RESTRICTION AND PREVENTION 
OF 
CONSUMPTION. 
Sometimes called “Tuberculosis,” “Phthisis,” “Phthisis Pulmonalis.” “Tubercular Phthisis.” 
“Tubercular Consumption,” or “Pulmonary Consumption.” 
LEAFLET ISSUED BY THE MICHIGAN STATE BOARD OF HEALTH. 
[175.] 
Five Thousand, September, 1891. 
Consumption is the most common and fatal disease. In Michigan, 
it causes more deaths than any other disease. According to the Registra- 
tion reports, issued by the Secretary of State (1887, p. 231), the average 
annual number of deaths from consumption in this State for the nineteen 
years, 1869-1887, is 1,698; but it is believed that not more than two-thirds 
of the deaths are reported, so that the number of deaths which actually 
occur in Michigan from consumption is probably over twenty-five hundred 
per year. A large part of this mortality can and ought to be presented. 
Consumption is now known to be a communicable disease, in 
which, frequently, the contagium is carried from the dried sputum of a 
consumptive to the lungs of a susceptible person, where it grows 
and multiplies and thus produces the disease. The germ which causes 
consumption is called the Bacillus tuberculosis, and it is present 
in the sputa of consumptives. These bacilli are from about one 
twenty-thousandth to about one ten-thousandth of an inch in length, and 
have a breadth about one-sixth of their length. (From 1.5 to 3.5, by .4 
micromillimeters.) These bacilli have been thoroughly studied, and 
repeated successful inoculations have been performed on lower animals. 
Interesting experiments have been made in this connection by Dr. George 
Cornet, of the Berlin Hygienic Institute, with the dust of rooms inhabited 
by consumptives. Dust, collected from those surfaces not likely to be 
contaminated directly by the spitting or coughing of the patient, was 
mixed with sterilized bouillon and injected into the peritoneal cavity of 
guinea pigs. Forty days later the animals were killed, and a careful 
necropsy was made. Twenty-one hospital wards, in which there were 
consumptive patients were examined in this way, and from the dust of 
fifteen of them, tuberculosis was set up in the guinea pigs experimented 
upon. Private houses where consumptives lived gave similar results; 
where patients had been in the habit of expectorating on the floor, the 
dust from the walls was certain to yield infectious cultures, but where 
cloths or spittoons had been used this was not the case. 
The mode of communication of this disease is mainly from the 
dried sputa from consumptives. The germs in the sputa are carried into the 
air by sweepings, and deposited upon walls or contents of rooms, or find 
their way to the lungs of persons. 
Destruction of the Sputa.—It is evident that the only certain prevent- 
ive of consumption is to destroy the sputum from the consumptive before 
it has an opportunity to dry and scatter the seeds. It is for the consump- 
tive’s own safety to destroy the sputa, because it reduces to a minimum the 
possibility of re-infection. Any person who has an habitual cough, and 
raises sputa, should have a microscopical examination of the ‘sputa, to 
ascertain whether it contains the bacillus tuberculosis. Without waiting 
for such examination, in all such cases the sputa should be disinfected. 2 
RESTRICTION AND PREVENTION OF CONSUMPTION. 
How the Sputa Should he Destroyed.—No consumptive should expec- 
torate on the floor. Cuspidors, in hotels and other public places and in 
rooms occupied by consumptives, should be partly filled with water. They 
should be washed twice each day in boiling water, and the contents should 
be disinfected with a solution of bichloride of mercury. The cuspidor 
might well contain constantly a disinfectant, such as a five per cent solu- 
tion of carbolic acid,—one ounce of carbolic acid dissolved in a [pint and a 
half of water. 
The consumptive should carry small pieces of cloth (each just large 
enough to properly receive one sputum) and paraffined paper envelopes or 
wrappers in which the cloth, as soon as once used, may be put and 
securely enclosed, and, with its envelope, burned on the first opportunity. 
Destruction of the Dejecta.—All dejecta of a consumptive person 
should be destroyed or disinfected; because it has been shown that the 
bacilli are to be found in the urine of persons having tubercular disease of 
the urinary organs, and in the faeces of those having tubercular disease of the 
bowels, and they may be in the faeces of those who swallow sputa contain- 
ing the bacilli, that is, possibly, of any consumptive. Disinfect each dis- 
charge from the bowels by thoroughly mixing with it at least one ounce 
of chlorinated lime in powder, or one quart of “Standard Solution No. 1” 
recommended by the American Public Health Association’s Committee.* 
Ventilation of buildings.—Through better systems of ventilation, 
much may be done for lessening the number of micro-organisms inhaled 
with the dust of floors, carpets, etc., especially by having the foul-air exits 
at the floor level, so that the general motion of the foul air shall be down- 
wards, and not upwards into the nostrils of the inmates of the room. This 
is especially important with reference to all public buildings, as, also, that 
they shall constantly have a liberal supply of fresh air. 
Personal precautions.—Those who sweep and dust rooms which con- 
sumptives have occupied might well use respirators. Much may be done 
to lessen the liability to contract consumption by having the sanitary sur- 
roundings as nearly perfect as possible, and by keeping the lungs strong 
and healthy. It is stated that “in no less than sixty per cent of all 
patients dying at Bellevue hospital there were old tubercular changes in 
the lungs, the disease having been recovered from.” Similar observations 
have been made at the Philadelphia hospital, and at the Paris morgue. 
Dr. Trudeau’s experiments prove that rabbits inoculated with/the Bacillus 
tuberculosis and kept in a cellar-like place, on restricted diet, died of the 
disease in much greater proportion than did similar animals similarly 
inoculated but kept in the open air with abundance of food. These facts 
emphasize the importance of pure food, pure air, and healthful exercise. 
Exposure to cold should be avoided.—Statistics of sickness and of deaths, 
collated with meteorological statistics, seem to prove that the consump- 
tive processes go on most actively after times of low atmospheric tempera- 
ture, and least actively after times of high atmospheric temperature. 
This makes it important that consumptives, and persons susceptible to con- 
sumption, should especially guard against the inhalation of cold air. It 
enforces the importance of having such persons spend the winter and 
spring months in a climate warmer than that to which they have been 
accustomed. 
Disinfection.—The dusting of objects in the room, the cleansing of 
floors, walls, and ceiling of the living and sleeping rooms of persons suffer- 
* “Standard Solution No. 1” is made by adding to each gallon oE soft water four ounces of chloride of 
lime of the best quality, which should contain at least 25 per cent of available chlorine. “Use one quart 
of this solution for the disinfection of each discharge in cholera, typhoid fever, etc. Mix well and leave 
in vessel for at least one hour before throwing into privy-vault or water-closet.” RESTRICTION AND PREVENTION OF CONSUMPTION. 
3 
ing from pulmonary consumption should be deferred until after the room 
and contents have been subjected to the fumes of burning sulphur. 
The unwashed clothing of a consumptive should not be mingled with 
the unwashed clothing of another person; care should be taken that the 
handkerchiefs be boiled, that other articles liable to harbor the bacillus 
shall be disinfected, and that no virus come in contact with a cut or 
injured hand. 
No one should sleep in the same room wdtli a consumptive patient; or in 
a room which has been occupied by a consumptive, unless the room has 
been previously subjected to the fumes of burning sulphur. A room which 
has been occupied by a consumptive person may weli (with all its con- 
tents) be thoroughly disinfected, first subjecting it, for twenty-four hours, 
to strong fumes of burning sulphur, and then it should for several hours 
be exposed to currents of fresh air. After fumigation the walls may be 
rubbed with bread crumbs, which should then be burned. 
Rooms to be disinfected by sulphurous fumes must be vacated. For 
a room ten feet square at least three pounds of sulphur should be used; 
for larger rooms proportionately increased quantities, at the rate of three 
pounds for each one thousand cubic feet of air-space. 
Hang up and spread out as much as possible all blankets and other 
articles to be disinfected; turn pockets in clothing inside out, and other- 
wise facilitate the access of the sulphurous fumes to all infected places. 
Close the room tightly, place the sulphur in iron pots or pans which will 
not leak, supported upon bricks over a sheet of zinc or over water in a tub 
or pan, so that in case melted sulphur should leak out of the pot the floor 
may not be burned; set the sulphur on fire by hot coals or with the aid of 
a spoonful of alcohol lighted by a match; be careful not to breathe the 
fumes of the burning sulphur, and when certain the sulphur is burning 
well leave the room, close the door, and allow the room to be closed for 
twenty-four hoars. 
Roil milk from suspected sources.—While by far the greater numbers 
of cases of consumption are caused by the inhalation of the germs of the 
disease from the dried sputa, the disease may be communicated by the use 
of milk from tubercular animals. The bacilli of consumption have been 
found in the milk of cows affected with tuberculosis, even where there was 
no evidence of localized tuberculosis of the udder. Experiments indicate 
that, while heating the milk to 167° F. so weakened the virus that six 
rabbits which drank the milk did not show any traces of the disease, boil- 
ing the milk will destroy these germs. These experiments render it 
important that all milk from suspected sources be boiled before being- 
used. 
Tuberculous Meat.—The Paris Congress, for the study of tuberculosis 
in man and in animals, voted almost unanimously that the flesh from tuber- 
cular animals should be destroyed, even where the disease is only localized, 
if a large part of the organ is affected. Not only should all meat from 
tubercular animals be destroyed, but all meat from an unknown source 
should be thoroughly cooked. 
The law in this State prohibiting the sale of diseased meat is as follows: 
Section 1. If any person shall knowingly sell any kind of diseased, corrupted, or unwholesome provi- 
sions, whether for meat or drink, without making the same fully known to the buyer, he shall be punished 
by imprisonment in the county jail not more than six months, or by line not exceeding two hundred 
dollars,—§ 9316, Howell’s statutes. 
Collection of Information.—Health officers and physicians in Michi- 
gan are requested to continue to send to the office of the State Board of 
Health, at Lansing, each year, information concerning cases under their 
observation where consumption appears to have been communicated, 4 
RESTRICTION AND PREVENTION OF CONSUMPTION. 
directly or indirectly, from one person to another, the relation between 
the individuals, the presence of family predisposition, if any, and other 
interesting facts in connection with such cases. 
This diagram is accurately drawn to a scale, and the relative importance of Consumption, as a cause of deaths 
in Michigan, is, therefore, correctly shown. 
DEATHS IN MICHIGAN, 1816-81 
CONSUMPTION. 
DIPHTHERIA. 
TYPHOID FEVER. 
SCARLET FEVER. 
WHOOPING-COUGH. 
SMALL-POX. 
MEASLES.