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tendencies, are less able to resist the inroads of this organism, but if
such persons are placed in healthy surroundings, there is no reason
why they should ever become tuberculous. Whereas not only they,
but persons without any such predisposition may and do succumb
to it when they live in rooms and workshops which are badly
ventilated, overcrowded or otherwise insanitary; intemperance
and deficient food are also potent factors in preparing the soil on
which the organism may grow. The application of the Public Health
and Factory Acts, together with the greater well-being of all classes
of the community, has reduced the mortality from this cause, but
little attention has been given to the destruction of the infective
germ of the disease.
A person suffering from consumption of the lungs coughs up
enormous numbers of these germs, and if such expectoration is not
carefully dealt with, but allowed to be spat on pavements, floors, &c.,
it becomes a source of infection to other persons, as the germ may
remain alive and active for long periods, especially in houses
which are dark, ill-ventilated, and dirty. Such houses may thus
become so infected that new families moving into them fall victims
to the disease. Numerous instances of this are on record, and
I have mentioned some clear cases of such infection in former
reports.
Cases of consumption occurring in families are often due to
infection by such infected dust, and it is extremely important that
persons who are consumptive should be instructed in the precautions
required to prevent the further accumulation of infection, and that
rooms which have already been contaminated should be properly
disinfected and cleansed.
Means to be taken for the Prevention of Consumption.—The British
Congress on Tuberculosis met in London in 1901, and the followingresolutions
were adopted at the final meeting:—
1. "That tuberculous sputum is the main agent for the conveyance
of the virus of tuberculosis from man to man, and that
indiscriminate spitting should therefore be suppressed."
2. "That it is the opinion of this Congress that all public hospitals
and dispensaries should present every patient suffering from phthisis
with a leaflet containing instructions with regard to the prevention
of consumption, and should supply and insist on the proper use of a
pocket spittoon."
3. "That the voluntary notification of cases of phthisis attended
with tuberculous expectoration, and the increased preventive action
which it has rendered practicable, has been attended by a promising
measure of success, and that the extension of notification should be