It is statistically known that there are more cases of advanced pulmonary tuberculosis among rural people than among urban residents. The author worked on the difference in the behaviors of tuberculosis in such two groups of people from a point of view of pathological physiology and discovered the following facts:
As a result of comparison of the rural and urban patients with radiographically similar extent of lesions, the rural patients were found to be inferior to the other group at the time of their hospitalization with respect to haemoglobin values, albumin-globulin ratio, body weight, icterus index, etc., and to show higher values of γ-globulin and higher rates of positive Gros reaction, Among these items, haemoglobin value, albumin-globulinratio and body weight of the rural group showed a marked increase after 6 months' and 12 months' hospitalization.Such increase is ragarded to be a combined effect of improvement both in disease and nutriture.
There are many anemic cases in rural area even among the apparently healthy people free from hookworm infection, and they also present a decrease in total serum protein and albumin values, icterus index, etc., for which their inadequate or unbalanced dietary intake is said to be accountable.In the light of this fact, it is considered that prior to the attack of tuberculosis rural tuberculous patients have already been in more or less poor nutriture, which is further aggravated by the disease, while such poor nutriture assists the progress of the disease itself playing as a causative agent for its ingravescence.