xii 



maximum the mortality is highest. Dr. Russell, of Glasgow, shows not 

 only the eflfect of overcrowding on the total death rate, but also the 

 great effect it has on the death rate from consumption. But there 

 are other impurities which tell on the mortality of phthisis besides 

 those from organic vapours, namely, those from trades of differenb 

 kinds, such as of knifegrinders, weavers, etc, AH trades which give 

 rise to du3t predispose, and particularly where metallic dust is floating 

 about, CO phthisis. Of other predisposing causes might be mentioned 

 improper food, in the case of infanta specially, alcohol in excess, 

 debilitating disease of any kind. In brief, it may be said that what- 

 ever reduces the vitality or resisting power of the body increases the 

 susceptibility of the individual to tuberculosis. The lecturer then 

 showed how prevention was effected, by diminishing the sources of 

 infection — through the air, milk, and meat — preventing the spread of 

 the bacilli outside the body, and by increasing the resisting power of 

 those who are most exposed to danger. Consumptives should only spit 

 in proper receptacles that have been infected. They should be strongly 

 warned against spitting on cesspits, floors of workrooms, offices, and 

 streets. Expectoration from all phthisical patients ought to be burned. 

 Consumption does not spread through the virulence of its infecting 

 agCLt, but rather because people are ignorant of its cause and mode of 

 extension. Should the consumptive patient die, or be removed, the 

 room and everything in it ought to be disinfected. Curtains, bedding, 

 and clothing should be boiled, blaniiets steamed, and all other furniture 

 cleaned and disinfected. Paper on the walls should be stripped off and 

 burned, and the walls washed with chlorinated lime. Many argue that 

 it must come under the compulsory notification Disease Act, and be 

 treated as any other of the infectious diseases. I confess this appeals 

 very strongly to one, but there are many difficulties in the way of 

 notification. For instance, we know that many consumptives are 

 continually changing their residence, and ofttimes, in the hope of 

 being cured, their medical attendant. Are we then to have a report 

 from each medical attendant, and will the patients be required to 

 notify any chasge of residence ? In New York it is subject to 

 inspection, and inspectors are sent, unless requested by the doctor 

 attending not to do so, to instruct patients and their fimiiies how to 

 guard against the spread of the disease, to disinfect all premises either 

 vacated by removal or by death of patients without any charge to 

 owner. Boiling milk will get rid of any danger, and it is a good rule 

 to boil all milk, as it will destroy the germs of other diseases as well 

 as of tuberculosis. The sale of milk from infected cows should be 

 rigidly prevented. There should be a rigid inspection of all beasts 

 sold, under skilled supervision, before and after slaughter. The 

 lecturer concluded by alluding to how indiscreet marriages perpetuate 

 the disease ; that special care of iafants affected the physical develop- 

 ment of youth, and the necessity to do everything that tends to 

 strengthen the constitution. Choice of profession to those predisposed 

 to consumption was important ; and exercise in the open air was of 

 great value, provided it was not carried to excess. Clothing should be 

 warm and light ; diet plain and nutritious, regular meals ; alcohol 

 should be avoided as a general rule ; and in the choice of a healthy 

 site for residence, high elevations above sea level were advantageous. 

 Tuberculosis (or consumption) was not only a preventable but a curable 

 disease, and the agents which prevent go far towards curing. He 

 was hopeful that a specific serum would yet be found, and that instead 

 of tuberculosis exterminating the human race, the human race would 

 exterminate it. 



Dr. Bright characterised the paper as a most able one. He agreed 

 with almost everything Dr. Sprott had said, and did not know he had 

 ever heard a paper calculated to be of better service to the community 



