COMMUNICABLE DISEASES. 209 



isolated from well people as much as possible. The sputum is the principal 

 source of infection, also other secretions; and the breath as in sneezing, laugh- 

 ing and coughing. Plenty of fresh pure dry air should be supplied to patients, 

 large airy sleeping rooms and easily digested wholesome food is essential. 

 Consumptives should not marry, should not kiss healthy individuals, espe- 

 cially children. Expectorated material should be disinfected at once. Treat- 

 ment should be begun early. The propaganda favoring well constructed, 

 well ventilated, comfortably warmed homes and less close segregation in 

 cities and a general improvement in sanitation will do much toward eradi- 

 cating tuberculosis. Tenement houses and large or small crowded houses 

 of all kinds should not be tolerated for moral as well as for sanitary reasons. 

 Above all, see to it that the milk used is free from tubercular infectipn. 



B. Typhoid Fever. — ^This is a filth disease. If the environment were 

 made clean and sanitary, typhoid fever could not exist. The primary cause 

 is the non-sporulating Bacillus typhosis which is found in filthy water, in 

 milk and in food materials. Slops, sewage, wash water, etc., poured on the 

 soil may seep into the well water and finally enter the system in drinking. 

 The bacillus develops readily in the intestinal tract where the reaction is 

 alkaline. It is quite susceptible to the action of weak acids and is easily 

 killed by boiling and by disinfectants. Typhoid is a widely disseminated 

 dangerous infectious as well as contagious disease. In large cities the 

 mortality rate from this disease is direcfly proportional to the" filthiness of 

 the drinking-water supply. In country districts epidemics are very fre- 

 quently due to contaminated well-water (contaminated from kitchen refuse, 

 bams, cow-sheds, etc.). Epidemics often follow in the wake of the dairy- 

 man, who supplies cow's milk in cans washed with or which contain milk, 

 adulterated with polluted water. Typhoid fever is carried in vegetables from 

 truck gardens where human and other excrement are used for fertilizing 

 purposes. The Chinese truck gardeners are particularly culpable in this 

 regard. Again, the vegetables are irrigated with stagnant and sewage- 

 polluted water. House flies are carriers of typhoid. 



The mortality rate in typhoid is high and the disease runs its course in 

 about five weeks. There are some mild cases, the so-called walking or 

 ambulatory cases. All of the excreta from the patient should be disin- 

 fected, using corrosive sublimate solution (i-iooo), copperas solution 

 (10 to 20 per cent.), blue vitriol solution (5 to 15 per cent.), milk of lime 

 (for stools), etc. All bed linen, clothing, etc., used by the patient should be 

 disinfected in s-per cent, carbolic acid before washing. Everything used 

 by the patient should be sterUized, disinfected and kept away from the rest 

 of the family. Those who nurse typhoid patients must be extremely care- 

 ful not to carry the infection to others. Pillows, mattresses and other large 

 articles used by the patient should be steam sterHized, or if that cannot be 

 14 



