Chapter XXXII: How Consumption Is Spread and How Prevented

[Sidenote: How tuberculosis germs leave the body:]

The sputum (spit) of the consumptive and the discharges from tubercular sores contain the germs that cause tuberculosis. Sometimes these germs are so numerous that thousands of them would be found clinging to the point of a needle dipped into the sputum or discharges from a patient. When the consumptive coughs, he sends into the air many of the germs that cause tuberculosis.

We cannot kill the germs while they are in the body of the consumptive; but we can kill them after they have left the body, by seeing that none of the sputum or discharge from tubercular wounds or sores is allowed to become dried and blown about as dust.

[Sidenote: (_1_) In discharges from sores]

When the discharge from a tubercular sore becomes dried and blows about with the dust, the germs are inhaled into the lungs of other people, or fall into other sores and cause them to become tubercular. Since this is one of the most frequent ways by which this dread disease is spread, you will say at once, "Why, every particle of matter from a tubercular sore ought to be burned, so that there would be no possibility of the germs being scattered." This of course ought to be done, but this is not enough.

People sometimes have consumption and are not aware that they have it. Others may have tubercular sores and not know them to be such. Any sore, whether it is tubercular or not, contains disease germs. They may not be the germs of tuberculosis, but even the least dangerous of them is the germ that causes pus (matter).

Since we are trying to get rid not only of the germs that cause tuberculosis, but also of the germs that cause all communicable diseases, it would be better to say, "All discharges from _any_ sore should be burned immediately."

[Sidenote: (_2_) In the sputum]

When people spit on the sidewalk or on the floor, the sputum will of course become dry. Sometimes a lady drags her dress through the sputum on the sidewalk or on the floor; it sticks to her dress and she takes the germs home with her. The sputum of the consumptive is loaded with the germs that cause tuberculosis, and if this sputum is allowed to be blown about with the dust, people will inhale it and thus get the germs into their lungs. Certainly the consumptive should never spit on the sidewalk or on the floor, or in the mine, workshop, or in any place where the sputum may become dry and form dust. Of course he should not fill the air about him with germs by coughing into it; everybody knows that.

[Sidenote: Why everybody should be careful about spitting and coughing]

But _no_ man or woman, boy or girl, should ever spit on the floor or sidewalk. In the first place it is bad manners. No person does this who is well brought up. In the second place, we must remember that the consumptive does not like to have others know that he has consumption; this feeling is a part of the disease. If you expect the consumptive to refrain from spitting on the floor or sidewalk, you must help him by your example. You cannot expect him to be the only one to hunt up a cuspidor, when you yourself are spitting on floor or sidewalk. If you expect the consumptive to take the precaution necessary to protect you from this disease, you must take the same precaution yourself.

In the matter of coughing, the same rules hold true. If you expect the consumptive to hold a handkerchief before his mouth when he coughs, you must do the same.

[Sidenote: How to avoid spitting on the floor or sidewalk:]

Since it is not right that the consumptive should spit on the floor or sidewalk, it will naturally be asked, "What is the consumptive to do with what he coughs up?"

[Sidenote: (_1_) By using paper napkins]

At a very small cost he can buy paper napkins and envelopes which have been treated with paraffin to prevent moisture going through them. If every one with a cough or with any such trouble as catarrh, which makes him want to spit frequently, would carry a supply of these paper napkins and paraffin envelopes, he would always have a suitable place in which to spit. When you cough up anything, spit into one of these little napkins, put the napkin into the envelope, and when you get home burn the whole thing.

[Sidenote: (_2_) By using pocket cuspidors]

There are other conveniences which can easily be carried in the pocket, called pocket cuspidors. Some are made of thin cardboard, treated with paraffin, and filled with cotton to hold all the moisture of the sputum; others are made of glass, shaped like a bottle, with a wide mouth. Those made of cardboard should be burned as soon as possible and the glass ones should be thoroughly washed with boiling water.

[Sidenote: (_3_) By having public cuspidors]

In some cities cuspidors have been placed at the edge of the sidewalk in an effort to lessen the spread of disease caused by spitting. These cuspidors have a stream of water running through them constantly and are connected with the sewer. They are so made that they cannot easily be kicked over or upset, and they are placed on stands just high enough to make it easy to spit into them. If properly made, they are not unsightly. Would it not be a good thing if your town would put such cuspidors on your streets, and if the merchants would put them into their stores? Every office, every workshop, every store, every railway and street car should be provided with cuspidors.

[Sidenote: How consumption is spread from the lips:]

We know that the substance which people cough up when they have consumption contains the germs that cause this disease. When they spit this matter out, many of the germs stick to the lips. This is true not only of consumption, but of the germs of other diseases, such as diphtheria, measles, and scarlet fever.

[Sidenote: (_1_) By drinking cups]

When there are disease germs on the lips, it is impossible for a person to drink and not leave some of the germs sticking to the edge of the cup or glass. If the germs of disease are in the mouth, every time that the person suffering from this disease drinks from a cup, he leaves some of the germs on the edge of it. The next person to drink from that cup may get the germs into his mouth.

Always avoid drinking from a cup or glass from which another person has been drinking. You can never tell who may have disease germs in his mouth, or when you may get them on your lips by drinking from the same cup. Each individual should have his own cup and should never let any one else drink from it.

[Sidenote: (_2_) By putting pencils into the mouth]

When you put the point of your pencil into your mouth, you will leave germs on it just as you do on the edge of a cup when you drink. Never put your pencil into your mouth; never use any other person's pencil; never trade pencils.

[Sidenote: (_3_) By the common bite]

Sometimes we see a child giving his friends a bite of his apple or candy or cake. Of course when disease germs are in the mouth of the one who takes a bite, the germs will be left on the apple, candy, or cake. By no means should a boy or girl be selfish, but if you have something to share with your friends, break it or cut it into pieces. Never take into your mouth anything from which another person has taken a bite.

[Sidenote: How tubercular cows cause consumption]

Milk that comes from consumptive cows may contain the germs that cause tuberculosis. When you drink the milk from such cows, you take these germs into your body. They find their way from the stomach and intestine into the blood, and there they travel about until they find a spot where the cells are dead or are not doing their work properly. When they find such a place, they settle down and begin to grow; and the first thing you know, you will have tuberculosis in that part of your body. Sometimes the germs do not have to go out of the stomach or intestines to find a favorable opportunity to take hold and grow. When this happens, we have consumption of the bowels.

One cannot tell by looking at milk or by tasting it whether or not the germs of tuberculosis are present. They do not make the milk sour; neither do they make it look different from pure milk.

One cannot tell by looking at a cow whether or not she has tuberculosis. Sometimes a cow will have tuberculosis and yet look very healthy. There is, however, a way by which we can tell when a cow has this disease, no matter how healthy she may look. This is what is known as the tuberculin test.

[Sidenote: How to detect tuberculosis in a cow]

If a little tuberculin is injected under the skin of a cow that has tuberculosis, it will make her have a fever and appear sick for a day or two. If she is free from tuberculosis, it will not make her sick at all.

It would seem as if all people who sell milk would want to know whether their cows have consumption so as not to run any risk of conveying the disease to their customers. Some of them do take this precaution, but a great many of them do not want to go to this trouble. Sometimes you will hear them say, "Oh, I do not believe in this tuberculin test." They do not want to believe in it because they know that the cows, if tested and found to have tuberculosis, will have to be killed.

The reason that dairymen sell us milk from tubercular cows is the same that makes the man with scarlet fever in his house fail to tell the health officer about it; the same that makes the butcher buy and sell meat from diseased cattle; the same that makes some people absolutely regardless of the welfare of others--it is selfishness.

=Questions.= 1. How does a patient give off tuberculosis germs?
2. Why should even well people refrain from spitting in public?
3. Why should the sputum be taken care of? 4. Why should we avoid
the common drinking cup? 5. What is the danger from putting
pencils into the mouth? 6. Is it safe to use another person's
pencil? 7. What is the best way of sharing food? 8. How can one
be protected from tubercular milk?

=Remember.= 1. The sputum and discharges from all sores should
be immediately burned or disposed of in such a way that they
cannot become dry and be blown about as dust. 2. Consumption
may be contracted by the use of the common drinking cup, or by
putting into your mouth such things as pencils and coins. 3. The
milk from a cow suffering from consumption contains the germ of
tuberculosis. 4. A cow may have tuberculosis and not appear to be
sick. 5. The only way to determine whether a cow has tuberculosis
is by using the tuberculin test. 6. Every milch cow should be
tuberculin tested.