(5) Mild but regular exercise.
15. Consumptive patients may also assist in preventing the spread of the disease. In the first place, they should follow the hygienic directions just mentioned, because such conditions fulfilled will materially lessen the contagiousness of such patients; next, the expectoration must never be allowed to get dry. A spitting-cup containing a little disinfectant solution (one teaspoonful of strong carbolic acid to two tablespoonfuls of water) should always be used, or the expectoration received into paper handkerchiefs which can be burnt. Spoons, forks, cups, and all such articles should be thoroughly cleaned before being used by other persons. The patient should not sleep in company with another, but occupy, if possible, a separate bedroom.
Isolation hospitals for consumptives, as for patients suffering from diphtheria, are now being established.
16. House influence has some effect, both directly and indirectly, upon tubercular diseases. Damp soils, darkness, and small cubic space in the dwelling-house exert a very prejudicial effect upon tubercular patients. Sir Richard Thorne[95b] has described the favourable house for such persons as one built upon a soil which is dry naturally or freed by artificial means from the injurious influences of dampness and of the oscillations of the underlying subsoil. The house itself should be so constructed as to be protected against dampness of site, foundations, and walls. Upon at least two opposite sides of the dwelling-house there should be enough open space to secure ample movement of air about it, and free exposure to sunlight. Lastly, it should be possible to have free movement of air by day and night through all habitable rooms of the house. It is clear that many inhabited houses could not stand to these tests; but effort should be made to approach as near to such a standard as possible.
17. Sunlight and fresh air are the greatest enemies to infection.
18. Disinfection is necessary after death from phthisis, and should be as complete as after any other infective disease. Compulsory notification of fatal cases and compulsory disinfection have been officially ordered by the Prussian Government. In this country also absolute disinfection should always be insisted upon after phthisis. Walls, floors, carpets, curtains, etc., should be strictly sterilised. Professor Delépine recommends spraying with 1–100 solution of chloride of lime.
[95a] Arthur Ransome, M.D., F.R.S., Treatment of Phthisis.
[95b] Practitioner, vol. xlvi.
[96] Journal of State Medicine, vol. iv. (1896), p. 169.
[97] For a fuller statement see Trans. Jenner Institute (First Series), pp. 7–32.