592 INFECTION AND IMMUNITY. 



irregular fever often seen in advanced tuberculosis 

 is commonly septic in its cause, and a terminal 

 streptococcus septicemia is not infrequent. It is 

 evident that mixed infections may complicate at- 

 tempts at serum therapy. 



principles of The essential principles in the prevention of 

 tuberculosis consist of, first, the early recognition 

 of the disease, so that the patient may be properly 

 treated and cured, if possible, with the result that 

 a new center of contagion is avoided; second, the 

 rendering of well-developed cases harmless by suit- 

 able isolation and proper disposal of infected ex- 

 cretions; third, the disinfection of the rooms, 

 clothing, linen and surroundings of tuberculous 

 patients. A fourth point, the prohibition of mar- 

 riage among the tuberculous, is one of great con- 

 sequence, although we have little ground to hope 

 for its realization. A fifth point, not yet fully 

 established, is the possibility of universal vaccina- 

 tion against the disease. 



Disposal The collection of infected sputum in properly 

 sputum, constructed water-proof paper boxes, which, with 

 their contents, should be burned daily, is the safest 

 method of disposing of this material, and the most 

 effective means of preventing infection of the pa- 

 tient's surroundings. Metallic, glass or earthen- 

 ware sputum-cups containing 5 per cent, phenol 

 solution are serviceable, but must be subjected to 

 frequent cleansing. When sputum is collected on 

 a handkerchief the latter should be boiled within 

 twelve hours and not allowed to dry ; that the hands 

 of the patient are likely to be contaminated from 

 the handkerchief is evident. In coughing, the 

 handkerchief should be held to the mouth to catch 



