The times. [volume] (Washington [D.C.]) 1897-1901, 1901-01-27

dictate that a ve6 large proportion Of all
persons at the age of forty have some
where in thea bodies slight tuberculous
LESSONS This shows the Importance of the
individual predispostion. upon which the
older writers laid so much stress and the
importance of maintaining the nutrition at
its maximum.
One of the most remarkable features of
modern protective medicine is the wide
spread interest that has been aroused in
the crusade against tuberculosis. What
has already been accomplished warrants
the belief that the hopes of even the most
enthusiastic may be realized. A positive
decline In the prevalence of the disease
has been shown in many of the larger
cities during the past ten years. In Mas
sachusetts. which has been "a hoibed of
tuberculosis for many years. the death
rate has fallen from q per 1O.Ooo inhabl-
tants in 1858 to rs per 10010 inhabitants
in 1895. In the city of Glasgow. in which
the records have been very carefully kept.
there has been an extraordinary fall in
tie death rate from tuberculosis, and the
recent statistics of New York City show.
too, similar. remarka BILE dimInution.
In fighting the disease our chief weapons
are: First. educauonof the public. particu-
larly of the poorer classes who do not
fully appreciate the chief danger in the
disease. Secondly, the compulsory Motif
cation and registration of all cases of
tuberculosis. The importance of this re-
lates chiefly to the very poor and IMPROVE
dent, from whom, after all, comes the
greatest danger. and who should be un-
der constant surveillance in order that
these dangers may be reduced to a mini
mum. Thirdly. the foundation in suitable
localities by the city and by the State of
sanatoria for the treatment of early cases
of the disease. Fourthly, provision for
the chronic, incurable cases in special hos
pitfalls
OBSERVATION-DISCLOSURES the discovery of
the germ of this disease and our knowl-
edge of the conditions of its transmission.
and the discovery of the antitoxin. there
has been great reduction in its preva-
lence and an equally remarkable reduction
in the mortality. The more careful isola-
ton of the sick, the thorough disinfection
of the clothing. the rigid scrutiny of the
milder cases of throat disorder a more
stringent surveillance in the period of
convalescence. and the routine examina-
ton of the threats of school children
these are the essential measures by which !
the prevalence of the disease has been
very markedly diminished. The great
danger is in the mild cases. in which the
disease has perhaps not been suspected.
and in which the child may be walking
about and even going to school. Such pa
tents are often a source Of widespread in |
lection. The careful attention given by |
mothers to the teeth and mouth of chill |
dren IS also an important factor. In chill !
dren with recurring attacks of tonsilitis.
in whom the tonsils are enlarged the or
gans should be removed. Through these
measures the incidence of the disease has
been very greatly reduced.
PNEUMONIA.-While there has been a !
remarkable diminution in the prevalence
of large number of all the acute infec- |
tons. one disease not only holds its own,
but seems even to have increased in its
virulence. In the mortality bills pneumonia !
is an easy second 10 tuberculosis. II at
tacks particularly the incorporate. the
feeble ard the old, though every year a
large number of robust. healthy indiYidu-
ais succumb. So frequent is pneumonia AT
advanced periods of life that to die of it
has been said TO be the natural end Of old |
men in this country. In many ways. too,
it is a satisfactory disease, If one may Use |
such an expression. 1t is not associated |
with much pain, except at the onset the .
battle is brief and short, and a great |
many old persons succumb 10 it easily and |
peacefully.
q q of he