land, found that only eleven of one thousand cases which he investigated had lost husband or wife by the disease, and our own Dr. Flint states that there were but five such instances in 670 cases observed by him.
Previous to the discovery of the bacillus, such observations as those last mentioned led many to doubt that consumption was communicable at all. It may be well, then, to consider a few other facts pointing to the same conclusion, as they are important in arriving at correct views on the whole matter. Chief among them may be mentioned the experience of the Brompton and Victoria Park Hospitals of London, where consumptives have been treated for many years. It is well to recall at the same time that special precautions against contagion have not been taken until recently. It was stated in 1882 that of sixty or seventy physicians employed at these hospitals during twenty years, but five had been attacked by consumption, of whom two died. The record of the large number of nurses employed during the same period, and whose relations with the sick were more intimate than those of the doctors, was still better; there were but two cases, and one of these was doubtful. One of the physicians to these hospitals. Dr. Williams, says that though he has been watching for twenty years he has not yet met with a case in which alleged contagion could be sustained, after close investigation. He adds that while the disease may be contracted in this way, the circumstances must be extremely favorable. At the Vienna General Hospital, where 2,736 deaths from consumption occurred in three years, not a physician or nurse was known to have contracted the disease. Nearly every one has known of relatives or friends who have lived in the most intimate relations with consumptives for long periods and have suffered no injury whatever.
Now, it does not follow from these observations that we are mistaken in assuming that consumption is communicable. We shall see in a moment that there is a good reason for exceptional instances. It is quite possible, though, that in our enthusiastic zeal to deal with it and stamp it out on this basis other important considerations are being neglected. Destruction of clothing and renovation of rooms seem to have been pretty thoroughly practiced in Naples and other places a hundred years ago without making any impression on the death-rate. Improvements in general sanitary conditions at Naples, however, have in these later times had a marked effect. It is, to be sure, highly important to destroy or disinfect sputa, and to discourage in general the pernicious practice of expectorating. The sputum is the very fountain-head from which the army of bacilli is re-enforced. This does not necessarily imply, however, that the concentration of our
