Über Kriegs- und Nachkriegseinflüsse auf den Tuberkuloseverlauf1

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Abstract
Incidence of tuberculosis in the yrs. 1943-1945 and in 9 mos. of 1946 was compared with that in 1935. Since 1943 a distinct increase of tuberculosis infections is evident. A slight apparent decrease in 1944 may not be real, because in that yr. only a part of deaths from tuberculosis could be autopsied. The primary tuberculosis infection is overcome by youths and adults if life conditions and nourishment are good. In time of war the primary infections, acquired by children and youths up to 15 yrs. old, and by adults, were more numerous and often showed fatal generalization. The number of fatal cases was the same in both sexes and in children and adults. This high incidence was due to poor nutrition and bad living conditions. The course of the chronic pulmonary tuberculosis in adults is altered in war time. The tuberculosis then spreads quickly in the lung, and necrosis, perforations and hemorrhage are evident at an early date. Microscopically, large exudations with caseous necrosis are evident, while the productive inflammation is less. In the intestine large, deep ulcers are observed which often lead to perforation. Mortality of persons between ages 50 and 70 is much higher than in peacetime. In tuberculosis of the aged, also, a quick spread with exudation and necrosis is observed. Together with tuberculosis of the lung, miliary tuberculosis and tuberculous meningitis are often seen; also tuberculosis of the lymph glands, the kidneys, the pleura, the peritoneum and the pericardium. These conditions are caused by the lowered defensive energy of the body in consequence of the insufficient nourishment, especially the lack of protein. Besides the insufficient nourishment, poor living conditions are responsible for the increased fatality of tuberculosis, especially the fact that many persons are forced to live together in small rooms, and hence exposed to a cumulative and intensive infection.

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