212  RAVENEL—WARFARE AGAINST TUBERCULOSIS. [April 4, 
THE WARFARE AGAINST TUBERCULOSIS. 
BY MAZYCK P. RAVENEL, M.D. 
(Read April 4, 1903.) 
It would seem almost*superfluous to dwell on the terrible destruc- 
tion of human life due to tuberculosis, or to dilate on the urgent 
necessity that exists for general and combined efforts to lessen its 
ravages; yet, in spite of all that has been said and written on the 
subject during the last ten years, and in spite of certain encour- 
aging signs of awakening interest in the public mind, it is still true 
that there exists a lamentable and inexplicable apathy in regard to 
this scourge of the human race. Philanthropists are lavish in their 
gifts to colleges, hospitals, libraries, museums and such like institu- 
tions, yet in America at least there have been very few substantial 
donations toward the eradication of tuberculosis, though it would 
be hard to imagine a greater boon to stricken humanity than the 
accomplishment of this end. Legislators give freely to all kinds of 
charitable institutions, but the amount given to the army of the 
tuberculous is pitiably small. This attitude of legislators may to a 
great extent be taken as indicative of public sentiment. This sen- 
timent becomes harder to understand when we consider that three 
facts have been absolutely demonstrated in regard to the disease : 
1. It is communicable. 2. It is preventible. 3. In the early 
stages it is curable. 
It is well to inquire into the causes of this lack of interest, and 
see if there is sound reason for them. One of the greatest draw- 
backs has been the persistent belief in the hereditary character of 
the disease, which is even now quite prevalent among the masses, 
and held by many physicians. While it has been shown that tuber- 
culosis may be transmitted in this manner, it has been equally proven 
that it is of very rare occurrence, and practically negligible. Among 
the lower animals healthy offspring may be constantly obtained from 
tuberculous mothers by separation at birth and artificial feeding—a 
plan carried out on a large scale in Denmark by Prof. Bang. It is, 
however, true that tuberculosis runs in families, the reason being 
that the children of phthisical parents are constantly exposed to 
infection. In man only some twenty cases of true hereditary tuber- 
culosis are on record (Osler), and in cattle there are less than roo to 
be found in the literature. Another obstacle to progress is the inevi- 
