CITY OF CLEVELAND

As regards the sex of cases handled during the first eight
years, 38% of patients admitted were females and 62% males.
The number of females treated last year was approximately 45%
of the total number of patients. The number of women affected
with tuberculosis has been shown to be increasing to some extent,
especially in the age groups under 30 years of age and to
some extent at least this condition may be charged to changed
social conditions among women.
For the past few years the number of native born cases
among the entire number receiving treatment has been increasing.
In 1926 the percentage of all cases occupying beds who
were born in the United States was 73% which was the highest
for any previous year. During the first eight years of operation,
namely between 1913 and 1920, only 43% of the cases
treated were born in the United States. This reflects the differing
conditions resulting from a restriction of immigration. Unquestionably
closing the ports of entry to immigrants has reduced
the number of tuberculosis cases of foreign birth handled
in such institutions as that at Warrensville. On the other hand
the increased number of colored cases must be noted and has
been dealt with previously, which may be considered as an intimate
part of the problem which has been raised through the
restriction of immigrants from foreign lands. During the first
eight years of operation but 19% of the cases treated at the
institution were born in Cleveland. In 1926 in a total number
of 694 cases treated 235 or 33% were born in this city.
Among the 27% of cases treated in 1926 who were foreign
born the larger number of cases came from Austria, Hungary,
Czecho-Slovakia and Jugo-Slavia. There were however 22 different
countries represented among the foreign born patients
treated during the year. 92 of the 188 foreign born cases came
from one or the other of the four countries above mentioned.
TREATMENT.
The routine treatment followed at the institution during the
year just closed has differed but little from that of the previous
years. There has been however decided improvements made in
systematizing certain special kinds of treatment, and particularly
does this apply to the application of helio-therapy.
Helio-therapy.
A word of warning is necessary whenever helio-therapy of
tuberculosis is being discussed as to dangerous results likely to
follow from ill-advised use of sunlight or of the shorter wave
lengths of light provided by artificial means, On more than one
occasion at the institution patients have felt that exposure to
sunlight was so easily accomplished that long periods of exposure
beyond those advised by the physicians would accomplish good
results whereas in one or two instances very serious results occurred.
The method employed in helio-therapy calls for a slow
exposure of the body to light, gradually increasing the length
of time and the area exposed but constantly checking against
any ill effects. Cases running fever or having hemoptysis or