Epidemiology of tuberculosis / by Robert Koch.

  • Robert Koch
Date:
[1910]
Catalogue details

Licence: Public Domain Mark

Credit: Epidemiology of tuberculosis / by Robert Koch. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    16/24 page 670
    especially by tlie specific treatment, in curing many cases. At pres- ent, however, only a comparatively small percentage of cases sliare this advantage, and for the cases not so treated we are unfortunately convinced again and again that pulmonary tuberculosis maintains the same deadly characters as formerly. Besides the decrease in con- cur:.: rir.r. had already been going on for several years before the new m-ih^ h 01 treatment had l^een widely dissemmated. The decrease in consumption has often been ascribed to the dis- covery of the i;oercle bacillus. It has been said that by this, the infec'tious ;::..racier of the disease was proved and that, in conse- quence of this, people became more cautious and avoided infection as much as possible, while previously physicians did not admit the infectiousness of consumption and the public at large followed them in this as a matter of course. There is certainly much to be said for this argument. In any case it is very striking that, with a few exceptions, the decrease in consumption set in everywhere within a few years after that dis- covery. Yet the exceptions prove at once that this new-bom fear of infection is not the only factor involved, although we must allow to it a certain influence which is by no means slight, German authors have frequently claimed that social regulations, particularly insurance against illness, has had an effect upon the decrease of tuberculosis. To a certain extent this is undoubtedly true, particularly as regards present conditions in Germany; yet in most other countries, where such regulations have not yet been estab- lished, the decrease has been just as great and has been going on at the same time, so these regulations can not be with us the most weighty cause. It would take me too long to enumerate and discuss all the attempts at ex]Dlariaticai that have been made, and I will therefore confine myself in conclision to those investigations of this question which appear lo ne i :> l^e of the most importance. These investigations were suggested by the striking fact that the death rate from tuber- culosis shows great differences in the three countries belonging to Great Britain. In England and Scotland it is decreasing.; in Ire- land, on the contrary, it is slowly but evidently increasing. News- holme, the well-known medical statistician, has endeavored to find the prime cause of this. With the greatest thoroughness he has ex- amined all the factors in the question, chiefly lodging, food, condi- tions '.f i^ervice. care of the sick, emigration, and has finally become convinct-rl that for Ireland the method of caruig for the sick is the determining factor. While in England and Scotland phthisical charity patients are committed to isolated institutions, in Ireland they are supported without being required to place themselves in an institution: they therefore remain in their own lodgings and con-
    digitised image 1
    digitised image 2
    digitised image 3