SOME PROBLEMS IN SANITARY SCIENCE. 113 



SOME PROBLEMS IN SANITARY SCIENCE. 



GUY L. KIEFER. 



When I was asked some time ago by the chairman of the Section of 

 Sanitary Science of this society to read a paper at this meeting, it 

 occurred to me that it might be well to bring np for your discussion a 

 few of the problems that are most commonly met with in public health 

 work. If I were to attempt to discuss many of these problems the time 

 would not suffice, and I will, therefore, limit this paper to the consider- 

 ation of only a very few such as have .presented themselves to me as of 

 especial importance. 



One of the greatest and most serious problems that our science has 

 to deal with is the so-called "Spitting Nuisance." As medical science 

 advances, the dangers due to this terrible nuisance become more and 

 more apparent and manifold. We know now that tuberculosis of the 

 lungs, pneumonia, and other very fatal diseases may be spread in this 

 way. In all of these diseases the specific germ which is the direct 

 cause of the disease, is located in the sputum and by the spitting nui- 

 sance, so common in our great country, millions of bacilli of consump- 

 tion and pneumonia are thrown upon the public streets and on the 

 floors, not only of public but also of private buildings. These parti- 

 cles of sputum become dry and infinitely small parts of them containing 

 the specific organisms of the diseases named are carried through the 

 air and conveyed to the throats and lungs of susceptible persons who 

 subsequently succumb to the given disease. Now what is the remedy? 

 What is the solution of this very important problem? The establishment 

 of public opinion against this nuisance. Boards of health all over the 

 country are attempting to educate the public in this respect and to 

 this end so-called "spitting signs" have been placed in public places, 

 in street cars, in theaters and other public buildings and even on the 

 street corners, calling attention to the fact that spitting in public places 

 is a nuisance and is detrimental to the public health, and that it is 

 therefore forbidden. This method has undoubtedly had some good effect 

 and as it becomes more universally adopted, the good effect will be 

 more apparent. But even with these and similar public measures prop- 

 erly carried out, the battle is only partly won. Such public measures, 

 even when legally enforced, reach only the offender who is guilty of 

 spitting in public places. The person who pollutes the air of his own' 

 home and endangers the lives of the very ones who are most dear to 

 him, can not be reached by legal measures. He must be educated, he 

 must be taught by public opinion that a habit which he has formed 

 years before and which he has always considered harmless, must be 

 broken off because it is positively dangerous to those about him. Now 

 let us see why the abatement of this spitting nuisance is of such prime 

 importance as a sanitarj" reform. Tuberculosis and pneumonia are the 

 principal diseases that may be spread in this way; not only does the 

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