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Show C MM q SM TENT TREATMENT FOR TUBERCULOUS INSANE Superintendent of Lnro Eastern Hospital lias Demonstrated Its Efficiency A K Mrdonald, I.. I. II, U ll , medical aupi rlnteudmt of the Minhat tan MUte Hospital Kant, ghrt a graphic account of tent life a tried under hit direction for a large tajml.er ot Inune raneumptlvea Th folio w-Ing w-Ing egtract are from hi paper In fie INrectory of lnalllutlona and Sodctlea dealing with "Tuherculoal la i"i United male and Canada"! That cnnanmptlve Inaaeo pitlent may lie kept, and treated, to tlietr ad vantage and Incidentally to tae ad vantage of their follow Inmate In canvas tenia, and throughout tb v-era! v-era! aeaaons of the year, haa been demonstrated In the recent liuHer) ot Ilia Manhattan fllnto Hospital, Knat The etperlment iiKin Ihe auceast nf which thla rlalm I advanced hat covered cov-ered a period of forty month. In all hoapllnl for the Insane tae In mate are claealned according tn th form of mental dlalurliaiic. To lak from all theae claae any MlSerlng from tubereuloal and pnt laetn together to-gether In one lent waa a aerlotii problem. prob-lem. Thla, however, ha liten very lucceaafully done Tho orlajanl pUn waa lo uae the csmp only atM n months during each aummr. The camp llfsi eslabllahoil exwalrt-ml exwalrt-ml of two large dormitory jetiM-twenly jetiM-twenly by forty fret each containing twenty lied, with smAlter tenti of dllTriit hape. about ten by '-n feet, Tor the armmmodnllon ot tlie nurse the care of the hospital (tor- pantrlva and a dining lent for aurh patient n were able to leave their beda and (rata, and go to th table Mr their meal Itunnlng water wm secured se-cured by mean ot underground glpsa and tie safe disposition of wast aid sewer." wa nlsn provided for. Aa haa been said, It was expecltd in contlaue Ihe camp only through the aumtfior and n far Into the ntituran is ftvnrnble wtnlher might renCer Juillflable Hut when In th lntJ an tumn It waa fmind that thn fnvopibl ezperlenc conllnueil, It waa deqlded to attempt to carry the experiment, on it moderate scale, Into, or ivrn thro'iah. the approaching winter. The ramp, as first established, hail Urn plnred lilwn nn elevated knoll adjayent to the rlveralde nnd purposely oiptnl to the full fore of the aiimjner brcete For Ihe winter experiment 11 tlte wn rerouted to the center of the Island, where treet and building Interpnaed lo net a a windbreak to the severe alorma from the eaat'and northern! which nre lo bo expected la thai locality. The number of patients w) reduced tn twenty, thoso In whom the dlaeaio wni rnont active belnic r-talacd r-talacd and Ihe other being retimed, for tho llmo being, and much agalnit tbilr will, lo the buildings Ono lilfco tent itirtlcee for tho housing nt night ot tho reduced number of patients, snd ono wni set apart as a sitting. room for day uic, with tho accessory tenia beforo mentioned, and largo stoves wcro placed In Ihcm, hero ind thore, with wlro screens unrounding them to protect the patlentt, anl a liberal uto of nibcalo and other Ore-proof Ore-proof material uid arrangementi for tlio prevention of fire. To mako n long itor) short. It has remained In cnntlnuout uae, not oSly throughout Ihe drat winter, but through tho two succeeding winter snd Intervening ssn. up to tie 1ato of the present writing The scape if Us employment has beau gradually enlarged until all patient In whom thero nre active manifestations ef tuberculosis nn average ot forty-three forty-three nut ot n total census of aboit ! 000 are Itoltted therein, and there ha been parallel enlargement ot tie elements of the plant Tho Isolation of the tuberculoid pi-tlcntt pi-tlcntt haa reduced to n minimum tbo danger of Infection of other patient and of emploea The pntlcnta then)-aolve then)-aolve linto luffered no Injur) or lurj-thlp, lurj-thlp, but linto. on the routrnry. been unmlitnkably beneniid, This It tliowt, among other way, by a decreaie hi tho death rate from pulmonary tuberculosis, tuber-culosis, both absolute nnd relative, and b) a marked general Increase bt bndlly weight. nn.outitlnc In the rate of ote ntlfiH to an actual doubling of ihe weight from eighty three to use hundred nnd st lx pound In foa teiia months ot camp residence Mental Improvement has as a genet al rule been the conmmltant of pliytj. ml, not only among the patients In tar tubeirulouls camp, but also In 'hi other, tnd In the former class Ink) haa betn somewhat of an anomtly My experience, and I think Ihnl a) others, has been that when phthln snd Insanity coexist the) are apt to alternate as to thn prominence of their tot ami manifestations tho nuutal symptoms being more pronounrag whilst the physical are In nb)an , and vice ertn Under the tent tnav ment we hate found a general .lie position toward accord In the manlfes. tatlena Improvement In both respiri) proo-edliig cofuurrently nnd some U11 dlscbaiges from Ihe hospital which gate most satisfaction to us at ti time, and most asm ranee for the p Unit's future, were of Inmates of the tuberculosis camp ( It was apprehended that not onl might the patients themselves rmrnt their transfer, but that similar obJec tlon might come from their relatives' and friend, since Innovation!, even progressiva, one, are apt In be frowned tion by those whu ooiitllut tho raajorlt) In the clientele of a public pub-lic hospital In a cosmopolitan city. Kven at the outset, however, the pro teata whether from patients or their friends were surprising!) few, and latterly they have been more apt tn arlae, It at all over Ihe patient' return re-turn to the building when that became be-came neceary The quern Ion of medication may In Ihe present writing be dismissed with n very brief reference It ha been found unneriasary lo extend It great ly, and it haa been limited mainly to the treatment of symptoms stimulationalcoholic stimula-tionalcoholic and the like haa been found of but little demand nr use, and Ihe quantities ronsumed always under un-der Individual medlral prescription bar been Inalgnlftrant On the other hand, Ihe dietary haa been mad aa liberal aa the Impoaed realrlcllon of Ihe State Hospital schedule hare permitted, per-mitted, both In Die way nf regular diet and eilraa. and In Ihe leading asntlals-mllk and egg private do-nation do-nation have supplemented the regular supply. Hut dependence, after nil. ha bn mainly placed upon Ihe rigid Isolation and disinfection, and upon tk unlimited uppt) of freh air. A aa Intereatlng Inrldentil fact It may be mentioned thai nol nnly the patient, pa-tient, bui alio the nurae living In the camp have enjoyed almost complete Immunity from other pulmonary die-aaaa die-aaaa Not a alngle raae-nf pneumonia baa developed In the ramp In It existence ex-istence of over three years though It onus 111 deaths In lb hospital proper prop-er In lhat lime Tho "common colds" so frequent among their fellows living upon th wards, or In the Attendants' Home, hare been unknown among the ten t-d wallers Tlia popular Idea lhat the enneump live Is n doomed man unlea he can at onee abandon borne and family nnd business nnd betake himself to tomo remolo region would seem to bo negatived nega-tived by our Ward' Island cxperl enee. Th Wards Island camp I hut a few feat above Ihe tide wnlr level, IU site I swept In winter by wind of high velocity, coming over the Icebound Ice-bound waters of the rltnra and the sound which surround II and It suffer suf-fer a 1 much a, nr more titan, any other part of the city of New York fiurn the trying changes nt temperature tempera-ture nnd humidity which are so char arlerlstlc ot Its climate If In spite nf nil thoe drawback, what ha been done can be done, and that for Insauo ratlents, what may not lie Imped from Ihe extension ot tho same, methods tn tho ordinary consumptive of sound mind, anxious fur recovery and capa bio of giving Intelligent assistance In tbo stniRglof |