470 POPULAR SCIENCE MONTHLY. 



ness of tuberculosis the opinion that it is hereditary, whereas its trans- 

 mission in the cases in question was due solely to the simplest pro- 

 cesses of infection, which do not strike people so much because the 

 consequences do not appear at once, but generally only after the lapse 

 of years. 



Often in such circumstances the infection is not restricted to a 

 single family, but spreads in densely inhabited tenement houses to the 

 neighbors, and then, as the admirable investigations of Biggs have 

 shown in the case of the densely peopled parts of New York, regular 

 nests or foci of disease are formed. But if one investigates these mat- 

 ters more thoroughly one finds that it is not poverty per se that favors 

 tuberculosis, but the bad domestic conditions under which the poor 

 everywhere, but especially in great cities, have to live. For, as the Ger- 

 man statistics show, tuberculosis is less frequent, even among the poor, 

 when the population is not densely packed together, and may attain 

 very great dimensions among a well-to-do population when the domestic 

 conditions, especially as regards the bedrooms, are bad, as is the case, 

 for instance, among the inhabitants of the North Sea coast. So it is 

 the overcrowded dwellings of the poor that we have to regard as the 

 real breeding-places of tuberculosis; it is out of them that the disease 

 always crops up anew, and it is to the abolition of these conditions that 

 we must first and foremost direct our attention if we wish to attack the 

 evil at its root and to wage war against it with effective weapons. 

 This being so, it is very gratifying to see how efforts are being made 

 in almost all countries to improve the domestic conditions of the poor. 

 T am also convinced that these efforts, which must be promoted in 

 every way, will lead to a considerable diminution of tuberculosis. But 

 a long time must elapse ere essential changes can be effected in this 

 direction, and much may be done meanwhile in order to reach the goal 

 much more rapidly. 



If we are not able at present to get rid of the danger which small 

 and overcrowded dwellings involve, all we can do is to remove the 

 patients from them and, in their own interests and that of the people 

 about them, to lodge them better, and this can be done only in suitable 

 hospitals. But the thought of attaining this end by compulsion of any 

 kind is very far from me; what I want is that they may be enabled 

 to obtain the nursing they need better than they can obtain it now. 

 At present a consumptive in an advanced stage of the disease is re- 

 garded as incurable and as an unsuitable inmate for a hospital. The 

 consequence is that he is reluctantly admitted and dismissed as soon 

 as possible. The patient, too, when the treatment seems to him to 

 produce no improvement and the expenses, owing to the long duration 

 of his illness, weigh heavily upon him, is himself animated by the 

 wish to leave the hospital soon. That would be altogether altered if 



