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On the general question of disinfection, the proper place for this would
appear to be after the removal or death of a patient. It is evident that as
long as an infected patient inhabits a house or room, no amount of disinfection
would more than temporarily arrest the accretion of the organism on the
walls, floor, utensils and furniture, inasmuch as the patient—the source of the
mischief—would continue to give forth germs in abundance over the same
area of distribution. In order that such disinfection should even be temporarily
thorough, it would be necessary to disinfect all his clothes, his hair,
his finger nails, mouth, and body surface. Tne disadvantages and objections
to this are manifest. Furthermore, at its conclusion, the same condition which
necessitated the primary disinfection would be almost immediately reestablished,
rendering necessary a second, third, and indefinite number of
operations at frequent intervals, without a corresponding hope of ultimate
finality, or even proportionate resulting advantage. The most practicable
method would appear to be the offer, or imposition of, one general disinfection
of rooms and contents, e.g., furniture, clothes, &c., followed by the provision,
or suggestion of special cups for expectoration, with instructions as to its
disposal and sterilisation, as well as the use and control of personal and
kitchen utensils.
Educational Advantages.
Here the authorities are almost unanimous as to the improvement manifested,
and the advantages derived.
It is questionable, however, whether the same result might not be obtained
without notification, and without causing the latent friction now often
demonstrated, as well as the resentment incurred, by the kindly advice, instruction
and suggestion of the medical man attending.
The chief facts to be impressed are : —
(1) The disease is caused by a micro-organism.
(2) The unity of Tubercle, whether the source be Consumption of the
Lungs, a Tuberculous gland, a Psoas abscess or other focus, the essential
organisms are one and indissoluble, and not to be distinguished from one
another by any known chemical or biological method.
(3) The method of dissemination of the Tubercle bacillus and its
prevention: —
(a) Here the sputum plays the chief part, but the discharges from
caseating abscesses and tuberculous sinuses, also contain the tubercle
bacillus. They are, therefore, possible sources of infection as long as,