466 
JOHN M. PARKER. 
we would probably find that in a large number of cases individ¬ 
uals would react to the test that are at present considered healthy. 
Under these circumstances we would repeat the question 
asked by Prof. Smith, “ shall all these people be considered 
diseased, or only infected ? ” We incline to the belief that there 
is a considerable difference between such infected people and 
those that are affected or diseased. 
In this connection it may be of interest to glance for a mo¬ 
ment at the statistics shewing the reduction in the death rate 
from tuberculosis in Massachusetts. During the past forty-five 
years consumption has steadily and uniformly decreased ; the 
maximum and minimum death rates being 42.7 per ten thousand 
in 1853 22.7 in 1893. 
In Glasgow, Scotland, the figures are almost exactly similar. 
In the period from 1860-64 phthisis reached its highest mor¬ 
tality, viz., 4094 per million. In the period from 1890-94 it 
was 2315, so that in 25 years consumption has been reduced 44 
per cent, in fatality without special treatment as an infectious 
disease. 
Unfortunately phthisis is the only form of tuberculosis 
which has been throughout consistently classified by the Regis¬ 
trar-General as a cause of death. 
Then the report goes on to say : ‘‘ We are therefore shut up 
the twelve years 1883 to 1894, for evidence of the movement of 
tuberculosis diseases other tha^i phthisis. Dividing them into 
two periods of six years we find that the death rate from ‘ phthi¬ 
sis ’ has fallen from 2849 per million to 2316 and from ‘ other 
tubercular diseases ’ from 1090 per million to 884, in both cases 
19 per cent., a result which quite casts into the shade the improve¬ 
ment in Prussia and Saxony, quoted from Cornet, which he puts 
down to the credit of special prophylaxis. Clearly, then, we are 
warranted in asserting that among infectious diseases, tubercu¬ 
losis is the most amenable of all to general hygienic measures, 
that, in fact from these alone as good results are obtained as from 
hygienic measures plus isolation, disinfection, etc., in the case 
of diseases popularly known as infectious. It is not implied 
