By Improved Digestion, and by Exposure to Open Air and St. John's
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178 Professor Koch of Berlin ; although other microscopical plants of allied though distinct character are often present in addition to the constant and essential bacillus tuberculosis and produce modifying and generally METROPOLITAN HOSPITAL SUNDAY injurious effects. FUND. 2. That the most frequent and dangerous mode of infection by the specific bacillus in adults is by its admission to the lungs and throat. THE were the amounts received 3. That the vehicle by which the bacillus is transmitted from a sick following among principal to a healthy adult is, in the great majority of cases, the phlegm at the Mansion House during the past week in aid of this coughed up. Fund. 4. That another vehicle of infection is either occa- important milk, E d. accidental defilement with moist from a sionally by sputum consump- Parish of St. Peter’s tive or children the milk of Peter, Eaton-square:-St. patient, frequently by young drinking JE1000 9s. Peter’s 25 2s. Church,St. 2 6 cows with tuberculous 6d. ; St. Chapel, 6d. ; 1076 affected disease of the udder. Wilton-road, B70 108. 6d....John, 5. That a third, though far less frequent mode of tuberculous infec- Rosslyn-hill Unitarian Church, Hampstead ......... 123 14 5 tion is muscle and fat-which is contaminated by eating mea,t-i.e., St. Peter, Cranley-gardens .................. 471 4 0 from tuberculous disease of the lymph-glands and other parts, and Holv Trinity, Sloane-street..............’ ... 263 16 9 has been cooked. imperfectly St. Peter, Eltham-road .................. 36 10 0 now 6. That, while it is proved that the specific bacillus is present in St. Margaret, Lee ..................... 41 19 3 every case of tuberculous disease, yet there is no doubt that of the St. Stephen, Wandsworth .................. 71 17 10 two conditions which always make up a disease (the external disturb- Christ Church, Forest-hill ’" ..........., ... 61 18 6 ance and on St. John the the internal result of that disturbance), the latter depends Divine, Kennington............ ", 62 11 7 the condition of the host as much as upon the activity of the infecting L. G......................... 20 0 0 parasite. West London Wesleyan Mission ............... 38 1610 Aldenham Parish Church 7. That infective tuberculosis in and or pulmonary (with additions) ......... 103 0 0 general phthisis All Blackheath tuberculosis in particular, is not "catching" in the popular sense of Saints, .................. 50 0 0 London ...... the word. The disease is not the breath, nor even by West Synagogue, Upper Berkeley-street 22812 6 conveyed by St. coughing, except as a rare exception, nor is it caught by contact with a John, Paddington .................. 137 84 consumptive patient. Christ Church, Streatham-hill ............... 100 0 6 St. Columba, Font-street .................. 143 14 0 For these reasons, Dr. we cannot throw St. John’s Presbyterian Church, Forest-hill ......... 102 2 6 says Pye-Smith, St. James’s the that from household infec- Chapel Royal, .................. 57 0 5 away experience showing apart St. Luke, Westbourne-park.................. 50 1 3 tion consumption appears in certain families more frequently St. Matthew, Upper Clapton, and Holy Trinity, Lea than chance can account for. Hence the importance of Bridge......................., ’" 44 10 3 strengthening the body against the invasion of tuberculosis St. George, Perry-hill .................. 37 14 10 St. ............... wholesome and Matthew, Ealing-common 27 11 4 by particularly by fattening food, by Upper Tooting Wesleyan Church...." ...." ... 20 0 0 increase of the colour and corpuscular richness of the blood, St. Peter, Ealing ..................... 23 18 7 North by improved digestion, and by exposure to open air and Finchley Congregational Church ......... 23 1 6 Hence the of the All Saints, Woodford Wells ............... 24 0 0 light. importance general hygienic All Saints, Putney .................. 27 10 0 measures in which this country took the lead from the All Saints, Upper Norwood....., ...... ,...., 20 0 0 latter half of the present century. The result has been the St. Mark, Regent’s-park ......... 23 3 4 diminution of the number of deaths by consumption in South Kensington Presbyterian Church ......... 27 4 1 St. Peter, Hersham ..................... 22 910 England and Wales by one half, in. proportion to the Dr. Ludwig Mond, F.R.S................... 50 0 0 population, during the 45 years from 1851 to 1895. St. Peter, Bayswater .................. 148 8 1 The following practical points in the prevention of tuber- St. Luke, Battersea ..................... 42 14 2 Holy Trinity, Anerley .................., 26 14 7 culosis as a widespread and destrucve disease were, says Dr. Pye-Smith, inculcated by various speakers at the Congress : A.-The primary importance of free ventilation and wholesome and VITAL STATISTICS. abundant food. Improvement in the dwellings and the food of the poorer classes in this country and their increasing cleanliness and sobriety have not only diminished sickness generally, but directly HEALTH OF ENGLISH TOWNS. reduced the number of deaths from consumption until the mortality IN 33 of the largest English towns 6495 births and 3496 from this cause is less in London than in any other city. large deaths were the week B.-The prevention of infection of the the bacillus of tubercle registered during ending July 8th, lungs by rate in depends chiefly on rational treatment of the sputa of consumptive The annual of mortality these towns, which had patients, or rather, for practical purposes, of the sputa of all those declined in the three preceding weeks from 16.5 to 15’7 per with affected cough and expectoration. The phlegm should never 1000, rose again last week to 16’0. In London the rate was be deposited on the ground or on a handkerchief where it can dry up; 15’0 while it 16-6 in the 32 it should be kept moist until it can be destroyed by heat and the per 1000, averaged provincial vessel used to receive it should contain phenol or some other towns. The lowest rates in these towns were 10’6 in antiseptic solution. Croydon, 10’8 in West Ham, 11’8 in Portsmouth, and 12’1 in C.-The prevention of infection by tuberculous milk may be Bradford and in Swansea ; the highest rates were 19’4 in accomplished either bv boiling all milk given as food to children, or 21-5 in 24’2 in and 24’8 in by inspection of dairies, so as to prevent tuberculous milch-cows Salford, ’Sheffield, Liverpool, being used. Manchester. The 3496 deaths included 468 which were D.-The prevention of infection by meat can be secured by careful referred to the principal zymotic diseases, against 411 and and thorough inspection of carcasses or by diagnostic testing of cattle 407 in the two preceding weeks ; of these, 133 resulted with tuberculin. This, the only undoubtedly useful application of the from 98 from 86 from so-called tuberculin, has the drawback that after the effect of the measles, diarrhoea, whooping-cough, inoculation has passed off a tuberculous animal becomes immune to it 81 from diphtheria, 35 from scarlet fever, 24 from ’’ fever" for a time, and so may be passed as healthy. (principally enteric), and six from small-pox. No death from of these was or The facts Dr. be any diseases recorded last week in Brighton in following may, however, says Pye-Smith, in the other towns caused the lowest death-rates stated as for the as well as their Derby ; they important people governors in and to be aware of :- Plymouth, Bristol, Norwich, Newcastle-upon-Tyne, and the highest rates in Liverpool, Manchester, Burnley, (a) That tuberculous disease of the bones and joints of the glands and Sheffield. The greatest mortality from measles occurred and skin and abdomen, though dangerous, is not incurable and by in Sheffield, Portsmouth, and the modern methods of operative medicine is in most cases successfully Liverpool, Burnley, Salford, cured. Manchester ; from scarlet fever in Halifax and Burnley; and (b) That tuberculosis of the lungs (phthisis or consumption) is from whooping - cough in Portsmouth, Blackburn, and more often now than frequently cured and probably formerly. Burnley. The mortality from "fever" showed no marked (c) That there is no specific drug which has direct influence upon excess in of the towns. The 81 deaths from consumption, but that many, both old and new, have valuable effects any large upon its complications. diphtheria included 31 in London, seven in Leicester, seven (d) That abundant food, particularly of a fatty nature, and a life in in Leeds, seven in Sheffield, six in Liverpool, five in West the open air, are no less valuable in the treatment than in the three in and three in Six prevention of phthisis and that the hospitals and asylums for providing Ham, Swansea, Birmingham. these essentials, which are now numerous in Germany, and far from deaths from small-pox were registered in Hull, but not rare in England, Austria and Hungary, France, and the United States, one in any other of the 33 large towns; and no small-pox are of essential value. patients were under treatment in any of the Metropolitan Dr. Pye-Smith’s interesting memorandum closes hopefully Asylums Hospitals at the end of last week. The number of with the following words : "The prospect of improved scarlet fever patients in these hospitals and in the London success in the treatment of tuberculosis in general, and of Fever Hospital on Saturday last, July 8th, was 2526, against consumption in particular, by the advance of pathology and numbers increasing from 2161 to 2430 at the end of the the progress of surgery and medicine is a hopeful one, seven preceding weeks ; 315 new cases were admitted during almost as hopeful as that of limiting the spread of the disease the week, against 262, 335, and 302 in the three preceding by preventive measures.