New-York tribune. [volume] (New York [N.Y.]) 1866-1924, 1907-05-30
DEATH RATE DROPS.
FEWER CONSUMPTIVES.
Nezo Restrictions Help the Health
Department.

the II T.. y
Department of Agriculture. on the discovery of
the origin of tubercle bac in milk. Commits
sioner Darlington and DR.. Hermann NJ. Briggs.
chief medical officer of the Health Department.
are taking more definite steps 10 enforce the
sanitary conditions throughout the city for the
restriction and prevention of tuberculosis.
In sepaking of the great decrease in deaths
from tuberculosis in the last twenty-seven
years. the Commissioner said that last year
there were 60 per cent fewer deaths than in 1881.
1T is well known TO the physicians of New York
City" said the Commissioner, that for num-
Der of years the Department of Health has been
earnestly engaged in the study of tuberculosis,
the most widespread and fatal disease occurring
in this city. and in the initiation of such meas
for the curtailment of its ravages as
seemed practicable and imperative.
After period of preliminary study and OBJ
servation lasting years, the Board Of
Health passed a series of resolutions on Feb
rurary 49, 1894, designed to assist in the &C
compishment of it's aims for the suppression of
this disease One of these resolutions involved
the reporting of certain classes of cases of tuher
culosis In compliance with it 4 166 cases were
reported in 1894 5S1S in 1895. and Ssh in 1880.
and the department was enabled without oppo-
sition or the imposition Of hardship upon in
dividuals to extend educational work and pro-
tect a large number of persons from exposure u
infection.
THE incidence of pulmonary tuberculosis IS
best estimated by its death ra+e, for' altioue4'
as will be shown later, the department mas every
reason to be satisfied with the success ATTAINED
in connection with the registration OF 'uoel-
culosis vet under the most favorable clrcuin-
stances certain nurnper Oh CaSes oi "
ported during life.
y
from pulmonary tuberculosis for 1000 inhaoi-
+ants was 427. It has steadily fallen since
then until in 1906 II was only PIG for loto
reduction of so per cent. In other words IN
1881. with population of 1244511, there were
5312 deaths from pulmonary tuberculosis
while in 1905. when the population mad m
creased TO 4152 $50. there were only $500
deaths from this disease, increase OF less
than so per cent in the deaths. altEougn the
population had increased almost 800 per cent
THE imperative demand for the enforcement
said Dr. Biggs, "of comprehensive measures lot
the prevention Of tuberculosis should have peen
as evident to sanitarians twenty years ago as II
is to-day. No facts have been added to our
1,nor-radgs within this period which are really
essential 10 the intelligent sanitary surveillance
of this disease The universal prevalence OF the
disease. it's infectious and communicable char
scter it's preventability and cura all OF
these facts-the important ones bearing on Ihe
administrative control-are not OF recent aus
covery. They have not been developed by the
o,5+ation If the last few years, but were as
manifest to the student of this subject fifteen
or twenty years ago as they are now
aryerv slowly has partial comprehension OF
the tremendous significance OF these wei KNOWN
facts forced itself on the minds OF the fneoCdl
nrofession. the sanitary and civil authorizes
ny1lv
throughout the civilized world have measures
heen nut into effect looking into the ahmlh-
istrative control of tuberculosis
Notwithstanding all that has been SAID ana
written. notwithstanding the popular educatioh
and agitation, notwithstanding the formation Oh
societies and anu-tuberculosls
leagues, Notwithstanding the organization oI
many associations for the erection OF sehato
riums and the foundation Of institutions TOT the
study Of tuberculosis, notwithstanding the
measures adopted for the prevention OF the as
ease in the animal, still only very small per-
centage Of the governmental, municipal ana
state sanitary authorities of this country Great
Britain and the Continent have ADOPTED prov
sions which can be regarded in any way com
prehensive effective in dealing with the dis
ease.
If we seek for an adequate explanation for
this attitude It is not, after all, difficult TO flnd
In speaking of this matter some years ago, Koch
said, in substance, that the adoption in Germany
of such measures already in force in New
York City will not be possible until the genera
ton Of medical men now in control has passed
away. Not until a younger generation has ap-
peared, which has had different scientific train
ing and holds views more in harmony with the
known facts regarding the etiology of tubercu-
osis, will it be possible, in my opinion to bring
about an intelligent supervision Of the disease.
The idea has been firmly fixed in the minds
of the authorities and Of the medical profession
that administrative control applies only to the
more readily communicable acute diseases. like
smallpox scarlet fever, diphtheria, etc, that the
inclusion Of tuberculosis with these diseases has
III
ment of legislation comforting power the
thorities to deal with this disease in another
way has either not been considered been
regarded as impossible In only few instances
have effective measures been adopted. and in
these instances, was the In New York,
the power has usually rested with the sanitary
authorities themselves to determine what diseases
should come under their surveillance and under
what conditions.
"Notihca ton is a necessary preliminary to any
plan Of supervision, and yet some years ago a
special commission of the Academy of Medicine
Of Paris reported against a proposition to place
In the class Of notifable diseases.
Two principal reasons were advanced against
the proposition: First, it pointed out that
involved the dvulging of a medical
secret, which would be harmful to the patient
(this applies, of course. with equal force the
diseases usually called contagious), and it was
insisted that as the public did not
regard tuberculosis as being contagious, or in
the same class with the contagious diseases, bur
the disease hereditary the public
would not accept such legal enactment without
protest and resistance. The second reason was
regarded more important and was in effect
that In family unwilling to follow Instructions
sanitary restrictions would be impossible as an
almost continuous Intervention would be re-
quired on the part of the sanitary officers for
months and years. The only efficient alternative
IN such cases IT was pointed out, would be the
consignment OF the consumptive to a hospital. d
practice followed in Norway The commission
that notification must not be consid-
cred at least, at that time
This is the great urgent sanitary problem
Of the twentieth century In no Other direction
can such large results be achieved SO certainly
and az such relatively small cost The tir,e 4.