714 PROCtEDINGS OF SECTION I. 



which can be prevented, surely that should be enough to awaken 

 them to a sense of their grave responsibility. 



The efforts which are being made by the National Association 

 for the Prevention of Consumption are hampered all along the 

 line by the everlasting want of funds. Representations have been 

 made to two Governments, and still we are marking time. 



The people should know that efforts are being made to show 

 them the methods by which the disease may be prevented, but 

 that although this could be done, and would be done, nothing can 

 be done because we find it impossible to sufficiently interest those 

 who have it in their power to help us to stamp it out. 



Several things are first necessary in this movement : — 



1. Universal notification, and only to the Central Board of 



Health should this be done ; 



2. The establishment of tuberculosis dispensaries ; and 



3. A campaign of education of the people in the means by 



which the disease is spread and the methods to combat 

 them. 



With sufficient funds for the establishment of a tuberculosis 

 dispensary much could be done, and a firm forward step taken in 

 the direction of stamping out this fearful and preventible disease. 



The sources of infection are sufficiently well agreed upon to 

 admit of positive statements being made concerning them, though 

 differences still exist about the relative danger of human bovine 

 tuberculosis. 



The most potent factor in dissemination is of course the human 

 sputum, either directly in the form of spray from the mouth, or in 

 a dried form as dust. 



Flugge's work goes to show that great danger exists in the 

 direct transmission of the tubercle bacillus, inasmuch as a cloud of 

 spray from the patient's mouth may extend for a distance of at 

 least four feet and be inhaled by anyone within that radius. 



In advanced cases also the urine and faeces are of an infective 

 character and constitute a danger. It has been long a matter of 

 controversy whether the milk and flesh of tuberculous cattle were 

 or were not sources of infection, and the weight of opinion now 

 appears to have decided that they are. 



The experiments of Fibiger and Jensen who procured cultures 

 virulent to calves from two children who had ingested milk from 

 tuberculous cows appears to be convincing proof. 



Von Behring has suggested that through long residence in the 

 human subject the bovine tubercular bacilli may become so modified 

 in virulence as to be indistinguishable from the human types. 



On the whole we must admit the transmission of infection 

 through milk and meat, but this must occur proportionately, only 

 of course to the amount of tuberculosis which may exist in any 

 particular country among the domestic animals, which varies very 



