BACTERIUM TUBERCULOSIS 137 



Predisposing Causes and Transmission. Tuberculosis spares 

 no walk of life, but is more common when the lack of body 

 care reduces resistance. It is preeminently the disease of 

 crowded, dark, illy ventilated, badly drained tenements. It 

 comes in the pulmonary form frequently, as an infection on 

 top of an acute cold. The disease is spread in by far the 

 largest percentage of cases by the direct inhalation of germs 

 coughed out by a tuberculous person and contained in dust 

 contaminated by tuberculous sputum. The sputum must, 

 of course, dry before it is pulverized into dust by walking on it 

 or sweeping it. The dust arising from soiled handkerchiefs 

 or cloths is likewise a danger. Park says that as many as 

 5,000,000,000 tubercle bacilli may be expectorated by a con- 

 sumptive person in twenty-four hours. Since the ordinary 

 uneducated consumptive is very careless of his expectoration 

 the danger is obvious. The great movement against the 

 " white plague," now active throughout the world, is rapidly 

 correcting the habits of careless patients. 



Tuberculosis may also be transmitted by the infection of 

 food in the soiled hands of patients, or flies may feed upon 

 sputum and carry the germs upon their body. The study of 

 the transmission of tuberculosis from the cow to the human 

 being has now progressed to a point near solution. Koch 

 said that the bovine bacillus is not infective for the human 

 being. This may be true for tuberculosis of the lungs, but 

 children are susceptible to the bovine form, which can pro- 

 duce in them tuberculosis of the glands of the neck and 

 abdominal cavity, and of the meninges. Cows may give off 

 tubercle bacilli in their milk even when there is very slight 

 evidence of the disease in their body. Milk, unless it is known 

 to come from a non-tuberculous cow, should not be used. 



The tubercle bacillus may be eliminated from the human 

 body by the feces, and health authorities are requiring the 

 disinfection of sewage from sanatoria. Tuberculosis is very 

 rarely hereditary, but children born of tuberculous parents 

 are not quite as robust as children born of non-tuberculous 



