Tuberculosis : a Social Suevey

Historical. Tuberculosis is essentially a disease of civilization, which dates back to the earliest days of history. Tuberculous lesions have been found in ancient Egypt, in Mummies from the time of Rameses I and II, about 2,000 years before Christ, but whether the Egyptians recognised it or not, is not known. The earliest published descriptions of tuberculosis are those of the Greek Hippocrates in his Epidemics, in which he reports 42 cases of Consumption, 25 of which ended in • death (a death rate of 59.5%). In the first century before Christ, Aretaeus, a Greek physician of a Roman provence in Asia Minor, describes the symptoms of tuberculosis in great detail. He refers to the bony fingers, the sharp and slender nose, the prominent Adams apple and the narrow chest. Even at this stage it is recognised that phthisis is more common in those of asthenic or linear diathesis—a factor still held, though never actually proved to my knowledge. Galen, about the year 17-5 A.D. knew that phthisis was infectious, saying " It is a matter of experience that those who sleep in the same bed with Consumptives fall into consumption, also those who live long with them, eat or drink with them, or wear their clothes and linen."" See how he interprets his observation. He recognises the infective nature of the disease, while today many incorrectly think that it is hereditary. On 24th March, 1882, Robert Koch announced to the Physiological Society of Berlin, that he had discovered the tubercle bacillus, the cause of tuberculosis. Thus we see five great historical facts about the disease, (i) its antiquity, (ii) its recognition as a separate disease, (iii) its relation to type or diathesis, (iv) its infectivity and social danger and finally (v) the discovery of the cause. It is the social aspect or environment of the disease, which concerns. us in this paper. The Investigation.—Information was collected from various sources, to represent as far as possible an accurate cross-section of the community. (i) Data from a random group of 640 persons attending Dublin Corporation Tuberculosis Dispensary at, Charles Street in 1942. (ii) Data from Domiciliary forms, concerning approximately 2,000 persons, recommended for admission from Dublin City to Sanatoria, during a period of ten years. (iii) Information from death certificates of all persons dying of tuberculosis in the City of Dublin, during a period of 5 years. (1940-1944). (iv) The results …