1. Universal and also relative.

2. Of a long duration, as a rule, before diagnosis has been made, during which time the disease has been healing in many areas.

3. That the disease tends to improve.

to poor judgment.

5. That exercise is an experiment that may or may not be successful.

6. That one does not become cured, but gets better.

CHAPTER I.

"Good morning!" "Good morning, Mike," I answered back to the young man who was plowing along the roadside, happy and singing. Had I not ventured on him unawares he probably would have qualified for a "Caruso" appointment if rehearsing has anything to do with it.

"Plowing or just working?" I asked, keeping my eye on the long rows just freshly turned and revealing the nice black loam of virgin soil. "That reminds me," answered Mike, "of the time in San Francisco when I saw my lady friend one beautiful morning hastening toward the railroad station with a suitcase and bag. I said, 'Are you traveling or just going somewhere?'" Perhaps this remark had something to do with his never hearing from her again; but that doesn't seem to worry Mike, as he is one of those extremely fortunate individuals whom the feminine sex just naturally radiate to.

Finally we got down to brass tacks and argued the subject of work, pro and con. The question of what effect work had on this happygo-lucky fellow brings me back to Mike, and naturally ushers in

CHAPTER 2.

Mike, unlike Little Eva in Uncle Tom's Cabin, who said she "just grew," declares that he graced the city of South Haven, Mich., with his presence in 1895. The father of the family, being a minister of the Gospel, had fond hopes that this addition might follow in the footsteps of his dear old dad. After an unusual grammar school education, with its current youthful exploits, Mike, with family en masse, sought a career and fortune in Milwaukee, Wis. Having selected that city for his operations, although not wishing to cast any reflections upon Milwaukee, Mike, much to the delight of "Senior Mike," seemed to feel that the city needed something in the way of reformation.

When he had finished high school with a checkered career, the doors of a seminary welcomed him-whether to benefit himself or his city or both will be seen later. Business looked encouraging until, near the close of his ecclesiastical days, the bolt from the sky fell. Not that Mike was in love; no, that was unnecessary as long as all the girls were in love with him. Whether it was seeing the hopelessness of the task he had set out to do, or pure, unadulterated patriotism, or both, I know not, and doubt if he does himself; but, at any rate, Mike joined the navy, which necessitates the interposing of

CHAPTER 3.

Some men are born with a strong mind, and some and it seems to me to be entirely too large a percentage-with a strong back. Analyzing Mike's career up to the present, I am constrained to put him in the first group and would like to make myself believe he really belonged there. The quiet, easy, simple, carefree existence seemed to please Mike, which accounts for his enlisting in the navy as a yeoman, that is, in the clerical department. Imagine Mike scrubbing decks, handling shells, etc., and you can imagine Niagara Falls running upwards. No, he was content to push the pen all day and to do the "heavy looking on," much to the detriment of the unusual physique which he had acquired by strict adherence to a healthy appetite and convictions in regard to too much work. After cruising around in Mexican and Pacific waters for four years, participating in numerous insurrections in Mexico and enjoying the salt air, Mike received notice that his enlistment had expired, and, with some bank account to his credit, anticipated a winter in California. But, oh, that wanderlust, how it worked on him, and he was not fully satisfied until he landed again in Milwaukee, where for appears

CHAPTER 4.

Mike had become of age by now, and ready to place any candidate he chose in the Presidential chair by his vote. The old adage says "With the ancients there is wisdom." He accepted a position in a commercial enterprise, but before long the indoor confinement began to tell on his once perfect health. Whether it was this particular line of work, or the t. b. germ that he swallowed-because a person with Mike's personality could not keep from smiling, consequently his mouth was always open-I do not know. I am inclined to think the bacilli got settled and the indoor job helped matters, with the result that Mike got the "con," which belongs entirely in

CHAPTER 5.

Were Mike dead, probably this article would substitute for a eulogy, but as he is one of the liveliest corpses I ever saw, I will endeavor to tell how he arrived at the plowed field.

It is needless to go into detail about the why's and wherefore's of tuberculosis. Each case is an individual case, some persons become sick gradually and slowly waste away from insufficient care and misdirected advice; others are more violent and are unconscious of the disease until a hemorrhage occurs. Such was Mike's predicament. Being of an optimistic disposition, he would have thought little of the trouble; but don't forget Mike had a mother and she sought to find relief for her boy. There was no use in calling on the seminary for help or on the navy; the family doctor was ushered in. Oh, that sanctimonious perplexed look! To the ordinary patient the verdict of tuberculosis would almost spell disaster; but Mike wasn't built that way. If a 14-inch gun on a battleship could not scare him, no mere M.D. had a chance. One thing in the doctor's favor is that he knew the peculiarities of the disease he was called upon to diagnose, and consequently Mike was ordered to a sanatorium, which gives me an opportunity to write

CHAPTER 6.

Sanitarium comes from the Latin sanitas, meaning good sense and regularity. I really don't see how Mike could find any fault with the prospects here of a year with "nothing to do till to-morrow"; but his hopes in this were badly shattered. However, he did not worryhow could he and still maintain that unusual disposition. Then, again, if he had worried, Mike would not be here to assist in this story as the principal, and I should have been spared considerable time.

Instead of twelve long months at the sanatorium, Mike accomplished the cure in six. How he did it is still a mystery, and I can't see why there is not a fortune for Mike in the prescription. In his six months of rest and cure-taking, he had lots of opportunities to devise ways and means of bringing home the bacon without manual labor; because, you must remember, that while Mike lost none of his 170 pounds avoirdupois, yet his muscular

system, which really never had an opportunity to develop itself to the full in the past, had suffered terribly.

The Sanatorium is a fine place, according to Mike's testimony, but it is not exactly the ultimate in the cure of tuberculosis. Without a follow-up for the patient, it is only a half-way measure. That is why Wisconsin has a record in anti-tuberculosis activities. Mike had to go all the way; he must be able to return to civil life as well in body as when he left and better yet in muscular development. Where does he go now? Well, this looks like a promising place to bring in

CHAPTER 7.

During my acquaintance with Mike I have as yet failed to find even the slightest trace of ill temper, but he would be justified in harboring hard feelings toward the conductor on the train when he bellowed "Tomahawk Lake next." As Mike stepped from the Pullman, the first sign of life that caught his eye was a cow with a bell on its neck; but on second look he discovered a team and sleigh. The figure in the seat was totally obscured from sight except for his nose. Upon inquiry as to the location of his objective point, Mike found that the figure on seat actually moved and finally spoke, intimating that this omnibus was to convey him to the State Camp for Tuberculosis Convalescents. If gratitude could make a person rich, that figure on the seat would be a millionaire by Mike's consent.

After driving three miles over a snowblocked trail, with the wind exceeding the speed limit and the mercury trying to keep as far below zero as possible, Mike arrived at the place that was going to make a man of him, if this first ride had anything to do with it. For the first time since leaving his parental fireside to seek his way in the world, Mike realized that there are such things as endurance tests and Northern Wisconsin blizzards. After he had come through with colors flying, he was duly introduced to the superintendent who was responsible for the manual labor (something new to Mike) that was going to put him in John L. Sullivan's class.

Mike had now become a part and parcel of a mechanism that was absolutely essential in restoring him, a victim of tuberculosis, to perfect health.

At 6:15 a. m. the military class assembled, and Mike was given a place with the other twenty men on the drill grounds. Yes, he adapted himself quite readily to these calisthenic exercises, because the navy had required them. "Dismissed," a welcome sound, finds him washing up for breakfast at seven o'clock. Thanks to the cook's foresight, an extra supply of victuals had arrived, else somebody would have been rather disappointed. I was glad to see that he was becoming acclimated to the work routine of which a hearty appetite is a sure sign.

Mike must not be dealt with too severely at first (oh, if he only knew what was in store for him), so he was told to work for only

one hour. His companion was the same figure who sat on the seat of the sleigh beside him the night before. Donning his sheepskin coat (thanks to his mother's intuition), he set forth on a two-mile ride which finally landed him in the midst of the tall timber. I can see him looking at those trees as if they have all congregated in that one spot for him to fell. The figure politely handed him an axe, with the remark that an hour doesn't last all day (sure, Mike was just as glad it didn't-there were two more meals in that day which he wanted to do justice to). "Woof" he takes the first stroke. It was fortunate that his leg was not where the axe landed because the tree was not, but, then, practice makes perfect, and after finally getting the tree notched, he took his place at the end of the cross-cut saw. At length, with the help of the figure on the other end, who didn't swear audibly, the tree came down.

"Is it dinner time yet?" asks Mike. "Not quite," comes the answer; "so we will separate the fallen monster from its limbs and cut it up so we can handle it and take it back for future use in preparing the meals at the Camp." Safe and sound and all unloaded, Mike started back to the cottage. After a short rest he found he had enough strength left to get his thermometer. If feelings regulated the mercury, he had 40°, but as they didn't, he had only 36.5°. The sound of the dinner bell made him wonder if they had enough food in the Camp to satisfy his appetite, let alone the appetites of twenty others in the same predicament; but his doubts were settled in a few minutes and he lost his appetite only too soon.

After dinner, at the request of the Superintendent, Mike went to bed for a while and slept until the supper bell roused him. On finishing this meal he was joined by another of the boys and they took the trail for an hour's walk to ascertain whether his legs could stand the same test his arms had been put to in the morning. Arriving back at the cottage he found all getting ready to retire, and felt that he had no objections to following their example.

The sleeping-quarters were not just exactly as comfortable as the private room at the San, but Mike finally settled down to make the best of it. The rest of the boys declared in sworn statements that it was the worst of it for them and that the new arrival should have confined his wood-sawing to the one hour in the morning set aside for that purpose.

Day after day followed with the same or slightly varied activities in the work program. Mike's appetite never swerved a bit from the original plan; he was going to observe its

dictates whatever happened. At the expiration of the first of the second six months, which were necessary to make a real cure of Mike, he was advanced to a two-hour man, with no complications attached, and he stood the test like a regular veteran. I say veteran judiciously, as he was beginning to feel now that he had some muscle after all, and he liked it. Matters proceeded thus for another month when he was again advanced, not in wages; there are no wages at the Camp. (Mike was only too glad to pay for this hardening process out of his dwindling bank roll.) He was now a three-hour man, doing real work, the kind that was converting his muscles into iron bands. The work was somewhat varied: first, the work of the forest, then with the change of the seasons new land had to be broken up for the first time as the result of those months spent in the woods cutting down the trees and extracting the stumps.

Now comes the call for hard-muscled, ablebodied men to work this land. Mike is now a five-and-a-half-hour man, equal to any occasion, so he is given the job with a team and a plow, which accounts for my finding him over by the roadside on that beautiful morning, and necessarily brings this article to a conclusion with an appendix in the form of

CHAPTER 8.

Mike is not a fictitious character, but one of the convalescent patients at the State Camp, and I have been extremely fortunate in making his acquaintance. He is an example picked at random to serve as the principal in this article. Mike has never realized that he was capable of developing his muscular system and at the same time effecting a perfect cure from tuberculosis. Never having been engaged in manual labor, and having worked in an office, he easily fell a prey to T. B. and was one of the worst cases on record at the San to which he was admitted. Here grit and determination scored another point; without them his hope for recovery was futile. Mike determined to get well and he did. So with his stay at the State Camp he decided to build up his muscles and he did. At this place he was able to carry out his plans successfully. By strict adherence to the daily routine, medically prescribed graduated labor, he made good. starting in at one hour per day he is now working five and one-half hours per day; all of which goes to prove that because a person has tuberculosis he is not necessarily doomed to die. As Mike has done, they can do. They can be restored to health and can fit themselves better than before to re-enter civil life and hold up their end in any undertaking with their fellow workers.

New York Association Reorganized The anti-tuberculosis work in New York City which, for the past seventeen years, has been thoroughly and energetically carried on by the Committee on the Prevention of Tuberculosis of the Charity Organization Society, has been taken over by a new and larger corporation, the New York Tuberculosis Association, Inc. All the members of the old committee including such proimnent workers in the tuberculosis field as Dr. Hermann M. Biggs, State Commissioner of Health, Dr. Royal S. Copeland, Health Commissioner of New York City, Dr. Lee K. Frankel, Dr. S. S. Goldwater, Mr. Thomas L. Lamont, Dr. S. A. Knopf and others are members of the Board of Directors of the new Association.

The objects of the Association are: The study of tuberculosis and of the means of preventing it; the dissemination of knowledge as to the nature of the disease, its causes and the methods of its prevention and its treatment; the promotion of adequate facilities for the prevention of tuberculos's and for the care, treatment and economic rehabilitation of persons afflicted therewith, and the coordination of the work of public and private agencies engaged in any of the foregoing activities.

Dr. James Alexander Miller is the president of the Association and Mr. Homer Folks is the vice-president. Dr. John S. Billings, former deputy commissioner of health of New York City, is the director.

A broad program of education, publicity, preventive work among children, of home treatment and aftercare, coordination of existing clinics and of relief agencies, will be developed by experienced

secre

taries. A novel

addition, in CO

operation with the Federal Board for Vocational Education, will be the opening of a workshop where, under the best sanitary conditions and medical supervision, arrested cases of tuberculosis will be restored to productive capacity under healthful surroundings.

Among the secretaries so far appointed are: Mr. G. J. Drolet, statistician; Miss Gretta Jones, relief organizations; Mrs. Josephine Toering, tuberculosis dispensaries; Mr. E. C. Rybecki, labor; and Mr. David Ryan, publicity.

Tuberculosis and Moving Picture Shows The moving picture shows "with which the entire republic of Argentina is plagued," are in halls which are kept closed against the sun and air and are never disinfected. According to an article in a recent number of La Semana Médica, they are actual hotbeds for germs of all kinds, and cannot fail to be a potent means for transmission of tuberculosis. Five guinea pigs were smuggled clandestinely on three occasions into a moving picture hall for a few

Etiological Studies in Tuberculosis The discovery by Koch in 1882 of the germ causing tuberculosis did not clear up all the problems of infection. Numerous declarations have been made as to the mode of infectionhow the germs get into the body and how they set up destructive processes. The facts are not yet established. There is no known period of incubation. Manifestations of disease appear months or years after infection. Tracing back from disease to source of infection presents great difficulties.

Lawrason Brown, S. A. Petroff and Gilberto Pesquera have undertaken at Trudeau some interesting experiments with guinea pigs "to trace the tubercle bacillus, if possible, directly from the source of infection to the apparently exposed animals."

They studied in succession the dust of rooms, the telephone receivers, the eating utensils, the infected hands of patients, the saliva,

the transmission by kissing, the infection of tooth brushes and the danger of flies and of coughing in tuberculosis infection for guinea pigs.

In the kissing experiment the patient, whose sputum contained tubercle germs was instructed to kiss a sterile Petri dish which was washed with sterile physiologic sodium chloride solution and inoculated, as previously described, into guinea pigs. "The guinea pigs, inoculated with the washing from plates kissed, some immediately after and some ten minutes after coughing, developed generalized tuberculosis, while those inoculated twenty minutes after coughing remained free from tuberculosis.

"Dust collected by a vacuum cleaner from the rug of a living room in the sanatorium was negative; swabbings from the mouthpiece of the sanatorium public telephone were negative. Washings of spoons, forks, glasses and cups, that had been used at meals by patients and had not been cleaned were positive; those of knives and dishes were negative. Washings of the hands of patients who had coughed upon their hands were positive; those of the hand of a second person who had shaken hands with a tuberculosis patient and those of a door knob rubbed by a contaminated hand were negative. Saliva collected from patients just before coughing was positive. The wash water of a tooth brush was positive; as were the fly specks of flies fed on tuberculosis sputum."

The investigators "do not wish to imply that these few experiments should be looked on as proof positive in a matter so important as this, but contend that they emphasize the caution that must be used when infection is inferred to follow proof of contamination.”

What Others Say

"Great as has been the destruction of life by influenza I believe it will eventually save more lives than it has destroyed, if we learn to cover our mouths and noses during coughing or sneezing as was recommended by Benjamin Franklin long before bacteria were discovered."

G. L. CRUIKSHANK, M.D., Windsor, Ont. "Over 15 years are lost to the average life through the lack of application of knowledge which already exists but which simply has not yet been disseminated and applied."

Report of Roosevelt Conservation Commission on National Vitality.

From a Child's Toy

Just one hundred years ago René Theophile Hyacinthe Laennec, one of the pioneers of modern medicine, observing some children playing in the gardens of the Louvre, listening to the transmission of sound along pieces of wood, conceived the idea of utilizing this method for listening to breath sounds in examining a patient's lungs. He went home, fashioned a tube by rolling up some glued paper and then experimented with this in his ward at the Neckar Hospital. From this in