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help and instruction can be given, and especially where the disinfection, which
is so urgently necessary when consumptives die or change their residences, has
to be effected." Notification is the key of the crusade against the disease.
It will not, however, be necessary to notify all cases of Consumption, but
only those which have arrived at that stage in which the sputum is tuberculous—i.e.,
contains the bacilli of Consumption—or those that, owing to the condition of
their households, are sources of danger to others living with them.
Disinfection will be necessary in all cases where consumptives die, or when
they leave their residences, lest the infection should be contracted either by
those who continue to live in the house or who might possibly succeed in the
occupancy of the premises.
In this respect let me say that I have had a search made in the mortality
returns of the last eight years as to the number of houses in which one or more
deaths from this disease have occurred, and I find that Phthisis resulting in
death happened in 3,428 houses, and that in as many as one hundred and
eighty four of these 2 deaths occurred at shorter or longer intervals; and that
in eight, 3 deaths occurred. I also find that in two Common Lodging Houses
2 deaths occurred at intervals, in four 4 deaths, in one 5 deaths, in one
G deaths, in one 8 deaths, in one 9 deaths, and in one 16 deaths.
How far the infection has been passed on from the primary cases in these
houses it is impossible to say ; but knowing, as we now do know, that dried expectoration,
especially when it becomes pulverized, in which the germs of the
disease retain their vitality so long, is the most fruitful agency in the propagation
of the disease, it is not too much to assume that very many of these deaths
were directly traceable to it. If this be so, then it at once becomes manifest
that it is the duty of every Sanitary Authority to adopt measures that will tend
to prevent the recurrence of the disease in the same house.