illustration: dr. robert koch.] prof. koch's _method to cure_ tuberculosis _popularly treated_ by dr. max birnbaum. _translated from the german_ by dr. fr. brendecke. _with an appendix being prof. koch's first communication on the subject, translated from the_ _deutsche medicinische wochenschrift_ _and explanatory notes by the author._ milwaukee, wis., h. e. haferkorn, publisher. 1891. copyright 1890, by h. e. haferkorn. press of the hartmann printing co., 126 reed st., milwaukee, wis. translators preface. consumption is curable. from time to time the news of some great discovery rushes over the land like a mighty wave; but never before has the intelligence of a great achievement been received with such universal delight. there is hardly a man, woman or child that does not bewail the loss of some dear relative taken away by tuberculosis, the most terrible of all foes. more terrible because it stealthily creeps into the system and takes a firm hold before its presence can even be surmised. now the appearance of a deliverer is hailed as would the advent of the messiah. koch, formerly a poor and obscure student, being especially interested in bacteriology has plodded and worked for years. even in the year 1882 he has made known to the world the evil spirit in describing the tubercle-bacillus as the specific generator of tuberculosis. we then knew the enemy but had no weapon to fight him. now koch has also manufactured the sword with which to combat the evil genius. the experimental tests thus far have not tended to lessen the merits of koch's remedy. added applications have resulted in additional success. the investigations are not yet complete; only meager particulars have thus far been given to the public from authorized sources. to guard against misleading representations the translator has undertaken to give to the american public only what has actually been achieved. he felt himself called upon to do this not only because he has followed the progress of koch's labors with the keenest interest, but also because he himself has worked and labored on this field for many years. justly has a vast excitement taken hold of all classes of the people, an excitement that has caused all other contemporary events to fall back. the search for an actual remedy for that exceedingly ravaging disease, tuberculosis, has at last been crowned with success, and even the most uneducated will be able to estimate the significance of this event. we need but consider, that pulmonary consumption, the most frequent form of tuberculosis, annually demands over 30,000 victims in the cities of the german empire over 15,000 inhabitants, and out of every 100 deceased 12-13 have fallen prey to this sickness. the number of sufferers from pulmonary consumption can not nearly be determined, it certainly exceeds all other diseases by far. in the case of many people we can only infer from their appearance and hereditary tendencies, before visible signs can be discovered, that they will succumb to this terrible disease. and this disease is now curable. millions of people who have considered themselves doomed, will be given back to life; their regained strength will greatly increase the national wealth. in short, we look forward to an era, such as was not dreamt of even by the most vivid imagination only a few years back. but rather than be carried too far by our enthusiasm, let us study koch's new method to cure, as far as we are now enabled to pass judgement on it. first of all we must explain: _what is tuberculosis? what relation does it bear to pulmonary consumption?_ pulmonary consumption is only one form of tuberculosis, by far the most frequent. this is the reason why pulmonary consumption, pulmonary tuberculosis, consumption and tuberculosis are used as _synonymous_ terms. tuberculosis is the _general_ expression. by that we understand a disease which is generated by a certain kind of organism belonging to the class of bacteria. these organisms are the tubercle bacilli, which were discovered by koch in the year 1882. now these tubercle bacilli settle most frequently in the lungs and here cause serious derangements of the lung tissue. _pulmonary consumption_ is the result. but the tubercle bacilli will also settle in any other portions of the body and cause tuberculosis. frequently the tubercle bacilli nestle in the _larynx_ and the result is _laryngeal consumption_. they may infect the mucous lining of the tongue and nasal passages and cause the rarely occurring diseases--_tuberculosis of the tongue and nose_. more frequently tuberculosis of the intestines results, the well-known _intestinal consumption_. the spreading of tuberculosis in the brain is of especial importance on account of the importance of this organ. very frequently small children are attacked by _tuberculosis_ of the _cerebral membranes_, a disease that has heretofore unexceptionally resulted in _death_. much oftener than is generally supposed the _kidneys_ are the seat of tuberculosis; and also the _suprarenal capsules_, whose functions are as yet entirely unknown, have in postmortem examinations been found to be tubercularly degenerated. in the diseases of the _bones_ and _joints_ tuberculosis forms an important part. those infinitely small and weak tubercle-bacilli have the power to destroy the hard and firm substance of the bones, to soften it and change it to pus. whole portions of bone may disappear in this way. tuberculosis can also destroy parts of the _skin_. in this case it is called _lupus_. finally tuberculosis is found in the _generative organs_. tubercular derangements are frequently met with in the _testicles_ of men, less often in the _ovaries_ of women. the well known children's disease _scrofula_ is considered a preceding stage of tuberculosis by many physicians. this much is certain that scrofula inclines to tuberculosis. let us study the several forms of tuberculosis after this general synopsis; we will begin with pulmonary consumption. pulmonary consumption. even before the discovery of the tubercle-bacillus by koch, different scientists had claimed that pulmonary consumption was caused by the immigration of bacteria into the lungs, and several of them had found bacteria of that kind. but it remained for koch to bring light upon the conjectures of other scientists, and he established the fact, that the bacillus discovered by him was the real generator of pulmonary consumption. millions of these bacilli exist in the lungs of the diseased, and millions of them are thrown out with the sputum. if we take a very small quantity of this thrown out matter and examine it with a microscope, we will find a greater or smaller number of these tubercle bacilli. of course the preparation to be microscopically examined must previously be colored with some coloring matter, otherwise it is very difficult, well nigh impossible, to detect the infinitely small bacilli. the method of coloring now generally in use consists in discoloring the preparation after the coloring has been completed, it is found that the bacilli tenaciously cling to the coloring matter, and in this way it is easy to recognize the tubercle-bacilli under the microscope. these bacilli are infinitely minute, they are 2/1000 to 8/1000 millimeters long, and about 5/100000 millimeters in width. therefore it is absolutely impossible to recognize them with the naked eye. generally they are somewhat bent, sometimes slightly nicked at one end. the temperature of boiling water destroys the vitality of the bacilli under all circumstances. even a temperature of 70° c. is able to lessen the efficacy of the bacilli. unhappily this temperature is too high to be applied against the tubercle-bacilli in the human body without causing the most serious injury to it. nevertheless it has been tried, we will speak of this later on. then the drugs that kill the bacteria, such as carbolic acid, alcohol, iodoformether, ether, sublimate, thymol, destroy the tubercle-bacilli so slowly and only in such high concentrations that their application is impossible without endangering the patient. therefore the prospects of directly destroying the bacilli in the human body had to be given up as impossible. we are now confronted with two questions: 1. in what manner does the tubercle-bacillus enter into the human organism? 2. under what conditions is the tubercle-bacillus able to generate pulmonary consumption after it has entered the human organism? all investigations, both of earlier and later date have established the fact that the tubercle-bacillus is inhaled with the air, and then it is mainly the foul air which is accused. but foul air is especially found in such places where people congregate, as in rooms, barracks, factories, etc. as it is a fact that there are always several consumptives among a number of people, so in this case there will always be occasion to inhale the tubercle-bacilli that have been cast out by the consumptives. therefore it is not the foul air in itself which generates pulmonary consumption, but the circumstance that in this connection there are always people present which are able to spread and scatter the bacilli. luckily the physical qualities of the tubercle-bacilli are such that they mostly adhere to the ground or floor and are rarely scattered in the air as dust; otherwise pulmonary consumption would be much more frequent than it is at present. unfortunately the bacilli are very often spread through uncleanliness of the people, because they touch objects with their fingers to which the tubercle-bacilli chance to stick and then they touch their mouth or nose with these fingers. in this way bacilli can be taken into the system especially easily with the food. children are particularly exposed to contamination, crawling about on the ground, on which, perhaps but recently, a consumptive has spit, and more so because they often have the habit to put all sorts of things and also the generally dirty fingers into their mouth. on the other hand there are various obstacles in the way of tubercle-bacilli entering the lungs. the distance from the mouth to the lungs is long and narrow; all sorts of projections check the further penetration of the bacilli. the trachea and the air-passages of the lungs possess equipments arranged for the purpose of ejecting small foreign substances, thus also to throw out the bacilli. in short it is not too easy a matter for the bacilli to penetrate into the lungs. and yet this happens only too often. for instance, in some people the passage from the mouth down may be a wide one, so that the bacilli can enter more easily; the protective arrangement by which foreign substances are removed may be deranged, it may be wanting in some place or its functionary qualifications may be bad; especially frequent this is the case after enfeebling diseases, which are associated with severe cough, as measles, whooping-cough, etc. this is the reason why pulmonary consumption is strikingly often observed to follow just these diseases. but the tubercle-bacillus can also enter the body with the food, as stated before. the acid gastric juice is a protective agent which considerably lessens the danger of infection by tuberculosis. it has not been definitely decided at the present time whether the drinking of milk from tuberculous cows brings with it the danger of tuberculosis for mankind. it will certainly be best to avoid such milk, especially when the cow's udder is found to be tuberculously diseased or when tubercle-bacilli can be traced in the milk. the use of meat as food may also become dangerous to man, but this is a rare occurrence. it is particularly dangerous to eat the liver, kidneys and lymphatic glands of tuberculous animals. the boiling heat while cooking generally destroys the bacilli contained therein and so lessens the danger from this source. it is of no little importance, to call particular attention to the fact that our chickens are very often severely infected with tuberculosis. the question, whether a consumptive can _infect his surroundings_, may be answered thus, that this does _not_ happen as a rule. several unhappy circumstances must come together to make this possible. above all things a direct transmission of tubercle-bacilli in some way into the body of the healthy person, then the bacilli must cling and propagate in the same, which is only possible when there is an inclination to this disease, of course this inclination is quite common. pulmonary consumption is _not hereditary_ in the strict sense of the word. only an inclination to this disease is transmitted. as the danger of contagion of those having such disposition is very great, so as a rule the disease makes its appearance sooner or later. on the other hand it must be considered that the penetration _only_ of the tubercle-bacilli into the body is _not_ sufficient to generate tuberculosis. if they do not find the ground adapted to their nourishment and propagation they perish. it may be assumed that every person is placed in such circumstances at some time that he will take in tubercle-bacilli; but only a certain percentage will get consumption. in the remainder the bacilli perish without leaving even a trace. very often the inclination to pulmonary consumption may be recognized from the external characteristics. as a rule the respective individuals have a slight body, thin lean skin, weak muscles, delicate skeleton, a long, narrow, flat chest, flattening of the regions over and below the shoulderblades, wide intercostal spaces, a winglike projecting of the scapulæ, long neck, clubby, knoblike appearance of the ends of the fingers. furthermore it has been found, that pulmonary consumptives on an average have a _smaller heart_ than is essential to a healthy body. on the other hand the volume of the lungs of consumptives is very often abnormally large. there are a large number of _diseases_ that predispose to pulmonary consumption. it is mainly the _enfeebling_ action of the same, which brings about such results. for this reason the _chronic_ diseases contribute so much toward the multiplication of the number of consumptives, because they stipulate a continuous weakening of the organism and an emaciation of the system. to these belong bright's disease, which very often turns into pulmonary consumption, greensickness or chlorosis, anaemia, continued febrile diseases, severe chronic suppuration, chronic catarrh of the stomach, frequent pregnancies, childbed diseases. thus we may often see young chlorotic girls afflicted with consumption, especially when they marry young and enjoy the honeymoon to its utmost limits. then also women will easily become consumptive when they give birth to a child every year, especially when the social conditions in which they live are of an unfavorable nature, and they are perhaps inclined to consumption already. childbed on the whole inclines to arousing the dormant inclination toward pulmonary consumption. of other diseases we have mentioned measles and whooping cough, as diseases that are only too easily succeeded by consumption. to these may be added typhus, especially when it is of a more protracted nature, and the reconvalescence is slow and incomplete. furthermore all those workmen that have to do with dust, are exposed to the danger of being stricken with pulmonary consumption. the dust enters the lungs, irritates and injures the same and so produces a favorable soil for any tubercle bacilli that may happen to penetrate. on the whole metal dust is more injurious than mineral dust. workmen, that are exposed to animal dust, as furriers, saddlers, brushmakers, fall prey to consumption much oftener than those, that fulfill their vocation in air pregnant with vegetable dust. according to statistics workingmen are stricken with pulmonary consumption as follows: of glass workers 80 per cent., needle grinders 70, filemakers 62, stone cutters 40, mill grinders, lithographers, cigarmakers, brushmakers, stone-polishers 40-50, millers 10, coal workers 1 per cent. pneumonia may culminate in pulmonary consumption: but on the whole this rarely happens. much oftener it is the case with pleurisy. but it is assumed and rightly, that most people who are attacked by pleurisy, are already consumptive. a hemorrhage of the lungs may nearly always be considered a sure sign that consumption has taken hold of the respective individual; but such a hemorrhage certainly forms considerable danger to falling a victim to tuberculosis, if the individual is as yet free from the same. age has a particularly decided influence on the origin of consumption; it is extremely rare before the third or fourth year, from that to the seventh it is more frequent; it most frequently occurs in the age from the fifteenth to the thirtieth year, and from there on the chances are again fewer. in very old age it is again very rare. there seems to be no essential difference as regards sex. _insufficient_ or _defective nourishment_ acts as a promoter in various ways. even the nourishing of infants with poor milk, with bread or flour-pap increases the disposition to pulmonary consumption. if this defective nourishment is continued, scrofula will surely follow and this is a stage antecedent to consumption. pulmonary consumption is relatively more frequent among the _poorer_ than the _well to do people_, this is partly due to the meagre and scanty food of the poorer, and that they are obliged to subsist almost exclusively on vegetable diet. the higher the meat prices rise and the less the majority of the people can afford to procure meat, the larger will be the number of consumptives. the poorly nourished offer a good soil for the tubercle bacilli in consequence of their weakness. the tissue offers little or no resistance to the growth of the bacilli, these propagate and destroy the powerless and yielding organism with fearful rapidity. the _frequency_ of pulmonary consumption increases with the _size of the cities_, or, which is the same, with the number of proletarians. extreme hunger and want are less frequent in the country than in the city. that the climate has an important influence on the appearance of pulmonary consumption has long been known. in certain elevated regions this disease seldom or never appears. this experience has been attained in switzerland and many other mountain regions. furthermore the plateaux of peru and mexico are considered free from consumption, but also lowlands like iceland, the kirgheez steppes and the interior of egypt are known to be exempt. _damp and windy climate_, especially with very high temperature, or abrupt changes in the temperature promotes consumption; on the other hand it is less frequent in the more moderated climates, especially if they are dry. now when the tubercle bacilli have settled in the lungs, they cause various symptoms. one of the most frequent is _cough_. in the beginning of the disease a short, clear but light, very often dry cough appears. during the further development of pulmonary consumption the cough becomes more periodic; it appears early after awaking, in the afternoon after dinner, and evenings at lying down; it may disappear entirely in the meantime or may be light only; but then as a rule it is no longer dry, but may be attended by expectorations of a varied nature. [illustration: section of a tuberculous knot in the lungs, in which two cavities are seen filled with numerous bacilli. the bacilli distinctly appear as dark lines as a result of the coloring. enlargement 900.] [illustration: tubercle bacilli, enlargement 2000. to the left bacilli without spores, to the right bacilli with colorless sections which are thought to be spores.] the tubercle bacilli destroy the lung tissue and change it into pus, which is coughed out. in this way larger and smaller cavities are formed in the lungs; finally the cavities may even take more space than the remaining lung tissue. when cavities have already been formed, coughing comes easy and with abundant expectoration. toward the end of life the coughing and spitting stops as a result of the extreme feebleness and weakness. the violence and frequency of the cough depends mainly whether the larger bronchial tubes and the trachea are affected; the more this is the case, the more violent the inclination to cough. further the strength of the cough depends on the excitability of the patient; the greater this is, the more as a rule will he cough. sometimes the position of the patient is of influence; if he lies mostly on the diseased side the expectoration becomes more difficult and coughing increases. coughing is generally that symptom which soonest attracts the attention of the patient and his surroundings. for that very reason consumption is in its beginning stages easily confounded with such other diseases as are also accompanied by cough. at the same time we know of exceptional cases where cough was entirely absent in the first stages of the disease, or was at least so slight that it was overlooked, and under such conditions the pale and poor appearance and reduced strength is mistaken for chlorosis or some other anaemic affection, also the existing febrile excitements are wrongly judged, or on account of lack of appetite or light derangements of the stomach a stomachic affection is surmised, until suddenly a hemorrhage of the lungs clearly defines the true nature of the ailment. on the other hand the cough may become so violent that vomiting is caused at the same time. nevertheless many consumptives describe their cough as very unimportant on account of their innate sorrowless nature, and they will not even be discouraged by the gravest symptoms. often however it is fear that induces the patients to make light of their coughing, their spitting blood, their losing flesh and to place but little importance on these circumstances. a _hoarse_ cough is a sure sign of a diseased _larynx_. many consumptives complain of cutting pains between the shoulderblades, under the clavicles or in the side; but these are rarely intense and are often entirely wanting. unfortunately it is unknown to the average layman that the internal organs may suffer extensive tearing down without an indication of pain. the _expectoration_ of consumptives which is thrown out by coughing with great exertion, is but scant in the beginning, as a rule phlegmy, glassy transparent and sticky. it is one of the suspicious symptoms of developing pulmonary consumption if this lasts for any greater length of time. sometimes sharply defined, yellowish stripes, at times branching, appear in the same. later on the expectoration becomes more purulent, and of greenish-yellow or greenish-gray color. still later the patients throw out rounded lumps of greenish yellow or yellowish green color, which flatten out like a coin in the spittoon. they sink in water which is a sign of forboding evil. _blood_ appears in different quantities in the sputum of consumptives. bloody streaks are of no importance; they may appear with every violent cough. on the other hand the casting out of _pure blood_ is indeed serious. the _quantity_ of blood thrown out during an attack may be very different, varying from a few drops hardly a teaspoonful, to hundreds of grammes, even more than a liter. it is generally light red, filled with airbubbles, foamy, and is largely coughed out in coagulated lumps. the coughing of blood is sometimes preceded by a feeling of oppression, rushing of blood to the head and palpitation. some patients experience a sweet taste in the mouth even before the bleeding. in many cases all preceding symptoms are missing and the patient is suddenly attacked by blood coughing during some more vigorous movement, during the exertion of coughing or even without any direct cause. _blood coughing_ seems to appear somewhat more frequently with the _female_ sex than with the male and has with them unmistakable relations to menstruation, as with the sick it often sets in before, often after or even during the same and at such times more frequently than at others. it is of great importance for the layman to know that a hemorrhage rarely leads to inevitable death. fatal hemorrhages are always preceded by warning attacks. blood coughing may appear at any stage of consumption. in some cases it is particularly lasting. sometimes the patients experience considerable relief from their feeling of oppression after a hemorrhage. a number of the consumptives as a rule complain of _difficulty_ in _deglutition_. this is caused by ulcers on the posterior wall of the larynx. with many patients the _appetite_ is _undisturbed_ for a long time, and there are consumptives that will eat a comparatively large dinner during an attack of fever reaching 40° c. generally the desire to eat disappears during the course of the disease, especially toward the end of the sickness. the _stool_ may be normal or costive, but is very often diarrhoetic. twelve or more evacuations may take place during a day; as a rule they are much increased by gasses and are of bad odor. they weaken the patient very much and hasten the end. one of the most constant attendants during the course of consumption is the _fever_. it is rather irregular. in cases of slow process the fever is often very insignificant; often it is only a state of general excitement that takes hold of the patient afternoons, slight dizziness, increased lustre of the eyes, slightly flushed appearance, somewhat increased pulse, which invites to test the temperature of the body by means of a thermometer, which by the way shows it to be about 38° c. with quick consumption the fever is generally high. _sweat_ is also a characteristic sign. the exceedingly debilitating effect of night-sweats is well known. during the course of pulmonary consumption extreme _emaciation_ of the patient is brought about. all tissues are subject to the same, most marked is the disappearance of adipose tissue. this symptom is of the greatest importance as a continued increase in weight means improvement and even cure. therefore weighing the patient from time to time gives a sure meter for the course of the disease. the _course_ of pulmonary consumption is very different. with quick consumption the end comes within two or three months. chronic pulmonary consumption may last for years. with this improvements in the fine season alternate with deterioration in the winter. concerning the former _treatment_ of pulmonary consumption, this will also be applied in the future in the same manner as far as preventive means and general hygiene is referred to. for every one will prefer to remain exempt from consumption although it may now be possible to cure those afflicted. the lately published and popularly treated precautionary measures, especially with reference to the expectoration of consumptives retain their full value. henceforth the sputum is also to be thrown in a _spittoon_ which is either entirely empty or on account of easier cleansing has the bottom covered with a thin layer of water. it should not be permitted to fill the spittoons with sand or sawdust as the tubercle bacilli can be easily thrown up with the dust. in the case of a _sudden attack_ of _cough_ a _cloth_ should be held to the mouth to hinder spreading of the fine spray, the same should also be used for wiping the mouth. however the cloth must soon be dampened and cleaned. as bits of the sputum easily stick to the _beard_ especially the moustache overhanging the lips, therefore lung consumptives are advised to wear a short or no beard. _glasses_, _spoons_, etc. used by consumptives must only be used by other persons after a thorough cleaning with hot water. the lungdiseased person should abstain from all active and passive _kissing_, in unavoidable cases kissing should be done on the forehead or cheek only, or hold out those parts only to be kissed. in the same way he should avoid to touch objects with his mouth that may possible be put in the mouth by other persons, especially children, for instance toy-trumpets. in the case of _death_ from pulmonary consumption, the walls of all rooms and apartments used by the deceased should be rubbed down with fresh baked bread, which is a sure method of removing the bacilli. the bread crumbs that may have dropped on the floor may be removed by a thorough scrubbing with soap, brush and lye. upholstered furniture, beds, clothes and wash should be cleaned in a disinfecting place. do not wait with precautionary measures till some member of the family has been attacked by pulmonary consumption, but make preparation to prevent the infection while everybody is still sound and healthy. this care ought to begin in a measure with the _birth of a child_. the same should not be nursed by a mother with diseased lungs nor by a wet-nurse with like affections. generally wet-nurses are only tested for syphilis; scrofula and tuberculosis receive altogether too little attention. an important precautionary measure consists in the supervision of the _food_. the abattoirs and dairies should be placed under the supervision of practical physicians, and the sale of products derived from tuberculous cattle be prohibited. this refers to the milk in the first instance. tuberculous cows should be excluded from dairy-farms. raw milk should be avoided as much as possible as boiled milk has the same value. the _meat inspection_ must be strictly conducted especially with reference to tuberculosis in the case of beef, pork and chickens. sheep are not subject to tuberculosis. the _associations_ of children in school and on the play-ground should be watched; do not let them visit in strange families before making thorough investigation as to their sanitary relations. the health of _servant girls_ should receive greater attention than formerly, as the disease is often carried into the house by them as investigation has proven. in the _schools_ and kindergartens the teacher ought to insist that children do not spit on the floor or in the handkerchief; in case of necessity he should keep sick children out of school and he should especially follow these precautionary measures as regards his own person. the _cleaning of the floor_ of a room should always be done in a damp way. _moving_ into another house it is advised to rub down the walls with fresh baked bread. as regards _societies_, every society and every health resort without exception and if possible every hospital should be obliged to have its own apparatus for disinfection and to make extensive use of it. smaller societies may unite to procure an apparatus of the kind. especial attention should be given to the _sprinkling of the streets_ during the dry season. the state and the larger congregations should make it a point to maintain _institutions for consumptives_, beyond the city limits if possible, a healthy location in the country preferred. every one individually protects himself best from consumption by a methodic habit of _washing with cold water_, cold rubbing and baths. river and sea baths are generally of excellent results; short shower baths with cool water lasting 20-40 seconds are to be applied later on; they do not only harden the skin but excite deep inhalations and exhalations and in that way act as gymnastics of the lungs. more direct is the action of muscular exercise, such as gymnastics, riding horseback or bicycle, driving, skating, rowing, etc. the carriage of children must be regulated, the drooping forward of their shoulders must be corrected by strengthening the muscles of the back and shoulders by means of dumbbell and other exercises. all this must still be observed in the future. on the other hand above all the numberless remedies will be dropped that have heretofore been applied as presumably specific remedies for consumption. creosote, which was so much praised at its appearance a few years ago and still applied, because of the non-existence of a better remedy, will be dropped into obliteration and with it guajacol which was just getting to be the "fashion". all the various inhalation methods that have matured in later years will disappear from the picture plane as far as this has not ever now happened. the medical remedies, which were given for the torturing cough, for hemorrhage of the lungs, sweats etc., will in most cases be superfluous after this. hemorrhages will now and then still be experienced as the same may set in unexpectedly. the diatetic cures with whey, koumiss, grapes etc. will retain their importance and also the bathing resorts will be hunted up by patients as formerly. the owners also of special institutes for curing pulmonary consumption need not despair with the idea that they will not be needed in the future. on the contrary, those needing cure will flock to them in all the greater numbers, as they now know that they certainly will be restored to health within a definitely limited time. the other forms of tuberculosis. of the other forms of tuberculosis _laryngeal consumption_ is very often combined with pulmonary consumption. it is estimated that this is true of at least one-fourth of all cases of pulmonary consumption. at first laryngeal consumption can not in any way be distinguished from an ordinary inflammation of the larynx. a certain weakness and sensitiveness of the organs however is suspicious, also great liability to hoarseness. on the other hand laryngeal consumption may exist without any sort of ailing to the patient. these appear later, however, when lung tuberculosis is progressing. the larynx shows more distinct outlines on the lean throat, difficulty in swallowing is experienced, pains radiate toward the ear. food and drinks come up again after being swallowed. the painful cough has a hollow, barking, harsh sound, provokes vomiting, and the sputum together with foul breath consists of foamy, slimy, purulent lumps. breathing gradually becomes more difficult and louder. as regards the duration of laryngeal consumption it generally runs parallel with pulmonary consumption. if the latter progresses more rapidly so also will the destruction of the larynx by the tubercle-bacilli be a more rapid one and vice versa. in several cases it has been observed that, if pulmonary consumption progressed or remained without any extraordinary symptoms, those with diseased larynx have lived for years, with alternating improvements and diminutions, and also an occasional suspension of all symptoms, till on account of often only a trivial, evil influence a new stimulus is given and the disease found an unexpectedly rapid completion of its course. until now only few cases of laryngeal consumption could be looked upon as really cured. lately it has been tried to accomplish cures especially by the application of caustics. this will not now be necessary. but those afflicted in this way, will henceforth be obliged to try and live in air free from dust, to travel south during the winter and to subject themselves to a general strengthening treatment. _tuberculosis_ of the _tongue_ is relatively very scarce. the individual in such a case nearly always shows pronounced pulmonary tuberculosis. sometimes tuberculosis of the tongue is combined with tuberculous sores on the lips and also on the anus. tongue tuberculosis forms small ulcers, generally on the rim, very seldomly on the back of the tongue. they always are very small, generally about the size of lentils or peas. they often remain unchanged for months. at times they are very painful, though as a rule the pain is mild. the male sex is attacked by tongue tuberculosis especially frequently. the treatment before this consisted in cutting out all the diseased parts; now it will be much simpler. _nasal tuberculosis_ appears similar to the common stopping up of the nose. but when ulcers are formed, the secretions from the nose take on a purulent somewhat malodorous character. but if the affection is neglected, the secretion becomes bloody and of very bad odor. until now nasal tuberculosis had been treated by applying caustics to the ulcerated portions. _tuberculosis of the intestines_ or _intestinal consumption_ is especially found in _children_. the appearance of the same is already characteristic; the limbs are emaciated and withered; the old-looking wrinkled face shows a harsh contrast with the immoderately expanded body (frog-belly) which is caused by an accumulation of gases in the limp intestines which are then filled to bursting. many such children have succumbed to gradually progressing emaciation and weakness. probably it will not be possible to save all children in the future that have been stricken with this disease as many are wanting in sufficient vitality to resist all external influences. with adults intestinal consumption makes itself known by everlasting diarrhoea, a result of the numerous ulcers in the intestines which have been caused by the tubercle-bacilli. _tuberculosis of the brain and of the cerebral membranes_ also attack children especially. before this no attempts have been made to try whether it is now possible to cure the _tuberculous inflammation of the cerebral membranes_ which has previously been unconditionally fatal. the decision will certainly soon be made. we will give a fuller description of the symptoms of this disease to thus enable timely summons of medical interference. this disease will be known to many as "acute hydrocephalus." as a rule children of 2-7 years of age are attacked by this fearful disease. the antecedents are extremely peculiar and manifold. even two or three weeks before the outbreak of the real sickness, emaciation takes place from which the face is strangely enough entirely exempt, so that children, when dressed show no signs of a change. attentive mothers and nurses, however, regularly notice the same and especially the appearance of the ribs causes no little anxiety. with this a slight pallor of the face is associated and a peculiar lustre of the eyes. the children lose their former feeling of gayety and activity. they sleep more than usual, withdraw from their favorite game, they become grumbly and shy toward their surroundings and cry for the slightest reason. it also is very peculiar that they avoid trying their former little tricks, such as climbing up on chairs, opening of door bolts that are almost out of their reach, they even will not try to look through a latticed window and asked to do so, decidedly refuse. boys, that would not stand anything from their associates, that fought and wrestled as long as their strength permitted it, sneak away cowardly and crying from such attacks. other children again become extraordinarily tender-hearted and affectionate, they hug their parents continually and can hardly console themselves when they leave them. in the case of older children that have already learnt something, teachers notice unusual inattention and indifference, committing to memory comes harder than usual and what is finally learnt is recited in an awkward and stammering way. the children sleep unusually much and often by day; on the other hand their sleep at night is less sound and is interrupted by horrid dreams, frequent turning over in the bed and frequent clamorous outcries. the appetite is lessened, and often a craving is noticed for stimulating food of which, however, little is eaten. thirst is not increased. urinal secretion is somewhat diminished and the urine is characterized by a brick-colored precipitate. the stool is rather costive, especially with larger children; but diarrhoea may attend this disease. the latter is principally the case with small children that are in the stage of first teething. headache is rarely felt and hardly ever complained of even by larger children; dizziness and unsteady walking is frequently observed. the children quite often complain of stomach-ache, which is very much increased by pressure on the abdomen. fever is not generally attendant, but the same may be present. the symptoms just described, separately or collectively, gradually increase; the children finally take to their bed and now the _real cerebral affection_ developes. now the principal symptoms are: vomiting, constipation, slow pulse, irregular abrupt breathing, increased temperature of the skin, contracted abdomen, headache, great excitement alternating with drowsiness, beginning decrease of reason, and deranged ability of moving the limbs. as regards _vomiting_, this is almost a continuous symptom and generally appears in the earlier stages. but the duration of vomiting is very different. some children vomit only for one or more days and not all they have eaten, while others vomit continuously from the beginning of the disease till they are relieved by death, and no food can be found that is not thrown up shortly after its being eaten. in this connection it is a peculiar fact that vomiting will not recur if it has once ceased for twenty-four hours. very important for the recognition of the disease is the manner of vomiting. for a child suffering from a spoiled stomach will be troubled with nausea, belching, choking and cold sweat long before it is forced to vomit, while children with acute hydrocephalus will throw up without any previous symptoms of that kind, just as though they filled the mouth with water and spit it out again. vomiting is facilitated when children are raised or placed on their side. it ceases for the time the stomach is empty, but as soon as fluid or even solid food is taken in it will be cast out at once without causing any particular distress or inconvenience to the child. gall is very rarely mixed with the vomit. a second and nearly as constant a symptom is _constipation_ from which nearly three-fourths of the diseased children suffer. as a rule cathartics have no effect and are generally thrown out through the mouth. this constipation will not last till the end, for a few pappy stools appear later on whether purgatives are administered or not. violent diarrhoea resulting from intestinal tuberculosis may be discontinued at the beginning of acute hydrocephalus. but the later stools will again be thin and of cadaverous odor. during the latter stages of the disease children will often _fail to pass urine_ for twenty-four hours, so that the physician is obliged to draw it off with a catheter. the appetite does not disappear entirely as a rule. there may not be any desire for food, but generally little difficulty is experienced in inducing children to take milk or broth, which is all the more surprising as vomiting regularly follows. the _fever_ is generally not very intense. the temperature of the head, especially the forehead, is considerably increased in all cases and remains so until death ensues, while the feet have great tendency to getting cold. the _pulse_ is characteristic in many cases. in the beginning of the disease the pulse is quickened only to slacken after a few days. the number of beats may be reduced to 40-60 a minute (normal 90-100), however it does not commonly remain at a certain figure, but varies, often inside of an hour, so that at one time 40, then 60 and again 80 beats may be counted inside of twenty-four hours. the pulse again increases 1-3 days before death and then to such a rate that it is almost impossible to count it. it may reach 180 and 200 beats a minute. as soon as this rate of the pulse follows one of the reductions described above a speedy death may be predicted. of great importance are the variations in respiration. in the beginning stages of the disease breathing is normal except in such case where tuberculosis has made great progress in the lungs and in the case of high fever. then of course breathing becomes more rapid. acute hydrocephalus influences respiration in such a way that it slackens and becomes irregular. in one minute children may breath fifteen times, in another thirty, then again 20 times; at one time breathing may be very slight with almost invisible expansion of the chest and without any noise whatever, then again it may consist of deep sighs; these are also characteristic of this particular disease. sometimes breathing is completely discontinued for ten seconds and more. if the pulse attains that extreme rate shortly before death the rate of breathing will also be increased. as regards the _skin_, the same is generally damp from the beginning of the disease; severe sweats are observed on the head; with progressing disease the skin becomes dry, brittle, comes off in flake-like scales and only when the death-predicting increase of the pulse sets in, there appears a profuse sweat, the cold sweat of death. _headache_ is also a prominent and pretty nearly constant symptom. as has been mentioned before, it does not as a rule attend the precursory symptoms. it generally begins with vomiting and soon becomes so violent that older children constantly cry aloud and lament, while the smaller ones put their little hands up to their head, pull their hair and ears and restlessly roll about on the pillow. these expressions of pain last as long as children retain consciousness, a particular part of the head is not commonly pointed out, but asked about it the majority point to the forehead. with small children automatic movements are noticed that also seem to refer to headache, and which consist in rapidly placing the hand on the head and then drawing it back. the larger children complain of _pains in the bowels_, especially in the region of the stomach, which remarkably often, though not regularly, become more intense by pressing and may become so violent that the children cry out aloud with pain, when the stomach or other portion of the abdomen is but slightly touched. but these pains do not last as long as the headache, they often stop suddenly, at times return. the shape of the _abdomen_ is extraordinarily characteristic. in the beginning nothing remarkable can be noticed, but after the symptoms of acute hydrocephalus, vomiting, constipation, etc., have lasted for some time, the abdomen gradually decreases in size, becomes wrinkled and collapses until it finally assumes a scaphoid shape and by slight pressure the large iliac artery can be felt on the spinal column. this contraction of the abdomen is attendant in every case of tuberculous meningitis. if the large _fontanel_ on the head is not yet closed, the same will gradually bulge out as the disease progresses. the _mental activity_ suffers premature derangements, such as have been fully mentioned in the description of the precursory symptoms. the most striking is the confused, staring look, the peevish and surly behavior, and again in other cases the extreme indifference toward otherwise well-liked persons and things. later on actual delirium sets in, but generally of a quiet nature. a very common symptom is a loud, plaintive outcry, that is repeated at longer or shorter intervals. children often cry out at partly regular intervals during a whole night; these cries are always accompanied by a loud sigh. these symptoms of excitement being extremely tormenting and depressing for the sympathizing relatives, fortunately last no longer than 6-8 days at the most, and are succeeded by a deep _stupor_. if the children have once become _unconscious_, they do not recover again as a rule but remain so until death; delirium and stupor may alternate with each other in certain cases, but the former process is by far the most frequent. _convulsions_ appear only in the later stages. at first the interval between the attacks are long, often as many as three or four days intervene. commonly however they come much oftener and may in some cases last for hours. all extremities are affected by these convulsions, the eyes become red, are rolled in every direction and turning way up are fixed so that nothing but the whites is visible. after several minutes, often after two or three hours, these general convulsions subside, the children, now very pale, drop into a deep sleep and their general condition appears much reduced. different muscular groups especially those of the face are subject to _local cramps_. the upper lip may become distorted, convulsive smiles have been observed, also peculiar sucking motions. the children point their lips and flatten them again, sometimes for hours in succession. in the latter stages a squinting of one or both eyes may be noticed but this may again disappear. _grinding of the teeth_ is another very peculiar symptom which is well-known and feared by experienced nurses. the _arms_ are subject to various motions, at times sweeping automaton like, then again convulsive contractions, sometimes trembling of the muscles, at others a throbbing of the tendons. many patients put their hands to their sexual organs and make motions tending to onanism. the _legs_ are not subject to cramps as much as the arms; they are mostly bent and drawn up in a half paralyzed condition. the _muscles of the neck and back_ are very much contracted and most children, when raised or laid on their side, bend the head far back. in most children an extreme sensibility at being touched is observed. they may be handled with the greatest possible care and lifted most tenderly, a slight pressure on the head, body or hands in changing their position will be violently resisted with obvious expressions of pain. in the latter stages this extreme sensibility gives way to _insensibility_. then the children may be pinched and poked, they may be turned and moved from one side to the other without any consideration, they will not resist and only give expression to the remaining sensibility by a low whimper. the lack of sensibility may be especially marked in the eyes; these can be touched with the fingers, without causing a closing of the lids. the sense of _hearing_ seems to continue its functions until very late. children show that they hear as long as they are not completely unconscious; even when addressed in a low tone of voice they react somewhat. the sense of _smell and taste_ also are lost toward the very end of the disease. _paralytic_ affections appear during the final stages. it has been observed in some cases that the arm and limb are paralyzed on one side only. often one upper eyelid is paralyzed and hangs down on one side of the face and the muscles of the tongue may be affected. generally the patient dies after violent general convulsions that last for hours. exceptionally only the paralytic symptoms increase gradually and cause death without any agony or struggle, simply a discontinuance of the functions constituting life. the duration of the disease varies from 2-4 weeks from the beginning of the characteristic symptoms. generally the day when the children take to the bed is fixed as the beginning of the disease. the former methods of treatment have been a signal and absolute failure in every case. every child that has once been attacked with this disease has heretofore died. until now koch has not been able to make any experiments with acute hydrocephalus, so that it remains an open question whether it is now possible to cure this disease. besides tuberculosis of the cerebral membranes with which children are afflicted, _tuberculosis of the brain_ may occur, although this disease is very rare. tuberculosis of the brain appears in the shape of small tumors in all parts of the brain. after longer duration of tuberculosis of the brain, tubercular meningitis appears. the process of this disease may be varied. in some cases the development of cerebral tuberculosis is manifested by the sudden appearance of high fever temperatures or violent headache; to this may be added, slackening of the pulse, vomiting, stiff neck and isolated cases of palsy; sometimes an attack of convulsions is the first manifestation. in other cases the beginning can not be accurately determined, as the beginning symptoms of the disease are so slight as to escape notice. impaired process of nutrition, languor and headache are symptoms from which the existence of some serious affliction may be inferred without being able to determine its nature in the earlier stages. again in other cases the disease may proceed through all its stages without any cerebral appearances whatever. this is especially true of small tubercles and of diseases of infants. however, we more frequently observe in children than in adults convulsions of varied intensity and distribution. nutrition is more and more impaired as the disease progresses, in isolated cases only, a temporary improvement may be observed. the _end_ of cerebral tuberculosis has been _death_ before this. ten days to two weeks, even three weeks may pass from the first appearance of tubercular meningitis to the completion of the process of the disease, attended by feverish motions characteristic of this condition and by cerebral symptoms, first with the character of excitement, later on with that of palsy. the treatment of cerebral tuberculosis has been entirely insufficient before this. let us hope that it will be possible to effect a cure by means of koch's new method. _tuberculosis of the kidneys_ is met with from the earliest childhood till old age. most frequently the male sex is afflicted during manhood. in most cases tuberculosis also exists in other organs, especially in the urinary and sexual apparatus. the existence of pulmonary or intestinal tuberculosis is not essential. the symptoms of renal tuberculosis are of such general and indefinite character, that it is often impossible to fully determine the disease. now, however, it will be more easily possible on account of koch's discovery. the _urine_ may, but need not contain pus and blood. sometimes small lumps are found in the urine. _pains_ are only sometimes felt in the renal regions; _fever_ may be occasionally attendant. the disease lasts for months and years; though before now it has inevitably resulted in death, though it has in exceptional cases taken ten years or more. the internal treatment of renal tuberculosis was ineffectual, surgical treatment has been attended with greater success. this consisted in removing the diseased kidney. now good results will possibly be attained by the application of koch's method to cure and resource to surgery will be taken in exceptional cases only. _tuberculosis of the suprarenal capsules_ is of very rare occurrence. it leads to a peculiar change in the color of the skin; the same turns dark brown or bronze color. sooner or later death results. perhaps the application of koch's method will, besides curing the disease, give us information regarding the functions of the suprarenal capsules about which nothing whatever is as yet known. a large space in the realm of disease is claimed by _tuberculous affections of the bones and joints_. these afflictions appear particularly in childhood though manhood is by no means exempt. they may appear in all portions of the body, although a marked preference is shown for certain parts. although the tubercle-bacilli are infinitely small, they possess the power to cause suppuration of the bones and joints and to produce acute inflammation of these parts. most frequently tubercular affections of the bones are found in the hip-joints, the knee and the spinal column. _tuberculous inflammation of the hip-joint_ is principally a disease occurring in childhood; though it rarely appears before the third year. it is most frequent from the fifth to the tenth year. inflammation of the hip-joint developes very slowly in children, it generally takes months before the slightest beginning symptoms reach a threatening appearance. the first sign is _lameness_; among laymen tuberculous inflammation of the hip-joints is known as "voluntary limping." by limping we understand that mode of walking in which one leg is spared and by this the trunk is supported only a short time by one extremity and all the longer by the other. in every painful affection of the lower extremity limping results as the weight of the body increases the pain. the lameness in the case of diseased hip-joint has something peculiar about it, inasmuch as not only a part of the extremity but the whole of it is dragged. for this very reason parents of children afflicted with inflammation of the hip-joint use the expression "the child draws" or "drags the leg". in the beginning even the examining physician finds no symptoms of disease in the joint. no swelling, no abnormal position, no restriction of the freedom of motion, no pain from pressure or while moving, in short nothing can be found that would otherwise indicate the beginning of an inflammation of the joints. yet _lameness only_ is sufficient data from which we may infer the probable beginning of hip-joint inflammation. it is much better to overestimate the significance of this symptom than to miss the proper time for calling in the aid of a physician by placing too little confidence on it. the second symptom, _pain_, rarely attends the beginning of lameness, generally it comes several weeks later and in the case of very slow development of tubercularly inflamed hip-joint several months later. in very small children the attendance of pain is manifested by the fact that they will not play and they often wake up in the night and begin to cry. children from the fourth and fifth year upward definitely point out the hip as the seat of pain, sometimes, however, the knee-joint on the diseased side is designated with great determination. this pain in the knee has often been the cause of mistakes. later on painfulness of the hip-joint is experienced from pressure and at about the same time the movements are impeded. then the leg takes a peculiar position. the thigh is slightly bent and rolls outward. for convenience the child drops the half of the pelvis corresponding to the diseased hip-joint, and naturally raises the other half. from this apparently a curvature of the spinal column results in the lumbar region. apparently only, for when the child is laid down and the morbid position of the thigh is restored the curvature of the lumbar column disappears. during the further progress of the disease the pain is increased, and the sensibility may become so acute that the slightest movement of the limb, even a shaking of the bed in which the patient lies will cause the most intense pain. in the previous stage walking could only be done for short distances and then awkwardly, now it is entirely impossible. children are obliged to lie in bed night and day, and under these altered conditions there is a change of the position of the extremity. the increased sensibility induces the child to seek the medium position, the leg is bent more than in the position mentioned above, it is halfway straightened. to this is added, that the child can not lie well on the sensitive and swollen hip; with right side hip-joint inflammation it turns on the left. as the diseased and bent thigh does not then rest on the mattress the same is placed on the healthy limb for support and for protection from movements, in the same manner as we lay one leg on the other in a healthy condition when we sleep on our side. the actual danger to life in tuberculous hip-joint inflammation begins with the time when the child takes to his bed. the fatal end comes almost without exception after suppuration has commenced, very rarely before that time. total suppuration of the hip-joint is an almost absolutely fatal process. if this suppuration sets in suddenly, it may result in an early death with attendance of acute fever. in other cases several weeks may elapse from beginning suppuration till death. a complete cure of tuberculous hip-joint inflammation may come about spontaneously. but often the knee remains bent and unserviceable for walking, so that crutches or machines must be used. even before this the beginning stages were treated with fair prospects of success, and it is a lamentable fact that in many cases the import of these seemingly trivial symptoms has been underestimated. _rest_ is of the greatest importance during the very first stages of the disease in which the attending symptoms are of so indefinite a character that it is almost impossible to know whether hip-joint inflammation will develop or not; the child must not be allowed to walk. aside from this the application of brine-, maltand sea-water baths is advised. an abundance of nourishing food is of just as great importance. all this will also retain its significance in the future. formerly recourse to surgery has been taken during the later stages of the disease in which suppuration of the internal parts of the joint has commenced and large parts of the diseased bones may have become mortified. an incision is made into the joint, the same is exposed and all diseased portions are carefully removed. in the future this operation must probably also be performed, although with the difference that the prospects of success are now much more certain than formerly when relapses only too often followed the operation. _tuberculous inflammation of the knee-joint_ is, as said before, very frequent with children and is rather lingering in the beginning. here also a slight dragging or limping of the diseased leg can be noticed. the child when asked about the limping, or of its own accord, complains of pain in the joint after walking or when the part is pressed; at first nothing abnormal can be seen on the knee by the layman. on closer examination, however, by comparing the two knees it will be found that the grooves on each side of the patella, which give the healthy knee-joint the beautifully modeled shape, have nearly or quite disappeared; nothing more can be noticed. the hinderance in motion may be so insignificant, that the children may slightly limp about for weeks and months and complain but little. generally the physician is not called until the limb begins to hurt and swell after continued exertion. the swelling which in the beginning is hardly noticeable is now more plainly visible, the knee-joint is evenly rounded and quite sensitive to pressure. if the disease is not now properly treated, its further course will be as follows: the patient may perhaps linger for several months; then comes a period when he must keep to his bed uninterruptedly because moving results in too much pain; generally the limb becomes more and more bent. now particularly painful points appear on the joint, especially on the inner or outer side or in the bend of the knee; on one of these points a soft portion distinctly developes, the skin becomes reddened and finally suppurates from the internal parts outward and breaks after a few months; thin purulent matter mixed with flakes is discharged. the pains now cease, and the condition is improved; but this improvement does not last; soon another abscess is formed and thus it continues. meanwhile perhaps two or three years may have elapsed; the general condition becomes greatly reduced. the child, formerly strong and healthy, has now become lean, the discharges of matter have often been attended by acute febrile attacks; the patient becomes exhausted, loses his appetite and digestion becomes more impaired from week to week. even now a spontaneous change for the better is possible, though this happens very rarely; more frequently the disease progresses and leads to death from exhaustion resulting from severe suppuration and continual attacks of fever. restoration to health is indicated by decreased suppurative discharges; the openings of the fistulae contract, the general condition is improved, the appetite is restored, etc. finally the fistulae heal, the joint becomes fixed at an angle or bent or otherwise crippled, but painfulness disappears and the patient escapes with his life and a stiff leg. this is the most favorable result known to have been obtained in severe cases. the joint may become a solid bony immovable mass or may admit of slight movements. the whole process may last from two to four years. the former treatment of tuberculous inflammation of the knee-joint was either of a general or a local nature. the general treatment was designed to strengthen and nourish, and will continue to be applied in the future. the local treatment consisted in the application of salves, brushing with tincture of iodine, spanish fly plasters, wet and dry bandages. as with inflamed hip-joint absolute rest by lying in bed is of the greatest importance. if after a certain period of rest and application of the above-named remedies no improvement in the state of health could be noticed, the diseased joint was laid in plaster or confined with splints. if even then, after such treatment for months, no improvement could be noticed but rather that the general state of health was reduced, nothing remained to be done excepting an operation, by which all the diseased parts of the knee-joint were removed, or amputation, that is, the taking off of the diseased limb. the latter method was generally adopted in the case of feeble and emaciated individuals and those who had passed the age of early manhood, as with these the removal of the diseased parts did not, as a rule, result in an improvement of the general condition, which was especially intended. now tuberculous inflammation of the knee-joint will be treated by koch's method and in extreme cases only will operation be necessary. at all rates, an absolute cure will be easily effected. aside from the hipand knee-joint the _spinal column_ is most frequently attacked by tuberculosis. here also it is the youthful age, from the third year upward, that has to suffer most from this serious disease. adults are rarely attacked by it and with them it generally appears in connection with general tuberculosis. the tubercle-bacilli penetrate into the substance of the vertebrae, destroy the same and transform it into purulent matter. as a result the destroyed vertebrae sink or rather settle down and cause a curvature of the spine, in other words a humpback. in the beginning the symptoms of diseased spine are very indefinite and misleading. the patient rarely complains of pain at first, and it is only noticed that the sick child easily tires of standing or walking and tends to hold on to chairs and similar objects with his hands to relieve the spinal column of the weight. from such uncertain data it is of course impossible to recognize the disease. only then when the softened vertebrae give way under the weight of the body, that is when the humpback begins to develop, can tuberculous inflammation of the spine be surmised with any degree of certainty. as a rule two other characteristic phenomena appear which are dependent on the pain in the affected spinal column. the child, while standing, places his hand on the thighs and thus directly supports part of the weight of the trunk with the lower extremities; at the same time he avoids bending the spinal column forward. this anxious care for the diseased vertebrae is especially noticeable when the child attempts to pick up an object from the floor. while the healthy child bends freely forward, the sick one crouches down and while bending the knee and hip keeps the spinal column as straight and stiff as possible. frequently a small spot on the spinal column is found to be extremely sensitive to pressure in this stage; but such a subjective symptom must be considered with caution especially with children. this humpback, which is a result of tuberculous inflammation of the spine, must not be confounded with the humpback caused by rickets. with the latter the curvature is more uniform as a rule, and in the start at least, disappears while in a horizontal position. besides the humpback resulting from rickets appears between the first and fourth years of age, while tuberculous inflammation of the spine rarely begins before the fourth year. and finally rickets never causes suppuration while this is always the case with inflammation of the spine. the progress of suppuration is downward as a rule and does not admit of examination until it gets near to the surface of the body; before this the feverish conditions toward evening are the only signs that indicate beginning suppuration. ardent fever is not attendant during this time; the temperature does not exceed 38 or 38.6° c. and even such trifling increase of temperature may be wanting. as soon as the skin is reached by the originally deepseated centres of suppuration, it gradually becomes red and later on also suppurated. if the skin is broken and the matter discharged, great care must be taken to keep the wound clean, as otherwise the suppurative cavities may suddenly become ichorous and lead to rapid death. in other cases this extreme result is not caused and fistulae are formed from which the ichor constantly flows. small bits of mortified and broken off bones may be thrown out with the matter. as a result of the sinking and settling of the vertebrae the spinal chord may suffer from pressure and contusion as it is contained in a channel formed by the vertebrae. aside from certain pain it may result in paralysis of certain parts. formerly the diagnosis of tuberculous inflammation of the spine in its beginning stages was very uncertain. a great number of afflicted are at present cured by surgical treatment; in former times this was not possible, as the majority of patients died in whose case the disease had progressed to suppuration. but the curvature of the spine could not be removed by any former treatment and can not be by koch's new method. vertebrae once destroyed can in no way be restored to their normal condition. nevertheless the number of patients whose life is spared will be a still greater one and the number of complete cures will also be increased in a short time. formerly tuberculous inflammation of the spine was treated as follows: the abscesses were opened and antiseptics carefully applied: mechanical apparatus and corsets were used to aid in a natural cure. these apparatus will surely be of inestimable value at the application of koch's method. as has been stated before tuberculosis may attack all other bones and joints and there cause the most serious derangement. formerly these tuberculous afflictions were treated surgically or by means of iodoform, which has produced pretty good results in certain cases. however it will certainly be possible to produce still better results with koch's method of treatment, especially in the restoration of the functions of the afflicted parts. here, as in all tuberculous affections, it is particularly essential to subject the respective case to treatment in as early a stage as possible and before incurable destruction of the tissues of the bones and joints have been caused. a certain disease of the skin called _lupus_ (ringworm) must be counted in with the number of diseases generated by the tubercle-bacillus. lupus may begin in two different ways. either in the form of a purple spot, which is raised above the level of the skin and which has no definite limits but blends with the healthy parts; or as a slightly raised, moderately firm, darkred grain, sharply limited and about the size of a pinhead or millet seed. if the disease has begun in the shape of spots, the afflicted portions of the skin gradually swell during the process of the disease. several isolated knots appear around which the disease spreads more and more. while the disease thus takes possession of greater area and developes new centers, a uniform scaling off of all knots begins. after prolonged existence, sometimes after short duration, decay and casting off of the epidermis in its entire thickness supercedes the scaling process, and suppuration transforms the ringworm into an ulcer covered by a dirty-brown rind and disagreeably colored serum. the ulcers of lupus are of various, generally irregular shape, the rims not hard, the ground flat and covered with purulent matter and decayed tissue; they are commonly surrounded by a faint reddish areola. these ulcers gradually become epulotic and form irregular, generally slightly protruding white scars in which new tubercles may appear. lupus appears most frequently in the face and especially frequent on the nose. sometimes its appearance is indicated only by an inflammation and swelling of the mucous membranes of the nose and at the same time a reddening of the epidermis. the nostrils are stopped up by a thin rind which, if torn off, is replaced by a thicker one below which an ulcer is formed that spreads with greater rapidity on the mucous membranes of the nose than on the external epidermis of the same. sometimes the whole process on the nose is so rapid, that very often the physician is not called to the patient, before a large part of the wing of the nose or of the nasal epidermis is destroyed and deep ulcers have developed under the rind. new tubercles of lupus are commonly noticed to spring up on the margins of these ulcers; the cartilage as a rule resists the progress of the disease for a longer period and may be unhurt, while the skin on the wing of the nose may be completely destroyed. frequently the process is extended to the mucous lining of the hard palate and to the gums. lupus generally appears on the lips in the same manner as in the nose. the upper lip especially appears very much swollen and covered with ulcers after a prolonged existence of the affection. sometimes even the aperture of the mouth itself is reduced in size by the development of ulcers and scars on the surrounding parts. if the process extends to the lower eyelid, the connective tissue as a rule becomes much swollen and reddened. the malady especially attacks the inner angle of the eye, destroys the entrance of the lachrymal duct, and from there the lupous tubercles appear on the connective tissue. gradually tubercular formations develop on the cornea and sight becomes impaired. on other parts of the face lupus generally appears in the form of small knots, about the size of millet seeds, which remain for a time then multiply and spread. the epidermis swells between these knots and irregular ulcers develop on a hard swollen and glossy ground, and are covered by dark brown rinds. tubercles appear anew on the margins of the ulcers and in the spaces between them, isolated whitish spots of sunken or raised scab tissue are observed on which very frequently lupous tubercles again develop. lupus appears on the throat, neck, back, breast, and the extremities, most frequently in serpentine form i. e. swellings of the skin develop, being arranged in curves, they progress in the same manner, these are transformed into just so many ulcers. between these whitish scarred spots are noticeable on which small red lupous tubercles again appear. lupus is more frequently found on the extremities than on the trunk. the surface of the skin is found to be tense and glossy on a firm base which is affected by lupus. deep ulcerous formations of lupus are sometimes observed on the fingers and toes, particularly on the finger-joints, these may at times penetrate into the inner parts of the joints, secreting whitish pus and covered with a thick rind. as regards the difference between lupus and syphilitic diseases it has been found that lupus commonly developes before puberty while syphilis appears in the mature age. the ulcers of lupus are often round like those of syphilis with sharply defined margins, but at the same time they are flat accompanied by little or no pain; rim and base of the same are loose, red, rank, and bleed easily. on the other hand syphilitic ulcers are very painful and rim and base are covered with greasy matter. lupus appears only in the form of knots, which are deeply inbedded, from size of a pinhead to that of a lentil, but never as large knots in the beginning. syphilis produces large and palpable knots from the start. loss of the bony part of the nose or destruction of the hard palate are observed, but rarely and after protracted existence of lupus, and often in the case of syphilis. the indicated peculiarities however refer only to typical cases of lupus and of syphilis. in other cases it was almost impossible to show a difference. as regards the course of lupus, the same begins, as has been stated before, in earliest childhood, sometimes only in the form of scaly spots and knots. less often lupus developes after complete development of manhood. it is more frequent with women than with men. sometimes some of the knots remain isolated and disappear again after a time; in other cases additions appear in the course of time, which may affect larger portions of the body and lead to more or less dangerous ulcers. as a rule the course of lupus, even of great extent, is not malignant and at the most the alliance with _traumatic erysipelas_ and possibly the appearance of _pulmonary consumption_ may succeed the affliction. in cases of not too rare occurrence it has been observed that lupus has developed into _cancer_, which has always resulted fatally. the _treatment_ of lupus has principally been a _local_ one. caustics were applied to destroy lupous tubercles by direct action, and furthermore recourse has been taken to the so-called mechanical treatment, in which the ringworm was scraped out. our experiences relating to the mechanical treatment of lupus have taught us the following. lupus can not be cured without destroying and removing the diseased and affected tissue. that method which effects the most radical destruction, protects most from relapses. therefore the best method of treating lupus is to cut out the diseased skin. but with the superficial spreading peculiar to many cases of lupus this method can only be applied within certain limits. then again the secondary growths after an operation may be of serious consequences. unfortunately it has not been possible before this to remove all diseased portions, no matter what method was applied, because often tiny lupous tubercles spring up which are almost invisible to the naked eye. these tubercles will again be the starting point for another spreading of lupus. we will see that koch's new method to cure has the advantage both to make visible all tubercles, even those that have escaped our notice and also to effect a cure in the shortest time even in old chronic cases that have before this been considered incurable. it is especially possible in this form of tuberculosis to follow the specific action of the new remedy, as we will learn later on. _tuberculosis of the testicles_ is not so very rare, it is found in about 2-1/2 per cent. of all men afflicted with pulmonary consumption. it is more rarely met with in children than in men. the conditions under which tuberculosis of the testicles and epididymis developes are various inflammatory processes with existing disposition. it is mostly gonorrhea or some other inflammation of the urethra, or injured testicle. it occurs less frequently without any apparent cause. according to the starting point of tuberculosis the symptoms are varied. if it starts in the testicle, this appears normal or larger in size, but never reaches extraordinary dimensions. the surface of the testicle is at first smooth in the case of increased tension, later only does it become irregular, bumpy and of unequal consistency. if the starting point is in the epididymis, hard, rounded lumps are formed generally in the head or tail of the epididymis, rarely in the body. these increase in size and cause a swelling often of extraordinary dimensions, the surface of which appears hard, irregular, bumpy and in certain parts yielding and elastic. if the process is extended to the testicle, this also increases in size. then both together form an oval swollen mass and can not be distinguished from each other. striking changes appear only later and consist in the softening of the lumps and in the development of abscesses. very soon the lobuli are affected. the same are then thickened in the septa, are hard and form an irregular, bumpy swelling surrounded by more or less thickened tissue. very soon tuberculous changes are caused in the prostate gland, an organ situated near the intestine and the functions of which are to dilute the semen. a hardening is often the first sign, this is followed by increase in size and then softening. with the affection of the prostate gland, that of the urethra also begins, which passes through the middle of the prostate gland. this disease often appears in the form of a yellowish secretion, which is more and more increased and becomes ichorous with the decay of the urethra and the prostate gland. this secretion must be distinguished from that which as a venereal affection caused the whole process. the tubercular derangements do not only extend forward but also upward. the bladder, the ureters and the kidneys are affected and show extreme derangements with altered urinal secretions and excretions. of other symptoms of tuberculosis of the testicles pain deserves especial mention. the same is slight in the beginning, but often becomes insufferable. the symptoms here related often increase very slowly. essential changes are caused during the chronic course of tuberculosis of the testicles if suppuration sets in. the skin is perforated and fistulae are formed. if there is no halt in the process, general tuberculosis results and this has until now always caused death. according to the time in which the general derangements come about, a chronic and acute tuberculosis of the testicles has been distinguished. the former is the more frequent, the latter of rare occurrence. the sexual functions may remain unchanged if only one testicle is diseased, but are generally ruined if both epididymes are affected, because the secretion of the semen is then interrupted by the stopping up of the vas deferens. in some cases the sexual function may be interrupted for a time only and may then be resumed. the treatment before this has been surgical, in which the diseased parts were carefully removed, and where this was impossible, even castration (removal of the testicle) was performed. without doubt koch's method will cause great changes in the method of treatment here also. finally we must include in our reflection the well-known disease of children, _scrofula_. although the same is not a form of tuberculosis in the sense of the diseases just considered, still tuberculosis and scrofula have the most intimate relations. scrofula is only too often a precursory stage of tuberculosis. the manifold scrofulous affections, such as inflamed eyes, diseased ears, skin diseases, catarrh of the nose, pharynx or bronchials, inflammation of the joints and suppuration are not caused through the cooperation of tubercle-bacilli. but here the same find an excellent soil for growth and propagation, and they use the same to the full extent and so give the impetus for the development of tuberculosis. scrofula is one of the most frequent diseases, it is spread over the whole world. it occurs more seldom in the tropics than in the north. furthermore it is more frequent in a cold and damp climate than in a dry one. elevation has no influence on the development of this disease. scrofulous individuals are found in the mountains as well as in the plains. scrofula principally attacks children; it occurs most frequently in the time from the second to the fifteenth year. rarely earlier developed scrofula drags beyond the age of puberty or more advanced manhood. sex has no particular influence on the development of scrofula. in many cases this particular disease is _inherited_. the following causes are considered in the inheritance of scrofula: great age, close relationship and infirmity of the parents; but the germ of scrofula is planted in the child by parents that are themselves afflicted with tuberculosis or scrofula. this is most frequently observed in children that have descended from parents, who were scrofulous in their youth and remained so, or that became tuberculous later on and at the time of generation were afflicted by advanced scrofula or tuberculosis, or that were suffering from oft-treated but never entirely cured syphilis. some scientists claim to have observed the inheritance of scrofula by children, whose parents at the time of generation were afflicted with tuberculosis or were suffering from general debility resulting from hunger and want. in the majority of cases scrofula is acquired, as a rule the development of this disease is favored by indigence and poor hygienic conditions according to the coinciding experience of all scientists; _nutrition_, especially in the first year of life, has the greatest influence on the origin of scrofula. in _infancy_ the most frequent cause of scrofula is the premature giving of _farinaceous_ food besides the mother's milk, or the feeding of children with so-called pap, especially when this is done in the _first month of their life_. in later months the excessive eating of bread, potatoes or vegetables instead of milk has an injurious effect. furthermore the development of scrofula is favored by the breathing of _foul damp air_ such as is frequently found in newly built or damp houses and also by _deficient care of the skin_. scrofula thrives in the narrow tenement dwellings in which is found a close, overheated, foul air pregnant with smoke, kitchen fumes and mustiness from the damp walls. frequently the development of scrofula has been observed to succeed measles, diphtheria, scarlatina or whooping-cough. the opponents of vaccination also designate vaccination as a frequent cause of scrofula. it is supposed that a poison is transferred into the system with the lymph which is enabled to generate the phenomena of scrofula. however the supposition has not as yet been proven. of course the fact cannot be denied, that cases of developing scrofula have been at times observed as succeeding vaccination. but the circumstances are the same as in the case of the contagious diseases mentioned above. no one will probably maintain that in those cases in which the development of scrofula had been succeeding those diseases, that this has resulted from a poison generated by the preceding disease. the attempt to designate symptoms by which to recognize a scrofulous constitution has at all times been made. many physicians have for a long time distinguished a _torpid_ and an _erethistic_ scrofulous constitution. with a _torpid_ constitution the body is pale, spongy and bloated, the nose and lips are thick, the abdomen swelled, there is plenty of fat and but weak muscles. such children are indolent, at times peevish and indifferent, they do not sleep quietly, have no appetite or may be voracious and suffer from derangements of digestion. an examination of all organs indicates no change. the children are easily afflicted with eruptions of the skin, with inflammation of the eyes and ears, and catarrh of the mucous membranes, which are characterized by great obstinacy. the derangements in nutrition here described are caused by the lymphatic glands though a swelling of the same can not be found. in the case of _erethistic_ scrofula the children are found to be of slight and lean structure, with fine hair and long eyelashes; they are active, easily excited, gifted and extremely sensitive to physical pain. the face is pale and becomes easily flushed by physical or emotional excitements. they are easily subject to palpitation and short breath; and are attacked by high fevers from the slightest reason. the lymphatic glands, especially the deepseated ones, are as a rule more or less swelled. in most cases, however, the characteristics of these two forms are blended. the phenomena of scrofula are manifold and extend over the entire body. the _skin_ is frequently the seat of scrofulous affections. these are particularly found on the head and face and are characterized by great obstinacy and tendency to return. most frequently herpes appear, the parts especially affected are the scalp, face, auricular passages, eyelids and the nose with its surrounding parts. pustules are sometimes developed under the skin and may appear in great numbers. these pustules may either break through the skin or shrink into a caseous mass. of all _mucous membranes_ that of the _nose_ becomes most frequently diseased; in a great number of cases this happens in the form of a chronic catarrh; the mucous membrane of the nose is reddened and swollen and a profuse, thick, purulent, ichorous and easily drying fluid is secreted. often the external parts of the nose are swollen as a result of the catarrh and the nostrils are stopped up with thick yellowish-green rinds. inflammation of the skin is caused by the flowing out of the purulent and ichorous liquid secreted. in many other cases the disease appears in the form of scrofulous ulcers on the mucous membranes of the nose; in such cases it is found that the nose is stopped up with numerous yellowish brown crusts; after removing the same the mucous membrane appears swollen and moderately reddened, on several places ulcers, the size of lentils, are found which are covered with a yellowish gray coating. at the slightest touch bleeding of the nose is caused; often also the external parts are reddened and swollen. in such cases erysipelas frequently developes, starting from the nose and spreading over the whole face. frequently a repetition of erysipelas occurs. the scrofulous catarrh just described is generally of a very protracted nature and is marked by many relapses. sometimes the fluid secretion of the nose is of very bad odor. the mucous membrane of the _throat_ becomes diseased at the same time as that of the nose. the same is found to be moderately reddened and swollen; the lymphatic glands especially those on the posterior wall of the throat are increased to swellings the size as large as peas. the _tonsils_ also become inflamed frequently and become enlarged through the repeated rather chronic inflammation. _inflammations of the ear_ are a common occurrence with scrofula. these originate most frequently by means of the eustachian tube, which connects the ear with the back part of the mouth as a result of the catarrh of the nose and throat. in a majority of cases the inflammations of the ears lead to perforation of the tympanum and may even result in fatal cerebral meningitis. the _eye_ is as frequently affected by scrofula. swelling of the lids and inflammation of the glands are the lighter forms. pustules on the connective tissue of the eye and on the cornea, accompanied by photophobia, cramp in the lids and flowing of tears are those severe forms that are so frequently observed in scrofula, and that often leave opaque and incurable spots on the cornea of the eye. swelling of the _glands_ has at all times been a characteristic phenomenon of scrofula. a swelling is merely the result of diseases of the mucous membrane of the throat or nose, of herpes of the scalp or face, of inflammations of the ears, eyes, periosteum, bones, etc. in the beginning the swelling of the glands is painless and results in flat swellings of about the size of filberts, which may be moved back and forth; such glandular swellings may exist for years, without showing the slightest alterations. with renewed attacks they enlarge and may become of considerable size. at times single glands become inflamed, hurt when pressed and develop abscesses which perforate the skin after it has become inflamed and reddened. these abscesses may heal within a few days. in the majority of cases, however, they remain for a longer period, months and even years and result in the well-known tumid, hard and immovable scars. inflammation of the periosteum and of the bones is one of the instances of scrofula. most frequently _spina ventosa_ is found; the same consists of a gradual, painless swelling of the diseased bones, most frequently on the fingers and toes, so that they become bottle-shaped. the skin covering these swellings is pale and tense. the swelling may gradually disappear or begin to suppurate. besides this hipand knee-joint inflammation are observed, also inflammations of the ankle, elbow-joint, spine, etc.; especially in the case of diseased bones it is extremely difficult to fix a dividing line between scrofula and tuberculosis. the frequence of anaemia with scrofula is only a _result_ of the disease and not a symptom. as a result of scrofula nutrition and assimilation become impaired, mostly in the cases of extreme suppuration. scrofula is a chronic disease. in many cases it is completely cured, the lighter cases after several months and the more malignant after several years. extreme scrofula may often remain until puberty and may be completely healed. _fatal_ results are due to scrofulously diseased bones, joints or glands, and it can not be denied that a large number of children succumb in this manner. fatal results may also be due to additional diseases, such as pneumonia, pleurisy, intestinal catarrh, etc. it has been frequently observed that _tuberculosis_ succeeds scrofula. it is a well-known fact that scrofula furnishes the largest contingent for tuberculosis. as a precautionary measure against scrofula a careful regulation of the diet is recommended. during the first nine months of life children should be fed with human milk exclusively if possible. if scrofula is hereditary in a family, or if the mother exhibits symptoms of the disease, she should not be allowed to nurse the child but a strong and healthy nurse should be engaged. recourse to artificial nourishment must only then be taken, when nursing the child is absolutely impossible. for this purpose exceptionally pure cow's-milk ought to be selected. all substitutes, that appear under various names, such as infant's food, condensed milk, etc., contribute much toward the development of scrofula. children 1-2 years of age are to be fed with milk, meat and eggs. only strong children, that show no sign of scrofula may be fed once or twice a day with small quantities of rice, tapioca, sago, green vegetables, pulse, etc., beside the food above mentioned. to prevent scrofula it is essential not to give the food of adults to children during the first years of life; avoid exclusively solid food and prepare the same in a pappy form as much as possible. of course a proper regulation of meal-time and a careful avoidance of overfeeding is by all means to be observed. it is of no less importance for a successful treatment of scrofula to provide surroundings of as favorable conditions as possible. first of all _pure air_ containing plenty of _oxygen_. therefore the _sea-coast_ is recommended as a proper place for scrofulous children. the children ought to stay there until the signs of scrofula have disappeared and the entire nutrition has been improved. the results obtained in the sanitary stations (vacation colonies) along the sea-shore for scrofulous children have received much favorable comment. _mountain air_ has a similarly favorable effect especially when _salt water baths_ are used at the same time; even the plain, pure _country air_ proves beneficial to scrofulous children. _very dry_ locations and dwellings ought to be selected. the children should remain _out of doors_ as much as possible. of great importance for scrofulous children, furthermore, is a suitable course in _gymnastics and rubbing-down with cold water_. to begin with the water may be 72° but should gradually be reduced to the natural temperature of well water. just how far koch's new method will take the place of former remedies used for scrofula can not be told at present as experiments in this direction are wanting. nevertheless it will be possible to prevent the dangerous transition of scrofula into tuberculosis and thus save the lives of a great many persons. anyone who has informed himself through the foregoing as to the great number of diseases and forms of disease that are directly or indirectly connected with tuberculosis, will now be able to estimate the farreaching import of koch's discovery. it will now be clear to him that pulmonary consumption constitutes only a part, although a great part of tuberculosis and that there are a great many diseases besides that can now be surely cured, it is hoped, with the aid of koch's method. but this much should be remembered by everyone that this remedy also acts best and surest during the _beginning_ of a disease. we hope that no one will allow valuable time to slip unimproved; it may easily happen that it is too late for successful treatment. everyone will be able to recognize the symptoms of diseases, which koch has taught to cure, from the foregoing complete description, and it is better to apply the remedy once too often than miss the proper time for application. koch's first communications relating to the subject have just been published and will be given unabridged in the following pages. as these communications are written for physicians we will add such explanatory notes as are deemed essential for general intelligence. [illustration: dr. koch in his laboratory] the first communication _relating to a method to cure_ tuberculosis, by prof. r. koch, berlin. in a lecture, delivered by me several months ago, at the international medical congress, i referred to a remedy, which makes animal subjects impervious to the inoculation of tubercle-bacilli, and in the case of diseased animals, checks the progress of the tuberculous disease. in the meantime experiments have been made with human subjects, about which i will report in the following. originally i intended to complete my investigations and especially gain sufficient experience concerning the practical application of the remedy and its production on a larger scale before i published anything concerning it. in spite of all precautions too much has already been published about it, and that distorted and exaggerated, so that i was obliged, in a way, to prevent false conceptions, to give even now a synopsis of the method as far as it has progressed at the time being. under present circumstances it must necessarily be short and leave unanswered many important questions. the experiments have been, and are still being made under my direction by dr. a. libbertz and stabsarzt dr. e. pfuhl. the necessary subjects and material have been provided by prof. brieger from his polyclinic, dr. w. levy in his private surgical clinic, geheimrath fraentzel and oberstabsarzt r. koehler in the charite-hospital, and geheimrath herr v. bergmann in the surgical university clinic. to all these gentlemen and their assistants i here tender my heartfelt thanks for their untiring interest which they manifested for this subject and also for the disinterested help and aid which they have offered at all times and without which it would have been impossible for me to make such progress in a few months in this difficult and responsible investigation. as my work is far from being completed, i can not as yet make any statements relating to the origin and preparation of this remedy and reserve these for some future time.[1] the curative is composed of a clear brown fluid, which in itself is not perishable, even without special precautionary measures. for use this fluid must be more or less diluted and these dilutions are perishable when made with distilled water; bacterian vegetation soon develops in them and they become turbid and are no longer fit for use. to prevent this the dilutions must be sterilized through heat and be kept under cotton batting or be prepared with a 5 per cent. phenol solution which is much simpler. through repeated heating as also through the mixture with the phenol the efficiency of the diluted solution appears to be curtailed after a time and for that reason i have always used solutions as fresh as possible. the remedy does not act through the stomach; to effect a reliable action it must be applied subcutaneously. for our experiments we have exclusively used a syringe decided upon by myself for bacteriological purposes, which is supplied with a small india-rubber ball and which has no stamp. such a syringe can be easily kept positively aseptic by rinsing with absolutely pure alcohol and on this we base the fact that not a single abscess has sprung from over a thousand injections. after trying various parts of the body as places for application we selected the skin of the back between the shoulderblades and in the lumbar region, because at these places the injection was almost painless and caused the least and in most cases no local reaction. even at the beginning of our experiments we found that in one particularly important point the human subject was affected by the curative in a way decidedly differing from that of the animal subject generally used, the guinea pig. therefore another confirmation of the rule for experimentors upon which hardly enough stress can be laid, not to rely upon a like effect upon the human being from the experiments on the animal without further confirmatory inquiry. man proved himself much more sensitive to the effects of the remedy than the guinea pig. up to two cubic centimeters and even more of the undiluted fluid could be injected under the skin of a healthy guinea pig without causing any particularly disparaging effect. in the case of a fullgrown man on the other hand, 25 ccm. are sufficient to produce intense results. in proportion to weight of body therefore 1/1500 of the amount which has no noticeable effect on the guinea pig has a decidedly strong effect on the man. from an injection that i have made on my upper arm i have experienced the symptoms which arise in man after an injection of 25 ccm., in short they were the following: three or four hours after the injection a raking pain in the joints, languor, inclination to cough, oppressed breathing, which rapidly increased; in the fifth hour i experienced intense chills which lasted nearly an hour, at the same time nausea, vomiting, increase of the temperature of the body to 39.6° c. after about 12 hours all these affectations ceased. the temperature sank and reached the normal height the next day. heaviness of the limbs and languor lasted for a few more days, and for the same length of time the place of injection remained red and painful. the lower limit of effect of the curative for a healthy man is about .01 ccm. (= 1 cubic centimeter diluted with a 100 parts) as numerous trials have shown. the majority reacted on this dose with only light pain in the joints and passing languor. with a few a slight rise in temperature set in, to 38° c. or a trifle higher. although there is a marked difference as regards the dose of the curative (according to relative weight of body) between the animal subject and man, an evident resemblance is shown in several other qualities. the most important of these qualities is _the specific action of this remedy on tuberculous processes of whatever kind they may be_. i will not relate the effects on the animal subject in this connection, as it would lead too far, but will at once turn to the peculiar effects on tuberculous human beings. as we have seen, a healthy man reacts but little or not at all on .01 ccm. the same is true of diseased persons, provided they are not tuberculous. but the relations are entirely different with those afflicted with tuberculosis; a marked general and also a local reaction resulted from an injection of the same dose of the remedy (.01 ccm.)[2]. the general reaction consists of an attack of fever, which, beginning mostly with chills, raises the temperature to over 39°, often up to 40° and even 41°. other noticeable symptoms are pains in the joints, a tendency to cough, great languor, and often nausea and vomiting. several times we observed a faint icteric coloring and in some cases the appearance on neck and breast of an exanthema resembling measles. as a rule the attack begins 4-5 hours after the injection and lasts 12-15 hours. in exceptional cases it may begin much later, but then it is not nearly so intense. the patients experience remarkably little weakness from the attack and feel relatively well as soon as it is over, generally better than they did before it came on. the local reaction can best be observed on those patients whose tuberculose affection is plainly visible, for instance those afflicted with lupus. in them changes take place that prove the specific antitubercular action of the remedy in a most surprising way. the diseased portions of the skin in the face, etc. begin to swell and turn red even before the attack of chills set in, although the injection is made under the skin of the back, a point decidedly remote from the affected parts. the swelling and reddening increases during the fever and can attain a very marked degree so that the lupus-tissue turns reddish brown and necrotic. in the case of more sharply defined lupus centres the more swollen and dark red parts were edged by a white seam nearly a centimeter wide and this again was surrounded by a wide bright red border. the swelling of the diseased parts gradually decreases after the cession of fever and may have entirely disappeared after 2 or 3 days. a serum exudes from these lupus-centres and, drying, forms a crust on them which changes into scabs that fall off in 2-3 weeks and sometimes leave a smooth red scar after a single injection. generally several injections are necessary to effect a complete removal of the lupose tissue, but of this i will speak further on. it is very important to note that the changes during this process are exclusively limited to the portions of the skin affected by lupus; even the faintest and smallest bits of diseased tissue go through the entire process and become visible on account of their swelling and reddening, while the actual scab-tissue in which the various stages of lupus have been completed remains unchanged. the observation of the treatment of lupus with the remedy is so instructive and must be so convincing as regards the specific nature of the remedy that every one wishing to occupy himself with the study of this remedy should if possible make his first experiments with lupus. less marked, but still apparent to the eye and touch are the local reactions in tuberculosis of the lymphatic glands, of the bones and joints, etc., in which case swelling and increased painfulness, and in the more superficial parts also a reddening can be observed. the reaction in the inner organs, especially the lungs is removed from our observation unless we consider the increased coughing and expectoration of the patients after the first injection a local reaction. at the same time we must assume that these parts undergo changes directly observed in the case of lupus. the different forms of reaction described have appeared without exception in previous trials on the dose of .01 ccm. when any form of tuberculosis prevailed in the system, and therefore i trust that i am justified in assuming, that in the future this remedy will constitute an indispensible diagnostic auxiliary. we will be enabled to diagnose in doubtful cases of phthisis even then, when it is impossible to obtain reliable information concerning the nature of the ailment, by the presence of bacilli or elastic fibres in the sputum or by a physical examination. glandular affectations, hidden tuberculosis of the bones, doubtful tuberculosis of the skin and the like will easily and reliably prove to be such. in case of apparently completed processes of tuberculosis of the lungs or joints it will be possible to show whether the process of the disease is in reality a complete one or establish the existence of centres from which later on the disease may spread like a fire from a live coal in the ashes. but much more important are the specific qualities of the remedy than the aids it offers for the diagnosis. while describing the changes, that are caused by hypodermic injections of the remedy, on the parts of the skin affected by lupus, attention was called to the fact that the lupose tissue does not return to its original condition after the swelling and reddening have ceased, but is more or less destroyed and disappears. on some places, as observation teaches, the process is such, that after a single injection the diseased tissues undergo mortification and are cast off as dead matter later on. on other places it seems that a diminution or rather a kind of melting of the tissue is caused, and to effect a complete disappearance a repeated application of the remedy is necessary. as the required histological investigation is wanting, it is impossible at the present time to state with certainty how this result is brought about. only this much is known that it is not a destruction of the tubercle bacilli, but that only the tissue containing the tubercular bacilli is affected by the application of the remedy. in this, as the visible swelling and reddening show, greater circulatory derangements are caused and with these vital changes in the _assimilation_ which result in a more or less rapid and thorough mortification of the tissue according to the manner in which the remedy is allowed to act. to make a short repetition, the remedy therefore does not destroy the tubercle bacilli, but the tuberculous tissue; on dead tissue, for instance, gangrenous cheesy matter, necrotic bones, etc., it does not act; nor on tissue that has undergone mortification through the action of the remedy itself. living bacilli can still linger in such dead masses of tissue, which are either cast out with the necrotic tissue, or may possibly migrate under special conditions into the adjoining living tissue. this quality of the remedy must be particularly observed, if its full specific action is to be obtained. therefore we must first cause the mortification of the tuberculous tissue, and then effect its removal as soon as possible, for instance, by means of a surgical operation; but where this is impossible and the excretion by the organisms themselves is necessarily slow, we must attempt by continued application of the remedy to protect the endangered living tissue from the immigration of the parasites. as the remedy acts only on living tissue and causes mortification of tuberculous tissue, we can readily explain another exceedingly peculiar property of the remedy, namely, that it can be given in rapidly increased doses. this may apparently be explained as being based on inurement. but noting that in about three weeks the dose may be increased to 500 times the strength of the first one, it is unquestionably something more than habit, as we know of nothing analogous confirming such a rapid and farreaching adaptation to any powerful drug. this fact can rather be explained thus: in the beginning there is an abundance of living tuberculous tissue and only a minute quantity of the effective substance is sufficient to cause a strong reaction; through each injection a certain quantity of this responsive tissue disappears, and then relatively larger doses are required to cause the same degree of reaction as before. aside from this adaptation may assert itself within certain limits. as soon as the patient is treated with such increased doses, and that he reacts no more than one not afflicted with tuberculosis, we may assume that all the reactive tuberculous tissue is dead. it is then only necessary to continue the treatment at intervals and with gradually increased doses as long as any bacilli remain in the system, to protect the patient from a new infection. it remains to be learnt in the future whether this conception and the deductions based thereon are correct. for the present i have directed the manner of application of the remedy on this basis, which in our experiments resulted as follows: to begin again with the simplest case, namely lupus, we injected the full dose of .01 ccm. in nearly all such patients to begin with, and allowed the reaction to take its full course, after 1-2 weeks we again injected .01 ccm. and so forth until the reaction became less and less and finally ceased. in the case of two patients with facial lupus three respectively four injections in this manner resulted in a clean, smooth scar in place of the affected parts; the remaining patients of this kind have also improved in a measure proportioned to the time of treatment. all the patients have suffered from their afflictions for years and have been treated by various methods without success. tuberculosis of the glands, bones and joints has been treated in a very similar manner, as in these cases larger doses were applied at longer intervals. the result was the same as with lupus, a rapid cure in the lighter and milder cases and a slowly progressing improvement in the severer ones. with the majority of our patients, those suffering from pulmonary consumption, the conditions are somewhat different, patients with decided pulmonary tuberculosis are very much more responsive to this remedy, than those afflicted with surgical tubercles. we were forced to reduce the quantity of the first dose of .01 ccm. as prepared for the phthisicist, and we found that as a rule he reacted strongly on a dose of .002 and even .001 ccm., but that the quantity could be rapidly increased from this low initial dose to that which could be easily tolerated by the other patients. we generally proceeded in such a manner that the patient at first received an injection of .001 ccm. and if a rise in the temperature set in this dose was repeated once daily until the reaction ceased. only then the dose was increased to .002 ccm. and applied till the reactions failed to appear. and so forth, always increasing the dose only .001 or at the most .002 up to .01 ccm. and higher. this mild procedure seemed to me imperative, especially with such patient as were in a weak and feeble condition. proceeding in the manner just described we can easily attain the application of very light doses with but slight attacks of fever and hardly perceptible to the patient. some of the stronger consumptives were treated with larger doses from the beginning, partly with a forced increase in the dosing when it seemed as though the favorable result was obtained in a correspondingly shorter time. the action of the remedy on the phthisicist generally seemed to be such that cough and expectoration increased somewhat after the first injection, then gradually diminished and in favorable cases disappeared entirely; the sputum lost its purulent nature and became slimy. the number of bacilli as a rule did not decrease until the sputum had attained a phlegmy appearance (only such patients were selected for these experiments in whose expectorations bacilli were contained). they entirely disappeared temporarily, but were again met with from time to time until the expectoration had completely stopped. at the same time the night-sweats left off, and the patients improved in appearance and gained in weight. all patients treated in the first stages of phthisis were freed from all symptoms of disease in the course of 4-6 weeks so that they could be considered as cured. even patients with cavities not too large were considerably improved and nearly healed. but in the case of such consumptives, whose lungs contained many and large cavities no objective improvement could be marked, although the expectoration diminished and they appeared to feel much better. i am inclined to assume on the basis of these experiences, that the _earliest stages of phthisis can with certainty be cured by this remedy_.[3] this may also hold good in cases that are not too far advanced. in exceptional cases only will pulmonary consumptives, with large cavities, derive continued benefits through the application of the remedy, when other complications exist, for instance, the penetration of other supurative micro-organisms, irremovable pathological changes in other organs, etc. even such patients were in most cases temporarily improved. it must follow that even in them the original process of the disease, tuberculosis, is influenced in the same manner by this remedy as in other patients, but that it is impossible to remove the gangrenous masses of tissue and also the secondary supurative processes. naturally we are led to think that perhaps in some of these severe cases cures may be effected by means of a combination of this healing process together with surgical aid (after the manner of operating empyema) or some other curative means. i would not advise anyone however, to apply this remedy without discrimination in every case of tuberculosis. the simplest mode of application will certainly be required in treating the first stages of phthisis and simple surgical affections, but in all other forms of tuberculosis medical science should draw on all its resources and individualize carefully to supplement and sustain the action of the remedy. in many cases i have had the decided impression that the attendance to and nursing of the patient was of no little influence on the curative process, and therefore i would prefer the application of the remedy in suitably adapted institutions, where a close observation of the patient and the adequate attention to them is possible, to the ambulant or home treatment. no estimate can at present be made as to the extent in which a profitable combination can be made between this new method to cure and those modes of treatment that have thus far been considered beneficial, the application of mountain climate, the free air treatment, specific nourishment, etc.; but i trust, that these remedial factors will be of considerable use in conjunction with the new method in many cases, especially the severe and neglected as also in the convalescent stages.[4] the nucleus of this new curative method lies in the earliest possible application. the proper objects of treatment ought to be the first stages of phthisis, because here the remedy can fully develop its curative qualifications. therefore it is of vital importance, more so in the future, than it has been in the past, that practical physicians employ all possible means to diagnosticate phthisis in as early a stage as possible. until lately the finding of tubercle bacilli existing in the sputum was rather considered as an interesting incidental evidence, which, although it insured the diagnosis, was of no further benefit to the patient and therefore was only too often omitted, as i have only lately discovered in numerous cases of phthisis which had passed through the hands of several physicians without having their sputum examined once. this must be different in the future. any physician who fails to search for tubercle bacilli in the sputum, to establish phthisis in as early a stage as possible, commits gross negligence toward his patient, because his life may depend on this diagnosis and the specific treatment which has hurriedly been introduced on this basis. in doubtful cases the physician should gain certainty as to the existence or absence of tuberculosis through a trial injection. only then will the new mode of treatment truly become a panacea for suffering mankind when that period is reached, where all cases of tuberculosis are treated in as early a stage as possible, to prevent the development of neglected severer cases which have heretofore formed a continual unlimited source of new infection. in conclusion i would remark, that i have intentionally omitted all numerical statistics and descriptions of individual cases in this communication, because the physicians to whose material the patients provided for our experiments belonged, have themselves undertaken the description of their respective cases and i did not wish to anticipate them in an objective representation of their observations. footnotes: [1] physicians who wish to experiment with the remedy, can get the same of dr. a. libbertz (berlin, n. w., lueneburgerstrasse 28 ii.), who has undertaken the production of the remedy with dr. pfuhl's and my assistance. but i must state that the present stock is very limited, and that larger quantities can only be disposed of at the end of several weeks. [2] we gave children of 3-5 years of age one tenth of this dose, that is .001 and very weak children .0005 ccm. and obtained a strong though not alarming reaction. [3] this statement is necessarily confined in so far as we have no conclusive experiences, and can not have at present, that show whether the cure is a permanent one, recidivations of course are not excluded for the present. but we may assume that these will be removed as easily and quickly as the first attack. on the other hand it is possible from analogy with other infectious diseases that those who are once cured become permanently exempt. this must also be considered an open question for the present. [4] it was impossible to collect data referring to cerebral-laryngeal-and miliary-tuberculosis, as we did not have sufficient material. explanatory notes. koch states that he can not at the present make any statement about the origin and preparation of the remedy, as his labors are not yet completed. we may assume that it is very probably a substance that corresponds in a way to the lymph used for vaccination. as vaccine lymph represents variolous poison greatly reduced in strength, as the remedy for hydrophobia is composed of a substance which is weakened hydrophobic poison, so koch probably obtains his remedy for tuberculosis by artificially reducing the tuberculous poison by means of various processes. a number of years ago it has been tried with syphilis in a similar way to obtain a substance that would not only cure syphilis but would also guard against infection from it. at that time however the experiment was not successful. from several intimations i am inclined to believe that koch was successful in finding a way in which a substance may be produced for contagious diseases, a substance that cures these diseases and also protects from infection. it is not impossible, since jenner found the vaccine virus, pasteur the hydrophobic lymph and now koch the tubercle lymph. to be sure there is this difference for the present between the substances named, that the vaccine virus only protects healthy person from infection by small pox but it does not cure those sick, while the hydrophobic lymph and tubercle lymph cure the afflicted. however koch seems to believe that his tubercle lymph has a certain power of producing immunity. according to koch, his remedy, consisting of a brownish liquid, is easily perishable as soon as it is diluted with water; he recommends the preparation of the dilution of the remedy with a 5 per cent. phenol solution. phenol is equivalent to carbolic acid. the dilution of the remedy for use must be considerable, as only small quantities of the same are used. koch tells us that his remedy does not act through the stomach, that is taken in through the mouth. on one hand it may be that this is due to the extremely small quantities necessary for an effect, on the other hand and principally all the substances probably act only when they are directly applied and brought in contact with the circulation of the blood. for a long time small syringes with fine needle points were used to inject strong acting drugs under the skin. this is done in a measure to have a guarantee of a sure effect which is not had by giving through the mouth. for instance, it is known that emetics given through the mouth often remain without results; if however the emetic apomorphine is injected anywhere under the skin, vomiting surely follows within a very short time. it is well known that morphine is injected under the skin in preference to taking it through the mouth as its action as a pain killer is much prompter. koch's liquid can also be injected under the skin with the aid of a so-called pravaz syringe. koch uses a somewhat differently formed syringe. the result remains the same, no matter what kind of syringe is used. at the same time it makes but little difference, on what part of the body the injection is made, as the fluid injected under the skin is distributed at once over the entire system. koch chose the skin of the back between the shoulderblades and the loins because here the injection could be made without causing pain or inflammation. the production of the liquid must be attended with great difficulties as koch plainly remarks that his stock at present is very limited and he can only furnish larger quantities at the end of several weeks. the price of a small bottle to be 25-30 marks about 6-8 dollars. the human being is much more sensitive to koch's remedy than the guinea pig, which is commonly used for experiments of this kind. it seems that no experiments have as yet been made with other animals. koch has tried the remedy on himself and has passed through all the symptoms of a poisoning. he certainly injected into his arm a considerable quantity of the liquid; twenty-five times as much as he injected in his patients. but here also there is a difference. in sick people much smaller quantities act than in the healthy. one cubic centimeter of the liquid has hardly any effect on a healthy person, but quite a marked one on those afflicted with tuberculosis. in the case of the latter one cubic centimeter produces about the same symptoms as twenty-five times the quantity would in a healthy person. the same must also be considered as symptoms of poisoning; but they are only of short duration and are accompanied with magnificent success. of all diseases based on tuberculosis only ringworm or lupus is perceivable by the eye, as it is a disease of the skin, all other tuberculous diseases take their course in the internal parts of the body, and therefore are not perceptible to the eye. the symptoms that follow an injection of koch's liquid can be best observed in the case of lupus. koch therefore selected for his first illustration patients afflicted with lupus that is ringworm. even a few hours after the injection the first perceptible changes begin to show in the diseased parts. these begin to swell and redden; in other words an inflammation is caused, through which the diseased tissue is obviously brought to mortification. soon the inflammation stops. the gangrenous tissue changes into crusts or scabs which drop off in a short time and the patient is cured of his ringworm. koch places particular importance on the fact that the inflammation is restricted to the diseased parts only, and that it does not attack sound and healthy parts. even the smallest otherwise invisible knots are made perceptible through the inflammation. we have similar illustrations for this specific action of koch's remedy for lupus (ringworm). so for instance a syphilitic ulcer on the thigh may be cured in a few days with iodide of potassium. in a similar manner a morbidly enlarged spleen may be reduced to the normal size by taking quinine. the observation is very interesting indeed, as it may be shown whether a person is tuberculous in any organ or not by the injection of .01 ccm. in case he is tuberculous the poisoning symptoms appear in a marked degree; if he is not, hardly any effect is noticeable. although we have had excellent methods for a long time to detect pulmonary consumption, although koch added the discovery of the tubercle bacilli, it occasionally happens that the disease can not be recognized in its beginning stages, because its progress is too slight. now the reaction following an injection is to be the deciding medium. also with other tuberculous affections physicians will welcome this diagnostic auxiliary, for in the beginning of the same it often happens that no certain diagnosis could be made and valuable time was lost. we must call particular attention to the further statements of koch, that through his remedy the tubercle bacilli are _not_ killed. with this it is admitted that the remedy will not be able to effect cures, without any more ado, yes, even the tubercle bacilli may continue to infect parts of the body even in spite of the action of the remedy. therefore the application of koch's remedy only, is not sufficient to effect a cure. provision must be made to remove the gangrenous tissue from the body as rapidly as possible, because it contains the still living tubercle bacilli. as a rule surgical aid is necessary to remove the mortified tissue. where this is impossible koch advises the continued application of the remedy to protect the endangered living tissue from the re-immigration of the tubercle bacilli. koch thereby believes that he can protect the tissue, perhaps in the manner as vaccination protects from small pox. the rapid increase in the quantity of the remedy applied in the course of time is something that has no parallel. koch gives an explanation, but leaves it to the future to be confirmed. we have no previous instance in case that his explanation should prove correct. reasoning from analogous application of our remedy, we are led to assume that _smaller_ quantities of the substance would suffice to cause mortification of the remaining tuberculous tissue. koch on the other hand uses larger and larger doses to reach a result. he admits inurement to the remedy within certain limits only. koch has made a difference between pulmonary consumptives and those suffering from tuberculosis of the bones and joints, etc. he was able to inject larger quantities in the latter than the former, for the quantity injected in the case of pulmonary consumptives was .001 ccm.; in other tuberculous cases .01 ccm. koch selected pulmonary consumptives for his experiments, whose sputum contained tubercle bacilli, so as to make no error in the diagnosis, and to ascertain by killing the bacilli contained in the sputum, whether the diseased tend toward restoration. as the remedy does not kill the bacilli, so a diminution of the bacilli can only be obtained in that manner, that the tissue of the lungs undergoes certain changes, which cause its properties to be such, that the bacilli are no longer able to exist or propagate in them. then a so-called immunity results which we know of in other similar diseases. we know that anyone who has had the measles or scarlet fever rarely is again attacked by the same, as a rule he is permanently proof against them. in the same way as vaccination protects from small pox, an injection of koch's remedy acts against pulmonary consumption. koch makes a cautious statement: "on the other hand it is possible, from analogy with other infectious diseases that those who are once cured become permanently exempt." koch reaches this result, that beginning phthisis can with certainty be cured with his remedy. on the other hand, advanced consumptives, in whose lungs large cavities already exist, may possibly be improved but can not be cured. however he provokes the idea, that perhaps his method of treatment together with a surgical operation, that removes all gangrenous matter from the lungs, may yet have beneficial results in the end. the idea is not entirely new to treat lung diseases with the aid of surgery; unfortunately the operations have heretofore been thought too risky. perhaps we will now have a new branch in operative technic, surgery of the lungs. koch advises to conduct this lung surgery after the manner of operating empyema. this is an operation performed in the case of suppurative pleurisy to remove the pus from the pleural cavity. this operation has been successfully carried out for a long time. koch makes it of especial importance, that while treating consumption with the new remedy, the general attendance and nursing is not to be neglected. koch also calls attention to what has been said before, that the general hygienic factors, good hospital treatment, mountain climate, etc., will never be dispensed with, on the contrary will be indispensible to the furtherance of cure. in conclusion koch again remarks that brilliant results are only promised in the early stages of pulmonary consumption (phthisis). physician and patient must move all levers as to the existence or non-existence of tuberculous diseases. then those daily pictures of extreme wretchedness from consumption will be a thing of the past. then the danger of contagion will be lessened resulting from the decrease of the number of tuberculous persons and of the tubercle-bacilli, and perhaps it will soon be possible to name the day on which with the last tubercle-bacillus the ravaging pest, tuberculosis, will be extirpated. +-------------------------------------------------------------+ | transcriber's note: | | | | inconsistent use of develops/developes, and centres/centers | | has been retained as in the original. | +-------------------------------------------------------------+ * * * * * transcriber's note: the original publication has been replicated faithfully except as shown in the transcriber's amendments at the end of the text. words in italics are indicated like _this_. obscured letters in the original publication are indicated with {?}. text emphasized with bold characters or other treatment is shown like =this=. footnotes are located near the end of the text. * * * * * dispensary department bulletin no. 1 nurses' papers on tuberculosis published by the city of chicago municipal tuberculosis sanitarium september 1914 city of chicago municipal tuberculosis sanitarium staff of nurses --of the- dispensary department rosalind mackay, r. n., superintendent of nurses anna g. barrett barbara h. bartlett olive e. beason ella m. bland kathryn m. canfield mabel f. cleveland elrene m. coombs margaret m. coughlin stella w. couldrey emma w. crawford fannie j. davenport roxie a. dentz c. ethel dickinson anna m. drake mary e. egbert maude f. ess{?} sara d. faroll mary fraser augusta a. gough frances m. heinrich laura k. hill isabella j. jensen emma e. jones letta d. jones jeanette kipp elsa lund mary macconachie josephine v. mark isabel c. mckay anna v. mcvady annie morrison katherine m. patterson laura a. redmond grace m. saville beryl scott florence t. singleton mabelle smith florence a. spencer harriett stahley genevieve e. stratton annabel b. stubbs alice j. tapping olive tucker elizabeth m. watts mary c. wright mary c. young karla stribrna, interpreter. board of directors theodore b. sachs, m. d., president george b. young, m. d., secretary w. a. wieboldt. general office 105 west monroe street frank e. wing, executive officer. [illustration: field nurses, dispensary department chicago municipal tuberculosis sanitarium] dispensary department bulletin no. 1 nurses' papers on tuberculosis read before the nurses' study circle of the dispensary department chicago municipal tuberculosis sanitarium published by the city of chicago municipal tuberculosis sanitarium 105 west monroe street september 1914 contents page introduction--nurses' tuberculosis study circle 5 historical notes on tuberculosis 7 rosalind mackay, r. n. visiting tuberculosis nursing in various cities of the united states 11 anna m. drake, r. n. provisions for outdoor sleeping 30 may macconachie, r. n. some points in the nursing care of the advanced consumptive 37 elsa lund, r. n. open air schools in this country and abroad 44 frances m. heinrich, r. n. notes on tuberculin for nurses 56 nurses' tuberculosis study circle it is well known that the gathering of facts and study of literature essential to the preparation of a paper on a certain subject is a very productive method of acquiring information. if the paper is to be presented to your own group of co-workers, and the subject covered by it represents an important phase of their work, or an analysis of some of its underlying principles, then there is a further incentive to do your best, as well as an opportunity for a general discussion which acts as a sieve for the elimination of false ideas and gradual formulation of true conceptions. lectures on various phases of the work being done by a particular group of people are very important. papers by the workers themselves are, however, greatest incentives to study and self-advancement. with this view in mind, i suggested the organization of a tuberculosis study circle by the dispensary nurses of the municipal tuberculosis sanitarium. the nurses chosen to present papers on particular phases of tuberculosis are given access to the library of the general office of the sanitarium; they are also given the assistance of the general office in procuring all the necessary information through correspondence with various organizations and institutions in chicago and other cities. as the program stands at present, the nurses' study circle meets twice a month. at one of these meetings a lecture on some important phase of tuberculosis is given by an outside speaker, and at the next meeting a paper is read by one of the nurses. at all of these meetings the presentation of the subject is followed by general discussion. the program since january, 1914, was as follows: january 9th, 1914--"historical notes on tuberculosis," by miss rosalind mackay, head nurse, stock yards dispensary of the municipal tuberculosis sanitarium. january 23rd, 1914--"channels of infection and the pathology of tuberculosis," by professor ludwig hektoen of the university of chicago. february 13th, 1914--"visiting tuberculosis nursing in various cities of the united states," by miss anna m. drake, head nurse, policlinic dispensary of the municipal tuberculosis sanitarium. march 13th, 1914--"provisions for outdoor sleeping," by miss may macconachie, head nurse, st. elizabeth dispensary of the municipal tuberculosis sanitarium. march 27th, 1914--"what should constitute a sufficient and well balanced diet for tuberculous people," by mrs. alice p. norton, dietitian of cook county institutions. april 10th, 1914--"some points in the nursing care of the advanced consumptive," by miss elsa lund, head nurse of the iroquois memorial dispensary of the municipal tuberculosis sanitarium. may 15th, 1914--"open air schools in this country and abroad," by miss frances m. heinrich, head nurse of the post-graduate dispensary of the municipal tuberculosis sanitarium. may 29th, 1914--"efficient disinfection of premises after tuberculosis," by professor p. g. heinemann, department of bacteriology, university of chicago. the organization of the tuberculosis study circle among the nurses of the dispensary department of the municipal tuberculosis sanitarium, calling forth the best efforts of the nurses in getting information on various phases of tuberculosis for presentation to their co-workers in an interesting manner has, no doubt, stimulated the progress of our entire nursing force. the first five papers presented by the nurses are given in this series. the pamphlet is published with the idea of attracting the attention of other organizations to this method of stimulating more intensive study among their nurses. =theodore b. sachs, m. d., president= chicago municipal tuberculosis sanitarium. historical notes on tuberculosis by rosalind mackay, r. n. head nurse, stock yards dispensary of the chicago municipal tuberculosis sanitarium. so far as our information goes, pulmonary tuberculosis has always existed. it is, as professor hirsch remarks, "a disease of all times, all countries, and all races. no climate, no latitude, no occupation, forms a safeguard against the onset of tuberculosis, however such conditions may mitigate its ravages or retard its progress. consumption dogs the steps of man wherever he may be found, and claims its victims among every age, class and race." hippocrates, the most celebrated physician of antiquity (460-377 b. c.), and the true father of scientific medicine, gives a description of pulmonary tuberculosis, ascribing it to a suppuration of the lungs, which may arise in various ways, and declares it a disease most difficult to treat, proving fatal to the greatest number. isocrates, also a greek physician and contemporary of hippocrates, was the first to write of tuberculosis as a disease transmissible through contagion. aretaeus cappadox (50 a. d.) describes tuberculosis as a special pathological process. his clinical picture is considered one of the best in literature. galen (131-201 a. d.) did not get much beyond hippocrates in the study of tuberculosis, but was very specific in his recommendation of a milk diet and dry climate. he held it dangerous to pass an entire day in the company of a tuberculous patient. during the next fifteen centuries, a period known as the dark ages and characterized by most intense intellectual stagnation, little was added to the knowledge of pulmonary tuberculosis. in the seventeenth century franciscus sylvius brought out the relationship between phthisis and nodules in the lymphatic glands. this was the first step toward accurate knowledge of the pathology of tuberculosis. richard morton, an english physician, wrote, in 1689, of the wide prevalence of pulmonary tuberculosis, and recognized the two types of fever: the acute inflammatory at the beginning, and the hectic at the end. he also recognized the contagious nature of the disease and recommended fresh air treatment. he believed the disease curable in the early stages, but warned us of its liability to recur. morton taught that the tubercle was the pathological evidence of the disease. in 1690, leeuwenhoek, a dutch lens maker, started the making of short range glasses which resulted later in the modern microscope, making possible the establishment of the germ theory of disease, including the establishment of that theory for tuberculosis. starck, whose observations and writings were published in 1785 (fifteen years after his death), gave a more accurate description of tubercles than had ever been given before, and showed how cavities were formed from them. leopold auenbrugger introduced into medicine the method of recognizing diseases of the chest by percussion, tapping directly upon the chest with the tips of his fingers. the results of his investigations were published in a pamphlet in 1761. this new practice was ignored at first, but after the work of auenbrugger was translated he attained a european reputation and a revolution in the knowledge of diseases of the chest followed. boyle recognized in miliary tubercle, as it was afterwards called by him, the anatomical basis of tuberculosis as a general disease, and, in 1810, published the results of one of the most complete researches in pathology. he described the stages in the development of the disease, using miliary tubercle as its starting point. he opposed the theory that inflammation caused tuberculosis and declared hemorrhage a result and not a cause of consumption. laennec discovered one of the most important, perhaps, of all methods of medical diagnosis--that of auscultation. by means of the stethoscope, which he invented in 1819, he recognized the physical signs and made the first careful study of the healing of tuberculosis; he gave also one of the best accounts of the sputum of the consumptive. he believed that every manifestation of the disease in man or animals was due to one and the same cause. up to this time the views which were held concerning the infectious nature of tuberculosis were not based upon direct experiment, but in 1843 klenke produced artificial tuberculosis by inoculation. he injected tuberculous matter into the jugular vein of a rabbit, and six months later found tuberculosis of the liver and lungs. he did not continue, however, his researches; so they were soon forgotten. to villemin, a french physician, belongs the immortal fame of being the first to show the essential distinction in tuberculosis between the virus causing the disease and the lesion produced by it. by inoculating animals, he demonstrated that tuberculosis is a specific disease caused by a specific agent. his paper presented in 1865 before the academy of medicine in france contained a detailed account of his experimental investigations. this was a most remarkable contribution to scientific medicine. it remained for robert koch in 1882, after years of painstaking investigation, to announce to the world the discovery of a definite bacillus as the causative agent in all forms of tuberculous lesions. koch isolated, cultivated outside the body, described and differentiated the infective organism of tuberculosis and proved that it could continue to produce the same lesions indefinitely. he showed the presence of the bacilli in all known tuberculous lesions and in tuberculous expectoration, and demonstrated the virulence in sputum which had been dried for eight weeks. following directly upon the knowledge of the cause of tuberculosis came the recognition of its curability, and the proper means of its prevention. although good food and fresh air have always been considered of importance in the treatment of the disease, it was not until the middle of the nineteenth century that anything like systematic treatment was undertaken. dr. george bodingon of sutton coldfield, england, wrote an essay in 1840 advocating fresh air treatment. he denounced the common hospital in large towns as a most unfit place for consumptive patients, and established a home for their care, but met with so much opposition that it was soon closed. in 1856, hermann brehmer wrote a thesis on the subject which has been the foundation of our modern treatment. he opened a small sanatorium in 1864. five years later he established the sanatorium at goerbersdorf, in silesia, which eventually became the largest in the world. he advocated life in the open air, abundant dietary and constant medical supervision. he believed that the heart of the large majority of consumptives is small and undeveloped, and that this predisposes them to the disease. in accordance with this theory he put a great deal of emphasis on exercise in the treatment of his patients. he built walks of various grades on the grounds of his sanatorium and installed a system of walking exercise. patients began with the lowest grade, gradually accustoming themselves to ascend to the highest. brehmer was himself a consumptive, and was cured by the method he so firmly believed in. dr. dettweiler, who opened the second sanatorium in germany, at falkenstein, near frankfort, was also a consumptive, having developed tuberculosis during the arduous campaign in the franco-prussian war in 1871. he entered the goerbersdorf sanatorium as a patient, becoming later an assistant of brehmer. dr. dettweiler laid great emphasis upon rest in treatment. in 1888, dr. otto walther opened his famous sanatorium at nordrach in the black forest, in germany. the first sanatorium for the care of the consumptive in the united states was opened at saranac lake by dr. edward l. trudeau in 1884. he was the pioneer of the sanatorium treatment in this country, and an example of what a man, although tuberculous himself, can do for his fellow men. in 1874, a seemingly helpless invalid, he made his home in the adirondack mountains. a little more than twenty-five years ago he became the founder of a village now crowded with tuberculous patients. the saranac lake institution, which began with one small cottage, has since developed into the best known sanatorium in this country. in 1891, dr. herman biggs posted the first anti-spitting ordinance in the street railway cars of new york. dr. lawrence flick brought about the formation of the first anti-tuberculosis society in 1892, and in 1894 the city of new york adopted a law to enforce notification and registration. dr. philip of edinburgh was the first to systematically and completely organize the anti-tuberculosis campaign. in 1887 he inaugurated that new institution, the anti-tuberculosis dispensary, which has since rendered such inestimable service. the fundamental principle of the edinburgh system is that the disease should be sought out in its haunts. the first dispensary in the united states was opened in new york in 1904, modeled after the edinburgh system. about the same time came the open air schools--charlottenburg establishing one in 1904 and providence, r. i., following in 1908. the first day camp in the united states was opened in 1905 in boston. new jersey established the first preventorium for children at farmingdale in 1909. all this naturally led to better provision for advanced cases; sanatoria for hopeful cases at small cost; factory inspection; and, in some countries, industrial colonies for arrested cases. the tuberculosis patient of today presents a hopefulness previously undreamt of. the outlook is brighter with promise than ever before, and we have every reason to look forward to a steady reduction in the mortality rate from this dread disease; but the extinction of tuberculosis will be achieved only when the social and economic problems have been solved. visiting tuberculosis nursing in various cities of the united states by anna m. drake, r. n. head nurse, policlinic dispensary of the municipal tuberculosis sanitarium. baltimore in 1903, the first visiting tuberculosis nurse was assigned in baltimore to follow up patients of the johns hopkins hospital out-patient department. her duties were varied as are the duties of the present day tuberculosis nurse. she was to instruct patients in the use of sunlight and fresh air and was allowed to furnish them with special diet in the shape of milk and eggs. she investigated home conditions and helped improve sleeping quarters. she placed patients in sanatoria, or brought them back to the dispensary for treatment. she gave bedside care to advanced cases, if she could not get them into hospitals, and applied to relief organizations for help in solving the problems of the family. from time to time other nurses of the baltimore visiting nurse association were assigned to the work, other dispensaries and agencies began referring cases to be followed up, and the work grew to such proportions as to be almost unmanageable for a private organization. in 1910, the tuberculosis division of the baltimore health department was organized. it began its activities with a corps of fifteen nurses and a visiting list of 1,617 patients turned over to it by the baltimore visiting nurse association. the object of the tuberculosis division was to bring under the supervision of the health department all persons in the city suffering with pulmonary tuberculosis. ambulatory cases were to be given advice and instruction; advanced cases, bedside care, if needed, or hospital care, if available. at present, it is upon the advanced cases, as well as those who are in contact with them, that the nurses of the tuberculosis division concentrate their efforts. the staff at present consists of a superintendent and sixteen field nurses. the city is divided into sixteen districts, a nurse being assigned to each district. each nurse is responsible for the care of all cases of tuberculosis in her district. in 1912, the tuberculosis division opened two municipal tuberculosis dispensaries. these dispensaries receive patients on alternate days from 3 to 5 p. m., nurses in districts nearest the dispensaries alternating for clinic duty. other dispensaries are the phipps tuberculosis dispensary at johns hopkins' hospital, and the university of maryland hospital tuberculosis dispensary. the problems which chiefly concern the tuberculosis division in its efforts to control the spread of tuberculosis in baltimore are the failure of physicians to report cases to the department of health until the patient is in a dying condition, and the inadequate provision for hospital care of advanced cases. these conditions are particularly marked in the case of colored patients, who are found going in and out of homes, restaurants, and laundries, as cooks, waitresses and servants of various kinds, as long as they are able to drag themselves about. the nurses of the tuberculosis division are graduate nurses and are registered. they are paid $75 a month, with car fare and telephone expenses, and are allowed two weeks' vacation with pay. they are not required to take a civil service examination, but are carefully selected with a view to obtaining women of a high grade of efficiency. they wear uniforms of blue denim with simple hats and coats, but not of uniform design. each nurse wears under the lapel of her coat a badge reading "nurse--baltimore health department," which she uses on occasions. the nurses report to the superintendent each morning at 8:30 to hand in reports of the previous day's work, to stock their bags, and to receive new work for the day. at noon each nurse reports at her branch office, of which there are seven, each situated on border lines of adjoining districts. an hour is spent at the branch office for lunch and rest, for receiving telephone calls and for restocking the bags for afternoon rounds. the nurse leaves her district at four o'clock to attend to about an hour's clerical work, which is usually done at home. the average number of patients per nurse is 212, about four per cent of whom are bed cases. these bed patients are visited two or three times a week, while ambulatory cases are visited on an average of twice a month. during the year 1912 the sixteen nurses made 72,058 visits for instruction and nursing care. new york the oldest tuberculosis clinic in new york city is connected with the new york nose, throat and lung hospital; it was established in 1894. in 1895, the presbyterian hospital established a special tuberculosis clinic. in 1902, the vanderbilt clinic organized a special class for the treatment of tuberculosis. in 1903, gouverneur and bellevue hospitals and, in 1904, harlem hospital added tuberculosis clinics. these were followed during the next few years by the establishment of many others. in 1906, when the tuberculosis relief committee of the new york charity organization society began its work among the tuberculous poor of the city, it met at every turn instances of overlapping and duplication in the work done by the various clinics. this lack of co-operation, with the resulting difficulties encountered by the committee in its endeavor to efficiently administer its special tuberculosis fund, demonstrated the advisability of forming an organization having as its object the co-ordination of the work of the various tuberculosis clinics. in 1908, nine of these clinics and several allied philanthropic agencies were organized into the association of tuberculosis clinics. today there are 29 clinics, 14 philanthropic institutions and organizations, five departments of municipal and state government, six tuberculosis institutions, and numerous other institutions and organizations having special interest in tuberculosis work. of the 29 clinics, eleven are under the supervision of the department of health, three are connected with city hospitals, and the remainder are operated by private institutions. this voluntary association of private and municipal dispensaries, sharing equal responsibilities and acknowledging equal obligations, is a striking feature of tuberculosis work in new york and presents a unique example of co-operation. the task of standardizing the clinics was a difficult one. one clinic had ten rooms with every convenience. another had one room and no conveniences. some clinics made no provision for sputum beyond a cuspidor; others provided gauze or paper napkins when patients entered the room. two clinics provided no drinking water; two had a metal water cooler in the waiting room; one provided sanitary drinking cups; and another had two enamel drinking cups chained to the wall. some clinics had sanitary fountains; in others the nurse kept a glass on hand for the patients. neither was there any uniformity in matters of dress. nurses and doctors at some clinics wore ordinary street clothes. at other clinics, gowns or aprons, with or without sleeves, were worn. three clinics occupied separate buildings of their own. four clinics provided separate waiting-rooms for tuberculous patients. at one dispensary the tuberculous patients had the use of the general waiting room, there being no other clinics held at that time; other clinics made no distinction, tuberculous patients using the general waiting room in company with patients attending other clinics. after studying the conditions existing in the various clinics, it was decided that to belong to the association each clinic must subscribe to and comply with the following regulations: a. tuberculous patients must be segregated in a separate class. b. home supervision of all cases by a graduate nurse especially assigned for this purpose must be maintained. c. each dispensary must serve a certain district, and all cases living outside of this district must be transferred to the clinic serving the district within which they live. early in the history of the association objection was made to this last rule by teachers of medicine, who held that it tended to deprive them of teaching material; but they soon fell in line with the other dispensaries when they saw the advantage it afforded them of improving their methods without loss of teaching material, and the further opportunity of securing home supervision. from time to time it has been necessary for the association to adopt certain methods of procedure in the administration of the various clinics. the general policy of the association is as follows: (1) each clinic should arrange for a physician to visit and treat in their homes patients who are too ill to attend clinic, for whom hospital care cannot be provided. (2) special children's clinics should be established wherever the size of the clinic warrants it. (3) sputum of every patient should be examined once a month; patients should be re-examined once a month, and the results entered on the records. (4) the physician should use the nurse's report of home conditions as a basis for advising patients. (5) patients refusing to attend the proper dispensary shall be dismissed as delinquent and reported to the health department. (6) all supervising nurses should be affiliated with some local relief organization in order to better organize the relief work of the clinic. (7) the home of every patient should be visited at least once a month. (8) the classification of the national association for the study and prevention of tuberculosis should be followed for recording stages of disease and condition on discharge. (9) a uniform system of record keeping should be used by nurses in order to facilitate the compiling of monthly reports. (10) the staff of physicians should be sufficient to allow at least fifteen minutes for the examination of every new case, and at least six minutes for every old case. (11) there should be at least one nurse for every 100 patients on the clinic register. (12) sputum cups, or a proper substitute, should be furnished to patients to take home. (13) paper or gauze handkerchiefs should be given to each patient on entrance to the clinic. (14) no cuspidors should be used. (15) sanitary fountains or sanitary drinking cups should be provided. (16) gowns with sleeves should be worn by physicians. nurses should wear gowns with sleeves or washable uniforms while on duty in the dispensary. that the association found it necessary to make so many recommendations for the administration of the various clinics is evidence of the diverse systems, and in some instances, the entire lack of system, in vogue in some dispensaries. the salary of nurses in privately operated tuberculosis dispensaries averages about $75 per month; no standard uniform is in use. the first tuberculosis visiting nurse of the new york department of health was appointed march 1st, 1903. by january, 1910, the staff had grown to 158, the health department becoming practically responsible for the home supervision of every registered case of tuberculosis in new york not under the care of a private physician or in an institution. the organization of the work of the new health department tuberculosis nurses has been based upon the district system in force among the associated clinics. in each clinic district a staff of health department nurses is maintained, charged with the sanitary supervision of cases of pulmonary tuberculosis in that district. they visit at least once a month all "at home" cases; that is, cases not regularly attending clinics, not in an institution, or not under a private physician's care. these nurses report daily at the tuberculosis clinic, which is used as a district headquarters, and there receive assignments. one nurse is detailed as captain, or supervising nurse of the district, and acts as official intermediary between the clinic and the department of health. each morning the nurse telephones to the department of health the daily report of her staff and of the clinic, and obtains information received at the department regarding cases in the district. in case of death or removal of tuberculous patients from a home the district nurses order disinfection of the premises and bedding; they make arrangements for admission of patients to hospitals or sanatoria, investigate complaints made by citizens, see that regulations of the department of health regarding expectoration are observed, and use their authority to induce delinquent cases to resume attendance at the proper clinic. they also visit families of patients in hospitals at intervals. each nurse keeps a complete index of all cases of pulmonary tuberculosis in her district, which is at all times accessible to nurses and physicians at the clinic. in the department of health clinics, the plan is as follows: a supervising nurse who does no district work, and several field nurses, each assigned to special duties on clinic days, such as registration room, throat room, examining rooms, etc. field nurses are also responsible for the care of patients in their sub-districts, each nurse carrying an average of about 125 patients on her visiting list at one time. boston a staff of twenty-five nurses, working from the out-patient department of the boston consumptives' hospital, has the supervision of all tuberculosis cases in their homes, and the follow-up work on all discharged sanatorium and hospital cases in the city of boston. all cases of tuberculosis reported to the health department, whether under the care of a private physician or not, are visited at least once by a nurse from this staff, to see that they are carrying out a proper plan of isolation. the boston consumptives' hospital dispensary, centrally located, is open every morning and one or two evenings a week. three or four nurses are on duty in the clinic each morning, taking histories, attending nose and throat room and preparing patients for examination. at the dispensary only a medical history of new patients is taken, the social history being obtained by the nurse on her first visit to the home. pulse, temperature and weight are also taken at the dispensary, after which the patient waits his turn for examination. each new patient is given an examination in the nose and throat room; old patients also, if necessary. after examination or treatment, all patients return to the general waiting room. from here each patient is called before the chief of clinic, who notes the general progress of the patient, the results of the last examination or any remarks recorded by the physician, and the report of home conditions as reported by the nurse. the chief of clinic advises the patient in accordance with the needs indicated. he makes no examinations, but sees each patient every time he comes to the clinic and is thus able to follow very carefully the progress of each patient and to advise such changes in treatment as may seem necessary. the city is divided into twenty-two districts, each nurse being responsible for the care of all tuberculous patients in her district. the number of patients cared for by each nurse is from 100 to 180. a very small percentage of bedside care is given; far advanced patients as a rule are sent to hospitals. boston tuberculosis nurses do not wear uniforms. they are paid $900 a year, with no increase for length of service or efficiency. buffalo the purpose of the buffalo association for the relief and control of tuberculosis has been to stimulate progress in fighting tuberculosis. it very modestly shares with the city officials and with private charities the credit for the work accomplished. all it claims for itself is that it has been able, and will continue, to "point the way." how thoroughly it has succeeded in this may be seen by the progress made since 1909 when the buffalo association made its first appeal for funds. at that time buffalo had: (1) a dispensary maintained by the buffalo charity organization society. (2) the erie county hospital for advanced cases. (3) a day camp, with a capacity of thirty patients, supported by a group of women. (4) one visiting nurse supplied by the district nursing association. the present facilities are: (1) a dispensary, open every day and one evening a week, with a nose and throat clinic, and a dental clinic with a paid dentist in attendance. (2) the j. n. adam memorial hospital for early cases, capacity 125, supported by the city. (3) the municipal hospital for the care of advanced cases, supported by the city. (4) the erie county hospital, as before. (5) tuberculosis division of the department of health with two tuberculosis inspectors and six visiting tuberculosis nurses. (6) an open air camp, with a capacity of from seventy to one hundred patients, with a special department for children. patients are kept day and night. the camp has three resident trained nurses and one interne, and is visited daily by the association's paid medical director. (7) two open air schools, with another promised. (8) a city hospital commission, with a plan for the erection of a pavilion for 500 advanced cases as the first of a general hospital scheme. (9) teachers soon to be appointed for the education of tuberculous children. (10) the trades unions organized to promote the campaign among their own members in a unique organization. (11) the whole community alert to the menace of tuberculosis, willing to shoulder the community burden and to assume the community responsibility. the dispensary is now operated by the association for the relief and control of tuberculosis, and the nurses are supplied by the health department. the nursing staff consists of a supervising nurse and six field nurses, the latter receiving $720 per year. they wear no uniform. they give a limited amount of bedside care, some member of the family being taught to properly care for the patient, if he cannot be sent to a hospital. recently an additional nurse was engaged by the association to follow up cases on whom no diagnosis has been made and who have not returned to the dispensary for re-examination. since the dispensary was opened in 1909, there have been over one thousand such cases. many of these had suspicious signs when examined, but there has hitherto been no means of keeping in touch with them, as the nurses have been obliged to confine their attention to positive cases. one of the chief difficulties of the buffalo campaign, as elsewhere, has been the fact that more than half of the cases have probably already infected others. this latest movement of the association should anticipate this condition to a certain extent, and is one more means by which it is "blazing the trail" toward its goal,--"no uncared for tuberculosis in buffalo in 1915." philadelphia and pennsylvania in the general appropriations act of 1907 the legislature of pennsylvania granted to the state department of health, in addition to its regular budget, the sum of $400,000, "to establish and maintain, in such places in the state as may be deemed necessary, dispensaries for the free treatment of indigent persons affected with tuberculosis, for the study of social and occupational conditions that predispose to its development, and for continuing research experiments for the establishment of possible immunity and cure of said disease." immediately after securing the above appropriation, the state department of health began to establish dispensaries throughout the state, one or more in each county. the staff of each dispensary consists of a chief, who is also county medical inspector, and a corps of assistant physicians and visiting nurses. there is a supervising nurse with one assistant at harrisburg, who oversee and inspect the work of the staff nurses. the number of nurses in the dispensaries throughout the state varies from a nurse shared by another organization or a practical nurse giving part time, to from four to seven nurses in one dispensary. there are now more than 115 state department tuberculosis dispensaries in pennsylvania, philadelphia having three. an idea of the general plan of the work may be gained from a description given of the state department dispensary no. 21, located in philadelphia, by dr. francine: "there are at present five nurses employed at dispensary no. 21, two of whom give their whole time to following up the return cases from the state sanatoria. as soon as the case is discharged from the sanatorium, that information, with other data regarding the condition on discharge, etc., is sent to us at once. at the end of a stated period, if that case has not been returned, the nurse looks it up, and gets it to come in. the nurses make out detailed reports on all cases discharged from the sanatoria, at periods of six months, whether our own patients or not. these will be and are valuable for statistical data. practically all the data for reports as to subsequent results in cases discharged from the sanatoria, which have appeared in this country at least, have been made up from information gleaned by writing the discharged patient and having him fill out his own report. it does not tax the imagination unduly to conclude which is the more accurate, the answers to questioning by a trained worker (we have selected for this work the two nurses who have been with us longest) who in addition takes the temperature, pulse, etc., herself, and usually succeeds in getting the patient back to the dispensary for at least one re-examination; or such answers as a patient may see fit to make to a printed questionnaire. for the purpose of regular dispensary and inspection work, the dispensary limits itself to receiving patients from certain districts of the city, though as a state institution it is impossible for the dispensary to refuse any case, no matter where they live, if they insist upon treatment. usually by a little persuasion, however, we can get the patients to go to the dispensary in their district, co-operating in this way with the phipps institute of the university of pennsylvania, the gray's ferry state dispensary, the kensington tuberculosis dispensary and the frankford state dispensary. the section of the city from which we draw our cases is divided, for purposes of inspection and social service work, into three districts with a nurse assigned to each, and this gives each of our nurses, roughly speaking, about seventy-five patients per month to take care of. these patients must be visited regularly every two weeks, which gives the nurse at least one hundred and fifty visits a month to pay, not including the visits to new cases. every new case which is admitted to the dispensary must be visited within one week of the day of admission. the nurses come in from their visiting work and report daily at 12:30 o'clock, for one hour in the dispensary office, and new cases, according to the district in which they live, are assigned to the nurse having charge of that district. the advantage of having a nurse report daily to the dispensary at a time when all the doctors are there, lies in the fact that the doctor has thus the opportunity of talking over with the nurse the new cases which she is to visit and of making any suggestions which he has gleaned from the history and examination of the patient. it is thus possible for the nurses to visit the new cases in the afternoon of the same day. the advantage of this close co-operation between doctor and nurse must be at once apparent. further, each nurse is required to report to every physician one morning a month, with the histories in hand of all the patients of that particular doctor which are on her list. this is valuable, because in no other way can the doctor get so thorough an understanding of the home conditions and social problems of a given patient as by talking the situation over directly and personally with the nurse in charge." a similar plan is in operation at the other two state department clinics in philadelphia. the best known tuberculosis dispensary in philadelphia, conducted by a private organization, is the dispensary connected with the henry phipps institute. this dispensary during the eleven years of its existence has contributed greatly to the standardization of tuberculosis dispensary work, not only in philadelphia, but throughout the entire country. connected with a scientifically conducted hospital for advanced cases, with its laboratories and other improved medical facilities, the dispensary of the henry phipps institute occupies a high place among the similar institutions of this country. the nursing staff of the henry phipps dispensary consists of three visiting tuberculosis nurses, aided by two additional nurses (both colored) assigned by other organizations to work on the phipps dispensary staff, one by the whittier centre, and the other by the pennsylvania society for the prevention of tuberculosis. some of the important features of the work of this dispensary in its relation to nurses are as follows: (1) an efficient training school for tuberculosis nurses, affording the opportunity of hospital and dispensary training. (2) a course of lectures on tuberculosis given to the nursing profession at large. (3) intensive home work among tuberculous families. visiting tuberculosis work in philadelphia is also done in connection with the presbyterian hospital tuberculosis clinic, st. stevens church tuberculosis clinic, and by the visiting nurse society of philadelphia. pittsburgh the tuberculosis league hospital of pittsburgh was opened in 1907 for incipient and advanced cases, with a capacity of eighty beds. the league conducts at present a night camp, an open air school, a farm colony, a post-graduate course for nurses and tuberculosis clinics for medical students at its dispensary. there is also a post-graduate course in tuberculosis for nurses. the course requires eight months and nurses receive during that time $25 a month. only registered nurses are accepted. the training is along the following lines: nursing advanced cases in hospital, open air school work, sanatorium care of early cases, service in dental, nose and throat clinics, and in the dispensary for ambulant cases, district nursing, service in baby clinics, educational work, and laboratory work. patients discharged from the hospital, families of patients in the hospital, and cases reporting at various tuberculosis dispensaries, are given complete follow-up care by the nurses taking the course, thus giving them excellent training in public health work, especially that phase of public health nursing dealing with tuberculosis. at present there are nine nurses taking the course. the dispensary of the tuberculosis league employs six nurses. pittsburgh has also a state department of health tuberculosis clinic, with ten nurses, each caring for from 90 to 100 patients per month. these nurses give a small percentage of bedside care and are not in uniform, except when on duty in the dispensary. they are paid $70 per month. the plan of work is similar to that of the philadelphia state dispensary. the department of public health of pittsburgh employs four visiting nurses, who investigate home conditions and instruct patients reported to the department who are not under the close supervision of a private physician, the state department clinic, or the tuberculosis league clinic. the nurses are able to correlate, in a way, the work of the two dispensaries by assigning patients to the clinic in the district in which they live. they receive $75 per month and are not in uniform. pittsburgh, then, has in all twenty visiting tuberculosis nurses, under three separate and distinct organizations. cleveland in cleveland, as in nearly every other city, the work of organizing the fight against tuberculosis was accomplished by private organizations, the anti-tuberculosis league and the visiting nurse association. for a number of years the health department confined itself to keeping a card catalogue of reported cases. in 1910 sufficient funds were voted by the city council to enable the establishment of a separate bureau of tuberculosis, whose duty should be the development of municipal tuberculosis work. this bureau has taken over and gradually developed five dispensaries, with a staff of twenty-four visiting tuberculosis nurses, and paid physicians, besides the director and office force. the work in cleveland is centralized in its health department. general dispensaries are required to refer all cases of tuberculosis to the tuberculosis dispensaries, and physicians are required to report all cases to the health department. on report cards and sputum blanks is the statement: "all cases of tuberculosis reported to the department will be visited by a nurse from this department unless otherwise requested by the physician." with very few exceptions the physicians are glad to have a nurse call, and every effort is made to co-operate with the physicians in handling the case. the city is divided into five districts, with a dispensary located in each district. patients are treated only at the dispensary serving the district in which they live. "this plan prevents cases wandering from one clinic to another and enables the nursing force to do more intensive work in each district." once a week the chief of the bureau of tuberculosis and the superintendent of nurses meet with each separate dispensary staff, and cases are carefully considered and work discussed. in addition, meetings of the active nursing staff are held, informal talks on tuberculosis being given, or the work of allied organizations studied, speakers coming from the associated charities, department of health, settlement houses, etc. each nurse is held responsible for the handling of every individual case in her district. by thus making the nurse responsible, the interest in her work is increased and much better results are obtained. if the problem presented is one that will take more time and energy than the busy dispensary nurse can give, it is referred to a special case committee. all dispensary cases are visited in the home within twenty-four hours after the first visit to the dispensary, where a complete history of the case is taken. the patient and family are instructed and each member urged to come to the clinic for examination. homes where a death from tuberculosis has occurred are visited immediately, with the consent of the physician. the family is carefully instructed as to disinfection, and advised to go to the physician or dispensary for examination. cleveland nurses wear uniforms. each nurse carries about three hundred patients, a very small percentage being bed cases, usually not more than two patients at a time. nurses receive $60 for each of the first three months; $65 for each of the next nine; $70 a month for the second year; the third year $80; and the fourth year $85. detroit the detroit board of health maintains a staff of ten visiting tuberculosis nurses. they give a small percentage of bedside care, wear a uniform, and receive $1,000 per year. they work in connection with the board of health dispensary and have the same general follow-up plan as other cities. milwaukee the head of the division of tuberculosis of the milwaukee health department is a trained nurse. she has six field nurses under her, each handling about 100 patients. nurses are in uniform, give bedside care when necessary, and receive $900 per year. the dispensaries are operated jointly by the health department and private charities. each case of tuberculosis reported to the department is turned over to a nurse, who visits the physician to see whether or not he wishes the help of the department. if he does, the nurse instructs the patient and family, arranges for the patient's removal to a sanatorium upon the physician's advice, attends to disinfection of premises and examination of remaining members of family. if the family is in need of material relief she arranges for a pension. all returned sanatorium cases are kept under the supervision of this staff. st. louis the st. louis society for the relief and prevention of tuberculosis has a staff of seven nurses, a social service department, a relief department, and an employment bureau. conferences of nurses and workers are held three times a week, the social workers assuming the various problems met by the nurses in their daily work. st. louis nurses carry on an average 100 patients each, about 25% being bed cases. nurses are in uniform, and receive from $60 to $75 per month. patients report to the city dispensary or to the washington university dispensary, and the usual plan of home supervision is in force. atlanta atlanta, ga., has a staff of four nurses and a dispensary under the atlanta anti-tuberculosis and visiting nurse association. they seem to have a particularly well organized plan of work, very hearty co-operation from the entire city (although the city government has appropriated nothing for the work), and are doing much good along lines of prevention, with dental, and nose and throat clinics, and open air schools. they have had difficulty in obtaining nurses with social training, and have been at some pains to arrange a social service training school, the program of which seems very admirable. * * * * * according to the latest report of the national association for the study and prevention of tuberculosis, there are 4,000 visiting tuberculosis nurses in the united states. there are more than 400 special tuberculosis clinics as compared with 222 in 1909. this paper deals with only a few of the larger cities. there are many other cities and small towns having tuberculosis nurses doing work well worthy of mention. several states have adopted the plan of carrying on the work by visiting nurses in each county. these nurses have a wide field, and are accomplishing much along educational lines, the territory which they have to cover making any great amount of actual nursing impossible. it is interesting to note their varied experiences. we read of patients prepared and sent to sanatoria and hospitals, the family and neighborhood protesting against every step; of county agents, churches, lodges or communities called upon to assist in caring for families; of long drives into the country to inspect and practically reorganize some home where several members have died, or are dying with tuberculosis; of repeated admonitions to keep windows open in rural communities, "where the air is pure because all the bad air is kept closed up in the homes and school houses." when the city tuberculosis nurse reads of all this, she feels like taking off her hat to the rural tuberculosis visiting nurse and wishing her success and fair weather. chicago the history of the present comprehensive tuberculosis work in chicago is closely interwoven with the history of the chicago tuberculosis institute, which was organized in january, 1906. the institute succeeded the committee on tuberculosis of the visiting nurses' association (the pioneer tuberculosis committee in chicago). the chicago tuberculosis institute gives the following as its chief aim: "the collection and dissemination of exact knowledge in regard to the causes, prevention and cure of tuberculosis." the progress made in the tuberculosis situation of this city in the last seven years is directly due to the systematic campaign of the institute. by exhibits, lectures, literature, stereopticon views and moving picture films, the institute was energetically spreading during these years the knowledge concerning tuberculosis and its proper methods of prevention. in the winter of 1906-07 a small and unpretentious sanatorium called "camp norwood" was built on the grounds of the cook county institutions at dunning, with a total capacity of 20 beds. the edward sanatorium at naperville, made possible by the munificence of mrs. keith spalding, was under construction at the same time and was later made a department of the chicago tuberculosis institute. the edward sanatorium was the chief factor in demonstrating and convincing this community that tuberculosis can be successfully treated in our climate. in 1907, the chicago tuberculosis institute established a system of dispensaries with a corps of attending physicians and nurses. the purpose was given as follows: (a) early diagnosis of tuberculosis. (b) control of tuberculosis by means of personal instruction and home visits. (c) education of the community in the necessity of further development of the dispensary and nursing systems. (d) spread of the gospel of fresh air and "right living." dispensaries were opened during the latter part of 1907 as follows: (1) jewish aid society tuberculosis clinic in existence since 1900; joined the chicago tuberculosis institute, december 13th, 1907. (2) olivet dispensary, may 15, 1907; transferred to policlinic in december of same year. (3) central free dispensary at rush medical college, november 16th. (4) northwestern tuberculosis dispensary, november 21st. (5) hahnemann tuberculosis dispensary, december 9th. (6) policlinic tuberculosis dispensary, december 13th. (7) west side dispensary at the college of physicians and surgeons, december 17th. the south west dispensary was opened in august, 1909. the underlying and controlling belief of the chicago tuberculosis institute has always been that no great progress can be made in the campaign against tuberculosis, or in any other reform movement, until the soil is sufficiently prepared. the soundness of this policy may be seen in the fact that the activities of the institute, its exhibits, more especially the success of the edward sanatorium, and also the work of the dispensaries, led finally to the adoption by the city of chicago of the glackin municipal sanitarium law and made possible the municipal tuberculosis sanitarium now nearing completion. the maintenance of the seven dispensaries having become a source of considerable expense to the institute, they were turned over to the city and became a part of the municipal tuberculosis sanitarium in september, 1910. the institute continued its activities as "an educational institution for the collection and dissemination of exact knowledge in regard to the causes, prevention and cure of tuberculosis." it concerns itself also with keeping before the minds of the public the proper standard of care for the tuberculous in public and private institutions. through its committee on factories, the institute conducted during the last three years a vigorous campaign for the adoption of the principle of medical examination of employes. the robert koch society, an organization of physicians, is the outgrowth of the institute. in brief, the institute for years has led the fight against tuberculosis in this city. the dispensary system of the municipal sanitarium, organized as above stated, has gradually developed into ten dispensaries with a superintendent of nurses, ten head nurses and fifty field nurses. a staff of thirty-one paid physicians are a part of the organization. the ten dispensaries hold twenty-six clinics a week. in 1913, the attendance at the municipal tuberculosis sanitarium clinics was 43,989 patients. nurses made in all 39,737 visits to the homes of the tuberculous patients. the system of visiting tuberculosis nursing in chicago is steadily moving toward greater efficiency in coping with the existing situation. the chief features of the chicago arrangement are as follows: (1) nurses are classified into: =grade ii. field nurse= group c: $900.00 group b (at least one year's service in lower group): $960.00 group a (at least one year's service in next lower group): $1080.00 =grade iii. head nurse= group b: $1200.00 group a (at least one year's service in lower group): $1320.00 =supervising nurse= group b: $1440.00 group a (at least one year's service in lower group): $1560.00 =grade iv. superintendent of nurses= group d: $1920.00 group c (at least one year's service in lower group): $2100.00 group b (at least one year's service in next lower group): $2280.00 group a (at least one year's service in next lower group): $2400.00 (2) civil service examinations for all of the above positions render possible the selection of the best candidates. (3) efficiency of the nursing force is stimulated by conferences of various groups of nurses: (a) weekly conferences of junior nurses. (b) weekly conferences of head nurses. (c) conferences of the entire nursing force twice a month. (d) a well organized system of lectures on various phases of tuberculosis by authorities. (e) bi-monthly meetings of the nurses' tuberculosis study circle, the proceedings of which are published in this pamphlet. (4) a centralized system of administration, with brief medical and social records of all dispensary cases for the purpose of clearing and information, in the office of the superintendent of nurses located in the down town general offices of the sanitarium. (5) nurses wear uniforms beginning with the middle of october of this year (1914). (6) before january, 1915, all tuberculosis cases in their homes will be cared for by the municipal tuberculosis sanitarium. this includes both far advanced and surgical cases. the chicago anti-tuberculosis movement has been more fortunate in its development than that in other cities where the dispensaries are under one organization and the nurses under another. here the dispensaries and their nursing and medical staffs have steadily developed under the same direction, the advantages of such an arrangement being clearly evident. we look into the future with confidence. the chicago municipal tuberculosis sanitarium, with its 900 beds and its comprehensive medical and laboratory facilities for the study and treatment of cases, is to open before the year 1914 expires. the county tuberculosis hospitals for advanced cases are undergoing a revolutionary change in the direction of administrative and medical efficiency. the dispensary department of the municipal tuberculosis sanitarium is extending sanatorium care to the homes of tuberculous patients by building and remodelling porches and supplying, if necessary, all equipment required for outdoor sleeping. we have eighteen open air schools. we have an effective tuberculosis exhibit. the principle of early detection of illness is being adopted by many business concerns and the sanitary conditions are gradually improving. the future is full of promise. [illustration] ------------------------------------------------------------------------- city population private number average bedside uniforms yearly 1910 census or of number of care salary public nurses patients funds per nurse ------------------------------------------------------------------------- new york 4,767,000 public (city) 158 $900.00 about 125 yes no average private 102 ------------------------------------------------------------------------- chicago 2,185,000 public (city) 50 135 yes yes $900.00 to $1,320 ------------------------------------------------------------------------- philadelphia 1,549,000 public (state) 12 varies yes yes $900.00 private 4 150 no no ------------------------------------------------------------------------- st. louis 687,000 private 7 100 yes yes $720.00 to $900.00 ------------------------------------------------------------------------- boston 671,000 public 100 (city) 25 to 180 yes no $900.00 ------------------------------------------------------------------------- cleveland 561,000 public (city) 24 300 yes yes $720.00 to $1,020.00 ------------------------------------------------------------------------- baltimore 558,000 public (city) 16 212 yes yes $900.00 ------------------------------------------------------------------------- pittsburgh 534,000 public (city) 4 no no $900.00 state 10 100 no no $840.00 private 6 yes yes $300.00 ------------------------------------------------------------------------- detroit 466,000 public (city) 10 100 yes yes $1,000 ------------------------------------------------------------------------- buffalo 424,000 public (city) 6 125 yes no $720.00 ------------------------------------------------------------------------- provisions for outdoor sleeping by may macconachie, r. n. head nurse, st. elizabeth dispensary of the chicago municipal tuberculosis sanitarium. in the treatment of tuberculosis, the best results have been obtained in sanatoria. in most cities, however, sanatorium treatment is not possible for many patients; consequently home treatment must be provided. this can be done most successfully when we imitate as far as possible the sanatorium method. this paper describes some of the arrangements for outdoor sleeping which may be provided for a patient taking the "cure" at home. the fresh air room. select the best lighted and best ventilated room, preferably one with southern exposure, for the patient to sleep in. all superfluous furniture and hangings should be removed. in doing this, however, the room need not be made cheerless; small rugs, washable curtains and one or two cheerful pictures may be allowed. there should be some means of securing cross ventilation in all sleeping rooms, as for the ideal fresh air room this is most essential. when this cannot be arranged and when there are windows only on one side of the room and a transom is lacking, the window should be open at both upper and lower sash. this arrangement allows the bad air to escape through the opening at the top, while the fresh air enters below. the "french window" which opens from floor to ceiling by swinging inward is to be recommended for the ideal sleeping room. in ventilating a room which is used for a sitting room in the daytime, especially in stormy weather, it is sometimes necessary to protect the patient from a direct draft. for this purpose a shield may be made from an ordinary piece of hardwood board, eight inches wide (or larger) and long enough to fit in between the side casings. it can be covered with wire netting, cheese cloth or muslin. there are a variety of wind shields on the market called sash ventilators, or air deflectors. window tents in the treatment of tuberculosis the window tent was originally devised to give fresh air to patients in their own rooms. to a poor family the window tent has an economic advantage, especially if the room where the patient lies serves as a living room for the rest of the family. the fact that the well members should not shiver is of vital importance in many respects. a simple home window tent, and one which can be made easily in the homes of the poor, consists of a straight piece of denim or canvas hung from the top of the window casing and attached to the outer side of the bed. the space between this and the window casing on each side is closed with the same material properly cut and fitted. ten to twelve yards of cloth is necessary. if made of denim, the price of the tent would be about $3.00; if of canvas, about $4.50. if this cannot be obtained, take two large, heavy cotton sheets, sew them together along the edge, tack one end to the top of the window casing and fasten the other end to the bed rail with tape. there will be enough cloth hanging on each side to form the sides of the tent, and this should be tacked to the window casings. the manufactured window tents are all constructed practically on the same principle. the difference between them is in their shape and the manner of their operation. there are two types: the awning variety, as illustrated by the knopf and the allen tents; and those of the box order, of which the farlin, walsh, mott and aerarium are examples. knopf window tent. the knopf window tent[1] is constructed of four bessemer rods furnished with hinged terminals, the hinges operating on a stout hinge pin at each end with circular washers so that it can be folded easily. the frame is covered with yacht sail twill. the ends of the cover are extended so they can be tucked in around the bedding. the tent fills half of the window opening and can be attached to the side casings three inches below the center of the sash, this space being for ventilation. the patient enters the bed and then the tent is lowered over him, or he can lower the tent himself by means of a small pulley attached to the upper portion of the window. the bed can be placed by the window to suit the patient's preference for sleeping on his right or left side. a piece of transparent celluloid is inserted in the middle of the inner side so that the patient can look into the room or can be watched. allen window tent. the allen window tent[2] is on the same order as knopf's, the difference being chiefly in size. the allen tent covers the entire window and has the appearance of an ordinary window awning turned into the room, ventilation being secured from openings above the upper and below the lower sash. box window tent. the box variety of window tent consists of a light steel frame covered with canvas or cloth. the frame fits between the window casing like a wire screen frame. the bottom, through which the head is passed, can be made of flannel and can be drawn closely around the neck. aerarium. dr. bull's aerarium[3] is another device similar to a window tent. this arrangement consists of a double awning supported on a wooden or steel frame and attached to the outside of the window with a special ventilating arrangement. the head of a cot bed is put through the window and the patient's head rests out of doors. the lower window sash must be raised about two feet and a heavy cloth or curtain hung from its lower edge so that it will drop across the body and shut off the room from the outside air. window tents have a few advantages. the patient's prolonged rest in bed will be more endurable when he is permitted to look out on the street and watch life than when obliged to gaze at the four walls of his room. also patients, who can be persuaded only with difficulty to sleep with the window wide open, will not hesitate when they have this tent as an inducement. draft which the patient usually dreads, particularly in cold weather and when he perspires, need not be feared when sleeping in a window tent. further, this limits the possible infection to the interior of the window tent, which is obviously an advantage. while, as a matter of course, the patient will have been taught to always hold his napkin before his mouth when he coughs or sneezes, this is not always done, and cannot be done when coughing in sleep. the constant exposure to air and light of the bacilli, which may have been expelled with the saliva and remain adhered to the canvas, will soon destroy them. also the canvas of the tent is attached to the frame by simple bands and its removal from the frame for thorough cleansing, washing and disinfection is thus made easy. tents tents are frequently used for open air living. however, they are not to be recommended for those who can afford to construct open buildings of more durable material. ordinary tents hold odors. they are often very hard to ventilate; for a strong draft is produced when the flaps are open. there is no ventilation through the canvas, as it is impenetrable by currents of air. in order to make a tent comfortable for a sick person it should have a large fly forming a double roof with an air space between, a wide awning in front where the patient can sit during the day, a board floor laid at least a few inches above the ground, and the sides boarded up two or three feet from the floor. many modifications of the ordinary tent have been made for the purpose of obtaining a well ventilated canvas shelter. gardner tent. the gardner tent[4] is conical in shape with octagonal floor area, with an opening in the center of the roof and one at the bottom between the floor and the sides. these openings act like a fireplace and produce a constant upward current of air through the interior. "the floor is in six sections and can be bolted together. it is made of 1ã�4-inch tongued and grooved boards supported eight inches above the ground on 2ã�4-inch joists. around the edge of the floor is a wainscoting of narrow floor boards four feet in height. there is no center pole, as the tent is supported by an eight-sided wooden frame. the roof and sides are of khaki colored duck. the lower edge of the canvas walls are fastened several inches below the floor and one inch out from the wainscoting on all sides. this leaves an opening through which a gradual inflow of air is obtained without causing a draft. the opening in the center of the roof is one foot in diameter and is covered with a zinc cap." the cap is raised or lowered by a pulley attachment. tucker tent. the tucker tent is similar to the gardner in that it is supplied with ventilation in the wainscoting near the floor and in the center of the roof. it is rectangular rather than octagonal in shape and is made in two sizes--one, eight feet wide by ten feet long, and the other, twelve feet wide by fourteen feet long. it has a wooden floor, wooden base and canvas side, with window openings on each side. "the canvas above the base in the front is attached to awning frames so that it can be raised or removed altogether for the free entrance of air and light." the roof and fly are made of 12-ounce army duck. la pointe tent. the la pointe tent is similar to the tucker tent. it is a canvas cottage with doors, windows and floor. the top is made of canvas, with a fly which projects two inches on all sides. the windows have a wire netting and canvas shutters, the canvas being so arranged that it can be pulled up as a curtain, or extended as an awning. its cost is $85 to $100. army tent. a simple ordinary tent is the united states army tent. there are two different styles, one with closed corners and one with open corners. it is made of army duck with poles, stakes and guys, and costs according to size. a small tent eight feet four inches long and six feet eleven inches wide would cost $7.50, and lumber for floor about $2.00 extra. this tent is easily put up, care being taken to select a dry soil, places where the water stands in hollows after a rain should be avoided. a small trench about one foot deep around the tent will help in keeping the soil dry. tent cot. for experimenting in outdoor sleeping a tent cot is a very simple arrangement. it consists of a plain canvas cot with a frame supporting a small tent. ventilation is secured by openings at both ends; also at the side where the patient enters. these openings are covered with flaps which can be opened or closed. it is light, weighing from twenty to fifty pounds, and its position and exposure can be conveniently changed. the cost is $9. knopf's half tent. another simple arrangement is knopf's half tent.[5] it consists of a frame of steel tubing covered with sail duck and secured with snap buttons on the inside. it is used for patients sitting out of doors. the reclining chair is placed in the tent with its back to the interior. its weight helps to hold down the floor bracing attached to the frame. sleeping porches one of the most important arrangements for outdoor sleeping is the sleeping porch. to be convenient, it should have an entrance from a bedroom, and, when possible, from a hall; for every outdoor sleeper should have, during cold weather, a warm apartment in connection with his open air sleeping room. the best exposure in illinois is south, southeast or east. sleeping out should be a permanent thing during all seasons. the sleeping porch must be kept neat and attractive. a cot placed between the oil can and the washtub on a dingy back porch is very dismal and bound to have a depressing effect on the sleeper. it costs very little to arrange an ordinary sleeping porch provided you have the porch to begin with. if a porch is fairly deep and sheltered on two sides by an angle of the house, sufficient protection for moderately cold weather can usually be obtained by canvas curtains tacked to wooden rollers. these can be raised and lowered by means of ropes and pulleys, the bed being placed so that the wind will not blow strongly on the patient's head. ordinary porches.[6] a useful porch can be built for $15 to $25 with cheap or second-hand lumber, and if only large enough to receive the bed and a chair will still be effective for the outdoor treatment. the roof can be made with canvas curtain, or a few boards and some tar paper. the end most exposed to the wind and rain and the sides below the railing should be tightly boarded to prevent drafts. second or third story porches are supported from the ground by long 4ã�4-inch posts, or when small they can be held by braces set at an angle from the side of the house. when the long posts are used they are all placed six feet apart and the space between them is divided into three sections by 2ã�4-inch timbers. the interior is protected by canvas curtains fastened to the roof plate and arranged so as to be raised or lowered by ropes and pulleys. these curtains are made about six feet wide and fit in between the supporting posts and rest against the smaller timbers. this arrangement keeps the curtains firm during a storm, as both rollers and canvas can be securely tied to the frames. this porch would cost between $30 and $50. porch de luxe. when a bed on a porch is not in use it is often unsightly and in the way, while in winter, unless well protected, the bed clothes and bedding become damp. in order to overcome this, the porch de luxe[7] has recently been devised. this consists of a low-built bedstead arranged to slide through an opening in the wall of the house between the porch and bedroom. sleeping cabin. to lessen the disadvantages of the high roofed, windy porch, the home-made sleeping cabin is to be recommended. this cabin is built on the porch. the frame is braced against the side of the house and rests on the floor of the porch, but the top of the cabin is much lower than the roof of the porch. the frame consists of 2ã�4-inch timbers. the sides and roof are of canvas curtains; these can be rolled up separately. some of these cabins have had the roof hinged so that it can be raised in warm weather. the greatest advantage of the cabin is the control of the weather situation. the cost is $15 to $20.[8] knopf's star-nook. another arrangement is knopf's "star-nook."[9] this is a wall house supported by the roof of an extension, or on a bracket attached to the wall of the building. this fresh air room consists of a roof, floor and three walls and, with the exception of the roof and the floors, is built of steel frames holding movable shutters. it is nine feet long by six feet deep, the height being eight feet at the inner side with a fall of two feet. at both ends are windows which can be opened outward. the roof can be raised entirely off the apartment by means of a crank. also the upper sections of the front windows can be opened or closed. sometimes new doors or windows will be needed to give access to a desired position. the "star-nook" can be secured with safety, and when strongly supported there need be no fear in regard to its stability. roofs the value of roof space for outdoor treatment in cities is gradually being appreciated. they can be made splendid sites for various kinds of little buildings. the roof of an apartment house offers a choice of situations, but there are different conditions to be considered, such as the best exposure and the most protected place, one that cannot be overlooked from neighboring buildings; also security from severe storms. tents have been erected upon the roofs of city buildings, but they are not to be recommended for such positions unless they can be placed in the shelter of a strong windbreak. when erected upon the roof of high buildings they should be protected on two sides by walls, or by other parts of the structure upon which they are to be placed. a cabin is most desirable for the roof. in its construction it is best to use a wooden frame for the foundation. it can then be moved and its position and exposure changed easily. this frame should be made of 2ã�6-inch planks laid flat on the roof. the upright frame and siding boards for the back and sides should be of 2ã�4-inch timbers. the front of the cabin should be left open, but arranged with a canvas curtain tacked on a roller so that it can be closed in stormy weather. tar paper is used for the roof. when completed, the framework should be braced to give firmness. if two buildings connect and one is taller than the other with no space between, a lean-to cabin is most desirable. * * * * * with the devices just described the home treatment can be secured with little cost. patients who are afraid of outdoor sleeping should begin in moderate weather. all shelters should be as inconspicuous as possible. in choosing a suitable position for a fresh air bedroom, it should be remembered that early morning sounds and sunlight should be eliminated, if possible. this can sometimes be done by selecting a room far from the street and by shading the bed with blinds. one's neighbor should be taken into consideration, and a position decided upon which does not overlook his windows, porches or yards, and when arranging for the rest cure in the reclining chair during the day one should always bear in mind that it is much more agreeable and conducive to the well-being of the patient to have a pleasant view to look upon. some points in the nursing care of the advanced consumptive by elsa lund, r. n. head nurse, iroquois memorial dispensary of the chicago municipal tuberculosis sanitarium. the problem of caring for the advanced consumptive is a very complicated one; it involves not only the patient, but the whole family as well. a complete rehabilitation of the entire family is necessary in most of the dispensary cases. the first thing the nurse must do is to gain the confidence of both the patient and the family. the chief requisite in the nursing of the advanced consumptive is a clean, careful, patient and sympathetic nurse. frequently she finds her patient extremely irritable, and often this mental condition has affected his whole family, or whoever has been associating with him. a painstaking, sympathetic nurse will readily understand that the causes for this state of affairs are most natural. the consumptive may have spent wakeful nights, due to coughs and pains and distressing expectoration; the enforced cessation of work may have caused pecuniary worries; all his customary pleasures are now denied him, and he has strength for neither physical nor mental diversion. realizing this, the nurse must kindly but firmly impress upon the patient the necessity of co-operation and the danger of infecting others and of reinfecting himself. she should at once create a more cheerful atmosphere by repeated suggestions that if he will only do his duty as a hopeful patient, he will not be considered a menace by those who come in contact with him, and his family will gladly associate with him. next comes the concrete problems which the nurse must solve. that of proper housing of the patient is one of the most important, and especially so in the case of the advanced consumptive, because of the greater danger of spreading the infection if the conditions are unfavorable. where it is necessary that the family should move, the nurse should assist in the selection of a new home. if possible, a detached house should be chosen, affording plenty of light and sunshine, away from dusty streets and roads. offensive drains and other insanitary conditions should be avoided. the water supply should be abundant and the plumbing in good repair. the room of the patient should be well lighted and well ventilated, and preferably have a southern exposure. cross ventilation is very desirable. when all unnecessary furniture and all hangings and bric-a-brac have been removed, and the old paper stripped from the walls, the walls should be whitewashed, or covered with washable paper, or painted. painted walls are inexpensive, and they have the further advantage that they can be washed frequently. the floor should be bare and likewise frequently washed. simple furniture is commendable, and old pieces can be made very attractive by having them enameled. proper furnishings include a comfortable bed (one made of iron and raised on wooden blocks makes nursing care easier), a bedside table, chairs, a rocking chair, a washstand, and even a couch on which the patient could be placed occasionally to relieve the monotony. two or three pictures which can be readily dusted and cleaned will brighten the bare walls one finds in what are generally recommended as sanitary rooms. flowers always add to the attractiveness of a room, and when the bed is placed near the window the patient is given the opportunity of enjoying, to some extent, at least, the pleasures of out-of-doors. the mattress should be provided with a washable cover. strips of muslin sewed across the tops of the blankets will protect them from sputum, in case the sheets happen to slip. soiled bed linen must be handled as little as possible, soaked in water, washed separately and boiled. if sputum-covered, it should be soaked in a five per cent solution of carbolic acid or a solution of chloride of lime. instead of dry sweeping and dusting, the floors should be washed with soap and water and dusted with wet cloths. great care should be taken in instructing and demonstrating to the family how to properly care for the room. special attention must be given to the bed, its comforts and its cleanliness. every nurse is familiar with what is known as the "klondike" bed, and it is unnecessary to discuss it here in detail. since both patient and family derive such direct benefit from a constant supply of fresh air, too much attention can not be given to proper ways of securing it, and at the same time keeping the patient warm. where bed coverings are limited, warmth can be secured by sewing layers of newspapers between two cotton blankets; again, sheets of newspapers or tar paper keep out the cold to a great extent. proper ventilation prevents night sweats. means of heating the room must be provided, because of the low vitality of the patient and the need of frequent care. the patient's clothing needs to be light but warm; where wool proves irritating to the skin, a heavy linen mesh has been found a good substitute, due to the fact that it dries quickly when the patient perspires. the patient should have two good soap and water baths a week. the nurse should let the family know when she is coming to give these baths and explain to them that she expects them to have ready for her towels, soap, clean bed linen, wash basin, wash cloths, newspapers and hot water. night sweats demand careful rubbing, first with a dry towel; vinegar sponging is found to be very effective; alcohol rubs prevent bed sores. the hair, nails and teeth require special attention; beards and mustaches should be shaved. every patient must learn to use the tooth brush after meals, that the mouth may be kept scrupulously clean. gargling should also be insisted upon. tooth brushes can be kept in a 50 per cent dobell's solution, liquor antiseptic (u. s. p.), or a 2 per cent solution of carbolic acid colored with vegetable green coloring matter as a warning against swallowing. as an aid in hardening the gums, all foreign deposits should be removed, the gums massaged by the patient and normal salt solution used as a gargle. where the patient is suffering from pyorrhea, the gums may be painted, on the order of the physician, with tincture of iodine (u. s. p.) or a 2 per cent solution of copper sulphate. while the patient is learning to cleanse his mouth carefully after every meal, he may also be instructed to avoid placing anything in his mouth, except food, drink, gargling solution or tooth brush. the reason for using some kind of mouth wash, instead of merely water, is because in that way the need of cleanliness is more forcibly impressed upon the patient. such matters as the use of separate dishes, etc., are so well known to every tuberculosis nurse that it is unnecessary to dwell on them at length in this paper. difficulties always arise regarding proper method for the care and disposal of sputum. the following are some of the plans adopted by tuberculosis hospitals for advanced cases: =1. infirmary of eudowood sanatorium, towson, maryland.= pasteboard fillers in such quantities as will be required during the current day are issued to the patients. when the filler becomes not more than two-thirds full, it is carefully filled with sawdust, wrapped in a newspaper, tied with a cotton cord and deposited in a large galvanized iron bucket, in which it is carried, with the others, to the incinerator. =2. north reading (mass.) state sanatorium.= a room specially equipped for the disposal of sputum is recommended. paper sputum boxes are changed twice daily, inspected as to character, quantity and presence of blood. then the box is filled with sawdust, wrapped in newspaper and carried to the incinerator for burning. =3. montefiore home country sanitarium, bedford hills, n. y.= in cases where bed patients have a very large amount of sputum, large cups of white enamel are used, with a hinged lid that lifts readily. the sputum is from there thrown into receptacles containing sawdust, taken to the incinerator and burned twice daily. both sputum cups and the large container holding sawdust are sterilized by live steam. =4. house of the good samaritan, boston, mass.= paper handkerchiefs and bags are recommended when the quantity of sputum is small. burnitol sputum cups without holders are used; the bottom of each cup holds a small amount of sawdust, which serves the purpose of hindering the sputum from penetrating through the cup. all the cups are carefully tied up in newspaper by the nurse or the patient before they are sent to the incinerator. =5. chicago fresh air hospital.= paper fillers and metal holders are used. the fillers are placed in a large can, covered with sawdust, and then burned in the incinerator. the holders are sterilized daily. the hospital recommends paper napkins where the quantity of sputum is small; if there is no possible means of burning the sputum, it should be treated with a strong solution of concentrated lye and then poured into the water closet. the chief source of infection is undoubtedly the expectoration of the consumptive, spread by careless coughing and spitting. be very emphatic in instructing the patient to cover his mouth with a paper napkin when he coughs and then to dispose of it carefully in such a way that no particle of the sputum touches either his hands or his face. insist on frequent washing of the hands. the following methods and solutions are employed in the treatment of laryngeal tuberculosis in various institutions: =north reading (mass.) state sanatorium.= the following are used as _gargles_: dobell's solution; dobell's solution and formalin (one drop of formalin to an ounce of solution); alkaline antiseptic n. f. (one to four water); salt and sodium bicarbonate (one dram of salt and two drams sodium bicarbonate to a pint of water). _sprays_ used at this institution are as follows: spray no. 1. menthol spray in proportion of fifteen grains of menthol to one ounce of alboline. spray no. 2. menthol (4 drams plus 10 grains); thymol (7 drams plus 25 grains); camphor (7 drams plus 25 grains); liquid petrolatum (64 ounces). heroin spray. from one to three grains of heroin to one ounce of water. cocaine spray. from one-half to two per cent, usually before meals, for dysphagia. for _local applications_: argentide, 1 to 200; argyrol, 10%; iodine, potassium iodide and glycerine; heroin powder applied dry to ulcerations; orthoform powder applied dry. =montefiore home country sanitarium, bedford hills, n. y.= in the _routine treatment_ of laryngeal tuberculosis at the montefiore home country sanitarium orthoform emulsion is used, made up as follows: menthol, 2-5 grams; oil of sweet almonds, 30 grams; yolk of one egg; orthoform, 12.5 grams; water added to make 100 grams. in addition, silver salts are used in various strengths; also lactic acid in various strengths. these two agents are applied by means of applicators, whereas the emulsion is injected by a laryngeal syringe. the laryngeal medicator of dr. yankauer, made by tiemann, is also employed. by means of this little apparatus a patient may medicate his own larynx, using the emulsion mentioned or any other agent (such as formalin) which may be desired. =eudowood sanatorium, towson, md.= at the eudowood sanatorium, towson, maryland, the following procedure is used in the treatment of tuberculous ulcers of the larynx: _topical applications_ of lactic acid, 15 to 50%, followed by a spray composed of 20 grains of menthol to 1 ounce of liquid alboline. a _spray_ of 2% cocaine is used as often as is necessary to relieve the pain. insufflation of orthoform powder, or the patient is directed to slowly dissolve an orthoform lozenge in his mouth. these treatments are enhanced by the application of an ice bag to the throat, enforced rest of the vocal cords and rectal feeding, if necessary. in laryngeal complications, semi-solid diet is generally more easily swallowed. this is facilitated by a reclining position. cold compresses give some relief. =chicago fresh air hospital= for the relief of pains and difficulty in swallowing, the nurse is instructed to spray the larynx with a 3 per cent solution of cocaine before each meal. as a more efficient treatment, but slower in action, the administration of anaesthesine to the ulcerated epiglottis with a powder blower is recommended. this is usually done by the physician, as is, also, the insufflation of iodoform. cold packs are also used to give temporary relief, but they are not recommended as being very reliable. * * * * * authorities differ regarding the proper _diet_ for the advanced consumptive. it is generally conceded, however, that it should not vary to any great extent from the ordinary liberal diet, unless intestinal or other complications arise. the physical idiosyncrasy of each patient must first of all be taken into consideration, and this is primarily a matter to be decided upon by the physician in charge. the nurse should, however, be resourceful in her suggestions as to preparing a variety of palatable dishes. according to walters ("the open air treatment"), in intestinal tuberculosis, such foods as oatmeal, green vegetables, fruit and various casein preparations are better dispensed with, as they are likely to cause irritation and diarrhoea. meat and meat juices should also be given with caution, as they, too, cause diarrhoea. in hemorrhage, a cold diet should be given, such as milk, eggs, gelatin and custard. the nurse must insist in absolute rest and the patient should not be permitted to move until the danger of bleeding is over. nervousness always accompanies hemorrhage, and the nurse can do much to allay this by assuring the patient that few people die from hemorrhage. in closing, it might be well to mention some points relative to the nurse's equipment, her mode of dressing, etc. her dress should be simply made and washable. aprons made of soft cotton crepe are recommended because of the small space they occupy in the bag. the contents of the bag, which should be lined with washable, removable lining, should include: alcohol, tr. iodine, green soap, olive oil, boric acid powder, boric acid crystals, vaseline, cold cream, mouth wash, tongue depressors, adhesive plaster (3" wide), bandages, safety pins (small and large), applicators, scrub brush, face shields, probe, scissors (2 pair), forceps, thermometers (3), medicine dropper, bags of dressings, dressing towels, hand towels (2), apron. because tuberculosis is so lasting and makes a family, ordinarily self-supporting, frequently dependent, it will be absolutely necessary for the nurses to have access to a loan closet. this closet should contain the following articles: sheets and pillow slips, bed pan, blankets, rubber rings, gowns or pajamas, rubber sheets, tooth brushes, cold cream, rubber gloves, glass syringes, pus basins, enema bags, connecting tubes, rectal tubes, nurses' hand towels, surgical towels, instrument cases, aprons and gown, loan book. * * * * * up to the present time the field nurses of the dispensary department of the chicago municipal tuberculosis sanitarium have taken care chiefly of ambulant cases, the total number of cases under observation in 1913 being 12,397, with 39,737 visits by nurses to positive and suspected cases in their homes. lately (september 1914) the nursing force of the dispensary department has been increased to fifty nurses to take care of all tuberculosis cases in their homes, including advanced cases and those of surgical tuberculosis. [illustration] open air schools in this country and abroad by frances m. heinrich, r. n. head nurse, post-graduate dispensary of the chicago municipal tuberculosis sanitarium. in every community where the tuberculosis problem has been seriously taken in hand the importance of the presence of the infection in children had to be considered and this has been carefully studied by those who realize that tuberculosis, far from being a disease chiefly of adult life, is intimately associated with childhood. therefore, is it not most important that all children, who have either been exposed to tuberculosis through the presence of an active case in their home, or show a family predisposition to the disease, should be given special consideration, and every opportunity furnished to make it possible for them to withstand the latent infection or to overcome the inherited lack of resistance? the best means of meeting this important problem, as far as school children are concerned, is through the medium of open air schools, not only because of the benefit to the individual case, but also because of the very important educational influence on the community at large. the first open air school was opened in charlottenburg, germany, a suburb of berlin, in the year 1904, a school of a new type, to which the germans gave the name open air recovery school. the object was to create a school where children could be taught and cured at the same time, and this same purpose has obtained in all other schools of similar type which have since been opened. this new educational venture was designed for backward and physically debilitated pupils who could not keep up with the work in the regular schools and who were not so mentally deficient that they were fit subjects for the classes of mentally subnormal children. it was felt that if these children were sent to sanatoria they would undoubtedly improve physically, but would fall back in the class work; while, on the other hand, if they remained in the regular school they would deteriorate physically. it was to meet these needs, then, that this new type of school was devised. as the name implies, the school was held almost entirely in the open air, the regime consisting of outdoor life, plenty of good food, strict hygiene, suitable clothing, and school work so modified as to suit the conditions of the children. during its first year the charlottenburg school was open for only three months, but upon publication of the first report of the results accomplished it was decided to keep the school open a longer period. the desire to open other schools of similar type spread rapidly throughout germany, as well as the rest of europe and other parts of the world. probably the best argument for maintaining such schools was not only the physical benefit derived, but the actual advance made by the children in their studies, although they spent less than half as much time on school work as did their companions in the regular schools, not only fully maintaining their standing, but ever surpassing their companions in the regular classes. through results obtained from this first experiment in charlottenburg came the resolve on the part of school authorities of other cities to inaugurate open air schools in their respective localities, and in less than three years the movement had spread to england, where, in 1907, london opened her first school, modeled after that of charlottenburg. the same remarkable results obtained during the first season here, as in the three years previously reported from charlottenburg, awakened such popular enthusiasm that towns and cities in different parts of england began to plan for similar schools in the communities most needing them. meanwhile, the movement spread to the united states. in 1908, one year after england had established her first open air school, this country opened its first open air school in providence, rhode island. although providence has the distinction of priority in this matter, the school inaugurated by providence was not, strictly speaking, the first open air school established on american territory, as a school of this type was opened in 1904 in san juan, porto rico, by l. p. ayres, now associate director of the department of hygiene of the russell sage foundation, at that time superintendent of schools for porto rico. the san juan school was an experiment. it was built to accommodate 100 children. it was simple in its arrangements; it had a floor and roof but no sides. venetian blinds were provided to keep out rain and the too direct sunlight. the school was designed for children of no particular class, but was established in the endeavor to demonstrate that the regime which has proven beneficial for weak and ailing children will also benefit those that are strong and seemingly healthy. the results demonstrated fully the correctness of this idea. the children greatly preferred the outdoor classes, and even the teachers were most anxious to be assigned to outdoor work. since then at least one more school of similar type has been opened in porto rico. before showing what the united states has done in this very important movement, it might be interesting to learn how germany and england have further developed their program, as the work done in these countries, particularly in germany, served as the basis of the open air school movement in this country in the initial stages of its development. for the past fifteen years germany has carried on medical inspection of schools in a very thorough and efficient manner. this has drawn special attention to backward children. these children are treated there in special classes and sometimes in special schools. the quantity of instruction given them is reduced and every endeavor is made to increase its effectiveness. the classes are taught by capable teachers and the children have the benefit of suitable dietary, bathing and other hygienic provisions. in charlottenburg, in 1904, there were a large number of backward children who were about to be removed from the ordinary elementary schools to special classes. when examined, it was found that many of them were in a debilitated condition owing to anaemia, or various other ailments in an incipient stage. this circumstance afforded an ideal opportunity for the co-operation of the teacher and the school physician in devising and operating, for such children, an open air school. the general school regime was modified to meet the educational and physical needs of these children, the treatment consisting, as above stated, of abundance of fresh air, pleasant and hygienic surroundings, careful supervision, wholesome food and judicious exercise. the ordinary school work was modified to meet the individual condition of children; the hours of teaching were cut in two and the classes so reduced that no teacher had more than twenty-five pupils under her care. the site chosen for the first school in charlottenburg was a large pine forest on the outskirts of the town. the sum of $8,000 was granted by the municipality for carrying out the plan, and inexpensive but suitable wooden buildings were erected. at first ninety-five children were admitted to the school, but later the number was increased to 120, and still later to 250. these children were mainly anaemic or suffering from slight pulmonary, heart or scrofulous conditions. those suffering from acute or communicable diseases were rigidly excluded. of the five buildings erected, three were plain sheds about 81 feet long and 18 feet wide, one of them being completely open on the south side and closed on the other sides, of sufficient size to shelter during rainy weather about 200 children. the other two sheds contained five classrooms and a teachers' room. these were closed in on all sides, provided with heating arrangements, and used for classrooms during very cold or unpleasant weather, only one of the buildings was fitted with tables and benches intended for meals, or for work in inclement weather. this building was open on all sides. all over the school grounds, which were fenced in, there were small sheds open on all sides, fitted with tables and benches to accommodate from four to six children. these served as shelters. there were small buildings for shower baths, kitchen and a separate shed where the wraps of the boys and girls were kept. in these were individual lockers which contained numbered blankets for protection against cold, and waterproofs against rain. the children in this school report at a little before 8 a. m. and leave at a quarter of 7 p. m. for breakfast they are given a bowl of soup and a slice of bread and butter. classes commence at 8 o'clock and continue with an interval of five-minutes' rest after each half hour. at 10 a. m. the children receive one or two glasses of milk and a slice of bread and butter. after this they play, perform gymnastic exercises, do manual work or read. dinner is served at 12:30 p. m. and consists of about three ounces of meat, with vegetables and soup. after dinner the children rest or sleep for two hours on folding chairs. at 3 p. m. comes more class work and at 4 p. m. milk, rye bread and jam is given. the rest of the afternoon is given over to informal instruction and play. the last meal consists of soup, bread and butter, after which the children are dismissed. some walk home; some use street cars. in case of the very poor children the city pays the fare, while the transportation is furnished for others through the generosity of the street car company. the expense of the feeding is borne by the municipality, in the case of those who can not pay, and, for the others, is defrayed in part or whole by the parents. the work of the school physician consists of careful examination, treatment and supervision of these children. attention is principally directed to heart, lungs and general condition with respect to color, muscular and flesh development. weight and measurements are taken every two weeks, and at the end of the school period the children are very carefully examined and condition compared with that noted upon their admission. the regime covers such important phases of hygiene as suitable clothing, attention to daily habits, bathing, giving of warm baths for those who are anaemic and nervous, and of mineral baths for those who are scrofulous. bathing plays a very important part. all of the children receive two or three warm shower baths a week. a trained nurse is in attendance. the educational, physical and moral results obtained are remarkable. there is a great improvement in their behavior, especially with regard to order, cleanliness, self-help, punctuality and good temper. this is undoubtedly due to their removal, during practically all of their waking hours, from the influences of the street life to the more wholesome influences of the school. the children are taught to regard themselves as members of a large family, are trained to assist in the daily work and are taught to be helpful and considerate of each other. this, in detail, is the regime of the first open air school conducted in germany. the number of open air schools at present in germany is at least ten, with an attendance of approximately 1,500. * * * * * in england the open air schools were made possible through the work of the local educational authorities and co-operation of dispensaries for treatment and care of tuberculous children. as in other countries, general legislation for the control of tuberculosis has had considerable bearing on the open air school situation in england. among the legislative acts should be mentioned: (a) the act of 1911 providing building grants for the establishment of sanatoria, dispensaries and other auxiliary institutions. (b) compulsory notification of tuberculosis, etc. notification of tuberculosis, for instance, besides bringing to notice of the school medical officer cases of tuberculosis which might otherwise not come before him until a late period, serves in many cases to keep him informed as to "contact cases"--cases of children in contact with communicable tuberculosis. at burton-on-trent a system was instituted for periodical examination of school children who are either members of a family in which there is or has been a case of pulmonary tuberculosis, or who are attending school while residing in houses in which there is an existing case of this disease. all notified cases of tuberculosis are visited by the assistant medical officer of health, who is also assistant school medical officer, and the names of any children living in the house, or related to the case, are ascertained, together with the school they are attending. these names are entered in a special register and when the pupils of a school, at which any of these children are attending, are examined, a special examination is made of the latter. this examination is repeated two or three times a year. in another part of england a special letter is sent to the occupants of all houses from which the disease has been notified, calling attention to the special importance of early detection of tuberculosis in children, and asking that the children should be brought to the school clinic for examination. in lancashire the medical inspector calls on the medical officer of health and obtains a list of names of persons suffering from tuberculosis, so that the children, if of school age, may be examined. at newcastle-on-tyne all children exposed at any time to infection are kept under observation and re-examined. the re-examination continues even after fatal termination of the tuberculosis case with which the child was in contact. under the finance act of 1911 a sum of about $500,000 was especially appropriated for providing what are known as "sanatorium schools" for children suffering from pulmonary or surgical tuberculosis. these schools are known as the residential open air schools of recovery, and the need of such schools for children requiring more continuous care than is provided at a day open air school is becoming widely recognized. many children of the type already mentioned can not be satisfactorily treated unless they can be taken completely away, for a time, from their home environment. such treatment as is needed for many of these children is not and can not be offered in the ordinary hospital and certainly not at their homes. the designs and arrangements of the residential open air school of recovery are very attractive. they are well equipped to fulfill their function. the children, received between the ages of seven and twelve years, are those suffering from anaemia, debility, or slight heart lesions. cases of active tuberculosis are barred. no child is received for a shorter period than three months, and this period may be prolonged on the recommendation of the medical officer. the children rise at 7 a. m. and retire at 6:30 p. m. those who are able, make their own beds and do some of the domestic work. the diet is liberal, with abundance of milk and eggs. careful attention is given to inculcating habits of personal and general hygiene. all children receive a daily bath. careful attention is paid to the teeth, tonsils and adenoids. all these conditions must be attended to before admission. beyond this, very little treatment is given. children are weighed once in two weeks. instruction is chiefly practical. instruction in gardening is given twice a week and other occupations taught are raffia work, plasticine modeling, cardboard modeling, brush work and needle work. the number of open air schools at present in england is at least thirty-five, with an attendance of at least 2,500. forty-two other cities are listed as carrying on some form of open air education. * * * * * in the united states the open air school movement, from its inception, has been closely connected with the general anti-tuberculosis movement. the credit of establishing the first open air school in america belongs, as previously stated, to providence, rhode island, where the work was begun in january, 1908. the school was opened in a brick school house in the center of the city. a room on the second floor was chosen and remodeled by removing part of the south wall. for the wall thus removed windows were substituted. these extended from near the floor to the ceiling, with hinges at the top and with pulleys so arranged that the lower ends could be raised to the ceiling. the desks were placed in front of the open windows in such a manner that the children received the fresh air at their backs and the light over their shoulders. suitable clothing was provided for cold weather and, in case of necessity, soapstone foot warmers were used. the school was started as an ungraded school and ten pupils were enrolled at the time of its opening, the number later increasing to twenty-five. practically all children were selected by the visiting nurse of the local league for the suppression of tuberculosis from infected homes under her supervision. in a few instances children with moderately advanced lesions were admitted. the children reported at 9 a. m. and a recess was given at 10:30, when they were served soup. at noon they had a light lunch of pudding served with cream, hot chocolate or cocoa made entirely with milk. some of the children brought additional food from home. all of the cooking was done by the teacher. careful attention to general cleanliness and hygiene of the teeth was insisted upon. individual drinking cups and tooth brushes were provided. the children took turns in washing dishes, setting the table and helping to serve. children were dismissed at 2:30 p. m. they were provided with car tickets by the league for the suppression of tuberculosis, some for traveling both ways, some for one way only, depending upon the means of the family. during school session light gymnastic exercises were given and proper methods of breathing taught. in the spring they had a garden to work in. the providence school is at present a part of the general school system. the school supplies and teacher's salary are furnished by the board of education. food and carfare are supplied by the league for the suppression of tuberculosis. a physician is delegated by the league and one of the regular medical inspectors of the city schools works in co-operation with him. providence has at present two schools, with an attendance of forty. one more open air school and two roof classes may be provided by the board of education in 1914. in addition, the providence league for the suppression of tuberculosis conducts a preventorium for thirty children at the lakeside preventorium, rhode island. * * * * * boston started its first open air school in july, 1908. the work was carried on by the boston association for the relief and control of tuberculosis. the school was located at parker hill, roxbury. the same regime was followed as in previously reported schools. no formal instruction, however, was attempted at first. the school was simply a day camp. the benefit derived by the children in the first open air camp for children led the association to ask the boston school board to co-operate with them in converting the camp into an outdoor school. this was agreed to, the school board supplying teacher, desks, books, etc., the association furnishing the necessary clothing, food, a nurse, attendants, home instruction and medical services. the same schedule was followed here as in the other open air schools. general and personal hygiene was insisted upon. the school was kept open saturdays and during the holidays. the children who were able paid ten cents a day to help defray the cost of food. in case they could not afford this, the money was supplied by some charity organization. while the combined public and private support had proved satisfactory, it seemed best, for many reasons, to reorganize the school so that it would be entirely under municipal authority, and this has since been done. at the present time the school is maintained by the boston consumptives' hospital and the boston school board. the hospital furnishes transportation, food, etc., while the school board gives school supplies, books, desks, etc., and pays the salaries of the teachers. the children are selected by the school physicians, the type considered being the anaemic, poorly nourished, those with enlarged glands, or convalescents. cases of active tuberculosis are not admitted. boston has at present fifteen open air schools, with a total enrollment of about 500 children. * * * * * the first school established in new york city was started under the auspices of the department of education and was located on the ferryboat southfield, which was maintained as an outdoor camp for tuberculous patients by bellevue hospital. it was through the special desire of the children who were patients at the camp that the school was started, for they banded together one day and informed the doctor that they wanted to have a teacher and attend school. when their action was reported to the board of education it was felt that such an unusual plea should be given a favorable response, and in december, 1908, the school on the ferryboat was made an annex of public school no. 14. this school, except for its location, does not differ from other schools of similar type. the board of education pays the teacher and furnishes the school supplies. food and clothing are supplied by the hospital. the school is an ungraded one and the number of children taught by one teacher averages thirty. four more open air schools have since been established, three on ferryboats and one on the roof of the vanderbilt clinic at west sixtieth street. officially, all these schools are considered to be annexes of the regular public schools. in october, 1909, $6,500 was granted to the board of education by the board of estimate and apportionment for the purpose of remodeling rooms in some of the public schools for use as open air rooms. a special conference was held in december of that year by medical and school authorities to decide how best to remodel, furnish and equip these new rooms for this purpose; also how the children should be chosen for these classes. it was decided that the maximum number of children admitted to any one open air classroom should not exceed twenty-five, the children to be chosen by the director of the tuberculosis clinic nearest the school and the school principal. no child was to be assigned to the room until the parents' permission had been secured in writing. children moving from one district to another were to be followed up and cared for in the new district. no special rule was adopted defining the physical condition entitling the child to admission. each case was to be considered individually, and the only definite rule was that no open case of tuberculosis should be admitted. the minimum temperature of the room was 50 degrees f. the rooms, wherever possible, were to be located on the third floor. the first of these open air classes was established in april, 1910. such popular interest was awakened by the inauguration of these classes that, as a direct result, a special privilege was granted by the commissioners of central park permitting children of the kindergarten classes of the public schools to pursue their studies in the open air in central park. at present new york has thirty-three open air schools and open window rooms, with a total enrollment of at least 1,000. * * * * * chicago's first outdoor school for tuberculous children was inaugurated as a result of the joint co-operation of the chicago tuberculosis institute and the board of education. this school was opened during the first week of august, 1909, on the grounds of the harvard school at seventy-fifth street and vincennes road. the board of education assigned a teacher to the school and furnished the equipment, while the tuberculosis institute supplied the medical and nursing service, selected the children and provided the food. except during inclement weather, the children occupied a large shelter tent in which thirty reclining chairs were placed. meals were served in the basement of the school building, where a gas range, cooking utensils and tables were installed for this special purpose. the nurse, who was assigned by the tuberculosis institute on half-time attendance, visited the school each afternoon, took daily afternoon temperatures, pulse and respiration, looked after the general physical condition of the children, made weekly records of their gain or loss in weight and did instructive work in the home of each pupil. of the thirty children selected, seventeen had pulmonary tuberculosis, two had tubercular glands, and eleven were designated as "pre-tuberculous." none of the children had passed to the "open" or infectious stage. on admission two-thirds of the children showed a temperature of from 99 to 100.2 degrees. the daily program was similar to that already described for the providence and boston schools. the school was kept open for a period of only one month, with excellent results. during this time the thirty children made a net gain of 115 pounds in weight, and at the close of the period practically all of them showed a normal temperature, with their general condition greatly improved. it is needless to say that the experiment created a great deal of local interest in the problem of better school ventilation. those who had the success of the movement most intimately at heart realized, however, that the undertaking lacked the element of permanency and that the results accomplished by it lacked that degree of conclusiveness which would attend the same results if secured through the operation of an all-the-year-round school. the opportunity to demonstrate the effectiveness of such an all-the-year-round school was realized in the fall of 1909 by a grant from the elizabeth mccormick memorial fund to the united charities for the purpose of conducting such a school on the roof of the mary crane nursery at hull house. this school was opened by the united charities in october with twenty-five carefully selected children, and was conducted throughout the following winter and spring with the co-operation of the board of education and the chicago tuberculosis institute. during the same winter the public school extension committee of the chicago women's club, co-operating with the board of education, established two classes for anaemic children in open window rooms--one in the moseley and one in the hamline school. here the regular regime was broken by a rest period, and lunches of bread and milk were served twice each day. "fresh air rooms," in which the windows were thrown wide open and the heat cut off, were also established for normal children in several rooms in the graham school. no attempt was made here to furnish lunches and no rest period was provided. there were, then, during the school year of 1909 and 1910, three distinct classes of children cared for by three distinct agencies--the classes for normal children in the low temperature rooms at the graham school; anaemic children, with rest period and two lunches, in the moseley and hamline open window rooms, and the roof school for tuberculous children, with specially provided clothing, sleeping outfits, three meals a day and medical and nursing attendance, at the mary crane nursery. the same condition existed throughout the following year--1910-11--with the addition of one open air school on the roof of the municipal bath building on gault court, given rent free by the city health department, and two open window rooms for anaemic children in the franklin school, all maintained by the elizabeth mccormick memorial fund. in 1911 the elizabeth mccormick memorial fund assumed the responsibility for all the open air school work carried on in the chicago public schools, and began the standardization of methods which should be employed in the conduct of such schools. through the initiative of the elizabeth mccormick memorial fund the chicago open air school work has been rapidly developed during 1912 and 1913, the program being along the line of additional roof schools for tuberculous children and an increasing number of open window rooms for anaemic children and children exposed to tuberculosis. in all this work the elizabeth mccormick memorial fund has had the co-operation of the board of education, the chicago tuberculosis institute and the municipal tuberculosis sanitarium. the board of education has supplied teachers and furnished rooms wherever there has been a distinct demand for such a provision. during the past two years the municipal sanitarium has made appropriations aggregating $12,000 to pay the cost of food for these schools, in addition to furnishing the necessary nursing service. at the present time four roof schools and sixteen open window rooms, with an enrollment of 500 pupils, are being maintained. for full information concerning the chicago open air school movement, see "open air crusaders," january, 1913, edition, published by the elizabeth mccormick memorial fund, 315 plymouth court, chicago; or write mr. sherman c. kingsley, director, elizabeth mccormick memorial fund, for more recent developments. * * * * * space will not permit a statement of the development of the open air schools in other cities in the united states since this movement was started in 1908. it is, however, encouraging to note what has been accomplished and the comprehensive plans which are being made to further this great movement for the good of the future citizens of america. [illustration] notes on tuberculin for nurses varieties of tuberculin--theories of tuberculin reaction--tuberculin tests. by theodore b. sachs, m. d. varieties of tuberculin and methods of preparation old tuberculin--t. announced by koch in 1890. tubercle bacilli of human origin. grown on beef broth containing 5% glycerine, 1% peptone, sodium chloride; growths 6 to 8 weeks. sterilized by steam one-half hour. evaporated (at a temp. not higher than 70â° c.) to 1/10 its volume. filtered. 1/2% carbolic acid added. let stand. filtered (porcelain filter). old tuberculin contains: 1. 40 to 50% glycerine (a small percentage of glycerine is evaporated) 2. 10% of peptones or albumoses 3. toxic secretions of the tubercle bacilli into the culture fluid, or such of them as are soluble in 50% glycerine 4. substances extracted from the bacterial bodies by the alkaline broth during the process of boiling and evaporation. appearance and characteristics: 1. a clear brown fluid 2. of syrupy consistency 3. mixes with water in all proportions without producing any turbidity 4. keeps indefinitely, but not advisable to use brands older than one year. boullion filtrate--b. f. denys--1907. method of preparation same as old tuberculin, with the exception of subjection to heat; b. f. is a filtered, unconcentrated culture. contains less peptone and less glycerine than old tuberculin. contains no substances extracted from tubercle bacilli by heat. some toxic substances may be more active (not having been subjected to heat). tuberculin ruckstand (residue)--t. r. announced by koch in 1897. ground, dried tubercle bacilli. distilled water added. centrifugalization. supernatant fluid removed (not to be used). sediment dried and ground; distilled water added; centrifugalization. fluid removed and _set aside_. sediment dried and ground again; distilled water added; centrifugalization. fluid removed and set aside. sediment dried and ground, etc., as above. the process continued until water takes up the sediment, then all the fluids set aside (except the first one) mixed together. glycerine 20% added. the mixture is t. r. koch was prompted by the following consideration in bringing out t. r.: he thought that the old tuberculin conferred only a toxic immunity, not bacterial. t. r. was supposed to confer bacterial immunity. each 1 cc. of t. r. contains 10 milligrams of dried bacilli. bacillen emulsion--b. e. announced by koch in 1901. finely powdered tubercle bacilli--1/2 gram. 50 cc. of water and 50 cc. of glycerine. all mixed together--prolonged shaking. b. e. is supposed to contain not only the extract of the body of the tubercle bacilli, as in t. r., but also its soluble products (which in the case of t. r. were discarded in setting aside the supernatant fluid). theories of tuberculin reaction _a_ robert koch ascribes the tuberculin reaction to the increased necrotic process around the tubercle, the histological changes consisting of hyperaemia, exudation and softening. _b_ ehrlich considers the formation of antibodies an essential feature in the mechanism of reaction. formation of antibodies takes place in the middle of the three layers encircling the tubercle, the layer damaged by toxins, but not yet rendered incapable of reaction. _c_ wassermann maintains that the antituberculin found in the tuberculous process draws the injected tuberculin out of the circulation to the tuberculous focus. the interaction that takes place between antituberculin and tuberculin results in formation of ferments which digest albumin, resulting in the softening of tissue. absorption of softened tissue causes fever. _d_ carl spengler--toxins in the blood of the tuberculous are kept in check by antibodies. injected tuberculin unites with antibodies, thus setting the toxins free. result--autointoxication. _e_ wolff-eisner--bacteriolysin is present in the organism of the tuberculous, as result of previous infection; bacteriolysin sets free the potent substances of the injected tuberculin; this acts on the body and the tuberculous focus, producing a reaction.[10] tuberculin tests i. subcutaneous (hypodermic); introduced by robert koch in 1890. ii. cutaneous; introduced by von pirquet in 1907. iii. conjunctival (ophthalmic); introduced about the same time by wolff-eisner and calmette in 1907. iv. percutaneous (inunction or salve); introduced by moro in 1908. v. intracutaneous (needle track reaction); introduced as a test by mantoux in 1909. described previously by escherich. i. subcutaneous tuberculin test 1. apparatus and solutions necessary: glass cylinder graduated to cc. 1 cc pipette graduated to 1/10 cc.[11] 10 cc pipette graduated to 1/10 cc.[12] hypodermic needle suited to the syringe. two or more 1/2 oz. bottles. 1/2% carbolic acid solution. normal salt solution. 1 cc. old tuberculin. 2. preparation of apparatus: glass apparatus, syringe and needles boiled before use. some keep needles and syringe in 95% alcohol. 3. making solutions: tuberculin no. i: tuberculin no. ii: label one bottle another _.1 cc. = 1 mg. t_ _.1 cc. = .1 mg. t_ no. i { put 0.1 cc. t in bottle no. i { add 9.9 cc. of 1/2% carbolic acid solution { put 1 cc. of tuberculin solution from no. ii { no. i into bottle no. ii { add 9 cc. of 1/2% carbolic solution in making dilutions you may use your syringe instead of pipette. dilutions can be kept _one week_ in a dark, cool place. discard turbid solutions. 4. preparation of the patient for the test: patient to keep quiet in bed, or reclining chair, for two or three days before injection. take temperature every two or three hours for two or three days (daytime). if the test is to be applied, highest temperature should not be above 99.1 f, by mouth, according to koch; not above 100 f, according to others. site of injection--back, below the level of the shoulder blades, alternately on the two sides. rub skin with ether or alcohol. an exact record of physical signs, _just before injection_, should be made by the physician. 5. time of injection: between 8 and 10 a. m. (bandelier and roepke). late in the evening, 9 or 10 p. m., or later (others). 6. dose: according to koch: begin with 1/2 mg., or 1 mg., according to condition of patient; give larger dose if no reaction. order of increase: 1 mg.; 5 mg.; 10 mg. (last dose repeated if necessary). interval between injections: two or three days. present usage: first dose in adults, 1/2 mg., or 1/5 mg., or smaller, according to physical condition. first dose in children: 1/10 mg., or 1/20 mg., or even smaller. thus, in adults: 1/2, or 1, 3, 5, 8, and rarely 10; in children: 1/10, 1/2, 1, 3. loewenstein and kaufmann's scheme: repetition of small dose, relying on exciting hypersensibility--2/10 mg.; in 3 days, 2/10 mg.; in 3 days, 2/10 mg.; in 3 days, 2/10 mg. some use 1/10 mg., or 3/4, or 1-1/4, in same way. this scheme is based on hypersensibility created by repetition of same dose in tuberculous subjects. scheme not used at present. some advise single dose: 3 or 5 mg., (on the ground that gradual increase of doses creates tolerance). 7. rules to follow in increasing dose: _a_ if no reaction with one dose, give a larger one next time, according to _b_. _b_ if temperature rises less than 1 degree f, repeat same dose; otherwise increase. _c_ avoid large doses in cases of weakness, nervous temperament, children, etc. in a majority of cases smaller doses suffice. 8. after injection: _a_ rest in reclining chair two or more days, unless severe reaction requires absolute rest in bed. _b_ take temperature every 2 or 3 hours for 2 or 3 days. 9. general reaction: _a_ rise of temperature. positive reaction, if temperature rises at least .5â° c. (.9â° f.), higher than previous highest temperature. degree of reaction according to bandelier and roepke: slight reaction if temp. rises to 38â° c. or 100.4â° f. moderate reaction if temp. rises to 39â° c. or 102.2â° f. severe reaction if temp. rises above 39â° c. or 102.2â° f. typical reaction temperature curve: rapid rise, slower fall, normal temperature after 24 hours. rise begins, in average case, 6 to 8 hours after injection (may begin within 4 hours or be delayed for 30 hours). acme of rise in 9 to 12 hours. duration of reaction, 30 hours or longer. rise, acme and duration of reaction vary. _b_ symptoms: may begin with rigor or chilliness, followed by feeling of warmth. following symptoms may be present: malaise, giddiness, severe headache, pain in limbs, pain in affected organ, palpitation, loss of appetite, nausea, vomiting, thirst, sleeplessness, lassitude, etc.; in short, a general feeling of "illness." with fall of temperature--disappearance of symptoms. 10. reaction at point of injection: area of redness, swelling, tenderness; important as indicative of sensitiveness, pointing to probable general reaction with repetition or increase of dose. 11. focal reaction: reaction at site of process, due to congestion around it. focal reaction is demonstrable by: _a_ change in physical signs; breath sounds, resonance, appearance of rales, etc. _b_ localizing symptoms, pointing to location of the tuberculous process. lungs--increase of cough, sputum, appearance of bacilli, pain in chest, etc. kidney--pain in the region of kidney, changes in urine findings, etc. joint--swelling, tenderness, etc. lupus--redness and exudation. focal reaction is an important feature of the subcutaneous tuberculin test; it permits localization of the disease in a certain percentage of cases. physical examination, sputum examination, urinalysis, etc., are very important _during the course of the reaction_. 12. contraindications: subcutaneous tuberculin test should not be employed in: 1. cases with temperature above 100â° f, by mouth (99.1â° f, by mouth, according to koch). 2. cases in which the clinical history and physical signs make the diagnosis certain (presence of tubercle bacilli in the sputum render, of course, any other test unnecessary). 3. cases of recent haemoptysis. 4. grave conditions, as severe heart disease, nephritis, marked arteriosclerosis, etc. 5. convalescence from acute infectious diseases, typhoid fever, pneumonia, etc. 13. interpretation of the positive subcutaneous tuberculin reaction: occurrence of reaction, following the subcutaneous tuberculin test, signifies the _existence of infection_; it does not signify that the individual is _clinically tuberculous_. to quote e. r. baldwin, of saranac lake: "the tuberculin test is of very limited value in determining tuberculous _disease_; it is of extreme value in detecting tuberculous _infection_." the test results in positive reaction in cases with latent as well as active processes. the decision as to the patient being clinically tuberculous (ill with tuberculosis) must rest on the consideration of the clinical history and the results of the physical examination. it is maintained by some that the subcutaneous tuberculin reaction is _more rapid in onset_ and _more marked in degree_ in cases of _recent_ infection. on the other hand, the test is negative in a certain proportion of far advanced cases. occurrence, then, of a subcutaneous tuberculin reaction does not indicate necessarily sanatorium or institutional treatment; neither does it absolutely indicate the necessity of tuberculin treatment. the decision rests on the consideration of all the clinical features of the case. _in the absence of any symptoms or physical signs of disease_, a reaction should call for regulation of every day life, tending to increase the state of general resistance (improvement of nutrition, etc.) frequently without discontinuance of work. the occurrence of reaction, _in the presence of slight symptoms or physical signs_, calls, according to individual condition, either for home treatment with or without discontinuance of work, or sanatorium treatment. 14. indications for the subcutaneous tuberculin test: the following considerations should guide its employment: 1. a thorough study of the history, thorough physical examination, examination of sputum (if any) give sufficient data for a reliable diagnosis in the vast majority of cases. 2. cases, with uncertain symptoms or inconclusive physical signs, pointing to possible existence of tuberculous infection, may be treated as "suspicious" cases (without resorting to subcutaneous tuberculin test), the treatment consisting of rearrangement of mode of life, diet, work, etc., that would tend to increase of general resistance of the patient. this can and should be done in the vast majority of suspicious cases. 3. the subcutaneous tuberculin test is indicated in cases in which, in the absence of conclusive symptoms or signs, an absolutely positive diagnosis is desired; then the test should be applied, with the consent of the patient, _after all other methods of diagnosis are exhausted_ (thorough study of the case, thorough physical examination, repeated examinations of sputum, etc). 4. the focal reaction (the reaction pointing to the seat of the disease) occurs in about 1/3, or less, of the general reactions following the subcutaneous tuberculin test; this enhances the value of the test in some cases where a focal reaction would clear the diagnosis. above all, the subcutaneous tuberculin test should be used rarely, and then only after all other methods of diagnosis were thoroughly applied. ii. cutaneous tuberculin test 1. synonyms: von pirquet test or skin test 2. apparatus and dilutions necessary: inoculation needle of von pirquet koch's old tuberculin (undiluted or dilutions according to method). a centimeter tape measure (divided to 1/10 cm.) to measure reactions ether alcohol lamp medicine dropper 3. application of test: inner surface of the forearm; clean the site with ether; place two drops of tuberculin 4 inches apart; stretch the skin and scrape off the epidermis (at a point midway between the two drops of tuberculin) by rotating the von pirquet needle between thumb and index finger, with slight pressure on the skin; repeat same through the two drops of tuberculin; let the tuberculin soak in for a few minutes. no dressing is necessary. the middle scarification is the control test. one tuberculin and one control test may suffice. a separate needle should be used for the control test. after each inoculation, clean the needle of tuberculin and heat the point red hot in the alcohol flame before applying it again. 4. reaction: gradual elevation and reddening of skin around the point of tuberculin inoculation, beginning in 3 hours or later; the reaction (papule) well developed, generally, in 24 hours and most distinct in 48 hours after inoculation. size of papule varies from a diameter of 10 millimeters in the average case to 20 mm. occasionally, and 30, rarely (bandelier and roepke). at the end of 48 hours the swelling and redness subside gradually, with the subsequent bluish discoloration of the skin, remaining for various periods of time, and slight peeling of the epidermis. individual reactions vary in degree of redness, elevation, size, contour of the border, etc. all these points should be observed and recorded. time of inspection--24 and 48 hours after inoculation. single inspection--best time in 48 hours. 5. cause of reaction: interaction between inoculated tuberculin and the antibodies (bacteriolysins, according to wolff-eisner) present in the skin of a tuberculous individual; interaction results in hyperaemia and exudation (papule). 6. interpretation of reaction: occurrence of positive reaction signifies presence of a tuberculous focus somewhere in the body. no indication as to activity or location of the focus. a negative reaction in adults (especially if repeated) signifies non-existence of tuberculosis (unless great deterioration of health, far advanced process, or tolerance to tuberculin established by tuberculin treatment). a positive reaction in children under two years of age signifies, generally, active tuberculous process; with the advance of age the determination of active tuberculous processes by means of cutaneous tuberculin test becomes impossible. iii. conjunctival tuberculin test 1. synonyms: eye test; ophthalmic test; wolff-eisner's test; calmette's test. 2. apparatus and dilutions necessary: 1 cc. pipette graduated to 1/10 cc. 10 cc. pipette graduated to 1/10 cc. 10 cc. glass cylinder medicine dropper koch's old tuberculin 1/2% and 1% dilution of old tuberculin in .85% sterile normal salt solution. to make 1% dilution, add .1 cc. old tuberculin to 9.9 cc. of diluent. 3. application of test: patient sitting, with head thrown back lower eyelid drawn slightly down and toward the nose--to form a small pouch of the lid; one drop of 1% or 1/2% instilled in that pouch and the lower lid moved up gently over the eye until the lids meet; eye kept closed for one minute or so. 4. reaction: onset in 12 to 24 hours (may begin earlier); acme in 24 to 36 hours; duration of reaction--3 to 4 days or even longer (in severe cases). some reactions are of short duration. 3 grades of reaction, according to citron: 1. reddening of caruncle and palpebral (lid) conjunctiva. 2. more intense reddening, with involvement of ocular (eyeball) conjunctiva, and increased secretion. 3. very intense reddening of the whole conjunctiva, with much fibrinous and purulent secretion, etc. 5. time of inspection: 12 and 24 hours after instillation; then once a day. 6. cause of reaction: hyperaemia and exudation resulting from interaction between _instilled tuberculin_ and _antibodies in conjunctiva_ (bacteriolysin, according to wolff-eisner). 7. interpretation of reaction: wolff-eisner maintains that positive conjunctival tuberculin reaction means _active_ tuberculosis, a conclusion accepted by but a few. 8. field of application of conjunctival tuberculin test: _should not be used_; connected with _danger_ to the eye. conjunctival test used very rarely at present. iv. percutaneous tuberculin test 1. synonyms: salve test; moro test. 2. salve: equal parts of old tuberculin and anhydrous lanolin. 3. application of test: site: abdominal wall below ensiform process, _or_ breast below nipple, _or_ inner surface of forearm. application: rub in with the finger (using moderate pressure) a small particle of salve about the size of a pea. rub it in into an area about 5 cm.; rub 1 minute. 4. reaction: in 24 to 48 hours--_either_ numerous small reddened spots which disappear in a few days, _or_ numerous small nodules, _or_ coalescing nodules on a red base, etc. 5. interpretation of reaction: positive reaction is assumed to indicate existing tuberculous infection somewhere in the body; does not indicate that the process is active. 6. field of application of percutaneous tuberculin test: the percutaneous tuberculin test fails in a large proportion of tuberculosis cases. the test is used rarely at present. lignieres test a modification of the moro test instead of salve, a few drops of old tuberculin rubbed in. used rarely at present. v. intracutaneous tuberculin test 1. synonyms--mantoux test 2. application of test: injection into skin (needle parallel to skin) of 1/100 mg. of old tuberculin (according to mantoux). 3. reaction: onset in a few hours, well developed in 24 hours, acme in 48 hours. reaction consists of a central nodule surrounded by a halo of redness. this is the intracutaneous test as originally suggested by mantoux. conclusions comparing the various tuberculin tests we find that: 1 _the subcutaneous tuberculin test_ has the advantage of focal reaction, disclosing in a certain percentage of cases the seat of the disease. the subcutaneous test should, however, never be employed unless _as a last resort_, and then only after all other methods of diagnosis are exhausted and an absolute diagnosis is very essential. in the vast majority of suspected cases of tuberculosis, thorough study of the history of the case, combined with thorough physical examination, furnishes all the necessary data for diagnosis and an efficient plan of treatment. 2 _the cutaneous tuberculin test_ is a very efficient diagnostic measure in children under two years of age in whom a positive cutaneous tuberculin reaction indicates active disease. positive cutaneous tuberculin reaction in adults indicates existence of a tuberculous process, somewhere in the body; it does not indicate that the process is active. negative cutaneous tuberculin reaction is one of the corroborative evidences of absence of tuberculosis, unless reaction is prevented by very advanced disease or tolerance to tuberculin established by tuberculin treatment. 3 thorough study of the history and thorough physical examination of each individual case are more important and should precede the application of any test. footnotes: [1] for illustration, see knopf, "tuberculosis," chap. iv, page 67. [2] see carrington, "fresh air and how to use it," chap. ii, page 29. [3] for illustration, see carrington, "fresh air and how to use it," chap. ii, page 37. [4] for illustration, see carrington, "fresh air and how to use it," chap. viii, page 128. [5] for illustration, see knopf, "tuberculosis," chap. iv, page 58. [6] for illustration, see carrington, "fresh air and how to use it," chap. vii, page 108. [7] see previous footnote. [8] for illustration, see journal of outdoor life, january 1914. [9] for illustration, see carrington, "fresh air and how to use it," chap. iv, page 55. [10] for a diagrammatic presentation of wolff-eisner's theory, see "tuberculin treatment" by riviere and moreland, page 6. [11] not absolutely necessary: may get along with graduated cylinder and syringe. [12] see previous footnote. (end) * * * * * transcriber's amendments transcriber's note: blank pages have been deleted. paragraph formatting has been made consistent. the publisher's inadvertent omissions of important punctuation have been corrected. other changes are listed below. the listed source publication page number also applies in this reproduction except possibly for footnotes since they have been moved. page change 7 the acute inflamatory[inflammatory] at the beginning, 9 systematic treatment was underaken[undertaken]. 9 bodingon of sutton, coldfield[sutton coldfield], england, 10 the fundimental[fundamental] principle 19 fit to make to a printed questionaire[questionnaire]. 23 who visits the physican[physician] 28 tuberculosis sanitarium is extending sanatorum[sanatorium] care 35 [split first footnote into two.] 36 in the shelter of a strong windbrake[windbreak]. 43 makes a family, ordinnarily[ordinarily] 58 [split first footnote into two.] 58 hyperdermic[hypodermic] needle suited to the syringe 62 absence of conclusive symptons[symptoms] or signs, 62 (thourough[thorough][et seq.] study of the case, 63 all other methods of diagnosis were thouroughly[thoroughly] 63 from a diameter of 10 millimeters in [the] average case 66 [added (end).] on page 50 of the original publication, the following portion of a paragraph has two extraneous lines here marked in brackets: all of the cooking was done by the teacher. careful attention to [is given. children are weighed once in two weeks. instruction] [is chiefly practical. instruction in gardening is given twice a week] general cleanliness and hygiene of the teeth was insisted upon. individual drinking cups and tooth brushes were provided. the children took turns in washing dishes, setting the table and helping.... the extraneous lines are duplicates of lines further up the page and have been deleted. * * * * * alamo ranch _a story of new mexico_ by sarah warner brooks author of "my fire opal," "the search of ceres," etc. cambridge privately printed mcmiii university press . john wilson and son . cambridge . u.s.a. to leon _across the silence that between us stays, speak! i should hear it from god's outmost sun, above earth's noise of idle blame and praise,- the longed-for whisper of thy dear "well done!"_ [illustration: alamo ranch] alamo ranch _a story of new mexico_ chapter i it is autumn; and the last week in november. in new mexico, this land of sunshine, the season is now as kindly as in the early weeks of our northern september. to-day the sky is one cloudless arch of sapphire! the light breeze scarce ruffles a leaf of the tall alamo, the name tree of this ranch. here any holding bigger than a kitchen garden is known as a ranch. the alamo, spanish for poplar, lends here and there its scant, stiff shade to this roomy adobe dwelling, with its warm southern frontage and half-detached wings. behind the house irregular out-buildings are scattered about. a commodious corral, now the distinguished residence of six fine jersey cows, lies between the house and the orchard,--a not over-flourishing collection of peach, apricot, and plum trees. here and there may be seen wide patches of kitchen garden, carefully intersected by irrigating ditches. near and afar, wide alfalfa fields with their stiff aftermath stretch away to the very rim of the mesa, where the cotton-tail makes his home, and sage-brush and mesquite strike root in the meagre soil. cones of alfalfa hay stacked here and there outline themselves like giant beehives against the soft blue sky; and over all lies the sunny silence of a cloudless afternoon with its smiling westering sun. basking in this grateful warmth, their splint arm-chairs idly tilted against the house-front, the boarders look with sated invalid eyes upon this gracious landscape. alamo ranch is a health resort. in this thin, dry air of mesilla valley, high above the sea level, the consumptive finds his eldorado. hither, year by year, come these foredoomed children of men to fight for breath, putting into this struggle more noble heroism and praiseworthy courage than sometimes goes to victory in battle-fields. of these combatants some are still buoyed by the hope of recovery; others are but hopeless mortals, with the single sad choice of eking out existence far from friends and home, or returning to native skies, there to throw up hands in despair and succumb to the foe. sixteen miles away the organ mountains--seeming, in this wonderfully clear atmosphere, within but a stone's throw--loom superbly against the cloudless sky; great hills of sand are these, surmounted by tall, serrated peaks of bare rock, and now taking on their afternoon array in the ever-changing light, rare marvels of shifting color,--amethyst and violet, rosy pink, creamy gold, and dusky purple. the el paso range rises sombrely on the gray distance, and on every hand detached sugar-loaf peaks lend their magnificence to the grand mesa-range that cordons the mesilla valley. and now, out on the mesa, at first but a speck between the loungers on the piazza and the distant mountain view, a single pedestrian, an invalid sportsman, comes in sight. as he nears the ranch with the slowed step of fatigue, he is heartening himself by the way with a song. when the listeners hear the familiar tune,--it is "home, sweet home,"--one of them rallying his meagre wind whistles a faint accompaniment to the chorus. it is not a success; and with a mirthless laugh, the whistler abandons his poor attempt, and, with the big lump in his throat swelling to a sob, rises from his chair and goes dejectedly in. a sympathetic chord thrills along the tilted piazza chairs. the discomfited whistler is but newly arrived at alamo; and his feeble step and weary, hollow cough predict that the poor fellow's journey will not take him back to the "sweet home" of the song, but rather to the uncharted country. and now the invalid sportsman steps cheerily on the piazza. "here, you lazy folks," mocks he, holding high his well-filled game-bag, "behold the pigeon stew for your supper!" and good-naturedly hailing a mexican chore-boy, lazily propped by a neighboring poplar trunk, he cries, "catch!" and deftly tossing him the game (pigeons from the mesa) goes in to put away his gun. when later he returns to the piazza, bathed and refreshed, it is as if, in a room dim-lit by tallow candles, the gas had suddenly been turned on to a big chandelier. seating himself in the vacant arm-chair, he fills a briar-wood pipe. some of the loungers do likewise; and now, while they smoke and chat, look at the new-comer, leonard starr. though not robust, he has the substantial mien and bearing of one who finds it good to live, and makes those about him also find it good. it is not long before most of these dispirited loungers are laughing at his lively stories and sallies, and cheerily matching them with their own. well is it for this troublous world of ours that some of its children are "born to turn the sunny side of things to human eyes." chapter ii it is the middle of december; the alamo boarders are now well arrived. first and foremost, mr. john morehouse--the one lion of the ranch--makes his bow. he is conspicuous for his able research in archæology, and among his fellow boarders is familiarly known as "the antiquary." mr. morehouse has come to new mexico in the interest of science; he is not, however, a mere dry-as-dust collector of knowledge, and is very much inclined to unbend himself to the lighter moods and pursuits of his less scholarly fellow-men. this well-groomed, handsome man of forty is james morley of bangor. he has come to try this healing air for a slight, but persistent, lung affection. mr. morley is known to be a man of means, with all the advantages thus implied; but all the same, he is given to railing at most things under the sun; hence by the boarders he is surreptitiously dubbed "the grumbler." mr. morley's growl is a foregone conclusion, and one may safely reckon on his bark; but as for his bite, it is simply nowhere. already he has manifested a most considerate kindness for this gray-eyed little lady from marblehead, miss mattie norcross,--a sweet-mannered, quiet gentlewoman, who is currently reported as scant of filthy lucre, and hence compelled to content herself with a cramped, inexpensive bedroom for herself and her invalid sister, who has one hopelessly diseased lung. this cheery-faced irishman, who with his shy little wife is, for a stubborn bronchial trouble, making the grand tour of the world's health resorts, and is now trying new mexico, is, strange as it may seem, a methodist minister. his name is patrick haley. it may be said of mr. haley that he has the genial temperament indigenous to green erin, and he has already won golden opinions at alamo ranch by the considerate brevity of his grace before meat. among the invalids attended by their wives are mr. bixbee, from ohio, and mr. fairlee, from new york city. mr. bixbee has been bidden by his medical dictator to repair his damaged vitality by rest and nourishing food. it is predicted that this surfeited "lunger," in escaping his scylla of consumption, bids fair to strand upon the charybdis of liver complaint, since mrs. bixbee, in her wifely zeal, not only plies him all day long with lunches, but makes night hideous by the administration of raw eggs throughout its drowsy hours. mr. roger smith, an over-worked harvard athlete, is taking as a restorative a lazy winter in this restful land. he has also other irons in the fire, of which, later, we shall hear more. roger smith is known in boston society as one having heaps of money, but badly off for pedigree. all the same, he is, in manner and appearance, a gentleman, and has distinctly the hall-mark of beacon hill. he is here known as the "harvard man." also, among the sound-lunged invalids, is mr. harry warren, a brilliant chicago journalist. mr. warren is taking a vacation in mesilla valley, where he is said to be collecting material for future articles, and possibly for a book. the browns have also two table-boarders from boston,--miss paulina hemmenshaw and her beautiful niece, louise, a superbly healthy brunette. their friend, mr. henry hilton, during an absence abroad, has lent for the winter to these ladies his toy ranch, with its aesthetically fashioned dwelling-house. the hemmenshaws dine and sup at alamo ranch, and the aunt, a cooking-school graduate, is known to make at hilton ranch for herself and niece wonderful blazer breakfasts, consisting mainly of dishes new-fangled of name, and eminently trying to mortal digestion. there are, besides, some half-dozen male lungers unaccompanied by friends; and two impecunious invalids to whom the kind-hearted landlord, george brown, allows bed and board in return for light-choring about the ranch. these latter are democratically counted in with the dining-room boarders. leon starr, by common consent the "star boarder" of alamo ranch, has already been presented to the reader. he has taken the large two-windowed room on the ground-floor commanding a glorious view of the distant organ mountains. after getting his breath in this unaccustomed altitude, leon's next care has been for the depressed lungers who daily gather on the boarding-house piazza and wonder if life is still worth living. to get them outside themselves by cheery good-fellowship, to perform for them little homely services, not much in the telling, but making their lives a world easier, has been a part of his method for uplifting their general tone. of an inventive turn of mind, and an amateur mechanic, he has brought with him a tiny tool chest; and it soon becomes the family habit to look to leon starr for general miscellaneous tinkering, as the mending of door and trunk locks, the regulating watches and clocks, the adjustment of the bedevilled sewing-machine of their good landlady, and the restoration of harmonious working to all disgruntled mechanical gear, from garret to cellar. he it is who, on rainy days, manufactures denim clothes-bags for clumsy-fingered fellows; who fashions from common canes gathered on banks of irrigating ditches, photo-frames for everybody, and shows them how to arrange the long cane tassels with decorative effect above door and window, and how to soften the glare of kerosene lamps by making for them relieving shades of rose-colored paper. pessimistic indeed is that lunger who, succumbing to the charm of this gracious nature, does not feel the cheery lift in his heavy atmosphere. from the landlord and his wife, both worn by the strain of doing their best for chronically discontented people, down to fang lee, the chinese chef, dennis kearney, the table-waiter, the over-worked mexican house-maids, and the two native chore-boys--one and all rise up to call the star boarder blessed. out on the mesa the air is finer and brighter than on the lower plane of the ranch, and full of the life and stir of moving things,--quail, rabbits, and doves. leon had at first found the thin air of this altitude somewhat difficult; but since time and use have accustomed his lungs to these novel atmospheric conditions, shooting on the mesa has become a part of his daily programme, and his quail, rabbits, and pigeons prove a toothsome contribution to the already excellent ranch table. a small, shy mexican herd-boy, pasturing his lean goats on the mesa, gradually makes friends with the tall, kindly sportsman. as they have between them but these two mutually intelligible words, _bueno_ (good) and _mucho calor_ (very warm), their conversation is circumscribed. kind deeds are, however, more to the point than words, and go without the saying; and when leon instructed the ragged herd-boy in the use of his bow, and made and weighted his arrows for him, he _understood_, and became his devoted henchman, following in his path all through the week-day tramps, and on sundays coming to the ranch with clean face and hands to adore his fetich, and watch, with admiring eyes, his novel works and ways. chapter iii after a protracted interval of tranquil sunshine, a stormy wind came blustering from the west, bringing to mesilla valley, in its wintry train, sunless days, light flurries of snow, and general dreariness. the boarders, weather-bound and dull, grew sullenly mutinous; and on the third of these stormy days, gathering in the ranch parlor after the mid-day meal, their discontent found vent in banning right and left this "land of sun, silence, and adobe." "beastly weather!" muttered the grumbler, drawing into the stove with a discontented shiver. "a precious sample, this, of your fine climate, brown," jeered bixbee, turning mockingly to the disheartened landlord, who, reckless of expense, commanded of the chore-boy fresh relays of fuel, and incontinently crammed the parlor air-tight, already red-hot. "i say, fellows," drolled the harvard man, "let's make tracks for boston, and round up the winter with furnace heat and unlimited water privileges, as the house-broker has it." "and with cut-throat plumbers thrown in," suggested the grumbler with a malicious grin. "see here, you folks, draw it mild," laughed the star boarder, crossing the room with a finger between the leaves of a volume which he had been reading by the dim afternoon light of this lowering day. "here, now, is something that fits your case to a t. let me read you how they doctored your complaint in these parts, æons before you were born." "anything for a change," muttered bixbee, and, with the general consent, leon read the following: "'when the people came out of the cold, dark womb of the underworld, then the great sun rose in the heavens. in it dwelt payatuma, making his circuit of the world in a day and a night. he saw that the day was light and warm, the night dark and cold. hence there needed to be both summer and winter people. "'he accordingly apportioned some of each to every tribe and clan, and thus it is down to the present day. then those above (that is, the sun-father and the moon-mother), mindful lest the people on their long journey to the appointed abiding-place succumb to weariness and fall by the way, made for them a koshare, a delight-maker. his body was painted in diagonal sections of black and white, and his head, in lieu of the regulation feather-decorations, was fantastically arrayed in withered corn-leaves. "'this koshare began at once to dance and tumble. then the people laughed, and were glad. and ever from that day, in their wanderings in search of a satisfactory settling-place in the solid centre of the big weary world, the koshare led them bravely and well. "'he it was who danced and jested to make happiness among the people. his it was to smile on the planted maize till it sprouted and flowered in the fertile bottoms, to beam joyously on the growing fruit, that it might ripen in its season. "'from that day there have been delight-makers in all the pueblo tribes. the koshare became in time with them an organization, as the free-masons, or the knights of pythias, with us. this necessity, we are told, arose from the fact that among the pueblos there were summer people who enjoy the sunshine, and winter people,--people who determinedly prefer to live in the dark and cold.' "is it not so," said leon, turning down a leaf and closing his book, "with every people on the face of the earth? "is not the 'delight-maker,'--the koshare,--under various names and guises, still in demand? it has struck me," continued he, looking quizzically at this disgruntled assemblage, "that the koshare might be an acceptable addition to our despondent circle." "amen!" fervently responded the methodist minister. "right you are," said the harvard man. "write me as one who approves the koshare!" "yes! yes!" eagerly exclaimed approving voices. "let us have the koshare here and at once!" "a capital move," said miss paulina hemmenshaw (born and reared in the climatic belt of clubdom, and regent of a chapter of daughters of the revolution). "let us have a koshare club." "good!" echoed mrs. fairlee, among her intimates surnamed "the pourer," because of her amiable readiness to undertake for her friends the helpful office that among afternoon tea-circles has been distinguished by that name. "we might give afternoon teas to the members." "and why not have recitations, with humorous selections?" bashfully suggested the gray-eyed school-mistress, who rejoiced in a fine-toned voice and in a diploma from the school of oratory. "yes, indeed; and music, acting, and dancing, and all manner of high jinks," exclaimed miss louise, who, an accomplished musician, and distinguished for her amateur acting, with her superb health and unfailing flow of spirits, might be counted in as a born koshare. "and we might unite improvement with diversion, and have, now and then, a lecture, to give interest to our club," suggested mrs. bixbee; and here she looked significantly at mr. morehouse, "the antiquary," who as a lecturer was not unknown to fame. "lectures," observed the minister, "though not strictly kosharean, would be highly entertaining, and we can, no doubt, count upon our friend, mr. morehouse, to give us the result of some of his research in mexican antiquities." the antiquary, with a smile, accepted the part assigned him by his fellow-boarder. here the boarders went to supper, after which the more sleepy sought their beds. the evening blew stormily in; but, gathered about the centre table in the warm parlor, the leading spirits of alamo ranch bade the storm go by, while they inaugurated the club of the new koshare. the star boarder was chosen president. the minister was elected vice-president, miss paulina secretary, and the harvard man treasurer. these preliminaries well arranged, a programme was voted on, and by general approval carried. mrs. fairlee--the pourer--was to give to the club-members a weekly afternoon tea. an entertainment open to the entire household was, on every thursday evening, to be given in the ranch dining-room by the koshare, consisting of music, tableaux, and recitations. a shooting-match, under the direction of leon, was to come off weekly on the grounds of the establishment. there should be among the clubbists a fund collected for magazines; and on fortnightly saturday evenings mr. morehouse promised to give them lectures, the result of his antiquarian researches in mexico, new and old; and during this course papers and talks relating to this subject should supplement his own. "the pueblo," commented the grumbler, "would not have found magazines strikingly kosharean; let us by all means have them," and suiting deed to word, he subscribed to the book-fund on the spot, and paid surreptitiously the subscription of the little school-ma'am, who had previously withdrawn in the interest of her invalid sister. in this fashion was inaugurated "the new koshare" of mesilla valley; thereafter the hemmenshaws bundled themselves in winter wraps and, handed into their vehicle by the harvard man, set out in the storm for their ride to hilton ranch, and the koshare betook themselves to rest. chapter iv on the morrow the sun shone warm and bright, and on the mesa, and on all the desert-stretches of mesquite and sage-brush, on the broad alfalfa fields and outlying acres of alamo ranch, there was no longer a flake of snow. early in this sunny day the star boarder and the pourer, driven by a leisurely chore-boy, might have been seen taking their way to las cruces, the nearest village and postal centre, intent on the procurement of sundry wafers, biscuit, and other edibles pertaining to an afternoon tea. el paso, the texan border-town, some forty miles distant, is properly the emporium of that region. between it and las cruces lies a stretch of desert more barrenly forlorn than the long island pine-lands, since it is totally void of forest growth, and has but here and there a sprinkle of mesquite-bushes about three feet in height, the rest being bare sand-ridges. at el paso one may ride in street cars, luxuriate in rain-proof dwellings, lighted by electricity, and pretty with lawns and flower-pots. but even at its best, modern civilization, with its push and bustle, ill becomes the happy-go-lucky native mexican sunning himself in lazy content against the adobe of his shiftily built dwelling. in a land of well-nigh perpetual blue sky, why need mortal man scramble to make hay while the sun shines? yesterday has already taken care of itself. to-day is still here, and always there is _mañana_--to-morrow. as for our own upstart civilization, in this clime of ancient pueblo refinements one must own that it takes on the color of an impertinence, and as incongruously exhibits itself as a brand-new patch on a long-worn garment. but to return to las cruces, which is "fearfully and wonderfully made." to look at the houses one might well fancy that the pioneer settlers had folded their hands and prayed for dwellings, and when the answering shower of mud and adobe fell, had contentedly left it where it stuck. all these structures are one-storied, and square-built; each has its one door, a window or two, and a dumpy roof, fashioned for the most part of wattles, for, as it seldom rains here, the las crucean has no troublesome prejudice in favor of water-tight roofs. when the sun shines he is all right; and when it rains, he simply moves from under the drip. here, among confectionery that had long since outlived its desirability, among stale baker's cookies and flinty ginger snaps, the koshare commissariat foraged discouragedly for the afternoon tea. duly supplied with these time-honored sweets, leon and the pourer, thus indifferently provisioned, turned their faces homeward, at such moderate pace as seemed good in the eyes of an easy-going mexican pony and his lazy indian driver. on the afternoon of that day mrs. bixbee, in her airy bed-chamber, where the folding-bed in the day-time masqueraded as a black walnut bookcase, gave the first koshare afternoon tea. mrs. fairlee poured from a real russian samovar brought over from the hilton ranch for this grand occasion. somewhat to the general surprise, the grumbler made his bow to the hostess in evening clothes, and though not exuberantly koshare, he was in an unwontedly gracious mood; partaking with polite zest of the stale chocolates, tough cookies, and flinty ginger snaps; munching long-baked albert biscuit; serenely bolting puckery oolong tea; and even handing the cups,--large and substantial ones, kindly furnished from their landlady's pantry,--and commending their solidity and size as far preferable to the dresden and japanese "thimbles" commonly appearing on afternoon tea-tables. as for the pourer, it must be recorded that her grace, facility, and charm of manner gave even stone china tea-cups an air of distinction, and lent to oolong tea and stale cakes a flavor of refinement. it was on monday that this function came off successfully. the next koshare festivity in regular order was the shooting-match. leon, who had inherited from some nimrod of his race, long since turned to dust, that _true eye_ and steady hand which make gunning a success, was here master of ceremonies as well as contributor of prizes. the first of these, a pair of gold sleeve-links, he, himself, easily won, and subsequently donated to dennis the dudish table-waiter. of the five prizes, two others were won by the two impecunious lungers, one by the harvard man, and another by the antiquary. the shooting-match, enjoyed as it was by the near population of mesilla valley, proved a big success, and weekly grew in grace with the aborigines as having a fine flavor of circus shows and mexican bull-fights, and was considered by the koshare as one of their happiest hits. equally successful was the thursday entertainment, held in the big dining-room, under the auspices of the landlord and his wife, with the cook, waiter, maids, and chore-boys gathered about the open door. it consisted of vocal and instrumental music, and recitations in prose and rhyme; and, at a late hour, wound up with a bountiful supper contributed to the occasion by the generous landlord. miss hemmenshaw, the star performer, gave, with admirable rachelesque gesture and true dramatic fire, "the widow of the grand army," recited with exquisite delicacy shelley's "cloud," and sent shivers down the backs of the entire assemblage, by a realistic presentation of rossetti's "sister helen." the grey-eyed school-marm recited with genuine "school of oratory" precision and finish "barbara frietchie," holmes' "chambered nautilus," longfellow's "sandalphon," and "tom o'connor's cat." leon read, with admirable humor, some of mr. dooley's best; and the harvard man brought down the house with kipling's "truce of the bear." there was some fine piano and banjo playing, and the singing of duets; and the journalist rendered, in his exquisite tenor, ben jonson's rare old love-song, "drink to me only with thine eyes." "strange," commented the antiquary (who in his miscellaneous mental storage had found room for some fine old elizabethan plays), turning to miss hemmenshaw in the pause of the song, "ben jonson is dust these three hundred years, and still his verses come singing down the ages, keeping intact their own immortal flavor. the song-maker's is, indeed, an art that 'smells sweet, and blossoms in the dust.' well might they write him, 'o rare ben jonson.'" "and how exquisitely," responded the lady, "is the air married to the words!" and now the minister brought forward his cremona. he was a finished violinist, with a touch that well-nigh amounted to genius. all praised his performance. at its close the grumbler, in an aside to the antiquary, thus delivered himself:-"to _some_, god giveth common-sense; to _others_, to play the fiddle!" from the entry audience the fiddler won rousing rounds of applause, and dennis, the waiter, ventured on the subdued shuffle of an irish jig. this it was that suggested to the koshare an impromptu dance, and thereupon the young people straightway took the floor. the minister, kindly oblivious of his cloth, fiddled on; miss paulina called off the figures, and so, merrily, ended the first koshare evening entertainment. chapter v as it is not proposed to give this record of the doings of the "new koshare" the circumstantiality of a diary, the chronicler may be allowed to include the ensuing teas, shooting-matches, and all the lighter kosharean festivities in the one general and final statement, that they each came off duly and successfully; and leaving their details "unhonored and unsung," proceed to a more extended account of the saturday evening entertainments,--as all members of the club were invited to contribute to these evenings, and it was expected that the minister would, from the storehouse of his travelling experience, contribute liberally to their delectability; and that the journalist (who naturally thought in paragraphs, and, like the fairy who "spoke pearls," conversed in exquisitely fashioned sentences) would supplement the papers of the antiquary by his own brilliant talks. and so it was that on the initial saturday evening, with a full attendance and great expectations, the koshare found themselves convened, the president in the chair, the secretary with notebook in hand, and all in dignified attention. the antiquary--with this apt quotation from cumming's "land of poco tiempo"--began his first lecture before the club. "'new mexico,'" quoted he, "'is the anomaly of the republic. it is a century older in european civilization than the rest, and several centuries older still in a happier semi-civilization of its own. it had its little walled cities of stone before columbus had grandparents-to-be; and it has them yet.' "there are," stated mr. morehouse, "three typical races in new mexico. the american interpolation does not count as a type. "of pueblo indians there are nine thousand, 'peaceful, home-loving, and home-dwelling tillers of the soil.' then, here, and in arizona, there are about twenty thousand navajo indians,--nomad, horse-loving, horse-stealing vagrants of the saddle, modern centaurs. then come the apaches, an uncounted savage horde, whose partial civilization has been effected by sheer force of arms, and inch by inch: who accept the reservation with but half a heart, and break bounds at every opportunity. last of all come the mexicans, shrunken descendants of the castilian world-finders; living almost as much against the house as in it; ignorant as slaves, and more courteous than kings; poor as lazarus, and more hospitable than croesus; and catholics from a to izzard. "the navajos and apaches," said mr. morehouse, "have neither houses nor towns; the pueblos have nineteen compact little cities, and the mexicans several hundred villages, a part of which are shared by the invader. "'the numerous sacred dances of the pueblos,' says cummings, 'are by far the most picturesque sights in america, and the least viewed by americans, who never found anything more striking abroad. the mythology of greece and rome is less than theirs in complicated comprehensiveness; and they are a far more interesting ethnological study than the tribes of inner africa, and less known of by their white countrymen.' "the pueblos of new mexico," explained the antiquary, "are by no means to be confounded with the toltecs or aztecs. it is, however, barely possible that in prehistoric ages the race in possession of mexico may have had some tribal characteristics of the latter-day pueblo. as of that remote time, there is not even a traditionary record; this supposition is absolutely conjectural. "by investigation and comparison it has, however, been proved that the pueblos have racial characteristics connecting them with some mysterious stage of human life even older than that of the more barbarous toltecs or aztecs. "this race has from time immemorial had its book of genesis. it is not, like that of the hebrew, a written record, but has been orally handed down, and with careful precision, beginning with their original emergence, as half-formed human beings, from the dark of the mystic underworld of 'shipapu' to the world of light. "after the fashion of most barbarous races, the pueblo appears originally to have 'pitched his moving tent' in various parts of mexico; and it may be inferred that he endured many casualities before settling himself in life. it was to tide over this trying epoch in his existence that 'those above,' according to tradition, made for the tribes that quaint 'delight-monger,' with whom we have already made acquaintance, who led them in their wanderings from the womb of shipapu to the solid centre of their world; but, as has been already stated, this record, going back to an indefinite period of time, and having only the dubious authority of folk-lore, is only of traditional value. "the pueblo, no less than the aztec, is the most religious of human beings. his ceremonial, like that of the age of montezuma, is wonderfully and minutely elaborated; and though originating in a civilization less splendid and refined, it is really less barbarous, since its rites have never, like those of the aztec, included the horrors of human sacrifice and cannibalism. "the pueblo, since his exit from the womb of mother earth, seems to have given his principal attention to the cultivation of its soil. all the same, he appears never to have shirked the less peaceful responsibilities of his tribe,--putting on his war-paint at the shortest notice, to settle the quarrels of his clan. "although like most men of savage birth and breeding, cruel in warfare, he seems never to have been abstractedly blood-thirsty, never to have killed, like his ever-belligerent neighbor, the apache, purely for killing's sake; but, his quarrel once ended, and the present security of his clan well achieved, he has contentedly returned to the peaceful ways of life; diligently sowing, weeding, and harvesting his crops of maize, melons, squashes, and beans, and--ever mindful of the propitiative requirements of 'those above'--taking careful heed of his religious duties. "for a succinct account of the pueblo cave (or cliff) dwellers," said the antiquary, "i am largely indebted to bandelier, from whose valuable pueblo researches i shall often take the liberty to quote. "the imperfectly explored mountain range skirting the rio grande del norte is picturesquely grand. "facing the river, the foundation of the chain is entirely volcanic. "colossal rocks form the abrupt walls of the gorges between these mountains, and are often so soft and friable that, in many places they were easily scooped out with the most primitive tools, or even detached with the fingers alone. "in these gorges, through many of which run unfailing streams of water, often expanding to the proportions of regular valleys, the pueblo indian raised the modest crop that satisfied his vegetable craving. "as it is easier to excavate dwellings than to pile up walls in the open air, the aboriginal mexican's house-building effort was mostly confined to underground construction. he was, in fact, a 'cave-dweller,' yet infinitely of more advanced architectural ideas than our own remote forbears of anglo saxon cave-dwelling times. "most of these residences might boast of from three to four rooms. they were arranged in groups, or clusters, and some of them were several stories high. "rude ladders were used for mounting to the terrace or roof of each successive story. the pueblo had, literally, a hearthstone in his primitive home. his fireplace was supplied with a hearth of pumice-stone. a rudely built flue, made of cemented rubble, led to a circular opening in the front wall of his cave-dwelling. air-holes admitted their scanty light to these dusky apartments, in which there were not only conveniences for bestowing wearing-apparel, but niches for ornamental pottery, precious stones, and the like indian bric-à-brac. the ground-floor entrance was a rude doorway closed by a hide, or mat. plaited mats of yucca leaves, and deer-hide, by day rolled up in corners of the sleeping-apartments, served for mattresses at night. a thick coating of mud, washed with blood, and carefully smoothed, gave to the floor a glossy effect. some of the rooms are known to have been in dimension ten feet by fourteen. their walls were whitewashed with burnt gypsum. "though the time when these traditional cliff-dwellers wooed and wed, lived and died in the rialto vale is long, long gone by, the ruins of their homes may still be seen. some of them are tolerably intact; others are crumbled away to mere shapeless ruins. "and now, having described their dwellings, let us note some of the most marked and interesting characteristics of the men and women who made in them their homes. "we are apt," said the antiquary, "to accord to our more enlightened civilization the origin of communism; yet, antedating by ages our latter-day socialistic fads, the communal idea enthused this unlettered people, and to a certain extent seems to have been successfully carried out. "let not the strong-minded anglo-saxon woman plume herself upon the discovery of the equality of the sexes. while our own female suffragists were yet unborn, the pueblo wife had been accorded the inalienable right to lord it over her mankind. "among the mexican cliff-dwellers, 'woman's rights' seem to have been as indigenous to the soil as the piñon and the prickly pear. "in the primitive pueblo domicile, the wife appears, by tribal consent, to have been absolutely 'cock of the walk.' the husband had no rights as owner or proprietor of the family mansion, and, as an inmate, was scarcely more than tolerated. "the wife, in those ever-to-be-regretted days, not only built and furnished the house,--contributed to the kitchen the soup pot, water jars, and other primitive domestic appliances,--but figured as sole proprietor of the entire establishment. "the pueblo woman, though married, still had, with her children, her holding in her own clan. in case of her death, the man's home being properly with _his_ clan, he must return to it. "the wife was not allowed to work in the fields. each man tilled the plot allotted him by his clan. the crops, once housed, were controlled by the woman, as were the proceeds of communal hunts and fisheries. "the pueblos had their system of divorce. it goes without saying that it was not attended by the red-tape complications of our time. as the husband's continuance under the family roof-tree depended absolutely on his acceptability to the wife, at any flagrant marital breach of good behavior she simply refused to recognize him as her lord. in vain he protested, stormed, and menaced; the outraged better half bade him _go_, and he _went_! thus easily and informally were pueblo marriages dissolved; and, this summary transaction once well concluded, each party had the right to contract a second marriage. "the pueblo indian is historically known as a catholic; that is to say, he told his beads, crossed his brow with holy water, and duly and devoutly knelt at the confessional. this done, he tacitly reserved to himself the privilege of surreptitiously clinging to the paganism of his forbears, and zealously paid his tithe of observances at the ancient shrine of 'the sun father' and 'the moon mother.' "some of the pueblo tribes are said still to retain the use of that ancient supplicating convenience, 'the prayer-stick.' "'prayer-sticks, or plumes,'" explained the antiquary, "are but painted sticks tufted with down, or feathers, and, by the simple-minded indian, supposed especially to commend him to the good graces and kindly offices of 'those above.' in a certain way, the aboriginal prayer-stick seems to have been a substitute for an oral supplication. "the pueblo, pressed for time, might even forego the hindering ceremonial of verbal request, adoration, or thanksgiving, and hurriedly deposit, as a votive offering to his easily placated gods, this tufted bit of painted wood; and, furthermore, since prayer-sticks were not always within reach, it was permitted him in such emergencies to gather two twigs, and, placing these crosswise, hold them in position by a rock or stone. and this childish make-shift passed with his indulgent gods for a prayer! "the most trivial commonplace of existence had, with the superstitious pueblo, its religious significance; and it would seem to have been incumbent on him literally to 'pray without ceasing.' hence the prayer-plume, or its substitute, was, with him, one of the necessities of life. time would fail me to tell of the ancient elaborate religious rites and superstitions of the mexican indian; to recount his latter-day ceremonials, wherein pagan dances, races, and sports are like the jumble of a crazy quilt, promiscuously mixed in with christian festas and holy saint-days; and indeed the subject is too large for my sketchy handling. it may not, however, be amiss to notice the yearly celebration of the festival of san estevan. it may be still witnessed, and seems to have been the original harvest-home of the mexican indian, the observance of which has been handed down in various ways from all times, and among all peoples, and is probably the parent of our thanksgiving holiday. "the monks of the early catholic church, in their missionary endeavor to commend the christian religion to the pagan mind, took care to graft upon each of the various festas of the pueblo one of their own saint-day names. thus it was that the acoma harvest-home masquerades under the guise of a saint-name, though an absolutely pagan ceremonial. "it is still observed by them with genuine koshare delight. there are dances, races, and tumbling, and the carnival-like showering of mexican confetti from the roofs of adobe houses. in summing up this brief account of the sedentary new mexican, i quote literally the forceful assertion of cummings. 'the pueblos,' says this writer, 'are indians who are neither poor nor naked; who feed themselves, and ask no favors of washington; indians who have been at peace for two centuries, and fixed residents for perhaps a millennium; indians who were farmers and irrigators, and six-story housebuilders before a new world had been beaten through the thick skull of the old. they had,' he continues, 'a hundred republics in america centuries before the american republic was conceived.' "this peaceably minded people, as has already been stated, are by no means to be confounded with the roving new mexican aborigines, with the untamed navajo scouring the plains on the bare back of his steed, or the fierce apache, murderous and cruel. "we must not," said mr. morehouse, "take leave of the pueblo, without some reference to the great flat-topped, slop-sided chain of rock-tables that throughout the length and breadth of his territory rises from the sandy plains, the most famous and best explored of which is known as 'la mesa encantada,'--'the enchanted mesa.' "according to tradition the mesa encantada gains its romantic name from an event which centuries ago--declares the legend--destroyed the town, then a well-populated stronghold of the acomas. as a prelude to this legend, let me state that the pueblo cliff-dwellers often perched their habitations on lofty, sheer-walled, and not easily accessible mesas, a natural vantage-ground from which they might successfully resist their enemies, the nomadic and predatory tribes formerly over-running the country. "the steep wall of the acoma mesa, with its solitary trail, surmounted by means of hand and foot holes pecked in the solid rock, was so well defended that a single man might keep an army at bay. what fear, then, should these acomas have of their enemies? "the acomas, like other pueblo indians, have from time immemorial been tillers of the soil. "from the fertile sands of their valley and its tributaries they won by patient toil such harvests of corn, beans, squashes, and cotton as secured them a simple livelihood; and 'their granaries,' it is asserted, 'were always full enough to enable them, if need be, to withstand a twelvemonth's siege.' how long the top of katzimo, the site of the enchanted mesa, had been inhabited when the catastrophe recorded in the legend befell, no man may say, not even the elders of the tribe; this much is, however, known,--the spring-time had come. the sun-priest had already proclaimed from the housetops that the season of planting was at hand. the seeds from last year's harvest had been gathered from the bins; planting-sticks had been sharpened, and all made ready for the auspicious day when the seer should further announce the time of repairing to the fields. on that day (so runs the tale), down the ragged trail, at early sunrise, clambered the busy natives; every one who was able to force a planting-stick into the compact soil, or lithe enough to drive away a robber crow, hurried to the planting. only a few of the aged and ailing remained on the mesa. "while the planters worked in the hot glare of the valley below, the sun suddenly hid his face in angry clouds. the busy planters hastened their work, while the distant thunder muttered and rolled about them. suddenly the black dome above them was rent as by a glittering sword, and down swept the torrent, until the entire valley became a sheet of flood. the planters sought shelter in the slight huts of boughs and sticks from which the crops are watched. "the elders bodingly shook their heads. never before had the heavens given vent to such a cataract. "when the sudden clouds as suddenly dispersed, and the sun-lit crest of katzimo emerged from the mist, the toilers trudged toward their mountain home. reaching the base of the trail, they found their pathway of the morning blocked by huge, sharp-edged pieces of stone, giving mute testimony of the disaster to the ladder-trail above. "the huge rock mass, which had given access to the cleft by means of the holes pecked in the trail-path, had in the great cloud-burst become freed from the friable wall, and thundered down in a thousand fragments, cutting off communication with the mesa village. the acomas, when asked why their ancestors made no desperate effort to reach the sufferers whose feeble voices were calling to them from the summit for succor, but left their own flesh and blood to perish by slow starvation, gravely shook their heads. "the ban of enchantment had already, for these superstitious pagans, fallen upon the devoted table-land; it had become 'la mesa encantada.' "the publication by mr. charles f. lummis, who resided for several years at the pueblo of iselta, of the story of katzimo, the tradition of which was repeated to him by its gray-haired priests some twelve years ago, aroused the interest of students of southwestern ethnology in the history of 'la mesa encantada,' and, subsequently, mr. f. w. hodge was directed by the bureau of american ethnology, of the smithsonian institute, to scale the difficult height of this giant mountain, for the purpose of supplementing the evidence already gained, of its sometime occupancy as a pueblo town. his party found decided evidence of a former occupancy of the mesa, such as fragments of extremely ancient earthenware, a portion of a shell bracelet, parts of two grooved stone axes, lichen-flecked with age. here, too, was an unfeathered prayer-stick, a melancholy reminder of a votive offering made, at the nearest point of accessibility, to 'those above.' "'when i consider,' says mr. hodge, in his charming paper, 'the enchanted mesa,' published in the 'century magazine,' some three or four years ago, 'that the summit of katzimo, where the town was, has long been inaccessible to the indians, that it has been swept by winds, and washed by rains for centuries, until scarcely any soil is left on its crest, that well-defined traces of an ancient ladder trail may still be seen pecked on the rocky wall of the very cleft through which the traditionary pathway wound its course; and, above all, the large number of very ancient potsherds in the earthy talus about the base of the mesa, which must have been washed from above, the conclusion is inevitable that the summit of 'la mesa encantada' was inhabited prior to 1540, when the present acoma was discovered by coronado, and that the last vestige of the village itself has long been washed or blown over the cliff.'" with this account of the enchanted mesa, mr. morehouse, amid general applause, ended his interesting paper on the pueblo indians; and after a short discussion by the club of the ancient and modern characteristics of these remarkable aborigines, the koshare, well pleased with the success of its endeavor to combine improvement with delight, adjourned to the next monday in january. little dreamed roger smith as, that night, after the club entertainment, he handed the hemmenshaw ladies to their wagon, for the return ride to hilton ranch, that the very next week he was to undertake, on their behalf, a hand-to-hand encounter with a blood-thirsty apache. yet so was it ordained of fate. it has already been stated that these ladies were but day-boarders at alamo ranch, occupying, together with sholto, a mexican man-of-all-work, the hilton ranch, a good mile distant from the boarding-house. louise hemmenshaw, usually in exuberant health, was ill with a severe influenza. it was the third and cumulative day of this disease. sholto had already been despatched to brown's for the dinner; miss paulina had, in this emergency, undertaken to turn off the breakfasts and suppers from her chafing-dish. after replenishing, from the wood basket, the invalid's chamber fire, miss paulina administered her teaspoonful of bryonia, gave a settling shake to her pillow, and hurried down to fasten the back door behind sholto. lingering a moment at the kitchen window, the good lady put on her far-off glasses for a good look across the mesa, stretching--an unbroken waste of sage-brush and mesquite-bush--from the hilton kitchen garden to the distant line of the horizon. as she quietly scanned the nearer prospect, miss paulina's heart made a sudden thump beneath her bodice, and quickened its pulses to fever-time; for there, just within range of her vision, was the undoubted form of an apache savage, clad airily in breech-clout, and navajo blanket. skulking warily along the mesa, he gained the garden fence and sprang, at a bound, over the low paling. for a moment the watcher stood paralyzed with wonder and dismay. meantime, under cover of a rose-trellis, the apache, looking bad enough and cunning enough for any outrage, coolly made a reconnoisance of the premises. this done, still on all-fours, he gained the bulkhead of the small dark vegetable cellar beneath the kitchen. it chanced to have been inadvertently left open. with a satisfied grunt (and eschewing the paltry convenience of steps) he bounded at once into its dusky depths. summoning her failing courage, this "daughter of the revolution" resolutely tiptoed out the front door, and, with her heart in her mouth, whisking round the corner of the devoted house, shot into place the stout outside bolt of the bulkhead door. this feat accomplished, she made haste to gain the safe shelter of the adobe dwelling. she next looked well to the bolt fastening the trap-door at the head of the ladder-like stairway leading perilously from the kitchen to the dim region below, where the apache might now be heard bumping his head against the floor-planks, in a fruitless endeavor to discover some outlet, from this underground apartment, to the family circle above. with the frightful possibility of a not distant escape of her prisoner, the good lady lifted her heart in silent prayer, and hurrying promptly to the chamber of her niece, gave a saving punch to the fire, a glass of port wine to the invalid, and, feigning an appearance of unconcern, left the room, and slipped cautiously down to the kitchen. here she dragged an ironing-table, a clothes-horse, and a wood-box on to the trap-door, and breathlessly waited for the apache's next move. and now, a step might be heard on the driveway, followed by a rap at the front door. prudently scanning her visitor through the sidelight, and assuring herself that he was no breech-clouted savage, but a fellow white man, miss paulina let in through the narrowest of openings,--who but their friend the harvard man! "dear soul!" tearfully exclaimed the good lady, while roger smith stood in mute wonder at the warmth of her greeting. it was but the work of a moment to explain the situation and acquaint him with the peril of the moment. sholto, at his leisurely mexican pace, now opportunely appeared at the back door with the hot dinner. "there is a time for all things," said the "president of chapter 18th," as (having pulled the bewildered mexican inside) she vigorously shot the door-bolt in place, deposited the smoking viands on the sideboard, and thus addressed him. "sholto," said miss paulina, "i have an apache here in the cellar. for the time being his ability to work us harm is limited; but an apache is never nice to have round; and, besides, he must have terribly bumped himself poking round there all this time in the dark. one would not unnecessarily hurt even a savage. we must therefore let him up, bind him fast, and take measures for delivering him to the police at las cruces. here is a clothes-line: it is good and strong; make up a lasso, and when i open the trap-door, as his head bobs in sight, throw it, and then help mr. smith haul him out, and tie him." sholto's lasso was soon in working order. the trap-door once raised, the head of the unsuspecting savage flew up like a jack in a box, and with such a rubber-like bound that sholto's lasso went wide of the mark. in this dilemma, a scientific blow from the fist of a harvard athlete deftly floored him, and, in the consequent lapse of consciousness, he was easily bound, and safely deposited in the bottom of the hilton express wagon. this accomplished, sholto and the harvard man summarily took the road for las cruces, some four miles distant. the horse and his driver being in absolute accord as to the ratio of miles proper to the hour, the captors drove leisurely along; the harvard man meantime relieving the slow monotony of the way, with incident and anecdote, and sholto, in turn, imparting much interesting new-mexican information. presently a faint stir, as of the quiet, persistent nibbling of a mouse in the wall, might (but for the talking) have been heard from the bottom of the wagon. "poor beggar!" said the harvard man, at last recalling to mind the captive apache; "he must, by this time, be about ready to come to." and taking from his over-coat pocket a tiny flask of brandy, he turned on his seat with the humane intention of aiding nature in bringing about that restoration. "gone! clean gone! by george!" exclaimed the astonished athlete. the cunning savage had, with his sharp, strong teeth, actually gnawed through his wrist cords, and, with tooth and nail extricating himself from the knotted clothes-line, was already on his return from the unsatisfactory husks of mesilla valley, to the fatted veal of the u. s. government, in his father's house,--"the reservation." "_they are fleet steeds that follow!_" quoted the harvard man as the jubilant apache, with flying heels, loomed tantalizingly on the distant plain. the startled cotton-tail, swept by "the wind of his going," scurried breathlessly to his desert fastnesses among the sage-brush and mesquite. with a humorous glance at his fast-vanishing form, the harvard man measured with his eye the intervening distance, the speed of the escaped captive, and the pace of the propeller of the hilton express, and gracefully accepted the situation. sholto lazily turned the horse's head, and in process of time the discomfited captors of miss paulina's apache--like john gilpin- "where they did get up did get down again." meantime, miss hemmenshaw brought up the mid-day meal. "auntie," said the invalid, "this feverish cold puts queer fancies in my head. while you were away, i must have taken a little nap, and when i awoke there seemed to be some sort of a rumpus going on below; after which i fancied that a team started away from the back door. it could not have been sholto's; for he would be coming from brown's about that hour with our dinner." "it may have been just a part of your dream, dear," pacified the aunt; "but come, now, here is our dinner. let us have it together. a wonderfully nice dinner mrs. brown has sent us, too, and you can venture to-day on a quail, and a bit of orange pudding. for myself, i am as hungry as a bear;" and, removing the books from the oval bedroom table, miss paulina laid the cloth, set out the dishes and glasses, and daintily arranged the viands, which the two ladies discussed with evident relish. "and now," said the aunt, "since you have dined, and have something to brace you up, i will 'tell my experience;'" and forthwith she related to the astonished louise the adventure of the morning. the good lady had but accomplished her exciting account, when the valiant captors of the apache drove up. miss paulina, with the concentrated importance of her entire "chapter," met and opened the door to her hero. "well?" asked she of the crestfallen athlete. "no: ill!" replied he; "the apache never reached las cruces. he managed to unbind himself, and slipped from our hands by the way. the clothes-line has come back safe; but the savage is, long ere this, well on his road to the mescalero reservation." "well," said miss paulina, judicially, "i can't say that i'm sorry. the creature had a rough time bumping about that low, dark cellar; and your blow on his head was a tough one. and when one considers the slip-shodness of things at las cruces, and the possible insecurity of their jail, _we_, on the whole, are the safer for his escape; and _he_ will, of course, feel more at home now in the reservation, and will probably remain there for a while, after the fright we gave him." thus reassured, the harvard man accepted miss hemmenshaw's invitation to stay to supper. and presently the convalescing invalid came down to express her thanks for his devoir of the morning. reclining on the parlor lounge, in a cream-white tea gown, she looked so lovely that a man might well have dared a whole tribe of savages in her defence. by and by they had a quiet game of chess. it goes without saying that the lady won. there _might_ be men hard-hearted enough to beat louise hemmenshaw at chess. the harvard man was not _of_ them. so slipped away this happy afternoon; and, at sunset sholto appeared with the tea equipage, and the young people covertly made merry over a chafing-dish mess achieved by the cooking school pupil; and under cover of rarebit, water-biscuit, and cups of russian tea, the harvard man made hay for himself in this bit of sunshine, and grew in favor with both aunt and niece. with miss paulina hemmenshaw, true to her aristocratic birth and breeding, pedigree far out-weighed filthy lucre. to be well born was, in her estimation, to be truly acceptable to gods and men. roger smith, with his plebeian surname and unillustrious "tanner" grandfather, was by no means a suitable husband for her motherless niece, to whom, as the head of her brother's household, she had for years filled a parent's place. louise hemmenshaw, as the good lady shrewdly guessed, was the magnet that drew this undeclared lover to mesilla valley. during the preceding winter they had met at many social functions in boston and cambridge, and he had become the willing captive of her bow and spear. he had never told his love. the social discrepancy between the lovely aristocrat and roger--the grandson of roger the tanner--was too wide to be easily overstepped. ostensibly the harvard man had come to new mexico to recruit his spent energies; but in his heart of hearts he knew that dearer than health was the hope of winning the heart of louise hemmenshaw. already his native refinement and charm of manner had commended him to miss paulina; and now, his prowess in the day's adventure had made her, for good and all, his warm friend. as to her niece, he told himself, as, that night, by the light of a low moon, he took his way to alamo ranch, recalling the tender pressure of the invalid's white hand, when, with a rosy blush, she bade him good-night, that in his wooing he had to-day "scored one;" and with the confident egotism of presumptuous mortals, when events play unexpectedly into their hands, he decided that fate had prearranged this timely call of his on the hemmenshaws, and had timed the arrival of the apache at that opportune hour, with an especial view to the fulfilment of his own cherished wishes. chapter vi another two weeks of lighter koshare festivities had again brought round the more solid fortnightly entertainment of the club. its members duly assembled, the president in his chair, and the secretary at attention, mr. morehouse thus began his second paper. "before texas," said he, "became a part of an independent republic, and until after the mexican war (when we forced mexico to sell us all california, new mexico, and arizona, nearly all of utah and nevada, besides texas, and the greater part of colorado), mexico proper reached way up here; and it is thought by some archaeologists that the mesas or table-mountain land especially characterizing the new mexican landscape may have afforded the suggestion for the teocallis of the great pyramid-like mounds, with terraced sides, built by the aztecs. some scholars have even convinced themselves that the aztec culture must have originated here in the north. others wholly discard the conclusion. "mr. baxter, in his valuable and interesting book of mexican travel, says, decidedly, 'the new mexican indians were not aztecs, and montezuma had no more to do with new mexico than he did with new england.' and with this assertion i think we must all, perforce, agree. "of the toltecs, the probable predecessors in mexico of the aztecs, all written records," said the antiquary, "have long since perished. they are known to us only through traditionary legends orally handed down by the races that succeeded them. "they are said to have entered the valley of anahnac from a northerly direction, coming from a mysterious unknown region, and probably before the close of the seventh century. they appear to have been a far more gentle and refined nation than their immediate successors, the half-savage aztecs, who, at last, with their semi-civilization, dominated mexico. by general archæological agreement, the toltecs were well instructed in agriculture, and many of the most useful mechanic arts. "'they were,' declares prescott, 'nice workers in metals.' they invented the complex arrangement of time adopted by the aztecs, who are said to have been largely indebted to them for the beginnings of that incongruous civilization which reached its high-water mark in the reign of the montezumas. so late as the time of the spanish conquest the remains of extensive toltec buildings were to be found in mexico. "'the noble ruins of religious and other edifices,' says the same writer, 'still to be seen in mexico, are referred to this people, whose name, _toltec_, has passed into a synonym for _architect_.' "after a period of four centuries--having succumbed to famine, pestilence, and unsuccessful wars--this remarkable people disappeared from the land as silently and mysteriously as they had entered it. it is conjectured that some of them may have spread over the region of central america and the neighboring isles; and that the majestic ruins of mitla and paleque are the work of this vanished race. tradition affirms that a remnant of toltecs still lingering in anahnac 'gave points' to the next inhabitants; and the tezcucans are thought to have derived their gentle manners and comparatively mild religion from the handful of toltecs who still remained in the country. a spanish priest, with that keen relish for the marvellous common to his kind, accounts for this mysterious disappearance by supernatural stories of giants and demons. "according to good authorities, more than a hundred years elapsed between the strange disappearance of the toltecs from the land of anahnac and the arrival on its borders of the aztecs. "after the nomadic fashion of barbarous races, this people did not at once make a permanent settlement, but pitched their tents in various parts of the mexican valley, enduring many casualties and hardships, and being at one time enslaved by a more powerful tribe, whom their prowess subsequently dominated. "some of these wanderings and adventures are perpetuated in their oral traditional lore. "one of these legends is well substantiated, and current at this day, having been the origin of the device of the eagle and cactus, which form the arms of the present mexican republic, and may be found on the face of the mexican silver dollar. thus it runs: 'having in 1325 halted on the southwestern borders of the larger mexican lakes, the aztecs there beheld, perched on the stem of a prickly pear, which shot out from a crevice of a rock that was washed by the waves, a royal eagle of extraordinary size and beauty, with a serpent in his talons, and his broad wings open to the rising sun. "'they hailed the auspicious omen, which the oracle announced as an indication of the site of their future city.' "the low marshes were then half buried in water; yet, nothing daunted, they at once proceeded to lay the sloppy foundation of their capital, by sinking piles into the shallows. on these they erected the light dwelling-fabrics of reeds and rushes,--the frail beginnings of that solid aztec architecture carried to such elegant elaboration in the time of the montezumas. in token of its miraculous origin they called their city tenochtitlan. later it was known as mexico, a name derived from the aztec war-god, mexitil. "it has been shown that the aztec race, once permanently established in mexico, finally attained to a civilization far in advance of the other wandering tribes of north america. "'the degree of civilization which they had reached,' says prescott, 'as inferred by their political institutions, may be considered not far short of that enjoyed by our saxon ancestors under alfred. in respect to the nature of it, they may better be compared to the egyptians; and the examination of their social relations and culture may suggest still stronger points of resemblance to that ancient people. "'their civilization,' he goes on to say, 'was, at the first, of the hardy character which belongs to the wilderness. the fierce virtues of the aztec were all his own. they refused to submit to european culture--to be engrafted on a foreign stock. they gradually increased in numbers, made marked improvements both in polity and military discipline, and ultimately established a reputation for courage as well as cruelty in war which made their name terrible throughout the valley.' in the early part of the fifteenth century--nearly a hundred years after the foundation of the city--that remarkable league--of which it has been affirmed that 'it has no parallel in history'--was formed between the states of mexico and tezcuco, and the neighboring little kingdom of tlacopan, by which they agreed mutually to support each other in their wars, offensive and defensive, and that in the distribution of the spoil one-fifth should be assigned to tlacopan and the remainder be divided--in what proportions is uncertain--between the two other powers. "what is considered more remarkable than the treaty itself, however, is the fidelity with which it was kept. "during a century of uninterrupted warfare that ensued no instance, it is declared, occurred in which the parties quarrelled over the distribution of the spoil. by the middle of the fifteenth century the allies, overleaping the rocky ramparts of their own valley, found wider occupation for their army, and under the first montezuma, year after year saw their return to the mexican capital, loaded with the spoils of conquered cities, and with throngs of devoted captives. "no state was able long to resist the accumulated strength of the confederates; and at the beginning of the sixteenth century, on the arrival of the spaniards, the aztec dominion reached across the continent, from the atlantic to the pacific." here mr. morehouse ended his paper on the toltecs, and the koshare, with many thanks for his interesting account of these ancient races, supplemented his information by a general discussion of the genuineness of the accepted authorities for the early history of the aztecs and of the time of montezuma. "prescott," said the minister, "traces some points of resemblance between the history of the aztecs and that of the ancient romans; especially in polity and military success does he compare them." "unfortunately," observed the antiquary, "the earlier records of the mexican people can only be scantily gleaned from oral tradition and hiero-graphical paintings." "later, however," remarked the journalist, "we have the seemingly more definite and reliable accounts of the spanish chronicles." "these," returned the minister, "being usually ecclesiastic, have warped their record to suit their own bigoted views; consequently, much of the narrative popularly known as mexican history is to be taken with more than the proverbial pinch of salt." "it has," said the journalist, "been urged by realistic critics of our own fascinating historian--prescott--that since he drew his historic data, with the exception of the military record of the spaniards, from these unreliable sources, his history is little other than the merest romance. plainly, the assertions of some of the chroniclers are scarce more worthy of credence than the equally fascinating adventures of sinbad the sailor, and the impossible stories of baron munchausen. 'bernard diaz'--that enigmatical personage from whom many of prescott's data are drawn--tells us that the aztecs actually fattened men and women in cages, like spring chickens, for their sacrifice, and asserts that at the dedication of one of their temples a procession of captives two miles long, and numbering seventy-two thousand persons, were led to sacrifice! by the way, it has, however, been latterly proved that the so-called sacrificial stone, now exhibited in the national museum of mexico, is not a relic of the aztecs, but of the earlier toltecs (who were not addicted to human sacrifice), and is as innocent of human blood as the calendar stone, referred to the same period. the critics of diaz have detected in his account constant blunders in many important matters, and his glaring geographical errors would seem to prove that, though he claims to have been, all through the conquest, the very shadow of hernando cortez, he has never even been in the country he describes!" "from what i have read of bernald," said leon, "i think we may finish him off with 'betsy prig's' very conclusive objection to sairey gamp's 'mrs. harris'--there ain't no sich person!" "even so," exclaimed the minister, "i, for one, agree with certain downright critics who contend that diaz was a pure fabrication, a priestly scheme of the roman church to screen the cruel enormities of their agent, cortez. father torquemada, another of prescott's authorities, is thought to be scarcely more reliable. las casas, another of our historian authorities, whose history was, at the time, promptly suppressed by the all-powerful inquisition, declares these spanish histories of the conquest to be 'wicked and false.'" "and yet, in spite of these strictures," contended leon, "i, for one, still pin my faith to prescott and his implicit honesty of purpose. he gave us, in his own learned and fascinating way, the narrative of these priestly chroniclers as he found it. if the chroniclers lied, why, so much the worse for the chroniclers." "lying," complained the grumbler, "is a malady most incident to historians;" and thereupon rose to open the parlor door for the gray-eyed school teacher, who just then bade the koshare good-night, adding that she had already been too long away from her sister. and now the chairman announced the next paper in the koshare course for the second saturday in february, and the members, one and all, dispersed. sholto, roused from a most enjoyable series of naps, brought his wagon to the side door, and with a friendly grasp from the hand of miss paulina, and a shy, tremulous clasp from that of her niece, the harvard man saw the ladies off. chapter vii february had come, bringing in its train such weather as verified the warmest praise of new mexico's perfect climate. it was on one of its most spring-like afternoons that a walking party of eight set out to pay a long-proposed visit to the ladies at hilton ranch. as the little party went gayly along the mesa, leon, carrying his gun, shot doves for the evening meal, while the rest walked on, chatting merrily. the ladies talking over, by the way, the late attempt of the apache on hilton ranch, mrs. bixbee declared herself curious to see the cellar in which miss paulina had caught that prowling savage. on their arrival that good lady, informed of this desire, kindly proceeded to gratify her guest, and the entire party was presently led by her to the kitchen, the hero of this adventure modestly walking beside the fair lady of his love. sholto, busied about the place, was just then out of call, and miss hemmenshaw, intent to afford them a peep into the cellar, begged the harvard man to raise for her the heavy trap-door. the dear lady never quite knew how it was that, leaning forward, she lost her balance, and, but for the prompt help of roger smith, might have landed, pell-mell, on the cellar bottom; or how, in rescuing her, he himself made the misstep that, ere he could recover his poise, threw him to the end of the ladder-like cellar stairs. recovering breath, roger smith cheerily called up to the affrighted group at the top, "all right!" but, on pulling himself together to make the ascent, he suddenly found all wrong. he had sprained his ankle; and it was with painful effort that he won to the top. at this juncture sholto, aroused by the unwonted rumpus, made his appearance, anticipating no less a disaster than the reappearance of the slippery savage, for whom he still held the lasso "in pickle." disabled by the sprain, the harvard man submitted himself to the stout arms of the mexican, and, by miss paulina's direction, was carried into the bedroom adjoining the ranch parlor. there, laid upon a movable couch which served the double purpose of sofa and bed, sholto having, not without difficulty, removed his boot and stocking, he submitted the swollen foot to the careful inspection of miss hemmenshaw, who, with a steadiness of nerve not unworthy of her "chapter," put the dislocated joint in place, bandaged the injured member with arnica, administered an internal dose of the same restorative, and duly followed it with a glass of old port. this done, sholto wheeled the sufferer's couch into the adjoining parlor. half an hour later leon came in with a well-filled game-bag; and after an hour of mild koshare merriment, in which the athlete but feebly joined (the pain of his ankle was still terrible), the little party took its way, in the fading sunlight, to alamo ranch. miss paulina, having promptly decided that her patient was unequal to the return by way of the jolting hilton express team, sent to mrs. brown an order for supper for her guest, louise, and herself. it was duly conveyed to hilton's by an alamo chore-boy. sholto, as the sole male dependence of hilton's, must stick to his post; for, sagely observed the "daughter of the revolution," two women, heroic though they might be, were no match for an apache marauder; and as for poor roger smith, he could now neither "fight" nor "run away." sholto lighted the lamps, laid the supper on the low queen anne table, added fresh water from the spring, and when a pot of tea had been made by the hostess' own careful hand, and sholto had wheeled up the couch of the invalid, that he might take his supper _à la roman_, the three made a cheery meal. when the man had removed the supper things, and piled fresh wood on the andirons, the ladies brought their work-baskets; and while they busied themselves with doily and centre-piece, the harvard man, lying in the comfort of partial relief from pain, watched the dainty fingers of louise hemmenshaw as she bent industriously over her embroidery, and fell fathoms deeper in love with the dear and beautiful girl. roger smith stayed on at hilton ranch, where, thrown day after day in semi-helplessness on the kind attendance of miss paulina and the sweet society of her niece, he (i grieve to say) fell a ready prey to the suggestions of a certain wily personage who (according to dr. watts) finds employment for idle hands, and thus conceived the wickedness of cunningly using this accident to further his own personal ends. thus devil-tempted, this hitherto upright young person resolved that it should be a long day before his sprained ankle should permit him to return to brown's, and lose this precious opportunity of establishing himself in the good graces of the aunt, and winning the love of the niece. far from approving the crooked policy which led roger smith to feign lameness long after the injured ankle had become as sound as ever, the present historian can only, in view of this lapse from integrity, affirm with widow bedott that "we're poor creeturs!" and, with that depreciative view of humanity, go on with this truthful narrative. a whole delicious month had been passed by the harvard man in this paradise,--elysian days, while, waited on by sholto, petted by miss paulina, and companioned by the loveliest of houris, he dreamed out his dream. at last, on a certain decisive evening, roger smith found himself alone in the gloaming with louise hemmenshaw. the aunt, who through all these weeks had zealously chaperoned her niece, had passed into the dining-room to evolve some chafing-dish delicacy for the evening meal. without, the setting sun flooded all the west with gold, touched the distant mountain peaks with splendor, and threw a parting veil of glory over the wide mesa. within, the firelight made dancing shadows on the parlor wall, where the pair sat together in that eloquent silence so dear to love. "well," said the athlete to himself (compunctiously glancing at his superfluous crutches, left within easy reach of his hand), "this performance can't go on forever. i have made believe about long enough; what better may i do than own up this very night, and somehow bring this base deceit to an end." mentally rehearsing the formula, in which, over and over, he had asked the hand of this beautiful aristocrat, his mind still sorely misgave him. "why," thought this depressed lover, "was not my name winthrop, endicott, or sturgis, instead of smith; and my grandfather a senator, a judge, or even a stockbroker, rather than a tanner?" neither miss paulina nor her brother, he discouragedly mused, would ever countenance this unequal match. his millions would with them weigh nothing against "the claims of long descent." the sun had gone down, the after-glow had faded to gray. they were still alone. the firelight half revealed the lovely figure beside the hearth. in that gown of golden-brown velvet, with the creamy old lace at wrists and throat, the brown hair combed smoothly from the white forehead, knotted behind and fastened with a quaint arrow of etruscan gold, louise hemmenshaw was simply adorable! it was indeed good to be here; and why should not a life so sweet and satisfying go on indefinitely? "it is four weeks to-day since i fell down cellar,"--such was the commonplace beginning to this much considered tale of love. "really?" said the lady, looking innocently up from an absorbed contemplation of the fender. "it has not seemed so long. i never before realized what a serious thing it is to sprain one's ankle. you have been a most patient sufferer, mr. smith; and, indeed, for the past two weeks, a most jolly one. aunt paulina was saying to-day that it was high time we all went back to alamo for our meals, and helped out the koshare doings of the club." "dear miss hemmenshaw," here blurted out the culprit, "do not despise me for my meanness, since it is all for love of you that i have been shamming lameness. for these last two weeks i could at any time have walked as well as ever." and, hereupon, without the slightest reference to his crutches, he rose from his chair and skipped over to her side. "a sprain," explained this audacious lover, "may be cured in a fortnight, but it takes a good month to woo and win a fair lady. having soon after my accident decided that point, i have done my best. tell me, dear louise," pleaded he, "that my time has been well spent. say that, deceitful ingrate though i am, you will take me, for good and all." "roger smith," replied the lady, with much severity, "you have repaid the devoted care of two unsuspecting females by a whole fortnight of wilful duplicity. for my aunt i cannot answer; for myself, i can only reply,--since to err is human; to forgive, womanlike,--dear roger, on the whole, i will." miss paulina, a moment later entering the parlor, surprised her invalid guest, standing crutchless on his firm feet, with his arm thrown about the waist of her niece. "well, well!" exclaimed the astonished lady, "and without his crutches!" "dear miss paulina," said roger smith with a happy laugh, "my ankle is as well as ever; and your niece has promised to marry me. say that you will have me for your nephew." "i seem already to have gotten you, my good sir, whether i will or no," laughed miss hemmenshaw. "but, my stars and garters" (mentally added she), "what ever will my brother say? a tanner's grandson coming into the family! and he a hemmenshaw, and as proud as lucifer!" "never mind, auntie dear," said the smiling fiancée, guessing her thoughts. it will be all right with father when he comes to know roger; and besides, let us remember that under the 'star spangled banner' we have our 'vanderbilts,' our 'goulds,' and our 'rockefellers;' but _no_ vere de veres. and if we _had_, why, love laughs at heraldry, and is "'its own great loveliness alway.'" "to-morrow," said miss paulina decisively, "we will all dine at alamo ranch." chapter viii through this month of wooing and betrothing at hilton ranch, the koshare, at alamo, never once remitted its endeavor to hearten the despondent. the weekly entertainments took their regular course, and were successfully carried on, and, in due time, the fortnightly club convened to listen to the antiquary's account of "montezuma and his time." and here the koshare chronicle returns on its track to record that able paper. "as a consistent koshare," said mr. morehouse, to his eager listeners, "it behooves me to give--without that dry adherence to facts observed by the 'gradgrind' historian--the charming melodramatic details of that romantic monarch's life and times afforded by the popular munchausen-like data of the spanish chroniclers, albeit they have in their entirety, all the fascination, and, sometimes, all the unbelievableness of a fairy tale. "the aztec government," prefaced the antiquary, "was an elective monarchy, the choice always restricted to the royal family. "the candidate usually preferred must have distinguished himself in war; though, if (as in the case of the last montezuma) he was a member of the priesthood, the royal-born priest, no less than the warrior was, with the aztec, available as an emperor. "when the nobles by whom montezuma the second was made monarch went to inform the candidate of the result of the election, they are said to have found him sweeping the court of the temple to which he had dedicated himself. it is further asserted that when they led him to the palace to proclaim him king, he demurred, declaring himself unworthy the honor conferred on him. it is a humiliating proof of the weakness of human nature in face of temptation, to find that, later, this pious king so far forswore his humility as to pose before his subjects as a god; that five or six hundred nobles in waiting were ordered to attend daily at his morning toilet, only daring to appear before him with bared feet. "it was not until, by a victorious campaign, he had obtained a sufficient number of captives to furnish victims for the bloody rites which aztec superstition demanded to grace his inauguration, that--amidst that horrible pomp of human sacrifice which stained the civilization of his people--montezuma was crowned. "the mexican crown of that day is described as resembling a mitre in form, and curiously ornamented with gold, gems, and feathers. "the aztec princes, especially towards the close of the dynasty, lived in a barbaric oriental pomp, of which montezuma was the most conspicuous example in the history of the nation. "elevation, like wine, seems to have gone to the head of the second montezuma. "an account of his domestic establishment reads like the veriest record of midsummer madness. four hundred young nobles, we are told, waited on the royal table, setting the covers, in their turn, before the monarch, and immediately retiring, as even his courtiers might not see montezuma eat. having drunk from cups of gold and pearl, these costly goblets, together with the table utensils of the king, were distributed among his courtiers. cortez tells us that so many dishes were prepared for each meal of this lordly epicure, that they filled a large hall; and that he had a harem of a thousand women. his clothes, which were changed four times a day (like his table service), were never used a second time, but were given as rewards of merit to nobles and soldiers who had distinguished themselves in war. if it happened that he had to walk, a carpet was spread along his way, lest his sacred feet should touch the ground. his subjects were required, on his approach, to stop and close their eyes, that they might not be dazzled by his effulgent majesty. his ostentatious humility gave place to an intolerable arrogance. he disgusted his subjects by his haughty deportment, exacting from them the most slavish homage, and alienating their affection by the imposition of the grievous taxes demanded by the lavish expenditure of his court. "in his first years montezuma's record was, in many respects, praiseworthy. he led his armies in person. the aztec banners were carried far and wide, in the furthest province on the gulf of mexico, and the distant region of nicaragua and honduras. his expeditions were generally successful, and during his reign the limits of the empire were more widely extended than at any preceding period. "to the interior concerns of his kingdom he gave much attention, reforming the courts of justice, and carefully watching over the execution of the laws, which he enforced with stern severity. "like the arabian ruler,--haroun alraschid, of benign memory,--he patrolled the streets of his capital in disguise, to make personal acquaintance with the abuses in it. he liberally compensated all who served him. he displayed great munificence in public enterprise, constructing and embellishing the temples, bringing water into the capital by a new channel, and establishing a retreat for invalid soldiers in the city of colhuacan. "according to some writers of authority there were, in montezuma's day, thirty great caciques, or nobles, who had their residence, at least a part of the year, in the capital. "each of these, it is asserted, could muster a hundred thousand vassals on his estate. it would seem that such wild statements should be 'taken with a pinch of salt.' all the same, it is clear, from the testimony of the conquerors, that the country was occupied by numerous powerful chieftains, who lived like independent princes on their domains. it is certain that there was a distinct class of nobles who held the most important offices near the person of their emperor. "in montezuma's time the aztec religion reached its zenith. it is said to have had as exact and burdensome a ceremonial as ever existed in any nation. 'one,' observes prescott, 'is struck with its apparent incongruity, as if some portion had emanated from a comparatively refined people, open to gentle influences, while the rest breathes a spirit of unmitigated ferocity; which naturally suggests the idea of two distinct sources, and authorizes the belief that the aztecs had inherited from their predecessors a milder faith, on which was afterwards engrafted their own mythology.' the aztecs, like the idolaters to whom paul preached, declaring the 'unknown god' of their 'ignorant worship,' recognized a supreme creator and lord of the universe. "in their prayers they thus addressed him: 'the god by whom we live, that knoweth all thoughts, and giveth all gifts;' but, as has been observed, 'from the vastness of this conception their untutored minds sought relief in a plurality of inferior deities,--ministers who executed the creator's purposes, each, in his turn, presiding over the elements, the changes of the seasons, and the various affairs of man.' of these there were thirteen principal deities, and more than two hundred inferior; to each of whom some special day or appropriate festival was consecrated. "huitzilopotchli, a terrible and sanguinary monster, was the primal of these; the patron deity of the nation. the forms of the mexican idols were quaint and eccentric, and were in the highest degree symbolical. "the fantastic image of this god of the unpronounceable name was loaded with costly ornaments; his temples were the most stately and august of their public edifices, and in every city of the empire his altars reeked with the blood of human hecatombs. "his name is compounded of two words, signifying 'humming-bird' and 'left;' from his image having the feathers of this bird on his left foot. "thus runs the tradition respecting this god's first appearance on earth: 'his mother, a devout person, one day, in her attendance on the temple, saw a ball of bright-colored feathers floating in the air. she took it and deposited it in her bosom, and, consequently, from her, the dread deity was in due time born.' he is fabled to have come into the world (like the greek goddess, minerva) armed _cap-à-pie_ with spear and shield, and his head surmounted by a crest of green plumes. "a far more admirable personage in their mythology was quetzalcoatl, god of the air; his name signifies 'feathered serpent' and 'twin.' during his beneficent residence on earth he is said to have instructed the people in civil government, in the arts, and in agriculture. under him it was that the earth brought forth flower and fruit without the fatigue of cultivation. "then it was that an ear of corn in two days became as much as a man could carry; and the cotton, as it grew beneath his fostering smile, took, of its own accord, the rich dyes of human art. "in those halcyon days of quetzalcoatl all the air was sweet with perfumes and musical with the singing of birds. "pursued by the wrath of a brother-god, from some mysterious cause unexplained by the fabler, this gracious deity was finally obliged to flee the country. on his way he is said to have stopped at cholula, where the remains of a temple dedicated to his worship are still shown. "on the shores of the mexican gulf quetzalcoatl took leave of his followers, and promising that he and his descendants would revisit them hereafter, entered his 'wizard skiff,' and embarked on the great ocean for the fabled land of tlapallan. "the mexicans looked confidently for the second coming of this benevolent deity, who is said to have been tall in stature, with a white skin, long, dark hair, and a flowing beard. undoubtedly, this cherished tradition, as the chroniclers affirm, prepared the way for the reception of the spanish conquerors. "long before the landing of the spaniards in mexico, rumors of the appearance of these men with fair complexions and flowing beards--so unlike their own physiognomy--had startled the superstitious aztecs. the period for the return of quetzalcoatl was now near at hand. the priestly oracles were consulted; they are said to have declared, after much deliberation, that the spaniards, though not gods, were children of the sun; that they derived their strength from that luminary, and were only vulnerable when his beams were withdrawn; and they recommended attacking them while buried in slumber. this childish advice, so contrary to aztec military usage, was reluctantly followed by these credulous warriors, and resulted in the defeat and bloody slaughter of nearly the whole detachment. "the conviction of the supernaturalism of the spaniard is said to have gained ground by some uncommon natural occurrences, such as the accidental swell and overflow of a lake, the appearance of a comet, and conflagration of the great temple. "we are told that montezuma read in these prodigies special annunciations of heaven that argued the speedy downfall of his empire. "from this somewhat digressive account of the aztec superstition, in regard to the 'second coming' of their beneficent tutelar divinity, which, as may be seen, played into the hands of cortez, and furthered his hostile designs upon mexico, let us return to the time in aztec history when no usurping white man had set foot upon montezuma's territory. "we are told that this people, in their comparative ignorance of the material universe, sought relief from the oppressive idea of the endless duration of time by breaking it up into distinct cycles, each of several thousand years' duration. at the end of each of these periods, by the agency of one of the elements, the human family, as they held, was to be swept from the earth, and the sun blotted out from the heavens, to be again freshly rekindled. with later theologians, who have less excuse for the unlovely superstition, they held that the wicked were to expiate their sins everlastingly in a place of horrible darkness. it was the work of a (so-called) christianity to add to the aztec place of torment the torture of perpetual fire and brimstone. the aztec heaven, like the scandinavian valhalla, was especially reserved for their heroes who fell in battle. to these privileged souls were added those slain in sacrifice. these fortunate elect of the aztecs seem to have been destined for a time to a somewhat lively immortality, as they at once passed into the presence of the sun, whom they accompanied with songs and choral dances in his bright progress through the heavens. after years of this stirring existence, these long-revolving spirits were kindly permitted to take breath; and thereafter it was theirs to animate the clouds, to reincarnate in singing birds of beautiful plumage, and to revel amidst the bloom and odors of the gardens of paradise. "apart from this refined elysium and a moderately comfortable hell, void of appliances for the torture of burning, the aztecs had a third place of abode for immortals. thither passed those 'o'er bad for blessing and o'er good for banning,' who had but the merit of dying of certain (capriciously selected) diseases. these commonplace spirits were fabled to enjoy a negative existence of indolent contentment. 'the aztec priests,' says prescott, 'in this imperfect stage of civilization, endeavored to dazzle the imagination of this ignorant people with superstitious awe, and thus obtained an influence over the popular mind beyond that which has probably existed in any other country, even in ancient egypt.' "time will not permit here a detailed account of this insidious priesthood; its labored and pompous ceremonial; its midnight prayers; its cruel penance (as the drawing of blood from the body by flagellation, or piercing of the flesh with the thorns of the aloe), akin to the absurd austerities of roman catholic fanaticism. the aztec priest, unlike the roman, was allowed to marry, and have a family of his own; and not _all_ the religious ceremonies imposed by him were austere. many of them were of a light and cheerful complexion, such as national songs and dances, in which women were allowed to join. there were, too, innocent processions of children crowned with garlands, bearing to the altars of their gods offerings of fruit, ripened maize, and odoriferous gums. it was on these peaceful rites, derived from his milder and more refined toltec predecessors, that the fierce aztec grafted the loathsome rite of human sacrifice. "to what extent this abomination was carried cannot now be accurately determined. the priestly chroniclers, as has been shown, were not above the meanness of making capital for the church, by exaggerating the enormities of the pagan dispensation. scarcely any of these reporters pretend to estimate the yearly human sacrifice throughout the empire at less than twenty thousand; and some carry the number as high as fifty thousand. a good catholic bishop, writing a few years after the conquest, states in his letter that twenty thousand victims were yearly slaughtered in the capital. a lie is brought to absolute perfection when its author is able to believe it himself. "torquemada, another chronicler, often quoted by prescott, turns this into twenty thousand _infants_! "these innocent creatures, he tells us, were generally bought by the priests from parents poor enough and superstitious enough to stifle the promptings of nature, and were, at seasons of drought, at the festival of haloc, the insatiable god of the rain, offered up, borne to their doom in open litters, dressed in festal robes, and decked with freshly blown flowers, their pathetic cries drowned in the wild chant of the priests. it is needless to add that this assumption has but the slightest groundwork of likelihood. "las casas, before referred to, thus boldly declares: 'this is the estimate of brigands who wish to find an apology for their own atrocities;' and loosely puts the victims at so low a rate as to make it clear that any specific number is the merest conjecture. "prescott, commenting on these fabulous statements, instances the dedication of the great temple of the 'mexican war god' in 1486, when the prisoners, for years reserved for the purpose, were said to have been ranged in files forming a procession nearly two miles long; when the ceremony consumed, as averred, several days, and seventy thousand captives are declared to have perished at the shrine of this terrible deity. in view of this statement, prescott logically observes: 'who can believe that so numerous a body would have suffered themselves to be led unresistingly, like sheep, to the slaughter? or how could their remains, too great for consumption in the ordinary way, be disposed of without breeding a pestilence in the capital? one fact,' he adds, 'may be considered certain. it was customary to preserve the skulls of the sacrificed in buildings appropriate to the purpose; and the companions of cortez say they counted one hundred and thirty-six thousand skulls in one of the edifices.' "religious ceremonials were arranged for the aztec people by their crafty and well-informed priesthood, and were generally typical of some circumstances in the character or history of the deity who was the object of them. that in honor of the god called by the aztecs 'the soul of the world,' and depicted as a handsome man endowed with perpetual youth, was one of their most important sacrifices. an account of this sanguinary performance is gravely given by prescott and other writers. though highly sensational and melodramatic, since our betters have found it believable, we transcribe it for the new koshare; thus runs the tale:-"'a year before the intended sacrifice, a captive, distinguished for his personal beauty, and without a single blemish on his body, was selected to represent this deity. certain tutors took charge of him, and instructed him how to perform his new part with becoming grace and dignity. he was arrayed in a splendid dress, regaled with incense and with a profusion of sweet-scented flowers, of which the ancient mexicans were as fond as are their descendants at the present day. when he went abroad he was attended by a train of the royal pages; and as he halted in the streets to play some favorite melody the crowd prostrated themselves before him, and did him homage as the representative of their good deity. in this way he led an easy, luxurious life until within a month of his sacrifice. four beautiful girls were then given him as concubines; and with these he continued to live in idle dalliance, feasted at the banquets of the principal nobles, who paid him all the honors of a divinity. at length the fatal day of sacrifice arrived. the term of his short-lived glories was at an end. "'he was stripped of his gaudy apparel, and bade adieu to the fair partners of his revelry. one of the royal barges transported him across the lake to a temple which rose on its margin, about a league from the city. hither the inhabitants flocked to witness the consummation of the ceremony. as the sad procession wound up the sides of the pyramid, the unhappy victim threw away his gay chaplets of flowers, and broke in pieces the musical instruments with which he had solaced the hours of his captivity. "'on the summit he was received by six priests, whose long and matted locks flowed disorderedly over their sable robes, covered with hieroglyphic scrolls of mystic import. they led him to the sacrificial stone, a huge block of jasper with its upper surface somewhat convex. on this the prisoner was stretched. five priests secured his head and limbs, while the sixth, clad in a scarlet mantle, emblematic of his bloody office, dexterously opened the breast of the wretched victim with a sharp razor of _itzli_ (a volcanic substance hard as flint), and, inserting his hand in the wound, tore out the palpitating heart. the minister of death, first holding the heart up towards the sun (also an object of their worship) cast it at the feet of the god, while the multitudes below prostrated themselves in humble adoration.' "the tragic circumstances depicted in this sanguinary tale were used by the priests to 'point a moral.' the immolation of this unhappy youth was expounded to the people as a type of human destiny, which, brilliant in its beginning, often closes in sorrow and disaster. "in this loathsome manner, if we may believe the account given, was the mangled body disposed of. it was delivered by the priests to the warrior who had taken the captive in battle, and served up by him at an entertainment given to his friends. "this, we are told, was no rude cannibal orgy, but a refined banquet, teeming with delicious beverages, and delicate viands prepared with dainty art, and was attended by guests of both sexes, and conducted with all the decorum of civilized life. thus, in the aztec religious ceremonial, refinement and the extreme of barbarism met together. "the aztec nation had, at the time of the conquest, many claims to the character of a civilized community. the debasing influence of their religious rites it was, however, that furnished the fanatical conquerors with their best apology for the subjugation of this people. one-half condones the excuses of the invaders, who with the cross in one hand and the bloody sword in the other, justified their questionable deeds by the abolishment of human sacrifice. "the oppressions of montezuma, with the frequent insurrections of his people," concluded the antiquary, "when in the latter part of his reign one-half the forces of his empire are said to have been employed in suppressing the commotions of the other, disgust at his arrogance, and his outrageous fiscal exactions, reduced his subjects to that condition which made them an easy prey to cortez, whose army at last overpowered the emperor and swept the aztec civilization from the face of the earth." "i find it strange," said the journalist (in the little talk that followed mr. morehouse's able paper), "that civilized nations have held an idea so monstrous as the necessity of vicarious physical suffering of a victim to appease the wrath of a divine being with the erring creatures who, such as they are, are the work of his hands. "that unenlightened races, from time immemorial, should have supposed that the shedding of blood propitiated their angry god, or gods, is but the natural outcome of ignorance and superstition; but, that in this twentieth century, civilized worshippers should sing- 'there is a fountain filled with blood drawn from immanuel's veins; and sinners plunged beneath that flood lose all their guilty stains'-passes my understanding." "in the ruins of palenque there is," said the antiquary, "a scene portrayed on its crumbling walls, in which priests are immolating in a furnace placed at the feet of an image of saturn the choicest infants of the nation, while a trumpeter enlivens the occasion with music, and in the background a female spectator, supposed to be the mother of the victim, looks on." "the sacrifices to moloch (or saturn)," interpolated the minister, "were marked features of the phoenician idolatry. in the bible account we read that even their kings 'made their children to pass through the fire to moloch.'" "well," commented the grumbler, "it may be said of a portion of this evening's entertainment that it is distinguished by the charm found by 'helen's' sanguinary-minded 'baby,' in the story of 'goliath's head,'--it is 'all bluggy.'" "right you are," responded the star boarder with a shudder. "cold shivers have meandered along my poor back until it has become one dreadful block of ice; and, judging by the horror depicted on these ladies' faces as they listened to the details of the aztec sacrifice, i fancy that they too have supped o'er-full of horrors." the minister's eye rested for a moment affectionately on his stanch little wife. he sighed, and looked with mild rebuke on these godless triflers. and now the koshare (some of them stoutly orthodox) wisely put by the question of vicarious atonement, and summarily adjourned. chapter ix it was but the next week when, unexpectedly as thunderbolts now and then surprise us on days of serene, unclouded sky, an unlooked-for domestic calamity startled alamo ranch. dennis, the good-natured irish waiter, and fang lee, the chinese cook, had come to blows. the battle had been (so to put it) a religious controversy, and such, as we know, have a bitterness all their own. it was inaugurated by dennis, who, as a good catholic, had, on a friday, refused to sample one of fang's _chef-d'oeuvres_,--a dish of veal cutlets with mushroom sauce. a mutual interchange of offensive words, taunts highly derogatory to his holiness pope leo xiii. and equally insulting to the memory of that ancient chinese sage, confucius, had finally led to a bout of fisticuffs. in this encounter, fang lee, a slightly built, undersized celestial, had naturally been worsted at the hand of the robust hibernian, a good six feet five in his stockings. dennis, the "chip well off his shoulder," had peacefully returned to the duties of his vocation, nonchalantly carrying in the dinner, removing the plates and dishes, and subsequently whistling "st. patrick's day in the morning" under the very nose of the confucian, as he unconcernedly washed his plates and glasses, and scoured his knives. fang, having meantime sent in his dinner, cleaned his pots and pans, brushed his baggy trousers, adjusted his disordered pigtail, and straightway gave in his notice; and with sullen dignity retired to the privacy of his bedroom, for the avowed purpose of packing his box. on the ensuing morning he would shake from his feet the dust of alamo ranch. vain were the endeavors of his discomfited employers to gain the ear of the implacable fang lee. he stood out resolutely for the privacy of his small sleeping apartment, obstinately refusing admission to outsiders. in a house replete with boarders, and forty miles from available cooks, fang's pending loss was indeed a calamity. in this dilemma, the disheartened landlord and his wife begged the intercession of the star boarder,--always in high favor with the domestics, and known to be especially in the good graces of the chinaman. long did this envoy of peace unsuccessfully besiege the bedroom door of the offended fang lee. in the end, however, he gained admittance; and with adroit appeals to the better nature of the irate cook, and a tactful representation of the folly of giving up a good situation for the sake of a paltry quarrel, he finally brought fang lee down from his "high horse," and persuading good-natured dennis to make suitable friendly advances, effectually healed the breach. ere nightfall amity reigned in the ranch kitchen, and the respective pockets of the belligerents were the heavier for a silver dollar,--a private peace-offering contributed by the arbitrator. an irishman is nothing if not magnanimous; dennis readily "buried the hatchet," handle and all. not so fang lee, who, smugly pocketing his dollar, covertly observed to the giver, by way of the last word, "all samee, pope bigee dam foolee." with genial satisfaction the star boarder received the thanks of the browns for having saved to them their cook, and, with simple pleasure in the result of his diplomacy, met the encomiums of his fellow-boarders. to this gracious and beautiful nature, replete with "peace and good-will to man," to help and serve was but "the natural way of living." chapter x at mid-march, in this sun-loved land, the genial season far outdoes our own belated northern may. already, in mesilla valley, the peach, pear, and apricot buds of the orchard are showing white and pink. in the garden, rose-bushes are leaving out, and mocking-birds make the air sweet with song. "in the spring," said leon starr, parodying tennyson one morning at the breakfast-table, "the koshare fancy lightly turns to thoughts of shalam. why not make to-day our long-planned excursion to that famous colony?" "all right," responded the entire koshare; and that afternoon a party of twelve set out from alamo ranch to explore that remarkable colony, some seven miles up the valley. a description of the place and an account of this excursion is copied verbatim by the present writer from the journal of one of the party. "to begin at the beginning," says the narrator, "the colony was started by one dr. ----, a dentist from philadelphia. he enlisted as a partner in his enterprise a man from that region of fads--boston, mass. to this chimera of the doctor's brain, the latter, a man of means, lent his approval, and, still more to the point, the money to carry out the doctor's plans. "some few years ago the original founder of shalam died, leaving to his partner the work of carrying out his half-tried experiment. "mr. ---lived on in the place, assuming its entire charge, and finally marrying the doctor's widow,--a lady of unusual culture and refinement, but having a bent towards occult fads, as spiritualism, mental science, and their like. "well, we arrived safely at shalam, and were met by mrs. ---and a dozen or more tow-headed kids. it is noticeable that the whole twenty-seven children selected for this experiment have light hair and blue eyes. mrs. ---kindly presented us to her husband,--apparently a man of refined natural tendencies and fair intellectual culture, but evidently, like 'miss flite,' 'a little _m-m_, you know.' "conventionally clothed, mr. ---would undoubtedly have been more than presentable; in his shalam undress suit he was, to say the least, unique. "his long, heavy beard was somewhat unkempt. his feet were in sandals, without stockings. his dress consisted of a pair of white cotton pants, and a blouse of the same material, frogged together with blue tape, the ends hanging down over his left leg. hitched somehow to his girdle was a plain watch-chain, which led to a pocket for his watch, on the front of his left thigh, placed just above the knee. when he wants time he raises the knee and takes out the watch, standing on one leg the while. "the place is beautifully situated on the banks of the rio grande, with a range of high mountains across the river. "it consists of two parts: 'leontica,' a village for the workers, where they have many nice cottages, an artesian well for irrigation, and a big steam pump to force the water through all the ditches; shalam, the home of the children, has a big tank, with six windmills pumping water into it all the time. near the tank is the dormitory,--a building about one hundred and fifty feet in dimension. through its middle runs a large hall for the kids to gambol in. on each side are rooms for the attendants and the larger children. "chiefly noticeable was the cleanliness of the hall, and the signs over the doors of the chambers, each with its motto, a text from '_oahspe_,'--the shalam bible. "at each end of the hall was a big sign, reading thus: '_do not kiss the children._' as none of them were especially attractive, this command seemed quite superfluous. after looking over the dormitory, we were led to the main building, projected by the late dr. ----. this encloses a court about one hundred and fifty feet by sixty in size, and planted with fig trees. "the front of the building is taken up by the library of the doctor; on the opposite side is his picture gallery. "rooms or cells for the accommodation of guests occupy the long sides of this structure. "i was cordially invited to occupy one of these; but the place is too creepy for me! the pictures in the gallery were all done by the deceased doctor, under the immediate direction of his 'spirit friends.' to look at them (believing this) is to be assured that artists do not go to heaven, since not even the poorest defunct painter would have perpetrated such monstrosities. "they all represent characters and scenes from the doctor's bible,--known as oahspe, and written by him at the dictation of spirits. the drawing is horrible, the coloring worse; and no drunkard with delirium tremens could have conceived more frightful subjects! "mr. ----, the doctor's successor, is a curious compound of crank and common-sense; the latter evinced by his corral and cattle, which we next visited. i have never seen so fine a corral nor such handsome horses and cattle. they are all blooded stock; many of the cows and calves having come from the farm of governor morton, in new york state. the cows were beautiful, gentle creatures; one of them is the largest 'critter' i ever saw, weighing no less than fifteen hundred pounds! "the county authorities--scandalized by the meagreness of the shalam bill of fare--compelled mr. ---to enrich the children's diet with milk, and, thus officially prodded, he is trying to give them the best in the land. "the stock department of shalam seems to be his undivided charge; while mrs. ---manages the garden. she kindly showed us all over it; and it is a beauty! with water flowing all through it, celery, salisfy, and lettuce all ready to eat, and other vegetables growing finely. she gave us a half bushel of excellent lettuce, which we all enjoyed. "the shalam idea is to take these children from all parts of the country, to bring them up in accordance with its own dietetic fad (which in many respects corresponds with that of our own dream-led alcott), feeding them exclusively on a vegetable diet so that they won't develop carnal and combative tendencies, and thus start from them a new and improved race. will they succeed? god knows; but they seem to have started wrong; for the children are largely the offspring of outcasts, and you can't expect grapes from thistle seed. however, mr. ---and mrs. ---are both sincere, kind-hearted reformers, trying to do what they think right in their own peculiar way. they are doing no harm by their experiment--hurting no one; and if the children turn out badly, it is no worse than they would if left alone; and if well, it is a distinct triumph of brain over beastliness. it may be well to state that no _materia medica_ is tolerated at shalam. the health of the colony is entrusted absolutely to the 'tender mercies' of mental healing. mr. ---is himself the picture of health, and says he does not know what it is to feel tired. ('they that be whole need no physician!') as for the lady of shalam, there is a look in her face that led me to think she was deadly tired of the whole business, but was too loyal either to her dead or living husband to 'cry quits.' "these children know not the taste of physic. all their ailments are treated in strict accordance with mental science. they eat no eggs, fish, or other animal matter, save the county-prescribed milk, living solely on grains, vegetables, and fruits; and it must be said that they all look extremely healthy. mr. ---informs us that he rises daily at three a.m., goes directly to his corral and milks, comes in a little after four and prepares the children's breakfast. they are called at four forty-five, and breakfast at five. at five thirty devotional exercises begin, and last until six thirty, when the father of shalam goes out and starts the hands on the farm. at eight the children begin lessons or some kind of mental training, which lasts till dinner time. "after dinner they run wild for the rest of the day. "we left shalam at about five p.m. on the homeward drive we discussed this odd colony, and compared notes on what we had observed. an irreverent member of the party thus summed up the whole business in his own slangy fashion,--'a man who all winter long prances round in pajamas, making folks shiver to look at him, ought to be put in an insane asylum.' so there you have his side of the question. "the original founder of shalam, dr. ----, not only aspired to be a painter, but, as an author, flew the highest kind of a kite, giving to the world no less than a new bible. "a glimpse at its high-sounding prospectus will scarce incite in the sane and sober mind a desire to peruse a revelation whose absurdity and fantastic assumption leaves the mormon bible far behind, and before whose 'hand and glove' acquaintance with the 'undiscovered country' swedenborg himself must needs hide his diminished head. "thus it runs: '_oahspe_; a new bible in the words of jehovih and his angel embassadors. a synopsis of the cosmogony of the universe; the creation of planets; the creation of man; the unseen worlds; the labor and glory of gods and goddesses in the etherean heavens with the new commandments of jehovih to man of the present day. with revelations from the second resurrection, found in words in the thirty-third year of the kosmon era.' "oahspe's claims are thus _moderate_: 'as in all other bibles it is revealed that this world was created, so in _this_ bible it is revealed _how_ the creator _created_ it. as other bibles have proclaimed heavens for the spirits of the dead, behold _this_ bible revealeth _where_ these heavens _are_.' "oahspe also kindly informs us 'how hells are made, and of what material,' and how the sinner is in them mainly punished by the forced inhalement of 'foul smells,'--so diabolically foul are these that one is fain to hold the nose in the bare reading of them! "'there is,' declares oahspe, 'no such law as evolution. there is no law of selection.' a vegetarian diet is inculcated; and we are gravely informed that 'the spirit man takes his place in the first heaven according to his _diet_ while on earth!' "a plan for the founding of 'jehovih's kingdom on earth through little children' is given. this 'sacred history' claims to cover in its entirety no less a period of time than eighty-one thousand years. at quarter-past six," concludes our informant, "we arrived, tired and hungry, but glad to have gone, and glad to get back, leaving behind us shalam, with its spirit picture-gallery and its fantastic oahspe, for the more stable verities of commonplace existence." chapter xi it was on friday that the koshare made their little excursion to the shalam settlement, and the next evening they gathered in full force,--with the exception of the hemmenshaws and the harvard man, who still remained at hilton ranch, losing thereby two of the most interesting of the antiquary's papers; but "time and tide" and saturday clubs "stay for no man," and now came the second aztec paper. "the aztec government," began mr. morehouse, "in a few minor points is said to have borne some resemblance to the aristocratic system evolved by the higher civilization of the middle ages. "beyond a few accidental forms and ceremonies, the correspondence was, however, of the slightest. the legislative power both in mexico and tezcuco had this feature of despotism; it rested wholly with the monarch. the constitution of the judicial tribunals in some degree counteracted the evil tendency of this despotism. supreme judges appointed over each of the principal cities by the crown had original and final jurisdiction over both civil and criminal cases. from the sentence of such a judge there was no appeal to any other tribunal, not even to that of the king. "it is worthy of notice as showing that some sense of justice is inborn; as even among this comparatively rude people we read that under a tezcucan prince a judge was put to death for taking a bribe, and another for determining suits in his own house (a capital offence also, by law.) according to a national chronicler, the statement of the case, the testimony, and proceedings of the trial were all set forth by a clerk, in hieroglyphical paintings, and handed to the court. "in montezuma's day the tardiness of legal processes must have gone miles beyond the red tape of a nineteenth-century court of justice. "this vivid picture of the pomp and circumstance attendant upon the confirmation of a capital sentence by the king is presented by one of the mexican native chroniclers: "'the king, attended by fourteen great lords of the realm, passed into one of the halls of justice opening from the courtyard of the palace, which was called "the tribunal of god," and was furnished with a throne of pure gold, inlaid with turquoises and other precious stones. "'the walls were hung with tapestry, made of the hair of different wild animals, of rich and various colors, festooned by gold rings, and embroidered with figures of birds and flowers. putting on his mitred crown, incrusted with precious stones, and holding, by way of sceptre, a golden arrow in his left hand, the king laid his right upon a human skull, placed for the occasion on a stool before the throne, and pronounced judgment. no counsel was employed and no jury. the case had been stated by plaintiff and defendant, and, as with us, supported on either side by witnesses. the oath of the accused was, with the aztecs, also admitted in evidence. "'the great crimes against society were all made capital. "'among them murder (even of a slave) was punishable with death. adulterers, as among the jews, were stoned to death. thieving, according to the degree of the offence, was punished with slavery or death. it was a capital offence to remove the boundaries of an estate, and for a guardian not to be able to give a good account of his ward's property. "'prodigals, who squandered their patrimony, were punished. intemperance in the young was punished with death; in older persons, with loss of rank, and confiscation of property. "'the marriage institution was held in reverence among the aztecs, and its rites celebrated with formality. polygamy was permitted; but divorces were not easily obtainable. slavery was sanctioned among the ancient mexicans, but with this distinction unknown to any civilized slave-holding community: no one could be _born_ to slavery. the _children_ of the slave were _free_. criminals, public debtors, persons who from extreme poverty voluntarily resigned their freedom, and children who were sold by their parents through poverty, constituted one class of slaves. these were allowed to have their own families, to hold property, and even other slaves. prisoners taken in war were held as slaves, and were almost invariably devoted to the dreadful doom of sacrifice. a refractory or vicious slave might be led into the market with a collar round his neck, as an indication of his badness, and there publicly sold. if incorrigible, a second sale devoted him to sacrifice. "'thus severe, almost ferocious, was the aztec code, framed by a comparatively rude people, who relied rather on physical than moral means for the correction of evil. in its profound respect for the cardinal principles of morality, and a clear perception of human justice, it may favorably compare with that of most civilized nations.' "'in mexico,' says prescott, 'as in egypt, the soldier shared with the priest the highest consideration. the king must be an experienced warrior. the tutelary deity of the aztecs was the god of war. the great object of their military expeditions was to gather hecatombs of captives for his altars.' the aztec, like the (so-called) _christian crusader_, invoked the holy name of religion as a motive for the perpetration of human butchery. he, too, after his own crude fashion, had his order of knighthood as the reward of military prowess. whoever had not reached it was debarred from using ornaments on his arms or on his person, and was obliged to wear a coarse white stuff, made from the threads of the aloe, called _nequen_. even the members of the royal family were not excepted from this law. as in christian knighthood, plain armor and a shield without device were worn till the soldier had achieved some doughty feat of chivalry. after twenty brilliant actions officers might shave their heads, and had, moreover, won the fantastic privilege of painting half of the face red and the other half yellow. the panoply of the higher warriors is thus described. their bodies were clothed with a close vest of quilted cotton, so thick as to be impenetrable to the light missiles of indian warfare. this garment was found so light and serviceable that it was adopted by the spaniards. "the wealthier chiefs sometimes wore, instead of this cotton mail, a cuirass made of thin plates of gold or silver. over it was thrown a surcoat of the gorgeous feather work in which they excelled. their helmets were sometimes of wood, fashioned like the heads of wild animals, and sometimes of silver, on the top of which waved a panache of variegated plumes, sprinkled with precious stones. they also wore collars, bracelets, and earrings of the same rich materials. "'a beautiful sight it was,' says one of the spanish conquerors, 'to see them set out on their march, all moving forward so gayly, and in so admirable order!' "their military code had the cruel sternness of their other laws. disobedience of orders was punished with death. "it was death to plunder another's booty or prisoners. it is related of a tezcucan prince that, in the spirit of ancient roman, he put two of his sons to death--after having cured their wounds--for violating this last-mentioned law. a beneficent institution, which might seem to belong to a higher civilization, is said to have flourished in this semi-pagan land. "hospitals, we are told, were established in their principal cities for the cure of the sick, and as permanent homes for the disabled soldier; and surgeons were placed over them who 'were,' says a shrewd old chronicler, 'so far better than those in europe that they did not _protract the cure in order to increase the pay_.' "the horse, mule, ox, ass, or any other beast of burden, was unknown to the aztecs. communication with remotest parts of the country was maintained by means of couriers, trained from childhood to travel with incredible swiftness. "post-houses were established on all the great roads, at about ten leagues distance apart. the courier, bearing his despatches in the form of hieroglyphical painting, ran with them to the first station, where they were taken by another messenger, and so on, till they reached the capital. despatches were thus carried at the rate of from one to two hundred miles a day. "a traveller tells us of an indian who, singly, made a record of a hundred miles in twenty-four hours. a still greater feat in walking is recorded by plutarch. _his_ greek runner brought the news of a victory of a hundred and twenty-five miles in a single day! "in the funeral rites of this ruder people one traces a slight resemblance to those of the more cultivated greek. they burned the body after death, and the ashes of their dead, collected in vases, were preserved in one of the apartments of the home. after death they dressed the person's body in the peculiar habiliments of his tutelar deity. it was then strewed with pieces of paper, which operated as a charm against the dangers of the dark road he was to travel. if a chief died he was still spoken of as living. one of his slaves, dressed in his master's clothes, was placed before his corpse. the face of this ill-starred wretch was covered with a mask, and during a whole day such homage as had been due to the chief was paid to him. at midnight the body of the master was burnt, or interred, and the slave who had personated him was sacrificed. thereafter, every anniversary of the chief's birthday was celebrated with a feast, but his death was never mentioned. "the spanish chroniclers have told us (and in reading these statements due allowance must be made for their habit of 'stretching the truth') that to the principal temple--or teocallis--in the capital five thousand priests were in some way attached. these, in their several departments, not only arranged the religious festivals in conformity to the aztec calendar, and had charge of the hieroglyphical paintings and oral traditions of the nation, but undertook the responsibility of instructing its youth. while the cruel and bloody rites of sacrifice were reserved for the chief dignitaries of the order, each priest was allotted to the service of some particular diety, and had quarters provided for him while in attendance upon the service of the temple. "though in many respects subject to strict sacerdotal discipline, aztec priests were allowed to marry and have families of their own. thrice during the day, and once at night, they were called to prayers. they were frequent in ablutions and vigils, and were required to mortify the flesh by fasting and penance, in good roman catholic fashion, drawing their own blood by flagellation, or by piercing with thorns of aloes. they also, like catholic priests, administered the rites of confession and absolution; but with this time-saving improvement: confession was made but _once_ in a man's life,--the long arrears of iniquity, past and present, thus settled, after offences were held inexpiable. "priestly absolution was received in place of legal punishment for offences. it is recorded that, long after the conquest, the simple natives, when under arrest, sought escape by producing the certificate of their confession. "the address of the aztec confessor to his penitent, with his prayer on this occasion, has come down to us. as an evidence of the odd medley of christianity and paganism that marked this queer civilization, it is quaintly interesting. 'o merciful lord,' prayed he, 'thou who knowest the secrets of all hearts, let thy forgiveness and favor descend, like the pure waters of heaven, to wash away the stains from the soul. thou knowest that this poor man has sinned, not from his own will, but from the influences of the sign under which he was born.' "in his address to the penitent he urges the necessity of instantly procuring a slave for sacrifice to the deity. after this sanguinary exhortation he enjoins upon his disciple this beautiful precept of christian benevolence: 'clothe the naked, feed the hungry, whatever privations it may cost thee, for, remember, their flesh is like thine, and they are men like thee.' "sacerdotal functions (excepting those of sacrifice) were allowed to women. "at a very tender age these priestess girls were committed for instruction to seminaries of learning, in which, it is recorded, a strict moral discipline for both sexes was maintained, and that, in some instances, offences were punished by death itself. "thus were these crafty mexican priests (the jesuits of their age) enabled to mould young and plastic minds, and to gain a firm hold upon the moral nature of their pupils. the priests had (as we are told) their own especial calendar, by which they kept their records, and regulated, to their liking, their religious festivals and seasons of sacrifice, and made all their astrological calculations; for, like many imperfectly civilized peoples, the aztecs had their astrology. this priestly calendar is said to have roused the holy indignation of the spanish missionaries. "they condemned it as 'unhallowed, founded neither on natural reason, nor on the influence of the planets, nor on the course of the year; but plainly the work of necromancy, and the fruit of a contract with the devil.' "we are told that not even in ancient egypt were the dreams of the astrologer more implicitly referred to than in aztec mexico. "on the birth of a child he (the astrologer) was instantly summoned, and the horoscope--supposed to unroll the occult volume of destiny--was hung upon by the parent in trembling suspense and implicit faith. no millerite in his ascension robe, awaiting the general break-up of mundane affairs, ever looked forward with more confidence to the final catastrophe than did the ancient mexican to the predicted destruction of the world at the termination of one of their four successive cycles of fifty-two years. "prescott gives us this romantic account of the festival marking that traditional epoch: "'the cycle would end in the latter part of december; as the diminished light gave melancholy presage of that time when the sun was to be effaced from the heavens, and the darkness of chaos settle over the habitable globe, these apprehensions increased, and on the arrival of the five "unlucky days" that closed the year they abandoned themselves to despair. they broke in pieces the little images of their household gods, in whom they no longer trusted. "'the holy fires were suffered to go out in the temples, and none were lighted in their own dwellings. their furniture and domestic utensils were destroyed, and their garments torn in pieces, and everything was thrown into disorder. on the evening of the last day, a procession of priests moved from the capital towards a lofty mountain, about two leagues distant. they carried with them as a victim for the sacrificial altar the flower of their captives, and an apparatus for kindling the new fire, the success of which was an augury for the renewal of the cycle. "'on the funeral pile of their slaughtered victim, the _new fire_ was started by means of sticks placed on the victim's wounded breast. as the light soared towards heaven on the midnight sky, a shout of joy and triumph burst forth from the multitudes, who covered the hills, the terraces of the temples, and the housetops with eyes anxiously bent upon the mountain of sacrifice. couriers with torches lighted at the blazing beacon bore the cheering element far and near; and long before the sun rose to pursue his accustomed track, giving assurance that a new cycle had commenced its march, altar and hearthstone again brightened with flame for leagues around. "'all was now festivity. joy had replaced despair. houses were cleansed and refurnished. dressed in their gayest apparel, and crowned with chaplets and garlands of flowers, the people thronged in gay procession to the temples to offer up their oblations and thanksgivings. it was the great secular national festival, which few alive had witnessed before, or could expect to see again.' "although we find in the counsels of an aztec father to his son the following assertion, 'for the multiplication of the species god ordained _one_ man _only_ for _one_ woman,' polygamy was nevertheless permitted among this people, chiefly among the wealthiest classes. "marriage was recognized as a religious ceremony, and its obligations strictly enjoined. their women, we are told, were treated with a consideration uncommon among indian tribes. it is recorded that their tranquil days were diversified by the feminine occupations of spinning, feather-work, and embroidery, and that they also beguiled the hours by the rehearsal of traditionary tales and ballads, and partook with their lords in social festivities. "their entertainments seem to have been grand and costly affairs. numerous attendants, of both sexes, waited at the banquet; the halls were scented with perfumes, flowers strewed the courts, and were profusely distributed among the arriving guests. "as they took their seats at the board, cotton napkins and ewers of water were placed before them; for, as in the heroic days of greece, the ceremony of ablution before and after eating was punctiliously observed by the aztecs. the table was well provided with meats, especially game, among which our own thanksgiving bird, the turkey, was conspicuous. these more solid dishes were flanked by others of vegetables, and with fruits of every variety found on the north american continent. "the different viands were skilfully prepared, with delicate sauces and pungent seasoning, of which the mexicans were especially fond. they were further regaled with confections and pastry; and the whole was crowned by an 'afterclap' of tobacco mixed with aromatic substances, to be enjoyed in pipes, or in the form of cigars, inserted in holders of tortoise shell or silver. the meats were kept warm by chafing-dishes. the table was ornamented with vases of silver (and sometimes of gold) of delicate workmanship. "we are told by the chroniclers that agriculture was, before the conquest, in an advanced state. there were peculiar deities to preside over it, and the names of the months and of the religious festivals had more or less reference to it. the public taxes were often paid in agricultural produce. as among the pueblos, aztec women took part in only the lighter labors of the field,--as the scattering of the seed, the husking of the ripened corn. "maize, or indian corn, the great staple of the north american continent, grew freely along the valleys, and up the steep sides of the cordilleras, to the high table-land. aztecs were, we are told, well instructed in its uses, and their women as skilled in its preparation as the most expert new england or southern housewife. "in these equinoctial regions, its gigantic stalk afforded a saccharine matter which supplied them with a sugar but little inferior to that of the cane itself (which, after the conquest, was introduced among them). passing by all their varieties of superbly gorgeous flowers, of luxuriously growing plants, many of them of medicinal value, and since introduced from mexico to europe, we come to that 'miracle of nature,' the great mexican aloe, or _maguey_, which was, in short, meat, drink, clothing, and writing material for the aztec, as from its leaves was made their paper, somewhat resembling egyptian _papyrus_, but more soft and beautiful. "specimens of this paper still exist, preserving their original freshness, and holding yet unimpaired the brilliancy of color in hieroglyphical painting. it is averred that the aztecs were as well acquainted with the uses of their mineral as of their vegetable kingdom, deftly working their mines of silver, lead, and tin. it has, however, been contended by wilson, in his 'new conquest of mexico,' that, in spite of cortez's statement to the contrary, 'it is not to be supposed that the spaniards found the aztecs in the possession of silver, since its mining requires a combination of science and mechanical power unknown and impossible to their crude civilization.' he considerately allows them the capability of gathering gold from their rich soil. "prescott, on the contrary, tells us that 'they opened veins for the procurement of silver in the solid rock, and that the traces of their labors in these galleries furnished the best indications for the early spanish miners.' "who shall decide when doctors disagree? not, indeed, a koshare, whose laudable purpose it is to eschew the wearisome 'gradgrinds' of history, and accept the infinitely more charming conclusions of the romancer. "gold, say the chroniclers, was easily gleaned from the beds of their rivers, and cast into bars, or in the form of dust, made part of the regular tribute of the southern provinces of montezuma's empire. they cast, also, delicately and curiously wrought vessels of gold. though their soil was impregnated with iron, its use was unknown to this people. as a substitute for this metal, they used, for their tools, a bronze made from an alloy of tin and copper, or of itzli,--a dark transparent metal, found in abundance in their hills. with the former they could cut the hardest substances, such as emeralds and amethysts. "it has been contended that an ignorance of the use of iron must necessarily have kept the mexican in a low state of civilization. on the other hand, it is urged that iron, if even known, was but little in use among the ancient egyptians, whose mighty monuments were hewn with tools of bronze, while their weapons and domestic utensils were of the same material. for the ordinary purposes of domestic life, the ancient mexicans made earthenware, and fashioned cups, bowls, and vases of lacquered wood, impervious to wet, and gorgeously colored. "among their dyes, obtained from both mineral and vegetable substances, was the rich crimson of the cochineal, the modern rival of the far-famed tyrian purple. later, this coloring material was introduced into europe, from mexico, where the curious cochineal insect was nourished with great care on plantations of cactus. "the aztecs were thus enabled to give a brilliant coloring to their webs of cotton, which staple, in the warmer regions of their country, they raised in abundance. with their cotton fabrics, manufactured of every degree of fineness, they had the original art of interweaving the delicate hair of rabbits and other animals, which made a cloth of great warmth as well as beauty. "on this they often laid a rich embroidery of birds, flowers, or some other fanciful device. it is supposed that the aztec 'silk,' mentioned by cortez, was nothing more than this fine texture of cotton, hair, and down. "but the art in which they especially excelled was their plumage or feather-work. some few existing specimens of this ancient art (one of them a vestment said to have been worn by montezuma himself) have, we are told, 'all the charm of florentine mosaic.' "the gorgeous plumage of tropical birds, especially of the parrot-tribe, afforded every variety of color, and the fine and abundant down of the humming-bird supplied them with a finish of soft aerial tints. the feathers pasted on a fine cotton web were wrought into dresses for the wealthy. hangings for apartments and ornaments for the temples were thus fashioned. labor was held in honorable estimation among this people. an aged aztec chief thus addressed his son: 'apply thyself to agriculture, or to feather-work, or some other honorable calling. thus did your ancestors before you. else, how could they have provided for themselves and their families? never was it heard that nobility alone was able to maintain its possessor.' "the occupation of the merchant was held by them in high respect. these were of prime consideration in the body politic, and enjoyed many of the most essential advantages of an hereditary aristocracy. mexico, as their abundant use among the aztecs testifies, is especially rich in precious stones. it is the land of the emerald, the amethyst, the turquoise, and the topaz; and that superbest of gems, the fire opal, is native to its generous soil. "one of cortez's wedding gifts to his second bride is thus described: 'this was five emeralds of wonderful size and brilliancy. these jewels had been cut by the aztecs into the shapes of flowers, and fishes, and into other fanciful forms, with an exquisite style of workmanship which enhanced their original value.' "it was gossiped at court that the queen of charles the fifth had an eye to these magnificent gems, and that the preference given by cortez to his fair bride had an unfavorable influence on the conqueror's future fortunes. among the 'royal fifth' of the mexican spoils sent by cortez to the spanish emperor, we are told of a still more wonderful emerald. it was cut in a pyramidal shape, and of so extraordinary a size that the base of it was affirmed to have been as broad as the palm of the hand. "this rich collection of gold and jewelry, wrought into many rare and fanciful forms, was captured on its road to spain by a french privateer, and is said to have gone into the treasury of francis the first. francis, we are told, looking enviously on the treasures drawn by his rival monarch from his colonial domains, expressed a desire to 'see the clause in adam's testament, which entitled his brothers of spain and portugal to divide the new world between them.' "the aztec picture writing, rude though it was, seems to have served the nation in its early and imperfect state of civilization. "by means of it, as an auxiliary to oral tradition, their mythology, laws, calendars, and rituals were carried back to an early period of their civilization. "their manuscripts, the material for which has already been described, were most frequently made into volumes, in which the paper was shut up like a folding screen. with a tablet of wood at each extremity, they thus, when closed, had the appearance of books. a few of these mexican manuscripts have been saved, and are carefully preserved in the public libraries of european capitals. the most important of these painted records, for the light it throws on the aztec institutions, is preserved in the bodleian library at oxford. the greater part of these writings, having no native interpretation annexed to them, cannot now be unriddled. "a savant who, in the middle of the seventeenth century travelled extensively through their country, asserts that, 'so completely had every vestige of their ancient language been swept away from the land, not an individual could be found who could afford him the least clue to the aztec hieroglyphics.' "some few aztec compositions, which may possibly owe their survival to oral tradition, still survive. these are poetical remains, in the form of odes, or relics of their more elaborate prose, and consist largely of prayers and public discourses, that show that, in common with other native orators, the aztecs paid much attention to rhetorical effect. the aztec hieroglyphics included both the representative and symbolical forms of picture-writing. "they had various emblems for expressing such things as, by their nature, could not be directly represented by the painter; as, for example, the years, months, days, the seasons, the elements, the heavens, and so on. "a serpent typified time, a tongue denoted speaking, a footprint travelling, a man sitting on the ground an earthquake. "the names of persons were often significant of their adventures and achievement. "summing up this account of aztec civilization, we find that, although of the countries from which toltec and aztec in turn issued tradition has lost the record, it is nevertheless affirmed, by so reliable an historian as humboldt, that the former introduced into mexico the cultivation of maize and cotton; that they built cities, made roads, and constructed pyramids. 'they knew,' says this authoritative historian, 'the uses of hieroglyphical paintings; they could work metals, and cut the hardest stones; and they had a solar system more perfect than that of the greeks and romans.' "after their mysterious disappearance from the table-lands of mexico, the aztecs, who succeeded them, gradually amalgamated all that was best in their civilization, and, engrafting upon it their own, became as a nation what they were in the time of the second montezuma, when cortez and his conquering army treacherously swept their civilization from the face of the earth. "a thoughtful traveller still finds in mexico traces of this people, its early possessors. "the mexicans, in their whole aspect," he observes, "give a traveller the idea of persons of decayed fortune, who have once been more prosperous and formidable than now, or who had been the offshoot of a more refined and forcible people." chapter xii it was but the day after the delivery of this most interesting paper by mr. morehouse, that the laggards from hilton ranch, who had missed it, and the preceding one, returned to their places at the dinner-table; and on that very afternoon miss paulina, with all due formality, announced the engagement of her niece to mr. roger smith. recovered from the first shock of surprise, the koshare celebrated the betrothal by a pink afternoon tea, and made such slight engagement offerings as were found available, remote from silversmith, florist, and bric-à-brac dealer. the ladies gave bureau scarfs, table doilies, and centre-pieces _ad infinitum_; the antiquary bestowed a bit of mexican pottery dating back to the "cliff-dwellers." leon framed the photographs of the handsome pair in mexican canes, as an engagement gift; and the most despondent "lunger" of them all had a kindly wish for their young and happy fellow-boarders, setting out on that beautiful life-journey to whose untimely end he, himself, was sadly tending. among the more observing of the koshare, much wonder was expressed at the slow mending of roger smith's sprained ankle. it was at the engagement tea that miss paulina innocently said, in response to these strictures, "yes, it _did_ take a long time to cure dear roger's sprain. years ago," continued the good lady, "i had the same accident; and, if i remember rightly, in less than a fortnight after the sprain i was walking without any crutches. one would think now," she went on, "that in this lovely dry climate a sprain would mend rapidly; but, though i did my very best, the result was far less prompt than i had hoped." "sprains differ," interposed the audacious subject of these remarks, unawed by the disapproving glances of his betrothed; "the surgeons tell us that fractures are both simple and compound. mine, dear miss hemmenshaw, was undoubtedly compound." this he said by way of accounting to his friends for his tardy convalescence. to himself he thought, looking at this kind, unsuspicious new auntie, "dear, delicious old goose!" this is what the niece said when, later, she got this incorrigible lover to herself: "roger, i am quite convinced that your conscience is seared with a hot iron, whatever that process, supposed to indicate utter moral callousness, may be." "my dear girl," laughed the unabashed culprit, "i am, as you know and deplore, a good catholic, and consequently hold with the astute jesuit fathers that the end justifies the means." chapter xiii it was in the sunny, lengthened days of early march that the antiquary, the journalist, the star boarder, and the grumbler undertook their long-projected trip to the sacramento mountains, there to visit the government reservation, nestled in the sheltered mescalero valley, which gives its name. well equipped with camping conveniences, the four koshares set forth on their journey of one hundred and twenty-five miles. it was their intention to "make haste slowly," and nothing could better have suited the leisurely pair of mexican horses, and the equally easy-going mexican driver, who, with his team, had been hired for the expedition. the first night of their journey was passed beneath the open sky, with the rounded moon riding clear and fair above them, and the desert of sand and sage-brush all about them. on the second, they lodged at the solitary dwelling of a ranchman, whose nearest neighbor was thirty-five miles distant. at the journey's end, they were cordially received by lieutenant stottler, government agent at the mescalero reservation, and throughout their visit were treated by him with a kindly hospitality and a genial courtesy beyond praise. of the apache, now transformed by the iron hand of civilization from a blood-thirsty savage to a passably decent and partially self-supporting member of the republic, it has been aptly said that nature has given him "the ear of the cat, the cunning of the fox, and the ferocious courage and brutishness of the gray wolf." the whole vast realm of his native ranges, desert though they seem, are known to teem with ever-present supplies for his savage menu. there are found fat prairie mice, plump angle-worms, gray meat of rattlesnake and lizard, and of leathery bronco,--all easy-coming "grist for that 'unpernickety' mill," his hungry stomach. is he minded for a vegetable diet, for him the mescal lavishly grows; and the bean of mesquite, reduced to meal, makes him palatable cakes. fruit of spanish bayonet dried in the sun, and said thus to resemble dates, is at hand for his dessert; and of mountain acorns alone he may make an excellent and nutritious meal. from the primeval years this belligerent savage is said to have especially harried that dismal waste in new mexico known as _jornado del muerta_, "journey of death." this awful desert is declared to be literally "the battle-ground of the elements." in the winter it is made fearful by raging storms of wind and snow, in which frozen men and animals leave their bodies, as carrion prey, to the hungry mountain wolf. in later times it is "the skulking place of unscrupulous outlaws, and many a murdered traveller makes good the name it bears." it is thus finely depicted by a modern traveller: "near the southern boundary of new mexico stretches a shadeless, waterless plateau, nearly one hundred miles long, and from five to thirty miles wide, resembling the steppes of northern asia. geologists tell us this is the oldest country on the earth, except, perhaps, the backbone of central africa; at least, the one which has longest been exposed to the influence of agents now in action. the grass is low and mossy, with a wasted look; the shrubs are soap-weed and bony cactus; the very stones are like the scoria of a furnace. it is sought by no flight of bird; no bee or fly buzzes on the empty air; and, save the lizard and horned frog, there is no breath of living thing. one might fancy that this dreary waste had served its time, had been worn out, unpeopled, and forgotten." in the (not long past) day of his power and might, to steal and murder, under the show of friendship; to beat out the brains of unsuspecting men; to carry off to captivity, worse than death, the women and larger children, was, with the apache, merely a question of opportunity. in the apache war--ending in october, 1880, and lasting but a year and a half,--it is estimated that more than four hundred white persons were scalped and tortured to death with devilish ingenuity. the details of indian fighting are everywhere much the same; but in strategy and cruelty that of the apache surpasses all the sons of men. victorio, the chief who led the war with his band, was surrounded at last, and captured, and killed in the mountains of mexico. with the death of victorio (whose only son, washington, was shot in the fall of 1879, leaving no one to succeed him) the cause was lost. his wife, we are told, after victorio's death, cut off her hair, in the old greek fashion, and buried it,--an offering to the spirit of this fallen chief, to whom (devil though he was) she was devoted. it is told of rafael, one of victorio's band, that when maddened by _tiswin_ (an intoxicant made by the indian from corn), he fatally stabbed his wife, and, after her death, overcome with penitence, sacrificed all his beads and most of his clothes to the "dear departed," cut his and his children's hair short, and sheared the manes and tails of his horses. these manifestations of anguish over, he went up into a high hill, and howled with uplifted hands. women are regarded by the apaches as an incumbrance. they are of so little account that they are not even given a name. mothers _mourn_ at their birth. the indians occupying a reservation of seven hundred square miles in southern new mexico, and numbering, at the present writing, about four hundred and fifty souls, are typical apaches, and closely related by blood to the other apaches of arizona and new mexico. they exhibit the usual race characteristics,--of ignorance, stubbornness, superstition, cruelty, laziness, and treachery. in december, 1894, lieutenant stottler first assumed the charge of these indians. in spite of the fact that for many years a generous government had supplied them annually with rations, clothing, working implements, etc., they were then living in _tepees_, or brush shelters, on the side hills; clad in breech-clout and blanket, wearing paint, and long hair, and thanklessly receiving their rations of beef, flour, coffee, sugar, salt, soap, and baking-powder. a few of them condescended to raise corn and oats; but acres of tillable land on the reservation were still unused. "they were," says lieutenant stottler, in an able and interesting report, "not only contented with this order of things, but desirous and determined to prolong it indefinitely." fifty per cent of their children were in school, but the parents were wholly opposed to their education. among them were twenty strong, broad-shouldered indian adults, educated at the expense of thousands of dollars, yet still running about the reservation in breech-clout and blanket, wilder than any uneducated indian on it. the girls were held from school, and at ten and twelve years of age were traded for ponies, into a bondage worse than any known slavery. fourteen indian policemen are allowed the agent. their especial duty is to see that the herd of beef cattle for their own eating is properly cared for. the police, each had a cabin to live in; but each, in scorn of this civilized innovation, had carefully planted alongside of his cabin a _tepee_ to sleep in. to get these policemen into civilized clothing, under threat of duress, and to order all _tepees_ away from their cabins, was the agent's first move. next, it was decided that all children five years old and upwards _must_ be placed in school at the beginning of the school year, whether the parents were willing or not. every indian man was ordered to select a piece of land, and put in his posts. to break up the influence of chiefs or bands, who, claiming the whole country, deterred the people from work, by threats, appears to have been up-hill work; "but now," says the agent (in 1897), "there are no chiefs, and 'work or starve' is the policy." formerly, government supplies of clothing, wagons, harness, and utensils, as soon as issued, had been packed on burros and sold for a mere song to settlers about the reservation. this abuse was promptly stopped, as also was the making of _tiswin_. this native drink, made from indian corn, is said to be more maddening in its effect than any other known intoxicant; indians brutalized by _tiswin_ fought, as do our own drunkards, and often wounded or killed each other. for corn to make this detestable beverage, an indian would trade away the last article in his possession. it was proclaimed by the agent that the maker of this poison would be imprisoned for six months, at hard labor, in the guard-house. this stopped its manufacture, and there are no longer drunken indians at the reservation. occasionally they still get liquor at las cruces, when sent there for freight. all supplies are hauled from the railroad over-land. the distance is one hundred and ten miles; about one hundred thousand pounds are annually brought in this way to the reservation, and without harm or loss. much of the indian's savagery lies (like samson's strength) in his hair; to his long, matted tresses he clings tenaciously. as a beginning, lieutenant stottler induced one old fellow--a policeman--with the reward of a five-dollar gold piece to cut his precious locks. thus metamorphosed, he became "the cynosure of all eyes." his squaw made life a burden to him; and thus badgered, he, in turn, pestered the agent to get the entire police force to cut theirs. it was long before the general consent to part with these cherished tresses could be won; and it became necessary to put some of the indians in the guard-house to accomplish this reform. finally, orders were asked from washington, and received, compelling submission to the shearing. when the indians saw the washington order, they all gave in, with the exception of a last man, who had to be "thumped into it." their hair well cut, a raid was made on breech-clout and blanket. now they all appear in civilized clothing. this seems to have been the turning-point in their wildness. "now," says the agent, "they come and ask for scissors and comb to cut their hair, and volunteer the information that they were 'fools to oppose it.'" about half a dozen of these indians were found by lieutenant stottler with two wives; since none others were permitted, this matrimonial indulgence, polygamy, is, consequently, dying a natural death at mescalero. it is found hard to control the ancient practice of dropping a wife and taking up another without the troublesome formality of a divorce, which has practically the same result as polygamy. in spite of the slip-shodness of the marriage-tie among the indians, "they are," says the lieutenant, "about as badly henpecked as it is possible to imagine. not by the wife, however; but by that ever dreaded being, her mother." he gives in his paper a most amusing account of the relation between the son-in-law and this much-maligned treasure of our higher civilization. "just why it is," he says, "no indian has ever been able to explain to me, but an indian cannot look at his mother-in-law. "if she enters his _tepee_, he leaves; if he enters and she is within, he flees at once. he cannot stay in her august presence. if his wife and he quarrel, his mother-in-law puts in an appearance, and manages his affairs during his enforced absence so long as she pleases. perhaps she takes his wife to her own _tepee_, where he dare not follow. in this dilemma, he either comes to terms, or the situation constitutes a divorce. "does the agent wish a child brought to school, or a head of a family to take land, and try to farm it, the mother-in-law, if hostile (and she usually is), appears on the scene. then the head of the family hunts the woods for refuge. "the sight of several stalwart bucks hiding behind doors, barrels, and trees, because a dried-up, wizened squaw heaves in sight, is a spectacle that would be ludicrous, were it not for its far-reaching results. as an indian may take, in succession, many wives, who still stand to his credit, the agent has, practically, many mothers-in-law to contend with. consequently, these family magnets have been officially informed that the guard-house awaits any of them who may be found maliciously interfering with the families of their children. "hard labor added to this sentence, it is hoped, may at length have the effect of breaking up this absurd superstition." by this account it may be seen that "one of the most far-fetched notions that ever entered into the minds of men" is found domesticated among the mexican aborigines. it is asserted, as a chronological fact, that the mexican pueblos "invented the mother-in-law joke gray ages before it dawned upon our modern civilization." the lamented cushing, in his account of the "restful, patriarchal, long-lonely world" of his research, tells us that he found the mother-in-law a too pronounced factor in the zuni family circle; and, as we know, in our own higher civilization the mother-in-law, held in good-natured reprobation, serves to point many a harmless jest. white enthusiasts--with whom the "wrongs of the indian" are a standing grievance--but imperfectly realize the difficulty of taming these savages, getting them well off the warpath, and making them cleanly and self-supporting. it may, therefore, be well to present the side shown us by the agent in his able paper of statistical facts. "the apache tribe," he tells us, "has one hundred and sixteen children at school,--nineteen at fort lewis, colorado, and ninety-seven at the reservation boarding-school. each child has one-half day in class and one-half day of industrial work. the girls take their turns in the laundry, sewing-room, and kitchen, and at dormitory work. the boys do the heavy work in the kitchen and laundry, chop the wood, and till the farm under the charge of the industrial teacher. all the vegetables for their use are raised on the farm, and the surplus sold. "the aim of the school is to teach the rising generation of apaches how to make a living with the resources of the reservation, and, in time, to become self-supporting. "to this end useful rather than fancy trades are taught. boys are detailed with the blacksmith and carpenter, to learn the use of common tools. to do away with the inborn contempt of the aboriginal male for the women of his tribe, boys and girls at the reservation are not only trained to study, recite, and sit at meals with girls, but a weekly 'sociable' is held for the scholars. "on such nights they have games and civilized dances. every boy is required formally to approach and request, 'will you dance this dance with me?' and to offer his partner his arm when the reel, quadrille, etc., is finished, and escorting her to her seat, leave her with a polite 'thank you.'" in the agent's report for the years 1896-97, "this year," he says, "the indian boys raised twenty-five thousand pounds beets, twenty thousand pounds cabbage, one thousand pounds cauliflower, five hundred pounds turnips, one thousand four hundred pounds celery, five hundred pounds radishes, one thousand four hundred pounds of onions, nineteen thousand pounds of pumpkins and squash, four hundred pounds of peas, nine hundred and sixty pounds of corn, six thousand five hundred pounds of potatoes, besides cucumbers, pie-plant, and asparagus. "the school has a pen of swine, a flock of chickens, and a fine herd of milch cows; and all the hay and fodder for them and the horses are raised on the farm. oats and corn are purchased from the indians, who, in 1895, raised one hundred and fifty thousand pounds. "the adult indians," he adds, "cut this year one hundred and sixty cords of wood for the school, for which i paid them two dollars and fifty cents per cord. in the winter of 1896 the industry of blanket-making was introduced into the reservation. navajo blanket-makers were employed to teach to the mescalero women their incomparable method of carding, spinning, and dyeing wool, and weaving blankets. twenty of the mescaleros," boasts the agent, "can to-day make as good blankets as the navajos themselves. "the reservation is mountainous, and one of the finest sheep ranges in the country. government has allowed five thousand sheep for general distribution at the reservation, and in addition, five hundred head for the school; where a room is now set aside for the looms of the older girls, who will, in their turn, become instructors in this useful art. this puts into their hands another opportunity to become self-supporting." the visitors from mesilla valley were kindly admitted behind the scenes at the reservation, to make acquaintance with its people, both old and young; and were highly interested and entertained by the picturesqueness of the indian character. the grumbler had brought his camera along. he was a skilled amateur photographer, and had offered his services in that capacity to the little party. to bring his household under the focus of that apparatus was no easy task for the courteous agent. an indian is nothing if not a believer in witches. in his aboriginal mode of life witch-hunting and witch-punishing are among his gravest occupations. he pursues them with a vigorous hand, and with a superstitious zeal equal to that of the most persistent white man in the palmiest days of salem witch-hunting and witch-burning. the mescaleros, to a soul, are believers in witchcraft. the camera, as might be seen from its effect, was plainly bewitched. they would have none of it. the school children, having no choice, must needs range themselves in scared, sullen rows, and be "took" under compulsion. suspiciously eying the operator, they sullenly took their prescribed pose, and heedless of the immemorial request, "now look pleasant," went sourly through the terrible ordeal. some of the older girls, pleased with the novelty, submitted more cheerfully; but the younger pupils, looking askance at the white men, covered their faces, so far as was possible, with hair, or hands, and were thus providentially carried safely through this process of bewitchment. some of the schoolboys had fine, intelligent faces; of others, the grumbler subsequently observed that "they were the kind that grow up and scalp white settlers." a curious young squaw, from the opened slit of her _tepee_, watched the approach of the party with their bedevilled machine. her position was excellent; but no sooner had the operator arranged his camera for a snap shot at this picturesque subject, than, with a scared yell, the woman bounded out of range, closing behind her the aperture--her front door. the result was merely an uninteresting view of an indian _tepee_, which is like nothing more than a mammoth ant-hill, minus the symmetry and nice perpendicular of that more intelligently fashioned structure. two incorrigible squaws in "durance vile" for making _tiswin_, as they sullenly served their sentence of hard labor at the reservation woodpile, looked defiantly up from their task of chopping fuel, and scowled viciously at the witch machine and its abettors. they, however, succeeded in getting a fairly good picture of these hideous-faced beings, as "withered and wild" as the uncanny sisters who brewed "hell broth" before the appalled macbeth, beneath the midnight moon, on hampton heath. a mild-eyed indian woman, whose peaceful occupation was to scrub the reservation floors, kindly submitted to the bother of being put into a picture, along with the insignia of her office,--a scrubbing-pail. not so "hot stuff," a highly picturesque squaw, claiming the proud distinction due to the "oldest inhabitant." this "contrairy" female, impervious to moral suasion, was finally induced to pose before the terrible "witch-thing" by the threat of having her rations withheld until her consent to be "taken" was obtained. scared and reluctant, she was at last photographed; but required lieutenant stottler to protect her with his arm through the perils of this unfamiliar ordeal. this he good-naturedly did, and is immortalized along with this aged squaw. after an interesting visit of two nights and a day at the reservation, the koshare turned their faces towards mesilla valley, where, after two uneventful days, they arrived in safety, full of the novelties encountered, charmed with the courteous and gentlemanly agent, but wearied with the long ride, and heartily glad to return to white civilization. chapter xiv it was at the close of the week succeeding that of the little journey across the mountains that the koshare held their last saturday evening session. to punctuate the finality of this gathering, a variation from the usual programme was proposed by the antiquary. members of the club were requested to supplement his brief paper by giving such written or verbal statements, along the same line as their own research might enable them to make. to this proposal many of the koshare had agreed, and had come well primed for lively discussion. the attendance was unusually full, nearly all the boarders, in addition to the regular club members, being in attendance. the antiquary led with the following interesting paper, which, as he explained, was, in a way, supplementary to those on the aztecs. "as the tezcucans were of the family of the aztecs," began mr. morehouse, "and are said far to have surpassed them in intellectual culture and the arts of social refinement, some slight notice of their civilization may not prove irrelevant. "ixtilxochitl is the uneuphonious name of the native chronicler, purporting to be a lineal descendant of the royal line of tezcuco, who has given us his highly colored narrative of the tezcucan civilization. it may be prefaced with the information that ixtilxochitl (who flourished so late as the century of the conquest) has had his reputation so torn to tatters by the critics of later years that he has, figuratively, 'not a leg to stand on.' "but as prescott commends his 'fairness and integrity,' and says 'he has been followed, without misgiving, by such spanish chroniclers as could have access to his manuscripts,' without attempting to settle the vexed question of the probability of its details (which are a combination of 'munchausen' and 'arabian nights'), we also will follow his marvellous story of the tezcucan prince nezahualcoyotl. passing lightly over the fascinating chapter of that prince's romantic adventures,--his marvellous daring, his perilous escapes from the fierce pursuit of the usurper maxtla, and the dethronement and violent end of that bloody-minded monarch,--we come to the time when nezahualcoyotl, restored to the throne of his fathers, is firmly established in the love and fealty of his people, and may turn his attention to the production of the odes and addresses handed down in castilian by his admiring descendant ixtilxochitl. this admirable monarch was, we are informed, 'the solon of anahauc.' his literary productions turn, for the most part, on the vanity and mutability of human life, and strikingly embody that epicurean poetic sentiment, expressed, at a later time, by our own english poet, herrick, in such verses as 'gather ye rose-buds while ye may.' "'banish care,' sings the royal tezcucan bard; 'if there be bounds to pleasure, the saddest life must also have an end. then wear the chaplet of flowers, and sing thy songs in praise of the all-powerful god; for the glory of the world soon fadeth away. "'rejoice in the green freshness of thy spring; for the day will come when thou wilt sigh for these joys in vain. yet the remembrance of the just' (piously adds the poet) 'shall not pass away from the nations; and the good thou hast done shall ever be held in honor.' and anon,--returning to his _epicurean_ 'muttons,'--he sings: 'then gather the fairest flowers in the gardens to bind round thy brow, and seize the joys of the present ere they perish.' "an english translation of one of nezahualcoyotl's odes has been made from the castilian. it harps upon the same old string, as also do his prose essays, which have less literary merit than his verse. we are told by his panegyrist that not all the time of this incomparable monarch was passed in dalliance with the muse, but that he won renown as a warrior, and in the interests of peace also fostered the productive arts that made his realm prosperous, as agriculture, and the like practical pursuits. between times he appears to have looked well after the well-being of his children, who, in numbers, rivalled the progeny of our modern patriarch, brigham young. it is recorded that by his various wives this monarch had no less than sixty sons and fifty daughters. (one condones his disgust with life!) the tezcucan crown, however, descended to the children of his one legal wife, whom he married late in life. the story of his wooing and winning this fair lady is almost an exact counterpart of the bible account of king david's treacherous winning of uriah's beautiful consort. "it is related of nezahualcoyotl, that having been married for some years to this unrighteously obtained wife, and not having been blest with issue by his beautiful queen, the priests persuaded him to propitiate the gods of his country--whom he had pointedly neglected--by human sacrifice. he reluctantly consented; but all in vain was this mistaken concession. then it was that he indignantly repudiated these inefficient pagan deities. "'these idols of wood and stone,' said he, 'can neither hear nor feel; much less could they make the heavens, and the earth, and man, the lord of it. these must be the work of the all-powerful unknown god, creator of the universe, on whom alone i must rely for consolation and support.' he thereupon withdrew to his rural palace, where he remained forty days, fasting and praying at stated hours, and offering up no other sacrifice than the sweet incense of copal, and aromatic herbs and gums. "in answer to his prayer, a son was given him,--the only one ever borne by his queen. after this, he made earnest effort to wean his subjects from their degrading religious superstition, building a temple, which he thus dedicated: 'to the unknown god, the _cause_ of _causes_.' no image was allowed in this edifice (as unsuited to the 'invisible god'), and the people were expressly prohibited from profaning its altars with blood, or any other sacrifice than that of flowers and sweet-scented gums. in his old age the king voiced his religious speculations in hymns of pensive tenderness. "in one of these, he thus piously philosophizes: 'rivers, torrents, and streams move onward to their destination. not one flows back to its pleasant source. they must onward, hastening to bury themselves in the bosom of the ocean. the things of yesterday are no more to-day, and the things of to-day shall cease to-morrow. the great, the wise, the valiant, the beautiful,--alas, where are they?'" "the compositions of nezahualcoyotl," observed the grumbler, as the antiquary folded away his finished paper, "though strictly founded on fact, are not exhilarating. his family was too large; and the wonder is, not that his odes and hymns are depressing, but that he should have the heart to 'drop into poetry' at all!" "we are told," rejoined the journalist, "by his descendant with the unpronounceable name, that once in every four months his entire family, not even excepting the youngest child, was called together, and orated by the priesthood on the obligations of morality, of which, by their exalted rank, they were expected to be shining examples. to these admonitions was added the compulsory chanting of their father's hymns." "poor beggars!" pitied the grumbler; "how they must have squirmed under this ever-recurring royal 'wet blanket!'" "you forget," said leon starr, coming to the rescue of the poet-father, "that in view of their inevitable mortality the bard had already advised them to 'banish care, to rejoice in the green freshness of their spring; to bind their brows with the fairest flowers of the garden, seize the joys of the present, and'--in short, had given them leave to have no end of larks, which, of course, they naturally and obediently did." "it is a noteworthy fact," observed mr. morehouse, "that many aborigines--though but scantily supplied with clothing, as the natives of samoa and the sandwich islanders--take great delight in adorning the body with flowers. to this liking the tezcucan king especially appeals in his odes and hymns. the mexicans have from time immemorial doted on flowers. this taste three hundred years or more of oppression has not extinguished." "do you remember, dear," asked mr. bixbee, turning to his wife, "the flower market in the plaza at mexico?" (the pair had, a year or two earlier, explored that city)--"that iron pavilion partly covered in with glass, and tended by nut-brown women and smiling indian girls?" "shall i ever forget it?" was her enthusiastic response. "the whole neighborhood was fragrant with perfume of vases of heliotrope, pinks, and mignonette; and such poppies, and pansies, and forget-me-nots i never elsewhere beheld!" "one can believe in absolute floral perfection," said the journalist, "in a country which embraces all climates. 'so accurately,' observes wilson, 'has nature adjusted in mexico the stratas of vegetation to the state of the atmosphere, that the skilful hand of a gardener might have laid out the different fields, which, with their charming vegetation, rise, one above another, upon the fertile mountain sides of the table-land.' "along with many other important vegetable growths, the cotton-plant is supposed to be indigenous to mexico, as cortez, on his first landing, found the natives clothed in cotton fabrics of their own manufacture. its culture continues to the present day, but with very little improvement in method since the earlier time of the spanish conquest." "and now," asked the harvard man, "since we are on the subject of mexican natural floral products, may i speak my little piece, which i may call, 'what i have learned about the cactus'?" the koshare graciously assenting, roger smith thus began: "in mexico the cactus is an aboriginal and indigenous production. several hundred varieties are identified by botanists. a beautiful sort is cereus grandiflora. as with us, this variety blooms only at night; its frail, sweet flower dying at the coming of day. the cactus seems to grow best in the poorest soil. no matter how dry the season, it is always juicy. protected by its thick epidermis, it retains within its circulation that store of moisture absorbed during the wet season, and when neighboring vegetation dies of drought is still unharmed. several varieties of cactus have within their flowers an edible substance, which is, in monterey, brought daily to market by the natives. that species of cactus which combines within itself more numerous uses than any known vegetable product is known as the maguey, or century plant. "upon the mexican mountains it grows wild as a weed; but as a domestic plant it is cultivated in little patches, or planted in fields of leagues in extent. its huge leaf pounded into a pulp makes a substitute both for cloth and paper. the fibre of the leaf, when beaten and spun, forms a silk-like thread, which, woven into a fabric, resembles linen rather than silk. this thread is now, and ever has been, the sewing thread of the country. from the leaf of the maguey is crudely manufactured sailcloth and sacking; and from it is made the bagging now in common use. "the ropes made from it are of that kind called manila. it is the best material in use for wrapping-paper. when cut into coarse straws, it forms the brooms and whitewash brushes of the country, and as a substitute for bristles it is made into scrub-brushes, and, finally, it supplies the place of hair-combs among the common people. so much for the cactus leaf; but from its sap arises the prime value of the plant. "from this is made the favorite intoxicating drink of the common people of mexico. this juice in its unfermented state is called honey water. when fermented it is known as pulque. the flowering maguey, the 'agava american,' is the century plant of the united states. "in its native habitat the plant flowers in its fifteenth year, or thereabout; and we are assured that nowhere, as is fabled, does its bloom require a long century for its production. the juice of the maguey is gathered by cutting out the heart of the flower of the central stem, for whose sustenance this juice is destined. a single plant, thus gingerly treated, yields daily, for a period of two or three months, according to the thriftiness of the plant, from four to seven quarts of the honey water, which, before fermentation, is said to resemble in taste new sweet cider. "large private profit accrues to the owner of maguey estates, and the government excise derived from the sale of the liquor is large. pulque is the lager of the peon. it was the product of the country long before the time of the montezumas; and ballou tells us that 'so late as 1890 over eighty thousand gallons of pulque were daily consumed in the city of mexico.' "it is said to be the peculiar effect of pulque to create, in its immoderate drinkers, an aversion to other stimulants; the person thus using it preferring it to any and all other drinks, irrespective of cost." the minister followed roger smith with an account of a famous tree of mexico. "it was at papotla," said this much-travelled invalid, "a village some three miles from that capital, that we saw this remarkable tree, which is called 'the tree of the noche triste' (the dismal night), because cortez in his disastrous midnight retreat from the aztec capital is said to have sat down and wept under it. be that as it may, the noche triste is undoubtedly a tree of great age. it is of the cedar family, broken and decayed in many parts, but still enough alive to bear foliage. "in its dilapidated condition it measures ten feet in diameter, and exceeds forty feet in height. long gray moss droops mournfully from its decaying branches, and, taken altogether, it is indeed a dismal tree. "it is much visited, and held sacred and historic by the people, who guard and cherish it with great care." "it calls up singular reflections," commented the journalist, "to look upon a living thing that has existed a thousand years, though it be but a tree. though so many centuries have rolled over the cypresses of chapultepec, they are yet sound and vigorous. "these trees are the only links that unite modern and ancient american civilization; for they were in being when that mysterious race, the toltecs, rested under their shade; and they are said to have long been standing, when a body of aztecs, wandering away from their tribe in search of game, fixed themselves upon the marsh at chapultepec, and, spreading their mats under these cypresses, enjoyed in their shadow their noontide slumber. then came the spaniards to people the valley with the mixed races, who respected their great antiquity, so that during all the battles that have been fought around them they have passed unharmed, and amid the strife and contentions of men have gone quietly on, adding many rings to their already enlarged circumference. 'heedless,' says wilson, 'of the gunpowder burned over their heads and the discharge of cannon that has shaken their roots, as one ephemeral mexican government succeeded another, these cypresses still remain unharmed, and may outlive many other dynasties.'" "apropos of the subject," said the antiquary, "nezahualcoyotl, according to his descendant, the native historian, embellished his numerous villas with hanging gardens replete with gorgeous flowers and odoriferous shrubs. the steps to these charming terraces--many of them hewn in the natural porphyry, and which a writer who lived in the sixteenth century avers that he himself counted--were even then crumbling into ruins. later travellers have reported the almost literal decay of this wonderful establishment. latrobe describes this monarch's baths (fabled to have been twelve feet long by eight wide) as 'singular basins, perhaps two feet in diameter, and not capacious enough for any monarch larger than oberon to take a ducking in.' "the observations of other travellers confirm this account. bullock tells us that some of the terraces of this apparently mythical palace are still entire; and that the solid remains of stone and stucco furnished an inexhaustible quarry for the churches and other buildings since erected on the site of that ancient aztec city. "latrobe, on the contrary, attributes these ruins to the toltecs, and hints at the probability of their belonging to an age and a people still more remote. wilson, on the other hand, positively accords them to the phoenicians." "in reading up on this famous empire, tezcuco," said leon starr, "one is inclined to believe that every vestige of this proud magnificence could not possibly have been obliterated in the short period of three centuries, leaving on the spot only an indifferently built village, whose population of three hundred indians, and about one hundred whites, maintain themselves in summer by gardening, and sending in their canoes daily supplies of 'herbs and _sullers_' (whatever this last may be) to mexico, and, in winter, by raking the mud for the 'tegnesquita,' from which they manufacture salt." "wilson," said the grumbler, "tells us that 'the tezcucan descendant of an emperor "lied like a priest."' however that may be, one cannot quite swallow his own relation 'in its entirety.'" "right you are," responded the harvard man; "and now here is miss norcross, waiting, i am sure, to cram us still further with mexican information." "it is only," said this modest little lady, "some bits that i have jotted down about mexican gems;" and shyly producing her paper, she thus read: "in enumerating the precious stones of mexico,--the ruby, amethyst, topaz, and garnet, the pearl, agate, turquoise, and chalcedony,--one must put before them all that wonder of nature,--the mexican fire opal, which, though not quite so hard as the hungarian or the australian opal, excels either of them in brilliance and variety of color. of this beautiful stone ballou has aptly said, 'it seems as if nature by some subtle alchemy of her own had condensed, to form this fiery gem, the hoarded sunshine of a thousand years.' he tells us that, in his mexican travels he saw an opal, weighing fourteen carats, for which five thousand dollars was refused. 'really choice specimens,' he goes on to say, 'are rare. the natives, notwithstanding the abundance of opals found in mexico, hold tenaciously to the price first set upon them. their value ranges from ten dollars to ten hundred.' "in modern times, as we all know, a superstition of the unluckiness of the stone long prevailed. now, the opal has come to be considered as desirable as it is beautiful, and, endorsed by fashion, takes its rightful place among precious gems. a london newspaper states that a giant australian opal, oval in shape, measuring two inches in length, an inch and a half deep, and weighing two hundred and fifty carats, is destined to be given to king edward the seventh; and that mr. lyons, the giver, a lawyer of queensland, desires that it should be set in the king's regalia of the australian federation. the london lapidaries believe it to be the finest and largest opal in the world. "its only rival in size and beauty is the hungarian opal, possessed by emperor francis joseph of austria. this gem is known as the 'imperial opal,' and is said, in its rainbow beauty, to display the blended colors of the ruby, the emerald, and the amethyst. "what is termed the 'fire' of the gem appears to burn in its remotest depths, with a glow and fervor which at times seem to convert the stone from the opaque to the semi-transparent." "we have in our own family," said miss paulina hemmenshaw, supplementing this account, "a rare mexican opal. long, long ago, it was given as an engagement ring to my mother's youngest sister, by her lover, who, while travelling in mexico, had secured this exquisite stone for a betrothal pledge. on the very eve of her wedding-day my beautiful aunt margaret died of an unsuspected heart-disease. the old superstition of the unluckiness of the opal being then dominant, my aunt's superb ring was laid by as a thing malignant as beautiful. "as a child i was sometimes allowed to take this sad memento of my dead aunt from its nest of cotton wool and admire its harmful splendor. at my mother's death it descended, along with all her own jewels, to me, her only daughter. now that we have outlived the foolish superstition in respect to this precious stone, i have made up my mind," said the good aunt, beaming kindly on her niece, "to take this ring from the safety vault, on our return to boston, and make it one of my wedding gifts to this dear child." "many thanks, dear ladies," said mrs. bixbee, as miss paulina ended, "for your talks about the opal. it is my favorite among precious stones. i even prefer it to the diamond, as something warmer and more alive. i am glad that its character is looking up in these days." "all the same," said mrs. fairlee, complacently turning on her slim white finger a superb hungarian sapphire, "nothing would tempt me to wear a stone even suspected of uncanniness. trials and crosses, of course, will befall one, but it seems to me foolhardy to wear jewels supposed to attract misfortune, and, for my part, i am still suspicious of opals; and were i king edward, i shouldn't thank my loyal australians for the gift of an ill-omened jewel, however costly and beautiful." "well," commented the journalist, "every one for his fancy; mine, i confess, is to 'mouse round' among musty book-shelves. looking over my portable store of odds and ends for something relevant to this evening's discussion, i came upon this extract from the 'voyages of one "thomas page,"'--a black letter copy of whose long-forgotten book, printed in london, in 1677, is still extant. as a curious picture of the times, it is not without an especial value; and, with your approval, i will now read it: "this account must be prefaced with the explanation that thomas page was an english dominican, who, as a missionary-monk, with his brother dominicans travelled to his destination in manila, by the road across mexico, landing, by the way, at vera cruz, and there depositing some illustrious fellow-voyagers. "'when we came to land,' says this quaintly circumstantial writer, 'all the inhabitants of the city had congregated in the plaza to receive us. the communities of monks were also there, each one preceded by a large crucifix,--the dominicans, the san franciscans, the mercedarios,--in order to conduct the virey (the viceroy) of mexico as far as the cathedral. "'the jesuits and friars from the ships leaped upon the shore from the ships. many of them (the monks) on stepping on shore, kissed it, considering that it was a holy cause that brought them there,--the conversion of the indians, who had before adored and sacrificed to demons; others kneeled down and gave thanks to the virgin mary and other saints of their devotion, and then all the monks hastened to incorporate themselves with their respective orders in the place in which they severally stood. the procession, as soon as formed, directed itself to the cathedral, where the consecrated wafer (called in the english original the bread god) was exposed upon the high altar, and to which all kneeled as they entered.... the services ended, the virey was conducted to his lodgings by the first alcalde, the magistrate of the town, and judges, who had descended from the capitol to meet him, besides the soldiers of the garrison and the ships. those of the religious orders that had just arrived were conducted to their respective convents, crosses, as before, being carried at the head of each community. "'friar john presented us [his missionaries] to the prior of the convent of san domingo, who received us kindly, and directed sweetmeats to be given us; and also there was given to each of us a cup of that indian beverage which the indians call chocolate. "this," the good friar tells us, "was but a prelude to a sumptuous dinner, composed of flesh and fish of every description, in which there was no lack of turkeys and capons. this feast," he naïvely apologizes, "was not set out for the purpose of worldly ostentation, but to manifest to us the abundance of the country." "'the prior of vera cruz,' he informs us, 'was neither old nor severe, as the men selected to govern communities of youthful religious orders are accustomed to be. on the contrary, he was in the flower of his age, and had all the manner of a joyful and diverting youth. his fathership, as they told us, had acquired the priory by means of a gift of a thousand ducats, which he had sent to the father provincial. after dinner he invited some of us to visit his cell, and then it was we came to know the levity of his life.... "'the cell of the prior was richly tapestried, and adorned with feathers of birds of michoacan; the walls were hung with various pictures of merit; rich rugs of silk covered the tables; porcelain of china filled the cupboards and sideboards; and there were vases and bowls containing preserved fruits and most delicate sweetmeats. "'our enthusiastic companions did not fail to be scandalized at such an exhibition, which they looked upon as a manifestation of worldly vanity, so foreign to the poverty of a begging friar.... "'the holy prior talked to us only of his ancestry, of his good parts, of the influence with the father provincial; of the love which the principal ladies and the wives of the richest merchants manifested to him, of his beautiful voice, of his consummate skill in music. in fact, that we might not doubt him in this particular, he took the guitar and sung a sonnet which he had composed to a certain _amaryllis_. this was a new scandal to our newly arrived _religious_, which afflicted some of them to see such libertinage in a prelate, who ought, on the contrary, to have set an example of penance and self-mortification, and should shine like a mirror in his conduct and words.... in the prior's cell of the convent of vera cruz' (concluded this character sketch) 'we listened to a melodious voice, accompanied with a harmonious instrument, we saw treasures and riches, we ate exquisite confectioneries, we breathed amber and musk, with which he had perfumed his syrups and conserves. o, that delicious prior!' exclaims our english monk, the humor of the situation overcoming his horror of the scandalous behavior of the ecclesiastic." "and now," said the minister, producing some leaves of sermon-like script, "may i call your attention, my friends, to the striking analogies found in the religious usages and belief of the aztec,--correspondent with those of the christian,--some of which i have considered in this little paper? "one of the most extraordinary coincidences with christian rites may, i think, be traced in their ceremony of naming their children,--the aztec baptism. an account of this rite, preserved by sahagan, is thus put into english: "'when everything,' says the chronicler, 'necessary for the baptism had been made ready, all the relations of the child were assembled, and the midwife, who was the person that performed the rite of baptism. after a solemn invocation, the head and lips of the infant were touched with water, and a name was given it; while the goddess cioacoatl, who presided over childbirth, was implored that "the sin which was given to this child before the beginning of the world might not visit the child, but that, cleansed by these waters, it might live and be born anew." this,' continues the narrator, 'is the exact formula used: "o my child! take and receive the water of the lord of the world, which is our life, and is given for the increasing and renewing of our body. it is to wash and purify. i pray that these heavenly drops may enter into your body and dwell there, that they may destroy and remove from you all the sin which was given to you at the beginning of the world. "'she then washed the body of the child with water. this done, "he now liveth," said she, "and is born anew; now is he purified and cleansed afresh, and our mother chalchioitlyene (the goddess of water) again bringeth him into the world." then taking the child in both hands, she lifted him towards heaven, and said, "o lord, thou seest here thy creature, whom thou hast sent into the world, this place of sorrow, and suffering, and penitence. grant him, o lord, thy gifts and inspiration; for thou art the great god, and with thee is the great goddess." torches of pine illuminated this performance, and the name was given by the same midwife, or priestess, who baptized him.' "the difficulty of obtaining anything like a faithful report of these rites from the natives," said the minister, "was complained of by the spanish chroniclers, and no doubt led them to color the narrative of these (to them) heathen rites and observances with interpolations from their own religious belief. 'the devil,' said one of these bewildered missionary monks, 'chose to imitate the rites of christianity, and the traditions of the chosen people, that he might allure his wretched victims to their own destruction.' leaving these monkish annalists to their own childish conclusions, and absurd interpretations of the aztec religious analogies, we pass on to the tradition of the deluge, so widely spread among the nations of the old world, the hebrew account of which was thus travestied by these semi-barbarians. two persons, they held, survived this historical flood,--a man named coxcox, and his wife. their heads are represented in ancient paintings, together with a boat floating on the waters. "another tradition (which is credited by humboldt) affirms that the boat in which typi (their noah) weathered the flood was filled with various kinds of animals and birds, and that, after some time, a vulture was sent out by typi, to reconnoitre,--as was done in the hebrew flood,--but remained feeding on the dead bodies of the giants which had been left on the earth as the waters subsided. the little humming-bird, huitozitsilin, was then sent forth, and returned with a twig in his mouth. the coincidence of this account with the bible narrative is worthy of remark. "on the way between vera cruz and the capital stands the tall and venerable pyramidal mound called the temple of chulola. it rises to the height of nearly one hundred and eighty feet, and is cased with unburnt brick. the native tradition is that it was erected by a family of giants who had escaped the great inundation, and designed to raise the building to the clouds; but the gods, offended by their presumption, sent on the pyramid fires from heaven, and compelled the giants to abandon their attempt. "this story was still lingering among the natives of the place at the time of humboldt's visit to it. the partial coincidence of this legend with the hebrew account of the tower of babel cannot be denied. this tradition has also its partial counterpart in the hebrew bible. cioacoatl, 'our lady and mother, the first goddess who bringeth forth,' who is by the aztecs believed to have bequeathed the sufferings of childbirth to women as the tribute of death, by whom sin came into the world, was usually represented with a serpent near her, and her name signified the 'serpent-woman.' "this fable, as will be seen, reminds us of the 'eve' in the hebrew account of the fall of man. the later priestly narrators, minded to improve upon this honest aztec tradition, gave the mexican eve two sons, and named them cain and abel. "in this aztec rite, coming down to us through tradition, the roman catholics recognized a resemblance to their especial ceremony of christian communion. an image of the tutelary deity of the aztecs was made of the flour of maize, mixed with blood; and after consecrating by the priests, was distributed among the people, who, as they ate it, showed signs of humiliation and sorrow, declaring it was the flesh of the deity. "we are told by a mexican traveller, torquemeda, a spanish monk, that, later on, when the church had waxed mighty in the land, the simple indian converts, with unconscious irony, called the catholic wafer 'the bread-god.'" here the discussion was, for a moment, interrupted by the withdrawal of miss mattie norcross and her invalid sister, who, wearied with long sitting, had dropped her tired head upon her sister's shoulder and gone quietly to sleep. as the grumbler rose to open the door for the two, all present might see the courteous air of protection and kindly sympathy which accompanied this simple bit of courtesy. evidently, the grumbler had met his fate at alamo ranch. "and now," said the star boarder, coming finally into the talk, "since mr. morehouse has kindly condensed for us the history of the aboriginal mexican from the far-off day of the nomadic toltec to the splendid reign of the last montezuma,--treacherously driven to the wall by the crafty cortez, when the spaniard nominally converted the heathen, overthrew his time-honored temples, rearing above their ruins christian churches, and, intent to 'kill two birds with the same stone' filled his own pockets, and swelled the coffers of far-off spain with aztec riches,--i have thought it not irrelevant to take a look at the humble native mexican as he is found by the traveller of to-day. "first, let me say that it has been asserted of mexico that 'though geographically near, and having had commercial relations with the world for over three hundred years, there is probably less known of this country to-day than of almost any other claiming to be civilized.' 'to the mexicans themselves,' declares an observing traveller, 'mexico is not fully known; and there are hundreds of square miles in south mexico that have never been explored; and whole tribes of indians that have never been brought in contact with the white man.' "mexico may well be called the country of revolutions, having passed through thirty-six within the limit of forty years. in that comparatively short period of time no less than seventy-three rulers, 'drest in a little brief authority,' have played their parts upon the mexican stage until the curtain dropped (too often in blood) upon their acts, and they were seen no more. "humboldt, in the seventeenth century, pronounced the fairy-like environs of the city of mexico 'the most beautiful panorama the eye ever rested upon.' on the table-land of this country the traveller is, at some points, eight thousand feet above the level of the sea. at such heights the air is so rarefied that the least physical effort well-nigh deprives the traveller of breath. 'through this rarefied atmosphere all the climates and productions of the world,' it has been affirmed, 'are embraced within the scope of a single bird's-eye view.' in portions of the country the _vomito_ renders the climate especially unkindly to the alien. "we are told that three quarters of the present mexican population can neither read nor write, possess little or no property, and can form no intelligent ideas of political liberty, or of constitutional government. "the degraded condition of the laboring classes is imputed in a measure to the constitutional inertia of a race who have no climatic conditions to contend with in their life-struggle; whose simple wants are easily satisfied, and who (it may be inferred) never know that 'divine discontent' which is the fulcrum on which the higher civilization turns. the manner of living, among this class, is thus described by wells: "'their dwellings in the cities are generally wanting in all the requirements of health and comfort, and consist mostly of rooms on the ground-floor, without proper light or ventilation, often with but the single opening for entrance. in such houses there is rarely anything answering to the civilized idea of a bed, the occupants sleeping on a mat, skin, or blanket, on the dirt floor. there are no chairs or tables. there is no fireplace or chimney, and few or no changes of raiment; no washing apparatus or soap, and in fact no furniture whatever, except a flat stone with a stone roller to grind their corn, and a variety of earthen vessels to hold their food and drink, and for cooking, which is generally done over a small fire within a circle of stones outside, and in front of the main entrance to the dwelling. "'their principal food is _tortillas_,--a sort of mush made of soaked and hand-ground indian corn, rolled thin, and then slightly baked over a slow fire. another staple of diet is boiled beans (_frijoles_). meat is seldom used by laborers; but when it is attainable, every part of the animal is eaten. should one be so fortunate as to have anything else to eat, the _tortilla_ serves as plates, after which service the plates are eaten. when their simple needs are thus satisfied,' says this observing traveller, 'the surplus earnings find their way into the pockets of the pulque or lottery-ticket sellers, or into the greedy hands of the almost omnipresent priest.' "these lotteries are, we are told, operated by the church, and form one of its never-failing sources of income, proving even more profitable than the sale of indulgences. "the idolatrous instinct, inherited from far-off aztec ancestors, decidedly inclines the native mexican to a worship that has its pictures and images, and its bowings before the virgin and countless hosts of saints, and the priest finds him an easy prey. "'while we were in the country,' says ballou, 'a bull-fight was given in one of the large cities on a sunday, as a benefit towards paying for a new altar-rail to be placed in one of the romish churches.' "religious fanaticism takes root in all classes in mexico, even among the very highest in the land. it is recorded of the emperor maximilian--a man of elegant manners, and of much culture and refinement--that he walked barefoot on a day of pilgrimage to the shrine of the virgin of guadaloupe,--distant some two or three miles from the city of mexico, over a dusty, disagreeable road. "it is but fair to add, in conclusion," said leon starr, "that it is asserted of the cultivated classes of mexico that they are not at all in sympathy with the extortions and other irregularities of their priesthood." with these interesting statistics ended the last effort of the new koshare to combine improvement and entertainment. hard upon this more solid delight-making followed the last afternoon tea, the lighter thursday evening entertainment, and the final shooting-match. all these gatherings took on a tinge of sadness from the certainty that the little winter family, brought together by fate at alamo ranch, were so soon to separate. chapter xv spring had now well come. in the shade it was already more than summer heat. fortunately there is, in new mexico, no such thing as sun-stroke; and one moves about with impunity, though the mercury stands at fervid heights. it was on all fools' day that the star boarder, accompanied by a little party of the koshare,--made up to escort him as far on his homeward way as el paso,--turned his back upon the loveliness of mesilla valley. through all this "winter of their discontent" leon had lent himself heartily to the work of delight-making; and the saddest of them all had been cheered by his genial atmosphere. what wonder if to these it was but a dolorous leave-taking; and that amid the general hand-shaking some eyes were wet, and some partings said with big lumps that would rise in swelling throats! a good face was, however, put upon it all; and even fang, dennis, and the chore-boy, sent a blessing and a cheery good-bye in the wake of the favorite boarder. as for the small mexican herd-boy,--who, with his best clean face, had come up to the ranch to look his last upon the adored white man under whose tuition he had become "a mighty hunter before the lord,"--he simply "lifted up his voice and wept." following hard upon this departure came the general break-up of the koshare circle. the hemmenshaws, with the bridegroom elect, roger smith, were the next to depart. miss paulina, as may be inferred, turned her face bostonward with her heart in her mouth, in view of that account of her chaperonage to be rendered to the father whose daughter she had, as it were, handed over to the grandson of a tanner. and here the historian, asking leave to interrupt for a moment the routine of the narrative, informs the gentle reader that that august personage, col. algernon hemmenshaw, was ultimately placated; and that if a tanner's descendant bearing the non-illustrious name of smith was not altogether a desirable graft for the hemmenshaw ancestral tree, a fortune of more than a round million tipped the balance in his favor, and the permitted engagement came out in early may-time. beacon hill, at its announcement, threw up its hands in amazement and distaste. "to think," it exclaimed, "that louise hemmenshaw, who might have had her pick among our very oldest families, should take up with the grandson of a tanner!" * * * * * out on the mesa it is early nightfall. the little day-time flutter and stir of moving things has, with the setting sun, given place to silence and rest. a rounded moon looks serenely down upon the grey sage-brush, the mesquite-bushes, on the lonely stretch of sandy desert. the last gleam of day has faded from the organ mountains, leaving them to dominate, in sombre grandeur, the distant landscape. in the warm, haunted silence of this perfect night two lovers saunter slowly along the mesa. these happy beings are not unknown to us. the lady is from marblehead; the other has before-time been dubbed the grumbler. the name no longer fits the man. his defective lung has righted itself in this fine new mexican atmosphere. no more is he at odds with fate; he has become sincerely in love with life, with the climate, and, most of all, with the sweet little teacher from marblehead. they are to be married early in june. the climate admirably suits the invalid sister, and it is hoped that in this fine dry air her well lung may remain intact, and so serve her for years to come. the grumbler, having money enough to order his residence to his liking, has determined to settle permanently in new mexico. to that end he has, for the time, rented the hilton place. later, he intends to lay out "as a gift for his fair" the ranch of her dreams. here, in the beautiful mesilla valley, we may predict that the married pair, like the enchanting couples of fairyland, will "live happy ever after." and now it but remains for the chronicler of the new koshare to take leave of "the land of sunshine." a backward glance at the half-deserted alamo shows us a dreary handful of incurables still tilting their piazza-chairs against its adobe front, warming their depleted blood in the grateful sunshine, and each, as best he may, accepting the inevitable. long, long ago it was that the pueblos made that traditional journey "from shipapu to the centre of their world" with the heaven-provided koshare, in particolored attire, and fantastic head-dress of withered corn-husks, jesting and dancing before them to lift and lighten the weary road. yet since then, through all the centuries, the "delight-maker," in one shape or another, has been in requisition in every land beneath the sun. 