Many children have malaria without showing symptoms, and, if allowed to sleep without being properly covered with a net, are very apt to infect a large number of malarial mosquitoes; the blood of children in malarial localities should be examined from time to time, and if the parasites be found, the children should be given the proper remedies until a cure is effected.
Particular attention should also be directed to the fact that almost all Negroes in malarial localities of the South harbor the parasites, though very few of them show symptoms of their attacks. It is, therefore, very important that they be treated properly, and their white neighbors should see to it, for their own safety, that they do not sleep in houses unprotected by nets.
If the precautions herein detailed were properly carried out, for even a few months, malaria would practically cease to exist wherever this was done, and would not recur unless individuals from other places suffering from the disease were to come into the districts where the Anopheles mosquito is present, and so give it to the gnats—to be by them recommunicated to humanity.
TUBERCULOSIS.
Of all the enemies of mankind, tuberculosis, in its various forms, takes the first rank. Of protean manifestations, occurring in almost every part of the body and producing diseases of the brain, of the nerves, of the bones, of the skin, and of all of the internal organs—pre-eminent is the terrible malady we call consumption, which is tuberculosis of the lungs. It has been estimated that one-seventh of all the people born into the world die as a result of this malady in some one of its various forms, and it is probable that one person out of every three dying between the ages of fifteen and sixty years, succumb to this disease. As a result of the labors of thousands of patient, self-sacrificing investigators—many of the most distinguished of whom have died of this disease while carrying on their work—the peculiarities of this affection are now fairly well understood, and if we were to apply the knowledge which we now possess in our attempts to free ourselves from its ravages, there is no question but that within a comparatively short period of time the disease would practically cease to exist.
Character and Course of the Disease.—Tuberculosis is produced by a minute vegetable parasite known as the Bacillus tuberculosis, a germ which not only occurs in the human being, but is widely distributed among the lower animals. Tuberculosis of the lungs (to restrict ourselves to this most important manifestation) generally comes on insidiously, there being usually no definite period from which the sufferer can date the onset of the malady. In the early stages there is usually loss of appetite and a pronounced feeling of weakness followed by a slight cough; the latter symptom frequently leads patients to erroneously believe that their trouble began with a bad cold, when as a matter of fact, the catarrhal trouble of the throat and bronchial tubes was originally produced by the germs of tuberculosis—there being no such thing as a cold changing into consumption. As the disease progresses the patient complains of fever and chills, these symptoms being oftentimes periodical, and lead to the belief that the trouble is malarial fever: this mistake is very common, and whenever such symptoms appear a good physician should be immediately consulted. The patient also suffers from exhausting night-sweats in many instances, though this is not invariable. A rapid loss of flesh is one of the earliest and most common symptoms. The symptoms above enumerated continue and grow worse, and in quite a proportion of the cases there is, in addition, spitting up blood, which in some instances may be so pronounced that it becomes a distinct hemorrhage. In the more rapid or “galloping” forms of the disease the patient frequently dies within a few weeks or a month or so, while in the less severe types the malady may persist for many years before death occurs.
Treatment.—The treatment of tuberculosis by drugs has proven an entire failure, but a large number of persons afflicted with this disease will recover, if placed under proper hygienic conditions.
The patient should be put on a porch or in a tent, whether it be winter or summer, and kept in bed at absolute rest as long as there is any fever, and should be fed in abundance with good, wholesome food. While this treatment appears simple it should always be carried out under the directions of a physician, as it is only possible for those having a thorough knowledge of the subject to give such directions as would lead to a rapid cure of the patient.
Modes of Infection.—Hereditary tuberculosis, notwithstanding a popular idea to the contrary, is very rare, but there is no question that those persons in whose family tuberculosis exists are much more prone to contract the disease than others. In just what manner the germ of consumption gains entrance to the human body, we are more or less uncertain, but there are reasons for the belief that in many instances they pass in by means of the inhaled air; there is no doubt that in a small percentage of cases the bacillus gains entrance to the body through an abrasion of the skin or of some mucous membrane; finally the bacteria are often taken in with the foods that we eat, or by putting objects upon which the germs are present into the mouth, or eating with hands which have been contaminated and not washed. Of the foods that contain the germs of consumption, milk is unquestionably the most common, as there can be no question that fully 25 per cent. of our cows have this disease, and under such circumstances their milk is usually infected with the bacillus that produces the malady; meats, likewise, often contain germs of this disease, but, as they are usually cooked, no harm, as a rule, results.
Of quite as much importance as the introduction of the germ into the body is the resisting power of the individual at the time when this occurs, since the disease can make no progress unless the tissues have become susceptible through lowered resistance. All things then that have the effect of lowering the vitality of the body act as predisposing causes to consumption; such, for example, as WANT OF PROPER FOOD, LACK OF SLEEP, IMPROPER CLOTHING IN COLD AND WET WEATHER, AND LIVING IN DAMP AND IMPROPERLY VENTILATED HOUSES; excesses, PARTICULARLY THE TAKING OF ALCOHOL, conduce to the development of the disease—long-continued inebriety being beyond doubt the cause that most frequently leads to consumption. It is a common error that alcoholic stimulants tend to ward off consumption, and it is absolutely certain that these substances not only do not act in a curative way in those who have already contracted the disease, but are positively detrimental. In order then to avoid consumption—and this is particularly of importance for those in whose family there is a predisposition to the disease—the individual should live soberly, should try at all times to obtain a reasonable amount of good food, should sleep a sufficient number of hours, and should be clothed properly, particularly in the winter. Those who devote their time and energy to the performance of their work—being careful of course not to labor excessively—are much more apt to escape consumption than those who do otherwise. It is particularly of importance that those who have a tendency towards consumption should early learn, and throughout life practice, the habit of BREATHING THROUGH THE NOSE: if this rule be followed a large percentage not only of the germs of consumption, but other bacteria as well, are filtered out during their passage through the nose and do not reach the lungs. Cleanliness is also of much importance—a bath taken each morning in moderately cold water being conducive to health, not only as regards consumption but other diseases as well. It is of course necessary that dwelling houses should be kept thoroughly clean.