824 
PROCEEDINGS OF SECTION I. 
occurs in the human subject in a variety of different forms, tbe most 
notable of which are : Acute general tuberculosis, tubercular phthisis, 
tubercular meningitis, tubercular pleurisy and peritonitis, tabes 
mesenterica, scrofula or strumous disease, lupus ; but it may affect any 
organ or tissue of the body. In cattle it is known as pining, wasting, 
the grapes, or grape disease (perlsuclit). 
The clinical differences between these diseases are so great that, 
except as being due to the action of the tubercle bacilli, it would be 
very difficult to associate them. These differences may be due on tbe 
one band to the bacilli, on the other to the characteristics of the host 
or person affected* The bacilli may be functionally different, may 
vary in virulence and activity, as they have or have not developed in a 
congenial soil ; they may infect in large or small numbers the host, 
whose tissues no doubt vary in resistance in different degrees at 
different times — (Klein). Whatever may be tlie causes of these 
differences, the point is the recognition of the fact that all are due to 
the one cause — viz., the Bacillus tuberculosis . 
The importance of the disease is indicated hv the terrible 
mortality. Hirsch estimates that among civilised communities the 
average deaths from phthisis (consumption) amount to one-seventh 
of the total mortality, and it must be remembered that this does not 
by any means include all the deaths which are due to tuberculosis ; 
and then in addition we must think of the many painful, disfiguring, 
and crippling affections that tuberculosis produces, which, while not 
causing actual death, entail much suffering. 
In England and Wales, in 1840, the death-rate of phthisis was 
nearly 4,000 in every 1,000,000 persons living. In the last five years 
it has declined to 1,035. 
In Queensland in 1892 the number of deaths from tubercular 
diseases was 601 out of a total mortality of 5,266, which is more than 
one-eighth and less than one-ninth (11 ’41 per cent.). In 1893 there 
were 670 deaths by tubercular diseases out of a total of 5,695 (476 
phthisis), between one-eighth and one-ninth, or 11*77 per cent. 
Taking 300 deaths which have occurred under my immediate notice, 
43 deaths were due to tubercular disease, which is almost exactly 
one-seventh (14*33 per cent.): — Phthisis, 38; tabes mes., 2; acute 
tubercular meningitis, 2 ; other forms, 1 ; total 43. Hirschberger 
estimates that 25 per cent, of all deaths occurring in children under 
one year of age are due to tuberculosis. To put these in another 
form, it has been found by calculation from the death reports in the 
United States that during every hour throughout day and night 14 
persons die of consumption alone* 
I beg to submit that tuberculosis is a communicable disease ; 
that it is a contagious disease, and therefore a preventable disease. I 
think we should thoroughly realise this fact. We have become for 
this disease like men in battle who, constantly seeing tlieir comrades 
dropping in the ranks, become almost indifferent — the everyday occur- 
rence is unnoticed. I do not think it is necessary to enter into any 
evidence to support my statement that tuberculosis is a communicable 
disease. It* has been so clearly demonstrated by experimental and 
clinical evidence that it is now accepted by all authorities and, I think, 
the medical profession generally. 
