No. 6. DEPARTMENT OF AGRlCULTURiS. 465 



that threaten him in intercourse with consumptives. It is only to 

 be desired that the instructions may be made shorter and more pre- 

 cise than they generally are, and that special emphasis be laid on 

 the avoidance of the worst danger of infection, which is the use of 

 bedrooms and small ill-veutilated workrooms simultaneously with 

 consumptives. Of course the instructions must include directions 

 as to what consumptives have to do svheti they cough and how they 

 are to treat their sputum. 



Another measure, which has come into the foreground of late, and 

 which at this moment plays to a certain extent a paramount part in 

 all elforts for the combating of tuberculosis, works in quite another 

 direction. 1 mean the founding of sanatoria for consumptives. 



That tuberculosis is curable in its early stages must be regarded 

 as an utidisputed fact. The idea of curing as many tubercular pa- 

 tients as possible in order to reduce the number of those that reach 

 the infectious stage of consumption, and thus to reduce the number 

 of fresh cases, was therefore a very oatural one. The only question 

 is whether the number of persons cured in this way will be greal 

 enough to exercise an appreciable influence on the retrogression of 

 tuberculosis. 1 will try to answer this question in the light of the 

 figures at my disposal. 



According to the business report of the German Central Commit- 

 tee for the Establishment of Sanatoria for the Cure of Consumptives^ 

 about 5,500 beds will be at the disposal of these institutions by the 

 end of 1901, and then, if we assume that the average stay of each 

 patient will be three mowths, it will be possible to treat at least 

 20,000 patients every year. From the reports hitherto issued as to 

 the results that have been achieved in the establishments, we learn 

 further that about 20 per cent, of the patients that have tubercle- 

 bacilli in their sputum lose them by the treatment there. This is 

 the only sure test of success, especially as regards prophylaxis. If 

 we make this the basis of our estimates, we find that 4,000 consump- 

 tives will leave these establishments annually as cured. But, ac- 

 cording to the statistics ascertained by the German Imperial OflBce 

 of Health, there are 226,000 persons in Germany over fifteen jeais 

 of age who are so far gone in consumption that hospital-treatment is 

 necessary for them. Compared with this great number of consump- 

 tives the success of the establishments in question seems so small 

 that a material influence on the retrogression of tuberculosis in gen- 

 eral is not yet to be expected of them. But pray do not imagine that I 

 wish, by this calculation of mine, to oppose the movement for the 

 establishment of such sanatoria in any way. I only wish to warn 

 against the over-estimating of their importance which has recently 

 been observable in various quarters, based apparently on the opin- 

 ion that the war against tuberculosis can be waged by means of 

 30—6—1901 



