CONSUMPTION, in medical language, phthisis, tabes, marasmus (q.v.), and more par ticularly phthisis pulmonalis or pulmonary C., is a disease of great frequency and severity, which, in the civilized nations of Europe, produces from one sixth to one tenth of the total mortality in ordinary times. It is uncertain whether there is any part of the world, or any race of men, exempt from C.; this exemption having been at different times claimed for the inhabitants both of hot and cold climates, as for India, Australia, Canada, Iceland, etc., but in most instances in consequence of imperfect knowledge of the facts. On the whole, C. appears to be one of those diseases that have a tendency to increase, unless great care be taken to remove conditions unfavorable to the public health, with the increased aggregation of the human family, and with that extended intercourse which is one of the consequences of an advanced civilization. Hence it is most frequent and most fatal in towns, and most of all In those that are near the great centers of intercourse; while in remc.,,t mountain districts, in islands cut off by a wide ocean from the general stream of human communication, it is commonly stated to be, and probably is, comparatively rare. As a rule, however, the presence of this dreadful Scourge has almost invariably been discovered to a greater or less extent, wherever the Causes of mortality have been carefully examined under enlightened medical superin tendence; and we are still very far from having acquired such an insight into its laws of diffusion, as to be able to deduce from them any exact doctrine as to its causation. C. affects peculiarly the young, especially those in the first period of adult life; though it is nearly certain that the seeds of the disease are commonly sown in the constitution in youth, and even in infancy. Its relation to sex is variable, being apparently determined in part by the predominating occupations, and the habits of living, of the population. It is often observed to be plainly inherited from one or other parent, most frequently the mother; and it is one of the diseases which has been stated to be frequently developed as a consequence of the marriage of cousins or other near relatives, especially when the parental stock is itself tainted or not free from suspicion. In life-insurance, all these circumstances are tsually carefully weighed by the medical officers of companies, as the grounds for admission or rejection of a candidate for insurance; and nothing is more certain to cause rejection, than a well-grounded suspicion of a consumptive tendency, either personal or derived from the parents, or shown in brothers and sisters. It is therefore a fair subject for consideration, on grounds of ordinary prudence. as well as on those of moral and religious obligation, whether those afflicted with this malady, or strongly predisposed to it, ought to enter into the married state. and to incur the prob• able afflictions and responsibilities connected with the maintenance of an unhealthy family. It has even been proposed to legislate on this subject; but sober-minded politi• cal economists will probably always consider, that it is in vain to constrain by laws the strongest instincts of humanity, especially when the application of the law must depend upon such refined distinctions as in the present instance. The subject is clearly one for as appeal to the reason and conscience of individuals, rather than for an attempt to lay down theoretical rules of conduct; but those Who would guide their lives by principle, and who would not rush into marriage from the inferior motives alone, would do well to take it into serious consideration.
Among the determining causes of a in large populations, the best ascertained are those connected with overcrowding and bad ventilation, especially when connected with all the depressing influences inherent in poverty, or associated with a reckless and aban doned life. It is certain that much might be done to improve the public health in this
respect, by more attention on the part of the employers of labor to the comfort and habits of those who are, in more senses than one, their " hands," and the sources of their prosperity. A certain amount of improvement has, indeed, already been effected by the improved living of the working-classes during the last twenty years. Still it is well known, and proved by careful inquiries, that the workshops of tailors, printers, bakers, and other businesses carried on in close, ill-ventilated apartments, by large num bers of workmen, are, in a very aggravated sense, nurseries of consumption. Cotton and linen factories have also been shown, when ill regulated, to be largely responsible for the death of their inmates from this disease. The finest regiments in the army were proved, some years ago, by evidence before a royal commission, to be decimated by this disease in time of peace to a frightful extent, in consequence, probably, of the bad ven tilation and deficient comforts of the barracks. The cutlers and needle-grinders of Sheffield appear to owe their notoriously short lives to C., brought on by the inhalation of metallic particles in the close and atmosphere of their workshops. The stone hewers of Edinburgh and Glasgow, and the colliers of the Lothians, were some years ago in a similar predicament, from the inhalation, in the one case of stone-dust, in the other of lamp-smoke not sufficiently diluted with air. And even agricultural laborers, in many parts of the country, suffer from C. to an extent that is quite appalling, owing to the discomforts, and particularly the close and overcrowded condition of their dwell ings. It is lamentable to think that such evils as these exist, and that they might be to a great extent avoided; but this conclusion appears to follow legitimately from the evidence that has been adduced of the intimate connection of C. with overcrowding and a diminished supply of fresh air iu workshdps and dwellings. Some years ago, Dr. Guy published the details of an inquiry into the health of the journeymen printers of London, from which it appeared, in the clearest manner, that the liability of these workmen to spitting of blood, and other well-known symptoms of C., was in exact proportion to the degree to which they had been subject to the evil influences of ill-ventilated workshops; and the marked improvement in the health of our prisons in the present day, has like wise been shown to be to a considerable extent due to the diminished prevalence of C. among the inmates; which, again, is attributed, on good evidence, to the improved con struction of the cells, and the increased facilities for wholesome exercise and occu pation given to prisoners under confinement for lengthened periods. It has even been plausibly maintained, that in some of our modern jails C. is less prevalent than it is among the general population of the classes from which prisoners are chiefly taken; so that the fact, of confinement, and the depressing influences of a penal discipline, are inure than counterbalanced by the effect of a regular life, wholesome but plain food, and a sufficient amount of occupation to maintain mind and body in a sound state. Even admitting, therefore, that the causes of C. may be in part practically irremovable, there seems no reason to doubt that very much might be done to diminish its prevalence, as well as to arrest its course when already formed. by due attention to the comfort of the laboring population, both in their dwellings and in the pursuit of their daily occupa tions.