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persons may associate with consumptive patients practically without
risk for many years, but in the absence of these conditions there is little
doubt that much more danger exists. It is. therefore, a matter of
the first importance, both to the patient himself and those with whom
they associate, that consumptives should not remain in rooms which are
close, badly ventilated, dark, damp or unclean. While recognising that
there are many occupations which can be engaged in by consumptive
persons under proper conditions with safety, I think very strong
objection must be taken to their employment in the preparation
or distribution of food, especially of food which may be consumed
in an uncooked condition, such as milk. No matter what precautions
he may take, a man engaged in distributing milk, as were two of those
who died during the last three years, cannot avoid contaminating the milk,
and I look upon the presence in milk of tubercle bacilli from a human
source as likely to lead to much more serious results than if the bacilli
came from the cow.
The list of occupations of persons who have died of consumption
discloses a number of persons who had been bakers, butchers, waiters,
cooks (both male and female) and other domestic servants. The large
number of domestic servants in the list (and it is possible that others
have gone to their homes in the country with the same complaint)
suggest that the conditions under which they work are not all that
could be wished, or more probably that the sleeping apartments set apart
for them are defective in many respects.
Waiters and other persons employed in restaurants are kept for
long periods in rooms which are often not well ventilated. Many of
them live in lodgings; one, two or more in a room, but as a rule these
houses are not overcrowded and are in fair condition, probably better
than many servants have provided for them. There is, of course, the
risk of them infecting one another, but I am inclined to believe that
other factors are at work in inducing consumption among them.
Their mode of life and their association, more or less, with the liquor
trade play important parts Many investigators have shown the
intimate relations which exist between alcohol and consumption. It
may be that the nature of the disease or the depressing conditions which
precede it lead to the taking of stimulants, but after making due
allowance for this there is undisputable evidence that alcoholism is a
potent predisposing cause of tuberculosis.
I trust that this inquiry (limited although it is) will show that the
result of the work of the Sanitary Authorities is sufficiently encouraging
to lead them to increased efforts in the future.