558 PROCEBDIXGS OF SECTION G^. 



curves for the infantile mortality are shown on Figure 1. It is evident 

 fiom this figure that the infantile mortality curves in all the States 

 have declined in harmony with the phthisis death-rate. As, however, 

 the phthisis mortality is at its maximum between 25-35 years of age, 

 in order to substantiate von Behring's view%s of infantile milk infec- 

 tion as a cause of adult phthisis, and, according to Newsholme's 

 theory of infantile mortality figure as a statistical index of possible 

 milk infection, the infantile mortality figure shoidd have been low 

 during the seventies and early eighties to conform to the low phthisis 

 rates in the first decade of the twentieth century. It is obvious from 

 the chart that this is not so. There remains the factor of isolation^ 

 and education,* on which Newsholme lays so much stress. . 



Table VII. shows the percentage of total deaths from phthisis 

 represented hj the phthisis deaths that occurred in Government- 

 subsidised hospitals (the majority of Australian hospitals receive 

 some subsidy from the State Governments). This table shows conclu- 

 sively that there is not in Australia any relationship between the 

 percentage of total deaths that occur in hospitals (and the stay of 

 patients is often very prolonged) and the decline in the phthisis 

 death-rate. 



While hesitating to criticise two such autliorities as Newsholme 

 and Bulstrode, I yet venture to suggest that neither of these authori- 

 ties has gone far enough in tlie search for an explanation. 



Figure 9 is a reproduction of Figure 7 in " The Prevention of 

 Tuberculosis" (1908), p. 34. This shows that the curve for plithisis 

 death-rate, Avhile falling from 1850, yet began to fall markedly in 

 the quinquennium 1865-1869, and has not since modified its regular 

 decline. 



Bulstrode (loc. n't., p. 37) shows a chart of the fall of the 

 phthisis death-rate since 1850, with four points marked as follow: 

 — Public Health Act, 1875; Discovery of the Tubercle Bacillus, 

 1882; Housing of the Working Classes Act, 1890; Commencement 

 of Notification and of Sanatoria, 1899; and points out that none- 

 of these has had any marked influence in producing a decline in the 

 phtliisis death-rate. In Australia it has been shown that the curve in 

 plithisis death-rate began to fall imiformly after 1883-1885 — i.e., soon 

 after the discovery of tubercle bacillus. The fall in England and 

 Wales began in 1865-9 quinquennium — i.e., shortly before education 

 became compiilsory. One is inclined to think that Dr. Bulstrode might 

 have included in his chart '" Elementaiy Education Act, 1871." In 

 short, it is not unlikely that the real explanation of the diminution in 

 tlie pluthisis death-rate is to be found in the rapid enlightenment of the 

 people in general, which began in the early sixties, led up to compul- 

 sory education in 1871, and has continued so rapidly since. ^ 



In thus singling out the Elementaiy Education Act, it is not 

 intended that this is to be considered as itself an important factor, 

 but ratlier as an indication of the spirit of the period which saw its 

 enactment. 



This decade, 1860-69, may be regarded as a landmark in the 

 career of the Eno-hsh ''working classes." Trades unionism became 



* E hication, i.e.,a,star as Dhthisia and its methoH of sprpad is concerned. In 

 this sense the word " education " is used throughout the succeeding remarks. 



