698 PROCEEDINGS OF SECTION I. 



germs, and when we consider that consumption is the immediate cause 

 of more deaths than any other disease, does it not seem extraordinary 

 that we should, nevertheless, allow such a man as this to travel hundreds 

 of miles over the country disseminating the seeds of disease wherever 

 he goes. 



The law of right social relationship is that every man shall have 

 freedom to do all that he wills, provided he infringes not on the equal 

 freedom of any other man. By scattering the tubercle bacillus, which 

 is the cause of disease, this man is breaking the law of right social 

 relationship, and I think that the municipal authorities should have 

 the power to detain such an individual, and to keep him under super- 

 Adsion until they are satisfied not only that he knows the proper way 

 of disposing of his expectoration, but that he can also be trusted to 

 carry out the instructions it should be their duty to convey to him. 



EMPLOYMENT OF CONSUMPTIVES. 



I think also that it should be made an offence at law for any person 

 to employ a consumptive in the manufacture or distribution of any 

 article intended for human food. 



I have known a man suffering from active and advanced consump- 

 tion to be employed at a dairy, a girl who was employed in handling 

 and packing sweetmeats, another who was employed by a retail butcher, 

 and so on. It is quite as important to stop such practices as it is to 

 find monev for the erection of sanatoria. 



HARMLESS CONSUMPTIVES. 



Before I proceed further I will show you the magnified image of 

 the expectoration of another consumptive patient (Plate I., fig. 2). I 

 wish to lay particular stress upon the fact, which is at once obvious^ 

 that there are no tubercle bacilli to be seen in this specimen. The 

 expectoration has been examined many times recently, but on no 

 occasion have we found the tubercle bacillus, although the patient is 

 very ill. The question will naturally occur to you, how do I know that 

 this man is actually suffering from consumption, and not from some 

 other illness. 



Well, apart from an examination of the expectoration, and apart 

 from the signs revealed by a physical examination of the chest, we have 

 at our disposal another test by which consumption may be detected. 

 This is known as the tuberculin test. 



If a minute dose of a fluid called the old tuberculin of Koch be 

 injected under the skin of a healthy person he feels perfectly well, and 

 nothing appears to happen to him as the result of the injection. But 

 if the same quantity of tuberculin be injected under the skin of an 

 individual who is suffering from consumption, then, within 24 hours, 

 a certain reaction occurs, which becomes evident chiefly by a rise of 

 temperature. I will show you the temperature chart of a man who 

 was injected with tuberculin on two occasions, but who did not suffer 



