THE TUBERCLE BACILLUS 603 







Direct infection must be prevented by compulsory notification, 

 care and disinfection of expectorations, isolation, at least as far as 

 the possibilities of sputum infection are concerned, in the home, in 

 hospitals, etc., with introduction of pocket sputum flasks and the other 

 simple measures by which a well-controlled tuberculosis patient can 

 avoid infecting others. The actual prevention in deed, as well as word, 

 of expectoration in public places, the protection of public drinking places, 

 introduction of individual cups and public cleanliness in general; espe- 

 cial supervision of these conditions in places of public lodgment and 

 public amusement in schools and public conveyances; introduction 

 of vacuum cleaning, etc. 



Attention in regard to the marriage of tuberculous people. 



Supervision of dairies and the marketing of milk by governmental 

 grading, and control, with pasteurization of suspicious milk or milk not 

 produced under the required conditions for grade "A" milk. 



Public provision for the proper and humane care of tuberculous 

 people in state and municipal sanatoria so arranged that the poor will 

 regard them as havens of hope, rather than as penalties imposed for 

 disease. 



The public must be educated in knowing that tuberculosis is a cu- 

 rable disease, provided that the diagnosis is made early and clinical 

 facilities must be so arranged in cities so that accurate diagnosis in the 

 early stages may be made and proper fresh air and nutritional care 

 instituted if necessary, at public expense. In our cities, roofs, play- 

 grounds, parks, etc., should be provided for school children. Summer 

 care of children living in the crowded districts must be developed on a 

 more generous and more important scale. The nutrition of school 

 children in the public schools must be supervised and subsidized so 

 that no child in a civilized community should suffer at any time from 

 under nutrition. 



The prevention of tuberculosis is only in small part a medical prob- 

 lem and must rest in its last analysis on the prevention of the means of 

 direct infection and the predisposing considerations in which the sociol- 

 ogist and the educator must play as important a part as the physician. 



Chemical Analysis of Tubercle Bacilli. 37 Diligent efforts by many 

 investigators to isolate the specific toxins which lend tubercle bacilli 

 their pathogenic properties have led to careful chemical analysis of the 

 organisms. About 85.9 per cent of the bacillus consists of water; 20 



37 Hammerschlag, Cent. f. klin. Med., 1891; Weyl, Deut. med. Woch., 1891; 

 De'Schweinits and Dorset, Jour. Amer. Chem. Soc., 1895; Hammerschlag, loc. cit. 



