Educational campaigns have been vigorously prosecuted for the past ten years, and gradually through the world is spreading a growing appreciation of the dangers of this disease. The effect of this increasing knowledge is reflected by a continually decreasing number of deaths in proportion to the population. The following diagram (Fig. 76) shows how this law is obeyed in New York State, the downward tendency of the line since 1890 being very plainly marked.
Fig. 75.—Outdoor sleeping porch for tuberculosis patients.
The results being so manifest, the prophecy of Dr. Biggs of New York, written in 1907, is certainly justified:—
"In no other direction can such large results be achieved so certainly and at such relatively small cost. The time is not far distant when those states and municipalities which have not adopted a comprehensive plan for dealing with tuberculosis will be regarded as almost criminally negligent in their administration of sanitary affairs and inexcusably blind to their own best economic interests."
Fig. 76.—Mortality from pulmonary tuberculosis. Deaths per 100,000 population.
Pneumonia.—The germ.
In New York State in the year 1908, the largest number of deaths from any specific disease was due to consumption, the number of deaths in the rural population alone being 2906. The next largest number of deaths in the rural communities, and always a close second to consumption, was from pneumonia, the number being 2191; so that pneumonia justly ranks as highly important in the list of diseases which are at present most deadly in their effect on the human race and against which a vigorous fight should be made.
While pneumonia, like tuberculosis, is due to the action of a specific organism, the germ itself is not so generally infectious; that is, the germ has not the power of remaining vigorous when out of the human body in the same way as has the germ of consumption. Like tuberculosis, the germ is expectorated and remains virulent when dried into dust, but the germ is much more sensitive to temperature changes and does not live longer than two or three hours when dried and exposed to the sun. It is, very curiously, a normal resident in the mouths of at least one third of all healthy persons, and it is only necessary for the body of these persons to become weakened for the germ to be able to secure a foothold and produce the disease. Unlike tuberculosis, which attacks chiefly those in the vigor of life, from fifteen to forty-five years of age, pneumonia attacks generally the very young and the very old; those under five and those over forty-five, the time of life when the vital resistance is the least.