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21
It will be seen that 54 deaths occurred in the Union Workhouses,
or a mortality of 13 per cent, so that the total mortality in the whole
district is high.
I wish to point out that the fact that this disease may be
communicated by the breath is commonly over-looked by those in
attendance on such cases. I am strongly of opinion that nurses or
attendants should adopt precautions, somewhat similar to those which
are recognised in cases of well-known infectious disease. I do not
wish, for a moment, to insist upon strict isolation and disinfection,
but I think some milder degrees of precaution should be recommended,
and such recommendations distributed among the poorer classes.
It so often happens that a consumptive is attended up to the last
by some near relative, such as a daughter or sister, who is predisposed
by heredity to the complaint, and who so lowers the resistive power of
the organism to disease by constant attention to the sick bed, that she
sooner or later succumbs to the same terrible complaint.
I hardly expect that we can take such steps as have been taken in
New York City, where the notification and registration of consumptives
is compulsory, and the most rigid precautions insisted upon. Still,
what we can do is to insist on the proper disinfection of rooms, in
which consumptives have lived and died, when it appears that such
disinfection would not be otherwise carried out.
I would lay special stress upon the absolute necessity of perfecting,
as far as possible, the hygienic surroundings of such sick rooms;
fresh air, light, and air space being of the greatest importance, combined
with the thorough disinfection of the sputum, and the strict
personal cleanliness of the patient.