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136 ON THE SANITARY CONDITION OF
Its infective nature is to a large extent bidden in this
country, but in warmer countries it has for long been
recognised as an infectious disease, and strict measures
of disinfection are resorted to. A number of observations
have established the fact that a house in which a
case of pulmonary consumption has been for some time
may become infected, so that members of fresh families
taking up residence therein may fall victims to this
complaint. The principal method by which the disease
is spread is through the material which is coughed up
by consumptives. This contains the germs in abundance,
and when expectorated frequently lodges on
places where it dries, as on the street, floors, carpets,
handkerchiefs, &c. After drying it is apt to become
broken up and diffused throughout the air as dust, and
as the germs it contains are preserved in the dust, they
may be inhaled with it by other persons.
The question of notification of tubercular disease
was discussed last year at the Congress of The British
Institute of Public Health in Edinburgh. The gain
thereby would be that houses and workshops occupied
by consumptives might be properly cleansed on their
leaving them, and that instructions might be given to
the patients to carry out the simple measures necessary
to prevent spread of the complaint. Such direction,
however, might very well come from the medical man
in attendance, and it might be well to prepare a set of
instructions for their use.* I have, during the last
year, investigated and recorded a number of the cases
wherein death has occurred, with a view to observing
*At the North London Consumption Hospital a printed slip containing such
instructions is handed to out-patients; but, of course, there is no means of seeing
that they are acted upon.