endowments, or else has used them to so slight an extent that the community has received no benefit. If the physicians of a community have been able to diagnose tuberculosis, and have been required by law to report it, why has it become necessary to establish municipal dispensaries for this purpose? Can the dispensary physician make a better diagnosis? Or is he more willing to fill in a blank and report the case? And if the physicians, required by law to instruct and keep careful watch over their consumptive patients, had been able to do this, why has it become necessary to place tuberculosis nurses in the field, designed to give just such service? Is the special nurse better fitted to explain the nature and danger of the disease? Is she a more efficient distributor of prophylactic supplies? To all these questions there should be but one answer—there is, or should be, no difference between the two. The private practitioner should be as well able to make a sure diagnosis as the municipal physician. He should be as ready to report the case. The private practitioner should be as capable a teacher, as careful a distributor of supplies, as alive to the danger of tuberculosis as the municipal nurse. The only difference between these two groups of people is that one acts and the other does not—or acts in such intermittent and irregular manner as to be productive of no results. And it is because of this lack of action on the part of the physicians in private practice, their failure to recognize, report, teach, and continually supervise consumptive patients, that our cities are placing the care of tuberculosis under municipal control. The care of tuberculosis is gradually being withdrawn from the man in private practice, and placed in the hands of specialists, who devote their entire time to the welfare of the community. And although now as always the latter solicit the support of the private physician, if he withholds his co-operation they can do without him, and reach their goal through other means. =Impossibility of Fulfilling this Obligation.= We may ask why the private practitioner is being supplanted by municipal control. Undoubtedly he once held the key of the tuberculosis situation, as he holds it of many other problems involving the public health. He is being supplanted for two reasons: because of the peculiar nature of tuberculosis, and because of the failure of the medical profession to act as a united whole.