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106
by direct infection. Still greater care should be taken to protect persons
of known phthisical tendency or parentage.
(2) Acquired want of resistance.—Overcrowding, living or working
in ill-ventilated rooms or in damp houses, dusty occupations, and any
condition which lowers vitality predispose to consumption. Among
these may be mentioned excessive consumption of alcohol, insufficient
food, other illnesses, over-training, prolonged suckling of children, and
frequent child bearing.
Unfortunately I can give examples of each of these from the
experience of the last year. (See details of typical cases appended).
It must be kept in mind, however, that these conditions have not in
themselves caused consumption. They may induce conditions of general
bad health, but in the absence of the tubercle bacillus they cannot
cause tuberculosis. There are, therefore, two lines of action which can be
taken to prevent tubercular disease.
(1) To raise the standard of health by the removal of such
conditions as I have enumerated above, and
(2) To prevent the possibility of debilitated persons being infected.
Both of these are important. It is the object of the existence of
sanitary authorities to take such steps as may be necessary to ascertain
the existence and obtain the removal of such conditions as tend to
lower the public health. It is too often thought by the public that
matters affecting the general well-being of the people at large should
be left entirely to those who are elected as representatives on Borough
Councils and their officers, but it is no less the duty of everyone to take
a share in the work of removing those conditions which promote the
development and spread of disease. In order for this to be done it is
essential that the public should be educated and their interest stimulated.
It is therefore a matter for congratulation that there is in the City of
Westminster active movement in this direction.
Cases of Tubercular Disease.
Source of Infection ascertained in
44 cases.
Husband 5
Wife 3
Brother or sister 7
Son or daughter 3
Father or mother 10
Other relative 2
Lo'ger 1
Neighbour 1
Fellow worker 12
Predisposing influences in 48 cases.
Condition induced or aggravated by.
Dusty trades 6
Exposure 3
Alcoholism 4
Insufficient food 4
Damp houses 3
Overcrowding 3
Defective ventilation 4
Injuries 2
Previous illness 15
Over exertion (racing, cycling, &c.) 4
It is further urgently necessary that provision be made in London
for the prompt recognition and early treatment of consumptive cases.