To ensure efficiency in a sanatorium a resident physician is, as a rule, necessary; and this is desirable also for a tuberculosis hospital. Smaller authorities may be unable to combine together or to provide alone an institution with about 100 beds, which is generally regarded as the unit best adapted to secure a well-placed and efficiently organized institution, with due regard to economy of administration. To provide such a unit, and even apart from this, the desirability of treating patients in all stages of disease in the same institution should be considered. Experience in England has shown that this combination presents no medical administrative difficulties, provided that the type of sleeping accommodation for patients consists chiefly of rooms for one or two patients or of small wards. With such an arrangement, if a section of the institution consisting of one or two bedded rooms or small wards is devoted to patients needing special nursing, irrespective of the stage of disease, efficiency is secured, the special needs of each class of patients can be met, and—this is especially important—the patient with advanced disease cannot infer the hopeless character of his illness from his place in the institution. Such a combined institution affords the medical and administrative advantage that the tuberculosis officer can, as a rule, watch his patients throughout the whole course of their treatment, both in the residential institution and at the dispensary. In choosing a sanatorium an area of at least twenty acres should be available; and at least one-fifth of an acre should be allowed per patient. For a hospital a smaller area is permissible. There should be a floor-space of at least 64 square feet for each patient; and the centres of the heads of adjacent beds should not be distant less than 8 feet measured against the wall. Experience appears to show that in a large sanatorium one nurse will generally be adequate for every twelve patients. In a hospital for advanced patients, or in a combined institution a larger staff may be required. _Observation Beds_ There is but little systematised experience as yet of the employment of observation beds; a difficulty arising from the fact that the tuberculosis officer under most local tuberculosis schemes has not been sufficiently in touch with the medical officers of the residential institutions to which he sends patients. There are practical difficulties in the provision of observation beds on the dispensary premises, including the difficulty of due regard to economy of administration in the nursing and treatment of three or four in-patients at a dispensary. Whatever arrangements are made for such beds, it is desirable that the tuberculosis officer should have access to the patients treated in them. _General Observations on Treatment in Sanatoria_