684 Tuberculosis 



Babes and Proca,* Maffucci and di Vestea,f McFarland,{ De 

 Schweinitz, Fisch,|| and Patterson** have all endeavored to obtain 

 serums of therapeutic value by immunizing animals against living 

 or dead tubercle bacilli or their products, but without success. 



From these discordant observations, the more favorable of which 

 are probably the hasty records of inadequate or incomplete experi- 

 ments, the conclusion that little is to be hoped from immune serums 

 in the treatment of tuberculosis is inevitable. 



Prophylaxis. It is the duty of every physician to use every means 

 in his power to prevent the spread of tuberculous infection in the 

 households under his care. To this end patients should cease to 

 kiss the members of their families and friends; should have individual 

 knives, forks, spoons, cups, napkins, etc., carefully kept apart 

 secretly if the patient be sensitive upon the subject from those of 

 the family, and scalded after each meal; should have their napkins 

 and handkerchiefs, as well as whatever clothing or bed-clothing is 

 soiled by them, kept apart from the common wash, and boiled; and 

 should carefully collect the expectoration in a suitable receptacle, 

 that is sterilized or disinfected, without being permitted to dry, as 

 it has been shown that the tubercle bacillus can remain alive in dried 

 sputum as long as nine months. The physician should also give 

 directions for disinfecting the bed-room occupied by a consumptive 

 before it becomes the chamber of a healthy person, though this should 

 be as much the function of the municipality as the disinfection 

 practised after scarlatina, diphtheria, and smallpox. 



Boards of health are now becoming more and more interested in 

 tuberculosis, and, though exceedingly slow and conservative in their 

 movements, are disseminating literature with the hope of achieving 

 by volition that which might otherwise be regarded as cruel 

 compulsion. 



So long as tuberculosis exists among men or cattle, it shows that 

 existing hygienic precautions are insufficient. While condemning 

 any unreasonable isolation of patients, we should favor the registra- 

 tion of tuberculous cases as a means of collecting accurate data con- 

 cerning their origin; insist upon the careful domestic sterilization 

 and disinfection of all articles used by the patients ; recommend public 

 disinfection of the houses they cease to occupy; and approve of 

 special hospitals for as many (especially of the poorer classes, 

 among whom hygienic measures are almost always opposed) as can 

 be persuaded to occupy them. 



* "La Med. Moderne," 1896, p. 37. 

 t "Centralbl. f. Bakt.," etc., 1896, Bd. xix, p. 208. 

 j "Jour. Amer. Med. Assoc.," Aug. 21, 1897. 



" Centralbl. f. Bakt. und Parasitenk.," Sept. 15, 1897, Bd. xxn, Nos. 8- 

 and 9. 



|| "Jour. Amer. Med. Assoc.," Oct. 30, 1897. 

 ** "Amer. Medico-Surg. Bull.," Jan. 25, 1898. 



