57 



It need not be wondered at then tliat tliose wlio work at 

 trades where the air is loaded with dust containing metallic 

 particles should be more lialjle to phthisis than those who 

 work in rooms where animal or vegetable dust is present. 



3. Other Predisposing Causes. — Of other predisposing 

 causes I need only mention improper food, in the case of 

 infants especially, alcohol in excess, debilitating disease of 

 any kind. In brief, it may be said that whatever reduces the 

 vitality or resisting power of the body increases the suscepti- 

 bility of the individual to tuberculosis. 



Prevention of Tuberculosis.— How do we hope to pre- 

 vent it r 



1. By diminishing the sources of infection — through 

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

 the bacilli outside the body. 



2. By increasing the resisting power of those who are 



most exposed to danger. 



In carrying out the first our attention must be directed to 

 sputum, because in this ^e have the most fruitful source of 

 danger. The consumptive should be instructed not to spit 

 anywhere except in a spittoon, in which there is a quantity of 

 disinfectant, say a 10 per cent, carbolic acid solution. They 

 should be strongly warned against spitting on carpets, floors 

 of workrooms, offices, and streets. 



Patients who do not care to carry a flask-shaped spittoon 

 with them ought to use pieces of linen instead of handker- 

 chiefs, which could be burned as soon as finished with. 



Expectoration from all j^hthisical patients ought to be 

 burned. Many people will tell you that the sputum in the 

 street does not harm because the sunlight destroys the bacilli. 

 I grant you the sun is one of the best natural disinfectants 

 we possess, but the spores of the tubercular bacilli are very 

 resistent, and they are not always exposed to the sun. Apart 

 from the habit of expectorating on the streets being a filthy 

 one, it is the greatest source of infection. What is required 

 is that consumptives should be told of the danger they may 

 be to others if they are careless in this matter. 



Consumption does not spread through the virulence of its 

 infecting agent, but rather because people are ignorant of its 

 cause and mode of extension. 



Hidden dangers are most to be dreaded, and it seems to 

 me absolutely necessary that the people should be taught 

 and able to appreciate the risk of this mode of infection. 



From the workmg of Cornet the G-ermans have come to the 

 conclusion that cleanliness is what is needed, and they have 



