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266
1902]
cases are known and dealt with, yet that these cases occur in such homes as
render them peculiarly dangerous, and the operations are, therefore, doing
a maximum of good."
The investigations in Manchester have also clearly demonstrated that
additional attention is required in public-houses and other places where
spitting is practised, among which may be instanced 'buses, trains, trams,
places of amusement, etc.
The inquiries, too, elicited the fact that in 220 cases the probable source
of the infection was a consumptive relative. These relatives were of all
degrees of kinship.
Among the sources of this class of infection were: grandfather 2 cases,
father 29, mother 25, brother 46, sister 39, husband 17, wife 22, son 5,
daughter 10, uncle 3, aunt 4, niece 2, brother-in-law 6, sister-in-law 3,
daughter-in-law 1, and cousin 6 cases. Again, other sources of infection were:
companion 65, fiance 2, employer 6, landlord or one of his family 5, lodger 11,
neighbour 16, infection from house 7, infection from public-houses 14, workfellow
45, and work 61.
In addition to these formidable lists, other lists containing 185 caees are
also given by Dr. Niven, the origin of which was marked " doubtful," although
the infection was probably derived from similar sources to the above.
Would it be too much to suppose that many of these cases would never
have occurred if the patients had been careful in their habits; had adopted the
simple precaution of destroying their sputum, or at least of rendering it
innocuous before it dried, pulverized, and mixed with the household dust ?
As bearing on this subject, I notice in a paper on "The Prevention of
Consumption," issued by the Board of Health of Maine, U.S., this phrase:—
" Investigation has proved that the careless consumptive patient is a focus of
infection, and a danger to all persons who come in much proximity to him."
It is because of this carelessness, often caused through ignorance, that he
requires instruction.
Dr. Cornet, Dr. Coates and others have shown the danger of spitting in
workshops, railway carriages, waiting rooms, tram cars, theatres, music halls,
clubs and public houses.
In the United States circulars giving information as to the infectious
character of the disease are issued by the State Board of Health of the following