Morning journal and courier., 1892-07-13
TUBERCULOSIS IN NEW RAVEN.

W M v hNs
An Interesting Paper on the Annual
Report Of the State Board of Health
by DR.. De Forest of the Yale Medical
schOOl-The Theory o. Injection
The Bacillus Tuberculosis Inn.
portant New Haven Statistics.
The report of the Connecticut state
board of health, which has just been is
sued, contains some peculiarly interesting
| statistics and information.
Among the most interesting articles In
the book is paper by Louis 8. De Forest,
| Am. MD, instructor in chemical medi-
cine in the medical department of Yale
university, the greater part of which is
| printed below.
| It has been printed in medical journal,
but the original character of the investiga-
ton and its local interest, as relating to
the most fatal disease in Connecticut,
was thought sufficient reason for pre-
senting it in the annual report of the
state board, to which the author kindly
| consented.
It is as follows: More than one-seventh
of the human race die from tuberculosis.
Dr. Salmon, estimating from census re-
turns, placed the deaths from this cause in
| the United States for the year 1880 at
| 10000.
Were such a number to die from any
| acute disease in one year, it would create
| a state of panic; but the stealthy, gradual
| progress of tuberculosis tends to prevent
| a true appreciation of the deadly role it
| ever plays in nearly every community.
| The attitude of the world on the subject
has generally been one of resigned in
difference.
| In Italy the theory of infection has been
believed in for some time. In England
the theory of heredity was thought to be
the reason for the propagation Of the dis
ease. 1t was proved by German scientists,
however, that the theory of infection was
right. It was first shown that the mere
breath of tubercular patients did not con-
| tain the bacillus tuberculosis which is the
| ever present, ever active agent of propo-
| cation.
| Secondly, experiments of Koch showed
beyond all doubt that inhalation of vapor
charged with cultures of the bacillus
| (twenty- three cultures extending over if
teen months) were highly infectious. Still
further, Cornet proved that the dried
sputum of phthisical patients contained
bacilli in large numbers, and that inhala-
| tions or inoculations of animals with the
bacilli or with the cultures obtained from
this source were highly infectious. And
lastly, Schill and Fisher we're able to OBJ
tain results with sputum which had been
| in dried state for ninety-f five days. De
| Toma also found that sputum, which had
been kept dry at an average temperature
| of IT., was infectious after nine months.
And Febhard asserts that sputum, diluted
to the proportion of 1:100, 900, is still vlru-
lent.
Impure air comes to our notice generally
in the form of air contaminated with dust,
either vegetable or metallic. Many trades
offer but very short lease of life. So,
for instance, the average duration of life
for dry grinders of forks is twenty-one
years; for razor grinders thirty-one years;
for edge tool grinders thirty-two years.
| tubercul osis is the predominant cause of
| death, photographers losing nearly so per
| cent NJ. de Neufvilles statistics give
locksmiths and blacksmjths 800 per cent,
| painters 329, and shoemakers $50 per
| cent; and it has been stated that three
| ffths of the f1ax-workers in Belfast were
| consumptive. Grinders phthisis was
| formerly considered as non 'tubercular in
nature. Opinion is, however, no longer
unanimous on this point, and such an
| authority as Fagge asserted its tubercular
| nature.
It will be noticed that all these trades
| result in what Koch has declared to be
| one of the necessary conditions for infec-
| tion-that is, an abrasion of the mucous
| membranes. These artisans, with the
many small wounds of the bronchial mem
brane, with vitality lowered by insult
GENTLY pure air day and night, are con-
Moreover, facts are accommodating to show
that very many of the tenement houses
| are capable of furnishing this infection.
Another hygienio condition favorable to
the development of phthisis is dampness
DR.. Bowditch was the first to call attention
| to this. His theory is strengthened by
such facts as the following: After a sys-
tenn of draining had been introduced, Sal
| isbury's tubercular death rate fell 40 per
cent, Ely's AZ per cent, Rugby's 43, and
| Banbury's Al per cent. In 1881, in two
contiguous health districts of Ontario, one
of which is a plateau free from malaria
and the other fat malarial district, the
deaths from tuberculosis were in the
former 81 per cent. of all deaths, and in
the latter 1877 per cent.
Cornet, in his Investigations, repeatedly
demonstrated the presence of the bacillus
in dust taken from tho rooms or the sur
roundings of tubercular patients. Flick,
accepting this theory of infected dwell
ings, applied himself to the task of demon
strating it geographically. His map of
the tubercular deaths for twenty-five years
in the Fifth ward of Philadelphia brings
out the point very clearly.
When the writer began the study of this
subject in New Haven he had not had his
attention called to Flick's pamphlet. Had
such been the case the plan of this work
would probably have been somewhat al
tered.
In studying this question in New Haven
we have no district equalling in antiquity
and density of population Philadelphia
Fifth ward. Nor are our vital statistics
available for this purpose for so long pc
riod as twenty-five years. Until this year,
indeed, no separate Typographical record
of tubercular deaths was kept.
From the statistics available and we'll
sifted 2, 500 deaths from the various forms
of tuberculosis in New Haven were report
ed from 1876 to '91.
1t will be seen that there are three prin-
cipal districts of Capitalization. First, in
the southeastern part of the city, in the
neighborhood of East, Wallace, Hamilton
and Franklin streets Irish and Irish
American population); second, in the
western part, in the neighborhood of lower
Oak street and Congress avenue Irish and
Irish -American population); and third, in
the northern part, in the region of Eaton
and Webster streets negro population). |
These two latter regions are somewhat |
loosely connected by line of infection |
running along Day and Orchard streets.
The deaths on this main map were dis |
tributed as follows: Three hundred and |
ten houses had 2 cases each, 70 had 8, % |
had 4, 2 had 5, and finally, 3 had respec-
lively each 6, : and 8. The remaining
houses had only one case each. That is,
very nearly 16 per cent. had more than
one case. This 10 not a very high per-
centage, but it will undoubtedly increase
with years. 1t will be seen that generally
the houses are not isolated; that is, the in
footed houses adjoin or are in close
proximity to each other.
The First ward will be seen to be COM
paratively free. Nevertheless, it has a
density of population per acre as whole
of thirty, while the Ninth, containing
Eaton and Webster streets, has only per
acre; and the Third, containing lower Oak
street and Congress avenue, has % per acre.
The second map (map ~ is an enlarged
reproduction of the southeastern district.
While the various sources OF error men
toned before have probably prevented alb
solute accuracy, the deaths have been plac-
ed with considerable care. The 514 cases
In this district Excluding the north side of
State street and the west side of Franklin)
occurred in 1851 houses. They were dis
tributed as follows: 70 houses had cases
d hol H. |