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fraction of this minimum amount, if it can be reasonably shown that such
expenditure will result in the elimination of a corresponding proportion of
the fatal terminations from tuberculosis ? "
By applying these Tables to Islington I find that the annual economic loss
here is approximately £33,000 per annum, which added to the cost of pauperism
represents an immense sum of money.
Is not the saving of this money worth striving for?
There is another point that I would like to mention briefly—and everything
must be brief in a short report of this character on a subject so
great and so vitally interesting-—namely, the enormous number of
years of life sacrificed through phthisis. This was well indicated by Dr.
Hayward in his life Table (based on the mortality in England and Wales in
the ten years 1891-1900), wherein he showed that if there were no phthisis
at 25 years of age the mean expectation of life for males would be 39.2 years,
and that at 35 30.8 years. It follows, therefore, that every male carried off by
the disease at these ages loses these numbers of years of life, while his family,
the community, and the State lose the money value of his earnings during
these years.
Writing on this subject in 1908, Dr. Newsholme in his " Prevention of
Tuberculosis " showed what the abolition of phthisis among men would mean,
for he says that " if we assume that the average wage of each is 20s. a week,
a possible gain of over £400,000,000 might be obtained on the above lives (the
working years of life before 65) or not far from £10,000,000 annually. And
this makes no allowance for the loss sustained by protracted sickness, nor for
the further loss from premature death of women from the same cause."
Do not these figures indicate what enormous money losses are due to
tuberculosis ?
Tuberculosis a Disease of Urbanization.—If we compare rural
with town populations we will invariably find that the disease is more prevalent
among the latter than the former. This is after all what might reasonably be
expected for two reasons; firstly, because the germ of the disease is destroyed
by fresh air and sunlight, which countryfolk enjoy more than townspeople ;
and also because urbanization means aggregation, congestion, and too often
overcrowding of the population. In the towns we find the working population
badly housed—and for the matter of that the same evil is to be found in the
country, where, however, the open-air life to a large extent neutralizes it—living
in dark rooms, amidst foul air, especially in the very poor districts, where poor
food and too little of it, are the usual concomitants. These are not of themselves
probably the cause of the disease, but, given its introduction among such