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in England there die annually some 51,000 persons; in London 7,500; and
even in Islington some 600 persons. These are staggering figures, representing
as they do in Islington about 12"2 per cent, of the deaths from all causes.
But this is not the worst feature, for each death from pulmonary phthisis
represents at the very least four persons who are actually and demonstrably ill
with the disease; and that they too, if some agency does not reach them
speedily, will in a comparatively brief period be tabulated in the mortality
returns. They can only be discovered by search, as a rule, for usually—and
unfortunately—the cases do not come under medical supervision until the
disease has taken so strong a hold of the victims that their cure is not certain —
nay, indeed, is very doubtful—while probably for months they have been
centres either in their own homes, or their friends' homes, in their workplaces,
in places of popular resort, or in public houses, from which the disease has
spread to others.
It is, therefore, of paramount importance that such cases should be
discovered at the earliest possible moment, not only for the purpose of their
own cure, but for the prevention of the spread of the disease to others.
Every one is not equally susceptible, for although the strong and robust
may escape infection, but not always, a person whose physical condition
is weak, or as we say "below par," even for a brief period, is easily infected.
So, too, are those who indulge freely in alcohol. Indeed, such persons
furnish a large number of the cases that end quickly. Again, persons
whose vitality has been exhausted by disease, especially by pleurisy,
pneumonia, measles, influenza and typhoid fever quickly succumb to the
influence of the germ. Environment, too, is a potent factor in causing
susceptibility, and therefore, we find the disease in dark houses and in damp
houses; among persons who live, sleep or work in dismal and overcrowded
rooms ; among people who work in badly lighted and badly ventilated offices
or workshops, and, therefore, amidst foul air, or at trades, producing much
dust; and also among people suffering privation, who are ever the first
to succumb to it.
Among Children.—Tuberculosis among children, who often inherit a
predisposition to it, is frequent. They are often, too, exposed to danger from
their parents, if either of them be tuberculous. The infection is conveyed to
them by kissing, fondling, using the same food utensils, towels, bedding, and
the many articles usually used in common in families. Indeed, the prevalence
of the disease in families having one or both parents affected is most
noticeable, and doubtless accounts for the opinion so prevalent up to very
recent years that the disease was inherited. In such a family, children
playing on the floor, drinking from unwashed cups, sucking those wretched