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Yes.

No.

No Answer.

1.-Have you an antispitting law?.

2. Is it enforced?

3.-Are T. B. patients instructed by the Board of Health as to care of sputa?.

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4. Is report of T. B. cases compulsory ?..

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5.

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Is report of T. B. cases requested?... 6. Do you require disinfection of premises after removal or death of T. B. patients?......

7.-Do your statistics for the past five years show an increase or decrease from death by T. B. ?.

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8.-Is T. B. increasing in the negro race?.. 5

And so you will perceive that in only one city in our State is an effort made to instruct the tubercular patient in his duty to his neighbor, by the proper care of his germladen sputum.

It gives me pleasure to announce that the city which has thus set itself upon a hill is one whose genial hospitality we are now recipients of-the city of Macon.

You will note that five of the seven report an increase of T. B. in the negro race,

It would be an easy matter to show that the disease is much more common among the negro than in the white

race.

The board of health of Atlanta reports no increase of T. B. in the negro, but the following significant figures: For the past five years the deaths from T. B. numbered 1,155, of these 429 were white, 726 negroes. The negro population is about forty per cent. of the total population, so that we have shown in round numbers over twice the number of deaths from T. B. in the negro.

The same is true of Augusta (22) and I believe of Southern cities in general.

So that in our most ignorant, unstable and drifting popu lation lies the chief danger to the public, and we have here presented a problem difficult of solution, indeed.

It is simply another phase of the "White Man's Burden," which we must take up and bear as best we can. From the foregoing, we may draw the following conclusions:

1. T. B. is a communicable disease.

2. The sputa and nasal secretions are with us the chief sources of infection.

3. Infection by T. B. may be prevented.

4. The prevention of T. B. must be brought about by concerted action.

5. Such action embraces the enactment of laws enforcing proper hygiene on the part of the T. B. patient on the one band and the public on the other.

6. By the education of the public, through the endeavor of the medical profession, local boards of health, and by free public lectures.

7. The enforced periodic investigation of dairy herds by the tuberculin test,

The time is ripe for action. Let us put our shoulders to the wheel-and then push.

BIBLIOGRAPHY.

1. Daniel, F. E. Medico-Legal Journal, September 1903, page 214.

2. U. S. Census Reports, 1900.

3. Mortality Statistics, Public Health Reports, 1902, page 5. 4. Oertel, T. E. Georgia Journal of Medicine and Surgery, February, 1902, page 64.

5. Brandt, Lillian. The Social Aspects of T. B. Based on a Study of Statistics.

6. Greene. Examination for Life Insurance.

7. American Text-Book of Pathology.

8. Koch, Robert. Trans. Brit. Cong. on Tuberculosis VI, pages 23-35. 1902.

9. Report of the British Congress on Tuberculosis, Public Health Reports, Vol. XVI, No. 36, page 2065.

10. Ravenel. Md. Med. Journal, February, 1900.

11. Reports on Bovine Tuberculosis and Public Health, page 60. 1904.

12. Dorset, Marion. Experiments Concerning Tuberculosis, page 25. 1904.

13. Galmou, D. E. Rept. Bi-annual Industry, page 384. 1902. 14. Mohler, John R. Infectiveness of Milk of Cows, Which Have Reacted to the Tuberculous Test, page 89. 1903.

15. Year Book Dept. Agr., page 588. 1901.

16. Abbott. Bacteriology.

17. McFailand. Bacteriology.

18. Park. Bacteriology.

19. Report Health Dept., Boston, page 37. 1902.

20. Consular Reports, Vol. LXXIV, No. 252. page 839. 1904.

21. Annual Report Com. on the Prevention of Tuberculosis, The Charity Organization Society, New York, page 101. 1903.

22. Coleman, T. D. American Medicine, Vol. VI, No. 17, pages 667-668. 1903.

THE PREVENTION OF TUBERCULOSIS.

BY GEORGE BROWN, M.D., ATLANTA.

One million people out of the ninety millions who owe allegiance to the United States are to-day suffering from some stage of tubercular diseases. At a glance. such a statement almost staggers belief, but a careful compilation of statistics which are available, and allowing a fair average condition of the same state of affairs to exist in places where the figures are not to be had, make this a reasonable estimate.

One person in ninety is a fair proportion, I think any one will agree, though the estimates vary from one in thirty-two to one in two hundred and fifty. The German estimate is that there are over one million in Germany suffering from this disease, and that there are one hundred thousand deaths annually from this cause.

Estimates for the United States show a much smaller ratio of people suffering from tuberculosis than one would find in the crowded countries of Europe.

In our own State there are no available figures that give us the exact number of people afflicted with this malady, though I am sure each of us finds it far more prevalent than the laity suppose it to be. I suppose that the establishment of our splendid State board of health will tend to soon give us this information that will be reliable. I propose to suggest to the next legislature that a tuberculosis commission be appointed to report to that body the exact state of affairs concerning

this disease in this State, in order to form a basis for future work in regard to suppressing this disease.

Now I will only take up a small portion of your time in calling your attention to the ideas which I wish to present in regard to the prevention of tuberculosis.

Three things are to be considered, and I will separate this paper into three heads accordingly:

First. The Patient.

Second. The Doctor.

Third. The State or Municipality.

THE PATIENT.

Tuberculosis, as we all know, is caused by the tubercle bacillus, which was first pointed out by Dr. Koch, of Berlin.

This germ has to be introduced into the human system to be of danger to the individual. The most usual way of this being accomplished is by inhaling these germs, which have been thrown off by persons suffering with the disease in the form of sputa, which, drying, diffuses them in the air, and they are inhaled by others. To be of danger, there must be a condition of the system of the person inhaling these these germs, which make them susceptible to the effect of these min

corn is planted in

ute creatures. If a grain of the earth a certain amount of heat and moisture is necessary to the changes which take place and make that corn germinate. If these elements do not exist in the proper proportion the grain of corn decays and fails to germinate.

The same may be said of the human system. Each of us have inhaled millions of the germs of tuberculosis, but given a healthy mucous surface in the throat and lungs, and a healthy, sound body, and their results amount to nothing. On the other hand, if the system

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