It is our purpose, during the coming years, to hold a conference with these societies and the other anti-tuberculosis organizations of the State, and to keep the people of every town acquainted with the anti-tuberculosis work done, not only in their own town, but in every other town in the State. Heretofore, the publicity functions of the Commission have reached only individual towns, cities, organizations, churches, factories, and schools. We hope for even more satisfactory results as the result of the "getting together" that we are planning.

OUR DEBT TO THE NEWSPAPERS.

In spite of the public absorption in war news, and in spite of the difficulties under which they labored because of the scarcity of print paper, the newspapers of the State have been extremely generous in giving us space for propaganda of the fight against tuberculosis. This has been especially noticeable at Christmas time, when the drive for the sale of Red Cross Christmas seals has been under way.

OUR SALE OF CHRISTMAS SEALS,

Perhaps a few words about the Red Cross Christmas seal. sale, and our connection with it, may not be out of place. Occasionally, a citizen receiving a request to buy these Christmas seals, has written to us to say that, in his opinion, a Commission of the State of Connecticut should not be engaged in superintending such a petty business. Usually, however, when the facts of the situation were made clear to him, his feeling of irritation disappeared and he himself entered whole-heartedly into the "drive." These facts are:

1. We took up the supervising and extending of the sale of these seals, at the request of the National Tuberculosis Association, which was the agent of the American Red Cross.

2. By conducting and energizing the "drive"; by enlisting all the school children of the State; by circulating tracts and leaflets and placards through the schools, factories and stores, and by securing the assistance of public speakers and proprietors of theaters, in setting forth the facts about tuberculosis, we were doing exactly what Section 13 of Chapter 183 of the Public Acts of 1913 directs us to do.

3. The gross proceeds of the sale of the Christmas seals in the State are about $40,000. According to our contract with the

American Red Cross and the National Tuberculosis Association, the local agencies keep 85% of the amount of their sales and send to us the remaining 15%. We send 10 of these 15% to the National Tuberculosis Association and the Red Cross. The remaining 5% we were supposed to keep to pay for our expenses in conducting the "drive." As a matter of fact, we return this 5% to the local agencies and keep none of it to pay for our central expenses. We are enabled to be thus generous because of a mail order sale that we conduct through those less thickly settled portions of the State, where we have not been able to establish local agencies to conduct the campaign. This mail order sale differs in no wise from the mail order sale in use by the fifty-odd local agencies in the larger communities of the State. This mail order income last year was $7,000. From this sum we offered every town, in which we have conducted the sale, such amounts as the town desired for helping in anti-tuberculosis work. Out of the balance we have sent again to the visiting nurse associations and the tuberculosis clinics of the larger cities, such sums as. in answer to our inquiries, they said they needed.

Because of the desire of the Red Cross to use this coming Christmas time for its great Roll Call, and its willingness to appropriate to the tuberculosis agencies a sum equivalent to the proceeds of last year's seal sale, the seal sale has been suspended for this year. However, next year we hope to arouse the antituberculosis sentiment at Christmas time, with the Christmas seal.

CONCERNING CLAIMS FOR COMPENSATION.

The considerable number of employees at the four sanatoria. working on the farms and in and about the various buildings, makes it certain that every year we will be obliged to pay compensation for injuries sustained by our servants. Already we have had several experiences with awards by the Compensation Commission. The amounts thus far have not been large, but it is not without the range of the probable that some accident would cause us to pay, for compensation to our injured employees, sums large enough to make serious inroads on our carefully calculated maintenance appropriation.

Perhaps this is not a very urgent matter at present. We merely call the attention of the legislature to the possibilities of the situation, and suggest that if our department is to be subject to the awarding of damages by the Compensation Commissioners,

legislation be enacted indicating the funds from which these awards to injured employees be paid.

MERIDEN.

Dr. Dinnan has been the only physician resident at the sanatorium for much of the last year, because the army and navy took his assistant physician.

There is here a very creditable open air school for the benefit of the children patients. We were indebted to the Meriden Public School officials for sympathetic assistance and advice in the conduct of this school. There has been no new construction at Meriden during the past two years, except the root cellar, the storehouse, and the barn.

During the coming two years it will be necessary to consider the erection here of a new infirmary. The present infirmary, though kept as attractive as is possible with frequent painting and scrubbing, has about outlived its usefulness. The nucleus of the building was an old roadhouse in the days of the stage coach. Then it served for years as the town house of Meriden. Addition after addition has been made to it since it came to serve in the anti-tuberculosis campaign, but it is bent with age. Its floors are aslant. Its falling plaster brings groans from the nurses and bills to the Commission office. We will submit our plans on this subject to the proper committees of the legislature.

HARTFORD.

The Hartford Sanatorium has continued to function successfully, during the two years, in spite of the fact that the army took from it not only an assistant physician, but also its superintendent, Dr. William H. Stockwell, one of the best men in the State's service. His worth was soon recognized by the Surgeon General and he has been for months engaged in the training of the Base Hospital Medical Groups of the army.

The farming activities have been increased by the renting cheaply of an unused property of our neighbor, the J. G. Balfe Company. Expert farmers of the State have complimented us on our crops of potatoes and garden truck, for the past two years.

SHELTON.

The completion of the infirmary at Shelton has not only increased the usefulness of the institution, but it has also greatly

improved its appearance. The site at Shelton is probably more beautiful than that of any other public institution in the State. The witching view from the infirmary verandas, of gracious hills and rivered valley and distant ocean, is one not easily forgotten, and of course, beauty of environment is not a small matter to the man or woman who is obliged to leave home to fight for life or health.

Hereafter, the Shelton Sanatorium will accommodate about 175 patients. This increase made necessary the providing of more accommodations for nurses and help. This has been accomplished by remodeling the buildings known as the old farm house and the nurses' home. By this plan, a good recreation hall for patients has been provided by the first floor of the nurses' home.

Dr. Lynch, the superintendent, has been fortunate in having an assistant during most of the two years, and both have been ably assisted by the head nurse and the other members of the staff.

NORWICH.

At Norwich, Dr. Campbell was for many months without an assistant physician. Nevertheless, the work of the institution went on almost as smoothly as before, and this, in spite of the fact that the new 60-bed infirmary, the superintendent's cottage, and the new barn were in process of erection, and that it was necessary for him to keep up a constant inspection of the new work. By the first of January, we hope that Norwich will accommodate 160 patients.

NURSES AND DISPENSARIES Needed.

Hardly any two of the more advanced states or countries follow the same formula in treating their tuberculosis problems. Nor is it necessary that they should. Many began with putting their entire reliance on the establishment of sanatoria, public and private. The futility of this reliance has become apparent to most authorities nowadays. Germany, thanks to her highly developed Sickness and Invalidity Insurance Societies, was the first to develop an elaborate Sanatorium System. But long ago, she saw that the sanatoria were good chiefly as educational agencies, and she has since adapted to her needs the Edinburgh dispensary system. This system, founded by Dr. R. W. Phillips of Edinburgh in 1887, is now copied more or less closely throughout Europe and in many cities in this country.

According to the Edinburgh idea, all tuberculosis dispensaries should be sustained by prviate charity and should feed suitable patients to the proper sanatoria and hospitals.

In New York, many of the dispensaries are financed by the city, that is, by the Departments of Health, or by the Board of Trustees of Bellevue and Allied Hospitals, which is a co-ordinate city department. Most of the dispensaries are conducted by private organizations, associations or hospitals. All these dispensaries are under the general supervision of the New York Association of Tuberculosis Clinics, which is an incorporated organization. To each of the dispensary districts is assigned a corps of nurses, some of which are supplied by the private organizations conducting the dispensary. The city supplies several hundred nurses for the home visiting. Attached to each dispensary is an auxiliary body of ladies, who look after the families of the patients, and who are considered an almost indispensable part of the work. Every tuberculosis patient discharged from a hospital or sanatorium is reported to the dispensary in his or her district, and here again, comes directly under the supervision of the nurses.

In many places, the dispensary physicians prescribe for the patients, but in some countries, chiefly because of the complex arrangements with the insurance society or "panel" physicians, the dispensary authorities merely examine the patient and send their findings and advice to his family doctor.

We have gone into this matter at length, because, in our opinion, this State should set its hand now to a thorough development of a tuberculosis dispensary system.

It will not be difficult. Already in New Haven, Hartford, Bridgeport, New Britain, Waterbury, Meriden and Norwich, the foundations are laid. What is needed to complete the structure is such an increase in the number of visiting tuberculosis nurses as will permit the existing dispensaries, with a few additional, to extend their beneficent control into every corner of the State.

We do not intend to suggest that the State should, at this time, make appropriations from the treasury for the employment of visiting tuberculosis nurses. We are strongly of the opinion that the financing of the dispensaries is a local problem. We bring up this matter now for the purpose of showing what, in our opinion, should be the next step, and also, to make clear to the enthusiastic gentlemen, who every year propose, in the General Assembly, bills for the erection of more State sanatoria in remote