[From Causes of Consumption, 1899]
Consumption is without doubt one of the most terrible diseases we in temperate climes have to deal with, not only on account of its very great prevalence, but also on account of its destructiveness.
It is computed that tubercle, in its various forms, carries off annually something like 70,000 persons, the very pick and flower of our population, and those who are most intimately associated with and form a most valuable part of the social and political life of a nation. This fact alone raises the subject from a mere scientific or medical study into a most important State question.
In the form of phthisis it carries away more than one-third of those that die between the ages of 15 and 45, and nearly half those between 15 and 35. It commits its depredations not upon the very young or the old, who are and must always be to a certain extent a burden to the State, but rather upon those essential units who contribute to its wealth, and whose moral and physical well-being are the State's most valuable assets.
The subject is a very old one ; much has been written upon it, and controversy fierce and hot has from time to time waged round it, and yet the debateable ground, although yearly being encroached upon by our best scientists, remains all too large,
Living as I do in an island where phthisis is notoriously rampant--an island which in its history, its government, and its native race, is in many respects peculiar and unique, I have been led to ask myself the question, as to whether these peculiarities have any influence, and if so what influence, upon the prevalence of this disease. Cut off from the laboratories and hospitals of large English towns, one still feels that the facts to be gleaned by a country surgeon are not altogether to be despised, and are certainly of some value when added to the great mass of accumulated facts that is necessary to the thorough elucidation of any question.
In preparing this thesis I have considered it advisable to briefly review the generally accepted causes of phthisis, only dealing at any length with those that bear in an especial manner upon the little Manx Nation.
Ramsey, Isle of Man, January, 1899.
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