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history was obtained in 2 out of 10 cases. Of children of school age,
the history was obtained in 8 out of 20 cases. Ill all cases the milk
supplied to the home had been treated by heat. The difference in
the proportions of cases in which a family history was obtained
suggests that the home infection was there, causing the disease in the
ease of children under school age, but that it is not until it is
sufficiently advanced in the infecting source that it is recognised,
and by that time the children have reached school age.
Amongst the males over school age, a family history was
obtained in one-third of the cases. One-third of the males were
engaged in some outdoor occupation, such as motor driving,
labouring, etc., 3 patients worked in the printing trade and another
6 were engaged in a dusty occupation. Of the females, most were
engaged in housework. A family history of disease was obtained
in nearly one-half of these latter cases.
The fact that the notification rate is lower than that obtaining
in the country as a whole is probably accounted for to a certain
extent by the age distribution of the population. Amongst
persons of over 45, only 15 notifications were received, which is a
lower percentage than ordinarily obtains, and is due to the shortage
of persons of these ages. This would however, account for only
part of the reduction, and one would assume that the better housing
conditions here have had a beneficial effect. Tuberculosis, however,
is essentially a disease in which nutrition plays a large part, and the
relative poverty of the inhabitants must adversely affect any
benefits obtained by better housing. Rents are high and in many
cases the family income is depleted by the cost of travelling expenses.
I he resulting net income is low and it is a question whether the
advantages of satisfactory housing in an area such as this are
sufficient to outweigh the effects of shortage of wholesome food
which occurs in many households.
Housing and Tuberculosis.
The relationship of housing to tuberculosis is one difficult
to assess. Although there is frequently found a close connection
Between poor housing conditions and a high incidence of tuberculosis,
so many factors arc involved that the association cannot
be said to be one of cause and effect—so often poverty following
disease in the wage earner results in the family being forced
into unsatisfactory dwellings. It seems that some tend to overstress
the beneficial effects of suitable housing in its relations to
tuberculosis. The consideration of suitability too must not be
limited to the fact that persons are placed in houses which are
from a sanitary point of view, sound—so much depends upon
the Use made of the premises. A house might be ideal for a