214 RAVENEL—WARFARE AGAINST TUBERCULOSIS. [April 4, 
the restrictions need not be so severe, since more or less prolonged 
exposure is necessary to bring about infection. 
Two parties are to be considered, the tuberculous person and the 
community, and while the former is entitled to every consideration 
and attention, the good of society in general must be the principal 
consideration which guides our actions. Fortunately, the interests 
of the two parties are not irreconcilable, and much can be done by 
education to smooth the difficulties which lie in our path. With 
this end in view there should be in every State, and in all large 
cities, societies whose object is the study of methods of prevention, 
and the dissemination of such knowledge in short, plainly written 
tracts among the people. In addition to this, Boards of Health 
should issue circulars constantly giving such information and advice. 
At present only twenty-two States and seven cities issue such circu- 
lars and recommendations, while five States have State societies and 
five cities have local societies for the prevention of tuberculosis. 
These societies can do much good also by shaping legislation. 
States and cities should have uniform laws regarding expectoration 
in public conveyances, buildings and on sidewalks, overcrowding 
of factories and tenement-houses, the construction of such build- 
ings as regards light and ventilation, and the employment of chil- 
dren under age. Health officers should have the power to force 
ignorant and vicious tubercular persons who persist in reckless 
expectoration and other offenses against public hygiene into hospi- 
tals provided for them bythe public. There should be notification. 
and registration of the persons suffering from phthisis, and apart- 
ments occupied by such persons should be thoroughly disinfected 
periodically, and always after death or vacation of the premises 
before new tenants are allowed to enter them. 
All of these things can be carried out with little or no increase 
of expense, and much good can be accomplished along these lines. 
However, the urgent need is for institutions in which the sick can 
be cared for and instructed. These should be of at least two types :— 
sanatoria, built in open country districts in regions known to be 
specially adapted to the treatment of tuberculosis; and, second, 
hospitals in or near cities for the hopelessly ill and destitute, where 
the maximum of comfort can be given them, and where they will 
cease to be sources of infection to their families and the public in 
general. In connection with the sanatoria convalescent farms are 
most useful, and may be made self-sustaining toa certain extent. On 
