222 PATHOGENIC BACTERIA. 



ficient. While not so radical as to suggest the unreason- 

 able isolation of patients and destruction of property once 

 practised in the kingdom of Naples, the author would 

 favor the registration of all tuberculous cases as a means 

 of collecting accurate data concerning their origin, would 

 insist upon domestic sterilization and disinfection, and 

 would have special hospitals for as many, especially of 

 the poorer classes, among whom hygienic measures are 

 almost always opposed, as could be persuaded to occupy 

 them. 



It has already been declared the duty of the physician 

 to use every means in his power to prevent the spread 

 of infection in the households in his care, and no disease 

 is more deserving of attention than this neglected one. 

 Patients should cease to kiss the members of their fam- 

 ily and friends ; their individual knives, forks, spoons, 

 cups, etc. should be carefully kept apart secretly if the 

 patient be sensitive upon the subject from those of the 

 family, and scalded after each meal ; the napkins and 

 handkerchiefs, as well as whatever clothing or bed-cloth- 

 ing is soiled by the discharges, should be kept apart from 

 the common wash, and boiled ; and of course the expec- 

 toration should be carefully attended to, received in a 

 suitable receptacle, sterilized or disinfected, and never 

 allowed to dry, for it has been shown that the tubercle 

 bacillus can remain vital in dried sputum for as long as 

 nine months. A very neat arrangement for collecting 

 and disposing of the expectoration is recommended by 

 some boards of health. It consists of a metal case into 

 which a pasteboard box is fitted. When the box is to be 

 emptied the whole of the pasteboard portion is removed, 

 and, together with the expectoration, burned. The metal 

 part is disinfected, provided with a new pasteboard box, 

 and is again ready for use. (See Fig. 20, page 120.) The 

 physician should also give directions for disinfecting the 

 bedroom occupied by a consumptive before it becomes 

 the chamber of a healthy person. 



Boards of health are now becoming more and more in- 



