TUBERCULOSIS AND THE PUBLIC HEALTH. 1057 
used for residence. Dirty trades should be regulated, and all 
buildings subjected to periodical sanitary inspection. 
Consumptives should be isolated as far as possible. They 
should spit into small pieces of rag or paper, which can be 
burned, or into a small spitting-cup containing an antiseptic 
solution, such as carbolic acid or corrosive sublimate. They 
should sleep in well-aired rooms by themselves, and should not 
have more communication with the other members of the house. 
hold than is absolutely necessary. They should not marry. 
Consumptive children should not be admitted to boarding-schools 
unless they can have separate rooms for sleeping in, and provision 
can be made for the destruction of the expectoration. 
Consumptive mothers should not nurse their children, nor 
should phthisical wet-nurses be employed. 
We cannot allow phthisical patients to enter the wards of our 
general hospitals for treatment, for we are unable to prevent 
communication between the consumptive and other patients in 
these institutions. Experiment has shown that the air which a 
consumptive breathes becomes charged with the bacilli of tuber- 
culosis ; the expectoration, which is usually copious, dries up and 
leaves the bacilli to mingle with the dust in the room, and cause 
infection among others. If then, consumptive patients occupied 
the same wards with others in the hospitals, they might communi- 
cate the malady to those who are debilitated by disease or acci- 
dent. The power of resisting disease is at a minimum among 
hospital patients, and thus they are peculiarly susceptible to the 
bacilli, to which they fall an easy prey. In time, then, every 
ward would become a permanent centre of contagion. 
There are many objections to a large consumptive hospital 
within our city boundaries. While the segregation of consump- 
tives might be beneficial to the community at large, their isolation 
in the bacilli-laden atmosphere of the town must prove injurious 
to the patients themselves ; but the plan of erecting a home for 
those who are in too advanced a stage to travel to the country 
districts and benefit by the climatic treatment is an excellent 
one. A small building containing a few beds would be ample for 
such cases. To this institution an outdoor department should be 
attached where patients who are unable to leave the city might 
be treated in the early stages. Such a hospital, together with 
the existing Hospice for the Dying in Darlinghurst, would be as 
much as it would be wise to establish. Ifa patient be found to 
be suffering from phthisis, and removal from the impure air of 
the city be impracticable, he might be treated as an out-patient, 
but such cases should not be treated within the walls of a city 
building. A small hospital should be established in Sydney, 
together with three or four homes in the country districts, which 
might be used by those who are in the curative stage, or in the 
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