1916] OF THE SENATE. 35

"Tuberculosis is curable only in the earliest stage of the
disease. In this statement 'curable' is used in its ordinary
practical significance, not in a strictly scientific sense;
that is, to mean that the patient loses all symptoms of
the infection, is able to return to accustomed ways of liv-
ing and is no longer a source of contagion to his associ-
ates. "

"The diagnosis of pulmonary tuberculosis in an early
stage is beset with such difficulties that its practical appli-
cation on a large scale has completely failed. This failure
has been due to two factors:

a. The lack of skill in early diagnosis displayed by

the medical profession; and
b. The nature of the disease. "

"The establishment of hospitals being accepted as the
best method for the State to deal with the problem of
tuberculosis in the negro, it becomes an important task to
decide specifically upon the character, plan, location and
management of such institutions. Your committee feels
that certain broad principles of policy should be decided at
once, but the details should be exhaustively studied before
a definite plan is accepted. Concerning the broad princi-
ples of policy, the following questions demand an imme-
diate answer:

"1. Shall there be one or two large, or a number of

smaller institutions ?"

"This question cannot be considered in detail, but your
Committee commits itself unhesitatingly to a plea for
County hospitals. The advantages of such a plan are so
important and so numerous that they outweigh the one
valid objection, namely: the increased cost of construction
and maintenance, that can be urged against it. Chief
among the advantages is the desirability of having an
institution for sick and dying patients near their home,
where relatives and friends may conveniently visit them.
The hardship of sending patients off to a distance to linger
in illness and die away from family and friends would