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111
Report of the Medical Officer (Education).
maintenance of some infection by the causes of disease. Those affected need never suffer malaise, but
they acquire and maintain the amount of immunity required to prevent epidemics, and catastrophal
outbreaks. Tubercle as an infection is probably more ubiquitous than measles and although everyone
acquires it, yet few become diseased. Not more than three children in a thousand in school, present
evident phthisis. Yet searching the families of adults suffering from tubercle, children are found coming
from such an environment, who are themselves infected and the observations taken in the school have
shown that the majority are seriously infected. Only long observation can determine how
extensive this infection is, and whether the main factors contributing to serious or lethal
disease are heredity, debilitated physique or infection. It is possible from the Registrar
General's records to reconstruct the facts for London so far as fatalities are concerned, but it is yet
impossible to even estimate how many of those infected seriously are able to recover. That, however
can be left for the moment.
Dr. Letitia Fairfield by taking the ten years 1900-09 in order to average
infectious diseases,ascertained that the mortality for London as deduced from the figures of the Registrar
General, and re-arranged by interpolation in years of life, give for the common infections (measles,
whooping cough, scarlet fever and diphtheria) and for tuberculous disease, the following numbers of
deaths.
Ages.
2-
3-
4-
5-
6-
7-
8-
9-
10-
11-
12-
13-
14-
15-20
Tubercular
diseases.
2,732
1,777
1,343
995
880
715
545
415
354
408
430
478
506
4,490
Infectious
diseases.
7,183
4,763
3,097
1,650
l,150
853
503
.330
190
134
90
60
45
180

recovery.
Hitherto the school authority has not been able to do much against tuberculosis. Indeed the
public health authorities have been very lax in regard to this disease, which is the chief single cause
of disablement in adult life in this country. A great deal has been written and talked about the importance
of tuberculous milk, and this has been enormously exaggerated as a factor in dissemination of
disease, whilst the other contributory factors have been much neglected. The tubercular cow has, unfortunately,
turned attention to itself, but it must be vanishingly small compared with the tubercular
person as a cause of disease after the first year of life. Heredity from the past is almost unalterable in
the present, but other conditions of debility notably the depressing factors, want of food, chronic fatigue,
alcohol and the irritating factor of dust and infection are ail more or less within immediate control if
the price oi control is paid. The tuberculosis tax must be paid in money or lives.