Evening star. [volume] (Washington, D.C.) 1854-1972, 1906-06-16
THE WHITE DEATH.
How the Fight Against Tuberculosis
Now Stands.
From the New York Herald.

From the New York Herald
There is perhaps nothing bearing on the
education of the public regarding protective
sanitary matters that has borne better fruit
than the increasing knowledge of the
causes, prevention and cure of tuberculosis
Fortunately, too, the continued discussion
of the subject has always an abiding inter-
est And why not, when fully 10000 die
yearly of the disease In the United States
alone?
Until 1882. when Koch first announced
his brilliant discovery OF the tubercle bacu-
LUIS, the essential cause of the disease was
more or less a mystery. Since then tho
argument against the extension of the dis
ease has been based on sound logical prin-
cipIes and accurate scientific knowledge. It
appeals to the popular mind, and the ortii-
narily intelligent person is willing TO listen
and learn. No one is sure that he may not
at any time be a hapless victim to the I'M
duly prevalent scourge.
For this reason the daily press Is striy-
ing in its earnest, untiring and direct way
to perform its legitimate missionary work
That the Herald has endeavored to do
articles that have appeared in its columns
1t Is the insistence OF line upon line and
precept upon precept"
Here, therefore, comes a message from
Koch himself as to How the Fight Against
tuberculosis Now Stands" published In the
recent issue of the London Lancet.
AS might be expected. he takes broad
views and advocates wholesale metno liz.
Much as has already been done in pre-
venting the extension Of the plague. much
more is required. The public must under
stand better why infection spreads before
1t can properly appreciate the present scitn-
tific attitude on the question. The dissemi-
nation of infected sputum by cough
pectoration Is at the bottom of the whole
business. The patient becomes particularly
dangerous when he Is personally uncleanly
or becomes too weak TO care for himself.
Light and air not only kill the baciili, but
at the same time strengthen the resistance
of the threatened victim. Tuberculosis thus
becomes house disease. The smaller the
house and the closer and more filthy the
quarters the greater the danger. For the
susceptible individual under such conditions
what chance is there If he Is cooped up
with a tuberculous patient who eXpec-
torates countless millions of bacilH dally3
1t is the concentration OF the poison that
does its work in the long run.
But how to remedy these apparently
simple difficulties Is still a great problem
In dealing with the man and his house
from the standpoint of necessary reform
there is sociological impeachment that is
more and more apparent as We examine
It. We can possibly educate him TO see
his errors, but at best this Is a slow pro-
cess. Even If he believee ne is wrong he is
not always able to right himself Plainly.
then, the state must come in to help him.
The first step in such a direction is the
normal notification OF his trouble The
starting point for the combating OF all pestt-
lences, says Koch, lis notification, because
without it most cases of disease would re-
main unknown"
The prejudice against compulsory notifi-
cation is the fear of hospitals and other
restrictive measures. But the answer is
that the victim should be shown that such
course is to his advantage and that OF
those. nearest him. Hospital treatment is,
of course, the ideal one. but Is at present
unattainable. No room can be found for
the thousands of sufferers. Fortunately,
however, 1t is not necessary to thus lodge
all tuoercuious patients. A goodiy majority
might be treated in their homes and only
the advanced and dangerously helpless pa
tients sent to special institutions. The go
betweens are the special dispensaries, aptiy
named "care stations The more of these
the better. Germany. which has carried the
system TO reasonable perfection, uses them
as clearing houses for the distribution
and allotment of all chance cases.
How to apply all these sensible sugges-
tons of the eminent German savant TO our
own needs must yet be great questions for
our municipal authorities to settle. What
seem to be necessary most of all are hospi-
tails for advanced cases, as the latter are
the most fruitful sources OF dangerous dis
senlination of the disease. The worst end
for helpless and hopeless victim is 10
coIlght his life away In a garnet and thus
poison the few friends who stand by him
as best they can in his last emergency.