A Handbook of Health by Woods Hutchinson (learn to read books .txt) 📖
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Every black dot represents one case reported. The groupings show how rapidly the disease spreads from one household to another in the same locality.
HOW TO CONQUER CONSUMPTION
Different Forms of Tuberculosis. The terrible disease tuberculosis is the most serious and deadly enemy which the human body has to face. It kills every year, in the United States, over a hundred and fifty thousand men, women, and children—more lives than were lost in battle in the four years of our Civil War. It is caused by a tiny germ—the tubercle bacillus—so called because it forms little mustard-seed-like lumps, or masses, in the lungs, called tubercles, or "little tubers." For some reason it attacks most frequently and does its greatest damage in the lungs, where it is called consumption; but it may penetrate and attack any tissue or part of the body. Tuberculosis of the glands, or "kernels," of the neck and skin, is called scrofula; tuberculosis of the hip is hip-joint disease; and tuberculosis of the knee, white swelling. "Spinal disease" and "hunch-back" are, nine times out of ten, tuberculosis of the backbone. Tuberculosis of the bowels often causes fatal wasting away, with diarrhea, in babies and young children; and tuberculosis of the brain (called tubercular meningitis) causes fatal convulsions in infancy.
Four hundred and seventy-seven cases in one month—February, 1909.
Tuberculosis of the Lungs—How to Keep it from Spreading. Tuberculosis of the lungs is the most dangerous of all forms, both because the lungs appear to have less power of resistance against the tubercle bacillus, and also because from the lung, the bacilli can readily be coughed up and blown into the air again, or spit onto the floor, to be breathed into the lungs of other people, and thus give them the disease. Two-thirds of all who die of tuberculosis die of the pulmonary, or lung, form of the disease, popularly called consumption.
The first thing then to be done to put a stop to this frightful waste of human life every year is to stop the circulation of the bacillus from one person to another. This can be done partially and gradually by seeing that every consumptive holds a handkerchief, or cloth, before his mouth whenever he coughs; that he uses a paper napkin, pasteboard box, flask, or other receptacle whenever he spits; and that these things in which the sputum is caught are promptly burned, boiled, or otherwise sterilized by heat. The only sure and certain way, however, of stopping its spread is by placing the consumptive where he is in no danger of infecting any one else. And as it fortunately so happens that such a place—that is to say, a properly regulated sanatorium, or camp—is the place which will give him his best chance of recovery, at least five times as good as if he were left in his own home, this is the plan which is almost certain to be adopted in the future. Its only real drawback is the expense.
But when you remember that consumption destroys a hundred and fifty thousand lives every year in this country alone, and that it is estimated that every human life is worth at least three thousand dollars to the community, you will see at once that consumption costs us in deaths alone, four hundred and fifty million dollars a year! And when you further remember that each person who dies has usually been sick from two to three years, and that two-thirds of such persons are workers, or heads of families, and that tens of thousands of other persons who do not die of it, have been disabled for months and damaged or crippled for life by it, you can readily see what an enormous sum we could well afford to pay in order to stamp it out entirely.
One of the most important safeguards against the disease is the law that prevents spitting in public places. Not only the germs of consumption, but those of pneumonia, colds, catarrhs, diphtheria, and other diseases, can be spread by spitting. The habit is not only dangerous, but disgusting, unnecessary, and vulgar, so that most cities and many states have now passed laws prohibiting spitting in public places, under penalty of fine and imprisonment.
In a suspected case, the physician sends a specimen of the sputum to the Laboratory to be tested, and receives a reply according to the result of the test. The form is filled in with the name of the patient and signed by the Director of the Laboratory.
The next best safeguard is plenty of fresh air and sunlight in every room of the house. These things are doubly helpful, both because they increase the vigor and resisting power of those who occupy the rooms and might catch the disease, and because direct sunlight, and even bright daylight, will rapidly kill the bacilli when it can get directly at them.
How great is the actual risk of infection in crowded, ill-ventilated houses is well shown by the reports of the tuberculosis dispensaries of New York and other large cities. Whenever a patient comes in with tuberculosis, they send a visiting nurse to his home, to show him how best to ventilate his rooms, and to bring in all the other members of the family to the dispensary for examination. No less than from one-fourth to one-half of the children in these families are found to be already infected with tuberculosis. The places where we look for our new cases of tuberculosis now are in the same rooms or houses with old ones. A careful consumptive is no source of danger; but alas, not more than one in three are of that character.
But, being necessary, it should be strictly respected and obeyed.
It has been estimated that any city or county could provide proper camps, or sanatoria, to accommodate all its consumptives and cure two-thirds of them in the process, support their families meanwhile, and stop the spread of the disease, at an expense not to exceed five dollars each per annum for five years, rapidly diminishing after that. If this were done, within thirty years consumption would probably become as rare as smallpox is now. Some day, when the community is ready to spend the money, this will be done, but in the mean time, we must attack the disease by slower and less certain methods.
Note the number of deaths from tuberculosis to one from smallpox; yet smallpox before the days of vaccination and quarantine, was the universal scourge. Similarly, by preventive measures, we are controlling the other diseases. Why not also tuberculosis? (Statistics for greater New York, 1908; total number of deaths from all causes, 73,072.)
Why the Fear and Danger of Consumption have been Lessened. Terrible and deadly as consumption is, we no longer go about in dread of it, as people did twenty-five years ago, before we knew what caused it; for we know now that it is preventable and that two-thirds of the cases can be cured after they develop. The word consumption is no longer equivalent to a sentence of death. The deaths from tuberculosis each year have diminished almost one-half in the last forty years, in nearly every civilized country in the world; and this decrease is still going on.
The methods which have brought about this splendid progress, and which will continue it, if we have the intelligence and the determination to stick to them, are:—First, the great improvements in food supply, housing, ventilation, drainage, and conditions of life in general, due to the progress of modern civilization and science, combined with a marked increase in wages in the great working two-thirds of the community. Second, the discovery that consumption is caused by a bacillus, and by that alone, and is spread by the scattering of that bacillus into the air, or upon food, drink, or clothing, to be breathed in or eaten by other victims. Third, increase of medical skill and improved methods of recognizing the disease at a very early stage. A case of consumption discovered early means a case cured, eight times out of ten.
Its Cure and Prevention. Fortunately, the same methods which will cure the disease will also prevent it. The best preventatives are food, fresh air, and sunshine. Eat plenty of nourishing food three times a day, especially of milk, eggs, and meat. Sit or work in a gentle current of air, keep away from those who have the disease, sleep with your windows open, take plenty of exercise in the open air, and you need have little fear of consumption.
In the camps, or sanatoria, for the cure of consumption, these methods are simply carried a little further, to make up for previous neglect. The patients sit or lie out of doors all day long, usually in reclining chairs, in summer under the trees, and in winter on porches, with just enough roof to protect them from rain or snow. They sleep in tents, or in shacks, which are closed in only on three sides, leaving the front open to the south. They dress and undress in a warm room, or the curtains of the tent are dropped, or the shutters of the shack closed night and morning until the room is warmed up. In cold climates they dress day and night almost as if they were going on an arctic relief expedition, and spend twenty-four hours out of the twenty-four in the open air.
They eat three square meals a day, consisting of everything that is appetizing, nutritious, and wholesome, with plenty of butter, or other fats; and in addition, drink from one to three pints of new milk and swallow from six to twelve raw eggs a day. You would think they would burst on such a diet, but they don't; they simply gain from two to four pounds a week, lose their fever and their cough, get rid of their night sweats, and usually in from two to five weeks are able to be up and about the camp, taking light exercise. When they have reached their full, normal, or healthy weight for their height and age, their amount of food is reduced, but still kept at what would be considered full diet for a healthy man at hard work. If sick people can be made well by this open air treatment, those of us that are well ought not be afraid to have a window open all night.
Two-thirds of the treatment that would cure you of consumption will prevent your ever having it. While tuberculosis chiefly attacks the lungs, it is really a disease of the entire body, or system, and cannot attack you if you will keep yourself strong, vigorous, and clean in every sense of the word.
How to Recognize the Disease in its Early Stages. To recognize the disease early is, of course, work for the doctor; but he must be helped by the intelligence of the patient, or the patient's family, or he may not see the case until it is so far advanced as to have lost its best chance of cure. We can now recognize consumption before the lungs are seriously diseased. Among the most useful methods with children is the rubbing or scratching of a few drops of the toxin of the tubercle bacillus, tailed tuberculin, into the skin. If the children are healthy, this will leave no mark, or reddening, at all; but if
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