Rural Hygiene

by Henry N. Ogden

Don't eat with soiled hands; wash them first.

Don't neglect a cold or a cough.

To be sure, the precept of "Don't spit," as applied in cities, has other reasons for enactment than to prevent tuberculosis. Spitting is a filthy habit, and its practice should be decried on the score of cleanliness whether on the streets or in any public place, so that the signs now seen in street cars and railroad trains, in halls and office buildings, are intended not altogether for consumptive patients, but also for those who need laws to force them to observe ordinary rules of cleanliness and decency. It is, however, the main step towards doing away with consumption, and the faithful observance of the injunction ought to be insisted upon quite as much in the individual home as in a city street or public building. Case after case has been cited of instances where one consumptive patient in a family has spread the disease through the household, and, at intervals of a year or so, one after another of the family has succumbed to the attacks of the consumptive germ, when by proper precautions and suitable care of the sputum of the first sick person, the other deaths might have been prevented.

Individual resistance to tuberculosis.

There is a remarkable difference in the ability of individuals to withstand the attacks of this disease, and it will be found always that the first to succumb are those whose vitality has been in some way depleted. The women of the family, who are generally confined to the house, who do not have their lungs reënforced by a continual influx of fresh air, who are tired and worn out with their household duties, give themselves an easy prey to the attacks of the bacteria, while the men and boys, who are more outdoors, who are vigorous and strong, throw off the attack and are not affected.

It is a significant fact that by examination, dead bodies, so far as was known, not afflicted with tuberculosis in life, have, to the extent of 60 per cent, been found to have evidences of consumption in their lungs; that is, the edges of the lungs have been found affected, although the vitality of the individual was such that the action of the germ had been stayed before any serious injury was done. Most of us, at one time or another, have had, unknowingly, mild cases of consumption. It would be strange, indeed, if we did not, in view of all the tuberculous infection flying around in the air. But most of us are able to successfully combat the disease, so that the germs are destroyed before they are able to affect the entire body.

The other part of prevention consists in building up and holding up the vitality of the individual to a point where the vital forces can successfully oppose the attacks of the germs. Probably the decrease in the number of cases of consumption in the last quarter of a century has been due quite as much to the improved sanitary conditions of living, whereby the germs have been unable to secure a foothold in the individual, as to any precautionary measures taken against the germ itself.

Precautions by the consumptive.

But the chief factor in the future restriction of the disease, as in the past, must be the disinfection of the germs immediately after they are thrown off from the consumptive patient, and it is well worth while to emphasize just what the consumptive should do or have done for him in order that he may not be responsible for the further spread of the disease. In the first place, when he spits, he must appreciate and act on the fact that the sputum is alive with consumptive germs, each one of which may possibly transmit the disease to whoever may come in contact with it. The patient must keep in mind continually that this sputum is poison, a deadly poison, and that it is his duty to see that every particle of it is disinfected or destroyed by one of the methods already indicated. He may expectorate into a vessel filled with a carbolic acid solution or he may expectorate into a vessel filled with water which may afterwards be boiled. He may use a cloth or paper, like a Japanese napkin, which may later be burned in the fire. But, above all things, he must not expectorate anywhere and everywhere, regardless of the consequences.

The consumptive patient must not cough without holding a handkerchief over his mouth, since small particles of sputum may become dislodged and distributed in this way.