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Probable Contact.
(ii.) In 19 cases the source of infection could not be definitely stated. Twelve
had near relatives, who had died of phthisis ; but such a long time (in one case
fifteen years) had elapsed since their deaths that it seemed unwise to trace the infection
to this source, although no other was apparent. Seven had relatives known to
be phthisical but who lived at some distance ; these patients said that they had no
personal contact with these relatives.
(iii.) In 5 cases there was no clue to the source of infection, but it seemed that
circumstances had rendered the patient an easy prey to attacks of infection.
Two widows had worked very bard for years on insufficient food. One man had
had an accident, resulting in damage to the lungs. One woman was of confirmed
intemperate habits. One child had been underfed and neglected, her mother having
to go to work for many hours daily ; the child's condition had improved since having
dinners provided at school
Conditions favouring existence of Tuberculosis.
The cases last mentioned indicate to some extent that the same influences
which I have referred to as adversely affecting infant life, are also at. work, producing
conditions favourable to the existence and spread of tuberculosis in all its forms.
These may be spoken of with more certainty in their effect upon children than en
adults ; for, with the latter, factors which may not necessarily affect the community
in general, operate differently in individual instances ; thus, one adult works at an
unhealthy trade, another frequents public-houses, and so on ; these constitute
dangers to which children are not directly exposed, although indirectly affected by
them.
Rather more than one-third of the phthisical-patients whom I have visited
have been children under 14 years, the youngest being 3 years old.
A great many of these are children, who though they may have enough food to
keep them from being hungry, do not have a sufficiently generous diet. These appear
to suffer very much from want of fresh milk, its place being taken by tea. to which
a little machine skimmed condensed milk (used for " economy's sake ") is added.
Then there is the very harmful effect of the want of air and space in sleeping
rooms ; frequently these children have been sleeping three together in a small bed
in a stuffy room, often used as a living room during the day-time. Thus the
children are not able, whilst growing, to build up constitutions fitted to resist the
attacks of infection from phthisis to which they are frequently exposed, both at
home, at school and in the streets.