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preventing the spread of the acute infectious fevers would not
be suitable, without considerable modification, to apply to
Pulmonary Tuberculosis.
In the acute specific fevers the patient requires immediate
isolation apart from the remainder of the household, or removal
to hospital. If removed to hospital the house, clothes and
bedding are disinfected. If nursed at home, the disinfection is
done on the complete recovery, or on the death of the patient.
It is quite clear that consumptive patients cannot be
treated in the above way. Isolation cannot be applied to these
in the same sense as in the case of the acute specific fever cases,
nor can hospitals be available to receive all cases of Pulmonary
Consumption, nor, indeed, are these measures necessary to
prevent the spread of this disease.
The ability to convey infection is limited and intermittent,
and infection can be prevented by the patient himself, when he
has learnt and is not too ill to practice elementary precautions.
This will be more obvious after considering.
The Chief Way in which Pulmonary Tuberculosis is
Spread.
In ordinary cases of Tuberculosis, infection is transmitted from
person to person by means of the sputa, or spit, coughed up from
the lungs of the consumptive patient, either in mass, or as cough
spray, because such spit contains at intervals the live germs of the
disease. Even when the spit is dried and reduced to powder the
germs of the disease remain alive, and if this dried and powdered
spit is inhaled or swallowed by healthy persons, the disease may be
so introduced into the healthy individual. The danger of spreading
the disease in this way is dependent on:—
(1) The Stage of the Disease.—In the early stage of the
disease expectoration may be absent, or very slight in amount;
consequently the danger of spreading infection is absent or