act its poisonous products, or reinforce the phagocytes in their attacks on it, but meanwhile sanatorial treatment gives expectations of recovery greater than those of any other kind of treatment that is known to us, and it seems to me inexpedient to say anything which may discourage the benevolent from putting it within reach of the poor and needy, or hinder the poor and needy, stricken with tuberculosis, from taking advantage of it. Even if sanatorial treatment were not superior to home treatment in the number of cures it effected, it is still deserving of support because it withdraws, for a time, from their own homes and from places of public resort persons who are jets of deadly dust, and thus diminishes the diffusion of tuberculous disease. And surely even the arrest of the disease, which Dr. Maudsley admits is secured by sanatorial treatment in advanced cases, is worth having. Even a damaged life is sometimes sweet to its possessor and precious to those who hold it dear; and it will be a sad day for humanity when the prolongation of life under all circumstances ceases to be the chief aim of the medical profession, and when euthanasia procured or suffered, is recognized as a justifiable mode of exit from the sick room. But beyond all this, even in hopeless cases, in which no arrest is secured, sanatorial treatment is not without its merits, for all patients who have undergone it return to their homes educated in the procedure that is necessary to make them innocuous to others, and trained how to deal with their infectious expectoration, and thus again the propagation of the disease may be in some measure limited.
But Dr. Maudsley is not only sceptical about sanatorial treatment, but apparently doubtful of the wisdom of any sort of curative treatment in tuberculosis. The ordained function of the bacillus in the universe is, he suggests, to make away with weak humanity. The loss to the community by the death of consumptives is not, he hints, as real as is imagined. "Might not the ultimate cost to the commonwealth," he asks, "be greater, were those persons allowed to go on living and breeding in it." The assumptions here are that consumptives inevitably breed consumptives, and that the tubercle bacillus invariably fastens on weak humanity, and both these assumptions are erroneous. Recent inquiries have shown that the influence of heredity in consumption is not so great as was at one time believed. Dr. Claud Muirhead found, after an elaborate investigation, and with peculiar facilities for arriving at the facts, that out of five hundred and twenty-four cases of death from phthisis, only one hundred and twenty, or 22.89 per cent., presented in their family history distinct evidence of direct phthisical taint, and other 62, or an additional 11.83 per cent., exhibited a suspicious family history of phthisis. That is to say, at the very outside, only 34.72 per cent, of these five hundred and twenty-four persons who died of consumption, exhibited in their family history any evidence of
