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42
at Isleworth Infirmary of persons removed from a common
lodging house in Acton, and in 1907 there were also two such deaths.
Factors other than liability to infection enter into the causation
of a death-rate from Phthisis among common lodging
house inmates, and these factors are probably common in both
male and female.
Improved housing conditions have largely influenced the
incidence of the disease among the poor, and these conditions
would be responsible for a greater reduction among females
as the men are absent from the home during a large portion of
the day. This subject will be referred to when dealing with
the distribution of the disease.
It has also been suggested that the explanation may in
part be a physiological one, and as such the case would be
outside the range of activity of a sanitary authority. It would
serve no purpose in discussing the subject in an annual report.
It is now generally held that Tuberculosis is an infectious
disease caused by the tubercle bacillus, but opinions differ as
to the degree of communicability in ordinary social intercourse.
The question as to whether any given series of exposures to
infection is to be regarded as the actual source of infection
must be decided upon a balance of probabilities, and having
regard to the widespread prevalence of pulmonary tuberculosis
and chronic cough, which may well be of a tuberculous
nature, it is extremely difficult to fairly measure the value of
irregular and intermittent associations and to ascertain how
far chance may have been operative. The evidence clearly
points to the conclusion that in most instances short exposure
to infection does not suffice to infect healthy persons to an
extent that will produce serious disease.
Under certain conditions, though, Tuberculosis seems to
be more likely of being communicated from one person to
another. The children of tubercular parents, for instance, are
more likely than others to become tuberculous, and in six of