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       that the disease is increasing steadily and rather rapidly.
        The estimate of just over two million cases of tuberculosis in
        India as a whole is probably much too low; every large town
        is known to be very heavily infected, and therefore an estimate
        which is based solely on the incidence of the disease in the
        agricultural villages must be unduly favourable.

       "Tuberculosis is a disease which has very special importance in
        India for the reasons—(1) it is likely that many villagers have
        never come in contact with infection and therefore are "virgin
        soil" on which the disease is likely to thrive, (2) the infection
        is being steadily spread from the larger towns to the villages,
        (3) the disease constitutes a reliable index of the standards of
        life which prevail in countries in which it has become estab-
        lished for long periods of time; it spreads rapidly among ill-
        nourished and badly housed populations and correspondingly
        diminishes when the people are well fed, well housed and
        cleanly in their habits."

   5. The Public Health Commissioner, while reviewing the tuberculosis
problem in India in his recent annual reports, drew particular attention to
the absence of accurate statistics regarding the incidence of the disease
and emphasised the necessity of tuberculosis surveys for securing reliable
information. His conclusions are briefly set out below:—

       "No reliable information is available regarding the extent of tuber-
        culosis infection in India. It has been estimated by workers
        in Bengal that, in that province alone, there are a million
        persons suffering from the disease. This is an alarming
        figure but it has to be remembered that it is only an estimate.
        It has been suggested that tentative figures for tuberculosis
        mortality might be arrived at by assuming that from 10 to 20
        per cent. of the deaths under 'fevers' and 20 per cent. of those
        under 'respiratory diseases' are actually due to tuberculosis,
        but such methods are obviously unsatisfactory. It is more
        than desirable that accurate information should be available
        and this can be obtained only by making detailed surveys of
        sample groups of the population.

       "Whilst there is general agreement among tuberculosis workers that
        the rural population is relatively more susceptible to the
        infection than those of urban and industrialised areas and that
        the facilities for rapid travel, which motor buses have intro-
        duced even into the remote corners of rural India, have
        enhanced the danger of a progressive spread of the disease,
        there is urgent need for more precise information regarding
        the special predisposing etiological factors which influence its
        spread among different communities. Properly conducted
        surveys can provide such information and they must therefore
        precede the formulation of effective plans of campaign against
        the disease".

   6. Other observers estimate an even higher incidence of the disease,
notably Dr. Ukil who, writing about Bengal in 1937, observed:—

       "The annual deaths from tuberculosis are estimated to be in the
        neighbourhood of 100,000. The number of persons suffering
        from this disease, at any given time, is estimated to be 9 times