1908] on The Present Phase of the Tuberculosis Problem. 279 



For instance, the Irish branch of the Celtic race is thought by 

 some of those who have studied the question to be especially prone 

 to develop the malady, no matter in which part of the world they 

 are found.* 



The incidence of tuberculosis upon the Irish at home in Ireland 

 is apparently excessive, " apparently " because there is some doubt 

 whether the increase which the official figures denote is actually the 

 result of increased prevalence of the disease or of some altered nomen- 

 clature, or whether the emigration of the non-tuberculous has not 

 altered the relation between the healthy and tuberculous at home, 

 and thus led to an apparent increase in the death-rate. It is inter- 

 esting in this connection to note that the incidence upon the Irish in 

 America is stated to be higher than upon any other people, and that 

 this excessive incidence is also o]:)served in the offspring (born in 

 America) of Irish parents. 



On the other hand, the Hebrew race appears to be relatively 

 immune to this disease, notwithstanding, at times, an environment 

 which amongst non-Hebrew people would be likely to be associated 

 with considerable prevalence of the malady. 



Flick, of America, suggests that the history of tuberculosis in all 

 new countries may indicate that the disease has a rise, a climax and a 

 decline, and the epidemiology of certain other diseases would appear 

 to lend support to this view. Still the registration of the causes of 

 death in new countries is not very reliable, and even in old countries 

 it dates back such a very short period that it does not enable us to 

 decide this point with any certainty ; and the English statistics, 

 which are admitted on all hands to be the best which the world pos- 

 sesses, do not extend back far enough into the past to indicate the 

 fact of a rise having taken place, and consequently to afford a sure 

 indication of the climax. Nevertheless, it is not improbable that as 



* It is a curious fact that this, too, seems to be the case with regard to 

 insanity in Ireland in so far as there seems to be a remarkable parallelism 

 between the behaviour of tuberculosis and insanity among the Irish born. 



In the Supplement to the Fifty-fourth Report of the Inspector of Lunatics, 

 which is a special report on the alleged increase of insanity in Ireland, the 

 Inspector writes, after quoting certain American observations : — 



" These observations by authorities on the subject in the United States, 

 read in connection with the statistics of insanity in Ireland, point to the con- 

 clusion that the Irish branch of the Celtic race is specially predisposed to 

 mental breakdown, and therefore the great increase in the number of regis- 

 tered insane all over the civilised world is for this, as well as other reasons, 

 very marked in Ireland. As to why this should be so we can offer no reasonable 

 explanation; but just as the Irish famine was, apart from its direct effects, 

 responsible for so much physical distress in the country, so it would seem not 

 improbable that the innutritions dietary and other deprivations of the majority 

 of the population of Ireland must, when acting over many generations, have 

 led to impaired nutrition of the nervous system, and in this way have developed 

 in the race those neuropathic and psychopathic tendencies which are the pre- 

 cursors of insanity." 



