CONSUMPTION MENACE.

Taranaki Daily News, 29 May 1922, Page 8

CONSUMPTION MENACE.

AN ENGLISH OPINION. DEATH-RATE ANALYSED. THE LAW OF IMMUNITY. London, March 31. “Tuberculosis, like the poor, is always with us, and it always will be with us,” said Dr. Maurice Davidson, in an address before the Institute of Hygiene. In this country, he said, tuberculosis accounted for approximately one-seventh of all deaths, while in the United States the ratio was about one in nine. In addition to these deaths, however, a very considerable number of people who die from other natural causes would, if subjected to a post-mortem examina- 1 tion, be found to have a lesion characteristic of tuberculosis, although they had never consciously suffered from the disease in their lives. Scientists had differed in their estimate of the percentage of people who thus either died from the disease or were unconsciously affected by it. A German scientist put it at 97 per cent., a French doctor at 60 per cent., while others had put it very much lower. In any case it would be found that the percentage was extremely high among town dwellers. Indeed, the majority of people it would be found had at some time or other during their lifetime been affected, but in the case of many their resistance had been strong enough to prevent any serious development and to prevent any symptoms from manifesting themselves. “Side by side with the changes noticeable as a result of the tissue destruction by the hostile agent,” Dr. Davidson continued, “we find attempts on the part of the body to destroy the hostile agent and to repair the damage done. The ultimate result, so far as the body is concerned, is a matter of balance between the processes of destruction and the processes of reconstruction or repair. If destruction predominates over repair, the result may be the death of the body; if, on the other hand, repair predominates, then the life of the body is preserved. This phenomenon is one of the features of what is known as immunity—the term used to denote the sum total of all ways and means by which the healthy body protects itself against infective germs and other causative agents of disease. The resistance of the body is not a fixed quantity; it is capable *of being raised or lowered. This is a fundamental point, for it is from the standpoint of race immunity that the problem of tuberculosis must be considered.

PREVENTION IMPOSSIBLE. “The prevention of tuberculosis, in the strict and absolute sense of the word, is an impossibility, for it presupposes the complete elimination of the tubercle bacillus from the surface of the globe, an achievement obviously outside the contemplation of any intelligent person. Under our present system we attempt to reduce the incidence of tuberculosis by treating and endeavoring to cure early cases, and by checking the spread of the disease by controlling, as much as possible, those already diseased persons who form a source of danger to others.” Systematic and scientific prevention of the spread of tuberculosis in a com-

munity could only be carried out by. the permanent isolation of a very large section of the total population, a thing hardly within the scope', of practical politics. Even if it were possible, for instance, to place all affected people on an island and so eliminate all active

sources of infection, such an achievement would be altogether undesirable, because it would remove one of the prime factors in the establishment of race-immunity, and so lay the people at some future period to an overwhelming epidemic of tuberculosis, which, falling on virgin soil, would bring about a holocaust to which the present mortality would be negligible in comparison. A comparison might be made with a country which had not been subjected to

foreign invasion for a hundred years or more. The mobilising capacity of such a country would be infinitely less than that of a country which had been subeeted to invasion from time to time and had as it were the enemy at its gates. In discussing the question of legislation, therefore, this matter of immunity was of vital importance.

LEGISLATIVE ACTION. This did not mean that our attitude should be one of laisser faire. The practical attitude for the authorities must lie somewhere between two extremes—that of endeavoring to eliminate entirely the infectious individuals from the community and that of leaving them uncontrolled. The first extreme would be as wrong as the second, because it Would involve measures of such a coercive nature as could not be contemplated, and chiefly because it would lower the resisting power of the community to tubercle by removing one of the principal factors upon which such resistance depended. To keep infection within reasonable bounds, the chief necessity at present seemed to be the provision of adequate institutional arrangements for advanced cases of consumption among the uneducated classes and, further, sufficient stiffening of the backs of the authorities to enforce the power they already possessed of seeing that adequate use is made of such institutions. “A more stringent application of the law is desirable,” the lecturer concluded. "There is a vast difference between the position of unfortunate relatives of infected persons who live in crowded quarters of large cities and that of residents and staffs of a large tuberculosis, institution, who are notoriously immune from the disease. The public often fails to grasp that it is the advanced an incurable case and not the early and curable case, that matters most in a rational methodical scheme of prevention.”