CASES THAT ARE ACCEPTED. A suitable case should conform to the definition of incipient tuberculosis as stated below. Patients suffering from early and slight hemorrhages are usually favorable cases, but if the hemorrhage is profuse or repeated, are not so favorable. The smaller the size of the tuberculous deposit, the more favorable the case. The presence of one deposit only, preferably at an apex or small part of one lobe, is most favorable. The most reliable physical procedure to demonstrate the disease, if it is demonstrable by physical signs, is Auscultated Cough. One skilled in auscultation can locate the disease months before bacilli appear in the sputum. No examiner in infallible. Errors in diagnosis will occur when the observation is a single one. Occasional cases, which from estimable signs should do well, develop unfavorable complications and go from bad to worse; an occasional unfavorable case improves remarkably. It too frequently happens, however, that cases are sent to sanatoria with a diagnosis of incipient tuberculosis, who have huge cavities in the chest, or have to be placed in bed immediately after arrival. Patients who are unable to walk up one flight of stairs or who are expectorating 100 to 200 cubic centimeters of infectious sputum, are not proper cases for sanatorium treatment. They need hospital treatment. Observation would indicate that these patients are not suffering from slight infiltration, but rather from large involvement, with extensive ulceration. Diagnostic ability is improving and this hospital obtains its largest number of suitable cases for treatment from those organizations which devote their entire attention to tuberculosis. Incipient: DEFINITION OF TERMS. Slight initial lesion in the form of infiltration limited to the apex or small part of one lobe. No tuberculous complications, slight or no constitutional symptoms (particularly including gastric or intestinal disturbance, or rapid loss of weight). Slight or no elevation of temperature or acceleration of pulse at any time during the twenty-four hours, especially after rest. Tubercle bacilli may be present or absent. Moderately advanced: No marked impairment of function, either local or constitutional. Localized consolidation, moderate in extent, with little or no evidence of destruction of tissue. No disseminated fibroid deposits. No serious complications. Far advanced: Marked impairment of function, local or constitutional. Localized consolidation intense. Disseminated areas of softening. Serious complications. Acute miliary tuberculosis. CLASSIFICATION OF RESULTS. Unimproved: All essential symptoms and signs unabated or increased. Constitutional symptoms lessened or entirely absent. Cough and expectoration with bacilli usually present. Absence of all constitutional symptoms. Expectoration and bacilli may or may not be present. Physical signs stationary or retrogressive. The foregoing conditions to have existed for at least two months. Apparently cured: All constitutional symptoms and expectoration with bacilli absent for a period of three months. The physical signs to be those of a healed lesion. Cured: All constitutional symptoms and expectoration with bacilli absent for a period of two years under ordinary conditions of life. The National Society reported at the Annual Meeting in May, 1913, the following classification: Incipient: DEFINITION OF TERMS. Slight or no constitutional symptoms (including particularly gastric or intestinal disturbance, or rapid loss of weight); slight or no elevation of temperature or acceleration of pulse at any time during the twenty-four hours. Expectoration usually small in amount or absent. Tubercle bacilli may be present or absent. Slight infiltration limited to the apex of one or both lungs or a small part of one lobe. No tuberculous complications. Moderately advanced : No marked impairment of function, either local or constitutional. Marked infiltration more extensive than under incipient, with little or no evidence of cavity formation. No serious tuberculous complications. Far advanced: Marked impairment of function, local and constitutional. Extensive localized infiltration or consolidation in one or more lobes. Or disseminated areas of cavity formation. Or serious tuberculous complications. Acute miliary tuberculosis. Apparently cured: CLASSIFICATION OF RESULTS. All constitutional symptoms and expectoration with bacilli absent for a period of two years under ordinary conditions of life. Arrested: All constitutional symptoms and expectoration with bacilli absent for a period of six months; the physical signs to be those of a healed lesion. Apparently arrested: All constitutional symptoms and expectoration with bacilli absent for a period of three months; the physical signs to be those of a healed lesion. Quiescent: Absence of all constitutional symptoms; expectoration and bacilli may or may not be present; physical signs stationary or retrogressive; the foregoing conditions to have existed for at least two months. Improved: Constitutional symptoms lessened or entirely absent; physical signs improved or unchanged; cough and expectoration with bacilli usually present. Unimproved: All essential symptoms and signs unabated or increased. Died. The report this year is based upon the classification of the Nomenclature Committee of 1904, as it was thought best not to interrupt or confuse the year with two classifications. How To ENTER THE HOSPITAL. If a person is advised by a physician that he has tuberculosis, and he wishes to enter the hospital, he must apply to the poor officer or commissioner of charities of the county, city or town in New York State of which he is a legal resident. If, after investigation, the officer finds that the applicant is a suitable case for his assistance, he will apply in the applicant's name for admission. (Commissioners of Charities and poor officers have special blanks for this purpose, chapter 376, Laws of 1902.) After receiving an application, the superintendent of the hospital requests the poor officer making the application, to have the applicant examined by the nearest medical examiner of the hospital. Upon receipt at the hospital of the medical report of the |