essential to send all patients away for treatment at this stage, but wherever initial symptoms are accompanied or followed by impairment of general health a period of residence in a sanatorium is probably the most efficient means of restoring condition and imparting valuable knowledge. These incipient cases retain their working capacity for very long periods after discharge from sanatoria, in whose records they constitute a considerable proportion of the cases classed together as "tubercle bacilli not found," and whose afterhistories are so good. Other methods of treatment can show a high percentage of successful records in this type. ' Where similar results follow such widely varying procedures as residence in sanatoria, regular attendance to receive medicine, or the inoculation of various kinds and doses of tuberculin, it seems probable that these results must be ascribed to the factors common to all such forms of treatment-namely, the warning, supervision, and greater or less degree of education and after-care which the patient receives. Recognised and supervised the incipient case does well, unrecognised and assured that nothing is amiss a considerable number certainly do very badly.In touching upon these causes of " sanatorium wastage " I have emphasised, necessarily, the gloomy aspect of the problem. Nevertheless, I am convinced that given certain essentials-viz., early diagnosis, reasonable treatment, and a chance to spend his future working life in a proper environment-certain attributes of this class of patient make him the most profitable subject for sanatorium treatment.
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