Tuberculosis Among School Children 



George J. Nelbach. 

 State Charities Aid Association, New York City. 



Tuberculosis among school children is more prevalent than 

 is commonly supposed. Recognition of this fact has been made 

 during the last five years and important constructive measures 

 of discovery, treatment and prevention have been instituted 

 in many cities in this country. 



As Dr. E. L. Trudeau, pioneer in America of open-air 

 treatment for tuberculosis, has well said, "the need of protect- 

 ing the child is shown by the fact that about fifty per cent of 

 children living in crowded districts become infected by the 

 time they are five years old. Regulation of home conditions, 

 better school hygiene, the segregation of actively tuberculous 

 children, and open-air schools for those who have latent tu- 

 berculosis are measures that should be applied more ex- 

 tensively ; the more so because the child shows a strong ten- 

 dency to recover, and the application of open-air methods seems 

 even more effectual in children than in adults in preventing 

 and curing the disease." 



The figures of Pirquet, Hamburger, Lowman, Philip and 

 many others show that over 90% of the children in poor dis- 

 tricts are by the time they are fourteen years of age already 

 the seat of tuberculous infection. This statement appears in 

 an article on "Conservatism in Tuberculosis Work" by William 

 Charles White, M. D. of Pittsburg in the December number 

 of the "Journal of the Outdoor Life." 



In New York City one thousand children die annually 

 from tuberculosis, according to the Department of Child Hy- 

 giene of the Russell Sage Foundation. 



Additional proof of the prevalence of the disease among 

 children has been revealed through special physical examina- 

 tion of the children in families in which the disease exists or 

 has existed. An examination of 150 such children in New 

 York in 1908 brought out the fact that 51% showed positive 

 signs of the disease, while in an additional 20% a definite 

 diagnosis could not be made, but suspicious symptoms were 

 found to be present. A somewhat more extended investigation 

 took place in Boston, where 679 children taken from the poor- 

 est homes were examined. Four hundred and seventy of these 

 homes contained living consumptives and in 179 others there 

 had been recent deaths from the disease. Of the children ex- 



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