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39
inheritance factor is far more important than the infectious factor,
because in a very large proportion of cases it does not lie in the
power of the individual to maintain, in the stress of urban life, a
wholly safe environment."
As regards the value of Sanatoria in our crusade against
Consumption, I have in a previous report expressed the view that
prophecies have been rather extravagant, and when the statistical
facts embodied in the annual reports of these institutions are carefully
analysed, the record is generally a somewhat disappointing one.
Such provision is quite a subsidiary plank in the Anti-Tuberculosis
platform. Certainly, in connection with these institutions, there
must be After-care Associations, which will keep in touch with those
who have been discharged and, where possible, obtain some form
of suitable occupation for those who are dependent upon their labour.
There is everything to be said in favour of a far more extended
provision of sanatoria for children is this country, where all the
tuberculous affections may be dealt with. There is no doubt that
exaggerated statements have been made with reference to the prevalence
of Pulmonary Tuberculosis among children at the school age.
This was well exemplified by the work undertaken in 1906 under the
Education Authority of the County, when it was found that only 1.3
per cent. of 1.670 school children examined were suffering from
Pulmonary Tuberculosis. Still children suffer to a considerable
extent from tuberculosis in its other forms, and the medical inspection
of school children will, especially in the case of the youngest children,
do a good work in weeding out those who may not only prove a source
of danger to others, but are capable of benefiting considerably by
treatment and improved conditions.
The reduction in the death-rate from Pulmonary Tuberculosis, or
Consumption, in the Administrative County of London is well shown
in the following table, reproduced from the annual report of the
Medical Officer of the County Council: