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(34)
In spite of all efforts in only six cases out of thirteen were
the mothers and fathers willing to attend for examination. In
all six cases either the father or the mother was found to be
suffering from pulmonary tuberculosis, in four cases with a
positive sputum. In one sputum negative case, 8115, the diagnosis
was confirmed at the Brompton Hospital. In the other
case, 8057, nothing was suspected until an X-ray examination
revealed definite mottling at one apex. In both these cases it
is possible that the parent might at one stage have been an open
case of tuberculosis.
As was stated earlier the general practitioner can be of great
help by urging on the contacts the necessity of attending for
examination.
It appears to be certain that direct infection from one person
to another, often a near relative, plays a very large part in the
spread of tuberculosis. In an industrial district overcrowding and
poor housing conditions are highly conducive to the occurrence
of multiple cases of tuberculosis in a family. Not only are several
people forced to live and sleep in too small a space, but the conditions
lower their natural resistance and render them more
easily a prey to infection. Home environment appears to be of
far more importance than occupation or place of work in the
majority of cases.
The following statement shows the housing conditions of
283 'sputum positive' cases on the Dispensary Register at the
end of the year:—

* Available for use as a sleeping room.