to wards occupied also by consumptives. Such instances are more often due to lack of funds than to a failure to appreciate the danger.
The idea is apparently widely entertained that sidewalks and the floors of public conveyances and buildings are a sort of ever-ready cuspidor. The habit of ubiquitous expectoration—always disgusting and unnecessary in health—becomes dangerous when practiced by consumptives. Sweeping trains catch a surprising amount of filth, and tubercle bacilli as well as other germs have been found in the skirts of ladies' dresses, whence they may be introduced into houses. How often do we see a consumptive shivering over a register and dropping the scourings of the cavities in his lungs down the hot-air pipe, to be dried and disseminated throughout the building 1 An apparatus, differing only in detail from the ordinary register, is used in laboratories for the experimental inoculation of guinea-pigs with tuberculosis.
On the other hand, the consumptive must not swallow the infectious material raised from the lungs, for, by so doing, he might set up tubercular inflammation of the stomach and intestine. The expectoration should take place into a cup that can be readily disinfected, or into a waterproof-paper receptacle that can be burned. For disinfection, strong carbolic acid or a solution of zinc chloride may be used, and the disinfectant must remain in contact with the sputum for a long time; preferably the cup should always contain some of the solution. For use away from home, pocket cuspidors, or those fitted into canes, may be used. The sputum should never be allowed to dry. Handkerchiefs, sheets, etc., should be boiled for at least half an hour so resistant are the tiny plants that cause the trouble—apart from other clothing.
The communication of tuberculosis through cow's milk is at length obtaining the attention that it deserves. Milk once infected can not be made safe except by such treatment as will seriously interfere with its nutritious qualities. Ordinary germs of putrefaction may be killed by boiling, or even by letting the milk stand in water previously brought to the boiling point, but the only satisfactory dealing with tuberculous milk is destruction at the hands of Government inspectors.
So long as tubercular patients are allowed the freedom of social intercourse they must be held to the moral obligation of certain restrictions. Kissing has been called an elegant method of transmitting disease. Consumptives must hold their affection in check; above all, they must not kiss little children, whose resistance to disease is slight. They must recognize the necessity, if they are not to be isolated from their surroundings, of isolating from themselves children and those at all inclined to tubercular
