorial comment.

The first statement by Dr. Charles J. Hatfield, Managing Director of the National Association, pointed out that the death rate from tuberculosis in the United States has been cut in half since the Association was formed and that at the present time this cut indicates a saving of approximately 100,000 human lives per year.

The second statement by Dr. Victor C. Vaughan, former president of the Association, and Dr. Livingston Farrand, formerly executive secretary and now President of Cornell University, pointed out that the general death rate in the United States during the last thirty years had been reduced from 20 to 13 per thousand; and, more significant still, that by the application of continuous scientific

methods it can be cut to at least 7. The present reduction in the general death rate means a saving of 700,000 lives a year, and the possible additional saving resulting from the further cut would mean 600,000 more lives saved.

The third significant statement was made by Hon. Charles E. Hughes, Secretary of State of the United States. He pointed out that the national, state and local tuberculosis associations representing the voluntary health agency group have been the most influential factor in this great reduction of the death

rate.

The fight for health is a winning fight. Twenty-five years ago few people would have ventured a prediction regarding the present death rate from tuberculosis. Tuberculosis was commonly considered at that time a visitation of Providence. As Secretary Hughes points out, it is not that, but rather a dispensation of evil, an evil which can be stopped. He contin

A

A Commbakk

By CHARLOTTE VIMONT ARNOLD, Glockner Sanitorium, Colorado Springs, Colo. FTER many long and weary months spent in bed, chasing the elusive cure, and making slow progress toward that goal, I became disheartened and was ready to give up the fight--but Chance, that fickle little god of destiny, brought to me HOPE and the WAY TO WIN in the guise of an article of encouragement and cheer, written by a TB. combakker for one of our leading health magazines.

But after reading this splendid treatise on "coming back" I find myself in a peculiar predicament, for now, knowing the proper and approved methods, I find myself totally unable to fill the first requirements as given by an eminent specialist who is quoted by the authoress of the article; "to get rid of that pain that is eating at your heart: that heartbreak over a love affair, that worry over a wayward child, those financial distresses."

I have no love affair.

I have no child.

And Uncle Sam has kindly relieved me of the last.

But ah, here is something! "I have never yet found an adult patient, affected with tuberculosis, who did not have some inner sorrow." Here then is the solution to my problem! But here again I find myself in an impasse.

I am an adult. I am affected with tuberculosis. Therefore I must have some inner sorrow-but what shall it be?

I need help! I need suggestions!

I have run over in my mind all the most approved secret sorrows in general use and

have been unable to decide on any suitable to my present needs.

"Weeping over the little shoes" held a cer-tain attraction until I realized that under the circumstances it would seem-well, not quite the proper thing, if you see what I mean; and this, together with the fact that the only shoes available are gaudy Chinese bed-room slippers, size "Four and a half 'B'," caused me to reject this plan as inappropriate.

Professional ethics forbids my physician divulging to me the many hidden sorrows that have been confided to him so I cannot look for assistance in that quarter; I therefore appeal to my brothers and sisters of the Chase for a suggestion for a good, strong hidden sorrow guaranteed to last a lifetime of hard wear and rough usage.

Another aid to "coming back" which the authoress of the article in question found of great value was the finding of "her dynamics of selfhood."

Now for a long, long time I have had a poignant craving for something, something,-I knew not what. My devoted family in striving to find the object of my vague desires brought gifts and presents, flowers, rare candies, lovely bed garments, and the kind nurses prepared dainty morsels and luscious cool drinks, to tempt my appetite, all to no avail. Still that dreadful aching void tormented me, but oh, the gladness that filled my heart when I read those magic words "dynamics of selfhood." Of course those are what I want and need and must have. But, alas! I have looked and looked and I cannot find mine anywhere!

Reading the article again, I discovered that she had found them in bed, so I began a systematic search through sheets and blankets

and even in the folds and seams of the mattress but to date I have not been successful. I have found only crumbs. Crumbs of varying and interesting character it is true; bread crumbs, soft and rolly, crisp, golden brown toast crumbs, crickeldy cracker crumbs which give a delightful friction and cause a glowing skin reaction when rolled upon, rich cake crumbs enhanced by chocolate or caramel icing of a sweet, I may say gooey, nature. But no dynamics!

One night I was suddenly awakened from deep sleep by a sharp pricking sensation. My first thought was one of jyo for I was confident that a baby dynamic had strayed away from its mother, so I quickly turned on the low bedside light, prepared to pounce upon the little unsuspecting thing and capture it unaware. But woe to my expectations! Upon investigation it proved only to be a very sharp pin which the nurse had left at a strategic point.

It is, of course, true, that I am not familiar with the appearance of the dynamics in their wild and native state and so may easily have missed them, and so I have come to beg the assistance of the gentle readers of the "Joy Fling" columns in my search for the "dynamics of selfhood."

Tell me, out of your vast experience, if one should sneak on them as they hide in their lair and so capture them off guard; or is it safer to boldly confront them and so cow them by hypnotism that they can be easily overpowered and muzzled; or to snare them, or set a trap, and what kind of bait is considered the best? What are their habits when in captivity? How will I know one when I see it? And most important-do they bite?

P. S. After you catch them what do you do with them?

"An' bless papa an' mamma and Uncle George, An' P. S.-God, don't let my hot water bag bust." -By DON CRAIG, Glen Gardner, N. J.