[Decrease in tuberculosis mortality--a credit to medicine or sequela of an improved standard of living].

Abstract

Tuberculosis was the major cause of death in 19th century Europe. A fall in the incidence of the disease was first observed in England. In Germany this reduced incidence - along with industrialization - did not take place until the time of the Reich. Scientists in the 19th century recognised various factors as being responsible for the decrease in incidence of the disease. Those who believed in the contagiousness of the disease hoped to be able to control it with preventive and hygienic measures resulting from their findings on the bacteriology of the epidemic. Constitutionalists, on the other hand, attached importance to hereditary factors and believed that "evolution by natural selection" would bring the disease under control. Social hygienists, whose findings at the beginning of the 20th century were a subject of wide discussion, found the disease to be chiefly influenced by eating, working, and living conditions. These assumptions were confirmed by a statistical analysis of the relationship between living conditions and the mortality associated with tuberculosis. It follows that better living conditions would help to reduce the number of deaths from tuberculosis better than any medical preventive measure.