214 BACTERIOLOGY 



heavy task public hygiene will require the aid of many workers in 

 many different fields is abundantly evident. For all of them, however, 

 bacteriology must furnish the only definite point of view. In the 

 full consideration of the "exciting causes," the tubercle bacillus 

 can never be allowed to drop into the background. Given foul air, 

 insufficient food, inhalation of dust, excessive and exhaustive labor, 

 and the other deplorable accompaniments of modern industrialism, 

 and it still must be constantly kept in mind that without the tubercle 

 bacillus these predisposing causes would never result in a single 

 case of tuberculosis. On the other hand, without these contributing 

 factors the tubercle bacillus would almost sink to the level of the 

 negligible "non-pathogenic organism." Witness the impotence of 

 the bacillus to produce infection, or even maintain itself, in the tissues 

 of those individuals able to live an outdoor life. 



It is evident that in the case of tuberculosis the forces of civilization 

 are on the whole working for its extinction rather than for its perpetu- 

 ation. The available statistics demonstrate that before the modern 

 movement for the suppression of the disease began, and, in fact, even 

 before the discovery of the tubercle bacillus, pulmonary tuberculosis 

 was already on the decline in widely separated parts of the world, 

 in London, in Boston, and in Chicago. 1 It is, perhaps, significant that 

 pulmonary tuberculosis is now one of the tenement-house problems, 

 and that as such it occupies a strictly delimited field. As yet the 

 campaign against tuberculosis has been a desultory one, waged by 

 a few enthusiasts without adequate material or moral support on the 

 part of the community at large, but signs are multiplying that this 

 condition will be a transient phase. The comparative absence of 

 intelligent, systematic endeavor for the suppression of disease is cer- 

 tainly a curious phenomenon in an age of otherwise extensive coor- 

 dination and organized action. The executive talents and restless 

 energy lavished on commercial, industrial, and engineering projects 

 may some day be turned to devising and carrying out hygienic 

 measures. If it were necessary to find an argument in the economic 

 value of human life, it would be readily forthcoming. The recent 

 movements for the study and suppression of tuberculosis mark one 

 of the first attempts to apply bacteriologic knowledge in a determined 

 and radical way to a problem of public hygiene. As regards the ulti- 

 mate extinction of tuberculosis, there may be more or less groping 

 after ways and means, but there need be no misconception as to the 

 scope of the problem. 



There are other fields in which a similar mode of procedure based 

 on ascertained bacteriologic facts and principles has been indicated 



1 Biggs, N. M., The Administrative Control of Tuberculosis. Medical News, 84, 

 p. 337, 1904. 



Vital Statistics of the City of Chicago for the years 1899-1903 inclusive, Chicago, 

 1904. 



