8 SMITHSONIAN MISCELLANEOUS COLLECTIONS VOL. 60 



morning'. (The Shop Act has given a little relief to these hours.) 

 Her office is away in the background — confined, windless, artificially 

 lighted. What is the use of the State spending a million a year on 

 sanatoria and tuberculin dispensaries, when those very conditions of 

 work continue which lessen the immunity and increase the infection 

 of the workers ? 



Isolation hospitals, sputum-pots, and anti-spitting regulations will 

 not stamp out tuberculosis. Such means are like shutting the door of 

 the stable when the horse has escaped. Fliigge has shown that 

 tubercle bacilli are spread by the droplets of saliva which are spread 

 yards around as an invisible spray when we speak, sing, cough, 

 sneeze. Sputum-pots cannot control this. The saliva of incipient 

 cases of phthisis may teem with the bacilli. The tuberculin reaction 

 tests carried out by Hamburger and Monti in Vienna show that 94 

 per cent of all children aged eleven to fourteen have been infected 

 with tubercle. In most the infection is a mere temporary indisposi- 

 tion. We believe that the conditions of exhausting work and amuse- 

 ment in confined and overheated atmospheres, together with ill- 

 regulated feeding, determine largely whether the infection, which 

 almost none can escape, becomes serious or not. Karl Pearson sug- 

 gests that the death statistics afford no proof of the utility of sana- 

 toria or tuberculin dispensaries, for during the very years in which 

 such treatment has been in vogue, the fall in the mortality from 

 tuberculosis has become less relatively to the fall in general mor- 

 tality. He opines that the race is gradually becoming immune to 

 tubercle, and hence the declination in the mortality curve is becom- 

 ing flattened out — that nature is paramount as the determinant of 

 tuberculosis, not nurture. From a statistical inquiry into the inci- 

 dence of tuberculosis in husband and wife and parent and child, 

 Pearson concludes that exposure to infection as in married couples 

 is of little importance, while inborn immunity or diathesis is a chief 

 determinant. Admitting the value of his critical enquiries and the 

 importance of diathesis, we would point out that in the last few 

 years the rush and excitement of modern city life has increased, 

 together with the confinement of workers to sedentary occupations 

 in artificially lighted, warm, windless atmospheres. The same con- 

 ditions pertain to places of amusement, eating-houses, tube railways, 

 etc. Central heating, gas-fadiators, and other contrivances are now 

 displacing the old open fire and chimney. This change greatly im- 

 proves the economical consumption of coal and the light and cleanli- 

 ness of the atmosphere. ]'>ut in so far as it promotes monotonous. 



