THE ADMINISTRATIVE ASPECTS OF TUBERCULOSIS 1 3 



uncontrolled spitting doubtless is a factor in perpetuating the circulation 

 of the tubercle bacillus. Spitting ought everywhere to be controlled. 

 Schools, churches, halls, theatres, markets, railway stations, railway 

 carriages, tramcars, omnibuses, hackney carriages, etc., etc., ought to be 

 periodically cleansed and disinfected. 



The Local Authority should also make use of their powers under 

 Section 58, and see that no person suffering from Pulmonary Phthisis, 

 or living in a house infected with that disease, shall milk any animal, 

 or pick fruit, or engage in any occupation connected with food, or carry 

 on any trade or business in such a manner as to be likely to spread the 

 disease. The powers of this Section are of primary importance. 



VII. Isolation and Treatnnent. 



Note. — The remainder of this article, except the concluding paragraphs, is taken from 

 a circular issued by the Local Government Board for Scotland in March, 1906. 



The provisions of the Public Health Act as to removal of cases of 

 infectious disease to Hospital (54) and as to the provision of hospitals 

 and houses of reception (66) are available for dealing with cases of 

 phthisis as with cases of other infectious diseases. These provisions are 

 comprehensive and elastic, and can be adapted in practice to any type of 

 case — incipient cases where the danger of infection to others though, for 

 the time, at a minimum, may suddenly become serious ; intermediate 

 cases, where the patients, still able to work, may, if uncontrolled, become 

 dangerous ; and advanced cases, where the patients, frequently unable 

 to attend to themselves, may be a source of grave danger. 



Hospitals for Pulmonary Phthisis may be classified as follows : — 



A. Curative Hospitals (Sanatoria) for early cases. 



Here the object is, by generous and selected food, by life in the open 

 air, and by other forms of recuperative treatment, to develop the resistance 

 of the body to tuberculosis, to produce a cure of the affected lungs, and 

 to restore the patient to normal efficiency. To achieve these objects, it 

 is necessary to have the patient closely supervised and carefully nursed. 

 The conditions of sanatorium life are in many respects the reverse of 

 those in the homes whence the patients come. The patients themselves 

 require courage and perseverance. This treatment has been more 



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