of Elkton, Dr. Charles M. Conley, of Frederick and Dr. Henry Barton Jacobs and myself, from Baltimore City.

The Board immediately organized, electing Ex-Governor Smith as President, who appointed a committee to secure a suitable site, and also a committee to consider the scope and plan of the new institution.

The Site Committee adopted the recommendations of the former Tuberculosis Commission, viz:-that the site should be at an elevation of at least 1000 feet; that it should be in immediate vicinity to a railroad, to insure economical hauling of supplies, patients, etc.; that it should have a southerly or south-easterly exposure, with proper wind protection from the north, and that there should be an unlimited water supply on the property, or nearby.

After inspecting sites in all sections of the State, the Committee finally decided to purchase a piece of property near Sabillasville, Frederick County, in the heart of the Blue Ridge Mountains, at an elevation of 1450 feet, overlooking the beautiful Hanover and Gettysburg Valleys, and immediately adjacent to the Western Maryland Railroad. I personally travelled from one end of the State to the other inspecting sites that had been offered to us, and I do not feel that I am exaggerating when I say that I think the Directors have chosen one of the most beautiful spots in the State for their purpose, and one that will compare favorably with the site of any other existing sanitarium east of the Mississippi River. In fact, I know of no institution, state or private, that will have so many geographical and climatic advantages as will the Maryland State Sanitarium. We have the desired altitude in a section remarkably free from moisture, where the summers are cool and bracing and the winters not unendurably cold, and best of all, within a few hours steaming distance of all our chief centres of population. The Directors are anticipating with pleasure the possibility of this Faculty holding one of its semi-annual meetings on the Sanitarium premises, when a symposium on tuberculosis might be the order of the day, and you will all have the opportunity of seeing for yourselves the beautiful spot Maryland has chosen for her consumptives.

The Plan Committee, in the meantime, has not been idle. Drawings of every existing institution in this country, and some of those from abroad, were obtained and carefully studied by ourselves and our architects, Messrs. Wyatt & Nolting, with a view of combining all the good features of each, and excluding those found by practical experience to have proven defective. The Committee further sent a circular letter to all the expert sanitarians in the country requesting them to give their views in writing as to just how an ideal sanitarium should be constructed. Replies were received from Dr. Herbert King, of Liberty, Dr. Lawrason Brown, of

Saranac, Dr. David Lyman, of Gaylord Farm, Dr. Charles Elliott, of Muskoka and Dr. H. L. Barnes, of the Rhode Island State Sanitarium, Wallum Lake. It is needless to say that all these letters contained much valuable information, and if published in combined form should furnish enough data for any other state committee engaged in a similar undertaking.

The result of all these deliberations was that the Committee decided that an administration building, dining hall and infirmary should be built in one building, and that the patients' quarters should all be built on the lean-to system as devised by Dr. King and improved by Wyatt & Nolting, such lean-tos to be grouped around the central building. The plans for the power heating and lighting plant and laundry have not as yet been completed, but they will all be of the most approved and modern design. In short, I think I may safely say that by the first of the New Year, Maryland will have added another institution to her list which will compare favorably with some of her already existing public institutions which have a world-wide reputation, and of which she should be justly proud. And now, just a word as to the scope of this sanitarium as tentatively outlined by the Board of Directors.

It will be open to all white residents of the State of Maryland who are suffering from tuberculosis in any of its forms, medical or surgical. Each individual will be charged a uniform rate, the exact amount not as yet having been determined. This charge will be necessary until the State sees fit to increase the annual appropriation for maintenance. The present plans call for about sixty patients, and as the average cost per patient per week will probably be in the neighborhood of $10.00, it will cost us roughly about $30,000 a year to maintain the hospital at full capacity. As our present maintenance fund is only $15,000, it will be necessary to charge each patient about $5.00 a week, or else take only thirty cases. I trust the next Legislature will increase the fund so that we will be able to take care of patients free of charge, or else pass laws making it incumbent upon the County to pay for their indigent consumptives, as they do now for their insane. The Committee on Scope and Plan have also decided that the sanitarium shall only be open for cases in the early stages of the disease that admit of a possibility of a permanent cure. My experience at Eudowood Hospital has been that physicians are wont to put off sending their patients to the hospital until the disease has so far advanced as to make any permanent benefit an impossibility. It will not be good economy on the part of the State to admit to the hospital advanced or hopelessly ill persons, who at best can only be temporarily patched up, and who will surely relapse after discharge, and by the prolongation of their sufferings become an increased burden on their friends or the community. The method of admission to the hospital has not yet been definitely determined,

but the medical members of the board will probably act as examining physicians in their several localities, and I do hope that I shall not be overwhelmed in Baltimore City with a lot of far advanced. cases seeking admission.

In this connection, before closing, I should like to say just one word about the use of tuberculin as a diagnostic agent in very early and obscure cases. We have been using this agent quite extensively at Eudowood with uniformly good results and without any untoward or deleterious effects whatever. In proper doses, I think it is perfectly safe, and it has been of immense value to us in clearing up doubtful cases in whom a positive diagnosis could not have otherwise been made. It has been my practice of late to give tuberculin to all persons who have been recently associated with cases of tuberculosis, and it has been remarkable the number of positive reactions that have been obtained. Such persons never fail to do well under sanitarium treatment, and I think I should say that in about three months' time can be regarded as permanent cures. We are at Eudowood, and will be at the State hospital, only too glad to take suspects for such injections, for I would rather see a dozen negative reactions than get one case when it is too late to do anything. Let me therefore beg of you gentlemen to see to it that when the institution is opened, it will be used to fulfill the purposes for which it was built.

Book Reviews.

MANUAL OF THE DISEASES OF THE EYE. For Students and General Practitioners. By Charles H. May, M.D., Chief of Clinic and Instructor in Ophthalmology, College of Physicians and Surgeons, Medical Department of Columbia University, New York, 1890-1903; Ophthalmic Surgeon to the City Hospitals, New York; Adjunct Ophthalmic Surgeon to Mt. Sinai Hospital, New York, etc. Fifth edition, with 362 original illustrations, including 22 plates, with 62 colored pictures. Price $2. New York: William Wood & Co.

We have before congratulated Dr. May upon his wonderful success with this little publication and exhausted our supply of good expressions in praise of the former editions. This, the most recent edition, shows still more improvements, and will undoubtedly hold the continued support of the profession, teachers and students alike. We consider it by long odds the best and most satisfactory manual of ophthalmology for the undergraduate student that has yet appeared, and wish its author all the success his excellent work deserves. H. O. R.

Secretaries of the County Societies are earnestly requested to send reports of meetings and all items of personal mention and of local or generai interest for publication addressed to Dr. Alexius McGiannan. 847 North Eutaw Street. Baltimore.

"WATCH IT GROW."

The New Building Fund during October and the first two weeks in November has shown a most gratifying increase since last month's report (see illustration), but there is still room for great improvement and increase in the subscriptions which we hope will soon be forthcoming.

It is expected that all the counties will enter into this campaign for the New Building with enthusiasm, especially as with our enlarged facilities in the New Building, the shipment of books and specimens, when wanted, can be done most promptly. A member of each county society has been appointed to take charge of this work, so that each county will be able to give a large subscription, as a body; even though some members may have already given individual subscriptions.

There are still a number of doctors who have not yet subscribed and this delay makes it all the harder for the members of the different committees to collect outside funds; please look into this important matter and see that your name does not block some outside subscription by being absent from the list of medical contributors, this being always the first question brought up by the laity.

The meeting on November 15th. which was devoted exclusively to the New Building Campaign was financially a great success, as about $6,000. was raised by pledges of those present; this was quite remarkable as less than one hundred members attended out of the large city membership of the Faculty. All praise must be given to those enthusiasts, but where were the other city members? The invited guests certainly made stirring appeals in their speeches, which those present much appreciated and responded to loyally. But what of those who did not attend, surely you, the absent ones, want a New Building. Which class do you wish to be placed under in Dr. Stephenson's classification: "Weak-sighted, near-sighted or far-sighted." Those present and those who have already contributed or worked on committees are certainly farsighted, the absent ones-"The weak-sighted member sees nothing in medical organization. He cannot be induced to attend meetings and so remains as a worthless asset to the society. The second class, Dr. Stephenson describes as near-sighted. These members can only see the benefits and results of organization which come very close to them and which affect them personally. This class should be encouraged, as there is hope for them, and some day they may be able to render good service. The third class are the far-sighted men who are always on the lookout for something good in medical organization and who are trying to better conditions, bring in the new members, aid the secretary and encourage the society in all good work. They are the members who attend the society meetings, rain or shine. They readily perceive the benefits of medical organization to themselves and to their patients.