438 PATHOGENIC MICROORGANISMS 



The striking power of the cold is probably not very great, and 

 direct or indirect contact, relatively close in time and space, seems 

 to be necessary for transmission. The gravity of the malady itself 

 is so slight that it is difficult to impress upon individuals the 

 necessity for care, and the very grave influence upon general 

 respiratory epidemiology cannot be made clear to those not profes- 

 sionally interested. 



It is our belief that general rigid attention to the prevention of 

 colds in schools, hospitals, military units, and other closely associated 

 groups of people would indirectly exert a very considerable effect 

 upon the general respiratory sick rate. 



Prevention depends upon impressing these facts upon the public 

 and laying stress upon the great danger of severe secondary disease. 



The avoidance of close contact, sleeping in the same beds, avoid- 

 ance of the kissing of children, protecting companions from contam- 

 ination by coughing and sneezing, disinfection of handkerchiefs, etc., 

 may prevent the disease from going through families as is so often 

 the case. 



Children in the initial stages of severe colds should be excluded 

 from school for a day or two. Periodical disinfection of nose and 

 throat with 20 per cent argyrol solution has a definite effect on pre- 

 venting transmission, in our opinion. 



Of especial importance . is the attention to colds during the 

 existence of epidemics of diphtheria, measles, poliomyelitis, menin- 

 gitis, influenza, and the epidemic pneumonias that may take place in 

 army camps. Under such conditions the common cold may be the 

 main "catalysing agent," as it were, which keeps the more serious 

 disease active. At such times people with increased mucous secre- 

 tions who cough, spit and distribute mucus with handkerchiefs and 

 hands, are a sufficiently grave menace to call for rigid public health 

 measures. That these cannot be successfully enforced in the general 

 population of cities, seems plain. But they can be controlled in 

 factories, schools, military organizations, hospitals, asylums, and 

 perhaps, under certain conditions, in places of amusement, and 

 innumerable ideal opportunities for spread can thus be eliminated. 



THE PNEUMOCOCCUS AND PNEUMONIA 



The opinion that lobar pneumonia is an infectious disease was 

 held by many far-sighted clinicians long before the actual bacterio- 



