By keeping out the virus of these diseases, or destroying it when it had gained access to our shores, we have for a number of years been remarkably free from these diseases, and it is certain that if these precautions had not been taken we should have suffered severely. For obvious reasons, the suppression of tuberculosis is not so easy a matter as the suppression of cholera or yellow fever. Neither is the suppression of scarlet fever or small-pox as easy. Yet whenever the public has been educated to a correct appreciation of the contagious nature of scarlet fever, the number of cases has diminished very much. Even in small-pox, with its virulent contagion, it is possible, by means of isolation and disinfection, to check its spread even among an unvaccinated population, as has been illustrated many times of late in the anti-vaccination city of Leicester, England. We must now put tuberculosis among these diseases, and, though its theoretical suppression is simple its actual extermination is a very difficult problem. It lies largely with the medical profession how long tubercular disease shall decimate the human race. The physicians are the educators of the people in these matters. When the doctor shall teach that tuberculosis is contagious, the people will believe, and will govern themselves accordingly. In combating contagious diseases the preventive measures taken often give discouraging results. This will be particularly so in tubercular disease. Half-way measures secure less than half-way results, and these alienate the support of those who only indifferently believe in contagion and the importance of precautionary measures. Efficient means of suppression are radical, and bear hard on the individual; they are not complied with, and they produce violent opposition. Yet, difficult as it may be, the medical profession should take aggressive action against this disease. We have no right to wait for the discovery of a specific, or the gradual evolution of a phthisis-proof race. We must take the world as we find it, full of men and women predisposed to tubercular phthisis, and with no idea of its contagious nature. What can we do about it? 1. Teach the people the true nature of the tuberculosis, that no one ever has tubercular consumption unless the tubercle bacilli find their way into their lungs. 2. Teach them, also, that, even if it finds its way there, it will not grow unless the conditions are right. Teach fathers and mothers how to rear healthy boys and girls. Tell them what to eat and what to wear, to exercise, to breathe fresh air. This alone would exterminate phthisis. 3. The contagion must be destroyed. Fortunately, in this disease there is no need of isolation. Disinfection is enough. The consumptive patient gives off the poison only in the sputum, or perchance the other excreta, if the disease extend beyond the lungs. The virus is not given off from these while moist. We must therefore disinfect all sputum at once with mercuric bi-chloride. Cloths must be used instead of handkerchiefs, and then burned, or, if the latter are used, they should be often changed, and immediately put in a bi-chloride solution and boiled. Bed-linen should be treated in the same way. Frequent disinfection of the entire person, and fumigation of the apartment, would be safe additions to the preventive measures. 4. Persons who have a marked predisposition to the disease had best not come in close contact with the phthisical. Children should never have tuberculous nurses, wet or dry. In the case of consumptives very great attention should be paid to ventilation, and to the alimentation both of the patient and the attendants. Such measures, if rigidly carried out, would be of enormous service in preventing this disease. But with the increasing prevalence of tuberculosis among domestic animals, something more is imperatively demanded. Active measures should be taken to free the country from animal tuberculosis.
There are some ideas which it is well to observe:—
1. Flies may carry the virus if they are allowed to frequent cuspidors into which consumptives have expectorated. Clean these out often. Do not permit the patient to spit into a handkerchief and then let it lie around to dry. The dust arising may inoculate some person prone to consumption.
2. Be careful about the meat you eat. It can and does convey tuberculosis. Investigations have been made showing that as high as 50% of a herd to be slaughtered in New York City had tuberculosis. Milk may be also infected and often is.
3. Have an abundance of flowers around. They invariably are helpful.
4. Constant and regular singing with proper care and not tiring is excellent for consumptive lungs, which should be done in well-ventilated rooms.
5. Be out in the open air as much as possible, and breathe through the nose entirely. Continually exercise the lungs by drawing in long breaths.
6. If possible try fumes of hydrofluoric acid. In glass factories if workmen are rendered consumptive by stooping over the grinding machinery, they usually find great benefit by being allowed to work in the room with the glass etchers, where so much hydrofluoric acid is employed.
7. Buttermilk is well recommended.
8. Consumptive and bronchial troubles in women are often due to irregularity of dress about the throat and lungs. There is danger from wearing décolléte costumes. So regular have we been in our habits that the throwing off of a 1-oz. neck-tie for half an hour in the open air will give us a cold with the thermometer at 70% Fahr.