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The Problem of Marital Infection in Pulmonary Tuberculosis

To determine the relative importance of infection and predisposition in the genesis of tubercular lesions is a matter of such interest to all concerned in public-health problems that I have taken this opportunity of laying before the Section some results which, although not in themselves decisive, may provoke discussion among those qualified to advance our knowledge. In a recent memoir [16] the late Dr. Pope and Professor Karl Pearson have published analyses which tended to show that there is evidence that the concurrent existence of pulmonary tuberculosis in husband and wife cannot be explained wholely by the fact of assortative mating in the community. Yet the values of the statistical constants obtained indicated unusually great exposure to the chance of infection to be of less genetic importance than the existence of a predisposition to react unfavourably to those means of contamination which cannot under ordinary circumstances be avoided. Among the rich material analysed by Pope and Pearson were some sets of the sanatorium figures published by the Kaiserliches Gesundheitsamt; since Pope and Pearson's memoir was written the eighth part of the " Tuberkulose Arbeiten" [21] has appeared, and contains the statistical data of other sanatoria, together with a summary of previous work. It seemed to me desirable to reduce the further data and to see how far the constants obtained tallied with those published by Pope and Pearson. Table I contains the correlation coefficients calculated for each sanatorium not dealt with by Pope and Pearson, together with those obtained when all the patients in the public sanatoria were grouped together. I determined the coefficients by the approximate method (Q5) [14], but some of the more striking values were recalculated by the exact fourfold process, and I find, in agreement with Brownlees, Elderton and Pearson [14], that the approximation is quite sufficiently accurate for material of this kind, when the values of h and k are not large. Thus, the Gorbersdorf female cases gave for A by the true fourfold method 062 as against 060 by the approximation, and the total males, A and B, gave 010 and 022 as against 011 and 023.