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.
[Illustration: FIG. 67. A sputum cup of waterproof pasteboard.]
[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.
[Illustration: FIG. 68. A pocket cuspidor.]
[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.
[Illustration: FIG. 69. The common drinking cup--a fruitful source
of infection.]
[Illustration: FIG. 70. The individual drinking cup--each cup clean
and free from disease germs.]
[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.
[Illustration: FIG. 71. A sanitary drinking fountain for public
places.]
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.