The Maui news. [volume] (Wailuku, Maui, H.I.) 1900-current, 1921-04-01

the appalling loss of life due to tuber.
c%ulosis, for if W. did we would be in
a continuous state of hysteria or de
preston.
When a cholera epidemic breaks
out it naturally arouses dread and
terror in a community; so also small
poX md other epidemics. Why? Be
cause of the suddenness of the at
tack-it is almost sudden death,
which is so shocking to our SENSIBLE
ties. A person is well one day, and
a few days later is dead! The re-
suit is the health authorities, or the
community itself, organizes Gas it Ger
tainly should, and regulations are
passed, action is taken, and the cpl
demic is stamped out. But in the case
of tuberculosis the disease usually
works slowly and insidiously and there
fore it is very difficult to realize its
terrible ravages. One case of acute
tuberculosis (called galloping consump
tion), which causes death within a
very few weeks, will make more inn
preston on a community than a hun
dred of the ordinary cases that drag
out for perhaps five years. Such is
human nature! | will not go into stat
istics, but perhaps the prevalence of
this disease can be pictured to the
mind when | say hat it has been Gsti-
mated that in Great Britain the aver
age number of deaths for each year
of the war from direct war-causes,
Outlets, so to speak, was only two
and a quarter times the number of
deaths from tuberculosis in the same
country for the year 1916.
Figures Deceptive
But statistics are often misleading.
Several years ago the Palama Settle
ment began their splendid anti-tuber-
culosis campaign; and the public ma
turally expected to see immediate
and startling results. After a year
Dr. two had gone by one of the
trustees called my attention to the
official board of health figures which
showed that instead of a decrease in
number of recorded deaths from tuber-
culosis per 1000 inhabitants there was
actually an increase. He was troubled,
and so was l, until l thought Of an al
most obvious explanation (Which |
still believe to be the true one), name
ly, that doctors, being human and not
always infallible, sometimes, when
signing a death certificate, will wonder
for a moment what they should put
down as the cause of death. Now if
much is being said and written about
tuberculosis, then naturally, in a
case of doubt, that diagnosis suggests
itself much more often than when
there is no community interest in the
subject. Also, with more general in
terest, and with district nurses fer
riting out the cases, a great many
more cases are bound to be correctly
J diagnosed as tuberculosis than for
merly when they would have died
in obscurity and been designated on
the certificate as dying from 'old
age" or some other indefinite usa
ton.
The board of health records for the
territory show that during the past
three years the death rate from tuber-
culosis has increased, especially dur
ing the year ending June 30, 1920
when it went to 90 per 1000 inhabit-
ants as compared to an average dur
ing thu lprevious eight years of near
ly 1.75.S On the other hand, the num-
Der of registered living cases for the
year ending June 80, 1920 was 944 as
compared to 1853 registered during
the previous year. DR.. Trotter attri-
butes the increased death rate as
due to the prevalence Of influenza.
Conditions Induce Disease
The most ideal conditions for the
high incidence of. tuberculosis obtain
where there is poverty coupled with
crowded living quarters. In he big
cities of Japan, tuberculosis has been
greatly on the increase, the reason
being that this nation has been chang
ing too rapidly from a farming to a
great manufacturing people. The
factory hands are poorly housed and
poorly paid. They therefore do not
have adequate fresh air, are under
fed and over-worked. An intelligent
Japanese guide once likened Toki to
me to a great vortex into which the
healthy country people entered, be-
came swallowed up, and died. We
may take such manufacturing cities
as exist today in Japan as typical of
the most suitable conditions that can
exist for the spread of tuberculosis.
Now let us turn to the opposite pic
! ture, namely to the places and condi-
lions of life that are safest from the
standpoint of escaping the disease.
One naturally thinks Immediately of
some isolated region with a glorious
climate, like the crater of Haleakala.
This is probably true if n was born
there and stayed there, but, as
DOlIltu Oul Ill dllOthCl poPSi' Nioo
who are brought up in isolated regions
are in great danger when they change
to city life of contracting a deadly
and rapidly fatal form of tuberculosis,
for the reason that during childhood
they have not received the usual
small NEGOTIATIONS of the disease; they
have not, as it were been vaccinated
against the disease. The great ma
jority of people live in villages, towns,
and cities and a very large percentage
of such people receive this Childhood
incubation which produces a partial
immunity-only partial but very i'm
portant. Now taking this normal life
under civilized conditions, what parti-
cular place would you select as being
the safest place to live in if you wish
ed above all things to avoid tubercu,
losis? ! think that not in a hundred
guesses would you think of h place
is in my own mind. The answer is,
a we'll conducted tuberculosis SAM,