1. health and fitness
2. disease

TUBERCULOSIS
J
A
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ISSUE
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PRIZE
ESSAY
BT
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the
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Omic
of the
Dndor
M.D.,
KNOPF.
S. A
for
Study
I^ibiMitfy
Phyadui
the
to
"International
Masses,**
Prize
International
Congress
convened
which
to
Fust
IsHie. 1901
Published
;
Repdnted.
by FRED.
P.
105
East
for
Con-
ai
a
Hc"
27,
CbmmittM
Street,
RavM
5 14 E. 82nd
for Sale
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1899, awarded
on
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EDITIONS
FLORI,
Alio
"CHARITIES
24
Reprinted. 1905;
1903;
of
TubercuioiU
through
AMERICAN
York,
York
HmMi
the
Sanalorium
Berlin, May
this work
of
of New
Combat
to
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o
TUBERCULOSIS
AS
DISEASE
A
OF
HOW
AND
TO
FOURTH
REVISED
Home
on
Installation
Treatment
at
of
the
and
the
Sanatorium
ical
Histor-
a
berculosis
Anti-Tu-
Movement
the
To
combat
successfully
ment,
trained
as
disease
a
combined
and
an
of the
of
action
physicians,
PRIZE
in
States
consumption
requires
well
United
the
School
Hygiene,
of
Home,
Review
Motto:
IT
ILLUSTRATED
Supplement
Hygiene,
MASSES
COMBAT
ISSUE
AND
With
THE
wise
a
masses
govern-
intelligent people.
ESSAY
BY
KNOPF,
S. A.
Director
in
the
National
Director
Visiting
The
'*
International
Masses,**
International
(or
Prize
Congress
to
to
the
of
the
to
at
this
the
Riverside
Gty
of
Combat
Issue. 1901
:
Reprinted.
1903;
of
the
York,
of
Health
(or
Sanatorium
New
York
May
through
24
its
to
Tuberculosis
Department
Associate
;
;
sumptives
Con-
etc.
Tuberculosis
a
as
27,
Committee
1899,
Disease
awarded
of
the
the
on
July 31,
1900
with
Supplement.
1907
EDITIONS
AMERICAN
Fust
New
Prevention
Diseases
Berlin,
work
and
Study
Puhnonary
f%ysidan
convened
which
(or
Association
CHnic
ot the
M.D.,
Repiinted.
1905
;
Revised
COLLEGE
HARVARD
GIFT
N\
\ 1, i
\'l l^O.
KENNETH
PROF.
IIORAPT
OF
B
MUSDOCK
Copyright, 190X
^'
S.
By
A.
KNOPF,
NEW
LIST
The
American
by
The
Arabic
TRANSLATIONS
OF
edition
Fred.
P.
is translated
Flori,514
Edition
East
The
The
The
The
The
The
The
The
The
and
published
York.
by Dr. Mary
the
Board
of
P. Eddy, Beirut,
Foreign Missions of
Brazilian
edition is translated by Dr. Clemento
and
Ferreira,
"
Revista Medica
de Sao Paulo," Brazil.
publishedhy the
Bulgarianedition is translated and publishedby Professor
A. Bezenseck, of Philippopel.
edition is translated
Dutch
F. Donath, and
by Dr. J. W.
publishedby F. Van Rossen. Amsterdam.
in England by Dr. J.
Englishedition is adapted for use
M.
Barbour, and
published by Rebman,
Limited, 129
ShaftesburyAvenue, London.
Finnish edition is translated
by Dr. Johannes Hoving and
and
L. Rosendahl, F.M.,
published by Dr. Johannes
York.
Hoving, New
edition is translated by Dr. G. Sersiron,and
French
lished
pubBoulevard
Saint Germain.
at Paris by G. A4asson, 120
edition is published by the ^'German
German
Central Committee
for the Combat
of Tuberculosis," at Berlin,9 EichStrasse.
horn
The
by the Author
Street,New
82d
is translated
Syria,and published by
the PresbyterianChurch.
The
M.D.
YORK
edition is translated by Dr. L. W.
Zwisohn, and
York.
publishedby E. Zunser, 158 East Broadway, New
Roth-Schulz,
Hungarian edition is translated by Dr. Wm.
and published by Mai Henrik
es
Fia, Budapest.
Icelandic
edition is translated
by Dr. G. Bjornsson, and
at Reykjavik.
publishedby the Danish Government
Hebrew
Italian edition
longo,
of
is translated
Verona,
and
Prof.
by
Dr.
published at
Roberto
Milan
MassaFrancesco
by
Valardi.
Another
The
Italian edition
by Dr. Giovanni
is translated
Societa
published by the
Japanese edition
Editrice
is translated
Dante
by
Dr.
Galli,and
at
Alighieri,
Goro
Rome.
Shibayama,
Tokio.
The
edition
Mexican
published by
The
Polish
and
The
edition
is
edition
Russian
The
physiciansby
The
auspices of
A.
the
PirogoflfSociety
of
A.
Mostar.
Spanish
edition
Rosal, and
The
S-ka, Warsaw.
by Dr. F. M. Blumenthal, and
Levenson, at Moscow.
and
Russian
edition is translated by B. I. Wender,
Second
publishedby P. 1. Makuschin, Tomsk, Siberia.
edition is translated by Drs. V. P. Popovic and V.
Serbian
VojislavMihailovic,Graz, and publishedby Paher " Kicic,
at
The
the
;'
Lagowsky,
i
is translated
published under
The
Murguia, Mexico.
translated
by Dr. Stanislaus
published by E. Wende
Russian
by Dr. D. Vergara Lope, and
is translated
Eduardo
Swedish
edition
Hoving,
New
Turkish
is translated
published by
Ernst
is translated
and
by
Dr.
Sanchez
Ernesto
y
Litfass'
Erben, Berlin C.
published by Dr.Johanne?
York.
edition
Beirut,Syria,and
is translated
published by
by
Dr.
Mary
the Translator.
P.
Eddy,
of
|
t
*
TO
PREFACE
Med.
Gbh.
(By
-Rath
forth
the
At
of
the
"
Professor
of
Way
GERMAN
under
which
convened
marks
was
awarded.)
for
Congress
as
Berlin,
May
by
Berlin
at
setting
Germany,
Berlin,
was
Tuberculosis
Combat
which
of
prize
the
"International
the
to
EDITION.
PRANKEL,
B.
conditions
meeting
Best
Masses
I
the
THE
the
Study
Disease
a
24-27,
of
the
the
1899,
sum
I
of
4,000
of
the
the
Congress,
"
subject
Combat
It"
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offered
Disease
of
for
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best
Masses
the
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and
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to
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best
decided
popular
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on
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committee
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essays
of
The
and
following regulations concerning
of
Kapitan
hardt;
Dr.
z.
Priisident
KChler;
Excellenz;
Geheimrath
Lucius
von
sky-Wehner,
that
S.
Excellenz;
Dr.
Excellenz;
Se.
Durchlaucht
second
best
find
two
Dr.
:
GeGer-
Ober
Eeg.-Eath
von
Leuthold,
Freiherr
Geheimrath
Dr.
;
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the
Prof.
Leyden;
von
of
judges
as
Dr.
Prof.
Pannwitz
act
Geh.
shaU
marks.
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Wirkl.
more
deserve
judges
2,000
to
not
pages,
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of the
receive
Generalarzt
Dr.
and
Disease
a
jury
essays
consented
Harms;
Prof.
two
decision
Frankel;
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the
case
marks,
shall
have
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each
following gentlemen
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3,000
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forty-eight, printed
decide
receive
as
It," comprising
marks.
4,000
should
may
Combat
less than
not
"Tuberculosis
subject
to
equal value,
heimrath
mann
the
on
How
prize
best
prize, the
essay
and
Masses
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than
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merchants,
prize :
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i.
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Congress
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Bekampfung
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von
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Posadow-
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who
shall
insert
his
The
the
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method
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5.
(see " 1),
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has
of
the
the
awarded
Central
mittee
Com-
latter will
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and
essay
been
German
Sanatoria."
of
printing
of
and
December
the
as
is to
judges
result
a
The
1st.
least
the
announced
be
take
expensive
the
through
them
medical
such
as
and
received
were
the
among
recommended
judges
The
essays
distributed
select from
to
request
eighty-one
the
in
published
were
essays
examination.
closer
writer,
envelope having
which
to
of
property
foregoing regulations were
the
the
by
press.
papers,
with
sealed
a
Strasse, Berlin,
selected
motto,
a
Privy-
to
of distribution.
public
lay
1, 1899,
Bellevue
4
within
name
Erection
the
decision
The
bear
the
the
itself
upon
FiSnkel,
B.
essays
prize,become
for
December
by
cover.
or
essay,
EDITION.
GERMAN
sent
Dr.
and
motto
THE
be
must
essays
Coimcillor
4.
to
by
judges
of
deserving
were
twenty-six
for that
purpose.
rejected
fifty-five
The
and
imdersigned
Finder,
Glaus,
At
the
of
any
the
decided
of
the
that
result
At
the
form
to
work
so
goveniment,
much
and
bearing
combat
''To
Frankel,
of the
the
judges, on
to
decide
committee
came
successfully
physicians,
well-trained
all
June
under
Batibor,
should
and
of
mend
recom-
be
for closer
15th, it
was
more
KShler,
Pannwitz,
and
von
the
choice.
decided
was
Frankel,
upon
final action.
the
it
once
Drs.
to
the
Gerhardt,
After
conclusion
that
motto,
consumption
surpassed
of
selected
composed
this
not
Gerhardt, Harms,
Lucius
von
Pannwitz,
Duke
essays
ultimately
were
sub-committee
consideration
careful
wise
a
three
meeting
next
KOhler,
Harms,
the
that
was
could
consideration.
further
selected
Freiherr
Meyer, Alexander,
gentlemen
the
the
by
February 25, 1900,
on
Highness
Drs.
by
Leyden,
von
jmy
twenty-six
carefullyexamined
Leuthold,
the
Serene
his
of
presidency
for
fifty-fiveessays
meeting
Edmund
these
but
Elwert,
examined
more
once
assistants, Drs.
his
and
were
essays
the
others
in
requires
and
an
the
combined
action
of
a
intelligent people,''
excellence, that
it
should
be
PREFACE
awarded
the
Knopf,
of New
A
few
Dr.
At
York,
It
the
was
have
and
resolved
was
GERMAN
been
author
found
of this
that
of the
in
the
German
and
1,
TO
THE
Central
Committee
for
arrange
FIRST
AMERICAN
presenting
the
to
and
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will
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consumption,
aspects,
and
dififer,
take
these
before
author
the
all who
that
differences
bear
should
in
be
lauded
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awarded
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Thus
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from
empire,
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all
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competition
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ble,
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as
habits
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did
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state
absolutely necessary
of
gentlemen
for
its
changes
a
essay,
tuberculosis
in
appear
With
prize.
to
having
that
it
situation
and
for
fact
the
passages,
also
but
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make
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pulmonary
the
mind
particularly
translation
a
reasons
medical,
changes
to them
THE
and
several
studied
essay
the
complete knowledge
now
change
account.
highly, these
submitted
OF
desires
exact
popular essay
a
consent
who
to
in
original German
Germany.
judges
as
its
particularlocal conditions
in
make
have
in
only
will
who
and
to
omissions.
to
not
tribution.
dis-
FrXneel.
translation
a
author
the
German,
in
ISSUE
States,
it necessary
foimd
he
its widest
B.
English-speaking world,
endeavored
having
it
EDITION.
United
the
originally written
while
the
to
of
people
work.
1900.
PREFACE
In
S. A.
accepted by
present
Peofessob
Bbrlin,' October
Dr.
work.
by the judges, were
publish this essay
to
then
incorporated
meeting
5
EDITION.
was
recommended
as
subsequent
a
THE
Congress prize.
changes,
Kjiopf,
TO
the
the
poor
detail
by
which
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to
over
the
find
in
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world,
the
regulations which
did
to
they expect the
the
extent
of
6
PREFACE
of
this
United
on
evils
and
of
the
causes
are
treated
fuUy
as
the
as
intended
the
tuberculosis, and
with
compliance
States, where
tuberculous
here
that
and
sanitarylaws
completeness
man
as
in
states
with
health).
I
and
seat
of the
and
guide
labor
health
do
"
the
will
of the
is not
similar
of
againstour
we
and
can
toward
people
common
will
health
look
at
largelend
foe,the "Great
a
the
and
human
willing hand
White
IfivETY'iFirtn Stbbbt, Nbw
State,
time
city board
yet
the
head
supreme
mean
of
loved
be-
own
Washington,
their
not
let
of
too
tuberculosis;
in
this
combat
Plague."
S. A.
19 WssT
authorities
all the
intelligent,
rigorous,and
bovine
inal
Medic-
ofl"cer at
our
State, county, and
; let each
"
(imperialoffice
In
sanitarymatters.
an
cabinet
to
as
in
homogeneous
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; when
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rigor
tuberculosis
when
distant
has
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widely
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must
Union
ministry for
**
a
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highest medical
secretary of public health,
its best
let the
far
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there
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ing
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of the
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regarding our
in
changes
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exist
illustration
there
of
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have
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best
held
laws
Germany
houses
permits.
may
companies
to the
America.
in
laboringman
with
(medical affairs)
timQ
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is
"
certain
making
every
provinces ;
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essay
regulations. They
In
those
tenement
forty-sevenStates
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speak
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Angelegenheiten
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Germany
in beast.
as
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"
against old
insured
diflfer very
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for
following:
be
own
the
the
important points bearing directly
as
or
of the
example
an
consider
practicablein
spread or
author
of all the
edition
of malnutrition
must
law
the
imsanitary dwellings of
state
its
the
Germany
of alcoholism, of
this work,
to
be
not
question of tuberculosis
The
As
in
States,and
American
the
TRANSLATION.
diseases.
social conditions
in the
would
or
suggestions to prevent
tuberculous
The
ENGLISH
THE
all that would
knowing
out
TO
Knopf,
ToitKi Jaxmaxy, 1901*
M.D.
TO
PREFACE
FOURTH
THE
three
of
of
either
is
what
original
edition
limited
the
number
things
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and
good
need
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reach.
has
not
medical
I
not
at
books
$5.00,
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book
who
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within
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explain why
The
the
for
but
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well-known
books.
put
There
day.
clothbound,
$0.50
costing $2.00,
layman;
are
of
and
there
movement
book
the
supplement
cheaper.
there
connection
a
Lastly,
the
on
lation
Instal-
text, is purely
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paperbound
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published
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one
valuable
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chapters
new
would
them
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to
them
inserting
correspondingly
information
book
of
four
important
paragraphs,
added
the
congress
anti-tuberculosis
the
beginning
these
Inserting
tuberculosis
popular
its
adding
while
of
review
of
of
tuberculosis
Home.
at
and
out
most
in
An
chapter
will
form
the
left
years
two
Hygiene.
the
in
Treatment
from
instead
retail
wholesale
In
on
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historical
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sold
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materially,
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supplement,
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me.
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problem
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in
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also
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lation
trans-
tuberculosis
more
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Thus
original
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to
Berlin
pages,
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Medical
the
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Sanatorium
short
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printed
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to
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hope
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taught
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making
interest
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confronted
am
contain
will
because
Hygiene,
Home
or
decided
which
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of
edition
change
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and
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Public.
the
material
edition,
new
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American
the
any
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writing
contain
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printed
been
of
issues
THE
EDITION.
AMERICAN
Apter
OF
ISSUE
insisted
insure
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and
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8
PREFACE
cient
I
remuneration
Fred.
P.
book
the
and
enough
Flori,
this
at
"
languages.
Combat
it"
reaching
It
in
The
reaching.
times
and
which
I have
official
his
fourth
supplement,
and
of
poor,
the
and
16
in
work
short
tuberculosis
Ninett-fifth
the
to
be
convey
all
and
all
the
Stbbbt,
add
and
York,
to
S.
April
1, 1907
Officers
thus"
done,
education
in
value
that
giving
in
the
by
the
has
and
in
been
which
information
help
A.
State
State.
patients,
employees,
the
Porter,
the
of
physicians
to
for
H.
Health
the
willing
many
Health
Empire
to
far-
so
thousand
Eugene
be
to
employers
people.
New
the
Dr.
may
been
Five
reception
helpful
thus
reprinted
is enhanced
and
and
able
been
furthering
kind
same
has
of
the
mation
infor-
give,
to
this
trust
editions,
problem,
of
I
statesmen,
to
sent
thank
and
thus
needed
preparation.
causing
to
Government,
Department
which
previous
parents,
happiness
We8T
in
How
languages,
German
to
native
and
much
has
throughout
with
is intended
and
teachers
the
the
efforts
issue,
meet
to
book
the
I wish
the
the
to
be
to
are
of
to
in
their
world.
the
by
Hoving,
Zwieshon,
Masses
the
my
Rosendahl,
into
different
edition
issue
his
of
that
edition
tuberculosis
of
this
accorded
second
approval
prevention
May
German
Galli,
and
essay
civilized
me
interest
Bezenseck,
Popovic,
the
is intended
distribution.
for
York,
New
book
Conmiissioner
present
of
to
present
for
State
of this
gratifying
a
Barbour,
Wender,
twenty-one
distributed
now
this
in
the
expressing
Ferriera,
Disease
the
original
Drs.
Shibayama,
a
of
selling
for
without
to
translating
parts
little
largely
of
copies
this
volume
Mihailovic,
as
and
him
Mr.
mine,
task.
the
Eddy,
of
all
particularly
is
by
printed
now
which
the
Sersiron,
me
people
little
of
secretary
thank
But
applied.
I
publishing
to
to
Donath,
Tuberculosis
is
former
I desire
brought
whom
to
the
Massalongo,
honored
have
a
appreciation
Rosal,
Roth-Schulz,
interest
this
out
Lope,
Lagowsky,
firms
has
Blumenthal,
Bjornsson,
various
price.
and
TRANSLATION.
undertaken
he
thanks
sincerest
who
low
send
not
must
to
has
which
devotion
I
who
AMERICAN
the
to
fortunate
was
THE
TO
the
to
rich
solution
health,
prosperity
KNOPF,
M.D.
TABLE
OF
CONTENTS.
CHAFTKR
PAOE
Preface
to
the
German
Preface
to
the
First
Preface
to
the
Fourth
Edition
Issue
of
1
Issue
Edition
American
the
of
American
the
5
Edition
plement)
(with Sup7
Introduction
I.
II.
What
Is
How
Consumption
the
may
the
How
IV.
What
by
B.
Disinfection
be
can
VII.
How
VIII.
Other
IX.
How
may
XI.
What
16
Caused
17
?
Small
the
by the
ing
Dur23
?
24
Tuberculosis
Our
in
of
Germs
or
of
?
Animals
Bacilli
Particles
Consumptive
Sneezing
of
Germs
Food
?
26
Substances
Inoculation
through
the
through
Tuberculosis
and
Exist,
tration
(Pene-
Skin)?
27
What
Their
are
?
28
Individual
Healthy
from
Contracting
losis
Tubercu30
?
XII.
How
Successfully
One
may
Consumption
XIII.
How
can
26
Consumption
?
Contracted
be
the
Out
or
to
Tract
Symptoms
Protects
?
Consumption
from
Thrown
the
may
of
of
Invalids
Ourselves
Against
Ways
Place
Expectoration.
Tuberculosis
Forms
Principal
Enter
Sick-Boom.
Tuberculous
Other
What
Tuberculosis)
Take
Spread
Speaking,
Tuberculosis
of
X.
Pulmonary
the
Intestinal
the
Enter
of
Bacilli)
Guard
We
can
What
the
Loud
Give
Man
Bacilli
Check
Protect
to
Cough,
may
In
of
Done
the
Tuberculous
Containing
Dry
How
to
of
Destruction
(Bacillus
16
of
Expectoration
Saliva
VI.
Done
A.
What
Consumption
Inhalation
be
must
15
?
System
the
the
?
of
Germ
Human
does
III.
V.
11
Overcome
to
31
?
Predisposition
a
Disposition
Hereditary
a
Other
Tuberculosis,
to
than
Hereditary,
y
be
XIV.
How
Created
may
What
can
XVI.
What
of
can
the
What
in
are
the
the
First
are
the
Dairyman
Animals,
among
of
the
Diseajsa
Occupations
Stages
among
in
of
the
Harmless
Which
Disease,
Do
Seemingly
?
Employers
Tuberculosis
Combat
and
Farmer
Tuberculosis
Propagation
XVn.
Help
to
and
Overcome,
Conscientious
and
Well-Meaning
Do
be
Relatively
Ma4e
Occupations
Country
41
?
Predi^osition
Acquired
an
Unhealthy
XV.
Acquired
or
42
in
City
and
?
to
and
Thus
Men
43
Diminish
the
Frequency
Indirectly
Stop
the
?
46
Tuberculous
Should
Invalids,
Not
be
Even
Employed
?.
65
.
SVIII.
What
of
Main
the
Signs
Lungs
and
or
Symptoms
Consumption
of
?
the
Beginning
of
culosis
Tuber56
I
I
10
TABLE
OF
\
CONTENTS.
PAGE
CHAPTER
XIX.
XX.
What
How
Children
can
of
XXII.
the
Have
are
XXIV.
What
is
a
XXV.
So
What
as
Sanatoria
sumption
Con-
or
Special
or
Consumption
Cured,
as
tutions
Insti-
Remained
62
Methods
Become
to
for
the
to
And
Consumption
Cure
And
?
65
"
Volksheilanstalten
are
71
That
Institutions
Hygienic
by
Masses
Consumptives
in
Tuberculosis
Measures,
Really
can
of
Care
Taking
by
and
the
bated
Com-
Successfully
be
?
XXVII.
Can
the
72
of
Treatment
Results
What
XXVIII.
Do
Masses
XXIX.
Solved
and
XXX.
of
an
Carried
?
and
Other
with
factory
Satis73
and
Men
Tuberculosis
Combat
Out
as
of
Women
a
Good
of
Disease
the
?
76
the
Might
How
Help
to
be
Institution
Consumption
Outside
Philanthropists
can
Will
63
Such
can
Neighborhood
"
What
?
?
Exists
of
and
Treat
Consumptives?
Danger
a
Sanatoria
Disease
a
Form,
61
Left
of
Sanatoria?
Evidence
57
Forms
Cured?
SaiTatorium
State
Special
Other
?
?
People's
What
and
Pulmonary
Its
Who
Treatment
Modem
are
in
be
Lungs,
Modern
the
a
Tuberculosis
59
Patients
Sanatorium
or
XXVI.
the
the
Lastingly
What
of
Forms
Scrofula
from
Especially
Former
for
XXIII.
Protected
be
Other
?
Tuberculosis,
Can
of
Symptoms
Tuberculosis
of
XXI.
Early
the
are
by
Tuberculosis
Problem
Legislation
Judicious
Philanthropy
Private
In
and
a
United
the
Combination
States
of
be
Public
?
80
Conclusions
85
SUPPLEMENT.
A.
Home
B.
School
C.
Installation
D.
Historical
Hygiene
Prevent
to
Hygiene
as
a
87
Tuberculosis
in
Factor
the
Prevention
of
89
Tuberculosis.
.
for
the
Sanatorium
Treatment
of
Consumptives
95
Home
United
.
at
Review
of
the
Antituberculosis
Movement
in
the
101
States
"
AS
TUBERCULOSIS
DISEASE
A
HOW
AND
OF
THE
COMBAT
TO
MASSES
IT.
INTEODUCTIOK
has
Tuberculosis
of
its
for
alas
and,
! also
father
true
the
was
first
through
Montano
dangerously
equally
autopsy
the
of
of
cities
the
of
who
of
Nancy
died
had
had
from
to
of
from
the
century
considered
Langrois
caused
the
one
of
reports
furniture
consumption,
to
be
that
and
brated
cele-
an
Toward
a
of
some
fectious
in-
highly
medical
author
of
mimicipal
bedding
destroyed
An
performed
authorities
the
most
the
was
tuberculosis.
French
a
the
diseases.
consumption
and
Christ,
of
never
sanitary
a
celebrated
the
contagion
who
treat,
also
transmissible
(1550)
be
the
to
before
disease
a
and
Isocrates,
contracted
died
had
**
century
ages
(1682-1771),
disease,
de
as
the
tuberculosis
difficult
most
fifth
theory
B.C.),
377
to
"'*i*"'"'^^*
been
has
prevalent,
most
pulmonary
"the
the
It
Hippocrates,
number.
easily
the
France
Janett
is
middle
who
contagious
of
name
and
(460
account
on
people.
diseases.
described
most
eighteenth
Italy
and
the
and
individual
all
masses
feared,
consumption
Morgagni
an
on
end
of
tuberculosis
the
advocate
anatomist
of
the
most
greatest
declared
contagious
strong
the
about
of
In
contagion.
physician
the
to
write
to
as
which
lived
who
physician,
the
classes
of
antiquity
of
disease
fatal
proves
all
medicine,
the
as
disease
fatal
most
scientific
a
years
physician
of
which
Greek
of
as
consumption
and
called
among
himdreds
celebrated
most
or
prevalence
great
known
been
by
of
a
thorities
au-
an
wom-
fire.
The
.
contagion
in
revealing
that
consumptive
disease.
this
the
girl
case
had
deceased
friend
actually
woman
until
she
been
had
demonstrated,
slept
inquiries
frequently
finally succumbed
to
the
with
same
a
12
TUBERCULOSIS
In
the
Naples
of
dated
lemon
or
law
of this
the
three
with
nobleman
to
he
300
pay
ducats.
of
ducats
for
banish
him
the
the
parents
first
the
paid
to
The
law
a
in
relative
for the
done
was
for
and
and
taught
last
making
in
regard
obliged
of the
his
thorities
au-
ease.
dis-
fection
disin-
death.
-
the
men.
could
disease
there
was
medical
by
even
it at
to
Portal
to
of the
period
be
not
physicians
were
infectiousness
the
would
little attention
century
of the
300
notify the
to
sure
patient after
thorities
au-
fined
which
a
had
the
neglect
Portugal
although
in
the
be
and
notify
to
tal,
mor-
to
fortress
According
the
at
of
of the
and
the
consumptive
a
arrived
believed
nothing positive was
Spain
communicability
or
who
there
years.
of
ordinary
patient was
of tuberculosis
theory
demonstrated,
scientifically
here
failed
nineteenth
of the
contagiousness
who
purpose
personal efifects
infectious
to
ten
vinegar,
happened
repetitionof
a
ments,
apart-
violation
Any
an
if he
tuberculous
a
patient had
first half
the
of
of
means
was
time
physician
country
was
the
of the
In
the
nearest
when
same
ofifence, and
there
or
This
The
individual
galleys,and
the
existence
from
(1742-1832),
the
for
sent
was
the
in
years
of their
fumigation.
or
if the
punished,
by
etc.,
ordered
20, 1782,
disinfection
books,
juice, sea-water,
was
MASSES
THE
September
and
consumptives
personal ofifects,fumitm^,
brandy,
OF*
DISEASE
A
royal decree,
a
isolation
AS
the
of
disease,
of
centres
cal
medi-
learning.
At
last, in
beyond
from
one
a
shadow
of
individual
doubt
to
and
but
also
in
its verification
Welch,
by
production
a
Villimin
tuberculosis
could
inoculated
He
reproduced
portions of
tuberculosis
an
scientist
Consumption
prevalent, and
less civilized
Kobert
is
an
it exists
Koch
people succumb
was
in
Cohnheim,
as
generally
reserved
the
discovery
that
discovery
The
berculous
tu-
to
of
the
knowledged
ac-
for
this
great
(1882).
endemic
in
this
disease, and
infectious
is essential.
with
only
not
been
has
it
transmitted
animals
Since
body.
specificorganism (bacillustuberculosis)
German
be
tuberculosis
others,
is
specificgerm
the
demonstrated
experimenters, such
numerous
Straus, and
Prudden,
that
its
other
that
physician
another.
and
substances
limgs
French
the
1865,
disease,
that
is to
Wild
all civilized countries.
to
the
disease, as
say,
a
habitually
tribes
and
rule, very rapidly
AND
as
soon
this
the
they
as
and
negroes
According
Blood
deaths
three
a
were
statistics
The
the
the
should
States
However,
let
mortality
among
Indians
blessings of civilization,but
and
of
excesses
all kinds,
among
United
Health
Of
the
Consnmp-
States.
of
Toronto
of
1898,
twenty-
Canadian
the
kept
are
an
Disease,
hundred
Indians
tion
Endemic
every
year
these
the
among
twice
and
and
on
Government,
reliable.
of
that
here
right
of
in
Since
considered
nearly
state
us
tribe
tuberculosis
is
Board
the
of
proof
dangerously prevalent among
supervision
be
mortality from
United
this
among
in
of Canada.
Dominion
consiunption.
to
imder
reservation
these
is
The
Indians
living
now
report
of the
civilization.
American
tuberculosis
occurred
due
North
of the
recent
Indians
which
the
13
IT.
with
descendants
(Canada), pulmonary
the
COMBAT
TO
contact
among
their
the
to
in
come
find
might
we
HOW
that
the
rather
the
to
alas!
which,
the
population.
of
be
this
increased
ascribed
vices, such
often
too
of
population
white
cause
is to
negroes
colored
not
the
to
alcoholism
as
izing
civil-
accompany
agents.
There
have
been
general mortality
that
of the
do
we
tuberculosis
think
It
is the
most
every
seventh,
Keene,
of
tribute
of the
minute
Tuberculosis
known
as
of
from
However,
1888
measures
New
the
world
be
stated
that
more
as
a
due
of
in
its
late
Philadelphia,
rational
over
to
the
the
the
and
methods
eral
gen-
is due
Dr.
to
berculosis
tu-
George
this
F.
annual
of
100,000
each
its
day
plague.
form,
monly
com-
tary
Sani-
Imperial
deaths
(during
the
consumption.
mortality
American
etc.),thanks
A
from
culosis
tuber-
cities
to
of treatment.
lin,
(Ber-
better
In
ventive
preone
Few
Statistics.
statistics
some
pulmonary
to
pulmonary
to
detail any
tuberculosis
1,095,000,
up
of
European
to
rope,
Eu-
some
that
the
and
observer, the
sacrifice
cent,
per
were
and
yields
According
thirteen
York,
with
to
is
scourge
frequently
some
close
very
people
most
in
According
a
in
sixth, death
every
this
to
1892)
decreased
London,
is
to
it must
has
who
consumption.
Berlin,
reproduce
According
other.
or
2 of its
occurs
States
ourselves
content
others
to
year
United
to
of death.
States
United
the
in
imiversally admitted
cause
Island,
Each
each
will
now
form
one
published concerning
it necessary
but
according
Ehode
inhabitants.
OflBce
is
frequent
in
years
from
not
statistics
many
published tables,
statements.
3,000,
so
14
TUBERCULOSIS
succeeding
the
of
mention
only
to
year
this
latest
Kussia
and
It
Austria,
of
also
other
many
but
prevented,
recent
in
can
Study
T^"
the
and
Comoat
gj^g^
01
and
governments
direction
of
have
forms
of
medical
International
Italian
last
medical
with
all
in
year
possible
the
as
and
men
We
a
million.
ately
immedi-
this
lastingly
unselfishly
worked
are
which
means
since
called
the
in
Empress
together
best
in
proof
to
of
in
the
much
the
Paris;
May,
the
1899,
and
same
zeal
the
of
Study
Germany,
for
of
cured.
this, and
so
the
1888
Berlin
at
the
for
be
only
of
governments
to
pose
purof
the
tuberculosis
combat
is the
work
give
brief
of
purpose
is
of
intelligent
indispensable.
intelligently
description
the
it, the
expresses
participate
foe
a
essay
this
in
people
tuberculosis
as
the
of
women
now
give
and
tion
consump-
not
may
Congresses
convened
was
that
means.
common
shall
known
greatest
per
aware
problem,
Majesty
which
and
most
The
which
her
arrested
biennially
met
Naples,
motto
the
of
against
of
Congress,
profession
But,
all
have
protection
and
people.
Congress,
the
the
lished
pub-
tants.
inhabi-
comes
tuberculosis
profession
important
the
of
which
Tuberculosis,
under
is
1,500
France
to
ing
Accord-
million
demonstrated
be
cases
the
this
solving
welfare
the
to
years
laboriously, energetically,
have
Berlin.
per
than
while
middle,
many
p
for
3,500
combat
pamphlet
a
of
tuberculosis
less
being
the
Austria.*
researches
and
the
about
from
than
more
England,
from
Ofi"ce
mortality
being
in
occupies
after
the
in
public
desire, lastly,
we
gleaned
of
detail
in
consumptives
Health
Imperial
report
is lowest
Germany
The
the
MASSES
more
statistics
to
facts
interesting
by
speak
for
relation
In
some
last
shall
we
THE
OF
institutions
special
tuberculosis.
against
DISEASE
A
chapters
and
prophylaxis
in
AS
this
To
this
in
operation
co-
enable
combat
essay.
of the
of
form
lungs, pulmonary
tuberculosis
tuberculosis,
consumption.
*
come
The
close
United
to
States
Germany.
was
not
included
in
this
table,
but
would
probably
or
16
TUBERCULOSIS
rods
AS
the
represent
substances
other
DISEASE
A
bacilli; the
which
OF
round
MASSES
irregular bodies
or
been
have
THE
ejected along
represent
with
the
bacilli
(Fig- !)"
CHAPTER
How
MAY
GeRM
THE
CONSUMPTION
OF
Enter
inhaled
1.
By being
2.
By being ingested;
3.
By
inoculation
through
Of
these
to
seems
the
DOES
A
Now
which
bacilli
the
^^^
of
there,
Bacilli
in
the
Expectoration.
that
^^^y
the
least
with
the
dust, and
phere
if his
"
By
is
favorable
the
or
a
in which
a
growth
the
condition
habits, through privation
spittle,the
which
danger
inhalation
be
may
dry cough,
must
the
or
also be
or
may
be
as
of
one
fined
con-
bacilli.
"
drunkenness
atmos-
tuberculous,
of the
bacilli.
be understood
must
permanently
or
from
or
mingle
dust-laden
growth
here
pulver-
it to
becoming
inherited
parents,
other
feebled.
enquired
ac-
or
intemperate
disease.
carelesslydeposited sputum,
the
of the
small
consumptive
speaking quickly
considered
of
temporarily
ingestion
expelled by
when
is
is not
become
cause
this
bacilli
of the
arising from
or
air may
danger
body
or
the
and
dry
to
soil for the
favorable
he
carelesslydeposited
breathing
the
to
through alcoholism
Besides
in
individual
soil for the
Such
first
PlACE?
quantities
enormous
spittle,is
motion
TAKE
period when
a
opportunity
an
certainly exposed
condition
any
it has
offers
at
expectorate
draught
system
enter, the
may
BACILLI
THE
even
expectoration, or
so
stance
sub-
m.
OF
individual,
bed, may
if this
tuberculous
skin.
INHALATION
THE
his
to
of
food.
important.
most
consumptive
lungs.
tuberculous
penetration
CHAPTER
How
the
into
with
is, eaten
is, the
in
in
ways
the
that
System?
is, breathed
that
LOSIS)
TUBERCU-
(BACILLUS
Human
the
; that
wound
a
three
be
;
II.
dangerous
or
for
during
loudly, or
those
or
particlesof saliva
who
his
when
come
so-called
sneezing,
in
close
AND
have
bacilli.
tubercle
contain
may
Caused
living with
those
instituted
are
and
from
others
them
the
that,
in what
matter
no
expectorated is
made
of
water
or
metal
for the
of
should
be
If such
to
should
cuspidors
made
railroad
if the
disease
chance
to
should
be
main
dry
to
matter
and
come
be-
have
this
some
vessel
half filled with
thing being
to
make
it
waiting-rooms, court-rooms,
cars,
well
expectorate
on
the
should
be
regularly
and
material
out, there
carried
are
^there
floor and
will
thus
have
be
endanger
sufi"cient
cleaned.
wide
no
^in short,
"
a
"
and
kept
unbreakable
of
measures
know
be, his expectoration
may
It is best
It
break.
people congregate
many
number
reinfection
saloons, meeting-places,theatres, menageries
restaurants,
wherever
he
a
his
disease.
of the
it has
before
from
consumption
germ
of
as
expectoration to dry.
factories, stores,
In
the
well
as
patient
disease
disinfectingfluid,the
some
impossible
of the
purpose.
to
not
as
so
^Consumptives
ures
precautionary meas-
invalid
the
?
patientshould, therefore,always spitin
for the
receptacleintended
all
contracting the
spread
The
of the
pulmonary
destroyed
not
pulverized.
one
of
stage
spittlemay
or
that
know
protect
patient sufferingfrom
A
Invalids
Expectoration.
interest
danger
tion
direc-
Consumption
of
Pulmonary
of
must
measures
this
means.
"
in the
These
fellowmen.
Spread
the
Tuberculous
of
saliva
IV.
Check
to
in
this
by
of
drops
experiments
infection
Expectoration
the
by
Destruction
A.
and
Done
be
must
invisible
Eecent
CHAPTER
What
17
IT.
almost
possibilityof
the
shown
COMBAT
These
invalid.
the
with
contact
TO
HOW
They
openings.
for any
excuse
the
lives
of his
fellow-men.
In
only
the
sick-room
covered
placed
spittoon
by
a
private home,
cuspidors should
last-named
in
clamp
a
2
a
to
box
the
kind
elevated
door
elevated
in
in
at
used, and
be
stands, in niches, or
on
of the
iron
of
hospitals
it is better
boxes.
Fig. 2, showing
on
of the
a
stand.
box, and
The
can
to
We
a
sanatoria,
or
blue
have
give
them
an
enamelled
spittoon is
be
ample
ex-
ened
fast-
easilyremoved
Spittoons,
18
TOBEBCULOSlB
for
in
cleaning.
the
all reach
OP
MASSES
when
besides
is
The
of
cover
flies
bacillus
in
matter
Elevated
or
their
beast.
Thirdly,
[tumble
the
into
way
to
dust
of
germs
these
which
the
contains
disease
may
of
next
article
its feet,
of
may
partaken
deposits
tunity
oppor-
food, and
man
dry
and
the
baeiUi,
and
thus
enter
may
the
carry
it
it
in
bacilli
the
organs
insects
may
if it has
at
d^stive
the
has
disease
wherever
some
pectoration.
ex-
which
it
its
on
carry
the
the
matter,
excrement
that
tuberculous
First,
them
tum.
spu-
sufficient
cover
of tuberculous
Spluoon.
from
sick-rooms
with
spread
leave
vents
pre-
the
particles of spittleon
thus
find
the
fly
alight. Secondly,
2."
insects
to
contact
ways.
and
Fio.
patient.
when
taken
may
small
the
proved
of
The
three
while
only
been
out
is not
come
making
with
consumptives
care
tional
addi-
especially flies,often
insects,
of
the
of
other
has
that
receptacle
contact
It
the
the
and
in
coming
has
by
feet
sure
feature
used
being
three
more
visible
cuspidor
it
it
spittoon,
pleasant
the
about
making
of the
inside
the
THE
convenient
arrangement,
an
wiU
sputum
DISEASE
A
is most
stand
The
Such
he^ht.
A9
the
lungs.
The
cuspidor
further
presents
of
vessel
such
to
the
reach
is less
metal
elevated
advantages
porcelain
or
ovei-
contents
of its
of the
bursting
freezing temperature
and
covered,
the
usual
earthenware.
dogs, cats, etc.,
as
danger
at
of
will
not
cuspidor
when
;
mals,
Anibe
and
placed
if enclosed
covered
un-
able
there
doors
out-
inabox.
tia.
a
"
I'i""k"il's
Sidt-
AND
For
nine
HOW
TO
factoriflB,
workshops,
inches
its
in
to
seems
all
be
suspended
atany
and
is very
easily
and
disinfected.
it
should
There
are
in
market,
metal
pieces (F^.
each
flask.
manipulated
Tlie
of
with
S
and
them
or
be
the
that
Where
of
poured
closet.
bacilli
are
there
is
better
before
good
a
tents
con-
cuspidors
be
danger,
the
into
Where
to
of
killed.
the
these
running
large
disposed
so
without
may,
in
pocket flasks,
system
sewerage
spittoons
The
receptacles,
should
of
cleaning
received
water-
there
water
boil
the
poiiring them
nickel-plated
of
usually
use
(Figs.
is easy.
of
Liebe's,
;
for
ones
The
spittoons
of the
P'"-,^.''i"^^"2^!l?''i!i'^'^''
and
6)
directions
any
it is
Dett-
glass
expectoration
sewer^e,
duce
repro-
pieces (Fig. 4) ; Knopf's,
all of
perfect
I
them:
blue
hand.
no
spittle.
flasks
expensive
one
tient
pa-
pocket
a
and
of
The
more
cleaned
tlie
(Figs.
7).
height,
numerous
few
in three
two
use
receive
weiler's,
in
can
outdoors, the
a
inches
the
(Fig, 3} indicates,
the
spittoon,
three
drawing
accompanying
to
and
tical
prac-
Aa
pm^KJses.
flask
largest
iron
diameter,
answer
When
enamelled
its
smallest
19
IT.
etc., Predohl's
inches
high, eight
in
COMBAT
are
and
tents
con-
into
4
and
blue
glass
Pocket
Bpittoona.
accompany
5)
can
be
so
TtJBERCUtOSlS
tie
water-cloaet,
possible,the
of
kept
for
with
water.
brought
a
to
be
might
''s^iuoa.
tuberculous
Disinfeotion
and
Destractian
_
jj*
lousKatter.
"^
the
ia
form,
their
total
better
a
disinfectant
diluted
be
when
the
be
to
not
as
by
boiling
able
recommend
method
:
ilask
several
careful
being
throwthe
A
used
"
a
not
use
Seheerer
rags
temain
of
the
to
at
substances
bacilli
thus
and
and
make
wood
commercial
we
and
spill any,
and
into
once
the fire.
reach.
that
Patients
sputum.
ot
the
who
aluminum
or
pasteboard
(Fig, 10)
Care
ol
AlumtDum
or
Pon"-
be
never
for
light porcelain
and
the
edges
should
easy
moist,
mercu-
iiews-
presaed-paper cup
within
or
of
of
spitting-cup
Johnson's
of
following
contents
receptacle
of
disinfection
pocket spittoons
up
whole
as
ba-
these
Ordinary
can
the
all
coagulate,
the
it
minutes,
not
dispose
layers
handkerchief
make
for
cover
the
After
cent.)
per
one
situated
so
to
the
gathering
per,
to
it
venient
con-
need
the
pour
on
expectoration
of water
for
certain, sioce
so
disinfection,
or
would
five
The
(5
contents
soda.
washing
acid
this
boiling point
quart
kUled.
catholic
more
are
of the
contents
of
lilled
so
or
the
pot
a
partially
and
each
in
hours
the
entire
used.
people
"When
to
difficult.
and
raise
for about
been
not
more
and
is
fire
the
say,
placed
totally harmless,
protective
a
destruction
is
boiled
by
the
in
measure,
To
add
to
have
is
(1:2,000)
albumen
a
vinegar
cilli will
expectoration
solutions
cause
well
considered
be
'"""
'
be
the
on
boil.
has
mixture
'''"'
put
teaspoonfuls
two
is to
Every twenty-four
be
whenever
Thus,
which
purpose
pot should
or
that
should
cuspidors,
that
UASSBS
otherwise.
expectoration,
classes
THB
OF
ot them
disposing
or
all
DIS"ASfi
A
tuberculous
of
contents
AS
should
used
ones
should
(Fig. 9),
be taken
are
a
that
burned
sick
to
(Fig. 8), Seabury
cups
have
too
are
the
or
number
the
before
Knyof moist
rags
always
they
have
AND
a
chance
also be
of course,
There
will
to
not
the
malady.
do
to
is to
use
Japanese
ot
which
pockets
or
can
should
They
use.
chiefs,
handker-
paper
chiefs
handkerfor
thoroughly
could
pocket
the
inside
and
clamps,
A
be
used
fia.
V b."
be
In
or
are
would
of
pouch
Folded
any
Alter
pouches,
being
so
Japanese
of
the
patient.
to
cleaned
inconvenience
no
or
Oriental
an
pocket
of
to
tobacco-pouch
may
materiaL
impermeable
U
Fta.
that
to
the
and
Of
paper
the
ditional
ad-
extra
Vae.
boiling water.
at
of
rubber
it is well
case
they
which
he
thus
Cwdbmrd,
Burned
do
that
rubber
fastened
vulcanized
place
in
reason
ordinary pocket by
the
of
of
This
be
simple
suaded
per-
in their
substance
cleaned.
the
be
after
place
lining
impermeable
other
be
removable
a
cannot
that
burned
also
who
should,
soft
cheap
be
can
coDtents
these
of
specially manufactured
purpose,
their
their
for
squares
cheese-cloth,
muslin,
for
to
only thing
Tlie
with
consumptives
some
attention
21
IT.
fire.
pocket flask,
draw
to
spit-cups
destroyed by
be
COMBAT
TO
paper
always
use
wish
people
The
dry.
to
HOW
immersed
all
than
more
patient
course,
as
have
ia~Kit;-Sclieerer'9
is
never
in
invalids
some
BtmlUry
of
one
without
one
disinfectant
using
SplllooD
these
pockets
while
they
solution
handkerchiefs,
receptaclesfor expectoration,are
Oup.
in
or
rags,
danger
i^
22
AS
TUBERCULOSIS
their
infecting
before
it is
floors, waUs,
of decease
be
have
have
a
Formalde-
hyde
the
in
openings
the
should
the
caulked
Booms,
etc.
2.
The
out
on
line
a
disinfectant.
should
room
with
suspended
and
be
and
the
articles
If
should
their
of
in
matter
however,
be
feet
and
to
distilled
the
thus
treated
much
*The
then
should
leakage
distillation
three
rapidly
as
should
door
should
of
be
be
packed
closed
remain
of gas
into
with
should
vessel
the
each
cloth.
4.
of the
mercial
com-
thousand
and
hours.
rooms,
a
made
The
room
If there
second
intervals
at
about
spaces
5.
ten
of
room.
one
and
keyhole
or
the
floor,
distillingapparatus
least
be
fall
of
the
oq
No
in
for
surrounding
the
formaldehyde
loosened.
cotton
at
floor
dried
are
the
The
possible.
as
the
the
Books
will
pages
(fiveounces)
in
stretched
thoroughly sprayed
be
of formalin
dows
wincloth.
heap.
the
remain
centimeters
placed
be
a
and
sputum
or
water
fiftycubic
of space
it should
or
and
possible to
as
that
walls
allowed
with
be
The
3.
forty-per-cent.solution
cubic
should
make
cracks
doors
into
so
All
strips of
surface
thrown
covers,
contained
soaked
and
hundred
One
be
not
by
masses
be
should,
water
or
board
to
one
1.
cotton
much
as
expose
freely exposed.
water.
they
to
should
They
be
open
order
in
health
the
the
attended
now
enable
gas:
quilts, blankets, carpets, etc.,
linen,
is
about
or
with
tight
Disinfec-
tion
of
floor,
the
fected.
disin-
thoroughly
of
will
In
everything
disinfection
formaldehyde
by
is advisable.
be
aid
occasional
ture,
particularly furni-
with,
the
fumitm",
the
that
directions
following
care
patient
etc., should
Where
the
a
tervals,
in-
regular
at
Even
contact
such
plaster,in
be
of the
in
come
disinfection
thorough
great
self-understood
health.
of
secured,
be
cannot
thoroughly
occupied by
rooms
infected.
effects
commimities
board
the
by
with
even
bedding, clothing, books,*
to
them
disinfected
thoroughly
it is, of course,
many
^The
been
personal
might
In
MASSES
wash
"
possible that
the
of
consumptive
THE
always
Sick-Boom,
the
etc., may
disinfection
should
should
patient
since
OF
DISEASE
food.
Disinfection of
tuberculous
case
and
hands,
touching
B.
A
or
is
third
of two
or
hours.
possibility
fingers with
of
transmitting
particularly
if the
saliva
turning
while
patient
the
tuberculosis
has
leave"
been
through
in
the
habit
books
of
has
been
moistening
monstrated,
dehis
24
Arrange-
ment
of the
Consump-
tive's
furniture, heavy
which
serve
might
of
furniture
should
rooms^
If
he
all
at
in
close
very
than
patient longer
be
tions
by
Vnrses.
to
to
only
use
to
be
All
the
etc.)
possible
Precau-
tions
with
these
articles
boiled
his
should
the
plain
curtains
should
of cloth,
velour,
air and
of the
out
sun
should
For
is
but
room,
almost
sleep
to
person
remain
not
the
and
ous
danger-
as
invalid
his
before
with
him
always
mouth
it with
after
nose.
By being
and
infecting his
with
and
nose
the
nose
advised
before
hold
having expectorated;
careful
should
be
to
one
:
the
near
very
tuberculous
should, furthermore,
He
of
own
well
a
patient
handkerchief
a
his
have
the
other
of his
use
bronchial
tubes
lessened.
(sheets, pillow-oases, underwear,
used
the
by
but
necessary,
after
in
and
rattan,
the
the
should
nurses
danger
linen
than
more
wipe
materially
soiled
allowed
bed.
one
sneezing.
wipe
to
handkerchiefs,
will
in
necessary,
or
and
mouth
his
be
not
and
or
fancy decorations,
curtains
keep
bed.
own
handkerchiefs
two
carry
and
tuberculous
a
hold
to
coughing
be
to
taken
urged always
while
to
relatives, and
Friends,
should
Fancy
patient
his
sleep together
to
as
have
always
bed
a
other
or
velvet,
discarded.
be
possible,every
should
Plush,
way.
best,
materiaL
dust
MASSES
THE
Leather-covered,
certainly the
are
accumulate
silk, which
or
same
curtains
patient.
of washable
be
always
the
dust-catchers,
as
tuberculous
a
wooden
Precan-
in
cleaned
cloth-covered
room
Boom,
be
should
niture
OF
DISEASE
A
AS
TUBERCULOSIS
removal
consumptive,
should
from
bed
separately,and
be
they
be
not
be
in
water
as
placed
body.
or
only
after
the
common
put
with
carry
out
these
strive
to
napkins,
should
It
is
having
handled
better
been
kerchiefs,
hand-
^oon
to
as
wash
thoroughly
laundry.
Wherever
the
it
is not
possible
Washing.
their
entirety, one
one's
power.
to
should
follow
CHAPTEE
How
In
MAY
of
one
the
Man
dogs,
up
etc., from
tuberculous
Tuberculosis
we
spittoons to protect
the
them
as
in
measmres
far
as
it is
m
VI.
preceding chapters
of elevated
cats,
Give
precautionary
danger
of
expectoration.
to
have
By
spoken
domestic
becoming
the
Animals?
of
animals,
tuberculous
careless
the
portance
im-
such
by
as
ing
lick-
expectorating
of
with
infected
feet
for
the
the
doors;
five
found
meadows
stable
of
the
by
is
the
and
dark
by
near-
result
that
cows
allowed
in
promenade
tuberculosis
air
places
the
renders
the
and
air
it is not
do
harm
have
had
may
and
sun
damp
influence
atmospheric
torated
expec-
the
longer
no
the
before, had
the
more
sputum,
substances
before
in
no
they
in
tuberculous
to
sun
tuberculous
Tuberculous
bacilli,and
the
that
true
of the
animals
sanatoriimi
pastured, and
cows
it
germs
this.
disinfected, and
strict
institution
time
the
of
the
peared
ap-
cattle.
his
although
destroy the
had
He
neighboring
his
among
and
and
some
Sisters
enough
walks
daily
tion
institu-
an
the
retested, with
them
-tuberculous.
cleaned
where
Now,
be
to
In
concerning
of
they liked,
who,
instructive
by
rules
outside
their
in
had
cows,
:
not
was
certain
as
farmer
neighboring
healthy
patients
do
liberty to
they pleased
A
killed, the
up
there
say,
within
were
upon
to
the
at
essay
come
be-
may
very
consumptives, managed
sorry
expectoration
this
of
only
meadows.
the
am
following
existed
wherever
two
I
where,
patients were
bought
of
stables, animals
The
author
26
FT.
supervision,there
medical
of
of the
treatment
Charity, and
care
disease.
the
notice
the
to
came
COMBAT
fields, or
meadows,
in
consumptives
TO
HOW
AND
it often
ultimately
wise
to
by being
time
takes
a
tuberculous
licked
kill
to
time
long
rely
the
fore
be-
ly
absolute-
matter
inoffensive.
The
stools
tines
should
acid.
The
patients sufferingfrom
of
disinfected
be
by
expectorations
considered
as
without
of
tuberculous
has
it
been
should
Guard
to
one
kill
carbolic
is
not
very
all the
Danger of
Superficial,
tuberculous
or
disinfection
be
must
,
Iqub
SubstanceB.
VII.
Against
Germs
and
thoroughly
Tuberculosis
of
in
Food?
reasonably
carefullyinspected
be
of
intes-
-.
Our
Whenever
the
dangerous.
We
CAN
meat
previous thorough
CHAPTEE
How
of
five-per-cent. solution
a
superficialburying
tuberculosis
certain
declared
cooked.
that
free
By
the
from
this
dangerous micro-organisms.
means
meat
disease
one
Against
he
eats
germs,
is
the
tain
cer-
sale
26
TUBERCULOSIS
of tuberculous
of
the
In
there
and
their
are
be
be
one
boiled
their
the
and
said
be
protect themselves
to
animals
stables
their
keep
time.
present
however,
must,
laws
the
of tuberculosis.
the
States
some
some
at the
best
very
danger
reasonably
sterilized
food
for
before
that
sure
and
healthy
are
or
as
be
can
is derived
tended
it
in
In
laws
no
regularly,destroy
and
laws
They have
which
found
are
for
utensils
milk
as
possible.
as
Unless
milk
are
dairymen
do
from
tuberculous,
clean
and
who
tested
MASSES
THE
exceUent
very
there
farmers
many
OF
rigorously enforced.
some
fellow-men
cows
are
are
in
justice to
their
Boiling or
Stenlizing
and
good,
that
to
which
Union,
less
are
there
milk
DISEASE
A
AS
the
obtained
Milk
should
milk
it is in-
especiallywhen
more
from
the
which
from
cows
tuberculous,
not
use,
children.
the
and
stores
from
Milk.
When
the
bacilli
half
that
for
at
in the
now
the
is to
market
of
about
of
number
a
can
cheap
CHAPTEE
In
V/hat
Ways
Other
Since
the
tubercle
patient, it
Infection
by
Saliva,
luouth.
rots,
habit
The
transmit
spoons,
patients
forks, etc.
tuberculous
; or,
at
patient
patient
should
He
tuberculosis.
will
have
such
whom
a
habits
these
of
person
berculous
tu-
a
the
on
animals
(paris
tuberculous,
are
their
animals
can
tainly
cer-
be
out
thus
avoid
boiled
of false
the
important
after
which
have
served
use.
modesty, swallow
danger
this
drinking glasses,
own
least, all table utensils
never,
How
saliva
kiss
sumption
Con-
man.
should
should
the
in
of
such
through
to
store.
of
?
kissing domestic
caressing or
for
There
drug
any
Tract
found
to
never
tuberculosis
Tuberculous
The
of
be
may
best
least
at
F.
Germs
or
Intestinal
the
canary-birds, dogs, cats), many
equally dangerous,
the
is
for
izing
steril-
practicalapparatuses
at almost
Bacilli
the
bacillus
and
the
by
160"
or
aU
minutes,
VIII.
may
Enter
C.
70"
obtained
be
five
heated
milk
ization.
steril-
boiling or
to
is obtained
the
keep
to
say,
which
milk,
sterilizing
result
same
temperature
a
submitted
kept slowly boiling for
killed, and
are
hour
an
is
milk
process,
are
invariably be
peddlers should
milk
of
his
contracting
warning
is
may
pectoration.
ex-
tinal
intes-
become
AND
evident
often
observations
from
swallow
their
tuberculosis
them.
food
his
the
hands
as
washed
care,
tuberculous
Inoculation
of
possible for
cleaning
the
hand.
while
which
bacilli
the
soUed
have
may
tion
Inocula-
Substances
entrusted
an
institution
or
while
times
cleaning
the
through
wound
with
his
also
which
used
for
circulation
have
to
chipped glass or
or
It is
by consumptives.
the
enter
with
the
if the
wound
a
or
of
care
sore
in
should
a
rubber
wear
his
in
himself
mouth,
by placing
dentally
acci-
an
by carelesslysoiling an
or
to
care
the
danger
have
is
of
themselves
wounding
in
come
the
veterinary science, butchers,
or
for
only remedy
with
tuberculous
with
contact
thus
all persons
exposed.
If
has
one
tuberculous
wound
unfortunate
inoculation
bleed
boiled, with
alcohol;
been
dress
liquids,and
is feared, the
freely,wash
a
enough
it
the
seek
By tattooing
wound
as
soon
tuberculosis
with
as
best
thoroughly
five-per-cent. solution
a
of
clean
possible the
has
been
to
receive
thing
with
water
carbolic
rag
to
advice
is to
that
acid,
dipped
injury
an
do
in
or
any
of the
transmitted
in
and
let the
has
been
with
pure
of
these
physician.
various
to
be
in
Cleaning
Spittoons.
on
spittoons
Care
Taken
person
open
the
consumptives
inoculate
may
may
Extreme
matter.
nicked
of medicine
exposed
instruments
cleaning
frequently
most
expectoration.
Physicians, students
are
perhaps
vessels.
these
patient
happens
been
to
Persons
injured finger
etc.,
had
spittoons happens
home
private
open
thoroughly.
very
through
Tuberculous
tuberculosis
porcelain cuspidors
At
Contracted
of
through injuriesreceived
gloves
Sputum
to
never
Skin)?
THE
his
among
IX.
be
(Penetration
also
of
Tubercu-
intestinal
frequent
he
Danger
impossible, Swallowing
remember
hands
un-
expectoration.
Tuberculosis
MAY
is
very
possible that
CHAPTEE
How
is
his
These
consequence
a
should
patient
it is
insane.
education
bowels
of the
having
greatest
with
tuberculous
hygienic
consumptive
27
IT.
expectoration, and
before
with
Even
COMBAT
the
whom
consumption
or
Every
touch
of
with
people,
fortunate
TO
HOW
in-
28
AS
TUBERCULOSIS
the
because
stances,
DISEASE
A
operator
was
profession of tattooing have,
the
colors, necessary
the
The
infection.
less
Of
the
in
best
decorations
barbaric
will
we
according
with
is
of
follow
dissolving
saliva, hence
own
permit
to
never
but
propagating tuberculosis,
ritual
the
who
habit
their
sanitary science,
cite
Men
such
body.
of
causes
the
which,
should
and
can
of
act
rites, when
Jewish
to
rule, the
a
thing, therefore,
modem
of
as
work,
one's
on
frequent
light
their
KASSES
THE
consumptive.
a
the
for
OF
be
circumcision,
vented,
pre-
practised
operator happens
be
to
sumptive.
con-
Ritual
well
is also
It
sioiL
ensued.
Too
The
is
makes
afterward
practice by
law
the
allowed
before
called
medical
medical
board
the
As
circumcision,
in
reliable
child, when
the
France
and
be
they
the
is the
suction
the
by
Other
the
Forms
symptoms
some
its
of the
consumption
stop
of
should
time
be
skill
they
are
themselves
to
from
certificate
a
as
a
eases,
specific dis-
from
circumcision.
possibilityof inoculating
the
glass tube,
a
of
method
orthodox
as
practised
or
of its other
mode
most
Principal
of
we
or
Exist,
Symptoms
have
entrance
frequent form
pulmonary
forms
X.
Tuberculosis
of
foregoing chapters
tuberculosis,
to
Germany.
Their
In
the
aid
prepuce
necessary
submit
ritual
upon
CHAPTER
What
every
freedom
insist
parents
the
persons
that
absolute
against
rapidly
religiousrite,
a
the
bearing
perform
of
such
when
measure
have
difficult
shown
and
to
of
be
exercise
only
allowed
in
part of physicians, and
rite, they should
the
infection
sucking
have
as
skill
ficed.
needlessly sacri-
it will
free
that
Only
regular physician, stating
should
the
of
skilfullyand
when
of examiners,
examination.
another
the
with
remedy
a
perform
to
upon
been
the
on
circimicision
perform
to
a
as
thus
Siuce
dangerous.
interfere
suggest
has
trifling,but
simple protest
a
cannot
I should
a
it
wound
of circumcision,
itself
in
life
young
operation
performed,
this
a
many
and
hemorrhage
secondary
after-treatment,
lack
that, through
known
Circamci-
treated
into
of the
tuberculosis.
manifestations.
the
are
?
of
the
system,
disease
Now
What
and
bacillus
and
that
"
we
will
of
is to
of
the
say,
consider
AND
More
the
nearly
with
it.
throat
has
of
Besides
in
such
with
common
as
or
and
bread, meat,
of
the
in
of
necrosis
the
of
decay
should
of
arms
the
or
one
legs,and
and
urine
WhUe
of
the
beginning,
to
maturation
it may
and
make
enough
to
In
younger
disease
of
be
bones
lead
this
to
bones
a
is
"
Tubercuio-
deformity
breaking
sis of the
Bones.
down
paralysis
marrow,
ing
difficultyin retain-
as
to
joints is
almost
loss of the
use
painless at
of the
become
may
The
digestive disturbances
are
leads
the
joints,
extensive
spinal meningitis
fatal.
proves
and
necessary.
tuberculous
often
nal
inter-
observed.
which
amputation
eating
spinal column,
in
spinal
such
and
destruction,
children
the
and
tissue.
of the
is the
through
as
ing,
breath-
growths
infrequently
result
of
such
The
not
decay
Throat.
curs
oc-
makes
neighboring
disturbances,
gradually
even
and, alas ! very
If
sis of the
not
frequent
and
may
Tnbercnlo-
of
symptoms,
and
disease
vertebrae
the
difficultyin
additional
final
of the
stools, may
tuberculosis
lungs,
little tuberculous
compression
the
the
exceedingly
and
of
tuberculosis
difficult.
which
is
sometimes
which
softening
other
disease
swallowing,
cords
seat
tuberculosis
but
hoarseness
hunchback.
a
of flesh,
disease
shows
bones,
more
as
result
or
This
loss
this
vocal
If the
known
commonly
there
the
disease.
rare
a
of the
^that is, a
"
not
throat.
of
food
throat
the
region
Tuberculosis
total
called
tuberculosis
of
act
solid
other
appearance
ulcers
also
form
other
any
symptoms
pronounced
the
pain during
intense
are
less
than
which
or
in
29
IT.
tuberculosis,
the
all
etc., there
more
the
pulmonary
as
fever, nightsweats, emaciation
cough,
COMBAT
consumption
to
tuberculosis
or
frequent
so
TO
laryngeal tuberculosis,
is
larynx,
the
related
closely
tuberculosis
HOW
essential
(vomiting
is not
rare,
of this
symptoms
constipation),
or
Tubercnlons
Meningitis.
uneasiness
delirium,
More
and
and
sometimes
frequent
in
on
almost
as
dangerous
children, is tuberculosis
also
the
called
symptom
diarrhoea, which
of
of
abdominal
consumption
in
cannot
such
be
paralysis of
the
extremities,
(profound insensibility).
coma
and
(the lining
sometimes
later
depression,
cases
the
as
tuberculous
intestines
cavity).
very
easily controlled
the
This
bowels.
of the
is
and
often
gitis
menin-
neum
perito-
afifection
The
a
by dieting
most
is
nounced
pro-
protracted
or
tion.
medica-
Consump-
tion
of the
Bowels.
v.
80
TUBERCtJLOStS
At
tiOXL
This disease
is then
like millet
are
always due
is invaded
by
been
at
The
of
those
Of
LupuB.
the
the
which
form
manifests
itself
So-called
itself
It is
and
manifests
the
skin, and
a
milder
disease
itself
mainly
This
prove
fatal.
the
What
Protects
the
other
all that
laden
think
not
must
bacilli would
with
that
consumptive, or
injury from
tuberculous.
the
the
the
themselves
to the
an
woman
hood.
child-
a
should
Contracting
rather
in
stomach
a
not
infection.
particular,
healthy
nulk
individual
or
a
tle
lit-
necessarilybecome
of
is to say,
chance
the
cavities,doubtlesslyalso
to do
have
they should, nevertheless,
danger of
a
atmosphere accidentally
must
nasal
our
properties;that
have
as
of tuberculosis,
consumption
cuspidor one
of the
they
also
glands,eruptionof
of tuberculous
secretions
and
tuberculosis,but
swallow
of
before
healthyman
a
as
face.
or
contagiousness,
in
secretions
bactericidal
germs
by
the
from
certainlyrender
broken
a
The
blood, and
have
breath
a
is known
?
said of the
that
the
Individual
communicability,of tuberculosis,and
one
forms
the
XI.
Healthy
have
we
of
ears.
Tuberculosis
After
and
erally
gen-
mention
must
on
are
exclusivelyduring
and
CHAPTEE
bercles
tu-
of miliary
one
considered
now
swellingof
of eyes
inflammation
is also
disease
skin
a
They
diseases,we
almost
than
in
first symptoms
The
patchesmainly
It appears
because
lesion,
fever.
as
organs.
the
localized tuberculous
scrofula, is
scrofulosis, or
of tuberculosis.
form
"
probably
tuberculous
ulcerous
as
in
typhoid fever.
of
often
so-called localized
lupus,showing
Sorofala.
which
of tuberculosis
a
disease,
all the
is
before.
depression,lassitude, and
forms
tuberculous
this disease
originof
outbreak
resemble
tuberculosis
the
MASSES
"miliarytuberculosis
standstill
a
THE
distributed
are
seeds.
sudden
to the
had
OF
body
called
-
DISBASfi
A
little tubercles
countless
which
whole
the
times
Hasty
ConsTunp- and
AS
.
an
not
a
ual,
Kealthyindivid-
they
harm.
kiU
the
gerous
dan-
Therefore,
exaggeratedfear
of
recklesslyexpose
33
TTJBBRCULOStS
The
wearing
AS
by
recommended.
be
muat
In
good
to
of this
in
To
the
best
for
and
and
be
power
change
up
Ladies
brave
the
in
the
cannot
and
show
others.
of
bacilli and
Trailing
and
brought
argumtiut
is
the
to
is
bowels
in
the
the less
neck,
told
be
too
of
into
the
at
world
When
least
that
one
the
liardly necessary
absolutely dangerous
to
this
to
health.
cold
the
similation.
as-
of
one
be
for
prove
the
gathered
the
the
take
hraiti,
neck
too
happens
mode
fash-
should
health
and
millions
of
with
the
up
to
cold.
unhygienic
They
the
cause
of the
there
to
many
that
lo("e.
is accustomed
the
unhealthy
may
one
he
how
neck
dress
street.
care
are
As
is
be
when
abandon
considers
by
house
To
will
they
micro-oi^anisms
and
order
arteries
less
The
in
b"\
can
should
the
the
taking
to
the
often
too
d^stion
around
liable
often
is
be
also
nothing
women,
dizziness.
resist
which
upon
good
the
disease.
for
atmosphere.
trailing dresses,
of
proper
bands
and
insisted
belt
of
intestines
with
as
or
the
tuberculosis
air-supply, congestion
lessens
bundling
ion
collars
headache
a
well
as
subsequently
warmly
to
men
constricting
insufficient
an
and
the
place
be
to
is constriction
be
to
safeguards against taking
Neckwear,
Tight
keep
of
It cannot
stomach
in
(ruptuies) may
interference
an
is not
suspenders
result
action
predisposed
MASSES
trousers
Hernias
of dress.
individual
an
the
the
THE
of
instead
natural
d^stion.
mode
OF
keep
to
the
injurious than
more
Skirts.
order
hindering
essential
that
belts
considerably tightened,
abdomen,
result
of
men
DISBASB
A
De
fare
wel-
gerous
dandust
of dress, further
wearing
poet of the
London
of
trains
Truth
HOW
AND
in his
puts it
do
of the
*Song
Sweep
the
Sweep
However
we
With
Oh,
men
It is
that
one
In
And
is also
Footwear
of
constriction
of the
should
be
with
modified
pensable
be
old-fashioned
veil
should
Shoes
free
hinder
should
never
but
movements,
the
impaired circulation
causes
underwear
purpose,
which,
aired
tendency
a
Footwear.
and
tuberculous
of
habit
the
is
It
with
air
open
enveloping
abandoned.
only
a
a
well
as
good plan
little
shirt
a
have
with
to
on,
the
practicable.
as
head
in
let the
for
iQ^g
Mother.
a
a
thick
little
whUe
one
.~L*^5
every
Air
"
1
day
A
m
a
closely
much
From
warm,
woven
to be
the
8
simny
room.
that
matting,
preferred to
tenth
A
can
1
1
bare- wooden
be
n
floor
twelfth
month
or
a
square
of
kept scrupulously clean, is
one
should
Baths
"*
dust-coUecting carpets.
to the
of
Tubercn-
its
the
ventilated, and
child's
the
bed
soon
Caxe
t/'P^
indis-
is
should
same
Hygiene
and
artificially
\)hysician
^
"^
chUd
be
disease, the
fed
be
or
of the
always
night-dress or
day-time.
sleep in the
should
into
the
with
The
never
night, a different
at
the
to
advice
The
never,
or
during
circumstances.
taken
naked
about
prove
healthy wet-nurse,
a
bedroom
The
run
may
"
wear
milk.
such
The
be
!
importance.
only
to
has
should
should
child
a
not
well
given
cow's
under
mother.
be
be
bed, and
own
skirt
of
for that
mother
a
should
it up
sweeps
as
necessary
night-shirt,should
chUd
!
extremities.
kept
Whenever
wives,
mode.
swarm
blood-vessels
the
If it is foimd
set
that
matter
a
sight
sorry
dirt,
tight. They
too
coldness
microbes
well
as
the
!
lives
hazards
dress
the
shroud
dear
expensive
triturated
the
from
turn
well-dressed
an
malignant
For
dust,
sisters
alone
;
disgust.
have
who
It is not
A
of
with
men
pick
and
gesture
a
"Oh,
worn
shudder
lies thick,
street
germ,
bacillus, and
Germ,
to
"
we
bacillus, and
Dost,
Till
path
our
made
"
the
sweep
"
be
dresses
:
of
waste
sweep
"
should
"
sweep
sweep"
"
Where
33
IT.
COMBAT
Skirt,* why
scavenger's dirty work
"the
**
be
TO
accustom
the
j^y Little
Children.
34
TU"ERCt^LOldtd
child
Use
of
Cold
Water.
gradually
^^^y
in
dipped
begin
may
the
In
cold
water,
with
cold
of cold
use
perceived by
the
is
caused
which
The
return
iQg
of
physician
the
Though
routine
there
careful, judicious, and
of
one
children
for
well
as
easily
for
week
a
alone.
this
By
of cold
a
sometimes
The
pour
essential
douche
be
the
can
water
to
and
the
five
into
the
pours
one
a
from
that
made
the
the
head
easier
a
individual.
cold
of
is
water
be
cold
of
they
week
more
water
alcohol
be
rubbed
with
self to
one's
douche
a
Foi? such
the
three
water
the
use
feet
in
of cold
water,
keeping
two
should
the
douche,
apparatus.
I wish
diameter
tepid
or
his
feet
pitcherfulsof
the
be
help
of
at
a
needle
a
large
and
ten
into
water
in
water
whole
wet
describe
to
Take
purpose.
inches
by
differ,and
third
of
luxury
or
should
day with
pitcher or watering-pot.
nearby faucet,
tardy, the
or
douches.
answer
about
redden-
the
should
educates
shoulder, thoroughly wetting
aU
attached
wiU
jumps
seconds,
each
over
at
a
pallor,
blood-vessels.
use
every
week
bathroom.
about
pour
bather
few
a
even
the
have
not
which
method
The
not
not
high, and
inches
for
does
applied
or
every
the
to
and
gradually
one
by
against taking cold,
rubbed
water,
English bath-tub,
circular
it.
and
is
generally should
use
second
baths, ablutions, and
sponge
simple
half
means
Every family
^^^
During
alcohol
to
measures
its
being
the
water
constitutions
whose
accustomed
by
so
so.
or
half
with
become
visible
causes
regular application
not
pleasant
a
made
lacking
applicable
not
adults, and
as
reaction
is beneficial, one
water
preventive
Persons
recommended.
can
best
the
is
one
sought.
people
is
by
external
surface
reaction
cold
The
the
the
whiteness
certain
a
external
of
treatment
that
cold
by
little douche.
a
is manifested
of
be
a
with
on
hands
the
By and
rapidly.
Whenever
should
that
perhaps
Douche,
the
are
with
externally is
first
at
application
that
forget
skin.
Whenever
skin.
of the
child, and
to
begin is after its
times
later
contraction
a
blood
it
wipe
MASSES
to
way
few
a
reaction
notice
by
of the
the
advice
never
wUl
one
the
THE
absolutely necessary
This
of the
appearance
skin
then
it is
water
warmth
to
best
child
the
and
OF
The
sponging, and
rapidly foUoV-
reddish
DtSfiASE
A
baths.
rub
to
should
a
Improvised
cold
to
b"th
warm
Ad
motion
ly
quickIt is
body.
the
second
If
bath,
a
or
same
time.
person
hose
can
direct
to
be
jet
HOW
AND
can
be
improvised.
60"
to
40"
warmed
in
F.
The
cold
weather.
time
or
in
the
that
is
does
not
to
is to
bed
so
cold
going
to
bed
again
to
take
the
half
the
warm
sufl"ce
Cold
be
recommended
the
keep
do
to
taken
every
w^arm
water
should
should
always
As
as
soon
should
in
be
be
the
taught
their
love
as
the
is
warm
the
cases
by
rise
return
if these
the
sign
that
the
and
the
cautions,
pre-
do
not
body
has
bath,
physician
day,
are
used
be
followed
breathe
the
open
average
boy
window
or
or
out
ocean,
Weakly
what
at
matter
no
the
in
or
of
are,
and
elderly
season,
good condition, cold
least
at
a
less
un-
once
the
deeply,
week.
growing
later
which
girl loves
of
a
and
baths,
sufficient, and
the
The
child
cold
assume
the
Warm
Baths.
water.
permit, it
should
take
to
learn
In
general gymnastics.
doors
bath
taught
child
and
warm
wiU
be
on
even
soap
ofifwith
rapid sponging
intelligenceof
to
river
always
not
by
a
physician.
in
and
clean
following breathing exercises,
the
result
after
weather.
warm
baths,
cold
by
so
skin
when
in
take
not
permitted
To
as
consulted.
should
persons
bed
reaction; but
of treatment,
manner
return
same
In most
a
plication
ap-
practicableto
the
the
friction
kind
for this
to
Help
If
:
the
the
and
is not
it
when
reaction, it is
proper
How
bath
earlier,
after
in
towel
obtain
thorough
a
baths, especiallybathing
to
course,
a
If
can
vigorous
to
hour
an
rapidly
application.
assure
resistance
be
should
will
one
the
Beaction.
Turkish
earlier, and
hour
addition
enough
not
morning,
an
produce
to
warm
dressing,
follows
as
retained; then,
bed.
venient
con-
is feeble,
after
proceed
taken
rough
a
the
cold-water
bed
in
of
with
is
be
most
reaction
rise half
morning
been
has
should
before
morning
should
warmth
water
in the
bath
the
from
vary
is taken
feeling of warmth
one
the
ia
the
that
bath
may
and, perhaps, also
is ia
pleasant
taken
possible to
as
the
take
to
be
water
retiring. Whenever
a
described, rub
quickly
bath
before
the
best
quickly enough,
come
of
above
a
of the
which
The
cold
when
say,
the
cover
to
in
35
IT.
COMBAT
temperature
room
take
evening
bath
the
The
TO
position
to
front
of
the
Respiratory
Exercises
military "attention,"
sides.
With
breathe
in
to
a
the
all the
horizontal
heels
mouth
air
together,body erect,
closed
take
possible),and
position; remain
hands
on
the
deep inspiration(that is,
a
while
thus
and
doing
holding
so
the
raise
air
the
inhaled
arms
for
with
Movement
of Arms.
86
TtTBBRCULOSIS
AS
about
three
seconds,
arms
down
to
the
and
DtSBASE!
A
while
OF
exhaling (breathingout) bring
the
exhalation,
or
This
act
of
rapid than
the
act
original position.
expiration,should
be
little
a
MASSES
THE
more
of
inspiration.
When
the
first
ly
thorough-
is
mastered
has
""
""""""
""
"
prac-
for
'""...-"
days,
one
begin
with
may
the
exercise,
is like
which
the
that
first, except
the
upward
of
ment
move-
the
arms
is continued
until
the
meet
hands
the
over
head.
The
c
a
tion
c
the
be
Breathing
Second
third
The
strength
more
first two
have
and
taken
well-being has
by
the
the
and
stretch
of the
the
back.
Eemain
during
exhalation
called
in
hands
this
the
arms
imtil
position a
bring
the
the
touching
outward
arms
arms
endeavor
few
each
a
for
day
and
the
a
few
general
third
this
comprehensible
military position
as
in
other.
the
seconds,
During
retain
again.
of
act
they finallymeet
forward
requires
make
to
more
same
out
cises.
exer-
until
breathing
dry swim,
a
Take
(Fig. 15).
then
backs
move
be
will
We
times
in
improvement
observed.
might
illustration
"attention,"
evident
an
two
undertaken
be
not
practisedregularly several
been
exercise, which
should
to
during
which
respiratoryexercise,
or
eudurance,
been
imtil
and
weeks,
breathing
14)
are
Exerdses.
those
-
tions
posi-
which
First and
m
(Fig.
shows
14."
o
illustra-
panying
FIG.
.
several
second
"."'"X^""
and
been
tised
ercise
ex-
This
ming,
swimthe
behind
the
of
spiration
in-
the
air, and
somewhat
HOW
AND
exercise
difficult
rising
on
the
during
Of
the
of
act
out
the
with
and
be
of
act
87
IT.
made
effective
more
and
inhalation,
by
descending
expiration.
when
course,
the
during
toes
COMBAT
facilitated
be
can
TO
of doors
one
of
the
movement
without
arms
these
take
always
cannot
ercises
ex-
tory
tion
attractingatten-
Exercises
; under
conditions
such
backward
position,holding
the
while
shoulders
normal
the
while
girlsand
of
the
17)
is to
following
straight,places
in
and
while
rises
with
far
he
as
inhaling.
easUy
the
dining
the
a
act
in
during
can
remains
few
seconds,
breath, and
then
ly,
rapid-
more
of exhalation.
following general
rule
cerning
con-
should
breathing exercises
mence
Com-
remembered.
be
a
slowly
He
somewhat
again
Fio.
the
with
(Figs.14
taken
hands
his
bends
holding
always
again
be
to
thumbs
the
position for
The
can
assuming
of Arms.
pecially
es-
effort
then
as
of
act
this
(Fig. 16)
exhale
The
best
his
hips
backward
the
downward,
then
without
Movement
(Fig.
recommended.
be
stand
front,
and
and
this
in
overcome
makes
his
and
exercise
child
on
seconds,
exercise
acquire
To
stooping.
this
few
rotary
a
inhaling ; remain
predisposed
are
often
consumption,
habit
making
riding
boys,
who
those
to
shoulders,
of
air.
open
Young
a
forward
This
position.
act
for
breath
walking, sitting,or
the
in
the
moving
the
during
movement
the
raise
and
easier
16), and
15."
Third
Breathing
Exercise.
exercises
do not
begin
with
the
difficult
more
ones
(Figs.
General
Bnles
15
17) until
and
three
every
become
six
to
half
a
the
former
are
respiratory exercises,
hour, and
natural
continue
habit.
These
this
either
of
practice
exercises
Take
mastered.
completely
one
until
should
kind
or
the
from
other,
deep breathing
always
be taken
has
in
Concerning
Sespiratory
Ezerdies.
38
TUBERCULOSIS
atmosphere
an
these
take
AS
and
fresh
as
exercises
A
DISEASE
as
free
OP
tired, and
when
caused
by
the
in
growths
certain
sometimes
throat
in
by growths
enlarged tonsils, or
the
of
perhaps
the
to
natm*al
assure
these
all
at
the
of
but
these
presence
vegeta-
s
n
the
in
throat
(retro-
pharynx)
16.
"
the
hearing and
the
intellectual
and
bodily
Exercise
Breathing
Boiling of Shoulders.
develop-
should
be
Fig.
17."
Exercise
of
Habit
.
_
_
of the
ment
become
""'
operations
by
0
9
that
say
dangerous;
t i
e
ted
permit-
not
are
moval
re-
cidentally,
Inw
to
The
only
method
be
(polypi,etc.)
is
rational
may
adults, is often
in
(adenoid vegetation), by
nose
aid
breathing.
of
to
as
by
surgical
CaoBeB
long
so
these
obstructions
may
Never
possible.
continue
never
children, and
in
Mouth-breathing
with
as
tired.
become
Fio.
dust
from
MASSES
THE
The
seriouslyimpaired.
for People
Stooping.
In the
_
._
child
earnestly recommended.
early removal
The
of such
growths
respiratoryexercises
just
Month-
described
are
Breathing.
otherwise
they
they might
had
retain
the
such
of
habit
children
after
operation,
imperfect breathing
which
acquired.
which
exercises
Among
strengthen lungs
in
Not
for
particularlyuseful
the
open
throat,
and
have
we
a
will
tendency
also mention
to
develop
singing
and
and
citing
re-
air.
only during
the
day, but
also at
night, there should
be
a
40
TUBERCULOSIS
filled with
water
water
to
of
so
as
Edncatine
'
Predisposed
Children,
early
after
condition
so
also
remain
work
too
the
the
of the
time
to
in
or
healthful
excesses
no
or
for too
to
live
a
more
girlsand
to
the
movement
as
of
Occupation,
the
is the
we
boys.
season,
of the
best
desire
The
and
body
they
should
be
may
the
has
time
comes
tendency
to
choose
any
we
yoimg
people
their
Of
to
say
to
To
be
cheerful,
avoid
eight
that,
violently
too
on
course,
here
all alcoholic
freely every
least
the
to
day,
to
out
of
hours
clothing of growing
should
garments
be
made
of its
none
interfered
way
profession or
tuberculosis,
who
t^j^^t
gardening, farming, forestry,and
to
to
well.
man
a
wish
always
a
time
often
continue
school.
move
free,and
in
not
much
too
to
left
sleep at
of the
thickness
too
hours
many
tendency
a
good food,
call attention
to
spend
injurious.
remain
them
should
too
be, if carried
but
is
tuberculosis.
to
have
bowels
to
to
way
respiration,digestion, etc.,
When
Choice
plain
that
see
spend
to
upon
injurious as having
especially should
sport may
eat
teeth
which
dress
recommended
they
body clean, and
whole
twenty-four,
be
ultimately prove
regular life, to
the
work,
As
diseases,
children
studies, have
after
a
long, it must
To
as
To
everything, and
healthful
how
beverages, to
Once
in
is
age.
girls
sports
their
tuberculous
Such
predisposed
young
injurious
are
matter
for
time
brain
should
exercises
outdoor
the
musical
chUd
good
eating.
clean
to
many
in
play outdoors,
to
indoors.
much
too
other
and
dislike
school
their
during
too
bowels
for
dislike
eaters
poor
allow
the
keep
taught
to become
good digestion is dependent
a
aU
are
to
by discipline.
most
sexes,
the
the purpose
tendency
a
not
to
little candidates
overcome
seriously the
both
touching
answer
Many
a
be
The
up
Gymnastic
keep
meal, for
teeth.
do
have
combat
should
them
piano
weaken
of
be
hard
that
and
to
bundle
sitting down,
at
each
of
only
them
it
will
Discipline,
means
children
of the
and
warmly
of children
birth.
best
characteristic
can
above
suspended
regular meal-times
possible
as
MASSES
THE
greatest importance.
their
the
are
thoroughly
the
the
observe
condition,
OF
atmosphere sufl"cientlyhumid.
of
day
^^
^^""^'
DISEASE
produce capillaryattraction,
is of
fj.Qjjjthe
A
cloth
a
bringing up
proper
tuberculous
BaiBmg
and
the
rendering
The
AS
one
all
so
be
ing
accord-
that
every
functions,
such
with.
trade
should
for
bear
occupations
a
young
in mind
which
de-
AND
mand
outdoor
an
and
man
useful
a
combat
old
"
cure,
is wrong.
of
cure
the
whether
upon
acquired
in
from
child
to
literature
mission
is
children
have
traced
a
the
kissed
the
child
the
on
AU
this
strictest
they
show
the
other
or
mouth,
the
from
hygiene
the
By
2.
By
intemperate
of all
life, excesses
be
certain
kinds,
typhoid
cough, syphilis,influenza,
3.
By
certain
is much
and
age,
theless
never-
consimiption.
course,
there
that
such
direct
can
in
translittle
almost
always
in
much
are
When
rare.
with
contact
iadividuals, having
the
on
of
dirty, infected
absolute
Tuberculosis,
cleanliness
of
Other
than
Acquired?
or
alcoholic
weaken
beverages,
a
the
dissipated
for
constitution;
fever, smallpox, measles,
ample,
ex-
whoopiag
etc.
occupations,trades, and
exposed
culosis
tuber-
XIII.
Created
to the
and
inhedation
professions,such
all
^^^
accidentally
early infancy.
hat-making, tailoring,weaving,
worker
depend
etc.
which
diseases
pneumonia,
use
chances
o"
Acquired
Consump-
directly transmitted
consumptive
to
Hereditary
Congumpnu-oMg
of
hope
Of
been
the
seem-
of healed
old
infection
importance
in
all
at
has
to
having played
or
shows
Hereditary,
1.
not
cases
exceediagly
are
haviQg slept or
Predisposition
A
CAN
the
is often
CHAPTEE
How
that
succumbed
which
cases
mother
fact
to
erroneous.
tuberculous
become
to
floor, etc.
and
few
possible,but
consumptive
been
equally
is
a
had
of
lived
have
tuberculosis
that
assumption
parent
who
mothers
or
no
or
to
cerning
con-
has
can
does
hundreds
are
women
fathers
medical
be
There
and
men
individual
who
have
hereditary tendency,
a
disease.
their
The
had
words
rooted
deeply
the
emphasize
to
taken
tuberculosis.
individual
disease,
the
to
few
a
say
and
prevalent
consumptive
he
the
desire
strong
a
be
pulmonary
or
tuberculous
a
should
which
must
we
consumption
tendency
We
him
make
society.
! very
that
41
IT.
likely to
most
tuberculosis,
to
his
COMBAT
precautions
"
ingly
a
the
people
inherited
for
of
stiU, alas
idea
of many
miads
member
curabilityof
the
The
the
tendency
a
TO
life,are
with
connection
In
HOW
occupations
of various
kinds
as
where
of
ing,
printthe
dust,
Hereditary
Transmis-
42
TUBERCULOSIS
AS
A
DISEASE
OF
the
and
in
workers
lead, wood,
How
MAY
Seemingly
All
who
who
have
been
weakened
from
For
consumptives.
to
^^ 1^"-
the
intemperate
is
there
excesses,
'^^^
has
of others
would
unfortunate
be
obeys
also
will
himself
holds
kind
good
In
in
Factories,
Workshops,
"
"
^^^^^^
this
in
Of
respect,
the
of
For
patient
to
the
there
dust
necessity
of
dust
from
is
regard
and
seeking
or
thus
can
exist
vice
adereal
ven-
instructions
the
patient
advice
of any
excesses
their
diminished
tubercle
for
room
to
gases
of
inhalation
the
these
Since
medical
bacilU.
laws
much
the
whereby
light and
are
a
constant
as
well
spaces
glucose (sugar) through
flour
the
as
dust
the
between
action
be
outside).
the
of
for
to
clean
much
their
By removing
saliva
formation
on
the
protection
People
teeth, the
the
ventilation
menace
worn.
should
in
improvement
sufl"cient
practicable,respiratory masks
thoroughly (the inside
flour
of
factories,workshops, department-stores, etc..
especially in
Whenever
thorough
diseases
physician's
now
lessness
care-
(syphilis,
comfort
faithfully.
constitution, and
the
or
to
becoming
against particularlyirritatingdust, should
exposed
"
infected, and
there
change
to
or
his
timely medical
by intemperance
Union
liver,
himself
seeks
the
of the
associate
disease
the
fering
suf-
are
not
all venereal-
that
say
invasion
course,
fiictories where
laborer.
who
of the
conditions
assured.
are
The
their
to
States
many
to
the
from
all those
resistance
submit
highly contagious,
others
reinfection.
for
a
to
physician.
when
undermined
have
natural
Hvffiene
protect
venereal
or
fast
fault
own
to
physician's instructions
the
are
from
a
desire
sufferers, we
diseases
victim
recommend
competent
a
successfully treated
and
"
fallen
urgently
by
treatment
exceptr
j
his
by
the
man,
remedy
no
who
unfortunate
who
should
occupations,
Diseases.
etc.)we
Eelatively
diseases, or
Venereal
^^"
and
through intemperance
serious
efifects of harmful
the
inclined
one
Made
Occupations
convalescent
are
from
with
Overcome,
be
?
persons
excesses,
XIV.
Unhealthy
Harmless
etc.
Predisposition
Acquired
AN
metals,
stone,
CHAPTEE
sis and
MASSES
bakers, millers, confectioners, cigar-makers, chinmey-sweepers,
as
Tnberonlo-
THE
the
teeth
the
of
flour is
AND
thus
avoided, and
soil for
favorable
In
his
all these
the
DuriDg
of
should
air, drink
the
48
IT.
fermentation
deprived
are
as
laborer
help himself
can
of
a
good deal by
a
seemingly dangerous occupation
a
recess,
and
always
strive
plenty of
regular a life
COMBAT
of
germs
matters
he
TO
development.
hours
afterward,
as
the
efforts to make
own
open
HOW
he
before
be
to
clean
pure,
well
as
as
possible in the
as
keep early hours, live
water,
the
possible,avoid
much
as
work
to
goes
safe.
more
saloon, and
take
never
Self-Help
of the
Laborer.
holic
alco-
beverages.
AU
other
the
of
general health
"
of
are,
which
have
we
successfully overcome
one
may
hygienic precautions and
such
just
course,
which
has
been
City
who
AU
employ
ia
bear
should
rooms
should
be
which
dry,
ground
porous
possibleto
render
cementing.
The
all
and
the
as
warmed,
but
should
be
in
be
made
all model
etc.,
culosis
tuber-
Employers
provide
and
propagation
human
overheated,
of
is to
the
and
of
good
same
in
time
free
material,
each
be
well
be
ventilation
family should
always
much
as
sufficient number,
kept
should
have
in
its
good
condition.
In labor
modem
colonies
and
densely populated
bathing facilities
cannot
be
tenement
districts,where
easUy installed, there
Sanitary
built, ^^wlinga
High,
should
rooms
must
course,
lated
venti-
be
light of day and
at the
houses,
tenement
badly
by thorough drainage and
the
Bathrooms
possible.
lodgings
It is sometimes
always be bmlt
winter
and
their
of tuberculosis.
beings
recommended.
be
in
Tuberculosis?
dangerous exhaktions.
receive
In
water-closet, which,
own
for
and
should
possible.
the
soil healthful
damp
should
not
in
miasms
house
rooms
sunshine
factors
particularlyto
a
Combat
people and
of
dwelling
a
free from
is
water,
disposition to
a
unhealthy, dark, damp,
powerful
are
cold
Conscientious
Help
to
number
that
mind
soil upon
The
Do
a
of
culosis?
tuber-
XV.
and
Country
and
"How
acquired.
Well-Meaning
can
Chapter XII.,
use
combat
to
CHAPTEE
What
the
the
improving
hereditary disposition to
a
essential
as
in
spoken
breathing exercises,
as
of
means
should
44:
be
Bathing
and
Facilities.
of
material.
and
up,
if
spitting
All
of
Meals,
for
that
rest
or
jg
^f
^Jqq
hands
the
before
for
should,
of
as
or
'j^qj.q
enjoy
the
is to
in
Child-labor.
The
say,
the
factories,
child
especially
will
well
be
bear
should
who
one
physical
hours
of
germs
find
and
etc., should
mines,
delicate
strain.
to
be
organism
laborer
to
the
may
vation
preser-
particularly those
soil
for
ment
developthat
Child-labor,
fourteen
tuberculosis
growing
underfed,
overworked.
the
but
lishments,
estab-
healthy
a
be
that
ticularly
parafter
employees
that
not
is
large
two
or
system.
large
aired
to
is essential
under
it
overworked,
all, so
his
conveniences
but
congenial
more
children
susceptible
its
any
a
wash
to
mind
disease,
enfeebled
of
is
which
rest
It
workshops,
one
should
for
meal.
only
in
kept
their
thoroughly
with
be
to
proper
not
should
workers
ventilated,
should
than
always
workshops,
more
and
be
the
laborer
Factories,
concern
menta)
The
when
of
should
which
to
after
the
food,
be
they
value
employment
is
combat
should
given
precautions apply
overworked
an
of
health
smallest
and
health.
and
promiscuous
class,
rooms
little while
purpose.
reasonable
be
tuberculosis,
in
be
Lastly, employees
bodily
of
of
greater
ghould
the
employer
housed.
badly
breakable
un-
floor, put
the
meals,
Special
a
course,
the
every
is of
laborer
uverworK,
and
well,
to
in
point
their
should
for
that
These
but
for
time
touching
that
necessary
hours.
working
the
law,
by
of
taken
are
whatever
of
women
air
for
provided
etc.,
important
and
on
be
always
elevated
precautions
workshops.
importance
be
stores,
and
open
thoroughly
should
bath.
should
etc., there
punishable
an
Opportunity
in
cold
or
the
enjoy
can
gained.
the
pmp^se.
walk
it
regular
in
taken
warm
such
and
men
and
ample
be
never
Eegularity
be
employees,
allowed
a
spittoons, preferably
cease,
will
price, people
stores,
making
soon
tuberculosis
MASSES
THE
signs, forbidding expectorating
necessary
will
big
Wherever
conspicuous
some
of
refreshing luxury
number
sufficient
OF
moderate
a
factories, workshops,
In
DISEASE
A
for
public places where,
cleansing
a
AS
TUBERCULOSIS
years
of
prohibited by
than
is
the
subject
age,
law.
adult,
to
tinued
con-
TO
BOW
Ain"
COMBAT
XVI.
CHAPTER
What
Farmer
the
can
Dairyman
and
Tuberculosis
Frequency
of
Indirectly
Stop
Do
Diminish
to
Animals,
among
Propagation
the
46
IT.
of
the
Thus
and
Disease
the
among
Men?
farmer
The
as
anxious
for
food,
as
farmer
who
keeps
in
help
the
who
by
the
direct
the
tuberculosis
of the
is
disease
much
to
the
already
propagation,
ways
which
by
has
:
of the
matter
coming
be
in
takes
not
from
the
the
place
believe
"Practical
the
that
he
of the
best
for
Tuberculosis," issued
of Animal
Industry
in
(vagina and
Washington
to
Theobald
:
Secondly,
if the
cow
to
of
copy
and
some
Fifthly,
body
may
calf.
contagion
author
does
of
very
Prevention
Smith,
tions
secre-
disease
the
the
culous
tuber-
whole
the
prevention, the
Suppression
Dr.
or
ous
vari-
particles
uterus).
in which
ways
than
in
glands
Finally, the
tuberculous
of
rather
or
place
say, little
men
Fourthly, through
tuberculous,
better
by
from
Thirdly, through
way.
various
the
of tuberculosis
also
the
tively
rela-
with
germ
takes
from
disease.
methods
do
can
Suggestions
is
the
from
frequency
or
bowels.
the
by
Bovine
contagion,
is to
also
organs
udder
is invaded
and
the
sexual
if the
The
animals
ordinary
from
and
men,
man
symptoms
begin
the
way
that
r^fg^f}
in
bacillus.
The
quainted
ac-
known
as
seemingly dry cough.
lungs,
the
coming
milk
the
animal
to
to
among
the
the
directly transmitted
As
The
explained.
disease
from
throat, coughed up
of the
been
well
as
They
man.
animals
expelled during
discharge
through
in
be
cattle, also
country.
every
First, by drop infection,
are
the
from
in
tubercle
disturbances.
transmitted
animals,
is the
nearly
the
or
should
cows
animals
In
like those
slight functional
is
in
dairyman
particularlydesirous
with
tuberculosis
disease
this
prevalent
are
be
and
animals.
do
to
tuberculosis."
of
cause
of
The
be
housing
proper
city.
among
anything
nature
"bovine
name
the
tuberculosis
has
the
with
their
should, however,
cows,
combating
Everybody
in
employer
of course,
employs help should,
physical welfare,
their
proper
to
who
dairyman
or
of the
the
of
vine
Bo-
Bureau
..
of Cattle,
46
Sunnression
and
Prevention
of Bovine
Tubercnlo-
TUBERCULOSIS
AS
"Fully nine-tenths of
i^"^^^
^7 inhaling the
OF
DISEASE
A
all diseased
tubercle
THE
MASSES
examined
animals
dried
bacilli,
have
been
suspendedin
or
the
air.
have been infected
"Fully one-half of all diseased animals examined
by taking tubercle bacilli into the body with the food.
in the
This impliesthat both food and air infection are recognizable
in many
animal
same
"Animals
such
or
disease
the
copulation. In
infected,though rarely,
dming
are
cases
sexual
in the
cases.
starts
and
organs
and its
in the uterus
lymph glands,
correspondinglymph glandsof the
buU.
from
"Perhaps
bom
are
cases
to two
one
infected.
writer, there
are
the two
Among
includingall ages,
about two
of all calves
per cent,
which
have
hundred
per cent, in which
the disease
from
the
by
is best
the mother
ing
dur-
before birth.
or
"We
define the
may
by
the statement
dangers of
infection
that in any
herd,even
infected,only a small percentageof
which
those
of tuberculosis,
cases
examined
been
transmitted
explainedas having been directly
of advanced
in
are
localized from
the
an
advanced
very
somewhat
in those
the diseased
stage,or
beginningin
the
such
nitely
defi-
more
extensively
animals, namely,
have. the disease
as
udder,
or
the
uterus,
or
activelysheddingtubercle bacilli. It is these that
broadcast
doing most, if not all,of the damage by scattering
the
lungs,are
are
the virus.
udder
of the
"Disease
normal
ynWlc at first appears
be used with
may
in
Similarly,
contain
are
many
tubercle
"The
what
others
of any
weeks, and therefore would
extent
the
of the uterus
bacilli.
cows.
A
These
the
vaginaldischai^es
deposited
anywhere may
of the virus, or
apply to individual
it may
be made
diagnosismay
existingdischargefor tubercle
foregoingstatements
in
some
dissemination
the bull to other
examination
for
the
usuallynumerous.
tuberculosis
lead to the extensive
by
particularly
dangerous,because
eased
impunity. Moreover, the tubercle bacilli in the dis-
gland tissue
"
is
be
ried
car-
by
the
only.
To
bacilli.
herds
does the
danger extend beyond the diseased herd to
neighborhood? To this we may give the general
^i^
48
TUBERCTTLOSIS
in
disease
"The
will
the
giving
owner
Tuberculin
reveals
to
changes,
when
not,
as
a
who
use
it
as
killed
the
stages
of the
small
the
suspected
hand,
by
other
any
"The
This
question
the
From
from
the
deeply
burned.
or
fattened
for the
and
destruction
animal
health
of aU
be
health
are
thus
were
in
standpoint, there
its demands.
worst
butcher
and
followed
in
appears
and
the
cases
But
using
be
sidered
con-
recognizable
no
case
should
be killed
signs
the
rejection of
stock
If
the
the
question
so
as
to
an
at
and
this
complete
disease, or,
and
of
all
if
fected
in-
of
public
of
public
demands
a
is
ity,
author-
But
milk
owner
might
This
French
the
once
buried
disease
prompt
plexity.
per-
matter
and
abattoir.
mild
however
of the
of
countries.
demands
the
separated at
prominent
a
tions
ques-
present
be
at the
infected
distinct
two
might
European
is not
the
of the
from
justifiable,
sense
the
in
must
with
cause
inspected
animals,
interests
be
On
reaction
mind
agriculturistalone
diametrically opposed.
could
the
not
of
outward
destroyed, the
every
in
A
it.
by
gives
done
be
animals
without
The
earlier
infallible.
tuberculin
shall
of the
Those
infected
not
animals.
health
borne
given by Nocard,
generally
point public
be
having
the
revealed
then
must
after
in
is not
to
those
Hence,
are
many
and
however,
infected
The
recommendation
nificant
insig-
Tuberculin
cases.
not
are
mainly
standpoint
non-infected.
disease.
the
really composed
is
The
simple enough.
in
life.
is
combination
making
earliest,most
moreover,
arises, What
next
use
non-infected.
the
revealing tuberculosis
in
during
means
whose
to
spite of them,
question
animals?
lapses
great value
of
of
now
the
outwardly entirely well,
that
disease
animal
These
In
as
of
observers
is
disappointed when,
Tuberculin,
cases
from
these
find
they
ones,
sound
a
tuberculosis.
tuberculin.
the
of
be
not
must
malady.
percentage
other
of
the
guide
the
indispensible in
disease
the
between
rule, discriminate
a
is
dangerous types
most
the
infected
animal
the
careful
most
become
stages, from
all
us
with
only
suspect it, without
inroads
the
distinguishing the
in
does
of
MASSES
detected
stages
least
at
THE
be
can
advanced
idea
an
gravest and
the
OF
Tuberculin, therefore, has
herd, and
his
early stages
the
In
DISEASE
A
probably recognize it, or
of tuberculin.
be
the
of tuberculin.
aid
is
AS
strictlyscientific
entire
simple,and
submission
gives
room
for
AND
diversity of opinion.
question aside
the
case
should
recommended,
have
may
possibly
dogs
found
introduced
animals
to
be
sound
that
"In
it needs
inspection, the
his herd
from
"
the
"
(2)
Those
have
of
which
"
of the
'^Disinfectionand
require
become
more
or
less
other
partly
by
which
else
placed
"Perhaps
is, that
following
the
4
a
the
owner
more
most
and
matter
promptly
with
and
osition
prop-
ofl"cial
remove
on
lower
recognize
be done
out
certain
study
of the
substantial
to
for
even
reduce
general and
disease
of
has
the
and
tuberculin
from
shipwreck
to
can
view
behind
It will
preventive
in
should
the
body
some
the
will
have
of
measures
time
fact
to
a
come.
that
advanced
the
udder.
probably
it is
disease
of
amount
fection
in-
specificsuggestions
either
originated
or
basis.
important preliminary suggestion to
of cattle
larged
en-
or
heal.
to
of uterus
of
use
jaw),
part
any
refuse
the
glands about
Measures,
the
kept
sufifer
coughing, and
flank, and
tuberculosis
Hence,
still be
Still,much
on
organized
the
sweUings
before
tuberculin
renewed
the
behind
Preventive
time
These
life.
of
"
must
difi"cult without
or
shoulder, in the
generally established.
measures
culous
tuber-
nose.
or
suspected
general character
during
the
having
with
self-evident
emaciation,
under
discharge a yellowish
(3) Animals
may
tested
a
enlarged, prominent
ears,
all animals
udder, and
cases
germs
been
carefullyand
show
with
in front
glands
test,
should
which
the
be
destroyed :
animals
(in front
head
have
such
is
tuberculin
suspicious discharges from
any
some
beings, or by
must
This
owner
animals
All
(1)
of
and
siu-e
comment.
no
stock
of
animals.
herd
a
beforehand.
absence
the
into
as
period
make
for
disease
the
or
of
repetitionsmust
human
domesticated
other
or
tuberculin,
tuberculous
by
first test, to
present knowledge,
our
the
by
reintroduced
be
cats,
"AH
missed
to
side
kiUed,
certain
a
Future
the
remaining healthy
within
the
after
of
farmer's
segregated or
tubercUn
with
overlooked.
been
according
been
been
disinfected,the
months
six
to
the
to
return
us
have
stables
the
has
disease
no
animals
49
IT.
public-health aspect
the
let
moment,
be retested
three
from
time,
that
be, and
may
animals
the
COMBAT
Leaving
all iufected
After
it.
for
TO
HOW
endeavor
to
familiarize
be
made
himself
50
TUBERCULOSIS
much
as
and
of
that
enter
spreads within
the
disease
the
and
open
his
He
peculiar
appearance
that
are
dying of
the
above.
animals
the
body,
to what
tent
ex-
possible the
made
of.
use
of
is the
This
are
know
removal
the
in
tary
Sani-
diseased
and
essential
most
of
only breeding places
specificvirus.
"After
to
diseased
for
requirement,
stated
acquainted
Wherever
be
demands
the
himself
may
damental
fun-
expect after
growths
he
the
it
quackery
to
meet
make
should
with
begin
as
to
malady.
veterinarian
should
suspected animals,
this
where
plane
how
that
sick
which
in
preciselywhat
dies, so
of the
body
ways
of tuberculous
animal
precautions
the
acquisition of such
the
above
should, however,
skilled
of the
services
the
his herd, and
health.
animals
leave
will, by
understand
entered
every
of tuberculosis, its
nature
may
lift himself
the
with
He
body.
specificsabound, and
public
MASSES
THE
well, and, lastly,the
and
has
OF
general
virus
the
the
knowledge,
of
the
which
in
ways
DISEASE
A
possible with
as
the
cause,
AS
stables.
the
cattle.
found,
been
and
the
bacilli
the
are
the
The
given.
following
^ight gallons
to
it.
as
to
give
the
Since
and
in
dirt
and
used
the
be
tubs
subb'mate
this
freely in
should
of
to
the
first
is
may
parts
barrels
to
removed,
to
After
it
a
Since
stables
has
The
water
added
been
be
kept
broom
it loses
manure
well
so
solved.
entirely dis-
should
dirt present, aU
the
in about
oimce
become
with
and
as
twenty-four hours,
be
of
the
than
sublimate
the
it
stable.
tubercle
germs,
cent.).
and
applied
dirt
:
per
stand
culous
tuber-
of aU
less
be
for
have
Since
disease
poisonous,
of the
amount
disinfectant.
tuberculosis
used
opportunity
solution
aU
or
allowed
an
It
of
not
one
in
common
by removal
must
winter
look
so
other
be
the
may
one
(mercuric chloride),
be
must
guarded.
proportion
applying
wooden
of
disinfectants.
may
water) one-tenth
whole
The
covered
of
cases
most
substances
sublimate
kept in
be
than
of
disinfecting solution
(a) Corrosive
should
application
resistant
few
a
be disinfected
should
stables
more
of
only
diseases
first of all
paid
suppressed, we
inhalation
when
Even
subsequent
strength
"
of the
be
long confinement
the
is all but
ventilation
of most
source
should
of these, attention
Here, during
when
months,
the
removal
the
or
well
mop
its virtue
and
cleaned
applied, the
other
before
stable
AKD
should
be
allowed
kept
"
with
of
(6)
should
This
The
"(c)
should
be
taken
be
to
ounces
the
protect
same
but
animals
of water
(fourper
way.
serviceable.
is
It
is not
quite corrosive, and
and
eyes
the
remaining poison.
gallon
a
is very
chloride,
which
parts
any
to
applied in the
mercuric
as
remove
disinfectant
following
dangerous
five
fiTiiniqlflare
possible. Before
as
to
61
M.
flush those
to
tongues,
lime,
COMBAI?
long
as
their
Chloride
cent.).
so
vacant
return^ it is best
to
reach
may
K)
HOW
hands
from
care
accidental
splashing.
Galloo
carbolic
Crude
sulphuric
"These
the
mixing
down
cold
in
the
tub
"(d)
Whitewash
of
walls
should
Whitewashing
dust
All
stables.
Those
down.
stanchions,
promoted
be
and
paid
be
to
has
thereby reducing the
bacilli,or
at
improves
the
resistance
least of
have
from
not
the
to
the
reducing
the
infection.
be
been
stables
of
effect
chance
vigor of
being
ratio
of
is
the
added.
to
one
gallons of
twenty
appearance.
strength
destroy
to
them
the
on
by prolonged drying.
of
the
sides
be
periodically washed
with
contact
by the regular removal
air
the
incrusting
should
in
they
of virus
Good
the
and
halters, troughs, etc., should
removal
containing
is
slightlymilky
a
harmless
cobwebs
when
of heat
amount
furnish
fecting
disin-
The
preceded by thorough cleaning.
should
parts coming
disinfected, even
"The
having
made
are
attention
"Particular
in
water
by imprisoning
they
if the
ing
Dur-
acid.
developed.
in itself of sufi"cient
is not
stables
to
glass vessels.
carbolic
sulphuric acid
acids will
solution
bacilli,but
tubercle
the
of mixed
or
glass demijohn
or
added
is
is
heightened,
while
water
in tubs
to the
of heat
is
strongly disinfectant
mixed
slowly added
mixture
gallon
One
be
large amount
a
resulting mixture
twenty.
a
should
by placing
acid
carbolic
The
")"
is very
of the
power
kept
i
acid
substances
two
sulphuric acid
The
acid
Crude
ceilingsof
heads
of
cattle,
frequently cleansed
used
by diseased
and
cattle.
should, furthermore,
and
manure
of
the
and
by abundant
diluting infected
be
tilation.
ven-
air, and
inhaling dried, floating tubercle
the
confined
number
inhaled.
animals, and
hence
It
likewise
increases
^
*
Stablei.
^
6d
TUBBROtJtX)SlS
^Cattle
should
each
gether;
have
at
same
place
head
impossible
to
stable, but
it
tubercle
should
of
bacilli.
"Cattle
of
the
may
ground
and
of food
the
the
surface
nose
the
healthy
use
his
"To
the
alternate
the
and
to
a
of
the
begin
must
of
it is
discharging
carefuUy
tected
pro-
with
affected
berculosis
tu-
remains
and
is
the
drinking.
and
quantity
restrict
the
dissemination
bring
boiling point
be
before
person
of water
the
is to
Each
ingenuity
with
to
of the
feeding
them.
may
be
nature,
tubercle
the
infection
Discharges
be
may
open
virus.
that
arranged
so
drawn
in
must
of
such
from
in
by
cases
infection, in
cordance
ac-
disposal.
disease
milk
be
the
on
of the
is the
prevent
his
at
skimmed
healthy,this
if the
inhaling
away.
surface
in
on
goes
and
action
The
attention
A
after.
long enough
of
what
passes,
soon
Even
should
To
gainsaid.
it
food
which
chances
the
floatingon
or
be difficult
great diluting effect
constantly flowing
left
mouth
would
inhalation.
agents.
the
more
a
air.
be
alive
drying
destructive
pasture has
by
which
the
with
for
The
fresh
in
over
Drinking troughs
water.
to
that
by increasing the vigor
as
dangers deserving
judgment
known
virus
minimum
other
plan
ing
strik-
outside
be
fields,it
on
grbimd
ready
speedily dried,
own
other
of infection
well
as
virus
virus
wetting
as
upon
cattle while
safest
to the
dried
water
or
It is true
perfectlypossible cannot
likelythat
the
animal
one
possible.
as
exertion
the
up
reduce
"Among
up
take
may
bacilli became
vent
pre-
beings
chances
virus,
soil the
become
air would
the
may
looked
be
may
it is
animal
sunlight,the
precautions will
suspected
human
muscular
pick
That
to
the
prevention
are
little
as
of the
animals
is not
occupy
should, furthermore,
housed
through
animals
"It
be
animals
tuberculous
which
and
space)
each
that
should
(each cow
another.
licking
cases
greatly reducing
estimate.
other
all
destruction
rapid
extent
to
of
air
close to*
are
limgs.
should
effect
heads
room
These
of
expectorations of
of the
of
remembered
Stables
the
from
less
be
removal
the
feed
animals
prevent
of
HASSfiS
vaginal discharges from
or
soiling the
or
feet
all times.
at
their
plenty
cubic
stable
the
in
have
THE
OP
that
placed so
hundred
six
DlSfiASfi
A
should
nasal, lung,
the
the
be
not
animal
last
the
with
AS
and
young
among
other
If the
stock,
dairy products
cows
unnecessary,
are
but
tively
posiwhere
AND
doubt
any
exists
HOW
the
heating
"In
great
a
keep
in view
not
within
reach
in
that
be
conditions
and
animals
tuberculin
and
the
ground
introduced
readily
is
as
by
is
will
diagnosing
of the
of tuberculosis, but
killing the
after
they
tuberculin
By
is
destroyed they
are
applied
is free
to
an
from,
or
is necessary
test
animal
for the
normal
determine
the
small
quantity
and
then
has
tuberculosis, its temperature
inject a
hours
after
the
properly
Of
which
there
predispose to
under
which
susceptibility.
suggestions made
are
also
an
We
the
animal
regarding
applicable to
in
disease.
believe
animals.
other
present."
of
cultures
either
dead
sterilized
or
by
ing,
heat-
through porcelain,so
that
been
of
from
removed
which
by
In
fluid.
whether
the
making
of
it
it
test
the
animal,
If the
animal
from
not
the
tuberculin
determining
tuberculin.
be
arise
animal
conditions
are
of
from
contain
not
if it does
will
healthy
made
rise within
always
danger
no
applied, the
course,
should
test
disease
eight
suffer
teen
six-
to
from
culosis,
tuber-
influenced.
is not
temperature
veterinarian, and
will
the
at
temperature
of the
injection,but
the
tuberculin
The
fluid
a
afflicted with, tuberculosis.
to
tions
sugges-
animals
for
process
purpose
the
purpose
it has
the
tionary
precau-
the
completely
is imderstood
is not
it
Koch
filtered
are
unless
(2)
tuberculin
it does
and
germs;
and
that
is
of tuberculosis, because
living germs
of
cised
exer-
instructions
Robert
It
be
other
dimensions
imknown
Prof.
tuberculin
that
with
diseased
or
is
ored
endeav-
healthy,
view
a
unnecessary,
diseases.
tuberculous
germs
thus
by
has
can
infallible,most
valuable
to these
invented
substance
a
add
only
the
seconded
man
species,a possibilityof whoUy
We
be
requires to
If tuberculin
fall to
writer
watchfulness
tried, b\it with
is
caution
pre-
food.
in which
from
a
calves, which
the
That
(1)
:
separating suspected
made
in
Such
to.
among
bacteria
to
measure
two
measures.
can
scouring
unusual
infallible
whoUy
resorted
be
only
which
in
should
68
IT.
foregoing suggestions the
the
presenting
to
is
in
due
COMBAT
reduce
will, furthermore,
probably
TO
The
to
it to
be
the
animals,
breed
as
competent
thereby.
there
as
well
to
live
perfectly safe
prevention
a
animals, for, when
affected
never
compelled
is
the
is
applied by
to
are
as
in
the
inan,
tions
condi-
determine
say
of tuberculosis
that
in
Lightsair,cleanliness, proper
its
the
man
food^
Tuberculin
Test
54:
and
PredlBPOS-
ing
AS
TUBERCULOSIS
exercise
sufficient
bovine
^^"
and
members
Conditions
for
room
herd
a
in
will
THE
tuberculosis
freed
its tuberculous
from
instituted, with
little
be
MASSES
combating
been
has
animal, there
every
OF
hygiene has been
strict
a
DISEASE
essential
are
After
race.
A
danger of
in
of
plenty
a
out-
new
in Cattle,
of the
break
Of
disease.
that
essential
be
the
as
permitted
the
of
dwelling
healing
of
ulcers
and
and
butter
Tnillr
being used
the
the
cattle
TnbercnlobIb in
Swine.
disease
is
of
kinds
of flesh
membrane
reddish
gases.
are
"
by
ease,
discows
pectoratin
Ex-
such
rhoea,
diar-
as
physician should
in
sought
course,
of
cases
in the
hot
with
be
slowly
handling
and
all the
water
before
essential
without
eaten
are
manifests
troubles.
The
bad
that
"
marked
main
additional
fiTn'miilR are
surface
of
the
being
inner
of
In
the
slaughtered, one
along the
lungs.
As
soon
forms
can
see
inner
as
a
dangered
en-
many
the
pale
mouth
of
and
the
are
mucous
loses its
of
ing
vomit-
tuberculosis
observed.
of the
disease
form
discharge
little tubercles
walls
the
in
disease
the
of the
is often
neck
is
Tuberculosis
lungs, cough
both
sausages.
that
frequently
of
a
swine
consumers
cooked.
lining
the
these
into
diarrhoea, flatulency and
symptoms.
ulcerations
often
already mentioned,
the
itself at
considers
one
symptoms
is tuberculosis
If there
of the
itself most
appearance
is to say,
a
health
tuberculous
made
meat
assumed.
recognized by
even
manifests
Very
the
usually
(for
tuberculosis
the
is
as
always be
not
especially when
swine
and
rare
emaciation.
procedures
evident,
color
and
the
the
appearance
swine
swelling of the glands around
these
disease
cleanliness
so
may
bad
marked
a
sausages
of intestinal
loss
farm
is, of
cows
general
such
young
among
have
To
is
strictlyprohibited
as
is any
is not
swine
among
and
date
through
That
be
also be
quickly slaughtered and
then
ai^
should
stables.
should
or
of the
stage
absolutely dangerous.
Scrupulous
fatted),in
be
can
early
^^^
dairy
instructions, it
what
thoroughly cleaned
be
among
of fat
loss
is
If there
in dairies
in
these
stable
the
Smith's
again.
Tuberculosis
While
Dr.
matter
no
enter
man.
sores.
should
used
vessels
in
help
a
advice
Medical
in.
of
floor
fever, etc., about
called
to
tuberculous
by
to
en
in
consumptive,
no
should
attended
already mentioned
as
course,
a
When
or
guts, and
vations
eleon
is discovered
56
disease, is, of
TTftuHlinp
Bread.
sale of
etc
^^^7
many
hands
and
bread
before
vogue
in
bread
the
wrapper
The
articles of food
mentioned
in
as
of
inclined
such
pursue
Tubercnlo818
among
AnimftU
this
in
also the
larger and
visited
in
ling
handout
comes
is
the
now
the
bread
placed, by
large enough
ends
two
be
of
the
practised wherever
for sale.
XIV.
that
We
in
have
certain
already
occupations,
cigar-makers, render
consumption
to
should,
his
;
therefore, any
interest, never
own
classes
people,
dangerous and
the
among
such
of apes,
is
There
old
capable
if
visitors
of
lions
as
that
young,
propagating
some
of
the
tigers,
losis
tubercu-
ape-house,
day,
the
of
keepers
to
an
every
tuber-
and
subject
are
doubt
no
and
of
namely, that
engage,
Large animals,
captivity.
of
occupation in which
more
never
smaller
thousands
considered
with
the
printers,and
one
menageries.
in
by
of the
cleaning
handled, it
should
and
disease
should
animals
when
XIII.
mention
must
individuals
culous
how
occupation.
an
Lastly, we
through
of
the
twisting
particularlyprone
to
be
exposed
or
stone-cutters,
individuals
weak
one
Chapters
those
By
possi-
wrapping-paper
cleanliness
handled
are
of
The
practice is
moment
to
handled
mouths
thinks
ever
the
completely enclosed.
is
scrupulous
most
such
loaf.
the
enters
in connection
hot
be
to
considers
it
The
piece
a
upon
whole
the
bread
with
dangerous.
one
large bakeries
do
to
recommendable
very
it is still too
shovel,
a
envelop
to
A
it.
the
while
aid of
the
of
oven,
is
before
transporting of bread.
and
of the
when
passes
dealers, butchers,
For
dealers
MASSES
have
who
that, probably" nobody
eating
some
all
THE
milk
to
substances.
bread
^
bread
the
consumers,
and
is evident
infection
^^
food
bakers
by tuberculous
OF
applicable
confectioners,
or
DISEASE
A
also
course,
bakcrs,
cooks,
preparation
of
Food
AS
TUBERCULOSIS
germs
animals
must
be
of tuberculosis
should
be
tuberculous.
CHAPTEE
What
the
ake
These
symptoms
gradually
as
Signs
Tuberculosis
OF
well
Main
that
by his
they
XVIIL
of
are
are
friends.
often
and
the
so
Symptoms
Lungs
obscure
of
Consumption?
or
and
frequently overlooked
Since, however,
Beginning
the
the
show
by
cure
themselves
the
of
patient
the
so
as
patient
AND
depends
man,
While
slow, gradual
a
tuberculous
the
patients
who
of
stage
red
In
to
comes
He
probably
symptoms
he
hours
Of
not,
or
who
persons
to
of
no
serve
warning
a
more
progress
lungs
is
a
a
no
or
the
that
physician
The
seek
these
appetite,
symptoms
signs and
of other
approach
of such
predisposed
medical
advice.
continually
should
science
recognition of
any
loss of
presence
to
a
toms
sympculosis
tuber-
to
Especially
submit
of
eases
dis-
selves
them-
medicine
has
sis
beginning tuberculo-
ever
difficulty;therefore, when-
beginning
assure
of
of
and
cure
the
consumption,
restoration
to
ing
call-
health,
.
present
the
OHAPTEE
examination
medical
will
quiet
ake
the
Eably
XIX.
Symptoms
of
Othee
Forms
berculosis
Tu-
of
?
In
about
case
the
ConsnmD-
easily.
hacking
a
also
to
fears.
imnecessary
What
of the
all, whether
of the
may
is
tired
getting
Importance
^^ Early
also to
work,
of
to
longer presents
the
formerly loved
chest, are
The
when
change
to
the
invalid
several
examination.
suspicion
tuberculosis
the
lungs.
less
present, and
Dyspepsia and
or
early sign.
light fever, and
a
indication
of the
thorough
a
there
in
as
cough
such
of the
the
tuberculosis
should, however,
have
some
ing
dur-
at times
skin,
common
dislike
a
the
pains in
course,
at times
may
the
may
complain
will
and
also be
may
than
and
recognized
occasionally sees
is often
is
which
evening.
or
heart
the
rather
a
There
also
weight
of
individual
the
occupations
importance.
if
ment,
treat-
stooping shoulders.
One
Paleness
frequent catarrh
to
morning
palpitation of
made
be
relativelygood appearance
a
disease.
outbreak.
will
the
cough in
of
timely
a
may
and
rule.
a
present
the
an
afternoon
the
as
loss of
and
means
no
disposition of
and
ursue.
narrow
cheeks, is, however,
pleasm^s and
the
and
hereditary predisposition to
a
chest
emaciation
by
inclination
marked
a
is
bright
character
f
this
first
disease
has
often
observed,
A
disease
symptoms
child with
or
woman,
consumption
with
of the
such
describe
67
FT.
layman.
The
be
COMBAT
TO
early discovery
will here
we
the
by
the
upon
HOW
of tuberculosis
same
as
those
of
the
just
throat, the
described
general symptoms
for the
beginning
of
are
con-
tion.
58
TUBEBCXJLOSIS
of
sumption
Early
Symptoms
hot
of Throat
in
the
and
hoarseness
cold
and
AS
of
early stage
the
of
roughness
hard
or
DISEASE
but
lungs;
liquids
A
this
OP
in
addition
the
voice.
food
also
be
will
there
Pain
may
MASSES
THE
in
certain
a
swallowing
sometimes
very
observed
be
disease.
Tubercnloof
early symptoms
The
tuberculosis
of
the
and
bones
joints
818.
themselves
manifest
A
affected.
sudden
light
wiU.
depend
of the
or
band
tight
pains
It
bowels,
toward
the
is, of
course,
the
through
of
example,
if this
be
If any
the
is
arm
should
the
be
will
of
be
be
toms
symp-
in
urinating,
the
like
accompanied
and
a
often
lower
the
of
gion
re-
ing,
breath-
in
is the
is
the
in
vertebrae
irritation
a
which
constriction
disease
much
to
the
observed,
of the
seat
there
of
one
causes
the
vertebra
leg
or
joints
affected,
the
feeling
a
inclination
an
column
of the
difficultyin swallowing,
will
chest
If
tion
por-
bladder
radiating
hips.
self-understood
discovered
are
location
spinal column,
the
lower
and
the
For
troubles.
of
region
spinal
affected,
the
aroimd
by digestive
of
is
tiring
easy
th3
dry cough.
chest
the
of
region
in
will
there
neck,
and
the
upon
frequent
a
If
disease.
the
by
lameness
pressure
pain.
severe
attacked
in
the
when
any
should
physician
careful
most
that
treatment,
be
these
called
patient
a
can
of
be
toms
symp-
in, for
saved
only
from
a
lasting deformity.
The
The
Early Signs
tuberculosis
bone-and-joint
is known
same
of
disease
a
and
scrofula,
as
of
said
be
may
is most
of
which
frequent during
form
that
might
children.
The
of
be
tuberculosis
considered
scrofulous
hood.
childwhich
almost
child
clusively
ex-
usually
is
Scrofdla.
pale
are
with
skin
flabby
and
swollen,
but
condition,
skin,
some
which
little
we
latter
makes
children.
scrofulous
of the
The
may
aflFections, the
timely
and
sore
find
a
the
treatment
around
running
the
ears
manifests
that
some
are
Fever
of
is,
quent
fre-
matic
phlegand
nervous
delicate
be
observed
in
curable
nature
of
may
very
the
neck
are
a
particularly white,
happily
importance
judicious
and
patient usually
visible.
of
glands
eyes,
have
veins
view
The
also
often
the
In
muscles.
disease,
The
symptoms.
irritable.
and
skin
early recognition
of course,
self-evident.
and
AND
TO
HOW
XX.
CHAPTEE
How
Children
CAN
Protected
be
Forms
Scrofula
type
from
comes
It has
those
been
how
to
medical
the
requires only
environments
damp,
crowded,
insufficient
clothing
conditions
same
the
of
germs
be
overcome
and
stated
we
directlytransmitted,
takes
the
of
The
place
various
tuberculous,
are
speak
restored
inmost
cases
to
one
in
their
Acquired
much
Causes
about
may
the
in
ings,
dwell-
rooms,
brought
these
explain
it
sought
by
of
the
to
conditions
velopment
deto
are
Chapters XII., XIV.,
sociologicalaspect
in
most
perhaps
ways
and
getting
learn
the
common
the
while
that
and
it is
that
they
in
are
which
therefrom
disease,
either
modes
following:
of
The
extremely
in
very
a
how
for tuberculosis
rare
children
the
healthy
to
child
protect
nearly
contagion
We
yoimg.
will
now
the
by inhalation, ingestion, or
infection
plain
ex-
become
may
it from
to
ger
danulation.
inoc-
during early childhood
consumptive
mother
caresses
the
of
Scrofala.
the
say
invasion
conducive
are
How
be
unhealthy
as
soil for
adult
in
alcoholism
are
fact,
In
be
can
abstain.
to
colds
to
from
ventilated
favorable
of them
diseases
cured
such
care.
to
diseases,
children
and
children.
in
be
badly
the
endeavored
will
we
41
page
always
in
enumerated
these
aU
conditions,
produce
sickly persons,
endeavor
in
of
of
Scrofdla.
of
use
XXVIII.
Chapter
be
have
we
XV.,
On
which
scrofula
and
honest
lack
and
chronic
Hereditary
Causes
ents
par-
and
weakly
necessary;
exposure,
consumption
of
that
unclean, and
life,imderfeeding,
the
to
litic.
syphi-
or
of the
being completely
always
and
both
or
above
To
scrofula
acquired
imhygienic
of the
again
and
one
is for
before
is not
earnest
of
causes
it
treatment.
physician's help
hereditary
scrofulous.
become
any
state
The
acquired.
or
addicted
say,
dangerous
children
wish
by timely
indoor
is to
?
when
that
proved
Other
and
scrofulous, tuberculous,
are
offspringhas
have
We
health.
The
who
afflicted with
and
marry
the
also
shows
this
or
cured
hereditary
parents
their
intoxicants,
to
either
Scrofula
from
Tuberculosis
of
alcoholics, that
were
All
be
may
59
IT.
COMBAT
60
child
Tubercu-
lous
and
kisses
it
judge its temperature
or
with
the
same
the
conveys
the
child.
Later
During
Early
and
should
there
playing
tuberculosis
only
of.
place
the
Again,
infecting its
inoculate
lupus,
the
with
the
may
result
from
such
prevent
by taking
the
associate
and
the
during
little
as
with
which
not
be
in
may
thought
take
can
the
infected
hold
of,
its mouth
child's
of
be
thus
the
skin,
accident.
childhood
is
Not
their
into
nails
fingers,and
Tuberculosis
certainly possible
should
only
sumptives
con-
expectoration, but
they
children, and
stay
possible with
yoimg
playgrounds.
We
as
acquire
of
them
the
gradually develop
following precautions :
religiouslycareful
it
unfortunate
an
thus
will
by putting
disease.
infections
these
toration,
expec-
little one,
The
can
origin
Lastly, should
system
lessness
care-
his
great facility inhale
air, and
of
room,
from
of
disposal
everything
result
may
who
development
and
that
to
floor of the
infected.
the
touches
its
be
fuU
itself with
scratch
may
be
nipple
unconsciously
mouth
family
the
the
when
bowels.
the
in
thus
the
the
rubber
same
own
on
with
in
years,
little child
of
neglected, it
should
dust
by ingestion
consumption
To
later
in
likely to
fingersthoroughly,
tuberculosis
or
the
her
play
prudent
inhalation,
in
wiU
floor, may
the
the
and
uses,
food^ tasting it
the
prepares
from
consimiptive
a
is indeed
on
by
take
child
is not
floating with
bacilli
child
MASSES
THE
through
disease
the
be
she
flavor
the
her
on
child
the
while
of
ignorance
or
Childhood.
and
OF
DISEASE
mouth;
spoon
germs
A
the
on
to
Infection
Kissing
AS
TUBERCULOSIS
Unsani-
tary.
from
away
children
be
taught
be
are
not
hands
only
be
;
infrequently
and
nails
kiss
their
on
own
the
cheeks.
of
they only
harbor
allowed,
friends
the
little children
and
clean.
as
of
germs
and
kissed
The
serve
that
repeat
be
nor
kept scrupulously
abomination
an
and
The
should
plays
place
then
by
be
never
to
never
kissed
possible,and
child
should
mouth
the
on
should
They
as
playrooms
should
ones
and
should
to
the
little
by strangers,
relatives
floor
and
little
as
which
on
Carpets
dust
kiss
in
dirt
the
such
a
tors,
collec-
contagious diseases.
be
kept
as
clean
as
possible.
Expectorating
Clean
offence
and
Play-
should
be
strewn
with
grounds.
should
playgrounds
on
be
kept clean,
clean
sand
punished
should
be
accordingly.
from
as
free
or
gravel
dust
as
considered
These
a
grave
playgroimds
possible, and
daily
AND
HOW
COMBAT
TO
CHAPTEE
Can
Consumption
This
question
eminent
the
and
past
Pulmonary
Lungs,
the
answered
be
Its
in
of
c|in
of
men
XXL
Especially
Tuberculosis,
61
IT.
be
with
a
in
their
consumptive,
but
present,
or
?
decided
very
who
Form,
Cured
Of
Yes.
youth
early
or
Celebrated
manhood
declared
were
nevertheless,
German
a
Dr.
physicians,
was
than
more
pupil.
Dr.
P^an,
Dr.
late
declared
of
twenty
years
him,
because
he
ought
twenty
for
vigor
statistics
all
stages
cent,
leave
and
their
early
many
years
from
the
as
stages
seventy-five
per
by
cent,
of
such
their
for
many
have
of
one
telling that,
in
the
more
pany
com-
for
where
life
the
insure
to
badly
physicians,
consumptives,
cured,
of
them
institutions
disease
cases
for
sixty-five, was
premiums
vocations
received,
are
absolutely
the
his
competent
sanatoria
In
lost
rium
sanato-
over
people,
have
mately
ulti-
with
paired
unim-
afterward.
disease
living.
of
having
how
tion.
twenty-five
refused
and
of
Sanatorium.
of
company
consumptive,
pursued
improved,
much
leave
of
insurance
thousands
are
consumptive
recovered,
The
how,
There
!
years
life
a
for
in
Cored
were
celebrated
Coppfe,
delight
Who
Consump-
presided
Falkenstein
age
Hen
consumptive,
a
been
Francis
takes
first
most
as
the
Peter
German
he
His
the
at
twenty.
declared
feel
of
died
France,
ago
was
to
declared
per
when
the
which
since
has
who
Paris,
started
the
own
foremost
sanatorium
and
our
the
over
attained,
mentioned
and
success.
director
modem
than
in
of
phthisical
greatest poets
once
medical
the
as
1859,
his
assistant,
s
he
great
entered
of
who
be
ijiay
First,
one
in
with
Dettweiler,
active
years
the
when
patients
years
Brehmer'
became
age,
Brehmer,
consumptive
a
thirty
advanced
.Napoleon
Hermann
tuberculous
for
less
or
Goethe,
poet
Cooper.
The
more
be
to
are
been
and
show
to
being again
received,
cured.
that
forty
where
only
as
where
many
patients
twenty-five
fifty
capable
patients
as
cent,
per
of
SesnltB
Obtained
Sanatoria.
ing
earn-
in
seventy
the
to
in
62
TUBERCULOSIS
AS
DISBASB
A
CHAPTER
Have
Institutions
for
Remained
That
preceding
the
in
great
who
men
lived
and
long
a
the
Wolff
Hanffe,
Von
Buck,
Baldwin,
in
of
at
time
the
^i^Q
^f^j,
of
the
had
occurred, but
the
21
21
1879
and
had
and
of
72
three
Of
former
these, 67
Saranac
Cottage
a
62
Euck,
von
that
essay
the
he
got
worse
or
70
had
felt
they
had
been
few
had
were
in
discharged
relapsed
constant
within
of
had
that
12
12
years.
in
wrote
between
written
to
from
Dr.
E.
at
the
last ten
to
AshevUle,
E.
or
N.
650
to
one
friends.
258
Baldwin,
Adirondack
correspondence
slightly,the
period
relativelycured;
died.
the
a
through
or
tients
pa-
relativelycured,
sanatorium
responded, directly
95
reported dead,
were
stiU
Y., reported recently
N.
Sanatorium
while
Dr.
had
7 to
institution
themselves
absolutely cured;
felt
Lake,
patients who
and
457
again;
of from
left the
re-
a
Goerbers-
after
Germany,
thought
left
in
well
years
cases
in
cured.
patients who
nine
improved
of from
reply, 5
not
of this
author
felt still improved;
of
had
did
15
period
a
period
a
patients who
201
before;
years
after
Sanatorium
Forty-six
the
after
well
absolutely
were
well
were
and
diswell
were
to
institution
alive
and
patients
In
Brehmer's
age.
of the
some
inquiries concerning
were
some
cured
were
sanatoria
three
was
patients had
WolfiTs
of
cured, 72
as
which
these
5
in
99
Among
Blasien
worse,
reported to
his
52
St.
the
1889.
grown
but
sanatorium.
from
were
former
324
to
of
Dr.
years;
38
Haufife, of
1891
C,
and
years;
Dr.
12
29
to
the
following :
,
of from
youth,
reproduce
Sanatorium
left
12
will
we
years.
made,
cured
as
in the
resulted
names
accomplished
was
died.
had
99
discharged
dorf
recent
inquiry
patients
l^ps" ^^^
12
in
Falkenstein
the
from
charged
the
shown
attaining a ripe old
even
cures
have
possible we
their
life,some
duration
published
statistics
'
is
consumption
useful
Cured,
as
?
consumptive
and
Special
or
Consumption
of
special hospitals for consumptives,
from
Sanatoria
chapter by enumerating
were
Concerning
Keports
So
of
cure
Left
Treatment
Lastingly
ksting
a
Who
the
MASSBS
THB
XXII.
Patients
Former
the
OF
with
twelve
majority were
115
years,
well
at
64
TUBERCULOSIS
judicioiis
use
of fresh
(milk, eggs,
do
The
the
by
of
a
the
nor
patient
if he
physician.
even
many
The
and
thorough
the
Supervision
inann
Essential
the
^^^"^*
illustrious
for
it
that
for
general
his
climatic
Advantaees
Hot
Essential
day,
be
while
which
it
that
conditions,
and
experience
the
or
differs
Uuited
modem
above
of
the
and
be
more
enough
of
control
their
pleasures,
pursue
well
dietetic
healthy
as
mentioned
in
the
did
an
institutions
should
always
recent
order
shown
These
not
differ
be
however,
that
specialhospitals,erected
in
though
al-
world,
near
or
much
from
tures
fea-
many
Brehmer,
have
at
in
particular
consider-
a
satis"ctory results.
in
properly
in
(1859);
special hospitals
hospital
situated
among
first sana-
has
should
Her-
medical
"
obtain
to
years,
Silesia
consumptives
such
in
the
erected
were
ago.
for
above
English
out
caused
purpose,
to establish
years
under
treatment
successfullycarried
most
entirely from
States, has
feel well
the
for that
years
former
sea
consumptive
relapse.
Goerbersdorf
sanatorium
maintained
The
in
a
us
mate
cli-
recovering consumptive
a
consumption,
sixty
in
the
just as
consumptives
as
beautiful
most
safely
physician
at
for
consumptives
elevation
as
of
done
let
here
right
they
to
said, in justice to
far back
as
hygienic
Grerman
cured
men
^^^"
to
the
be
only
can
curabilityof piihnonary tuberculosis,
the
exclusively intended
the
that
work
serious
a
disappear rapidly
treatment.
part of
supervision could
must
ones,
by
on
selves
them-
cure
may
up
the
in
in
special hospitals
"
his
they
take
or
consumptives,
large cities
in
manifest
the
can
dietetic
invalid,
drink,
themselves
that
that
Brehmer,
torium
Special
belief
medical
institution
^^
submit
resulted
conviction
constant
resort
patients think
carelessness
time
a
of
thiok
and
pulmonary
not
not
inal
medic-
disease.
Therefore,
that
namely,
excesses,
Such
people.
^
to
They
sometimes
Med'fiAl
need
longer
no
has
class
and
physician.
;
the
food
good
of certain
the
do
or
food
wisely guided
this
and
symptoms
new
delightful
is not
Sometimes
to
when
aggravated
warning
MASSES
help
supervision of
trained
most
the
combat
to
prescribing of proper
note
THE
abundant
water,
themselves
become
thoroughly
sound
in
constant
ones
the
OF
just-mentioned hygienic
intervention
old
enough,
to
and
thorough
or
the
suffice
immediate
the
air, sunshine,
when
not
DISEASE
A
vegetables,fruit),and
meat,
substances
means
AS
Europe
conducted
regions
with
no
as
well
toria
sana-
claims
AND
for
closed
layman
the
give
To
situated
institutions
as
institution
of
TO
COMBAT
of
consumptives,
will
we
what
is
Modern
a
Such
to-day by
for the
a
ment
treat-
foUowiug questions :
XXIV.
Sanatorium
Sanatorium
a
understood
the
answer
CHAPTER
What
is
in the
resorts.
exclusively intended
sanatorium,
or
results
just as good
typical climatic
in
idea
an
66
FT.
advantages, obtained
special climatic
end
HOW
Consumptives
for
Become
Danger
a
And
?
to
can
borhood
Neigh-
the
?
from
relativelyfree
tuberculosis
institution, and
of
rigor
the
in
are
with
It
is of the
the
to
seems
"The
word
for
of that
; and
This
latter
in
favorite
mental
the
better
a
word
this
resort
or
nervous
neighbors
to
violation
of
by
a
merated
enu-
destruction
with
out
of
prevent
precautions
for the
followed
where,
every-
mission
possible trans-
the
or
provide
voluntary
preventive
of
such
kind,
word
called
to
is derived
country
for
in
the
utmost
rules, relating
immediate
"
it
missal
dis-
to
from
the
a
in
essay
Heilanstalt,"
the
German
designate
convalescent
diseases.
the
the
of
word
than
Latin
sanitas,
place
considered
patients,
or
an
of
Hygiene
the
becoming
else.
anywhere
physicians,nurses,
tuberculosis.
how
the
a
to
word
health, and
institution
as
to
of
founder
means
sanare,
It
easily infection
preference
the
which
Latin
sanatoria
danger
than
Brehmer,
from
modem
contract
this
reasons:
"sanatorium,"
equivalent
of
any
good proof
very
used
is
there
institution
following
the
one
that
a
is in less
consumption
an
is
this
in these
measures
be said
it may
sanatoriam
"sanitarium"
institution
the
the
carried
are
exercised
exercised
All
V., which
occurrence
in
that
us
is
care
expectoration, is
germs
rarest
employees
or
and
that
thorough
so
and
elevated,
oflFender.
hygienic
infected
avoid
to
themselves.
A
the
is
care
employees, visitors,
sanatorium.
of the
The
IV.
an
from
Only patients suiBTeriug
surroundings,
to
is
consumptives
locality,somewhat
greatest
expectoration,
disposal of
the
The
patients
infectious
the
traffic.
equally great
Chapters
in
of
the
of
treatment
healthy
a
and
and
disease
the
reinfection
in
dust
buildings
of
for the
received.
are
in
to
situated
usually
institution
the
*
sanatorium
modem
A
word
the
the
healing
first
tution
insti-
heal, gives
tainly
cer-
"sanitarium."
is
usually
ployed
em-
especially healthy,
for
the
treatment
a
of
in
u.
r^^^fft;
-fett; tut:
.UV"jn:i5r
MUt'ZlUt.
-Uia
3
JTRSt
"!:
*
tfTTTtr.
ij::*r""r
-
rr:c
t'HAf^f^
""
tl^ d^^adLs
In O'^/Wjrf/irf
fr:m
l7Vi""
o
csiheicl
ic
were:
"
\h"%-^
14
o
\^^"-^fy
7
"
Ift'if^^*
4
\"fl^f^If4
U
1^0_7"
5
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\"Ah
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.,,,,.
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in
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nitt^'A iitfm
\u UM5
fHm*t
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iiiit
\nf\nihii"niof
yWhuiftof
M/itflkil$tt0tnt
Falkenstein
17,2
GoCTberadorf
the
EstabUsfament
of ttie Suuiftariiim.
1877-70
n.OperlOO
u
1880-S2
14.6
"
t4
1883-85
6.0
"
"
imr,
4^1
14.0
li
1886-88
6.0
mm
70
i".7
U
1889-91
13.9
IH7I
7;j
21.0
H
1892-94
15.1
iHli
70
Hii.ii
imtinnlH in
hucJl
'''I
nnd
''^^^ ^*\*^^^Vdmiulas
nl
a
sanatorium
During
and
of
ulyi}il
they rioiJp,
has
tuberculosis:
22,0
"*^'
Aiff
After
100
and
1859,
M
'" ^''" '^1**'*^
lUii^ura'^'^''^^
Optn
from
of
in
\m2
Tho
lit tlli
village
died
per
7,7
\HfMm
established
was
the
t4 thtt tkumUfrtum.
fM
)Hm
O^jerliersdorf
5
take
the
live, so
day they lie
walking
course,
to
with
and
the
on
u
speak, day and
lounging chairs
breathing exercises,
windows
open.
It is
AND
sorprising
loDged
rain,
how
sojotim
snow,
nor
HOW
COMBAT
TO
easily consumptives
in
even
the
open
wind,
air.
gel: accustomed
Neither
providing
67
IT.
it
change
is not
too
to
Uid
of weather,
strong,
jso-
cold,
hinders
68
TUBERCULOSIS
tiie
spending
from
patients
rest-cure
in
sanatoria
on
the
trained
galleries of
sanatorium
rain
summer,
themselves
the
Tonsaasen
the
open
shine.
or
little
a
from
five
blankets
hours
nine
to
his
day
a
F. below
from
tliat
under
of
a
or
the
rest
Forest
in
a
the
photograph
(Fig, 19)
"Liegelialle
in
how
We
cold.
cure
in
"
summer
well
also
give
(Fig. 20),
in
the
know
how
to
Dr.
The
have
of
of
temperature
a
reports
at
a
L.
Trudeau,
the
States.
We
winter
the
day
good
that
at
patients
German
us
Cottage
are
in
lery
gal-
rest-cure
picture representing
sanatorium
latter
to
come
Adirondack
a
finally a
a
cover
Andvord,
United
on
typical
woods
patients
at
comfortable
and
ter
win-
in
the
the
taken
a
in
out
Dr.
Edward
in
and
(Fig. 21).
Germany
sanatorium
of
direction
the
on
patients remained
Similiar
institution,
treatment
showing
institution,
spite of
the
well.
very
sanatorium
the
reproduce
felt
American
excellent
Sanatorium,
pioneer
and
zero,
cure
(iallery.
Reat-Oure
13"
cold
furs.
or
that
reported
rest
carried
it is very
influence
little
the
that
physiciaDS
house
has
successfully
\Vhen
with
more
Sanatorium,
air
be
can
the
of weather
piazza, porch,
the
on
by
patient, and
MASSE?
THE
time
made
change
consumptive
the
OF
of their
most
the
that
prove
DISEASE
A
Observationa
gallery.
or
or
AS
shows
time.
in
how
One
the
the
Black
patients
must
not
HOW
AND
think
of
these
the
recovery.
iuatitutiotis
patienta
As
a
do
TO
dreary
well,
consequence
as
a
and
COMBAT
cheerlesa
rule, and
they
feel
69
IT.
places.
progreaa
happy
and
The
ity
major-
favorably
impart
toward
their
joy
70
TUBERCULOSIS
and
in
good humor
is
for
as
the
to
make
where
a
but
learn
some
from
the
gained,
at
of Patient
to
all the
patients
regulations
and
and
the
also
All
that
himself
the
the
the
and
cold, and
which
how
he
"uch
of the
will
take
place
should
learned
the
lose
home
in
physician
the
what
he
with
him.
his
or
unlimited
sexual
be
has
sanatoriimi
a
have
should
right
a
he
the
contracting
marriage,
as
be
have
of
to
whether
advice
physician's
not
of
the
only
will
from
patient, and
questions
have
advice
others
consumptive,
friend
he
their
interest
where
place
a
have,
which
not
as
institution
nurses
must
should
patient
the
the
physician
sanatorium
the
devotion
in
sanatorium
a
of
be
to
means
no
in
interest
necessary
futm^.
lessons
the
all
In
is
by
physicians
cured, but
take
of
be
must
A
protect
precious
childbirth,
and
keep
to
of
regulations,and
to
not
physician
home,
felt.
for the
and
how
confidence.
The
it
becomes
rules
are
the
and
environments,
lessons
disease, how
rules
when
authority
patient
concerning
Belation
MASSES
deserves
patience, forbearance,
their
his
The
THE
Discipline
in
good.
calling requires ;
patients and
institutions
The
common
rule, the
a
helping
essential
as
else.
everybody
are
OP
objectionable feature.
an
consumptives
for
these
disciplinein
considered
for
DISEASE
rest, thus
the
to
A
cheer.
good
The
Discipline.
AS
relations,
Much
sought.
and
Physician.
and
unhappiness
might
even
on
the
gain
may
On
and
arriving
at the
the
by
weighed
regular intervals
office hours
who
unable
of the
of
to
for
be
up
in
the
are
cold
water,
one
meals
the
the
on
order
one
usually
are
piazzas
that
they
an
tional
addi-
strength, receive
and
entire
charge
this
or
of the
means
is
of
a
repeated
patient at
of
one
twice
carefullyexamined
process
stay of the
convenience
visited
is
his
the
the
assistants
one
rooms
of treatment,
torium.
sana-
Those
of the
for the
are
at
keeps
patients.
day by
Specially constructed
institution.
of
One
nutrition,
lunches
patient
every
physician,
the
ample
patients,in
and
by asking
advice.
principal
the
avoided
daily.
institution
during
regular
weight
milk
physician
The
are
in
of fresh
quantum
The
dining-rooms,
rapidly
more
is
galleries. Many
rest-cure
be
physician's
treatment
overfeeding.
say
well- ventilated
in
taken
sanatorium
of
features
main
often
can
the
conscientiously obeying
and
or
misfortune
family
sicians
phyplication
ap-
usually
72
TUBERCULOSIS
AS
according
State
4,480
their
to
Nearly
of
Consump-
tives.
funds
these
marks
1,300,000
of between
why
Need
of
State
and
People's
Sanatoria.
this
of
curabilityof
that
some
for
care
deal
done.
be
to
little
with
of those
some
no
or
that
and
people's sanatoria
are
we
xnasses,
shall
great
to
hope
us
see
In
England
be
the
as
have
their
note
consimiptive
is
of
yet
"
consumptives
of
drop
a
multiple
it
is
relief
work
good
great
a
will
creation
dent
evi-
in
go
of
an
on,
State
thorough hygienic
as
a
measures
disease
of
the
following chapter.
by
a
Care
Taking
and
Disease
Combated
existed
that
dent
evi-
XXVI.
Successfully
there
among
privately imdertaken
tuberculosis
in
of
States.
Institutions
Tuberculosis
Eeally
the
and
That
Special
IN
that
United
prove
Exists
Evidence
like
the
CHAPTER
What
spite
nimiber
are
the
of the
thickly populated States,
combat
to
try
have
companies
within
persons
sufferers, there
the
will
the
purpose.
gratifying to
for
care
women
special institutions
calculated
well
in
in
fund
a
discussion
a
insure
not
1897
1898
come
into
it is most
to
oiu*
let
centm-y
new
such
That
in
means
and
the
of
not
occurred,
unfortunate
view
In
Thus
of woe."
ocean
has
existing institutions
the
that
will
undertaken
men
does
vantage
ad-
altogether
in
for that
enter
While
and
and
to
their
year
invested
destined
we
companies
have
noble
while
and
poor,
to
States
can
disease.
the
For
Germany
country
consimiption
the
it to
invalidity insurance
this
less
insm-ance
relatives
near
in
found
own.
toria.
sana-
contribute
companies
have
was
state
Still
work.
private life
whose
such
subsidized
to
consumptives,
millions
four
feasible
practicableor
scope
Urgent
and
whether
discuss
To
for
in sanatoria
three
of
have,
collectivelyassisted
sent
were
of their
societies
insurance
state
MASSES
companies
1897,
; some
special sanatoria
erect
for
insm-ance
state
THE
insurance
4,432
establishments
such
of
to
are
of whom
these
all
OP
government
published figures
consumptives,
Insuranoe
the
these
of
Thirty-seven
DISEASE
A
by
of
of
Hygienic
consumptives,
is to
say,
in
relativelylarge numbers,
for
can
?
hospitals and
over
ures,
Meas-
Masses
the
special institutions
of
tives
Consump-
for the
sea-coast
fiftyyears.
As
ment
treattoria,
sana-
a
result
HOW
AND
of
excellent
most
the
of these
maintenance
the
and
surprising manner,
world.
which
and
it
The
Wales
was
death
the
thirty years
ago.
1870
1880
1885
1890
These
figures are
head
the
of this
Treatment
the
Dr.
registrar-general's
the
of
population
of
half
wellnigh
of
that
England
and
in
was
"
1,468
1,386
1,398
1,307
1894
1896
1896
best
of
to
answer
the
asked
question
XXVII.
Carried
be
Outside
Eesults
question, too,
of
cure
that
the
are
such
of
that
physician.
and
trained
answered
Out
with
Institution
an
essential
hygienic
treatment
of
to
and
?
obedient
and
aflBrmative, for
willing
to
in
success
the
hope
carry
out
at
he
for
case
ments
environso
the
sential
es-
disposal
be
may
weU
unless
success
detail
every
of
a
measures,
are
though
such
general
dietetic
cannot
the
possible outside
consumption,
latter, however,
exceedingly skilful,
patient is
the
patient and
all the
The
in
is certainly also
position of the
modern
in the
the
patient
conditions
The
social
be
may
consumptive
a
sanatorium.
the
most
a
"
This
of
country
population
Consumption
of
Satisfactory
*
are
any
the
to
the
CHAPTEK
Can
years
other
chapter.
-
a
the
perhaps
to
in
1893
2,410
2,202
1,869
1,770
1,682
1875
at
of
tuberculosis
pulmonary
possible
a
reduce
last
among
reduced
million
per
in
of
enforcement
was
the
in
tuberculosis
been
the
following statistics, compiled by
superintendent
has
rate
from
Wales
it
than
rapidly
from
mortality
England
to
statistical
the
office, the
and
diu-ing
more
According
Tatham,
institutions
tuberculosis
IS
IT.
general public hygiene,
from
mortality
the
COMBAT
TO
of the
treatment.
We
give
house
own
ing
the
a
here
may
small
night.
illustration
with
of the
(Fig. 22)
for permanent
arrange
addition
greater part
sleep at
an
galleriesand
day,
Another
and
the
patient in
by
open-air treatment
where
awnings
where
simple
of how
method
in
warmer
for
he
weather
carrying out
his
build-
spend
can
he
the
may
rest
Sanatorinm
at
Home.
li
TUBERCULOSIS
in
cnre
the
A
fashionable
the
that
the
patient
is
patient
also
may
his
at
be
wind
the
that
day,
so
sun,
while
advised
to
as
i"r
as
should
possible
and
balcony.
at
In
day,
with
his
little
a
on
light, the
been
chair
artanged
There
sun.
books
table,
whole
our
has
reclining
whole
and
home.
moved
summer,
according
body
in
be
may
the
be
the
and
ing
writ-
which
on
he
can
so
his
shifted
received
the
During
the
near
or
on
not
too
by
the
time
of
of the
rays
have
and
the
day
cold
such
sanatorium,
a
under
his
the
lounge
if
or
there
windy
veniences
con-
ho
must
guidance
tate
imi-
instalment
sanatorium
window
open
different
cannot
in
practicable
the
(Fig. 23).
reasons
physician,
a
to
bathed
shade
financial
cannot
of
be
and
for
help
treatment
chair
or
the
the
ner:
man-
at
aeen
seat
A
wind
Being
remains
who
ask
the
the
the
placed
chains
head
and
from
is
as
After
and
following
AirangemBntlorOpen-Alr
patients, who
Poorer
and
side
invalid's
the
his
for
served.
."
whenever
in the
padding.
interior,
the
protected
himself
installs
with
MASSES
auch
procured.
lined
in
THE
accomplished
is
are
its back
materials
meals
waBa
OF
of wicker-work,
resorta,
inner
with
be
chair
sea-side
placed
is
beach
DISEASE
A
might
air
open
large
removed
AS
or
is
reclining
no
days
porch
in win-
HOW
AMD
ter
the
the
flat roof
small
patient
of
form
boards
the
from
be
plain
A
the
answer
How
have
to
The
course,
hygienic
be
do
his
friends
a
modest
and
out
Thus,
duty,
page
the
just
Cure
the
yard
at
in
relatives
the
if the
who
a
or
a
plat
email
sheltered
quilt
a
or
costly lecluung
Home.
treatment
the
home,
at
expectoration
home
as
an
earnest
has
pliysieian, and
live with
temporarily
as
with
on
we
34.
private
his
well
a
epot
a
padded
cold-water
patient
in
m
chair
umbrella
an
garden
or
chair
as
his
on
by
sun
chair
^."Reet
on
confidence
home
for
steamer
for
wrapped
the
a
76
IT.
precautions eoncemii^
carried
institution.
is
purpose
arrange
described
already
from
arranged
FiO.
chair.
head
If there
tent
ma^
wmd
will
blanket
his
protecting
improvised
COMBAT
placed wannlj
be
may
TO
suitable
him,
it is
for the
rigorously
of
must,
as
in
the
determination
the
good
possible
sanatorium
to
will
make
to
of
the
even
treatment.
76
TUBERCULOSIS
AS
A
DISEASE
CHAPTER
What
Good
Will
OF
Do
XXV.
Chapter
In
the
for
sanatoria
without
and
care
one
offer
sufficient
unfortunate
these
could
their
of
families
and
hardly
But, besides
large
or
they
time
sufferingit
needs
class
of
dark,
to
their
kin
A
the
further
of
living
present
of
made
these
their
tients
pa-
unhygienic
in
respect, how
lives
many
of
breadwinners
treatment
how
caa
isolation
or
from
this
Perhaps
time
torium.
sana-
a
much
ery
mis-
it may
thus
demonstration.
from
sufferers
and
proper
in
ticularly
parall
nearly
neighbors.
the
treatment
away
alleviate, and
any
of sufferers,
do
are
of
filthy tenement-houses,
health
received
may
In
large percentage
taken
need
urgent
consumptives
at
the
very
were
and
may
ease
Dis-
a
institutions
and
Union
for
to
most
poor
their
restored
great good wealth
What
Need
if
in
surroundings
save,
cured
of
as
population.
in
people.
be
of
facilities
hospital
the
These
poor.
great cities of the
of all the
of
thousands
are
disease
their
Tuberculosis
spoken
centres
treatment
or
spreading
not
large
there
cities
large
have
we
in
Women
and
?
consumptive
wanted
our
Combat
Help
Masses
the
Men
Other
and
to
MASSES
THE
XXVm.
Philanthropists
can
OF
tuberculosis, there
pulmonary
children
the
especiallyamong
of the
is
a
poorer
of
Sanatoria
for
Children.
classes, who
are
afflicted
with
particularlyscrofula, and
prevalent
in
people
careful
the
that
at
of
125
We
from
have
in
the
have
than
114
the
sea-cuast
The
climate
sanatoria
at the
on
of
of
the
tuberculous
France,
se^-shore,
many,
Ger-
did
not
and
it
115
of
foimd
was
attend
of
school
the
latter
troubles.
63
page
among
Berlin,
In
of them
former
scrofulous
or
already spoken
treatment
of
very
dren
chil-
daily attendance
the
one
girlswho
132
How
are
idea.
an
In
schools.
and
tuberculous
the
diseases
kept concerning
are
disease,
tuberculosis.
bone
scarcely
tuberculous
of
tuberculous
and
public
boys
less
regularly,not
suffered
general
statistics
children
out
joint and
scrofulous
these
forms
other
of
the
and
scrofulous
Germany,
in addition
to
result
excellent
children
Holland,
good
nutrition
and
and
tained
obin
Italy.
qold
and
warm
cure
of scrofula
sea-baths,
sanatoria
like
factors
combating
The
of
creation
be
as
in
those
wish
who
important
the
masses.
be
cannot
country
own
our
the
for this
are
of
disease
a
for
Institutions
consimiptive adults,
institutions
to
favorable
particukrly
tuberculosis
such
rr
IT,
children.
in
for
recommended
warmly
too
COMBAT
to
seems
tuberculosis
and
treatment,
in
TO
HOW
AND
help sufferinglittle
to
children.
The
only by
supervision, in
of the
home
The
consumption,
be
aU, in the
to-day
the
and
masses,
must
the
all
and
men
inclination, should
the
distribution
health,
of
useful
The
other
or
under
circumstances
strict
permit,
women
unite
to
at
the
and
in
be
time,
life in
the
the
lectiu-es
nature
of
societies
for
encouraged
in
not
in
order
the
vention
pre-
State
boards
only
to
and
diseases,
every
governments,
should
talent,
means,
by
masses
of
co-operate
disease.
of
favor
of
of
these
increase
their
usefulness.
To
sun,
give
the
to
of
which
to
create
we
a
not
shall
number
people
poor
it is essential
only
speak
of
to
in
of
large
provide
detail
parks
and
in
limgs
of
Such
a
parks
great city.
and
for
the
more
air, light,and
good sanitary dwellings,
next
chapter,
playgrounds, by public
private philanthropy, particularlyin
districts.
cities
the
breathing places
but
also
means
or
densely populated
more
are
justly called
of
lous
Physicians, teachers,
have
the
authorities
of the
General
Causes
Tubercu-
recognize
we
particular,among
educated.
who
rance,
igno-
kinds, and,
modes
hygienic
to
municipal
gladly
of all
or
imclean
tenements,
propagation
formation
should
sanitary
in
In
causes.
excesses
concerning
The
State
the
the
on
tuberculosis
beverages, must
educate
pamphlets
enterprises,but
food,
the
masses,
pulmonary
tuberculosis
of
of the
unhealthy
regard
and
tuberculosis
Union.
in
of
particularlytuberculosis.
the
accomplished
treatment
combating
factors
duty
and
of
in
alcoholic
hygiene
be
of
sun,
ignorance
the
employers,
of
important
the
combat
be
can
disease
a
form
sufficient
abuse
most
general
the
sought
or
proper
above
if
or,
as
light, air, and
of
linen, lack
dietetic
of tuberculosis
must
of
lack
and
sanatoria,
especiallyin
hand,
other
forms
its various
patient.
prevention
To
in
hygienic
thorough
a
medical
the
of tuberculosis
cure
the
Diseases.
78
TUBERCULOSIS
Cleanliness
Public
Baths.
before
time
the
respect and
excellent
the
report
Baths
and
were
opened
have
cost
in
of
is constructed
building
and
for
men
old
women
six
superintendent,
The
laundry.
of
piece
all
The
$137.01.
the
records
of
the
made
than
years
demonstrates
those
occupying
the
baths
conducted
is
the
habits
strictlyon
very
worst
largely due
a
business
Their
quarters
the
basis, the
there
1,175.
total
the
the
has
the
they
ceipts
re-
tions
condibeen
ever
past eight
instilled
city.
that
daily
July
In
be
can
of
increase
and
better
for
passed
sur-
expenses.
an
was
live
rate
sepa-
balance
and
to
of the
fact
a
baths
monthly
record
of cleanliness
to
the
120,347,
population
tenement
Baths.
includes
number
and
plant
steam
$5,571.99,
were
for
tubs
living quarters
are
surpassed.
the
The
(seventeen
are
credit
interesting attempt
more
that
also
22d
July
expenses
People's
the
on
also
were
no
baths
operating
All
4,662.
which
free.
batlis
a
was
They
equipment
for
(1899)
shows
bathers
of
bathers
operating
which
under
of
of
No
of
York.
contains
which
their
ciation
Asso-
iron, and
the
year
paid
work
year
bathers, and
$5,709.
Last
have
number
fiscal
number
total
"The
towel.
year's
total
previous
17,452
were
the
basement
is five cents,
records, and
previous
of
a
the
These
People's
its
spray
floor
second
of
from
the
"The
water
three
be
in this
year.
land
and
other
of which
example
by
and
the
are
the
in
bath
a
and
soap
result
over
of
cost
last
Poor:
brick
The
On
and
of
on
the
extract
Place, New
of which
women).
children.
and
for the
The
for
an
the
some
In
an
give
city furnishes
twenty-six baths, twenty-three
As
building
enamelled
be
poor
managed
situated
is
It
of the
Bath
and
The
The
I
of
will
that
colonies, will
of labor
baths
tically
prac-
desirable
public baths,
disease.
to
be
must
obtained.
be
of
Market
1891.
charged.
is
rent
it
condition
Condition
$28,000.
about
the
9 Centre
August,
bathroom,
maintained
the
No.
at
be
People's
are
Improving
it would
speaking
public
York
New
bath
will
liable
such
of
number
a
in
43
less
of
located
are
ground
them
the
of
improve
to
erected
for
condition
page
work
of
were
ideal
own
MASSES
THE
a
WhUe
its
means
render
the
baths
on
OF
influence
have
establishment
best
of the
one
DISEASE
ignorant.
this
mention
made
we
A
beneficent
should
yet
mean
the
to
family
time
the
and
taught
every
AS
The
have
into
success
been
patrons feelingthat they
80
TUBERCULOSIS
all education.
above
do
little
such
light beers,
as
with
taken
the
desire
should
for drink,
attacks
of
excessive
should
who
of
he
absolutely refuses
in
American
our
and
coflfee
bouillon
sold
are
houses
combat
in
warm,
and
winter
be
the
children
to
evil
fearful
of
the
treatinghabit
caused
in
out
non-alcoholic
if
to
treat
prevalent
man
of
should
be
to
of these
some
and
young.
inteUigent propaganda
alcoholism,
tea
including
are
old
for
amusements
though
creation
summer,
advantage
him
young
drinks
in
ones
so
an
life
enable
a
The
that
by
order
in
many
wreck.
sire
de-
taught
alas !
"
ruined
cool
has
will
saloon
people
occasional
starting
liquor
has
drinks
polite gentleman,
a
a
transmission
receive
help
ment
encourage-
everybody.
Might
Solved
by
OF
Public
and
spread
against
the
Problem
in
Judicious
Legislation
Private
Philanthropy?
there
that
Presuming
XXIX.
Tuberculosis
the
BE
the
when
if all
often
man
through
CHAPTEE
against
drinks,
adults
best
experience
of additional
be
societies, which
from
laws
for
physical
offer healthful
also
Temperance
How
also
training which
enter
which
and
It would
could
at
of all
alcoholic
mildest
young
It is this
where
houses
encouraged.
to
to
ever
moral
a
and
unhappy
given
acquired only
considered
society
him
made
schools
hereditary
"
and
will
intemperance
to
be
of
It would
moral
be
drink.
to
laws
feebly alcoholic
never
the
even
The
the
and
gentleman,
treated
In
most
(periodicalsprees) are
him
be
be
of
harmless
as
fear
a
smoke,
tobacco.
with
the
of
use
have
may
never
to
or
is
drink,
dipsomania
take
a
there
would
use
fanatical
dangers
as
should
absolutely avoided.
be
and
quantities.
strong
predisposed, or
so
pictured
alcohol
MASSES
taught.
considered
be
may
which
for
be
moderate
meals,
in
be
very
smallest
families
In
of
their
the
in
even
the
the
should
should
THE
prosecution
consequences
WhUe
mortals.
OF
early childhood
drunkard
the
home
DISEASE
Extreme
From
good.
its fearful
and
A
AS
were
in all the
of tuberculosis
propagation
from
States
man
of tuberculosis
the
United
and
a
States
Combination
sufficient
to
man,
by
animals
regulations
and
that
were
the
imi-
HOW
AND
form
plan,
particularlyfor
more
Just
there
as
is
who
insane,
of
there
to
commission,
a
and
exist
commission
of
Each
charity organizations.
of
and
physicians
following
aided
be
for the
asylum
an
the
determination
for
consumptives.
of
general
its work
m
for the
titioners
practhe
by
investigated by
laymen,
mission
com-
mining
of deter-
purpose
number
should
case
in
for
be
the
sible
pos-
municipalities a
institution
officers, should
best
population :
of
care
certain
a
the
suggest
or
state
state
or
composed
health
committee
for
a
in
for the
subject
municipal
a
all states
special examiners
proper
should
so
admission
Such
a
work,
larger centres
nearly
in
of
nimiber
a
or
exists
the
enforced
and
further
for
would,
we
manner,
81
IT.
COMBAT
States
United
the
throughout
TO
a
bined
com-
following
poses
pur-
:
applicant's condition
1.
To
determine
2.
To
visit
his
such
hygienic
institute
the
has
if he
home
been
measures
as
pocket spittoons,disinfectants,
found
seem
etc.,
by
medical
a
nation.
exami-
tuberculous,
and
to
of
(distribution
necessary
gratuitously if
the
is
patient
poor).
To
examine
if any
of
3.
out
counsel
4.
the
of
or
or
in
the
become
other
5.
To
imperative
"
sanitary
determine
able
is not
institution
If the
to
the
latter
will
should
be
to
the
the
individual
and
Its
find
to
so,
is evident
the
to
concerning
renovation
or
that
the
struction
de-
even
tuberculosis
condition
of
the
soil
should
have
case,
to
his
it would
be
In
family.
being
is
patient
taken
to
an
necessary
many
attendant
cases
of the
a
for
the
letter
of
patient, would
investigation committee.
the
physician
for examination
by
not
the
destitute.
medical
of the
work
or
become
the
whether
condition,
for the
former
every
it
whether
family
inquiry, sent
materially aid
when
there, owing
and
pay,
provide
person
to
disease, and, if
sanitary authorities
financial
the
to
any
order
defects.
municipality
Any
the
patient's dwelling.
"endemic
to
the
full to
be
may
has
contracted
family, in
treatment.
report
condition
of the
members
also
have
them
proper
To
other
right to present
should
the
board
be
at
himself
libertyto
of his
for
amination,
ex-
recommend
precinct or
district.
*
S^
TUBfiRCtTLOStS
The
institutions
A
1.
needed
should
admission
for want
of
from
possibilityof
2.
One
be
to
3.
the
One
possible,of
ground,
the
convalescent
in
sent
there
from
A
afflicted
farm
improved
also
be
atmosphere
is
the
through
a
paratory
pre-
sanatorium.
here.
greater
distance
from
altitude, if
an
thousand
and
the
do
light work,
feet,on
porous
preferably surrounded
vicinity,where
the
make
place
the
thoroughly
the
tion
institu-
selected
sanatorium
moimtaiu
for
department
cipient
in-
should
city sanatorium
the
To
cure.
the
might
this
To
from
a
if
by rail, at
in
attached
children
suffering
tuberculosis.
for
sanatoria
tuberculous
with
counsel,
nearly as possibleprotected from
as
cases
their
sea-side
Several
tient
pa-
outskirts, and
pass
no
two
self-supporting.
pulmonary
4.
seek
mountain
at
hours
and
exposure,
complete
should
the
serve
to
the
retained
by higher mountains,
the
to
five
to
in
the
to
all be
thousand
one
measure
a
sent
sanatoria
patients could
and
be
three
forest.
pine
a
delayed
guard against the
region, where
would
mountain
southern
winds
located
patients should
being
cases
from
with
all
before
between
coldest
by
Here
several
city than
to be
also
and
improvement
elevated
pure.
or
has
or
place
a
The
patients,whose
should
as
city sanatoria,
advanced
more
impracticable
:
dispensary.
tuberculous
sanatorium
continued
somewhat
sojourn
The
is
be
would
plan
relapse.
a
a
ambulant
dispensaries
the
several
or
possible in
known
his
aid in
thus
the
These
discharged
MASSES
THE
this
out
carry
sanatoriimi
room.
OF
reception hospital and
treat
the
into
DISEASE
A
to
centrally located
dispensary
and
AS
diseases
the
of the
treatment
of
joints and
other
children
lous
tubercu-
manifestations.
(scrofulous)
A
5.
be
received
roimded
a
in
few
the
by
remain
the
only by taking
and
homes,
such
an
that
the
birth
can
sanatorium
maternity
months
best
placing
institution,
fearful
be
for
them
under
time
among
to
their
dietetic
from
their
and
tuberculous
should
and
confinement,
They
after
constant
before
mothers
care.
time
some
mothers
mortality
reduced.
and
these
some
tuberculous
previous
hygienic
sanatorimn
away
where
should
childbirth.
unsanitary
medical
after
their
mothers
sur-
also
It
is
tenement
supervision
in
confinement,
after
child*
The
beneficial
such
through
and
the
child
at
care,
the
such
an
to
effect
These
will
and
their
the
from
ing
Leav-
largely assured
organisms
need
the
will
have
mother
mother
to
tender
most
received
herself
lasting utilityto
need
All
be
not
that
would
and
in
child,
situated
be
at
essential
dis-
great
a
is that
they
gi'ound,preferably somewhat
good, porous
on
over-estimated.
be
thus
the
constitutions
community.
sanatoria
city.
erected
be
of
be
the
to
maternity
should
hardly
hygienic training which
family,
stance
when
period
a
child's
and
woman's
can
83
IT.
COMBAT
physical well-being
institution
the
the
on
arrangement
an
aside
TO
HOW
AND
vated,
ele-
Matemity
Sanatoria.
and
in
The
buildings
of
of
Another
ways
of
for rest
which
be
might
private philanthropy,
the
multiple
of
make
to
are
authorites
lack
has
which
any
of air,
been
before, if
them
in
Overcrowdiug
and
the
living in
six to
ten
direct
light and
for any
length
He
saloon.
to
of time.
finds
healthy, and
houses,
for
He
model
public
is
the
time
be
will
be
be
a
and
in
and
it.
a
owing
to
As
make
not
A
them
the
only
good
wage
and
rumshop
husband,
of from
receives
one
of health
state
of the
room
to
earner
becomes
a
crime,
a
family
cheerless
the
saloon
better
if there
considered
workiugman
and
home,
the
empower
condemned.
perhaps
drives
the
tion
legislahouses
habitation
should
life in the
be
only remedy.
dreary
often
Give
particularly iu
tenement
same
renovation
of which
It is the
will
of
everywhere
human
possibly remain
light and
comfortable
for him.
legislative measures,
combination
responsible for
rooms,
which
conditions.
home
attraction
three
tuberculosis
existing tenements,
houses
held
air, cannot
dwelling
tenement
be
and
ments
equip-
to
the
be
will
tenement
should
owner
all
imsafe
down
other
a
but
at
thorough
a
the
of the
ventilation, they should
light,or
tear
or
childbirth,
by
should
any
should
unfit
quirements
re-
Tenements
of
inspect
to
are
said
sanitary,to
law
the
solution
tenement
There
erection
the
the
model
population.
impossible, and
sanitary
of
creation
the
to
invalids.
addition
in
ble.
possi-
as
pure
in
baths, and
sun
cin^es,
as
according
treating women
accomplished
and
large centres
constructed
toward
work
is
atmosphere
for tuberculous
important
problem
the
be
sanatorium
a
where
should
modem
facilities
ample
with
locality
a
the
ent
indiffer-
pleasant, clean,
will
have
less
father, and
citi-
and
Tuberculo-
sis.
lA
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itze
iz,;
ti^ir*
^vjiiar
himses
.n
paiodic
^exvluaoa
from
^^.i^r-iilosis.
ju'-t?.
.jeacioa
jesides
ct
wooing
specol
insti-
AND
for
tutions
to
the
ing
induce
and
large
a
city, the
outdoor
of
the
farmer,
rising generation
instruction
in
iDstitutions
large cities
cultivated.
will
of
In
country
good
coimtry
life in
in
proportion
the
to
which
this
people ;
be
should
done
is
by
tional
educa-
liviug outside
young
air
open
and
also
other
making
attractive
to
institutions
libraries, and
districts, thus
terests
in-
decades;
profitableagriculture,and
and
in
more
tuberculosis
I^
decrease.
The
creation
destruction
healthful
region
of
of
is
trees
healthful.
more
to
in
It would
hereditary
overcome
well
attractive
or
preser-
wasteful
a
give useful
people, as
offer
^^
the
where
would
on,
of
number
with
States
many
carried
now
to a
connection
forestryin
of forests
employment
seeking
men
of schools
cultivation
and
vation
and
render
as
to
careers
the
young
acquired tendencies
to tuberculous
much
asked
diseases.
CHAPTEE
XXX.
Conclusions.
The
in the
author
of this essay
preceding
pages
may
is
prove
in
far easier
mortality and
for
a
the
more
any
He
is
the
be
the
the
disease
against this
In
in
realized ;
view
the
task
of
the
all
will
great
question, his hopes
foe of all mankind
common
to
been
to be
problems,
anticipated.
of
has
co-operation of
earnest
various
optimistic enough
of the
community
of
by
that
difficult
at first too
that
ravages
rigorous crusade
eradication
If
might
fearful
justified.
are
solution
than
that
aware
appear
nevertheless, he is convinced
interested
City to
Coimtiy.
to
attraction
more
by endowing
statesmen
and
iufluence
the
from
liv-
protect the
last few
the
amusements,
nature
the
ia
have
be
family
a
to
should
will
had
interestiug and
more
love
short, the
in
migrate
to
farming
the
scientific
healthful
providing
of
aid
in
all his
exert
Statesmen
it has
than
philanthropists should
for
should
members
that
so
mission
Bmiirration
its appearance
physician
occupations.
additional
an
villageto city should
from
made
has
especiallythe younger
seek
the
cousumptives,
emigration
If tuberculosis
reversed.
in
tide of
86
IT.
COMBAT
TO
of
treatment
The
perform.
HOW
believe
even
in
an
mate
ulti-
disease.
is visited
by
an
acute
contagious disease^
^
*^"
86
TUBERCULOSIS
smallpox
is
for
while
arms;
demanding
years
pulmonary
is
form,
the
and
prosperity,
disease
of
All
that
of
a
people.
wise
the
of
the
required
government,
few
have
cases
made
be
of
power
where
most
to
to
lastingly
in
much
have
study
but
disease,
living
with
a
civilized
intelligence,
tuberculosis
combat
for
in
especially
and
so
prevail,
a
tuberculosis,
man,
disease,
wellnigh
disease
completely
everybody
prevalent
treated
is
the
die,
may
more
preventable
a
States,
far
year,
that
only
people
a
every
philanthropy
masses
is
lives
who
not
United
the
as
is
within
a
conclusion
majority
certainly
such
all
the
to
come
in
of
Yet
which
MASSES.
THE
OF
consumption,
thousands
indifference.
DISEASE
A
of
example,
in
up
can
AS
its
which
one
cured.
It
country,
wealth,
as
successfully.
attain
well-trained
this
goal
is
physicians,
combined
the
and
an
action
intelligent
a
88
TUBERCULOSIS
doea
not
have
Dry
or
work
of
window;
OF
THE
the room,
it in;
but
only brushes
it settles down
or
and
it into
then
you
again.
over
soft, dry cloths
the
DKEA8E
from
dust
breathe
you
do the
"Use
out
Clotlu
that
so
to
XoiBt
the
remove
air
the
A
AS
dust
to
or
with, and
shake
them
slightly moistened
use
frequently
and
cloths,
rinse
in
?Uoeof
Feathu-
them
the
Bnitertk
dust
"
In
rooms
well
as
as
dust
rooms
which
dripping
wet."
not
a
Thus
Ymdhhi
should
we
remember
them.
over
which
mop
floor
You
have,
bare
after the
dust
has
wrung
been
clean
out
homes
our
How
sanitary
The
the
as
The
the
to
or
in
to
per
The
from
of the
a
instrument
and
of
that
and
we
moist
which
even
moist, but
"ot
so
process.
and
fresh, pure,
relativelyeasy.
is
make
to
as
also
-houses, can
cleaning
as
problem
the
all the
the
air
as
in
heating
be
little
is 60.
If
in
body
and
dry an atmosphere.
in
perfectly comfortable
lower, provided
this
moisture
The
suggested various
enough
to
other
be sanitary.
helpfulin determining
tbe
30
are
absorbs
air
discomfort.
illustrated
to
dry skin
dry
open
that
falls
and
nose,
lays them
I have
page
dwellings
too
simple.
causes
there
Chapter XII.,
American
our
dry throat, dry
is
then, but
time
frequently aired whether
referred
a
in this way
will be
the
over
when
tenement
rendered
can
39, Chapter XII.,
page
be
comes
vacuum
producing thereby
"humidifier," and
the atmosphere
the
left open
already
explanation
the
we
all this
schoolhouses, but
causing colds, grippe, pneumonia,
t^^^;amsms
On
be
of moisture
membrances
mucous
called
F.
cent, then
evidoiii'e.
tiie mnislure
of
of 65"
upon
air
greatest difficultyis experienced
custom
proven
time
and
left open
thoroughly
and
percentage
20
The
the
remove
only
to
as
or
this
be
I have
much
be
summer
can
unwholesome
temperature
homes
cannot
be
Exyierience has
relative
In
doors
not.
or
pneumatic
our
windows
altogether too
a
in
outside.
should
rooms
is sickness
39,
and
that
winter.
hy^enic
air
possible?
as
windows
fresh
the
by
may
easily
until the
ordinarj'citizens, including
the
settles
is stirred into
so
the
of
dust
settled, by passing
the HoBt
homes
get
you
floors, in houses, stores, shops,
has
only factories, public buildings, hotels,
be cleaned
this way
that
can
Clraning
Sanitary.
In
finished.
furniture,and
the
on
by walking
schoolrooms, etc,
should
you
breathe
in
have
you
room."
of the
out
cleaning
floors
the
when
in water
out
The
drying
the invasion
to
and
an
ways
losis.
tubercu-
apparatus
to
render
I reproduce here
an
the relative humid-
AND
has
It
ity.
of
Board
been
Fig.
Hygrometer.
of
a
and
these
than
importance
This
but
attended
be
general
of
ening
In
and
epidemic
fever,
a
If the
Hygrometer,
passages.
the
concerning
used
by
absolute
secure
be
for
it
such
a
disinfection
certainty
rooms,
have
we
would
or
for
scarlet
measles,
of
consumptive
tuberculosis
as
add
disease
grippe,
diphtheria,
smallpox,
pneumonia
airing and
scrubbing
with
walls
and
wearing
and
are
papered
be
repapered.
do
apparel
soap
that
disposing
pre-
or
and
absolutely
are
permit
not
been
fever, whooping
thorough
floor,walls, furniture,
essential.
the
less-
great
tuberculosis
typhoid
of
in
air
disinfection,
cough,
water,
would
apparel, etc.,
To
explicitly given.
to
If
carefully
directions
furniture, wearing
every
rate
accu-
there
very
a
IV.,
Chapter
after
as
was
of the
diseases
curate,
ac-
cal
practi-
improvement
health
more
uure
for
it is
one,
every
decided
a
a
absolutely
humidity
by
to
one
thermometer.
ordinary
of
Hair-
Pteading
Direct
fact
tempera
Indeed,
the
as
matter
ia
the air ia of
ia not
purposes.
the
have
it
sufficiently so
is
description
following
of
name
State
schoolroom,
the
hygrometer
the
Indiana
the
picture
a
for
of
humidity
it with
the
should
instruments,
the
that
is
every
workroom
every
of
by
89
hmr-hygrometer.
household,
Every
recommended
under
24
reading
direct
IT.
published
bulletin
its monthly
in
strongly
which
Health,
COMBAT
TO
HOW
thorough
a
Diginfeo-
tion, Sornb-
bing,
and
Ajrinjf,
Pure
washing
should
they
By
thorough
disinfection
Sriukinff
followed
can
be
Lastly
by
made
board,
localities, in choosing
streets
suitable
are
all
boiling
Hygiene
school
most
the
to
and
cleaning
spread
ordinary
airing
of many
home
Water.
infectious
drinking
water
will
as
serve
preventative.
School
the
thorough
real barrier
a
filtering or
additional
The
equally
an
wide
a
OF
Tuberculosis.
board
or
a
the
of
site for
locality
and
Factor
as
is
a
education
a
school
somewhat
surrounding
PRBVENTIo^f
the
in
it is called
as
should
elevated
houses
not
bear
in
region,
too
in
mind
where
high
and
some
that
the
not
90
too
close
the
construction
be
together,
said.
the
in
has
be
permitted
recently
enacted
York
New
Concerning
up-to-date
to
sanitation
be
erected
of
village or
is not
and
model
schoolhouse
construction
of this
No
third
of the
city
district
of
class
known
of
New
all
to
the
of
law
a
York
which
ence
in refershall
in any
or
could
interest
schoolhouse
and
State,
the
portion
a
Legislature
"
much
well
are
About
heavy.
too
still in
here
quote
in the
schoolhouses.
in any
school
MASSES
traffic
architects,
to
THE
OF
the
of such
been
of
DISEASE
modem
a
essentials
and
A
where
I may
cause
State
and
of
The
sanitarians
Law
AS
TUBEBCULOSIS
after
here-
incorporate
no
addition
to
be
erected,
the
school
a
Construc-
tionof
School-
building
which
in
any
exceed
shall
for the
houses.
of
same
of such
addition
feet
square
for each
of
foul
of the
of
detailed
by
this act, shall have
and
aisles, and
arranged
the
such
and
cases.
by
shall
staircase
shall
but
being
upon
shall
a
and
Roof-
gardens.
only
relation
having
be
made
few
a
to
air space
room
unless
for
and
vision
pro-
feet
cubic
exhaustion
which
approved,
plans
from
movable
with
such
large playground,
the
a
at
of
site
operated
the
the
such
which
in
taneously
simul-
door.
a
No
form,
plat-
tion
in direc-
changes
immediately
open
width
of the
door
doorways."
I
locality does
roof-garden
afford
to
shall,if double
of
runs,
shall
tuberculosis
or
apparatus,
and
steps in lieu of
least
and
stairs
prevention
Where
door
landing
a
bolts
straight
No
platforms.
and
face
inner
winding
with
passageways,
public protection
outwardly
the
required
as
and
accident,
or
of
independent
for
for
open
with
constructed
points.
thirty
positive
and
of fire
case
constructed
the
him
by
heating appliances
shall
handle
between
be
of
or
fifteen
recitation
facilities
accommodations
doors
by
provided
be
a
be
and
fastened
one
feet
or
schoolhouses
filed
be
in
flight of stairs, but
Play-
groundsIn
proper
be
used,
be
the
least
halls,doors, stairways, seats,
egress
All exit
study
building
at
cubic
and
shall
...
shall
all
school
provide
least
at
shall
and
plans
of education
approved
and
pupil,
lighting
facilitate
to
requisite
doors
all
be
All
changes.
Such
any
in each
air therein
statements
of
hundred
two
cations
specifi-
commissioner
ventilation, heating,
shall
assuring
per
vitiated
or
the
same
shall
for
to
thereon.
erection
and
plans
minute
atmospheric
and
the
therein
every
the
the
of
cost
and
plans
commissioners
accommodated
such
no
is made
air
Such
for
space
be
to
endorsed
detail
in
unless
floor
pupil
therein, and
show
the
submitted
been
approval
plans
thereto
dollars,until
have
buildings.
any
approve
pure
his
shall
specifications
lighting
shall
hereafter
shall
place
five hundred
and
education
not
such
can
would
not
be
suggest
permit
covered
of
in
AND
winter
is
which
French
to see
sliding
permit
twice
which
in that
come
of
tilation
kind.
the
easy.
oil
with
can
of
without
desks
or
the
thus
eliminates
and
the
^that is to
"
^should
"
be
together,
after
so
each
which
one
of
the
cleaning
walls
painted
the
say,
that
a
cleaning
It
Equipment
of Schoolrooms,
goes
the
Sanitary
Drinking
Fountains.
sary,
unneces-
cup
transmission
,
.
they
replaced by
of
use
j
school
session.
be
the
method
plain, to
thorough
a
daily
should
makes
improved
arranged
so
that
ven-
be
and
the
air
good
general
most
should
and
ofif,
drinking-cup
hygienic drinking-fountain,
and
rounded
possible
that
of
of
dows
winall of
pivot,
a
and
Heating
course,
equipment
folded
is made
on
out
go
be
should
I
schoolhouse,or
virtually impossible
be
and
air to
windows,
extent,
turn
of schoolrooms
interior
moved
their
in every
do.
of
of dust
The
saying
or
American
our
that
windows
should
benches,
floors
the
of
those
should,
corners
easily be
one-half
woodwork
accumulation
furniture,
of
of foul
ordinary
and
paint.
Instead
amount
91
IT.
windows
wall,
the
our
walls
All
to
casement
the
schoolrooms
The
make
opened
or
into
COMBAT
TO
necessary.
be
only
can
wish
to
absolutely
HOW
of
microbic
disease.
Every
and
warmed
to
suitable
a
the
be
given
To
learn
be
supervised by
I
in
duties
of
should
the
detriment
children
much
and
bear
be
in
The
physician
puberty
that
are
the
the
class
every
has
week.
the
^^^
"
"Wimming
should
and
pupil
will not
only
and
intellectual
moral
struction
inhave
ula
scrof-
contagious diseases, particularly
that
Gymnasi-
well-equipped
a
regular bathing
for every
who
of
manifold.
to
never
a
In
has
been,
brain
and
the
has
in private
studied
that
status
predisposed
individual
the
training
of
our
to
too
boys
at
the
becomes
Prober
Mental
of
beginning
period
most
of
culous
tuber-
entering
susceptible
and
Physical
Development.
schools.
the
Curriculum
?. .?^?^"
of the
altogether
system
nervous
pre-
curriculum
welfare
physical
is yet,
the
in
intellectual
and
closely
it is often
school
arranging
or
There
also
public
the
push
bodily development
and
knows
diseases
which
makes
superintendent
of the
girlsin public
and
water,
should
pupil
master.
school
which
salt
or
during
times
obligatory,
swimming
and
school.
overtaxing
several
public
but
mind
of the
his
winter.
gymnasium,
higher.
the
in
bathe
obligatory
of tuberculosis
vention
Each
and
tuberculosis,
will
in
made
the
swimming
pupils
The
he
that
of infectious
cases
and
constantly running
competent
a
well-equipped
a
fresh
to
be
establishment
swimming
of its
should
convinced
have
temperature
opportunity
swim
to
am
fewer
with
swimming-tank
a
should
school
public
92
to
AS
TUBERCULOSIS
the
of the
invasion
is put
the
upon
both
and
to
seem
of
only
me
divided
tuberculosis,
of
but
strain
holds
This
outdoor
instruction
factor
all indoor
in the
diseases
of
good
with
curriculum, interspersed
much
as
additional
when
system.
important
most
a
MASSES
THE
OF
mental
or
judiciously
gjrmnastics, swimming,
would
DISEASE
bacillus,particularly
physical
A
sexes.
A
possible,
as
prevention,
and
not
nervous
even
troubles.
Instruction,
outdoor
^^
Outdoor
instruction
geological excursions,
I
weather
to
is neither
the
prevent
exercises, such
of
course
as
or
two.
The
must
be
adapted
lessons
should, of
feasible
methods
as
habits
the
rules
simple
and
school
on
which
don'ts
These
purpose
alphabet
Rules
Simple
Every
children
Do
child
until
ready
Do
not
by
on
in
purpose
your
for the
spit
in
a
put your
and
and
and
other
children
them
a
these
from
tracting
con-
printed leaflet
do's
the
contain
prevention
of
source
impress
to
of
losis
tubercu-
and
tuberculosis
colleges.
in
this
For
following:
to
spittoon,
alone.
mother,
or
Prevent
to
help
can
a
of
the
to
have
to
should
the
and
coughing
words
prevent
life,is
helpful by complying
for that
burned
thus
Children
adult
spit except
not
Never
School
and
be
can
u^d
cloth
for
and
public schools,
the
compiled
good
practical
mouth,
method
every
school
The
The
from
the
on
at
pupils.
prevention
simple
leaflets
kindergartens, private and
I have
in
A
school
during
the
are
taught
a
of the
disease.
kissing
children,
child.
the
to
should
time
hygiene
all the
expectoration,
from
classes.
primary
each
to
be
can
tuberculosis
given
regard
communicable
people's faces,
in
even
in
vogue
with
means
book
at
and
understanding
familiar
be
indiscriminate
from
unhygienic
of
in
a
the
Breathing
of this
minutes
physiology
and
age
course,
infectious
an
sneezing
the
to
teacher
in
few
tion.
recita-
excellent
diseases.
Chapter JCII.
for
outdoor
most
are
pulmonary
in
least
at
cold,
and
and
tours
recitation, when
and
singing
of
described
are
singing
too
nor
development
hour
infection
windy
instituted
be
outdoor
that
too
only botanizing
not
mean
also outdoor
but
convinced
am
I
the
piece
a
the
of
cloth, or
return
your
your
mouth.
or
a
home
handkerchief
slate, floor,playground,
rules:
following
wash.
fingers into
School
fight consumption.
with
On
Tuberculosis.
sidewalk.
put
chief
handkerhave
in
the
water
AND
Do
not
Do
not
pick
wet
HOW
COMBAT
TO
it
wipe
or
your
nose
your
fingers in
on
93
IT.
hand
your
your
mouth
mouth
or
sleeve.
or
when
the
turning
leaves
of books.
not
put pencils in
Do
not
hold
Do
not
put pins in
Do
not
put
anything
Do
not
swap
apple
money
wash
or
Never
hold
or
Keep
with
and
When
do
by others,
Clean
to
your
meal
Do
teeth
; but
at
night.
not
kiss
Turn
mouth.
face
your
Wash
yourself,
home
the
on
one
any
food,
to
one
mouth.
hands
your
as
if
possible, after
and
morning
allow
or
school.
at
water,
in the
mouth
do
you
and
up
hurt
been
have
or
teacher.
the
to
report
at
getting
on
the
it.
face.
cut
toothbrush
least
in
meal.
have
to
dren
drink.
half-eaten
in the
is put
your
each
clean
with
at
lips.
your
and
gum,
finger-nailsclean.
well,
as
that
eating
before
food
except
person's
a
and
afraid
yourself just
Keep
in
feel
be
not
mouth
anything
or
before
water
don't
you
to bed
C
"^ Tubercu-
fruit before
face, hands
your
soap
each
B
Prevention
candy, chewing
cores,
handkerchief
a
with
mouth.
in your
cough
or
them
wet
mouth.
your
your
sneeze
your
in your
whistles, bean-blowers,
side
a
for Chil-
Do
Peel
mv
anybody
on
going
to
do
so
you.
fresh
to
These
leaflets should
and
love
air and
Learn
and
explained
should
be
read
be
at
commented
allowed
deeply
and
regular periods, say
the
by
upon
the
keep
to
to breathe
learn
leaflets
and
once
teacher.
take
it often.
do
them
month,
a
children
The
home
to
their
parents.
In schools
collected
and
^Hbefore they
of
spread
measles,
so
as
always
at
distributed
and
diphtheria,
to
this
by
of
all, is, in
the
my
far
given
articles
the
to
fever,
be
simple precaution.
The
same
child
every
use
pencil, while
opinion,
not
be
a
so
disinfected
only
the
diseases, such
prevented
suitable
safe
to
as
as
among
in
custom
preferable
nearly
children
Not
pupils.
may
the
to
should
contagious
more
scarlet
having
have
lead-pencils are
hours, these
but
tuberculosis,
schools
some
school
again
are
and
slates
after
children
school
in
where
vogue
envelope,
no
a
tion
precau-
thorough
disinfection.
On
playgrounds
flushing
and
devices
in
and
corridors,elevated
cover
such
as
spittoons
illustrated
with
in
matic
auto-
Fig. 25,
",|j^^
Lead-pen-
oils, etc.
d4
TUBERCULOSIS
should
to
never
An
expectorate
important
and
there
the
ground.
here
placed
be
on
in the
point
remind
is that
with
The
and
the
in
The
should
be
grippe;
diseases
the
visits
;
of
and,
of
all
school.
that
might
those
or
Fio.
25.
Elevated
bert
Knopf-Thi-
"
the
parents
the
school
Self-Tluah-
In
ing Spittoon.
it is with
that
all
child-labor
a
this
of
sense
the
as
have
one
is not
our
its
However,
to
that
the
of
employees
of
infection,
tive
impera-
an
be
to
given
make
problem.
in
the
upon
hood
childpression
supWhile
necessities.
done
to
factor
important
entirelv
vet
the
of all individuals
must
we
tion
funcof
tuberculosis
prima-facie
note
and
looked
always
the
swimming-
tuberculosis
of
the
child, will
most
a
the
humiliation
deep
States, it is gratifying
toward
of
prevention
of
childhood
to
curse
physician
the
becomes
tuberculous
a
solution
I
of
of
and
advice
the
acute
tary
sani-
source
a
treatment
and
necessity,
in the
weeding
dren
chil-
of
examination
out
constitute
whose
of
important
pupils, teachers,
The
cian
physi-
of the
buildings; regular
most
periodical
at
bronchitis
and
lastly,the
of
XVIII.
school
supervision
school
gymnasium
all, the
chests
the
the
to
school
the
including
of the
toms
symp-
described
propagation
constant
condition
should
chapters,
of
the
sideration
con-
characteristics
daily inspection
avoid
infectious
under
teacher
been
duties
a
young
consumption.
to
preceding
XIX.
to
the
have
symptoms
length
school
and
predisposed
person
and
objective signs and
of tuberculosis
a
old
disease
the
the
the
MASSES
the
of
prevention
familiar
be
THE
OF
to
children
school
among
DISEASE
A
AS
acknowledge
with
away
ever-increasing
in
progress
suppression.
there
is
one
kind
of child
labor
which
the
law
can
only
CUld-labor
reach
Home
at
as
difficulty,except
is
Perni-
and
teacher
ciouscruel
that
with
as
or
in
the
F^tories.
the
school
as
labor
which
child
will
would
probably
never
I
impose
of household
task
the
physician.
thoughtless parents
fulfilment
it has
the
upon
duties
but
a
often
school
cases
where
delicate
performance
grown
when
those
to
their
the
or
strength of
complain;
co-operation
refer
of the
person.
the
teacher
dren
chil-
of manual
The
or
timid
school^
96
TUBERCULOSIS
and
arranged,
Sflleotian
Boom
of
for
Tnberon-
lout
AS
DISEASE
A
this supplement
in
OF
it is
^SS^stionsincasethehometreatment
^""^ show
how
possible.
on
one
most
washable
If
the
at
much
night and
the
^^'^^^P*^'"
instances,
and
the
better.
rest
be
not
the
the
that
made
in
Fig.
in
cure
or
desirable
aa
nearly
preferably
All
purpose.
fixed
and
Fig.
will
only
in
A
23
be
few
rugs,
be
allowed.
for
outdoor
by day
air
open
fluous
super-
should
carpets
well
may
as
best-
sunniest,
house,
cheerless.
22
the
prai-ticable
all
at
that
pictures
This, however,
is not
imitated
curtains, and
illustrated
arrangements
for
cheerful
some
be
of
room
must
room
curtains,
sleeping
so
the
but
removed,
mind
suited
dust-catching
furniture,
be
best
give additional
to
necessary
can
in
comfortable
is the
floor,
-bear
MASSES
purpose
becomes
treatment
should
and
higher
a
sanatorium
First,
ventilated,
Patient.
the
our
THE
be
feasible
added,
in
few
a
large cities, particularly
of Windowin
apartment-
our
and
To
tenement-houses.
make
the
open-air
tent
feasible
treatir.ent
living
in
consists
window,
that
the
cities, I
of
an
by day and
have
awning,
is attached
air from
on
the
night
devised
which,
the
room
instead
inside
cannot
of
in
even
Icall
what
the
a
homes
of
"Window
the
of being placed outside
the
enter
It is
room.
or
mix
mih
poor
Tent."
so
It
of the
constructed
the
air
in the
AND
The
tent.
patient
lying
the
window,
has
his
26,
27, 28).
By
followmg
be
seen
that
the
with
frame
of
half.
A
in the
air
warm
reduced
be
to
and
cold
of the
Dr.
the
tent,
8.
form
the
formed
furnished
a
stout
interposed
same,
to
the
insure
a
hinge
to
which
at
hinged
each
end
its maintaining
being
the
(Figs.
for
it
be
can
attached
the
window,
in
to
be
need.
left
breath
patient's
independent
rod
the
as
will
duced
pro-
to
fill the
quite
not
is left
not
the
the
lower
of
escape
the
this
space
On
extremely
and
hardened
open
will
rise
to
The
of Bessemer
the
terminals;
with
any
ventilation.
made
foupframes,
with
tent
the
with
can
Raised
need
aids
in
is
tent
less, according
The
of
pin
insure
Bessemer
of
series
inches
lowering
there
parallel
(Fig. 29) closely
it does
Wfndow.leDt
or
frame.
tent
of
on
Kaopra
A.
nights
constructed
and
By
placed
resting
The
but
three
inch
one
windy
all above
about
is
nearly perfect
as
device.
a
which
description
is
97
IT.
shoulders
the
room.
S7."
Fia.
COMBAT
bed,
window,
of
space
and
ventilation
American
an
the
in
head
simple
so
TO
HOW
suitable
easy
to
original form.
action
make
a
rod
space
at
the
top
tent
is
suitably
hinges
operating
circular
washers
in
folding
the
stiff,rigid frame
lrUB"BCUL0ai8
The
frame
fitted, and
is covered
having
in under
and
the
room.
lowered
over
attached
to
the
AS
with
extra
elongated
ends
around
the
The
they
of
can
tent
as
weather
suit
so
the
that
window,
a
as
patient's preference
he
has
of the
the
outside.
be
convenient
If, however,
air most
the
window-tent
The
the
time
being
of
be
must
placed
his
on
this
of
A
tent
to
It
he
the
the
family
bed
be
must
angle
the
the
to
saying
tanen
the
from
when,
this
can
ignited
be
allowed,
must
be
urged.
I
the
danger
impreased
prefer
of
celluloid
them
upon
celluloid
the
to
in
glass
and
for
the
this
what
is
If the
at
a
as
rule,
smoke;
exceptional
greatest
in
out
witha
not
servation
ob-
put
goes
window
right
the
be
can
purpose,
if
can,
window,
that,
to
contact
room.
It
is
less outdoors
he
see
snould
patients
outside.
feel
as
aide.
either
on
to
serves
placed
glass
nurse
this
in
to,
in
on
if
also
of
vation
obser-
an
for
more
desires
going
loid
cellu-
front
as
family,
his
well.
as
the
patient
and
with
window,
patient
necessary.
the
the
in
of
the
make
rooms.
serve
members
watch
small
to
window
or
will
window
transparent
is placed
the
from
arranged
of
piece
tage
advan-
attention
the
be
to
right side,
or
have
can
window
Another
right angle
a
in stormy
the
attract
who
outside
window-
the
left
face.
not
poor
at
Venetian
the
on
with
alongside
the
manipulate
or
by
is
tent
little pulley
can
or
placed
in his
it wilt
placed
majority
a
bed
the
the
neighbors, and
be
sleeping
ing
enter-
a
he
inside
the
can
air from
Shutters
the
for
is that
bed
for
of
bed
tucked
and
window
of
being
then
conjunction
gazes
The
protection.
a
the
cord
a
on
in
cold
and
himself.
tent
utilized
intercept
to
screen
be
of
the
attached
are
the
bed
twill, properly
their
of
prevent
md
the
yacht-ami
the
of
THE
admit
to
enters
the
of
OF
thick
to
portion
raising
blinds, whether
the
with
or
upper
and
towering
bedding
patient
hun,
the
BIBBABB
A
cases,
becoming
tion
precau-
because
AND
is
there
of
danger
no
HOW
TO
its
COMBAT
when
breaking
"d
IT.
the
rmsed
is
tent
and
lowered.
If
it
is necessary
sillj this
the
bed
the
to
of
height
the
window
Adjust-
be
can
raise
to
with
done
few
additional
the
legs by
inches
wooden
facility.
If the
the
during
moved
iron
bed
or
from
closed.
the
put
The
"""j"'
during
tent
and
the
pulled
can
taken
out
of
the
sufferer
the
and
the
If
Beditead
to
Suitable
Height,
equal
the
bed
and
the
the
hooks
way.
of
the
tive
consump-
If
the
he
bed
in
his
is
visable,
ad-
is
entire
people
where
is of
course,
the
to
spend
room
day,
stay
can
tent.
and
winter.
his
or
he
in
in
tools;
patient only
from
service
greatest
ment
of
a
to
with
up
window-tent,
feverish,
with
the
be
iron,
attached
the
serve
be
window
the
Or
be
accomplished
can
of
is
handy
is to
tent
bed
can
one
be
can
the
piping
window-tent
night, the
away
window
of
plumber
any
a
raiang
If
little expense.
Advantages
time
poor,
are
consumptive
of
the
Windowtent
in
Winter.
sufferer
the
lies
of
rest
the
well
while
serves
the
in
much
aside
Laying
when
that
he
and
that
The
other
gjve the
their
In
number
does
he
to
deprive
his
less
members
patient
was
loved
and
a
of
the
of
ones
needs
their
on
and
warm
to
side,
that
he
it
the
of
a
need
feels
warmth
and
feel
dow.
win-
patient
their
will
family
poor
comfort
to
room
if the
as
closed,
the
room,
hinderance
family,
air he
all the
one
the
front
advantages
than
burden
in
tent
no
open-air
importance
happiness.
that
they
can
suffer
not
for
comfort.
winter
of
throughout
as
more
to
not
is
there
economic
the
heat
obliged
not
if
than
warmer
as
entirely
that
shiver
not
While
quite
was
fact
his
vital
respects.
be
not
window
be
of
is
many
will
need
takes
patient
treatment
the
family,
members
the
for
living-room
as
press
or
the
patient's bed
blankets
the
down
tire
to
night.
upon
him.
assure
Still,the
the
The
body
must
be
his
absolute
coverings
and
tightly
make
woven
with
covered
a
comfort
should
the
Warm
and
be
not
patient
blanket
sufficient
is
a
warmth
heavy
so
feel
fortable
uncom-
better
ering
CovBut
not
too
Heavy
EssentiaL
pro-
is
100
TUBERCULOSIS
tection
than
AB
the
of blankets
loosely
woven
is, alas, often
tell them
put several
to
l"I8"ASg
A
To
one.
limited,
very
of
layers
make
the
the
such
cap,
is shown
as
Some
Cold
the
wooiienHoadorHeiin
Sleeping
patients
the
"
culty
I counsel
instances
colored
material
This
eyes.
the
ing the
Ml.
the
""T
Utilized
for
be
observed
the
tent
bed
*
have
early
diffi-
t
In
again.
such
light-weight but
hose)
lisle-thread
the
to
put
inconvenience
by merely
finds
patient
there
be
himself
in
^.
the
service
l
darkhis
over
caused
by
away,
be
raised
to
and
with
the
can
warm
and
case
for
be.
may
window-tent
the
roof,
or
rest
the
during
cure
in
its
The
day.
The
place.
height by wooden
necessary
rais-
ready
room,
reclining-chair put
the
the
the
window
u
veranda,
for
and
^.
the
as
massage
or
garden,
no
into
put
is moved
latter
is
the
closing
^.
also
can
the
thev
-
sleep
some
obviate
to
too
,
to
going
have
to
black
a
that
,
When
can
as
usually sufHces
toilet, sponge-bath
Window-
be
(such
,.^^
.,
tent
patient
that
that
complin
them
bright light.
It will
How
the
m
a
helmet,
30.
\
Westher.
with
ears
oftsn
and
moHiing,
in
sweater
a
woollen
bright light awakens
jn
and
cold
sleej)ing
wear
Fig.
will
tainly
cer-
light,
and
or
in
This
.
extremely
head
shawl,
mends
recom-
layers of paper
should
his
protect
"woollen
1905,
while
patient
window-tent,
and
Out-Door
In
to
coverings.
cheap,
a
covering.
weather,
the
dozen
a
disposal
advice
good
layers of flannel
two
warm
whose
December,
half
will
tor
may
be
of
sew
between
Fia.30."
poor,
between
lAfe
to
MASSES
the
it
newspapers
OvidooT
met
THE
OF
blocks
or
a
th
platform,
Reclinise
Chair
Day.
by
t^"
can
room
be
breathes
window,
open
aerotherapy,
according
to
it is of
the
should, however,
hours
be
attending
physician
gradually
accustomed
A
hot-water
often
must
be
be
bottle
necessary
kept
warm
the
few
will
to
in
if he
air.
that
it must
the
patient
him
upon
that
during
regulate
live
the
extreme
is to
in
feet
all
the
beneflt
this
pure
either
cold
the
in
be
the
mght
air
in the
tent
as
to
cold
weather.
done
to
day
bed
tur
or
of
in
The
by the open-air
the
gradually
cold.
is
the
as
for
chair.
get the
day
the
this
beginning
in
so
air from
front
in
When
of
hours
the
patient, being
begin by placing him
to
for
comforters
essential
impressed
a
and
outdoor
only
susceptibility
night, and
at
blankets
and
course
It is best
air.
day
as
aid of
excluded,
It
pure
a
few
The
patient
and
chair
night.
may
patient's feet
treatment.
AND
Review
Historical
of
United
Movement
States.
for
first private sanatorium
The
101
IT.
Antituberculosis
the
THE
IN
COMBAT
TO
HOW
tuberculous
patients
was
tablished
es-
First
Dr.
by
It
followed
was
the
some
devotion
the
consumptive
of
Dr.
E.
established
climatic
advantages
to
any
It
was
and
of
opened
first State
of
act
the
It
patients
Since
State,
and
States
State
the
and
Mass.,
Lake.
Sanatorium,
of
United
States.
construction
authorized
by
in
for
opened
tives
in the
enthusiasm
The
was
for
Consump-
Boston.
Massachusetts
was
The
regard
near
the
to
consumptives
personal
without
Bowditch.
Y.
the
of
1895.
of
reception
1, 1898.
and
then,
of
and
its existence
owes
for
Rutland,
Oct.
of the
Vincent
sanatorium
at
on
It
of Dr.
Legislature
is situated
Sharon
the
was
large city
a
establishment
Saranac
of
toria
Sana-
(1875).
ago
through
poor
Trudeau,
near
1890.
work
personal
the
an
in
L.
j^'ears
the
(1884) by
for
first sanatorium
thirty
some
later
years
first sanatorium
efforts and
Gleitzmann
J. W.
particularly during
of
the
have
sanatoria
municipal
Union,
the
at
are
or
five
past
established
been
this
private.
years,
in
many
projected
moment
in
or
of construction.
course
In
there
1903
established
was
called
Stony
the
at
Lake
N.
Kushaqua,
which
Sanatorium,
Wold
is
Y.,
unique
an
stitution
in-
of its
kind.
It
its
owes
physicians,
it
inception
Mrs.
consecrated
is
to
to
children
and
and
hearted
of wealth.
women
first
seaside
children, called
the
by
the
of two
maintained
Shrady;
F.
of
treatment
York
New
Geo.
Mrs.
consumptive
noble-
by
mainly
First
Breeze,
for the
wives
and
for
sanatorium
Sea
Society
Newcomb
exclusively
workingwomen
The
thoughtful
the
E.
James
tuberculous
established
was
of
Improvement
few
a
the
and
scrofulous
years
(1904),
ago
Condition
of
the
Poor,
torinm
is situated
The
first
by
Dr.
Throat
The
dispensary
the
to
Nose
first
of Clinic
class
in
the
United
tuberculosis,
of
Bermingham
States,
inaugurated
was
this
City,
at
the
was
for
Pulmonary
dren.
in
New
1894
York
First
cial
SpeTuber-
dispensary
established
Chil-
sively
exclu-
devoted
Hospital.
municipal
poor
name
J.
Island.
of
treatment
Edward
and
Coney
on
for
Tuberculons
and
side
Sea-
Sana-
by
for
the
Diseases
the
city
of
treatment
of
of the
New
Health
York
the
under
sumptive
con-
the
Department.
oolosis
Dis-
pensa
102
TlTBEBCtJLOSlS
It
started
was
the
Biggs,
Since
established
F*
t
ciety
First
and
Com-
mittee
^^^
The
^^^Sely through
c^osis^"
there
or
The
and
of the
Health
I'St
tions
Their
and
Edu-
cational
Inflnence.
of the
-d
cur.
exhibition
of
Like
educational
and
been
enlisted
installed.
by
Dr.
and
Thomas.
Morris
History.
Since
so
a
On
of the
President
one,
that
up
Newark,
of
Jesup,
then
to
regard
this
the
same
date
Organization
the
it has
of the
been
Indianapolis, Chicago,
and
of
has
shown
facts
made
Health;
become
of
a
in Boston,
Milwaukee,
Grand
had
had
by
McClellan;
B.
Museum
diar
its prevention
were
George
an
culosis.
tuber-
country
of the
addresses
as
charts,
disease
the
American
exhibition
Society
against
Commissioner
the
the
campaign
Hon.
the
on
planned
to
evening,
the
was
it
demonstration
York,
was
for
Committee
the
all parts
from
December
to
exhibition
Association
Charity
Public
tuberculosis
27
The
and
in January,
Commission
models, photographs,
opening
of
gospel
important
exhibition
with
Darlington,
K.
the
of
of New
of the
cost, prevention,
causes,
National
the
comprehensive
the
city
60
Maryland
November
wide-spread
means
facts
City
the
objective presenta^
Museum.
Baltimore
the
the
the
an
most
from
of
Cooperation
cure.
been
Mayor
by
main
etc., the
the
the
in
It showed
the
and
in Baltimore
and
Tuberculosis
of
measure
1902,
Ph.D.,
Society
Tuberculosis
was
next
History
Tuberculosis
York.
grams,
held
of the
Health
of
auspices
Prevention
Prevention
Devine,
spreading
was
York
in New
the
in
tuberculosis.
T^e
Natural
under
active
Organization
organizations, and
to
exhibition
This
held
the
at
and
of New
of
Board
tuberculosis.
was
organized
Study
T.
history, distribution, varieties,
of
9, 1905,
State
15
joint auspices
Association.
tion
Flick,
only
founded
was
Organization
exhibition
State
Maryland
F.
the
was
Charity
Edward
Charity
curability
the
the
relief work
least
first tuberculosis
1904, under
of
all devoted
committees
preventability
society
the
,was
Lawrence
This
been
first secretary.
at
are
have
tuberculosis
Dr.
March
States.
United
of
by
of Prof.
the
opened
was
patients
of the
M.
Hermann
ago.
and
Committee's
To-day
societies
Prof.
of
1892
Committee
efforts
of
general secretary
Tuberculosis
in
president.
educational
the
MASSES
for tuberculous
prevention
five years
Tuberculosis
doing
THE
initiative
larger cities
the
founded
^^^^
^^
until
first
Society
S^^^^^^^^
for
Society
organization
for
of the
society
*^"^
^^
the
OF
Officer of the city,and
dispensaries
in many
j"rst
JPennsylvania
8
Medical
then
DISEASE
A
through
mainly
General
1, 1904.
The
AS
and
by
Natural
traveling
phia,
Philadel-
Rapids,
104
TUBERCULOSIS
of the
Phipps
through
the
Institute
the Head
now
The
of the Educational
Medical
Profession
^^
^^"
British
tional Eecent
Tuber-
culosis
in
represented this country on that occasion and
honored
by being elected as vice-presidentswere
W.
Billings,
J.
Councilman,
Charles
Congresses
those
Among
1901.
^'^^
Frank
officially
resented
rep-
was
Tuberculosis
tuberculosis
on
mainly
Klebs, who is
of that Institution.
States
in International
Congress
Interna-
United
in 1906,
C.
Arnold
Department
of the
for the first time
Chicago
in
of Dr.
enthusiasm
MASSES.
THE
OP
established
was
efforts and
DISEASE
A
AS
those
who
such
names
were
as
Denison, George Dock,
Congresses, ^y. A. Hare, A. Jacobi, E. G. Janeway, H. M. King, H. P. Loomis,
J. H.
Musser,
G.
Shattuck,
J.
Thomas,
and
B.
At
the
in
Otis, Arthur
Shattuck,
S. Weir
Tyson,
International
1905, the
official
an
E.
S.
Rowley
Solly,A.
Mitchell, W.
also
were
such
McCarthy
At
have
the
the
Profession
men
of
next
H.
K.
Reynolds,
Stone,
Welch,
C.
F.
R.
Arthur
J. C.
Wilson,
as
Profession
Brannan
of New
medical
York,
of this congress
Tuberculosis
will be the first time
country by
well
the
Congress
as
the
its presence,
Public
at
the
White
of the United
of
in
that this
and
the
large should
Cleveland,
was
soon
given to
in the
Washington
distinguishedbody
Medical
American
rejoicein the
greatest minds
Plague
whom
Angeles, etc.
invitation
an
meet
There
Knopf.
centers, among
Lowman
Los
prospect of having the
against
and
in
represented
was
President
the
Beyer, Flick,Jacobs,
the various
convened
which
Congress
Medical
Philadelphia,Pottenger of
This
our
combat
Capital.
as
closingsession
and
the
of Drs.
delegatesfrom
fall of 1908.
will honor
Tuberculosis
American
delegationappointed by
States,composed
were
in
O.
others.
Paris
by
Edward
tinction
dis-
engaged
gathered
in
our