INTRODUCTION AND SUMMARY "The physician must not only be prepared to do what is right himself but also to make the patient, the attendants and externals coöperate." It is well for every patient to understand the nature of this disease, and what his problem is. It is no easy problem and a large percentage of patients fail in the attempt to solve it. The disease, tuberculosis, is the most widespread in the world; it occurs everywhere, you might say, that man lives, from the north polar regions to the equator and south to the south pole. It is more prevalent, however, in certain regions than in others. All races are prone to it. Some of them, especially those that live out of doors, do not have it until they begin to live indoors. The American Indian, for instance, is more susceptible to it since he has begun to adopt the ways of civilization. The Arabs and Bedouins and some of the African tribes do not get it until they begin to live in houses and towns. The disease is caused by a tiny, microscopic plant. It is called, as you know, the tubercle bacillus. It is not green, like the fern in the window, but is very much the color of a wall (buff), and is shaped just like a lead-pencil. It is so small that through the hole made by a pin in a sheet of paper, a thousand of these little germs could pass, side by side, without touching each other and without touching the sides of the hole. Consequently, on a particle of dust, such as we see floating in a ray of sunshine, many of these little germs can easily ride as in a chariot, and thus we may breathe them into our lungs. A curious thing about this little plant is that it differs from most other plants in two very important particulars, which everyone ought to remember. All ordinary plants, geraniums for instance, need sunshine and fresh air. This plant, this tubercle bacillus, cannot live in sunshine and it cannot live in fresh air. Give it either all the fresh air that it can get (for example, place it in a room with the windows open), or put it in the sunshine, and it will die. Sunshine will kill the tubercle bacillus, if not in a thick mass of sputum, in four or five hours, and possibly in less time. Of course in a dark corner of the room, where direct sunlight never penetrates, an exposure for two or three days to the indirect sunlight may be required to kill it, but such light will kill it eventually. In other words, light is one of the best germicides, and it will surely kill these germs. If, on the other hand, the tubercle bacillus is put in a dark place, but given plenty of fresh air, it will also die. It cannot stand either air or light. Thus, in a well-lighted and ventilated room the tubercle bacillus is very speedily killed. This leads me to say that tuberculosis is a house disease. I mean by this that it is practically never contracted out of doors but always in the house. The tubercle bacillus can live out of doors only a short time and practically never infects anybody out of doors. For instance, if a person expectorates on the pavement and someone walks in it and takes it into the house on his shoes, or brings it in on her skirts, it gets on the carpet and dries. The maid then sweeps the carpet with a broom, breaking up the sputum into fine dust which settles on the window sills, furniture, etc. The tubercle germ has no power of locomotion. It can no more move from place to place than a geranium or a tree. It depends on outside agencies to get from one place to another. A further curious thing is, that as long as it is moist, it can never get into the air except when subjected to a violent blast of air, as we shall see later. The great object, then, is to keep this germ moist. For this reason, "moist" sweeping should always be employed; that is, moist tea leaves or moist sawdust should be sprinkled on the floor, or a moist bag placed over the broom. This collects the dust so that it can be burned and does not allow it to fall upon the furniture, where the usual practice is to stir it up once more with a dry duster. This gives the germs one more chance. Here, too, "moist" methods should be employed and the duster moistened with oil for furniture, with water for paint. The duster should then be boiled. By far |