528 SCIENCE PROGRESS 



The Causes of Tuberculosis, together with some Account of the Prevalence 

 and Distribution of the Disease. By LOUIS Cobbett, M.D., F.R.C.S., 

 University Lecturer in Pathology, Cambridge. A volume in the "Cambridge 

 Public Health Series" issued under the Editorship of G. S. Graham-Smith, 

 M.D.,and J. E. Purvis, M.A. [Pp. xvi 4- 707.] (Cambridge : The Univer- 

 sity Press, 1917. Price 21s. net.) 



War has seriously hindered the progress of the Tuberculosis Movement in this 

 country. Of the truth of this there is abundant evidence. That serious restriction 

 has occurred in our anti-tuberculosis work and endeavours to meet the needs of 

 tuberculous sufferers is made clear by Sir Arthur Newsholme, Chief Medical 

 Officer of the Local Government Board, who, in his recently issued supplement to 

 the Annual Report of the Local Government Board for 191 6-1 7 (Cd. 8767), 

 declares : " One of the most urgent of after-war problems will be to secure the 

 early resumption and extension of this work [tuberculosis work], particularly in 

 regard to the provision of greatly increased hospital accommodation for advanced 

 cases of consumption." It is certain that there will be a considerable development 

 in the prevalence of tuberculosis : that this is already the case is shown by the 

 returns from many centres. The deaths from pulmonary tuberculosis in both 191 5 

 and 1916 were 12 per cent, in excess of those in 1913. War conditions and 

 probably after-war conditions must serve to encourage the establishment and 

 spread of tuberculosis among most classes of the community. 



In order to meet the many needs of the present and the almost certain increase 

 in the requirements of the near future, there is every reason why the most serious 

 consideration should be given at once to the Tuberculosis Problem. Hitherto many 

 of our endeavours have been experimental, extravagant, and unscientific. We have 

 been content to be directed by political and social expediency, controlled by senti- 

 mental considerations, satisfied with merely palliative and ameliorative measures, 

 and ready to wage warfare with an inadequate service and an imperfect equipment. 

 Our enterprises have lacked co-ordination, and our workers have not learnt the 

 importance of co-operation. The existing attitude of mind and the prevailing 

 insufficiency of practice must be changed if serious calamity to large sections of 

 the community is to be avoided. We need to seek guidance in a clearer concep- 

 tion of scientifically established fundamentals. Since Koch's epoch-making dis- 

 covery of the tubercle bacillus investigations have been carried on in all parts of 

 the world, and many of these have thrown a flood of light on the aetiology of 

 tuberculosis. The records of the most important of these researches and the 

 conclusions which are to be drawn from them have been gathered together and 

 presented with great skill by Dr. Louis Cobbett in his recently issued monograph 

 on T/ie Causes of Tuberculosis. This monumental book is one the value of which 

 cannot well be exaggerated. The author has collected his material with pains- 

 taking precision and a rare judicial discrimination, and has set forth facts, theories, 

 arguments, and controversial considerations with philosophic calm, logical force, 

 and much literary skill. The book is well arranged, effectively illustrated, 

 abundantly provided with references, and there are serviceable indexes to subjects 

 and authors. Needless to add, the University Press of Cambridge has issued the 

 volume in a worthy form. No serious student of tuberculosis can afford to be 

 neglectful of this notable volume, the most valuable contribution to the subject 

 which has appeared in this country for many a long day, and one which will always 

 rank as a first-class work of reference. 



Dr. Cobbett's book is addressed mainly to those who are concerned in the 

 stamping out of tuberculosis, and does not seek to deal with the clinical aspects of 



