DK. J. W. POUCHER. 249 



and suffering of the last few weeks or months of the fell 

 disorder, render its study all important, not only to 

 medical men but also to all who are concerned in the 

 welfare of the nation. Up to quite a recent date, not 

 only was consumption supposed to be incurable, but it 

 was also regarded as almost inevitable. Families in 

 which there existed a taint of the disease were supposed 

 to be doomed to lose some of their members from this 

 cause. 



A great change has, however, been wrought of late 

 years in medical opinion upon this subject, and tuber- 

 culosis has come to be looked upon as both a curable 

 and preventable disease. With regard to its prevent- 

 ability there is not the shadow of a doubt. In England 

 the report of the register general is positive proof that 

 the influence of modern sanitary measures, such as good 

 drainage, good ventilation and improved hygiene, has 

 reduced the mortality from this disease during the past 

 thirty years more than one-third. In the year 1858, out 

 of every million persons 2,560 died from phthisis or con- 

 sumption, but in 1888, thirty years later, it was only 1,541 

 per million, a diminution of over 1,000. This in a popula- 

 tion of over 29,000,000 was the rescue of about 30,000 lives 

 every year from this cause alone. In Massachusetts, 

 which has at present probably by far the best hygienic 

 management of any state in the Union, the number of 

 deaths from consumption in 1857 was 39.50 to every 10,- 

 000 of population. In 1883, under improved hygiene, 

 this was reduced to 29.90 to 10,000 people. In 1858 a 

 commission was appointed to inquire into the sanitary 

 state of the British army. The result was the publica- 

 tion of a very interesting table showing that the mor- 

 tality among soldiers crowded into unsanitary, illy venti- 

 lated barracks, many of them in foreign and unhealthful 

 climates, from consumption alone was something fright- 

 ful, ranging from 15 to as high as 91 to 1,000, almost 



187 



