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24
monary Tuberculosis in children should be made with great
caution. The reason I lay so much stress on the figure showing
the number of cases with Tubercle Bacilli in the sputum is twofold.
Firstly, because it is the only certain test we have that a
patient is suffering from Pulmonary Tuberculosis. In all other
cases the diagnosis is merely an opinion more or less accurate
according to the experience of the physician.
Secondly and most important, we must always remember that
everyone of these cases is a source of infection, or rather a source
of supply of the Tubercle Bacillus. Whether he is a source of
infection depends on his personal habits and his circumstances
generally. There is at present a vast amount of money being
spent on the treatment of patients who have developed Consumption
with the hope of curing them, and only too frequently this
hope is not fulfilled; whereas there is very little being done to cut
off the supply of the Bacillus. It is a matter which ought very
seriously to be considered by Sanitary Authorities whether money
would not be better spent by using it for this purpose. In these
times there is not likely to be money forthcoming for both prevention
and treatment, and in my opinion cheaper, quicker and better
results would be obtained by measures which would cut off the
supply of the Tubercle Bacillus than by attempting to arrest the
mischief after it has been allowed to get a start.
Turning to the figures setting out the working capacity and
the work being done by the patients, it will be seen that those for
1915 show a slight improvement on those of 1914. This, if it is
maintained in coming years, will show that the treatment obtained
is having a beneficial result on the individuals. Regarded from
the wider aspect, this may be a two-edged sword, for whilst prolonging
the activity of the individual it may also (though it should
not) be prolonging the supply of infection. Lastly, considering the
number of deaths, we see that there are 60 for 1915 as against 54
for 1914. This is an increase, and if continued would tend to
prove that though our methods of treatment have beneficial results
they are not curative.
The remaining tables call for no special comment, as they
explain themselves. They form a record of the work being done.