CO129-468 - Governor Sir Stubbs - 1921 [6-8] — Page 60

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THE PREVALENCE AND CHARACTER OF TUBEROULOSIS IN HONGKONG

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III, THE MORBID ANATOLT AS HET WITH IN CASES AMONG CHILDREN

The differences betwem the findings in children dying from tuberculosis and those

present in adults are considerable. As already stated in the foregoing papers,of the

first 300 cases of death from this disease there were 225 children under 10 years of

age. The remaining 75 are insufficient for a study of adult tuberculosis and in the

present papas I propose to restrict my remarks to the disease amongst childrm.

Unless some such limitation is made the subject would angme too vast proportions,

and also it is a matter of interest (not merely or academic or medionl, but of vital

public import) to enquire into the subject of tuberculosis in children in Hongkong:

to see,if we can, in what respects the disease sa met with here differs from that

seen at home. We shall thus incidentally elucidate the reasons for its extensive

prevalence and so indicate means to combat ita ravages. Sine this is a matter for

continued and prolonged study, in the present paper only the first 300 cases will be

form dealt with (comprising 22” under 10 years of age), a number sufficient to Ezen a

basis for drawing certain conclusions,at least tentatively.

It is a well know fact that the primary portal of entry of the bacilli and the

mode of spread of the disease are by no means always easy to determine; in some

Gases, indeed,one can hardly do more than hasard a sonjecture. When we remember that the basil11 may pass through a mucous membrane and even through the walls of vessels and siroulate as foreign bodies without setting up any immediate injury, but only

more remotely causing changes at some distant site where they finally settle, we must always be cautious against employing too freely the anatomical distribution of

the lesions as found in the post-mortes room for the interpretation of their genetic relations. In some instances, again,none of the ordinarily described routes seem to explain the method of spread, as some of those mentioned in the last paper indiente.

The extent and distribution of tubereulous lesions in an animal inoculated experi-

mentally depend upon several factors,vis., the number and virulence of the basilli, the resistance set up against infection by the inoculated animal, the seat of inocu ulation, and the time which has elapsed since infection. It was found as a result of several experimente in which the same dose of bacilli from the sedla soures mRO inoculated at the same site, (namely, subcutaneously into the left hind leg), i

into

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