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Lorsque le document est trop grand pour 3tre reproduit en un seul clichd, il est film6 d partir de Tangle supdrieur gauche, de gauche d droite, et de haut en bas, en prenant le nombre d'images ndcessaire. Les diagrammes suivants ellustrent la mdthode. 32 X 1 2 3 1 2 3 4 5 6 V REPORT OF THE ) INAUGURAL MEETING OF The Toronto Association for the Prevention and Treatment of Consumption and Other Forms of Tuberculosis '' HELD IN ASSOQATION HALL, May 8th, 1900. TORONTO: WILLIAM BRIGGS, 29-33 RICHMOND STREET WEST. i9oo. ?»^i..-*>fS*>tf,«»«',»>«4*»j«;*»w,'"J«ji"^fc"?» ■• • » I ^ -Che Hui^tg of fl,T\r **«**•' ^«'9^<ir» oar aim,^ in 1 *..■ *0' the Pie. ^<^ Tuber- 1,1900. Powible for wwthetwne *«<»o«Mon. ' and Dr. I. INAUGURAL MEETING. jreso. In the absence of Sir Oliver ]\Iowat, Professor Clark took the chair. The CiiAiKMAN — I am very sorry, indeed, to have to announce the inability of Sir Oliver Mowat to be present at this nieetiiiji; this evening. I am sure he would have been pleased to have been here and to have taken part in the good work in which we are en;i;aged ; but as it is impossible for him to be here, the duties of filling the position of Chairman have devolved upon me. 1 am not going to detain you, ladies and gentlemen, by any exten- sive setting forth of the objects of this meeting ; that will be done by our Pi'csident, Dr. Barrick, who has mastere(J the whole subject completely. You will also hear other speakers of eminence who are familiar with the subject. I may just remind you that this is one of the most .important undertakings in which men can possibly be engaged, that of endeavoring to shut out and put down that awful malady in the human family. You will hear from Dr. Barrick and others that this terrible disease of consumption, which we once thought was merely hereditary and incurable, is not always heredi- tary, although the predisposition to it may be inherited. We lind it is contagious ; we find to a large extent that it is curable. If that be the case, it becomes an absolute duty for all men and women who love their kin<l to do all in their power to remove this scourge fiom the face of the earth. With regard to the meeting to-night, it is a matter of great satis- faction to see that so much interest is being taken in our enterprise. You will be addressed by gentlemen belonging to all the churches. We have here Anglicans, Roman Catholics, llebrews, Piesbyterians, Methodists and representatives of almost every conceivable creed. We do not come here to propagate any opinions which we may hold as individuals; we come here engaged in a work for humanity with one heart and mind. I have very great pleasure in calling upon the President to deliver his inaugural address. The Presidknt, E. J. Bahrick, Esq, M.D. — Mr. Chairman, Ladies and Gentlemen : Before commencing my address I wish to read a short letter from one who has done more to advance this cause than perhaps any person in this country, who has been instrumental in introducing into the Legislature at the last session a Bill which makes it possible to bring a Sanatorium within reach of every consumptive in every municipality of this Province. I refer to the Hon. J. R. Stratton, whom we expected to have had with us to-nignt. Wherever the caiiipai^n afj;aiiist consumption is pressed the «' Stratton Sanatorium lUll " will be referred to as an up-to-date measure, and worthy oi being copied in every Province and Territory in this Dominion. TouoN'TO, ^lay 8th, 1 900. Dear Sii{,— I very greatly regret that pressure of otticial occupa- tion deprives me of the pleasure of accepting your kind invitation to be present at the meeting of your Association. I can assure you, however, that my sympathy is with it, and my best wislies for the success of the work of your Association accom- pany my regrets at my inability to be with you to-night. Yours sincerely, J. K. Strattox. Dr. E. J. Barrick, GO Bond St., City. On the 20th and 21st of May last year there was held in Berlin, at the request of tlie Emperor of Germany, a congress of leading medical men and scientists, who for two flays discussed the subject of con- sumption and other forms of tulxn-culosis. On the 25th of April of this year the International Tuberculosis Congress opened in Naples in the presence of the King .and Queen of Italy, tlie Prince and Princess of Naples, the Duke of Genoa, the Premier the :\[inister of Public Instruction and other notables. Nearly every country in Europe has had its Tuberculosis Congress. In America a few weeks ago a Tuberculosis Congress was held in Chica"o. The Prince of Wales is the Honorary President of the National Association for the Prevention of Consumption and other forms of Tuberculosis in England. At the recent session of our Local Legislature a Bill was passed encoura-^ing the establishment and maintenance of Sanatoria for consumptives in this province. And to-night we have the inaugural nieetin<r of "The Toronto Association for the Prevention and Treat- ment of Consumption and Other Forms of Tuberculosis." In Guelph a similar association has been formed, and steps have alreadv been taken for the formation of an Ontario, and also a Canadian Association. Why all these congresses ? Why all these associations 1 Why are kings, queens, princes, princesses, dukes, knights, premiers and <rov^rnments, etc., giving attention to this question 1 ° The Hon. G. W. Ross, on the 7th of March, in replying' to the deputation, said: "The most valuable asset any nation can have is its people, its men and women, its sons and daughters. The white plao'ue is abroad among these people, the men and women, the sons and" daughters are stricken down, the wail of anguish is heard in every land. It comes from the cities and the country ; it comes from the mansion and the cottage ; the king and the beggar are alike sub- ject to its ravages ; premature graves are being filled ; the tramp ot the orphans produced by this disease is heard in every orphanage ; the poverty caused by this disease is heard knocking at the door ot every philanthropic and charitable institution. This is why. I y 3 f ^ lli.s.ismso produces more than twice as many cleatl.s as small- pox, .iiphtheria scarlet fever, measles, whoopin- eouyh and typhoid fever put toj^.-thcr ; in industrial occupations it is the cause of nearly one-half of the mortality, an.l more than half of the invalidism : of all the people who die between the ages of 10 and CO no less than ;{7 out ot every hundred die of this disease; 37 out of every hum I red die at an a«e when their lives are of most value to the nation the niunicipahty and the home ; 37 out of every hundred die of a disease that IS contagious, infectious, preventible and curable, especially in the earlier stages ; that in the United St/ites causes the death annua ly of no less than 100,000; that in this Dominion claims each year about i) 000 victims ; that in this Province in 18!)8cause<l the death ot 3,-jyi— e.pial in number to more than the three contin-ents senttoNouthAfrica; that in this fair city each year carries oft" ..oout ;)00 of our people. This is why. Add to this the popular error, that consumption is hereditary and incurable an. you have a picture so dark, the contemplation of which makes the stoutest lieart grow faint. To dispel this darkness 1 am glad to say that the star of hope has risen. Throu'di the dis- covery oi Prof. Ivoch, some eighteen years ago, and subsequ(>nt investigations, ,t is a generally accepted fact that consumption is produced by a germ entering the body from without, mainly by the inhalation of dried anrl pulve.ized particles of sputa Hoatiii" in the air, and by food, especially milk from tuberculous cattle. " In the later stages of the disease millions of these germs are said to be thrown oti daily in the sputa. That while heredity may predispose _ the systeni to the development of the disease, yet until tlie -erm is introduce, trom without the person, there can be no consumption It has also been clearly established that the disease is curable Science and clinical experience have therefore! exploded the popular error referred to. But it is only by a campaign of educaticm that the public mind can be disabused of this deeply seated error To do tins and to ciieck the spread of the disease, and save and proloii'' the lives ot the people is the main object of this Association " The concensus of medical and public opinion in both Europe and America is that Sanatoria treatment of consumption produces the best results. At the Congress in JJerlin, already referred to, all the dis- courses led up to and culminated in a hearty endorsation of Sanatoria treatment of consumption. In Germany, where compulsory life insur- ance IS in force where all receiving a wage lower than a certain amount are obliged to be insured, the growth of Sanatoria treatment has been remarkable, owing largely to the action of life insur.tnce companies expending much money in the erection and maintenance of Sanatoria where they send their insured who are suffering from consumption, hnding that, from a financial standpoint, it is economy to prolon^^ the lives of their insured in this way and postpone the day of payin* the deith claim. That while in 1895 there were only two of such Sana- toria in Germany, at the present time there are over sixty, and more being built each year. While we find that Sanatoria have been built in various parts of tilt' world for the admission of those who are able and willing to pay, and are in tlie early stage of the disease, the door is etVectively harred against the groat mass of sufTei'ers who ai-e poor, and others where the disease has passed the early stage. These outcasts for whom there is no Sanatorium accommodation are left to roam abroad, ride in our street cars, cough in the faces of our children, drink from the same cup at t!ie fountain, expectorate in tlu^ pul)lic halls and con- veyances. Some of them pass into the hospitals where little or no isolation from other patients is adopted, others are confined for months in small, unsanitory rooms, badly ventilated, and the whole family exposed to the contagion, and there they die, followed later on by other members of the family to a premature grave, and everybody wondeis why so many people die of consumption. In this Province in 18i)S, 3,29 1 persons died of tuberculosis. This disease may e.xttmd over one, two, three, four (»r more years ; it is therefore w"ithin the mark to say that we have continually in Ontario eight to ten thousand atllicted with the disease— we have say <S,000 who should be Wiought within reach of Sanatorium treatment. The Sanatoria accommodation of this Province is fifty beds at Gravenhurst Saiuitorium— an excellent institution doing a good work and a credit to its promoters. Here only those are admitted who are in the early stage of the disease, and are able and willing to pay $6 or i?7 a week. For the balance, 7,'jr)0, there is no Sanatorium accommodation. To bring Sanatorium treatment within reach of these 7,950 is the problem that this Association is trying to solve. The only Sanatorium that seems worth contending for is one where neither poverty nor advanced disease bars the door, where all those who are curabh; may be cured, where all those who are improvable may be improved, where all those who are incurable may be viived for until they pass over to the great majority, and where each patient may, if they wish, be under the care of their own family physician To secure tliis ideal Sanatorium always has been, is now, and shall continue to be the high aim of this Association. After fully considering the (juestion from every standpoint, the following plan was formulated and" placed before the puljHc in a paper read before the Canadian Medical Association last August : 1. The establishment of a rural Sanatorium in connection with each municipality or group of municipalities for the reception of such cases as admit of a reasonable hope of cure or improvement. 2. The erection and maintenance in connection with the above Sanatorium of suitable isolated buildings for the reception and treat- ment of such advanced cases of the disease as are unsuitable for Sanatoria treatment. 3. The co-operation of the Government, municipality, philanthropic and charitable organizations and individuals, in providing the necessary funds therefor. On the 7th of March, a large representative deputation laid this plan before the Local Government, and asked for legislation on these lines. Within thirty days a bill was prepared, which passed the first> ely l)ui'red lers where tor wliom (ul, ride in tVoin the ami coti- ttlt' or no iifincd for the whole (1 later on everyljody •sis. This ■ars ; it is in Ontario say S,000 nt." y beds at Ljood work sd who are to pay $6 lation. To 16 problem one where ! all those mprovable ■ be oared oil patient physician and shall Ipoint, the in a paper 3tion with on of such the above and treat- litable for lanthropic idinfi; the I laid this n on these d the firsts second, and third reading' without opposition. Surely in this im|iortant matter it may truly l)e said that "none were for a party, and all were for the State." Tlie |)aHsaj,'e of this liiii is tins hi<,'hest compliiiieiit that could have been paid to the etlbrtsof this Association toward the solution of this problem. It crystfdlizes into law the leadinj; features of the plan, secures (Jovernmeiit co-operatioi), and paves the way for the co-operation of the nmnicipality, pliil.inthropy, and charity. This permissive lej,'islation (.n certain co operative lines provides for the erection and maintenance of a Sanatorium for con- sumptives in each municipality or group of municipalities in the Province of Ontario. To put this permissive lej^'islation into force in this city for the benefit of oui' own consumptives, is the first duty of this Association ; its other objects are set forth in its constitution. Havinj,' accoraplislied so nnich up to the present time under the name of the Citizens' Sanatorium Committee, let us, under the new name, and with renewed confidence and ener^ty press forward, complete the co-operative plan, and tsrect and maintain for our people an ideal Sanatorium that will be a credit to the (.^ueen City. The first thing to be done is to increase the membership to at least 1,000— our enthusiastic Secretary says H.OOO. and our still more optimistic friend, the Editor of the Christltin Guardimi, says --'5,000. However, we should aim first at 1,000 and get it, then take a higher aim. This iii itself will Ije a means of education, and will provide the necessary funds to carry on the campaign. The second is to ask for subscriptions, donations, legacies, beiiuests, etc., on condition that a by-law for §50,000 is passed to assist the Trustee IJoard, which will be formed under the provisions of this Act, in the erection of buildings and the maintenance of the Sanatorium! I might just say hei'e that this legislation provides that the Lieuten- ant-Co vei-nor in Council may grant to the Trustees of any Sanatorium one-fifth of the cost of the building and land up to 84,000, and a further grant of 81.50 pei' week for each patient treated therein. Now I think this is a very liberal stand for the Government to take. (Applause.) And further, that the munic',:, '••.ty shall pay a like sum of 81.50 per week. In this city we are w> v paying S'2.^0 a week for the poor in the hospitals. I hope that my friend,' Dr. Sheai'd, when we get tins Sanatorium in operation, may see his way to recommend the payment of 83.00 a week by the municipality. That will bring the income within perhaps 81.00 or 81.50 of the cost of maintenance per week per patient. Now one object of this Association is to help make up this deficiency, so that the door shall not be barred against any poor person. For instance, here is John Smith who is ill with consumption, and is able to pay in this Sanatorium the full pi'ice of his maintenance. Then he should pay in full. We do not by any means intend to pauperize the people. If John Smith is not able to pay the 85.00 or more a week for his maintenance and can only make up the deficiency, then he should do so and be no care to this organi- zation. If he cannot do it himself, it will be the duty of this organiza- tion thi'ough its counnittees to see whether his friends can help, or his church— as every church has its poor fund, and to what bettei 5r use 6 could this t'uiicl 1)1' put than to liolp its duisurnptivo pixir Id swuro Saiiitoria trcatinciit. If hi' hclmij^s to no ehurt'h, perhaps his lodj^o or t'latcriial scuicty will help to make u|) this balance; and when all these fail this Assoeiatiim wants to stand ready to say, ".luhn Smith, we will luit alK)W ytiur poxei'ty to bar tho dodi", and shall out (if our funds, make up the deficiency, and securt^ for you the care and treat- ment which you ought to have." (Apj)lanse.) Ijast year in the County of ( )ntario, in connection with the erection of a House of Refuge for the poor, .John Cowan, of Oshawa, otl'ered t*r),COO cash, and his brother, \V. F. Cowan, offered 45 acres of land, on condition that a by-law was endorsed by tlm (pialified ratepayers. 'Hw bylaw was sulMnitted and carried. Tiiis action also seemed the 81,000 from the (Government. I believe there are many persons in this city who, when they under- stand the comprehensive and co-o[)erative plan that has now become law, will, like John and VV. F. Cowan, say that they will give a cer- tain amount on con<lition that the by-law mentioned is en«Iorsed. Thirdly, to secure the aid of the Council in preparing and submit- ting the by-law and agreement at the next general municipal election in accordance with the Act. And fourthly, to carry on the campaign of education, until the ratepayers, like the insurance companies referred to in Germany, are convinced that it will bo cheaper and more economical to expend money on the erection and maintenance of a Sanatorium foi" the consum}itives of this city than to go on as we are now doing, expend- ing about 880,000 each year for the care of orphans and other poor persons who are largely produced by this disease. We ai-e paying as it were the pound of cure when we should be applying the ounce of prevention. Our legislators are fully aware of the unparalleled natural resources of this country, of the valuable assets we have in our minerals, our fisheries, our forests and our fertile lands, and they also recognize the important fact that the most valuable asset that this province has is its people, and for them have established a national school system that has brought a free school within reach of every person of school age in eveiy municipality, have arranged by per- missive legislation for bringing a house of refuge within reach of the poor in every county, and a Sanatorium within reach of every con- sumptive in every municipality, on a national basis. Outside of this national pi-ovision for schools, houses of refuge and sanatoria for consumptives, there are individual schools, refuges and sanatoria. Upper Canada College is one, an institution ojien for those who are able and willing to pay. This institution has been of great value to the country, is presided over by a principal whose name is a household word in this Dominion. Has any one heard Dr. Parkin say one word in opposition to our national schools, or has he indicated in any way that they are in opposition to the institution over which he presides 1 In this city we have the House of Providence and the House of Industry, both old and worthy institutions that have cared for many I & ti) secure Ills lod^e I when all liii Smith, »ut of our iiikI trcat- lO erootioii II, oH'ert'd 8 of Itiiul, iitt'payprs. cuiihI the lej'under- iw JH'coine ^ive a cer- oi'sed. 1(1 suhiuit- ^l election until the •miiiiy, are to cxjjend M for the !,', expend- itlier poor payinj.^ as 3 ounce of d natural ve in our I they also i that this :\ national li of every id by per- ach of the every con- refuge and efuges and I open for as been of hose name heai'd Dr. or has he institution House of 1 for many poor p«M\sons. Has any one iieard the friends of .>ithor of those institutions py one word in opposition to the natiotuvl houses of refuge in lIus province '. At («rav<'nhurst there is a Sanatorium for Consumptives with fifty beds, admitting oidy those who are in th(! early stages of the «liseaso, and who are able and willing to pay .*G.OO or^•i^7.0(; per week. This institution is a credit to the country and is worthy of gen(^rous support. Has any one ever heard the friends or agents of that institution say a word in opposition to this Association, which has been the life and soul of the national movement to bring an ideal Sanatorium within reach of every consumptive in every municipalit v, in accordan.'e with the provisional legislation already refe.nd to ! ]i you have heard of such opposition is it not time that a deaf ear should be turmnl towards such ] As I have had many incjuiries as to whether this Association was in any way connected with Dr. Playter's Sanatorium in Moore Park, [ think it is due to the public and to this Association to state that this As.sociation is in no way, directly or indirectly, connected with that enterprise. We are in opposition to no institution. Our object is first to set in motion the provisional legislation, so as to bring an ideal Sanatorium within reach of every consumptive in this city; and secondly, to encourage every other municipality in this province to take steps to secure a similar privilege for their people who are suffering from this disease, hoping thereby to check the spread of the white plague, and save and prolong many valuable lives. Dh. Adam H. Wkiout, on being introduced to the audience to supply the place of Sir James Grant, who was unavoidably prevented from being present, saiij : Mr. Chairman, Ladies and Centleraen : I ara embarrassed, in the first place, at being called upon to speak for Sir James Grant, my dear old friend ; and I am embarrassed in the second place by the very pleasant remark made by the Chairman. In the first place, I hardly know why I should be called upon to speak for Sir James Grant. It reminds me of an occasion, many years ago, when I was very much embarrassed by being called on to respond to the toast of the ladies. I was perfectly innocent about the matter, I had no idea why I should be called upon, but I was told I was called upon because I was the youngest person present. Well, I thought the matter over pretty carefully, and I told them this : I said, " If you want to get hold of some person who is particu- larly fond of the girls you could not find a more suitable boy in the whole country than myself." I may say in the same connection that if you wanted to find in this country a man who admired Sir James Grant very highly you could get no better person than myself. I admire him as ii, man ; I admire him for the views which he has expressed on this very important subject of Tuberculosis. Notwithstanding the fact that I have studied the matter of Tuber- culosis for many years, I have learned much from the very able and very interesting address that has been delivered oy the President of 8 this Association. I can only take out of that address two or three points. The very important points in connection with this subject are these : In the first place, consumption is, at least to a large extent, a preventable disease ; and second, consumption is a curable disease. I do not mean to say that the mortality will not be high, so far as we know now, for many years to come ; I do not mean to say that consumption is a disease that can always be cured; but I am very glad to be able to say that it is positively a curable disease. I will not attempt to say what proportion may be cured. In the whole of my professional career there is nothing that gives me more pleasure than to be able to say to some poor unfortunate patient of mine, " You may recover ; I cannot speak definitely, but you may be cured." The third important feature in connection with it is, that it infectious. Now what have you, the people of this country and city who take an interest in this subject, to conside. ? You have to consider this, that it is your duty and our duty to try and proviile proper institu- tions for these poor unfortunates. There is one thing, we have learned that the consumptive patient properly treated in a well equipped Sanatorium has a better chance than a wealthy consumptive patient in any palace in Toronto. Therefore we want to get these places established. We, in advocating this, are not opposed to any other institutions or Sanatoria at present existing. I>ut, oh dear ! there is room for so many of them, for so much more work in this field, that I would like very much to have the public sympathise with the address of our President, read it carefully, and work on the lines recommended in it. (Applause.) I want you to think of these poor unfortunates that are in hovels in this city. I want you to rembem- ber that if you get hold of them and bring them out of these places into a healthy Sanatorium, you may cure them. I want you to understand this, that if you can get tiiem away from these places, you will diminish the number of consumptives. T am really proud of this city. I do think there is no place with its population in the world where there are more generous instincts evidenced every day. I think this — T know in fact that there are lots of good men in the city of Toronto who are willing to give their dollars, their tens, or hundreds, or more foi' the sake of suffering humanity. I know beyond that, I know above all something that is far better still, T know that in this city there is a grand army, if not a number of grand armies, of good, generocS, magnificent women who are doing great work in the interests of suffering humanity. I appeal to you, men and women combined, of all kinds, to join in promoting this good cause. (Applause.) Mr. Thomas Crawford, M.L.A. — Mr. Chairman, T.adies and Gentlemen : T am in rather an awkward i)osition because perhaps of the subject under discussion. But you, sir, in your opening remarks said one word which will, perhaps, justify my presence here, and inay bu souiu fair reason to give why I should say a word on this occasion. You said, sir, that this was largely a business meeting, and 1 suppose 9 th.it is about the only feature of this question that I am at all capable of discussing. Now. I daresay I myself and yuu arc largely influenced liy what we liear and what we see ; and we have heard from this platform to- night, and we have heard through the press, statements made and statistics given us as to the growth or development of this disease in our midst, known, as Dr. Wright has said, by the plain word " con- sumption." Now because of the advance in medical science and the discoveries which have been made and backed up by these statistics as given, we find that we have a number of gentlemen, and some ladies I am glad to say, who interested themselves and formed them- selves into a Citizen's Committee. Dr. Barrick has very nicely covered the ground as to the operations and the work done by that committee. They approached the Legislature, and the Legislature which is the voice of the people, to carry out the voice of the people, was ready, and did, we are glad to be able to say, place a law on the statute book endorsing a movement such as we have collected together in this hall tonight to discuss, perhaps it ma' ^ said, for inaugural purposes. Now the Legislature, whose sympathy is with this work, and every right-minded man and woman in this city and in this province cannot help but think, and stop seriously to think, from the statements that we have heard to-night as to the great necessity there is for an insti- tution where those who are perhaps less favored than we are and who are called upon to suffer and to die, may be properly cared for. Now, sir, I think it may l>e truly said that in the City of Toronto there is suHicient human kindness in the hearts of the people of all classes, of all creeds and denominations — and I am glad, sir, that you made that statement in your opening remarks that we do not represent any class or any denomination or ci-eed in connection with this great work and in tiie formation of this society for the purposes wliich have been set forth very clearly by Dr. Barrick. Then, sir, we are now in a fair way to establish a Sanatorium such as may be helpful to the many who are closed up in our cities and who get this disease. When some of us were boys, and even of late days we did not think so much of this disease known as consumption ; we did not fear it so much as it had not been said that it was conta- gious to the same extent that we have it now. Some of us, perhaps, have been called upon to see some of our friends afflicted with this disease. I may say that I have known in my own experience one family in this city, with whom I was intimately associated and acquainted, where the father took sick, and after being ill for about a 3'ear he died, leaving eight children and his wife. During the seven years following six of his children with his wife diefl, making eight of that family that were taken over to the majority by consumption. These things, together with the statements which we have heard here to-night, are something, as I said before, that should stir us up, and is stirring us up to active work, and v.-n ■r\y(^ here to-niglit, and I do not think, sir, tliat for you or for me or for any gentleman on this platform or for any lady or gentle- 10 man in this audience there is any necessity for an apolo^'y for appcarinir in tiiis liall in connection witii this great work. Now, I do not iviiow, sir, tliat it has het^n clearly set forth as to the conditions upon whicli you can become anuMuber. T understand, sir, by payinj,' on(> dollar a year you may become a member ; you may become a life member by payinji tw(>ntv dollai-s. Now, we llave the endorsation of the Lefj;islature of the Province, and «(^ will base the co-op(>ration of the Municipal Council of the City of Toronto. You are tiie people. W'ti have the united etibrt of the peopl.>, whose reprtv sentatives are in the Council, whose representatives are in the Legis- lature, and 1 would ask you to join in this l)and— and I would say to you you imvd not bi> asiiamed of it— enroll vours(>If as a member, and if you can give ^-JO, or ^50, or !?100, whatever you feel disposed, do so, and let us have as (juickly as possible this buiidini,' erected, so that we may in some way be able to prevent the spread of this disease, and as far as possible cure all who are curable, and those that may be incurable that we may at least give them tlie necessary comforts until they depart in peace. Thanking you for the opportunity ycu have afforded me. and as there are others to speak, T shall sit down. (Ai^plause.) ^ Ukv. PiuNcu'Ar. Cavan, D D., LL.D.— Mr. Chairman, Ladies an.l (..entlemen : 1 shall not trespass long upon yt)ur time to-night. This very important (piestion has been fully and clearly presented to the audience. 1 am glad to think that this cause has had a good .send- otr ni Toronto. I should, indeed, have been greatly disappointed if Toronto had not been able to do something on its behalf. Our city IS, I think, fairly represented to-night. The ladies, as we would expect from their sympathetic and benevolent nature, are, I see, in the msijority, but tliere are a sufficient number of gentlemen here to show that the movenuMit has taken hold of the conununity in general. Dr. Parrick has, T think, said everything that needs to be" said in exposition of the subject ; and not only so, "but he has dealt with the moral, as well as tlw? physical and economic aspects of the case. He has presented to us very clearly our duty, and has urged it upon us, not e.vactly in the form of an exhortation, but in the very ajipropri- ate and, I would say, touching statements which he has made regard- ing consumption. Toronto is entitled to tak(> the lead in this matter. I am very glad that Dr. Harrick has said what he has regarding the Sanatorium at Gravenhu-st and some other institutions, which some persons might unwarrantably regard as in competition with the scheme which we represent. There is nothing of the Hnd. There is abundant work for every good institution in this department ; and nothing seems to be wanting now except a little money to supple- ment what the Legislature, 1 am glad to think, has un.animously pledged itself to do, and what. T am free to say, this municipality, and, I trust, a great many other municipalities throughout our province will be prepared to second. Of course, a government cannot do everything for the people ; and there is a prevalent feeling against a government undertaking to do everything in a counuunity. Now, I ■ ) 11 believe (hat wlmtever is necessary for tli(! safety of a cominuiiity, if it is in tli(^ govennnent's power to do it, ou^'lit to Ix; (ion(!. 'I'iio safety of t-lin State is the supreme hiw, and T am sure that the adch-ess made to night hy Dr. Jiariick shows tliat a case is l)efore us with wliich the public, represented by the Legislature and our munici- palities, ought to deal. I am sure, Mr. Chairman, ladies and gentlemen, that Toronto will not be wanting in its duty. We shall, in the first place, hav(; an institution in this city that shall be worthy of Toronto, and our example will influence the whole Province. I should supjjose, from what Dr. Barrick has said, that there is room, that there is necessity for perhaps a dozeji or a score of similar institutions throughout the province of Ontario. 1 trust that the meeting which we have attended here to-night is the begiiniing of a movement that will do a great deal of good, that will remove a gnvit deal of sufF<n-ing, and that will bring joy and comfort to many families and individuals in our country. (Applause.) Presidknt Loudox— Mr. Chairman and Ladies and Gentlemen : I presume the most important item on the programme is the part relating to the business, and as that lias not yet Ijeen reached, I shall not detain you more than a icw moments. Let me say, then, in the first place, that in my of)inion there is no citizen of Toronto who will not approve most heartily of the primary object of this Association — the establishment of Sanatoria for the treatment of consumption. I hope, however, tliat when this object has been accomplished the Association will not imagine that its whole duty has been done. The ultimate object of every member .should be to preach the gospel of sanitation, and to see that others practice what he preaches. To this end the; first step is to educate the people in those preventive measures which have been reftsrred to. The.se .should not be confined to Sanatoria. Every man's home should be a sanatorium, and I ara glad t(j know that with the means now at our command it is possible for one to have consumption fairly well treated in the house. I suppose that many present knew the late Dr. W. T. Aikins, who for a long time was my own phy.sician. As many know, the prevention of consumption was a subject on which he was never tired of talking, one of the remedies on which he insisted being a proper system of ventilation in the home, to provide the patient with pure air. So zealous was he in this matter that he personally often devised a means of ventilating a room. Indeed, his visits could be recognized by the ventilating devices he left behind him. It would be a good thing if every member of this Association had a 'little of Dr. vVikin-s' zeal in this particular matter. Another dutj- devolving on us will be to strengthen the hands of the Health Inspectors ; to encourage them when they do their duty, and to give them reminders when tliey fail to do so. Perhaps the most important of these duties, so far as consumption is concerned, is the inspection of our milk supply, Milk, if it is pure, is perhaps the best product we have. If it is not pure, it is, perhaps, the most dangerous 12 thing wo have. Our Health liiS])ectors liave done inucli for us in tliis matter, hut let them remember that continued success depends on eternal vigilance. There is still one other point that I wish to mention before taking my seat. In this age, when science has made such progress, especially in the direction of electricity, there is no excuse for our public buildings not being properly ventihited. A few of thenj are admirably ventilated ; most of them, however, not at all. Might I suggest to our church othcials tiial a great deal can yet be done to improve the ventilation of our churches. We have electric power all ovt^r the city. The electric fan solves what was formerly a very dillicult problem. Let us, tlien, be protected from the danger of physical tli.sease whilst we are being treated for our moral ailments. Dr. SnuAUD — Mr. Chairman, Ladies and Gentlemen: I venture to think that the remark which the worthy Chairman has made in refer- ring to me as being in any way eloquent, or that eloquence should be necessary on an occasion like this, is very unfortunate. 1 am sure tl'.at anyone who will critically examine the statistics anil tlu; details of tuberculosis throughout the Dominion of Canada, or the civilized world for that matter, will find these statistics are sulliciently elo- <iuent to hold him spellbound. When we look at the history and advance of sanitation throughout the world we find at the close of the century the practical disappearance of many devastating scourges which caused so nmch alarm amongst the people in the early part of the century. There are many — some here I dare say — who can re- member the visitation of the cholera in the '.'50's to the City of Toronto, and its later reappearance some tifteen or tsventy years iifterwards. The numbei" of deaths on these occasions was something beyond con- templation ; and the advancement of sanitary science I may say has been to such an extent that I very much fjut^stion the possibility of such a stati' of affiiirs to(la3^ When we look back for a far briefer period than thfit we can see what wonderful work is being done in other diseases of an infectious nature, notably that of smallpox. It is a fact that there has not been a death from smallpox in the City of Toronto for upwards of fifteen years ; yet I can remember when I was a medical student seeing smallpox attended in the General Hos- pital here, side by side with other patients, or at all events, in wards across the corridor. But with the advancement of science and the true nature of contagion, with the education of the people, this has become a thing of the past, and to-day we look upon a death from smallpox or the widespread ilisseniination of the disease as a very serious redection upon the authorities, and I venture to hope that ere the close of the century upon which we are soon to enter we will find that tulierculosis as a disease has been relegated to a bygone age, and with the advancement, the enlightenn>ent and the education of the masses it has ceased to be. We do know that consumption is an infectious disease, and that it is communicable. Dr. Barrick has already explained this in detail, and it is not necessary for me to make any remark upon it. 13 V- i This was to Im; a l)iisin<'ss ineotiri;,', and I suppose I was askrd to spiuik Ik^i'c in or(l(!r tliat I niij^'ht make some oflicial statcnncnt, prob- ably cointnit myself to some recommendation which would conK^ within tin; scope and work of this association. I do not luisitate to do so. I hav(! luul occasion to report, 1 think, to Dr. Barrick and to the membeis of the former Sanatorium (JonuMittct! re^^'ai'ding their i)lans, and I am glad that I did so. I reported tlien somewhat critically, because I said tliat the time liad not arrived when the education of tlie peoi)l(i had come to such a statt; tliat they might l)e e.\[)e(;ted to give it that (indorsation and encouragement which the work and the subject so richly deserved. If you will make your plan broad (snough, if you will open tlm door wide (uiough so that. ev(!ry one that is poor and needy and infectcid with tul)erculosis will gain access without let, hiiidrance or (piestion, you will I'eceive my su})port and endorsation to the fullest [)f)ssible degree ; but you must be prej)ared to do tliis, you must be prepared to remembiM- that the great trouljle with which we have to deal to-day is not the consumptive in the incipient state. IFe is willing and anxious to work : Ik; has Ins family to support, liis wife dep(Mi(lent upon him ; it is under the most extreme circumstances that he can be induced to fon^go his daily labor, and Ik; is kei)t in a Sanatorium or at homt; with the greatest dilKculty. He works on while the disease ])rogresses, until ulc(!ration of tlu; lungs and breaking down of the tissues and the system gisnerally leaves him at the <ioor of some charital)le institution, and a more mi.serable, sufTtM'ing piece of humanity is nowhere to be found upon the top of our earth. And this is the individual to whom the Sanatorium in a private sense, the Sana- toria which are particularl}^ intenwtful in piling up statistics of cures, closes its doors. That man is the very one tliat such an institution would not touch uiuhir any circumstances whatever. lie is driven into an hospital, he is put in a ward side b}' side with some other poor unfortunate human being. Yet you say with your enlightened ideas tliat consumption is a disease spread by contagion. Sanatoria in its true idea is to help the poor man, it is to give accommodation to those who cannot get nursing or food or medical attendance at home. I suppose one of the steps of the advancement will lie the education of the public and the submission of a by-law to empower the munici- palities to supply the necessary funds to start an institution here. If you will build an institution upon the line of those which have been constructed and carried on in Germany I am with you. Give us large enough grounds, give us at least twelve acres of sjiace. We do not want an institution that is going to be side by side with .some other man's home. We want a place where there will be grounds which can be cultivated, with a building upon it suitable for the work which it intends to accomplish, with its conservatories and its galleries, so that the consumptive can find occupation and gain air and sunlight. We want to get all those benefits which the Sanatoria in Germany give, and then when you have your plans enlarged and put upon that basis, if yuu go to the Municipal T^nuncil of tlie City of Toronto, and if I happen to be the Health Officer on that occasion^ u T shall Ik. .,uite piepaml to support h l,y.hiw heing s«l„nitte.l to tho . .1. o to .rant tlu, sun, of 850,000 to .arry it outran,! v.ly upon to . toll.^.MK.. ot tlu. pcopl. and upon the ability of tins .Usoo^ i , tor ho vot„,« ot tho nec-ossary n.oney, to soe what can h. .1 mi lu-rt.o n.KH w. l.or.an./..< and vv„Il-...,uipp,.d institution with a wi, ' ...loo,- that kn,.wsn.uhe.-o..e.,.l nor color, a fm. institution in h . truest sons,, to do the work, a nol.le work and ono which will be .1 hcncht to humanity wherever humanity exists. (Applause.) '[»"•: Kk-.. I)|{. I':mv, Secretary-Or-ainV.er -Mr. Chairman lidies and gent en.en : The first part of ,he business of th e '„ conduced, nan.ely U,. President's i„auj,nnal ad.lress and .he '^te ;;-"."""";•• ;-H'al, business an,l professional ,nen. setti -/f th the lustoncal develop.uent and the sdentiile basis upon which Vi enterprise has thus far moved, and an outline of what ue h ,e I . uccomphshed It noWremains for n.e to en.phasize the imu.ci s.de and .he tact that this moven>ent is a popular ,me, not on y a.M.at.nv.n. these benefits to all the people, even to the poet but n. the sense that this atteu.pt to cure consuu.ptives and sZ ess -..Ksun.p nm ,s by a con.bination of all classes and (len m Es and ,M-adat.ons of the people. Th.- fact that the nHMnb.M^shi i Z U everyone who wd pay the nuxlest sun, of .^1 annuallv in. ias," ' uth .Htluence to further the hunuu.itarian object which Ve h e h Mew .nd.caes that none need be barred frou! co-operation K ve -v "HMU her .s eh,nble for n.en.bership on the (l.neral Hoar ; a t^ i:;:;:;!;:;:'.:/;,!:^;"^ ^"-"""^-^ '- ^^ ^^^' '•-- -^J'^ As has already been intimated, this whole nu.vement n.ust first be l.l^'el^ a ca>npa,,o:n ot educatmn and ,>f preparation, the ultimate o ret ben.o. the entn-e e.xtinction of the scmrge of consun.ptio ot only ui tins c.ty but in the wh,.l,> l),>n,inion. The un<ler.,al n" sunp ly nnmense. Once smallpox carrie.l off people bv the h r,i ' tor hfteen years, according to Dr. Shear,!, there has not been a tuJi fn.m smallpox ,n tl,e City of Toronto. Tuberculosis slays 500 ic- timsin loronto in one year; between one an,l two thousan.l are wounded an, slowly ,lyi„., An,l yet this ,lisease is as p,"'t ab e and as curable as smallpox. In twenty years it may be as rare v..n ! f'''"" P •""'■'" ^^,^«, ^'^y"'^- of '"'OO lives in Toronto for many years of usefulness; a,000 in Ontario ; nearly 10,000 in the Domn "!) OmS'i^'rr";? '" ''''''''' ''^ •^20.000,000 in the Province and an a tack with such disas.rous results should we not rally our forces ? on^n.,' In] '"'''' ''n ^'^P'" ^"^ "^'^ '^"""- ^he few who know look o in he plessuess But we are now organizing those who know in order ( ) t,> enlighten those who do not. (2) to"combine all who wiTl womtded. '''3's^emat.ze the effort to expel the enemy and save the The way of advance is clearly marked out by science and experi- ence in other lands. The plan of campaign is in capable Imnd Preparations have been long and carefully made. 15 \Vc (U(. now ()rj,')uii/in^' for a final adviincc nil alony tli(! line and are making the City of T.jronto the .starting place. If we liave here an Association that will gather the foires of the people into a solid army as im (sxample of successful advance, we may expect the I'est of the municipalities in the Province, and the rest of the Provinces in the Dominion to follow our exainph;. ^ In carrving on this campait,'!!, thrcje things have to be accomplished. First, the <Mlucating of the mass of the peoph) to an understanding of the facts of the case -of the inftjctious character f)f the disease ; ui the curability of the disease, and tlu; possibility of its extinction. J le second is, that we will have to bring the electorate into a state of williiigiu'ss to vot(i a large sum of money which may mean an in- crease 111 the rate of taxation. The third is, that in order to accom- plish the purposes in hand and maintain the institution after it has been erected, a larg(! amount of money will be re(|uired at once for tlie campaign and then annually f(jr maintenance!. All of these three purr>oses can be (iHectively reached on the simple lines of securing a large membershij) for the Association. The appeal to men and wonien to give !^1 to becoiiK; annual members will arouse their interest. They must find out tli(! reason. Kv(;ry new member, convinced sulliciently to join, will also be sutHciently interested to talk and explain the matter to friends or to hand on the literature needefl to give light. 'J'liiis by the increase of membership there will be an increase of information until it reaches every home. The .sec- ond point will also be gained if we reach a membershii) within the next six month.'i of from 10,000 to 2r),000 in thiscitv, and why should we not say .-)0,000 for such a cause as this ? The number of (pialified ratepayers included will be naturally very large, and a popular move- ment of this description will carry immense influence in Council Chamber and on the hustings. The third point will also alreadv have been secured, ff we have a membership that run.s up into tens of thousands, that wilJ mean tens of thousands of dollars. A part of this will be spent for campaign purposes and educative literature, for a measure of missionary work in municipalities beyond, and a large amount could be invested as a fund to lielp poor patients. Thus the three-fold object will have 1)0(^1 gained, and the campaign will have L-een successful. It will then be very easy to ask men of larger means to contribute .?r)0,000. The city will readily pass a by-law for $50,000, when the mass of the people have done their part. When these things are ac- complished the purpo.ses of tlie Association will be reached : an ideal Sanatorium will be erected in the immediate neighborhood of Toronto, under ideal conditions, and an irre.si.stible movement will have started, not only for the practical purposes of this city and locality, but also as a national impulse and example which will sweep the Dominion of the plague. 16 Letter from Sir James Crrmt. mo PJLfiiN St., Ottawa, May 21, 1900. Beau Dr. Bakkick,-! regn-t I was unal.le to bo present at the Toronto meeting of the 8th inst., to take part in the\liscus.sion on lul)ercu]os,s Ontlnscontnienl, raees have been born ami .lisap- peared, of winch to-dav we know little except fronnnounds in the far West and vestiges n, Florida, which point out at least two extinct races, the causes so tar beiiu; undiscovered. Our duty now is to secure as far as possible the perpetuation of the present race on this con Hient, to meet successfully tlu* demands that our climate and civilization make So important is the subject of Tuberculosis at the present, that conferences are now being held, in various parts of the wodd in order to ascertain what can really be accomj.lished to stay Its fata progress. Last year in Vienna ovr 2,f)00 delegates from many chief centres of England, Europe and America we^e present In .(OI a conference will be held in London, to be presided over by The White Plague." Doubtless there lurks in our country, our homes and our places of business and pleasure a far more deadly intluence tnan any other known <lisease. To Koch the world owes a great debt of gratitude for the discovery of the Tubercle liaciUus as tlie direct cause of this disease, known to be infectious and curable Aow tliat sputa of the consum|.tive is the chief source of infection great care is necessary to be exercised in this particular, and more especiallv as, according to Xuttall, a patient well advanced in tuber- culosis will expectorate one and a half billion tubercle bacilli in twenty.four hours. Theatres, churche.s, school rooms, otlices, sleeping cars, hotels cottages in health resorts, ship cabins, the drinking cup" and ev(.n the telephone, may become conducting melia for the SMM-ead ot tins disease. Abattoirs, creameries and dairies should be under governmental or local municipal inspection, and the strictest c.uaran- tine possible should be maintained against this disease, which is now undoubtedly on the increase. Sanitariums are now the order of the ^^!l-"'^ r ,'''1 ^'"" '''''''■^' '"''''^''' "^ y''''' effo'-ts to stay the progres,g of this fatal disea.se. Sincerely yours, J. A. GUAXT. I •• >^--,.r'- we ( nidi OGD 1 !■*■ met k --^r-' \.<i-r'^'^-^.> i,^,,' HISTORICAL RECORD. In 1898. on a petition of eighty medical men of the City of Toronto^ a public meeting was called, prodded over by the Mayor which issued in the formation of the Toronto Citizens' Sanatorium Committee. After a series of educative and tentative meetings and statements, appeals to the City Council and to the pobUc, a definite line of policy, weking the ovoperation of Oovemment, municipality And the people had grown into matured form and was placed before the public in a paper read before the Canadian Medical Association in August, 1899 On the 7th of Mat«h, 1900, a krge deputation waited upon the Government, asking for legislation whereby this policy could be inaugurated and made to cover the province. Qiithe 27th of Mardi, the ann«*l meeting of the Citizens' Sana- toriumCommittw to which other interested citizens were invited, waa hel** in City Hali, where it was determined to form a Torontd Aswxaation for the prevention and Treatment of Consumption and other Forms of Tuberculosis^ with a view to a Camidian Association to cover the Dominion. A Provisional Committee was appointed to frame a oMistitutiou and secure a membership. On the 5th of April thefirst reading of the Stratton Sanatorium A<jt» on the lines asked for by the above dtepntation, took phMse wicfc ; the unanimous consent of both sides of the House. The second read- ing occurred on the Uth of the same month. The Bill was greatly improved in the committee of the whole House, on the suggestion of the Hon. J. R. Stratton, and anally passed into law during the first week of May. ^. ,%>*»« 23rd ^ay of April the Assodatiouww fully organized in a Mating held in the theatre of the Normal School, on the basis of the oonstitttU<m as^publisfaed. Kie inaugural me etin g was held on thA «feh rrf M&h. -na u..-^^^-^ meetings hare been held every week since. OFFICERS OF THE ASS0CIA110N. Hon. President, President, Vice-Presidents, Treasurer, - - Sec'y-Organizer, Hon. Sir John A. Boyd, Chan. H.C.J. E. J. Barrick, M.D. Rev. Prof. w. Clark, D.C.L., Thos. Crawford, Esq., M.I,. a., Albfrt A. Macdonald, M.D., W. R. Brock Esq., E. O'Keefe, Esq., Prfs. Jas.' Loudon, ll.d., Rev. Father Ryan. D. W. Alexander, Esq. Rev. C. S. Eby, B.A., D.D. \^