opposition is met with from the residents of the section in which it is desired to build. A report of the Rutland sanatorium shows that during the first six years the institution was in operation, the deaths from tuberculosis in that town had been-aside from people who had gone there with the disease-less than in any other period of six years, for eighteen to twenty-four years prior to the establishment of the sanatorium. The number of taxable polls in that village increased, and taxable property also increased largely. Of course the demand for skilled and unskilled labor also increased. Saranac Lake has, as is well known, grown to be a large town from almost nothing, because of the reputation given it by the Adirondack Cottage Sanatorium of Dr. Trudeau. The location of the sanatorium should be at a distance from any large town, but easily accessible by rail. If you are near large towns you will have much dust and smoke in the air; and there will be a great many temptations, especially to men, which should be withheld from them if possible. There is no large town within fifteen or twenty miles of our sanatorium, but the railroad passes within almost a stone's throw of our door. In regard to the general design of a sanatorium I believe that the combination of a one-building institution and a number of tents and lean-tos would be the best. A central building for dining room, kitchen, administration offices, etc., with a dormitory on each end, would provide for patients who are not in very good condition, and the tents and lean-tos around it would provide for cases who could walk about more, and who were well enough to withstand the slightly greater exposure of housing in such structures. This would also provide for those who through nervousness, etc., might do better in smaller and quieter quarters than could be had in the large dormitories. Of course the number of people to be cared for would greatly influence the general arrangement. A sanatorium on such lines could be easily enlarged by adding lean-tos, tents or cottages, or additional dormitories. Last winter we had so much pressure for places at our sanatorium that we were obliged to put two patients in a room. Some slept on the porch, and some in the rooms. We have better facilities for ventilating our rooms than in some buildings I have seen, the rooms being very large. Not only are there two large windows in each room, but over these windows are transoms of equal width, which go clear up to the ceiling of the room. There are also transoms opening into the hall, so that it is easy to pass the air right through the room. The only objection that I have seen to having two patients in a room is, that occasionally a person that has a bad cough annoys her roommate at night. This does not make any practical difficulty, as it is always easy to provide such a patient with a roommate who will sleep on the porch, so that the one who coughs has the room to herself at night. Furthermore, most people quickly learn to disregard the coughing of their roommates, and sleep as well as if alone. In the Ray Brook Sanatorium they have as many as three patients sleeping in a room. We have no washing facilities of any kind in the rooms, principally because of the extra expense entailed by providing them, and also because in winter so many accidents occur from water freezing in rooms, where the windows are open at night. There are large bathrooms on each floor of the dormitories, where the patients perform their ablutions and take their shower baths. After considerable discussion the society elected the following gentlemen as officers of the Vermont Society for the Study and Prevention of Tuberculosis: LIST OF OFFICERS NOMINATED FOR BOARD. Dr. C. S. Caverly, Rutland, President. Vice President. Vice President. Vice President. Secretary. With power to fill up vacancies to complete the Organization. DEATHS FROM TUBERCULOSIS IN THE CITIES AND LARGE VILLAGES QUARANTINE. BY B. H. STONE, M. D. Quarantine is always something of a hardship. It is a sacrifice on the part of a few for the protection of the many, and has its legal basis in the police regulations of the state. A large part of our freedom from the plague of the olden time, which would affect three fourths of the entire population of cities and countries, is due to the strong work of the sanitarian in quarantining cases of cummunicable diseases. These are truths which all of us are willing to accept in the abstract, but in the concrete, when the full application demands a personal sacrifice, it is not always so easy to see the justice in the restriction. Especially is this true in a case of diphtheria. When a patient is obviously ill, it is not difficult to comprehend that he or she may be a menace to others, but in a case of diphtheria, the patient may be entirely free from objective or subjective symptoms within a few days, and still it may be necessary to maintain quarantine for weeks and in some cases even months. The reason for this is that serum therapy has shortened the quarantine course of this disease. Before the use of antitoxin, very few cases would have recovered in a space of two weeks. Now if the case is seen early enough, the disease can be brought to an abrupt end. Antitoxin produces this result by neutralizing and rendering inert the poisons produced by the bacteria. It unfortunately does not possess any germicidal action on these bacteria. The diphtheria bacillus will grow vigorously in commercial antitoxin, consequently the organisms will remain in the throat until they are killed and removed through the ordinary course of nature, which is comparatively slow. It is altogether probable that we can obtain a fairly accurate idea of how long the disease would have lasted without the use of antitoxin, by the length of time which the bacteria persist in the throat. These organisms, so long as they remain, although perfectly harmless for the individual rendered immune by antitoxin, are as much of a menace to others as they would be coming from the throat of a dangerously ill person, and in a way they are more important, for the patient without symptoms would not be confined to the room, whereas a patient suffering from an acute disease would not be out of the house. To prevent the spread of disease in this way, our State Board wisely requires the procuring of two negative cultures from the throat before quarantine is released. Usually these will be obtained within two weeks, but there are occasional cases in which the organisms persist for a much longer time. Cases are on record of a quarantine of nine months, made necessary by the persistence of the germs in the throat during this entire period. The quarantine period may usually be lessened very materially by the use of local antiseptics. Several things should be borne in mind during this treatment. First. A non-irritable and normal mucous membrane has a greater reactive power than one which is continually irritated by the application of strong antiseptics and by too frequent raking of its surface in the taking of cultures. Second. That the diphtheria bacilli may lodge deep in the gland crypts or in the passages of the posterior nares, so that the superficial washing of the throat may not affect them. Third. That the bacilli grow vigorously in a feebly acid menstruum, so that logically either a comparatively strong acid or alkaline solution would be advisable. Fourth. No single antiseptic solution can be relied upon in all cases, and various agents should be tried if the organisms show a tendency to persist. Peroxide of hydrogen, lemon juice, silver nitrate solution, bichloride solution, alphozone, acetozone have all been used with success in some cases. UNDER OUR PURE FOOD LAW THE FOLLOWING EXAMINATIONS OF MISCELLANEOUS ARTICLES HAVE BEEN MADE SINCE LAST REPORT. Lab. Brand. Manufacturer. Where Sold. Remarks. 35192 Cream Soda 35193 Lemon Soda 35194 Apple Cider 35195 Root Beer 35198 Standard Appetizer 35199 Ginger Ale 35425 Mocha and Java Blend Coffee 35543 Mustard 35544 Cinnamon 35545 Cloves 35546 Black Pepper 36253 Gluten Flour 46 46 Standard Bottling Works, St. Johnsbury Standard quality Standard Bottling Works, 66 Direct Coffee Co., Boston, Bennington Citizens' Wholesale Supply Rutland Citizens' Wholesale Supply Illegal-contains salicylic acid. Standard quality Illegal-colored with coal tar dye Illegal-colored with coal tar dye Standard quality Pure coffee Pure 46 64 46 66 Burlington BULLETIN OF THE VERMONT STATE BOARD OF HEALTH. Volume VI. No. 2. Issued Quarterly at Brattleboro, Vermont. The Bulletin is published quarterly by the State Board of Health under the authority of Section 5 of Act No. 90, Legislature of 1900. It will be sent to all Boards of Health. A copy will be sent to any person in the state upon request addressed to the Secretary, Henry D. Holton, Brattleboro. NEWS ITEMS. TOWN CLERKS. The attention of town clerks is called to the third paragraph of Section 2 of No. 140 of the laws of 1904, which is, viz.:— "Town and city clerks shall semi-annually, in the months of February and August, transmit to the Secretary of the State Board of Health a certified copy of each birth, marriage and death certificate received by them during the six months last preceding the first days of January and July respectively of each year in which the copy is made, such copy to be upon blank forms furnished by the Secretary of the State Board of Health." Also to Section 14 of the law relating to the returning of certificates, viz.: "If a town or city clerk fails to transmit to the Secretary of the State Board of Health the copy of the returns of births, marriages and deaths once in six months, as provided for in this act, he shall be fined not less than twenty dollars." It is of very great importance that these returns be made |