(305.3) from consumption in the registration States." This is ascribed to the large proportion of coloured population. In Recent researches have led Professor Koch to the conviction that tuberculosis is more often communicated by means of the minute drops of sputum forcibly ejected by consumptive patients during paroxysms of coughing than by the masses of sputum which have been coughed up and expectorated. However this may be, there can be no doubt that the main source of infection is to be found in the sputum of persons suffering from pulmonary tuberculosis. tuberculosis of the bowels, tubercular meningitis, and tubercular joint affections, the patient must have been infected by such material, or by tubercle bacilli in articles of food, such as milk or meat from tuberculous animals. But such cases do not assist in propagating the disease. An infant, crawling upon the floor of an infected house, is especially liable to infection through the medium of the dust, which naturally settles upon the floor, and to develop tubercular meningitis, which is the form of tubercular infection to which young children are most subject. Older children are more likely to contract tubercular joint disease "hip disease," or "white swelling" of the knee joint," or tubercular disease of the spinal column ("Pott's disease"). The child with tubercular meningitis or tubercular peritonitis is usually doomed to death, but many children recover from the other forms of tuberculosis just mentioned and may grow up to be useful citizens, although the results of the disease from which they suffered are manifest in the stiff knee, immovable hip joint, or deformed spinal column. Susceptibility to pulmonary tuberculosis is much greater in young adults than in children. This susceptibility depends upon several factors which constitute the predisposing causes. First we may mention an inherited weakness of constitution, or conformation of body-narrow chest, insufficient lung capacity, feeble circulation, imperfect digestion. Second come the conditions relating to an unfavourable environment-living in ill-ventilated or overheated rooms, absence of sunlight and dampness in apartments occupied, insanitary surroundings, overcrowding of living- and sleeping-rooms. Next we must place lowered vitality as a result of other acute or chronic diseases or of vicious habits, and the catarrhal inflammation of the bronchial mucous membrane which is a prominent feature of certain other infectious diseases -especially measles, whooping-cough, and influenza -or which may result from "taking cold." Finally, occupation has much to do with establishing a predisposition to the disease. The following table, compiled from the last census return (1900), gives the death-rate per 100,000 from this disease for persons of various occupations: Bankers, brokers, and officials of companies.. Farmers and farm labourers.. Clergymen... School-teachers, female... School-teachers, male... Railroad employees.... 92 94 111.7 123.5 126 144 129.8 Occupations in which the air is filled with dust par ticles, which irritate the bronchial mucous membrane, and are often deposited in the lungs in considerable quantities, constitute a predisposition to infection, as is shown by the high death-rate among marble- and stone-cutters. The number of deaths from consumption both in this country and in England is greater among males than among females. In the United States, the total number of deaths from this disease, reported as occurring in the registration area during the last census year, was 53,962, of which 29,192 were males and 24,770 females. The Imperial Health Board of Berlin has issued the following statistics regarding the mortality from phthisis in Europe: Russia has more than 4000 deaths per 1,000,000; Austria-Hungary and France, more than 3000 per 1,000,000; Sweden, Germany, Switzerland, and Ireland, more than 2000 per 1,000,000; Netherlands, Italy, Belgium, Norway, Scotland, and England, more than 1000 deaths per 1,000,000. Certain races seem to be especially liable to infection by the tubercle bacillus. The census return (1900) shows that among those whose mothers were born in Ireland the rate was 339.6 per 100,000, in France 184.7, in Scotland 172.5, in the United States 112.8, in Russia and Poland 71.8. The comparative immunity of Russian and Polish Jews from pulmonary consumption had previously been established by the vital statistics of the city of New York for the six years ending in 1890. It was found to be 76.72 per 100,ooo, while for Irish, during the same period, it was 645.73, for coloured 531.35, for Germans 328.8, and for native-born Americans 205.14. With reference to age, the statistics show a comparatively low rate below the age of fifteen, a rate of 252.4 between fifteen and forty-four, a smaller rate between forty-five and sixty-four years of age (232.5), and a maximum rate of 260.1 beyond the age of sixty-five. While pulmonary consumption is an extremely fatal disease when those who contract it are obliged to live under the unfavourable conditions which contributed to its development, it is now well known that cases in the early stages of the disease are very amenable to suitable treatment, and that a considerable proportion of the cases recover under the influence of pure air and nourishing food. The fact that there is no specific medication for the disease is set forth in the following authoritative circular. "THE COMMITTEE ON THE PREVENTION OF TUBERCULOSIS OF THE CHARITY ORGANISATION SOCIETY OF THE CITY OF NEW YORK "WHEREAS, It has come to the knowledge of the Committee on Tuberculosis of the Charity Organisation Society that many so-called specific medicines and special methods of cure for tuberculosis have been and are being exploited and widely advertised, and |