Dr. Patrick also questioned the accuracy of star of consumption in Shanghai, suggesting that many cases of so-called consumption wens but cases of mal-nutrition resulting from poor and inadequate food. The doctor suggested that the proper policy would be for the ratepayers to instruct the Council to proceed with the erection of the already scheduled pavilion at the Isolation Hospital, and use that for tubercular cases. When in the course of time the educational campaign had made progress, Dr. proper tuberculosis hospital might be built further out.
The Chairman in reply observed that the extension of the Isolation Hospital would follow in due course, and the proposed new building would neither stop nor delay the general public health policy. Without more ado, the resolution was put to the meeting, and defeated; and there for the time being the matter stands. conditions, and when once these have been realized it can scarcely be doubted that-the matter will in future be treattd with comparative indifference. It is still unfortunately true that tuberculosis is extremely prevalent in Shang-i, and is responsible for enormous death rate, significant of conditions of over-crowding against which there is at present no legisl1- tion. Tuberculosis heads the list of fatal diseases both among foreigners and Chinese, and the prevention of this disease offers fine field for future work.
It must always be remembered, as Dr. Stanley points out, that tuberculosis bears little relation 13 climate, being common wherever men are in close aggregation.
Overcrowding in Poor Quarters.
Having stated in brief the main features of the hospital scheme, attention needs to be given to the class of people for whose use and benefit such an institution is primarily intended.
Tt was pointed out in theca columns in the latter part of 1913, when the subject was discussed at some length, that tuberculosis waa rampant in Shanghai, and we are assured that conditions have not changed to such an extent a6 would warrant either withdrawal or modication of the statement, For the most part, the foreign community is immune from the ravages of disease, which does not thrive under conditions of proper sanitation and hygiene, and a good standard of living, but there io a large and increasing class of people compelled to live under conditions extremely favourable to the spread of consumption.
They are crowded into small, insanitary dwellings, often in ' the deep of thickly populated Chinese quarters, and it is amongst such people that the disease ie most prevalent and likely to spread to a serious extent. Under the most favourable conditions, " consump. tive patient, unless isolated, will carry infection on an average to three persons, and the probability is great that this average will be more than doubled in over-crowded houses.
Text read from the printed page and cleaned; old type leaves the occasional error.