628 TRANSACTIONS OF SECTION I. 
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 indisposition. I believe that the conditions of exhausting 
work, and amusement in confined and overheated atmospheres, together with 
ill-regulated feeding, determine largely whether the infection, which almost 
none can escape, become serious or not. Karl Pearson suggests that the 
death statistics afford no proof of the utility of sanatoria or tuberculin dis- 
pensaries, 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 
reneral mortality. He opines that the race is gradually becoming immune to 
tubercle, and hence the declination in the mortality curve is becoming flattened out 
—that Nature is paramount as the determinant of tuberculosis, not nurture. From 
a statistical inquiry into the incidence 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 inquiries and the importance 
of diathesis, I 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 lit, warm, windless atmospheres. The same 
conditions pertain to places of amusement, eating-honses, tube railways, &c. 
Central heating, gas-radiators, and other contrivances are now displacing 
the old open fire and chimney. This change greatly improves the economical con- 
sumption of coal and the light and cleanliness of the atmosphere. But in so far 
as it promotes monotonous, windless, warm atmospheres, it is wholly against the 
health and vigour of the nation. The open fire and wide chimney ensure 
ventilation, the indrawing of cold outside air, streaky air—restless currents at 
different temperatures, which strike the sensory nerves in the skin and prevent 
monotony and weariness of spirit. By the old open fires we were heated with 
radiant heat. The air in the rooms was drawn in cool and varied in temperature. 
The radiator and hot-air system give us a deadly uniformly heated air—the very 
conditions we find most unsupportable on a close summer’s day. 
In Labrador and Newfoundland, Dr. Wakefield tells me, the mortality of 
the fisherfolk from tuberculosis is very heavy. Jt is generally acknowledged 
to be four per 1,000 of the population per annum, against 1°52 for England 
and Wales. Some of the Labrador doctors talk of seven and even eight per 
1,000 in certain districts. The general death-rate is a low one. The fisher- 
men fish off shore, work for many hours a day in the fishing season, and live 
with their families on shore in one-roomed shanties. These shanties are built of 
wood, the crannies are ‘ stogged’* with moss, and the windows nailed up, so that 
ventilation is very imperfect. They are heated by stoves and kept at a very 
high temperature, e.g., SO° F. Outside in the winter the temperature may be 
30 degrees below freezing. The women stay inside the shanties almost all their 
time, and the tuberculosis rate is somewhat higher in them. The main food is 
white bread, tea stewed in the pot till black, fish occasionally, a little margarine 
and molasses. The fish is boiled and the water thrown away. Game has become 
scarce in recent years; old, dark-coloured flour—spoken of with disfavour—has 
been replaced by white flour. In consequence of this diet beri-beri has become 
rife to a most serious extent, and the hospitals are full of cases. Martin Flack 
and I have found by our feeding experiments that rats, mice, and pigeons cannot 
be maintained on white bread and water, but can live on wholemeal, or on white 
bread in which we incorporate an extract of the sharps and bran in sufficient 
amount. Recent work has shown the vital importance of certain active principles 
present in the outer layers of wheat, rice, &c., and in milk, meat, &c., which are 
destroyed by heating to 120° C. A diet of white bread or polished rice and 
tinned food sterilised by heat is the cause of beri-beri. The metabolism is 
endangered by the artificial methods of treating foods now in vogue. As to 
the prevalency of tuberculosis in Labrador, we have to consider the inter- 
marriage, the bad diet, the over-rigorous work of the fishermen, the over- 
heating of, and infection in the shanties. Dr. Wakefield has slept with 
four other travellers in a shanty with father, mother, and ten children. In 
some there is scarce room on the floor to lie down. The shanties are heated 
with a steve on which pots boil all the time; water runs down the windows. The 
