464 ANNUAL REPORT OF THE Off. DoC. 



As, however, unfortunately, the aid of the state, the muoicipali- 

 ties, and rich benefactors will probably not be forthcoming for a 

 long time yet, we must for the present resort to other measures that 

 may pave the way for the main measure just referred to, and serve 

 as a supplement and temporary substitute for it. 



Among such measures I regard obligatory notitication as specially 

 valuable. In the combating of all infectious diseases it has proved 

 indispensable as a means of obtaining certain knowledge as to their 

 state, especially their dissemination, their increase and decrease. 

 In the conflict with tuberculosis also we cannot dispense with ob- 

 ligatory notification; we need it not only in order to inform our- 

 selves as to the dissemination of this disease, but maioly in order to 

 learn where help and instruction can be given, and especially where 

 the disinfection which is so urgently necessary when consumptives 

 die or change their residence has to be effected. Fortunately it is 

 not at all necessary to notify all cases of tuberculosis, oor even all 

 cases of consumption, but only those that, owing to the domestic 

 conditions, are sources of danger to the people about them. Such 

 limited notification has already been introduced in various places, 

 in Norway, for instance, by a special law, in Saxony by a ministerial 

 decree, io New York and in several American towns, which have fol- 

 lowed its example. In New York, where notification was optional 

 at first and was afterwards made obligatory, it has proved eminently 

 useful. It has thus been proved that the evils which it used to be 

 feared the introduction of notification for tuberculosis would bring 

 about need not occur, and it is devoutly to be wished that the ex- 

 amples I have named may vei'y soon excite emulation everywhere. 



There is another measure, closel}' contiected with notification, viz., 

 disinfection, which, as already mentioned, must be effected when con- 

 sumptives die or change their residence, in order that those who 

 next occupy the infected dwelling may be protected against infec- 

 tion. Moreover, not only the dwellings but also the infected beds 

 and clothes of consumptives ought to be disinfected. 



A further measure, already recognized on all hands as effective, is 

 the instructing of all classes of the people as to the infectiousness of 

 tuberculosis, and as to the best way of protecting oneself. The fact 

 (hat tuberculosis has considerably diminished in almost all civilized 

 states of late is attributed solelv to the circumstance that knowl- 

 edge of the contagious character of tuberculosis has been more and 

 more widely disseminated, and that caution in intercourse with con- 

 sumptives has increased more and more in consequence. If better 

 knowledge of Ihe nature of tuberculosis has alone sufliced to pre- 

 vent a larj^c immber of cases, this must serve us as a significant ad- 

 monition to make the greatest possible use of this means, and to do 

 more and more to bring it about that everybody know the dangers 



