NO. I AIR AND TUBERCULOSIS HINSDALE 21 



hours' it would indeed be a terrible situation if it were true that 

 the expired breath could convey pathogenic or other bacilli. The 

 millions of bacilli which we take into the air passages are arrested 

 in the air passages and for the most part mercifully destroyed by 

 the secretion." In any event we have the assurance that the expired 

 air is free from micro-organisms. With reference to tuberculosis 

 this means that if healthy persons are exposed only to the expired air 

 of tuberculous subjects no infection can occur. Only through bacilli 

 contained in the sputum or in tiny drops of moisture coughed by 

 the patient is the disease communicated ; and it is further probable 

 that, as in the case of other infectious organisms, when once re- 

 ceived into the nose and mouth and upper air passages, they quickly 

 lose their activity or are soon extruded. (See page 13 et seq.) 



ATMOSPHERIC IMPURITIES 



In view of these facts it would scarcely seem necessary to state 

 that for the treatment of all respiratory diseases and especially 

 for the treatment of infections such as tuberculosis, which invades 

 the larynx and the lungs, or for the treatment of patients whose 

 throats and lungs owing to other infections, such as tonsillitis, 

 pneumonia, or influenza, may be specially susceptible, no city air can 

 be considered favorable. It is our duty to provide as nearly as possi- 

 ble air with a very low bacterial content such as may be obtained in 

 forests or in the neighborhood of the seashore. 



COAL AND SMOKE 



Aside from the presence of bacteria in the air of cities and towns 

 there are other impurities which are of great disadvantage to tubercu- 

 lous patients. The prevalent use of soft, or bituminous coal in Great 

 Britain and America, especially in manufacturing centers, undoubt- 

 edly shortens human life and hastens many a consumptive to his end. 

 Volumes have been written on this subject and most valuable contri- 

 butions have been made by Dr. J. B. Cohen, of Leeds, Mr. Francis 

 A. R. Russell, Henry de Varigny and others, published in connection 

 with the Hodgkins Fund.^ 



^ About 380 cubic feet which is equal to a volume yVs feet (220 cm.) in 

 height, width, and thickness. 



" It has been calculated that in a town like London or Manchester, a man 

 breathes in during ten hours 37,500.000 spores and germs. F. A. R. Russell. 



'See Smithsonian Miscellaneous Collections, Vol. 39, 1896 (Publications 

 1071, 1072, 1073). 



See also " The Influence of Smoke on Acute and Chronic Lung Infections," 

 by Wm. Charles White, M. D., and Paul Shuey, Pittsburg. Trans. Amer. 

 Climatological Association, 1913. 



