WHEREAS, State institutions as now managed are better adapted than local prisons for the proper discipline and reformation of delinquents;

Resolved, That this Conference recommends that the state take over the care of offenders convicted of misdemeanors as well as those convicted of felony, and that the Legislature be urged to establish institutions properly fitted to accomplish this result.

The following, by Mr. Lang, is reported favorably:

Resolved, That the president appoint a committee to conside the subject of the character, preparation, service, pay and social life of caretakers in charitable institutions and report at the next meeting of the Conference.

The following, offered by Mr. Stewart, is reported favorably:

Resolved, That the officers and members of the Tenth New York State Conference of Charities and Correction, assembled in the Senate chamber in the Capitol at Albany, on Thursday, November 18, 1909, send affectionate greetings to Dr. William Pryor Letchworth, of Portage, the first president of the Conference. They arc not unmindful of the inspiration they early derived from the lifelong services to humanity rendered by Dr. Letchworth. In his venerable retirement he is not forgotten, and earnest wishes for his future health and happiness we now convey to him.

The following, by Dr. Bernstein, is also reported favorably:

WHEREAS, No comprehensive and scientific investigation has yet been made with reference to the various phases of child-caring work, and

WHEREAS, The problem is one of national importance, therefore, be it

Resolved, That the State Conference of Charities endorses the proposed establishment of a federal children's bureau, one of whose first duties should be the making of such an investigation, and, be it further

Resolved, That if the national government should fail to establish such a bureau, we urge the government of the state of New York to appoint a commission, consisting of not less than twelve expert representatives of various child-caring plans, to make such

a study, and that we urge the Legislature to provide for the expenses of such a commission, including the services of statisticians, physicians, educators, nurses, investigators and other employees.

Also the following, presented by Mr. Blatchly, is reported favorably:

Resolved, That the thanks of this Conference be tendered to Mr. Daniel W. Cahill, Superintendent of Public Buildings, and to his assistants, for the many courtesies extended to the Conference in its use of the Capitol rooms.

Resolved, That the thanks of this Conference be tendered to all who have contributed towards making this Tenth Conference of Charities and Correction a success.

THE PRESIDENT: You have heard the report of the Committee on Resolutions, which covers the recommendation on the several resolutions just read. What is your pleasure concerning them?

MR. BLATCHLY: I move that those resolutions be adopted by the Conference as read.

The motion was seconded and carried.

THE PRESIDENT: Is there any further business to be transacted by the Conference? If not, I shall have the pleasure of introducing to you the Chairman of the Committee on Public Health. Hon. Robert W. Hebberd, who will take charge of the session.

MR. HEBBERD: Owing to the inability of Dr. Hermann M. Biggs of the Health Department of New York City to serve as chairman of this Committee of the Conference, because of the pressure of innumerable other matters upon his time and attention, the present chairman at almost the last hour was drafted to act in that capacity. Although each member of the Committee has been requested to make suggestions with respect to the report and the program, and some members have responded with helpful advice and information which have been put to as much use as possible, there has been neither time nor opportunity for conference. Accordingly the usual thing happened and the chairman has been obliged to . assume almost the entire responsibility for the program as weli as for the report of the Committee. These facts are mentioned in

order that my associates on the Committee may not be held responsible for anything in this report set forth which is not directly attributed to them.

Having made these explanations, we shall now proceed to consider briefly the subject of this meeting. At the outset it must be evident that a subject so important and comprehensive as this cannot be treated other than in the most general way within the small amount of time which the rules of the Conference allow for the presentation of reports. You may further be assured that it will be my purpose to keep well within the time limit.

REPORT OF THE COMMITTEE ON PUBLIC HEALTH, INCLUDING THE PREVENTION OF TUBERCULOSIS.

ROBERT W. HEBBERD.

"The Public Health, including the Prevention of Tuberculosis," is a subject which may, in the main, be treated from two general viewpoints, namely, the prevention of disease and the cure of disease. The first mentioned, which I am sure no one here can be found to gainsay, must be everywhere regarded as the issue of primary importance. With singular unanimity, the answers which I received.from the other members of the Committee, when I asked for their views and suggestions, indicate a wider horizon for the future, and an earnest desire for the establishment of broader and more comprehensive methods of dealing with the great and ever pressing question of the health of the people. The primary need of improving the standards of living, the need for better and cheaper transit facilities, for the advancement of education, particularly of the young, with respect to hygienic living, for the hospital care and the segregation of those suffering from "social diseases," so called, as well as from tuberculosis, are all emphasized in these answers, and are precisely in line with the viewpoint of the chairman.

One member of the Committee, Dr. S. S. Goldwater of Mt. Sinai Hospital in the city of New York, whose opinions are most valuable because of his professional attainments, as well as because of his almost unrivaled opportunities for knowing the facts, makes the following contribution on the subject of tuberculosis, to the report of the Committee: "I am more and more inclined," says Dr. Goldwater, "to differ with those optimists who believe and teach that pulmonary tuberculosis, as it actually comes to the

notice, let us say of the workers in tuberculosis clinics, is a 'curable' disease. I mean that from a careful analysis of the work of one such clinic, and from a consideration of the actual circumstances of the lives of patients, before, during and after attempted cures in day camps, sanatoria, or at home, the conviction has come that in an overwhelming majority of these cases, the patients who actually come to the clinics for treatment (not the hypothetical patient of good home surroundings, favorable occupation, and habits, and exceptional vital resistance), cannot be cured by any means at present available. I believe," continues Dr. Goldwater, "that the campaign formula Tuberculosis a Curable Disease,' is misleading; that it arouses false hope; that it will lead to reaction and resentment, and will produce hostility to those through whom the lessons of hygiene should be taught, not with the hope of curing tuberculosis but for the purpose of preventing it.

"The mistaken belief," says Dr. Goldwater, "(if it is a mistaken belief), that tuberculosis is a practically curable disease among the poorer classes, and under the social and industrial conditions actually prevailing, leads or will lead, to a relatively wasteful application of limited resources that should be used more advantageously in ways calculated to prevent the spread of the disease."

In conclusion, Dr. Goldwater says: "For the present and so long as limited resources only are available for use in the struggle against tuberculosis, I would advocate the following as to the proper campaign method:

1. The abandonment of useless efforts to cure patients who may be relieved, but who cannot be cured by irregular attendance at day camps, by an insignificant and temporary increase in food supplies, or by brief periods of sanitarium treatment followed by a return (with the disease still active or, at least, latent) to the original conditions of living.

2. A concentration of effort to secure: (a) means for the prompt and proper care of all persons who are socially or industrially unfit or unproductive, and who suffer from open tuberculosis; (b) preventoria for susceptible and exposed children, i. e., temporary homes where hygienic living can be practiced, at least, for a time, in lieu of the (at present unattainable) provision of permanently proper and favorable conditions of living for such children; (c) supplementing this special concentration of effort,

everybody, who is interested in the effort to stamp out tuberculosis, must be ready at all times to lend his aid to any and every move

ment for social betterment which is calculated to raise the standard of living among the lowest strata of society." Whether in full agreement with Dr. Goldwater or not, the questions he raises and the suggestions he offers are worthy of consideration and discussion by the members of this Conference.

The question naturally arises, "Are we as a people earnestly putting forth our best efforts to prevent disease?" How shall this question be answered? If the simile may be pardoned it would seem that much of our efforts, instead of being directed toward the extinguishment of the flames of disease, are exhausted in an attempt to run after and stamp out the flying sparks, leaving the fire itself to smoulder on or to burst anew into flame at some favorable opportunity. And, yet, it must be apparent, if we are to make any real headway in the work of controlling disease, we must direct our chief efforts toward putting out the fire itself that produces the sparks, no matter how stupendous and almost insurmountable the task may appear. In order to accomplish this result we must raise the standards under which a very large proportion of the people of our great cities work and live. To this end we must have their active coöperation if we are not to work largely in vain.

One of our chief difficulties in this matter arises from a surprising lack of forethought in the planning of our cities. This may be, in part at least, due to our unstable, even if in other respects more satisfactory, form of government. It is, also in part, due to a somewhat noticeable defect in our public officials, who rarely plan even their institutions, more than two or three years in advance, or just about the time moneys for improvements are about to be expended. This lack of forethought in city planning causes what are known as "The Slums " to grow up not only in the center of the city, but even in the suburbs. This takes from our great systems of rapid transit, the bridge, the tunnel and the subway, what should be from a proper civic standpoint, the very essence of their purpose, the transportation of the workers to and from the crowded centers of employment in order that they may enjoy the benefits of more hygienic living in the suburbs.

Of what use is it, and how can it benefit a family, may I ask, to move from the congested surroundings of the great East Side, to ride ten or more miles, morning and evening, to work and back,