COMMUNICABLE DISEASES 377 



should be disinfected at once. Treatment should be begun early. The 

 propaganda favoring well constructed, well ventilated, comfortably 

 warmed homes and less close segregation in cities and a general improve- 

 ment in sanitation will do much toward eradicating tuberculosis. Tene- 

 ment houses and large or small crowded houses of all kinds should not be 

 tolerated for moral as well as for sanitary reasons. The milk used must 

 be free from tubercular infection. Dry warm climates and the higher 

 clear atmospheres favor recovery from tuberculosis (California, Colorado). 

 The following test has been found very reliable in the hands of 

 clinicians. 



The Jefimoff -Klein Urinary Test for Tuberculosis 



1. Mix 4 cc. of the fresh urine with 2 cc. of a 20 per cent. lead 

 acetate solution, warm and filter several times while hot. 



2. The filtrate, while still hot, is mixed with ten or more drops 

 of an alcoholic solution of silver nitrate. A precipitate forms which 

 varies in color from brick red to cherry red, according to the progress 

 of the disease. Normal urine remains uncolored (white precipitate). 



The silver nitrate solution is made by dissolving 10 grams of silver 

 nitrate in a minimum of water and adding strong alcohol up to 

 100 cc. 



Most tuberculous urine is amphoteric (amphochromatic) , when 

 warmed, that is it will turn red litmus blue, and blue litmus red. 

 This behavior may be utilized as a corroborative test with the above. 

 In advanced stages of the disease the urine becomes markedly acid, 

 and is no longer amphoteric. 



B. Typhoid Fever. This is a filth disease. If the environment were 

 made clean and sanitary, typhoid fever could not exist. The primary 

 cause is the non-sporulating Bacillus typhosus which is found in filthy water, 

 in milk and in food materials. Typhoid contaminated slops, sewage, 

 wash water, etc., poured on the soil may seep into the well water and finally 

 enter the system in drinking. The bacillus develops readily in the intestinal 

 tract where the reaction is alkaline. It is quite susceptible to the action 

 of weak acids and is easily killed by boiling and by disinfectants. Ty- 

 phoid is a widely disseminated dangerous infectious as well as contagious 

 disease. In large cities the mortality rate from this disease is directly 

 proportional to the filthiness of the drinking-water supply. In country 

 districts epidemics are very frequently due to contaminated well-water 

 (contaminated from kitchen refuse, barns, cow-sheds, etc.). Epidemics 

 often follow in the wake of the dairyman, who supplies cow's milk in cans 

 washed with or which contain milk, contaminated with polluted water. 

 Typhoid fever is carried in vegetables from truck gardens where human 

 and other excrement are used for fertilizing purposes. The Chinese 



