as Professors Prudden, Biggs, and Janeway, of our city, have declared this action not based on scientific principles, and Dr. Biggs pronounced it unwise, unjust and inhumane. I heartily indorse the opinion of my eminent friend, and have expressed my views on this subject in a recent paper read at the Academy of Medicine, entitled "Public and Private Phthisiophobia," that is to say, exaggerated fear of the vicinity of consumptives. In a lay audience it is essential to avoid medical terms which may lead to a misunderstanding. Permit me, therefore, to give you a definition of what is meant by the terms communicable and contagious. The great danger from infection in tuberculosis lies in the indiscriminate deposit of sputum containing the bacilli, which, when dry and pulverized, may be inhaled by susceptible individuals and then cause the disease to be developed. The communication of the germ of tuberculosis is, however, less obscure to us in its process and far more easily guarded against than the contagion arising from such maladies as diphtheria, scarlet fever, small-pox, or yellow fever. To be in contact with a consumptive who takes care of his expectoration and other secretions which may contain the bacilli is not dangerous. This cannot be said of small-pox or yellow fever. Herein lies the difference between communicable and contagious. What can you, friendly visitors and charity workers, do toward helping to solve the tuberculosis problem? The first thing that I would advise you to do is to protect yourself, not by becoming a phthisiophobic, that is to say, afraid to go near a consumptive, but by making yourself strong and vigorous, so that, if you do happen. to inhale a few bacilli, they may not do you harm. For you must know that the nasal secretions, is, well as the blood, are bactericidal; that is to say, certain cells contained in the healthy blood and healthy nasal secretions are stronger than the little bacilli, and do away with them by simply swallowing them. The scientific name for this process of destruction of the germs is phagocytosis. Having kept yourself strong and vigorous, what can you do in your work among the tuberculous in the tenement-house districts? You should first make yourself acquainted with the two sources of infection; the one coming from the dried tuberculous expectoration has already been mentioned, and the remedy is the use of wellkept spittoons and pocket flasks, and the strict order to the patient never to expectorate anywhere but in those vessels. This, you must tell him, he has to do as much for his own protection as for the protection of others. You must tell him that if he should re-inhale the pulverized dust of his expectoration he would re

infect himself and make his condition more serious. Tell him also that he must always have two handkerchiefs with him, one to use to wipe his mouth after expectorating, and the other for his nose. Kissing on the mouth should be discouraged in a family where there is a consumptive. If the patient is helpless, so that he cannot use either his pocket flask or the ordinary spittoon, moist rags should be near his bed and used to receive the expectoration. They should be burned before they have a chance to dry. Tell the people who attend to the cleaning of the spittoons to be careful if they have any scratches on their hands, not to soil them with matter from the spittoon. They should be particularly careful with nicked glass or porcelain spittoons. If one has been unfortunate enough to receive an injury, and tuberculous inoculation is feared, the best thing to do is to let the wound bleed freely, wash it thoroughly with water that has been boiled, with a five-per-cent. solution of carbolic acid, or with pure alcohol; dress the wound with a clean rag dipped in any of these liquids, and seek as soon as possible the advice of the physician.

There is one source of infection little known which you, visitors of the tenement houses, should be acquainted with. This is what we call drop infection. During the so-called dry cough, excited speaking or sneezing, small particles of saliva are expelled from the mouth and nose which may contain the bacilli. At a distance of three feet these drops fall to the ground. To guard against the danger of this sort of infection you should not approach the patient unnecessarily near for any length of time, and you should always insist that the patient hold a handkerchief before his mouth while he coughs. Incidentally, I should also like to mention that the so-called dry cough is, with a great many people, a matter of habit. They have a slight tickling sensation in the throat, and in order to relieve it, cough and make the irritation. worse. Discipline in such cases has often cured the cough.

While there is absolutely little danger of infection from tuberculous meat, since diseased meat is destroyed under the direction of the inspectors of our slaughter houses, there is danger from tuberculous milk, and you should advise mothers in the tenements to boil or sterilize all milk before giving it to the children.

With this knowledge of the prevention of tuberculosis, what can you do toward its cure? The ideal solution of this problem would be that at the moment you discover a tuberculous man, woman, or child in the tenement districts you should be able to recommend the immediate removal to a sanatorium, where the patient has the

best possible chance of becoming cured. Even the best-kept tenement home is not a good place for a consumptive, and if the home of such an unfortunate one is ill-kept, badly ventilated, dark and dreary, it is the saddest place to be. Deprived not only of the many hygienic and dietetic agents whereby we nowadays treat and cure this class of patients, but lacking, perhaps, the very essentials to sustain life, the poor consumptive of the tenement is doomed to a certain and lingering death.

You must interest all your friends who can and are willing to help to assist our State and city authorities to create a sufficient number of sanatoria for the consumptive poor adults, and enough seaside sanatoria for tuberculous and scrofulous children.

In the meantime, when you visit a consumptive, besides inaugurating the above-mentioned preventive measures, impress upon the patient, his family and friends, that fresh, pure air all the time is almost a specific for the disease. To keep the window open twenty-four hours of the day, winter and summer, rain or shine, is the first requisite for a consumptive. The next thing you must do after your visit is to get a doctor, if the patient has not yet a medical attendant. Then combine your forces with the doctor and see what you can do in the providing of good food and in arranging, as far as possible, a sanatorium treatment at home. More you cannot do, except, perhaps, to ask the doctor if he would not be good enough to examine occasionally, also, the other members of the family, to determine whether some infection has taken place. By the discovery of an early case and the immediate inauguration of treatment, you may be sure to have saved at least one life, if you have been called too late to save the other.

We have spoken of ignorance concerning personal hygiene, food and cooking: we have mentioned alcoholism and tuberculosis; it remains now for us to say a few words on that other problem of the tenement dweller, inability of the many to get along with their earnings. Besides alcoholism and disease, which make the poor very much poorer, there is often the expense of rent, which takes far too great a portion of the earnings of the laborer.

This problem, ladies and gentlemen, you will probably not be able to solve alone. It is a social problem, and we can only partially solve it by appealing to our generous fellow-citizens who have given millions for churches, colleges, libraries, to help us now to get enough model tenement houses where the average wageearner may for a modest sum have a cheery, healthy home. Rents are too high in our cities. The poor pay relatively higher rent

than the wealthy. Let our great lovers of mankind direct their gifts in this direction. Let them create pleasant, cheery, and healthy homes for laborers' families, at reasonable rents. There will be, as a consequence, less misery, less crime, less disease, and our tenement-house problem will be ultimately solved in all its aspects.

NEW PLAN FOR VENTILATION.

PROFESSOR S. HOMER WOODBRIDGE, of the Massachusetts Institute of Technology, who has recently had charge of the ventilation of the Capitol at Washington, has prepared a general statement (Brooklyn "Eagle") of the problem of properly ventilating theatres, churches and audience halls, which is of very general interest, since, although the buildings in which he has made his experiments are mainly in Boston, yet the conditions in that city are practically duplicated to a greater or less extent, according to size, in every other city in the country.

The importance of the subject will be realized by any one who has sat in a crowded auditorium, coming in from the fresh air out of doors only to go home, however entertaining the performance or eloquent the speaker, with a headache or sensation of heaviness arising from the impure air, or with a cold, or worse, from the draftiness caused by an unscientific method of ventilation. Professor Woodbridge points out that in residences, offices, shops, and the like, the air space to each occupant varies from 5,000 cubic feet, say, down to 500; while in auditoriums the individual space is only 500 as a maximum, and often sinks to as low as 50. In the auditorium, therefore, special methods of ventilation are an absolute necessity, but the sort of ventilation that the contractor or architect provides is often as dangerous, one may almost say, as no ventilation at all.

Yet the principles on which correct ventilation depends, although so seldom fully recognized, are simple enough when once stated. For example, it is obvious that the smaller the space through which a volume of ventilating air is to move, the more rapid its motion must become-which accounts for one of the more important difficulties of auditorium ventilation. And the movement of ventilating air becomes sensible, it is obvious again, in a ratio corresponding with its velocity or with the drop in temperature which it causes, or with both.

Obviously, too, the aim of the ventilating engineer should be to furnish a maximum in the air quantity with a minimum in draft effect. Usually he has gone about his task by what appeared, on first examination of the problem, to be the easiest and simplest way, though in the end either wholly or partly ineffective. That is, he has introduced his fresh air at the ceiling of the auditorium, as being removed farthest from his audience, his flow of air extending thence downward in an area which might be likened in shape to a huge tent covering the floor of the theatre or audience hall, the overplus of air escaping, that is, at vents scattered equally over the floor.

The method looks reasonable enough at first, but it is essentially faulty. For instance, it ignores the influence of the audience itself, each member of which may be compared to a big lighted candle, contributing to heat the surrounding air. Thus Professor Woodbridge states that if through a theatre seating 2,500, 40,000 cubic feet of air an hour are passed, the ultimate rise of temperature from this aggregate human heat may be safely estimated as II or 12 degrees Fahrenheit. It is clear enough, then, that the cooler air entering at the top of the theatre, with the humanly overheated air at the bottom of the room, will create a state of unstable equilibrium, and that by an immutable law the cooler air at the top must fall, while the warmer and lighter air at the bottom must rise. The result will be drafts, fitful or steady, as the case may be. And the higher the ceiling-the place, that is, which has been selected as being most remote from the audience, and therefore the most unlikely to produce drafts-the more violent these drafts will be. The remedy is to reduce the air quantity, in itself a confession of weakness, or to increase the temperature of the air supplied, which is much the same thing.

It is further pointed out that currents of unequally heated air are not only unhygienic, but that they seriously interfere with the transmission of sound from the stage or platform, the finer qualities of the singer's or speaker's voice being often quite lost as a result. Even more important is the question of air impurity. Not only does each member of the audience influence the temperature, but he takes to himself a proportion of the vital properties of the air, and returns to it his own semi-poisonous exhalations; besides throwing off a certain amount of what Professor Woodbridge aptly calls "personal débris." With the imperfect method of "downward ventilation," as it is called, just described, it will be seen that a large part of these noxious elements-which in the main