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31
In New York the Board of Education will not appoint an applicant as
teacher unless he produces a certificate that he is free from tuberculosis.
In Pennsylvania there is a law forbidding the employment by bakers of
persons having consumption; and in Yonkers it is a misdemeanour for bakers
or marketmen to pursue their occupation if they suffer from this disease.
So potent a factor is tuberculous dust, all derived from sputum, in the
propagation of Phthisis, that Dr. Bigg, of the New York Board of Health, a
body which has grappled with this disease as no other body in any other
country has hitherto done, has found that adjoining houses tend to become
infected with tuberculosis in so marked a manner as to strongly suggest that
one house becomes infected from another. The cause apparently being that
the infected dust from one house when swept out gains an entrance to its
neighbour, and is liable to infect persons living in it.
In this connection let me state that I have discovered that in Islington,
during the last five years, deaths from Consumption have occurred in 105
pairs of houses next to each other, that is, in 210 houses ; that it has occurred
in 7 sets of three houses next to each other, that is, in 21 houses; and that it
has occurred in 2 sets of five houses next to each other, that is, in 10 houses.
The objects attainable by notification are these :—
1.—It will afford an opportunity of instructing the patients and the
householders, especially those living in tenement dwellings and
lodging houses, both orally and by printed matter, as to the
precautions that are essential to prevent the spread of the
disease, and as to the destruction of the sputum as it is
discharged.
2.—It will afford an opportunity of carrying out such measures of
disinfection as are necessary to destroy infective matter both
in the house itself and in the bedding and personal clothing of
the patient.
3.— It will afford an opportunity of inspecting the infected house
and of discovering whether the rooms are overcrowded or
dirty or insufficiently ventilated.