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In 12 instances there was a history of Consumption in the family,
but we know that hereditary transmission is so rare as to be left out
of the question. In the majority of cases, the sputum must be regarded
as the main source of infection, and the germs must have
reached the lungs by inhalation. It is difficult not to infect the rest
of the family when a case occurs amongst the poor. The whole family
have to live in two or three ill-ventilated rooms, and the patient is left
without the nursing he requires. At night he sleeps in the same room
as other members of the family do. The sufferer scatters the morbid
matter secreted by his diseased lungs every time he coughs, and his
relatives close beside him must inhale the poison. Thus whole families
are infected. In one case inquired into 9 members out of a family
of 11 had succumbed to the disease. In another family, the father,
son, and 3 of the daughters died from the disease. Instances of 2, 3,
or 4 deaths from Consumption in the same family were not infrequent.
Such events awaken in the minds of those who do not know the infectiousness
of tuberculosis the opinion that it is hereditary, whereas
its transmission in the cases in question was due solely to the simplest
processes of infection, which do not strike people so much, because
the consequences do not appear at once, but generally after the lapse
of years The fact that some of the family escape is no argument
against its infectiousness. Apart from the question of immunity, the
infectivity or communicability of a given disease bears an inverse ratio
to the duration of. the malady. The object of the parasite is to provide
for the continuance of its species. Tn Measles, Scarlet Fever, and the
acute infectious diseases where their duration is short, the communicability
is high, since the opportunities afforded to the parasite of reproducing
its species are limited. In Consumption, on the other
hand, where the duration of the disease is long, the communicability
of the disease is low, as ample opportunities are afforded for its propagation.
It is on this assumption that disinfection is carried out after
the death of the patient, though in a large majority of the cases the
damage has already been done. Disinfection was urged in all cases
where death has occurred, but only in 17 instances was the offer
accepted.
It is pointed out on another page that the most dangerous period
is the last month of the disease, and arrangements have now been
made so as to obtain a list of those removed to the