The southern sentinel. (Winnfield, La.) 1883-1910, 1904-06-30
The Duty Of the
State IN Restricting
tuberculosis
By HAROLD N. MoYER. N. D.

With an Increasing recognition of the
infectious nature OF tuberculosis has
come tendency to urge legislation that
should restrict the spread of the disease
by quarantining the consumptive. The
educational effect of this propaganda is
apparent in certain legislative enact
ments which have tended to impose bur-
densome restrictions upon the consump-
tive and his friends. In certain COM
munities to which consumptives COM
monty resort something like panic has
developed due to the fear of contagion.
Teaching of this kind is pernicious in the
extreme and will ultimately fail Of its
aim. A shotgun quarantine and most
rigid segregation would not materially
restrict the spread Of tuberculosis. Such
view of tuberculosis does not express
the underlying factors by which it is
propagated. 1t does not recognize that
tuberculosis is house and factory bred
disease, and while the element of per-
sonal contagion is present, it is by no
means the dominating factor. The most
important lesson that recent years have
taught in the study of tuberculosis is
that individual resistance is the impor-
tant factor in preventing its spread.
Large numbers of autopsies show that
a very large percentage of those who die
have at one time in their lives been in
fected with tuberculosis and have re-
covered. This shows that the element
of exposure is almost universal, and that
no matter what care an individual may
take to avoid personal contact with con-
sumptives, he will almost inevitably ac-
quire the disease. 1t also shows that the
element of vital resistance is the most
important factor in its treatment and
care, as more than two-thirds of those
who get tuberculosis recover spontane-
ously and never know that they have
the disease.
The reported cases Of personal con-
tagion show 1t plays only an insig-
nifcant role in the spread of tubercu-
losis, particularly II we eliminate those
cases In which the environment is the
same and make proper allowances for
lowered family resistance, which is the
| main factor In what is understood by
heredity as applied to tuberculosis. A
full recognition of these facts would pre-
vent unnecessary laws restricting the
movements of the tuberculous. Such
laws are essentially cruel and they ere
ate in a community an unnecessary
dread of the individual afflicted with the
disease and consequently lead to great
hardship with no corresponding advan-
tage. It is doubtful II any system Of
compulsory notification would be Of
value, particularly il It were coupled
with system OF notification by which
| Il would become known that particu.
lar individual was suffering from tuber-
| culosis. A further and very good reason
| why laws of this kind should not b.
passed is the doubt which still remains
| as to exactly how tuberculosis Is spread
| When the bacillus was first discovered
II was a natural conclusion that the
| expectoration OF consumptives dried and
puIverized and inhaled by healthy indi.
viduals was the means by which the dis
ease was conveyed. No one has definite
" proven that this Is the chief methot
OF transmitting the disease. but it wal
SO fascinatingly simple that 1t at once
1 gained general acceptance. It is still
the favorite theory. though some very
1 good observers, such SIS Behring, be
1 lieve that almost the sole means o
spreading tuberculosis Is by ingestini
the bacilli with the food. In view o
these uncertainties ard Of the folly o
attempting to limit by segregation o.
other means the movements Of thu
chronic tuberculous, restrictive ant
compulsory statutes should not be en-
acted. The work of the state shouls
be limited to the education Of the cen
sumptive and his family with the activ'
cooperation Of the family physician.
One Of the most important problems
In the restriction of tuberculosis Is tn
carly recognition of the Individual case
The significance of the early loss Of ap
petite. sleepleesness, slight cough ant
the general failure of health is not ap
preciated until abnormal sounds develop
il the chest or there is abundant sputun
together with fever and night sweats
the unquestioned signs Of tuberculosis
when this stage II reached the oppor
tunities for treatment are lessened an
the possibility Of arrestirg the diseas
is limited. Such an individual tor
number OF months after this stage !
q reached becomes an active cultur
ground for the breeding of the hacill
Hence from the standpoint OF restric
ton the recognition and cure OF the In
diyidual case early in the diseaseis mos
important. In this way the productio
of the contasion Is limited and the Id
bility Of spreading the infection to oth
en- Is ;essened. One Of the most impol
tant Of the early diagnostic signs is tn
recognition Of the presence Of the tube'
lie bacillus In the sputum. 1t may 3
safely asserted that large proportio