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if not for a longer period than an ordinary case of consumption. These
latter foci are often overlooked and discarded, but if the crusade is to
be effectual, they must be subjected to the same rigid supervision, scrutiny,
hygienic treatment and restrictions, as are imposed on a case of pulmonary
phthisis.
(b) Indirect spread of infection by utensils. A phthisical patient
at every meal leaves a large number of baccilli on all the utensils he
uses. When these are used indiscriminately for the whole household
there is a danger that the next user may be infected. Let us follow him
at breakfast, his cup is placed to his lips and withdrawn, bearing a small
quantity of mucus which may trickle down to the saucer. This mucus
may contain the specific germ. In the act of eating, his fork is introduced
into the mouth, and replaced on the plate bearing the specific
organism too. Thus before the end of the meal in all probability the
whole of his utensils, the adjacent tablecloth and napkin (if any) are
infected. Even if they are washed, as they generally are in luke-warm
water in a bowl, this is not sufficient to Kill off the germ, but is, instead,
a further means of spreading to the utensils of the unaffected inmates.
For it must be remembered that the tubercle germ is a particulate thing,
(not a mere miasma, or ethereal abstraction), and as such, subject to the
usual laws of gravity in the same proportionate degree as the largest
boulder. In the act of washing kitchen utensils, done by the rough and
ready householder by wiping one wet rag (common to all) round the rim,
and into the bowl of cup and saucer, tne mucus is carried from one article
to another. The wet rag and dry rag become both infected, and sources
of further spread.
The inference is that the consumptive should have his own
utensils, and that these should be cleaned by themselves, preferably in
warm water containing an alkaline disinfectant.
(c) Indirect spread bv handkerchief.
It were better to use the thin gauzy paper handkerchief to be
burnt at the end of the day, or failing this, spare bits of household rag.
(d) The care of the Sputum.
By expectoration into recognised sputum cups or flasks, or as
under (c).
c