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from reaching other persons. The intestinal diseases from which so many young children die in hot weather are caused to a great extent by germs taken in impure milk, but these germs can also be carried by water or by flies. A little baby should be kept away from other children that have such diseases.

Questions: 1. How do typhoid germs leave the body? 2. Are typhoid germs hard to kill? 3. What are some of the ways in which they may be scattered? 4. What can we do to keep the disease from spreading? 5. What are some of the ways in which we can protect ourselves from typhoid germs? 6. What other disease germs are spread in the same way as typhoid germs?

Discuss with the

Suggestions and topics for development: class the Rules for the Care of Typhoid Patients issued by your City or State Board of Health. Show that it is cheaper to use disinfectants liberally in case of typhoid fever than it is to allow other members of the family to become infected, as is often done. Find out the chief sources of infection in your community and discuss methods of avoiding infection. Teachers who live in rural communities should show how wells and springs are often infected by washing clothes where the drainage reaches them or by the hands of some one who is taking care of a typhoid patient. By multiplying the number of typhoid deaths in your city or state by 8 or 9, the approximate number of cases of the disease will be obtained. It is estimated that the direct cost of the average case in loss of time and medical fees is $240.

Almost every State Board of Health issues posters and bulletins on typhoid fever and intestinal diseases. Obtain copies of these for the children in the class from the Board, and discuss the facts brought out in them. Encourage the children to be on the watch for conditions in the community which may lead to infection of the water supply of families or of the school.

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FIG. 99. An open-air school for children who have tuberculosis. Most of the children in these schools improve in health at once. (After a photograph in The Survey, March 5, 1910.)

TUBERCULOSIS has spread itself through the whole world. In the warm tropics the people fall before it, and in the frost-bound regions of the earth it is well known. It finds its way into the mansions of the rich and it enters the cottages of the poor. It causes the death of one seventh of the human race, and in our own country one person in every ten dies of it. The germ that causes this disease may grow almost anywhere in the body, and we may have tuberculosis of the bones, of the kidneys, of the intestines, or of any other part of the body. By far the most common form of the disease, however,

is tuberculosis of the lungs, or consumption. This disease has long been called the Great White Plague, and the germ that causes it has been well named the Captain of the Men of Death.

Tuberculosis an expensive disease. Consumption is a long, lingering disease, and it often attacks people at the time of life when they are earning a living not only for themselves but for others as well. For these two reasons it is one of the greatest of all causes of poverty. Exactly how much this disease costs our country in money it is not possible to say, but one estimate places the figure at a billion dollars a year.

The germ of tuberculosis. The germ of tuberculosis withstands drying longer than most germs, and in a damp or dark house it sometimes remains alive for months. It attacks many animals as well as man, and cattle especially suffer from this disease. It grows slowly, and usually the germ has been in the body for months before the disease shows itself. It gets into the body either by being breathed into the lungs or by being swallowed and carried through the body in the blood.

1 In the city of Washington it was found that about one half of all the poverty in the city was due to sickness, and that as a cause of poverty consumption was far more important than any other disease. Every day in the United States tuberculosis makes orphans of over two hundred children under twelve years of age, and it has been found that out of every ten children in the county homes for children in Indiana, four are there because one or both parents have died or have become unable to work because of consumption.

Tuberculosis germs spread from consumptives and in milk. Tuberculosis germs do not grow in

Early treatment

Late treatment

FIG. 100. Of con

sumptives who begin treatment early in the disease, 76 in 100 re

cover or have the disease arrested.

Of those who be

gin treatment in the late stages of the disease, only

the fields and pastures. They are not found in the rain or on the leaves of the trees. They come from the people and from the cattle that have tuberculosis, and they get into our bodies by way of the mouth or the nose. This means that if we are to check the disease we must keep the germs from spreading from the people and the cattle that are carrying them.

How tuberculosis germs are spread from consumptives. Millions of germs are coughed up in a day by a consumptive and they are always in his mouth. If the patient is a careless one, the germs will surely get on his hands and clothes. They are left on drinking cups and dishes that are used by consumptives, they 19 in 100 recover or have the disease may be in food or milk that a conarrested. (From sumptive has handled, or they may the experience of the State Sana- be left on pencils, books, door knobs, torium at Rutland, or on anything that he has touched. Massachusetts.) If the sputum is not carefully destroyed, the germs will get on furniture and clothing, they will be carried about by flies, they will get into food and drinking water, and in many ways they

will reach other persons and start the disease in them. When a consumptive coughs he may send out into the air for several feet droplets of saliva that are full of germs. A consumptive therefore should hold a handkerchief or paper napkin before his mouth when he coughs, lest some other person breathe in the droplets and the germs that fly from his mouth.

Spitting a most dangerous habit. Spitting on floors, sidewalks, or similar places is a habit that is most dangerous to the health of a community. When tuberculosis germs are left in such a place, they are a great danger to the children that play among them, they are carried into houses on shoes and trailing skirts, they are spread by flies to food exposed in stores and houses; and in many other ways they are carried about. Not more than half the people who have tuberculosis germs in their mouths know it, and no one should spit on the sidewalk, in the street car, or on the floor of a public building or private house.

Germs from a consumptive should be destroyed. The first great point in preventing the spread of germs from a consumptive is to destroy the sputum. It should be received in a pasteboard cup or on a piece of cloth. This should then be burned, and not left where flies can get to it or where the germs may become scattered about in other ways. The dishes of a consumptive should

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