forwarded through the Canadian Association for Prevention of Tuberculosis to the Provincial Governments, to the municipalities, and to interested associations throughout the Dominion.

The resolutions are appended:

Resolved, That the attention of the States and central governments be called to the importance of proper laws for the obligatory notification by medical attendants, to proper health authorities, of all cases of tuberculosis coming to their notice, and for the registration of such cases, in order to enable the authorities to put in operation measures for prevention.

That the utmost efforts should be continued in the struggle against tuberculosis to prevent the conveyance from man to man, as the most important source of the disease.

That preventive measures be continued against bovine tuberculosis, and that the possibility of the propagation of this to man be recognized.

That we urge upon the public and upon all governments the establishment (1). of hospitals for the treatment of advanced cases. of tuberculosis; (2) the establishment of sanatoria for curable cases of tuberculosis; (3) the establishment of dispensaries and night and day camps for ambulant cases of tuberculosis, which cannot enter hospitals and sanatoria.

That this Congress endorse such well-considered legislation for the regulation of factories and workshops, the abolition of premature and injurious labor of women and children, and the securing of sanitary dwellings, as will increase the resisting power of the community to tuberculosis and other diseases.

That instruction in personal and school hygiene should be given by properly qualified medical instructors.

That colleges and universities should be urged to establish courses in hygiene and sanitation, and also to include these subjects among their entrance requirements, in order to stimulate useful elementary instruction in the lower schools.

That the Congress endorses and recommends the establishment of playgrounds as an important means of preventing tuberculosis, through their influence upon health and resistance to disease.

611 Spadina Avenue, Toronto.

J. H. E.

THE AMERICAN HOSPITAL ASSOCIATION MEETING

THE tenth annual conference of the American Hospital Association was held in the King Edward Hotel, Toronto, September 29th and 30th and October 1st and 2nd. There was an attendance of about 200 delegates, most of whom were hospital superintendents.

Acting Mayor Harrison welcomed the convention to the city. He said in part:

"The name 'Toronto' is an Indian one, and signifies 'place of meeting.' Legend tells us that it was in the cool shadow of the stately trees which in the distant past adorned the banks of our beautiful bay that various tribes of redmen held friendly intercourse; and that it was here also the hardy pale-face, who sought adventure or gain on the great Indian trails, bivouacked with the Hurons. You will, therefore, see that Toronto's claim to the title 'Convention City' is not without justification.

"It is, however, seldom that it falls to the lot of an individual-no matter how exalted his position-to address a more important. assemblage than that which I find present here this morning. It is to your charge that the well-being of thousands of suffering humanity is unreservedly entrusted.

"This, I understand, is the first occasion in the history of your Association that Canada has been honored with your presence. I trust that it shall not be the last, for I learn with no little pride that, though the American Hospital Association comprises some 470 superintendents and hospital trustees, 50 of these are Canadian.

VISIT THE HOSPITALS.

"You will, within the next few days, be afforded ample opportunity of visiting the various hospitals, including the Toronto General, Grace, the Western, the Hospital for Incurables. the Orthopedic, the Hospital for Consumptives at Weston, also the Lakeside Home for Little Children, the Hospital for Sick Children, and the Nurses' Home, the three last-named institutions constituting the life-work of one of our leading citizens, whose earnestness and enthusiasm know no bounds, and whose munificence knows no limit other than his means. The gentleman to whom I allude is. I am pleased to observe, an honored officer of this Association, Mr. J. Ross Robertson. (Applause.)

"It may not be amiss to inform you that Ontario boasts of some 67 hospitals, and that probably as many more are contained in the other Provinces of Canada.

"If I may be permitted to throw out a suggestion, it is that every State in the Union should be prevailed upon to form an association; that each of such associations should send delegates to the A. H. A., and that the latter should form an alliance with the Canadian Association. You would then have an international association, in which every State of the Union and every Province of Canada would be represented.

"It may be of interest to you to learn that in Toronto the city contributes to the hospitals seventy cents per diem per public ward patient, and that the Provincial Government is also a contributor to the extent of twenty cents.

"When you again visit us we hope to be able to show you through a general hospital that will be worthy of our city, our Province, and of Canada."

PRESIDENT'S ADDRESS.

Dr. S. S. Goldwater, of Mount Sinai Hospital, New York, President of the Association, in his address showed a deep study of hospitals and the various spheres in which the Association must work and expand. He drew attention to the fact that, although nine years old, the Association had nearly doubled in membership the present year, and he deemed the time opportune for the discussion of organization work to enlarge the life and scope of the Hospital Association.

WHAT ASSOCIATION MEANS.

"What are the factors which will in the long run determine the usefulness of this Association?" asked Dr. Goldwater. They appear to me to be the number and character of the Association's members; the extent, thoroughness, comprehensiveness and coordination of its investigations and studies; the effectiveness of its public activities, including in this latter means for the dissemination of its observation and recommendations for the enlightening of the public on hospital affairs and the use of public opinion to influence and guide philanthropists and legislators."

EFFECTIVE WORK.

He joined hands with those who wished an effective institution rather than a large one, but saw no reason why a large one should not be more influential and perfect than a small one. The Association was the result of that which is inherent in every medical man and nurse-the desire to associate with and seek the friendship and advice of those interested in similar occupations.

BUT FEW Devoted MindS.

"For ten years," continued the President, "this institution has cautiously felt its way, slowly and steadily gathering strength and

purpose. Its contributions to hospital literature have depended upon the activities of a few devoted minds, each working more or less independently of the other. With its larger membership of to-day, with its still larger membership and its inevitably greater resources of the immediate future, its progress need no longer be left to the chance interests of temporary executive officers, or to the contributions of a few active and willing members. The progress of this Association should proceed in the future according to the plan calculated to turn the light of public investigation and discussion upon every condition which, for good or ill, affects, or is capable of affecting, the welfare of the institutions with whose management we have charge. But we cannot hope to bring about the sustained, searching, many-sided criticism of hospital methods which is desired unless our plan is one which will turn to use the great latent powers of our Association.

MANY HARD PROBLEMS.

"The problems involving the hospital management are multitudinous. Many of these reach far beyond the sphere of the ave rage, hospital superintendent's daily thought. We must learn how best to apply to our work the principles of medicine, of sanitation. of public and personal hygiene, of hospital and district nursing and nursing education, of social economics, ethics, law and finance, of business and domestic administration, of engineering and architecture. All this lies within our reach through the medium of this Association."

Dr. Goldwater expressed the opinion that all interested in hospital work, including trustees, should be members of the Association. He concluded by suggesting that the organization should be modified so as to take in the different sections under regularly constituted departments.

In her paper on the "Relationship of the Training School to Hospital Efficiency," Miss C. A. Aikens hit out from the shoulder, and made statements sufficiently important to rouse the whole Association to a deeper sense of its responsibilities. She deemed the training school essential to efficiency in nursing. Poor conditions might be overcome by good nurses, but poor nurses could never be perfected by the best of hospital conditions. "The real essence of nursing," said Miss Aikens, "must always be personal service to the sick or helpless." No matter into what field of knowledge a nurse might venture, she would soon become aware that she trespassed upon the field of others, and that the crowning glory of her achievements must be nursing.

Too MUCH TRAINING.

Miss Aikens showed that the tendency of the times was to plan and insist on a great deal of instruction that in no way benefited

hospitals or nursing. It seems strange to her that the modern nurse must pass through the hands of from twenty to thirty lecturers, dealing with a hundred subjects, before being qualified for humanitarian work. She believed it nonsense to think that the nearer a nurse approached the medical profession in training so much the better would be her standard. There was a vast difference between medicine and the duties of a nurse. Nurses were frequently taken away from care of patients at critical times to listen to lectures that were, from a nurse's standpoint, pure twaddle.

TOO MUCH CLASSROOM.

The essence of the whole problem was: "What are the essentials of a nursing education, theoretical and practical?" "I am firmly of the opinion," she said, "that the efficiency of the nursing service will be increased by having more teaching done at the bedside and less in the classroom." The laws bearing upon training schools, upon which the efficiency of hospitals depend, went a long way to imperil the efficiency of the nursing service. While it was desirable that nurses should be educated, she could never believe that a high school training was a necessary qualification for a nurse, the fitness of whom would never be determined by any gauge of education. A moral, sympathetic, Christian woman with little education might make a ten times better nurse than the graduate of the best college in the world.”

So far as the choice of candidates is concerned, the superintendent of every school had the right to exercise her own judgment, and should not be forced into a certain line of choice by statute.

CRAZE FOR LAWS.

Men in this age seem to have a craze for making laws that are more of a reproach than a benefit to society. They exacted unjust conditions, to the detriment of the well-being of many an institution, particularly hospitals and training schools. To make haste. slowly in many matters of this character was a splendid motto. The nurse is best fitted for her work who has had some training along the line of household responsibilities. Too often was important work left to pupils instead of being performed by the heads of hospitals. It should be the duty of the American Hospital Association to plan and work out all matters peculiar to hospitals and nurses ' on a common-sense basis.

Rev. A. S. Kavanagh, D.D., Superintendent of the Methodist Episcopal Hospital, Brooklyn, submitted the report of the subcommittee on the training of nurses, discussing at length the curriculum of studies, and reviewing the history of the movement which culminated in the re-adoption of the two-year course in some of the leading New York hospitals. Dr. Kavanagh did not advocate. either the two-year or the three-year course, but moved a resolution