TUBERCULOSIS IN LARGE CITIES

To the Editor:—  Several highly controversial points are raised in the editorial entitled "Prevalence of Tuberculosis in Large Cities," which appeared in the Feb. 5 issue of The Journal, page 512. These are based on the assumption that the actual prevalence of tuberculosis is increasing, which is certainly unproved. In New York City, there were 17,451 known active cases of tuberculosis registered on Dec. 31, 1946. On Dec. 31, 1954, eight years later, the total was 15,982. This reduction occurred during a period when the population was increasing and the proportion of Negroes and Puerto Ricans in the city had risen sharply. The first reason given in the editorial, the higher survival rate and subsequent relapse rate of patients currently treated, completely disregards the importance of the large number of patients who signed out of institutions with active disease in the prechemotherapeutic era. A substantial proportion of such cases now