i y8 INFECTION AND IMMUNITY 



published paper by Dr. Hermann M. Biggs, Medical 

 Officer of the Department of Health of New York 

 City: 



" Last year there were reported to the Department of Health 

 more than 13,000 new cases. It may be safely estimated that 

 this represents less than one-half of the cases actually existing in 

 New York City, for many cases live for several years after they 

 are brought to the attention of the Department, and are only in- 

 cluded when originally reported, and many are not reported at 

 all. For example, nearly 5000 other cases were reported in 1901, 

 which had been previously reported. I think we may safely esti- 

 mate that 30,000 cases of tuberculosis in a stage of the disease in 

 which it could be easily recognised by a competent physician 

 are present in New York City. 



44 1 have had a census of the cases actually under treatment in 

 the hospitals in New York City made annually for a series of 

 years, and the total number never much exceeded 1000, or less 

 than 4 per cent, of the cases actually present in 'the city. The 

 vast proportion of the remainder are in tenement houses. I 

 have estimated that the total expenditure in the city of New 

 York in its public institutions for the care and treatment of tu- 

 berculous patients is not over $500,000 a year, or not more than 2 

 per cent, of the actual loss to the city annually. If this annual 

 expenditure were doubled or trebled it would mean a saving of 

 several thousand lives annually, to say nothing of the enormous 

 saving in suffering. 



" It is now fifteen years since the New York City Health De- 

 partment first began, in a very small way, its efforts for the pre- 

 vention of tuberculosis, and these have been rewarded by a 

 reduction in the mortality out of all proportion to the expendi- 

 ture in money and time which has been made. Still, more has 

 been done in New York than in almost any city in the world. 

 The measures, however, now in force are quite inadequate, as 

 compared with the importance and magnitude of the problem. 

 The sanitary authorities, however enthusiastic and efficient, and 



