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32
4.—It will afford an opportunity of maintaining some observation
over consumptive patients, so as to ensure that they continue to
take precautionary measures.
5.—It will afford an opportunity of inquiring into the possible source
of the infection.
6.—It will enable information to be gleaned as to the conditions
under which the patient worked, which is a most important
matter, because ill.ventilated workshops have been most
fruitful sources of this disease. And it will enable special
attention to be drawn to the habit of spitting, which is so
common in these places.
7.—It will afford an opportunity of obtaining information as to the
part different occupations or trades play in the distribution of the
disease.
These are all important objects, and I have not the least doubt that the
information gained through enquiries will tend to the decrease in the number
of deaths from Phthisis.
During the last thirty years, but especially during the last ten years, there
has been a gradual decrease in these deaths throughout England and Wales,
as has been shown on page 26.
This decrease in the mortality has been due mainly to :—
1.—Improved drainage.
2.—The abatement of overcrowding.
3.—The improvement that has taken place in the conditions under
which the labouiing classes live.
4.—Better and more wholesome food.
This is well demonstrated in the case of young children, among whom the
mortality is only one.third of what it was forty years ago, while at all ages it
is only three.fifths of what it was.
These sanitary measures were mainly directed against other diseases than
Phthisis, and on them the effect was very marked.