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143
It is generally regarded that the cause of the increased incidence of
the disease in the 15-20 year old group has been due to their going
out to work, a condition which did not obtain so much before the war.
There has always been much discussion and a good deal of difference
of opinion on the subject of the incidence of tuberculosis on the
conjugal partners of tuberculosis patients. In this matter I have
always held the view that marital tuberculosis is much more common
than is generally supposed, and my contact with a Dispensary for a
good many years has confirmed me in this opinion. Many years ago
I had a tuberculous male patient who had three successive wives who
died of the disease and a woman patient who had two husbands in
succession who died of this complaint. A case occurring in the Dispensary
practice of a cross infection, i.e., the wife, infected by a husband
who died, married again and the second husband died of tuberculosis.
This suggested to me the advisability of looking through the
Register to determine the number of such cases which had come under
observation.
For this purpose the consecutive names of married patients were
taken from the register, only those cases being recorded in which both
husband and wife had been examined, or in which it was reasonably
certain that either husband or wife had died previously of tuberculosis.
The names of 166 couples were thus extracted. In 117 the first
patient attending was the husband and in 49 the first was the wife.
In 36 of these cases both partners were affected, i.e., 21.7 per
cent.
In 9 of these couples one partner had died prior to attending the
Dispensary, but in 27 cases both partners were seen at the Dispensary,
giving a percentage of 16.2 per cent.
Of the 27 couples seen at the Dispensary, in 20 cases the husband
was the first case and in 7 the wife.
Of the 9 in whom one partner had previously died, in 3 cases it
was the husband and in 6 the wife.
Of the rest of the 166 cases inspected, in 28 cases one partner was
suspect, in 8 cases the husband and in 20 cases the wife.