The disease usually dwelled in the city, or in areas with poor sanitation and over crowding, where the lack of hygiene allowed the infection to multiply quickly. Infection from tuberculosis occurs in two ways, either by the respiratory route or by drinking milk infected with the tubercle bacillus. Most humans acquire tuberculosis by inhaling minute droplets of the disease, spread by sneezing, coughing and even talking, which can contain hundreds of infectious cells. Once acquired, tuberculosis attacks the lungs with vigor. Often a person does not feel any symptoms apart from a raspy cough that lingers for months.
Proper nutrition is crucial in fending off further infection from the disease.
Without adequate food and rest, however, infection can seep into the bloodstream and throughout the body, causing severe damage to the bones and joints. At this stage, recovery from the highly fatal disease is unlikely. Winter turned into spring as Hope waited for Trimble's return. Hope knew Trimble's health was failing despite Trimble's determination to fight off the infection. Finally, a letter came saying that Trimble couldn't hold on much longer.