instance, the lungs—and find the locality favourable for its growth, it begins to multiply, damaging the tissues badly during the process, and the condition known as tuberculosis of the lungs becomes established. The point to be emphasized here is that every form of tuberculosis is caused by the tubercle bacillus, and by it only, and therefore the eradication of tuberculosis means the eradication of the tubercle bacillus.

Under ordinary circumstances tubercle bacilli are extremely tenacious of life, though with suitable means they may be easily killed. The sputum of consumptives teems with these organisms, and is the most prolific means of spreading infection. So that clearly this is a question requiring serious consideration.

We have all observed the absence of dust inside our homes as well as out-of-doors in damp weather, the reason being, of course, that the moisture in the atmosphere condenses on the particles of dust in a room, overweights them, and they sink down and settle on the floor or walls, the air so becoming clarified. I mention this every-day fact to make clearer a point I wish to bring out—namely, that it is not the sputum or spittle just when dejected from a patient in a moist condition and so containing the bacilli in certain confined limits that is the trouble, but the danger arises when the sputum dries up, becomes pulverised, and floats about in the atmosphere, to be breathed in by all and sundry.

We do not all get tuberculosis, though frequently exposed to risks, any more than we get many other diseases; that, however, is another question, introducing the subject of immunity, which it is not within the scope of this paper to discuss. Suffice it, then, to summarise thus:—

• (a.)

  Tuberculosis in every form is due to the tubercle bacillus.

• (b.)

  The most fertile, if not the only, source of human tuberculosis is the sputum of consumptives allowed to dry and get converted into dust, so contaminating the air.

• (c.)

  Tuberculosis is infectious.

• (d.)

  Tuberculosis is preventible.

Tuberculosis is, then, an infectious disease, and any person, place, or thing contaminated by the expectoration of consumptives is a focus of infection for human beings. Hence houses or rooms inhabited by consumptives are infectious, as has been sufficiently proved many times; also handkerchiefs, & c., used by such persons are obviously infectious, and the filthy habit of indiscriminate spitting is a prolific source of infection.

I think the above is sufficient explanation of the main factors in the spread of tuberculosis so far as is relevant to

this paper. Let us now consider what we in the colonies are doing in the matter of checking the evil, and so take up our subject proper. I will begin by first stating how things stand with us in New Zealand, and then compare the other colonies.

During the last two decennial periods there has been on the whole a steady decline in the death-rate from phthisis in New Zealand. In 1900 the figure for phthisis stood at 7·56 per 10,000 living, and for all forms of tuberculosis 9·85. The deaths from tuberculosis represented as a percentage of total deaths equalled 10·44 in 1900. Practically throughout the last decennial period phthisis heads the list of all causes of death. The New Zealand Year-book contains the following paragraph re phthisis: “In all the Australian Colonies the rate is materially increased by the deaths of persons who have come out either already suffering from phthisis or predisposed thereto. There is no reason for believing that this circumstance has more effect on the death-rate in Australia than in New Zealand; so that the lower rate referred to in previous issues of this work as obtaining in this colony may be taken as proof of its superior climate for withstanding consumptive tendencies.”

The Health Department here has issued circulars and handbills, also large-type placards, on tuberculosis, which latter are posted up in public places, and the former widely distributed. The language used is plain and free from any technicality, and points out that tuberculosis is an infectious disease, exhorts people not to spit in public places, explains the necessity for disinfection of infected rooms, & c., and how consumptives should deal with their sputum in order to minimise the risks of infection of others.

Our Public Health Act of 1900 is a very up-to-date Act, and provides for the notification of infectious diseases (in which are included all forms of tuberculosis). The occupier of the house, as well as the medical attendant, has to notify every case of tuberculosis. When the disease has been notified the Act provides for disinfection of infected premises. A penalty is provided for selling infected things, or letting houses or rooms where an infected person is lodging. The Act also deals with the question of overcrowding. “The Factories Act, 1901,” deals with the notification of persons suffering from tuberculosis if engaged in the handling, & c., of any article for human consumption. It deals also with persons working up goods or materials in infected dwelling-houses. Our local bodies have power to make by-laws against spitting in public places; Wellington and Christchurch have recently made such by-laws, Auckland and Wanganui are moving in the same direction, and doubtless many other places will follow a similar course. The railway authorities