CONSUMPTION AND CONSUMPTIVES. 343 



may show these characteristics, but also those of parents gener- 

 ally enfeebled, or whose ages are widely separated, or who are 

 closely related by blood, or of a mother who has previously borne 

 a number in quick succession. Even when heredity is sound, tlie 

 same condition is sometimes induced by coddling, by improper 

 feeding, by attacks of acute disease, or by want and distress. In 

 growing children, a bad carriage of body may act injuriously by 

 contracting and deforming the chest. The stooped position which 

 boys sometimes assume in bicycle-riding should be discouraged 

 for this reason. 



Before the period of bacteriological research conditions thought 

 to bear a causative relation to consumption were eagerly studied. 

 Some of these thought to be important, it can now be seen, were 

 principally operative by affording favorable circumstances for 

 contagion, or were themselves symptoms of disease already pres- 

 ent. They still teach useful lessons, however, and deserve more 

 attention than is at present given them. We all know now the 

 reason why bad air was for so long regarded as a cause of the dis- 

 ease, but it still remains the fact, nevertheless. Imperfect food 

 supply was also assigned a place among the causes, but second to 

 an imperfect supply of pure air. Well-fed factory operatives who 

 work in close rooms are much more prone to the disease than 

 poorly fed laborers who work outdoors. A French laborer moved 

 to Paris with his wife and three sons from the country, where they 

 had worked outdoors. The father and two of the sons soon died 

 of tuberculosis ; the mother and remaining son returned to the 

 country and survived. This illustrates the well-known fact that 

 the mortality increases with the density of population, being great- 

 est in large cities and in barracks, prisons, and factories. Sixty- 

 seven per cent of the deaths among the Guards in the English 

 army are due to it. The death-rate in prisons increases steadily 

 with the years of confinement, and diminishes as ventilation is 

 improved. Inadequate nutrition because of insufficient food sup- 

 ply or of indigestion, which in turn may be the result of improper 

 or poorly prepared food, undoubtedly predisposes to the disease. 

 The same may be said of exhausting discharges or hsemorrhages, 

 of childbearing, of enervating habits or practices, and of depress- 

 ing emotions, all of which tend to reduce the resistive power of 

 the body. Considerable importance has been attached to damp 

 soil, and it would seem justly so. Dr. Buchanan, of England, 

 found that the drainage of such soil always reduced the death- 

 rate among the inhabitants of the region. Dr. Bowditch, of Bos- 

 ton, says that three fourths of 201 cases investigated by him lived 

 in houses built on damp soil. He observed also that the death- 

 rate was lowered by draining. He mentions several specific in- 

 stances, among them the following: A and B married sisters. 



