efforts on the destruction of the bacilli is the only, or even the best, way of exterminating the disease. Few diseases prevail so generally throughout the world as tuberculosis. No zone is exempt from its ravages, and it has prevailed from the earliest times. Its victims constitute seventeen per cent of all deaths, and nearly five thousand succumbed to it in New York city in 1894. It affects also the lower animals, especially the cow, which is so important a source of food supply. Many persons are fatally affected by it long before they are obliged to leave their occupations, or even to consult a physician. The methods which have proved so successful with the acute infectious diseases can hardly be applied effectually with such a disease as this, and the attempt to deal with it solely on this line may even prove mischievous sometimes by fostering a belief that exemption can be secured simply by shunning the sick. Should such a view prevail generally, unnecessarily severe and even cruel measures would sometimes be adopted by the timid and ignorant. Not long ago a writer proposed that all cases be segregated and quarantined in a valley in New Mexico, where climatic conditions were favorable to recovery. Government aid being given the impecunious, and a leading New York daily commented favorably on the proposition.
The importance, then, of correct views on this subject can scarcely be overestimated. We have seen that, though the disease is undoubtedly communicable, it does not prove so under all circumstances. It is a question if any one of sound heredity and good health has ever developed it simply from living with a consumptive in ordinarily good hygienic surroundings. It is generally admitted that predisposing conditions can always be found. The germs of this disease can not obtain a foothold until the resistive powers of the tissues have been reduced. There must be not only the seed but the soil. This impaired power of resistance may be the result of heredity, and this influence in the causation of disease is seldom shown to better advantage than in the history of consumption. There have been instances in which a single case introduced into a long and sound ancestry has vitiated the stock forever. How unfortunate that such matters are so little considered in marrying and giving in marriage! It is not that the disease is inherited, but the vulnerable tissues, the feeble resistive powers, render the offspring an easy prey to the ubiquitous bacillus. This weakness often shows itself by a tendency to become ill from slight causes, a sickliness, not by any means to be confounded with merely a lack of robustness or strength. One organ or part of the body, frequently the mucous membrane, is usually more prone to become affected, and the beginning of the disease can often be traced to an attack of some slight ailment. Not only the children of consumptive parents
