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airy ward or open liege halle receive visits from their friends
even in these last days, but let them go to the grave with the
consolation of knowing that they are not handing on a legacy
of tragedy to those they leave behind.
" In all other infectious diseases we attack infection at
its source; cases of smallpox, of leprosy, of diphtheria, of
plague, are isolated, but cases of tuberculosis in their last
stages, the most deadly stage of the most deadly disease of all,
are still allowed throughout Europe to spread further infection
broadcast in the midst of their already destitute families. This
fact does not yet seem to be learned. "When it is, and when
we have these homes (for the hopeless cases) adjoining every
city, then tuberculosis will pass from the midst of us."
According to this view the attack by this disease of
relatives in houses where consumption has occurred should
show out prominently, but so far as Camberwell is concerned I
have found nothing to lead me to believe that this happens
with any frequency.
That phthisis has vastly diminished of late years is
demonstrable from statistics, but that this diminution is due to
the measures which have been taken, on the hypothesis of the
great direct infectivity of phthisis, for its notification, disinfection,
&c., I have not seen any direct proof; indeed, the decrease
of mortality commenced in England long before any of these
measures were thought of.
It is stated that in Prussia the only decline in
the mortality from tuberculosis shown by the records has
occurred since 1888; and this is co-incident with the taking
of precautions even among the lowest classes in Germany,
together with the bringing into operation of the workmen's
sick insurance laws, and with the establishment of sanatoria,
which is also set out as a prophylactic measure, but of too
recent date to be quoted with certainty.
But to ensure the validity of this argument it must be
proved that other diseases, particularly those dependent on
defective hygienic surroundings, such as enteric fever, have
shown no such corresponding diminution during the period
referred to. If they, on the other hand, have shared in the
decrease it may reasonably be argued that it is to the improved
conditions under which people live that we must look for an