PREVENTION OF TUBERCULOSIS 353 



than in phthisis or tubercular meningitis, i.e. less in the kind of 

 tubercle located in the abdomen chiefly. Fortunately, the State is 

 beginning to realise its duty in regard to preventive measures. The 

 abolition of private slaughter-houses, the protection of meat and 

 milk supplies, the condemnation of tuberculous milch cows, and such- 

 like measures, fall obviously within the jurisdiction of the State 

 rather than the individual, and claim the earnest and urgent attention 

 of the public health departments of Government.* 



Methods of Prevention. A consideration of the various facts set 

 forth in this chapter will suggest the best means of the prevention of 

 consumption. These means depend upon broad principles of sanitation 

 and personal health rather than on bacteriological niceties or theore- 

 tical considerations. What is required has been stated briefly by 

 Sir Hermann Weber as: (a) Purity and free circulation of air; (6) 

 sufficiency of good and pure food ; (o) well-constructed and ventilated 

 sunny rooms in houses situated on dry and pure soil; and (d) the 

 maintenance of the resisting power of the body and its different 

 organs.f These general desiderata are to be secured by practical 

 preventive methods, of which the following are some of the more 

 important : 



1. Personal hygiene and the maintenance of a high degree of 

 resistance in the human tissues is a matter which must rest with the 

 individual rather than the State, which can only exert its influence, 

 generally speaking, on the environment of the individual. Below will 

 be found a number of particulars as to the disease, stated in simple 

 form, and many of which bear a direct relation to the management 

 of personal conditions. The healthy life with sufficient food, exercise, 

 etc., is what is necessary to maintain healthy tissues. Mention may, 

 however, be made of the abuse of alcohol and the neglect of simple 

 illnesses as two most powerful factors in the creation of conditions in 

 the body favourable to tubercle infection. 



2. Only second in importance is general sanitation and the 

 creation of a healthy environment for the individual and the com- 

 munity, and in this, and subsequent methods, much of the preventive 

 work in tuberculosis is centred. Such conditions as dust in the air, 

 overcrowding in houses, too great a density of houses on the area, ill- 

 ventilated and unclean rooms and workshops, etc., exert an indirect 

 influence of great force in the propagation of tuberculosis, and there- 

 fore the reduction and abatement of these conditions serves as a 

 means of prevention. The right enforcement of the Housing of the 

 Working Classes Acts, the Public Health Acts, the Building Acts, 



* See the Harben Lectures, November, 1898, by Sir Richard Thome Thorne, 

 Medical Officer to the Local Government Board ; also the Reports of the Royal Com- 

 missions on Tuberculosis, 1896, 1898, and 1903. 



I Tuberculosis, 1899, vol. i., p. 9. 



Z 



