CONTROL OF INFECTIOUS DISEASES. 695 



But since many, perhaps half, of the infected persons are not sick 

 enough (if sick at all) even to remain at home; since, also, even severe 

 cases, under surveillance in bed during the height of the attack, have 

 a prodromal stage and a convalescent stage during which they are going 

 about although infective, it is not hard to see that the population of 

 any community is likely to embrace at any time infective persons 

 at large persons who may or may not be aware of their own 

 condition. 



Theoretically and practically, then, the official control of infectious 

 diseases must begin with the blanket assumption that the discharges 

 of every individual must be confined to himself and especially prevented 

 from reaching, through any public utility, the mouths of other citizens. 

 Official control of the exchange of discharges by the individual within 

 the family and in the absence of any specific proof that the discharges 

 are infective, is impossible, although through various agencies the in- 

 dividual may be urged to that end. The moment, however, that the 

 individual or the family engage in any occupation which permits them to 

 inflict their discharges upon others, especially through food, milk, or 

 clothing, that moment should the individual or family come under offi- 

 cial cognizance, their methods be inspected and their infectiveness es- 

 timated. The same arguments apply to aggregations of individuals 

 from different families. So long as private meetings are held, it is diffi- 

 cult to supervise or prevent exchange of discharges. But public and es- 

 pecially compulsory meeting, at school, at church, at theatre, etc., should 

 receive official attention. Provision should be made concerning all such 

 meetings that they be held only in suitable places, without overcrowding, 

 with good ventilation, and the exclusion by the officers, attendants, or the 

 general public of all known or suspected of infection and of all who more 

 openly disregard ordinary rules of decency in the disposal of discharges 

 (spitting, etc.), should be part of the studies of the health department. 



Finally, the strictest supervision of those concerned publicly and 

 officially in the handling of public utilities on a large scale (water supplies, 

 milk supplies, hotels, restaurants, food stores, etc.) should hold all strictly 

 accountable for the contamination of such supplies with discharges 

 whether these be normal or not. Hence official control of infectious 

 disease divides itself naturally as follows: 



The recognition and isolation of frank cases of the diseases in question, 

 at home or, better, in a proper hospital. 



