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BACTERIOLOGICAL WALL CHART FOR THE PHYSICIAN'S Office.-One of our scientific and artistically produced, bacteriological charts in colors, exhibiting 60 different pathogenic microorganisms, will be mailed free to any regular medical practitioner, upon request mentioning this journal *This chart has received the highest praise from leading bacteriologists and pathologists, in this and other countries, not only for its scientific accuracy, but for the artistic and skillful manner in which it has been executed. It exhibits more illustrations of the different micro-organisms than can be found 1 any one text-book published.



A palatable emulsion of lecithin. Rich in
organic phosphorus. Stimulates nutrition,
increases hemoglobin and leucocytes and im-
proves the appetite. LECITHOL is indicated
in rickets, infantile atrophy, pancreatic dia-
betes, chlorosis, tuberculosis, and as a tonic
for the aged and overworked.




Rest, Recuperation and Health at the Battle Creek Sanitarium

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An examina'ion of their illustrated booklet hows show different the Battle Creek Sanitarium is from other health

Its cuisine, conducted according to the Caloric system is different. Its remarkable system of baths including Nauheim is different. Its system of manual Swedish movements is different. Its school of nealth is unique and fascina'ing. lis (are and treatment of guests, especially invalids, are preculiarly its own. Indeed, the whole vast institution, its atmosphere and environments are suffused with what has becc me known the world over as “The Battle Creek Idea.'

Its main building, absolutely fire procf, contains seven acres of ideal indoors. It has over 100 suites with private baths, lelepnone in every room, model kitchen and sunny dining rooms on top floor with 50-mile view, great palm g rden, delightful sun parlors, elegant lobbies, parlors and rest foyers, wide porches and spacious home-like roos It employs the most elaborate and costly scientific equipment for phototherapy, electricity, X-ray electric light, baths, Finson rais, etc.

The Rates are Moderate. Board and room, including baths, services of bath attendants and necessary medical attention, cost less at the Battle Creek Sanitarium than board and room alone at many resort hotels not so elegantly appointed.

Those désiring absolute quiet and rest can have it at any rime. For those desiring them, there are marches, lectures, stereopticons, musicales, contests, exhibitions, walking, driving, tally-ho a'd picnic parties and other in Joor and outdoor en: ertainments and amusements. Write for copy of their catalogue, Address,

Box 402, THE SANITARIUM, 'Battle Creek, Mich. All through railroad tickets have stop-over privilege at Battle Creek.

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The Executive of the Association, in requesting me to discuss briefly the question of Tuberculosis in Immigrants coming to Canada, had not, I feel sure, any idea that a defence of the work done by the Medical Officers of the Immigration Department was necessary, but rather felt that I, as the Chief Medical Officer of that service, was naturally in a position to present any facts relating to this very important matter clearly before this Association, and through it before the people of Canada generally.

I have therefore to thank the Association for the honor conferred upon me, and shall endeavor to indicate the situation as it exists by referring to the immigrants during 1907, which had notably the largest immigration (196,143 being examined at seaports) to Canada ever arriving in any single year, and who came in any manner before the attention of public bodies, whether Federal, Provincial or Municipal, as being tuberculized. In

*Delivered before the Canadian Association for the Prevention of Tuberculosis.

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addition to published reports, I have received answers from all provincial health officers, and from hospitals and charitable institutions, to a circular sent out to all such throughout Canada. From these replies I have been able to estimate very closely the number of immigrants who during 1907 became subjects of hospital treatment or official charity.

The circulars asked for the name, age, sex, nationality, date of arrival in Canada, the date of entering any institution, and the final disposition of every case.

From Ontario I received answers from 61 institutions; from Quebec, 18; from Nova Scotia, 9 answers; and 40 institutions reported upon in the Provincial Charity Report; 5 from Manitoba; 3 from Saskatchewan, included in a total of 12 cases reported by the Provincial Health Officer; 9 from Alberta; 7 from British Columbia, and one from the Yukon. Of these only 10 institutions in Ontario reported any cases, there being 21 in all; 7 in Quebec reported 66 cases; 3 in Manitoba reported 25 cases; 12 were reported from Saskatchewan ; 3 from Alberta and none from either British Columbia, Nova Scotia or the Yukon ; or, in all, 127 cases were reported. By examining the names of these, so far as given, I find that, apart from 11 who died, those who remained in the institutions for any length of time were mostly reported to the Minister of Immigration, and where they had arrived in Canada within two years, such were returned to their own countries and friends. In all, this number amounted to 59. In addition to this number coming under the direct purview of the Immigration Department, 16 more were debarred on examination at the seaports and were not admitted to Canada. As it will be remembered that under the Immigration Act, as amended in 1906, any immigrant who becomes a charge in any public instituion in Canada within three years after landing may be deported, and as 400 were deported during the eight months ending in November, 1907, in a total of 181,784, as compared with 925 on account of diseases in a total of 1,286,000 who entered the United States in the past fiscal year, it is apparent that the Act has been made use of to a very full extent. have endeavored to analyze the cases dealt with by the Department, with a view to ascertaining the exact number who, from being unable to work very shortly after arrival, were evidently advanced cases on arrival; those who, though working for several months, became thereafter inmates of some institution or came under the notice of the Department, and the number who it would appear were well on arrival, but took the disease in Canada.





in this manner the results are:
Evidently tuberculized on admission to Canada. ... 25
Not tuberculized
No particulars

Died in hospital

1 Of other cases not deported and regarding whom particulars were obtained, I found two recent arrivals died in Hamilton, both tuberculized on arrival; two died at Port Arthur within a year of arrival and two others with no particulars, in hospital; 4 Austrians died in St. Thomas hospital; 1 died at Lethbridge. Of 22 cases in their homes visited by the Margaret Scott Nursing Mission in Winnipeg, it is stated “that none were visited who had not had the disease before leaving the Old Country,” but how many of the 22 visited came from the Old Country is not given. Of 61 cases of various forms of tuberculosis treated in Victoria Hospital, Montreal, not born in Canada, 18 had arrived in Canada within three years, and 4 were in Notre Dame, Montreal, all of whom had arrived within one year.

Thus, taking the exact figures, and others more or less exact, I think it may be said that at least 100 immigrants who came to Canada did, within two years, develop tuberculosis and become public charges, of whom more than 50 were probably tuberculized on arrival, 25 badly so, and 25 probably contracted the disease after arrival. Taking in round numbers 350,000 as the total

. immigrants from amongst whom, during 1906 and 1907, these mmigrants came, it means that 0.3 of all immigrants, who were examined before admission to Canada, became tuberculized within two years. Out of this number, at least 25 were probably in so advanced a stage as to have been diagnosable if yet greater care had been taken by Medical Inspectors, but when it is remembered that this means but one in every 14,000 examined who was overlooked, and that specialists tell us that the average existence of the disease before it is diagnosed in office examinations is at least eight months, it is plain that the official sins of omission have not been very great.

Perhaps the immunity of immigrants from tuberculosis may be best comprehended by comparison with an ordinary Canadian community. I find that almost exactly 100 deaths occurred last year in Ottawa from pulmonary tuberculosis, and that, as modern exact satistics have shown that the average duration of cases of consumption in Great Britain and the United States is five years,

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