In English counties containing populations of 100,000 or over the highest rates were-in 1908-London, 1806; Lancashire, 1848; Northumberland, 1947; Carnarvonshire, 2025; and Carmarthenshire, 2328 per million living. Of the fifteen counties in England and Wales with the highest tuberculosis moralities, no fewer than seven are Welsh. Cardi anshire, with 2270 for both sexes, has a rate nearly double that 07 England.
According to the United States census of 1900, the death-rate from tuberculosis in the area chosen for registration which embraced ten registration states, namely, Connecticut, Maine, District of Colum ia, Massachusetts, Michigan, New Hampshire, New jersey, New York, Rhode Island and Vermont, and 153 registration cities Number of Deaths from
I by phthisis at ages under 5 years, more liable at the age of 5-20, and again less liable at subsequent ages." These observations, it must be noted, refer only to consumption. The comparative immunity of the very young does not extend to all forms of tuberculous disease. On the contrary, tuberculosis of the bowels and mesenteric glands (tabes mesenterica), tuberculous peritonitis and tuberculous meningitis are pre-eminently diseases of childhood. The tables at foot of page show in detail the relative incidence of pulmonary phthisis at different ages, and the steady diminution of the disease in England and Wales since 1850.
Occupation has a marked influence on the prevalence of pulmonary tuberculosis. The comparative mortality figures for various occupations are taken from the supplement to the registrar-gc-neral's 65th annual Report, and show the incidence of pulmonary phthisis, agriculturists being taken at 100 for purposes of comparison. outside these states, was:-
Tuberculosis. Deathqate Def I°0'O°O' Occupied Males: England and Wales. Highest. Lowest.
1890 48,236 245-4 Tin miner ..... 816 Coal miner .... 89 1900 54,898 190-5 Copper miner 574 Chemical manufacturer 98 -f Scissors maker 533 Carpenter, joiner 150
The returns of the mortality statistics of the United States for the File maker ..... 387 Artist 156 year 1908 cover an area of 17 states, the district of Columbia and General shopkeeper 387 Blacksmith. 158 74 registration cities, representing an aggregate po ulation of ' Brush maker .... 325 Worsted manufacturer 159 5,028,767, or 51-8 % of the total estimated population ofpthe United Furrier ' 316 Baker .., 165 gtates, Printer . ... 300 Bricklayer .... 194
Chimney sweep 284 Cotton manufacturer 197
Mortality from Tuberculosis in the United States in given areas. Hatter 230 Tailor 243 5 The high incidence in the first group will be seen chiefly to affect QSQQZL rI?;Hef, § , i';, § '§)'s Pf>'}, 'a?, ';§ ;ry I§ , '“;2;')e;;“F§ °'C:;gi§ fig those occupations where there is dust (scissors and file makers and 1981-1985. 62835. ' 5§ ,2§ I.' population, '1o3~2. furriers) The high mortality amongst general shopkeepers can 2' - only be ascribed to continuous indoor occupation. Coal miners 1904 66,797 58,763 201-6 enjoy an unexplained immunity. 1905 65,352 56,770 193-6 Dr Von Korosy has tabulated the result of seventeen years 1906 75,512 65,341 184-2 observation in Budapest, which is an excessively tuberculous town. 1907 176,650 66,374 183-6 His figures include both males and females above fifteen years of 1908 78,289 67,376 173-9 age, and extend to 106,944 deaths. The field of observation is In the United States tuberculosis of the lungs forms from 86-to 87 % of all cases. The death-rate, as we see, is steadily decreasing. It is, however, difficult to estimate the ravages of the disease in that country owing to the fact that rather less than half the United States is still unprovided with an adequate system of registration. The following was the death-rate from tuberculosis (all forms) per 500,000 of the population of the chief cities of the United States r' 1 8:- -
evidently very different from those which furnished the statistics already given. His results are: (1) Males-printers 606, butlers 520, shoemakers 494, dyers 493, millers 492, joiners 485, tinkers and locksmiths 484, masons 467, labourers 433, tailors 18, bakers 398, drivers 370, servants 360, carpenters 339, officials 336, butchers 333, innkeepers 272, merchants 253, lawyers 205, physicians 118, capitalists 106; (2) Females-servants 353, day labourers (? char-women) 333, washerwomen 314, gardeners 269, capitalists u mg 90 42. The inmates of lunatic asylums, whovare classed among the New Orleans .... 298-3
Sacramento, California 294-3 ENGLAND AND WALES 1173511108100 -~-~ - 264'0 Tuberculnus PIithisis -Mortality in several Periods, 1851-1899. ?3.l(l;](gi . Annual Rate per Million Living.
erse 1 y ... . . °
New York ... . ' 234-4 MALES
Philadelphia N. k 234-1 AGES
Saratoga Springs, ew Yor 232-2 ' °
Indianapolis . 222-6 1
Boston, Massachusetts 219-1 Pe11°d° All Uf1d€f St Louis .... 188-3 Ages, 5 5- 10- 15- 20- 25- 35- 45- 55- 55-Chicago 180-7 - Y€a1'S-Kansas
City .. . 172-9 ff-Cleveland,
Ohio . 142-4 1851 1800 2579 1329 525 703 2399 4052 4031 4004 3830 3331 2389 Pittsburg, Pennsylvania 139°2 1801 1870 2407 990 431 005 2190 3883 4094 4100 3801 3297 2024 Detroit . '122-5 1871 1380 2209 783 340 481 1075 3092 3099 4120 3860 3195 1924 sr Paul, Minnesota 111-8 £35 5937 584 274 37; 1331 342; 3342 3732 356% 2937 130; 21 234 31 1212 3 344 2 O4 1
The returns in the United States show a 1891-1895 1634 467 197 260 1075 2026 2548 3268 3205 2286 IS;-2 high rate of mortality from tuberculosis 1896-1899 1521 403 140 195 908 1841 2341 3110 3173 2627 1530 amongst the coloured population, the 1900-1904 1479 366 149 182 799 1643 2147 2811 3130 2560 1309 negro being particularly susceptible to 1903-1907 1385 359 138 163 743 1472 2022 2573 2945 2498 1316 pai monary phth1si1s;dthebfiea}§ h-rate from 1908 1310 205 134 161 676 1858 2114 1964 2000 1830 1061 t is cause is near y on e t at amongst
whites. FEMALES
Age and Sex.-The most complete information
under this heading is derived A
from the English records. “ In both l GE*
sexes, ” says Dr Tatham, “ the real - l 5
liability to phthisis begins somewhere Period' All Under 6 between the fifteenth and the twentieth Ages. Y5 5- Io- I5* 2O'° 25" 35- 45” 55' 5year. Among males attains iris maxi- ears
mum at age 45-55, w en it reac es 3173 "
per million living. Among females it 1§§ 1'1§ 5° 27;4 1281 f 620 1293 5516 4228 457-3 4178 351 2323 1655 attain sits, ,, a, d, ,, ,, ,, , (2096) at age 35 45 1 1-1 70 24 3 947 477 1045 3112 39 7 437 3900 2 5° 2 5 1239 In both sexes the rate rapidly declines '871“'88° 2028 750 375 846 2397 3140 3543 3401 2464 1777 1093 after the attainment of its maximum, 1881-1885 1758 555 550 749 2006 2596 307° 2927 2197 1541 995 Practically the incidence of pulmonary $864890 1497 483 507 658 1626 2075 2552 2565 1936 '49°' 966 h — 1891-1895 1303 421 260 561 '1428 1740 2155 2305 1742 1294 800 p thisis is upon the ages from 15 to
75 ears' Very old people and young 1896-1899 1141 334 201 410 1165 1547 1862 2096 1597 1242 787 Chilcfmn being comparatively exem t AC 1900-1904 1042 316 203 417 1002 1274 1593 1807 1481 1136 670 cording to recent experience femaiési seem '9°3'19°7 975 508 194 391 959 1194 1488 1643 1382 1075 666
to be rather less liable than males to death 1908 931 229 192 441 1270 1458 1761 1407 I X56 945 554