Dr. Claude A. Smith: This question of tuberculosis is one of the great questions which confronts this profession at the present time. It can not be solved hastily, but we should go at it slowly and surely and consider it from every point of view. I heartily agree with the idea of educating the masses, for we can accomplish very little without the co-operation of the people. If the people only understood the disease thoroughly we would have far less trouble in preventing its spread. The idea of passing laws to control these patients is one that we should approach cautiously. When we talk of forcing people to do something which they do not understand then we are on dangerous ground. The first thing to do is to educate thepeople. Every year we have some very excellent papers read before this Association in regard to this disease and its prevention, and these papers are freely discussed and the members are practically of the same accord in their views, and yet no definite action has been taken in the matter or anything accomplished. Therefore, it seems to me that a committee should be appointed at this meeting to take up this matter in an intelligent manner and to report at the next annual meeting such suggestions as they deem proper in regard to this disease. Dr. Kime: Dr. Smith has just forestalled me in the idea which he has presented, as I was just rising to present the following resolution: Resolved, That a standing committee of five (each member to serve five years) be appointed from this Association to investigate the conditions in our own State and suggest methods of education on the subject and prevention of tuberculosis and work in unison with other similar organizations in the State. Dr. Hooten: The key-note to the situation is education. It has been my experience that the history of the disease is something like this: The patient contracted a bad cold some time ago and kept hoping that it would get better with the home remedies, and by the time they reach the doctor they are in the advanced stages. The treatment should have been instituted some time previously, but the people do not understand that a bad cold may be a serious matter. When we adopt some course whereby the public could be taught to understand the gravity of these troubles, then I believe that we would make the most important step of all toward the prevention of tuberculosis. Dr. Todd: This discussion is very gratifying to me. It shows the progress of the medical profession and how slowly the truth is disseminated. I remember that my old professor, Dr. Dixon, of Philadelphia, was regarded as rather extreme when he said that he feared to say that this disease was contagious. Now, of course, there is no doubt about its contagion. We saw families dying off for years, but did not recognize that it was contagious until its germ character was proven. It took us a long time to learn this. The fetal heart beat for years before we realized that this little drum was heralding a new life. I remember that I read a paper before this Association some years ago on this subject, and there was no comment on it because it was too new. Education is the thing; disseminate literature and let the people know that the man with tuberculosis in the last stages, with his lungs breaking down, is spreading two billions of the bacilli daily. Wake them up to the fact that this man is dangerous to the community. It is through ignorance that the disease increases. While I agree that climatic treatment is the best, yet it is not the only treatment. When it comes to sending patients away from home, we must remember that some are not able to stay at home, much less go away, and as Drs. Clark and Harbin have said, we have a climate here that is unsurpassed, and we need not send our patients away to get well or die, but let them stay here in Georgia. But remember that climate is not everything. We have the hypophosphites, alcohol, arsenic, and other medicines, and they have been used so long that we know they must have some curative virtues, and we are certain that they are adjutants that will help. We must not go wild about climatic treatment. Dr. L. H. Jones: I am glad that Dr. Todd mentioned the use of alcohol in the treatment of tuberculosis. I believe that infinite harm has been done by the indiscrim:nate prescribing of alcohol in tuberculosis, and that more are injured than are benefited. If the patient is lacking in appetite, a little alcohol may increase the appetite and do good, but I believe that this is the only way that it does any good. The great desideratum, of course, is nourishment. It is essentially a disease in which the patient loses flesh. The name "consumption" means a burning up and wasting away of flesh. Some think that you can not get too much alcohol, but I think that it will help to kill the patient. I am satisfied of this in my own mind and want to enter a protest against the indiscriminate prescribing of whiskey. To say that it is easily oxidizable in the human body is not saying that it is a food. We do not know that it is a food. We can not say that it conserves any useful purpose in the body, and we may be interfering with physiological processes when we don't know what we are doing. Dr. Todd: I was not talking about the abuse of alcohol, but of its use. Dr. Jones: I am not criticising Dr. Todd, but I believe in most cases of tuberculosis the so-called use of alcohol is its abuse. Dr. Lockhart: I only wish to speak of one phase of this question, that presents itself to us in the way which ne groes have tuberculosis. When I first began to practice medicine there was not a negro in all the land that was known to have tuberculosis, but now every time you see a negro funeral you may say that there goes another that has died of tuberculosis! This is a matter of great importance to us as doctors or as citizens, because we know that these people as servants come more or less in contact with us in our daily life and in our homes, and they are the ones who cause the rapid spread of the disease. Dr. Roy: I believe that tuberculosis is communicable, but I also think that the bacilli must have proper food in order to be propagated. I lived for two years in a hospital where there were fifty or sixty tubercular patients, and in the wards nurses had to stay all the night, but there was never a case that was not traceable to an inherited tendency. It is well known that we can get the tubercle bacillus in the secretions and not have tuberculosis develop in the body. But, I believe that we are on the right track, as it is possible for tubercle bacilli to pass from one person to another. However, observation has shown that the way to control the disease is to start in the cradle and take the child and watch it in its growth. If there is not the proper food in the body of the individual for the tubercle bacillus, then I do not believe that the disease will produce the ravages that it now makes. We hear of cases where pneumonia has been followed by tuberculosis because the disease has rendered the lung incapable of performing its function and there results a proper soil for the tubercle bacillus. We should keep the respiratory tract in as good a condition as possible from the beginning of life. There are cases of children where the nose is filled and stopped up with secretions, thus causing them to become mouthbreathers. It is well known that the nasal tract is for the purpose of purifying the air that goes into the lungs, and if there is obstruction, the air is taken into the lungs be fore it is purified, and thus the tubercle bacilli have a better chance of getting into the lungs. If we will watch these cases in the beginning and build the body up gradually and give them fresh air and sunshine, etc., we will find that we can prevent the disease time and again. Dr. O'Daniel: Consumption is confined to two classes, millionaires and paupers. Take the child that is born with the silver spoon in its mouth and it eats ice-cream and lives on sugar and is usually very pale. There are those who do not take the proper amount of exercise and who are living under strained, unnatural conditions, and who do not have the proper food and clothing. While I believe in educating the people, yet our work will be principally among these two classes, the millionaires and the paupers. Of course, I mean where consumption is acquired, these two classes are most apt to acquire it. Any class may inherit it. Dr. Hardman: I think that Dr. Roy has touched upon one phase that is exceedingly important, and as fully imPertani as any other phase of the subject. I think that we are paying a great deal of attention these days to the raising of stock and cattle, and breeding them to a high state, but I think that we are paying too little attention to the raising of children. Doubtless there is not a man in this assembly who has not inhaled some tubercle bacilli, ani yet they did not devolop the disease. We begin to prepare the soil for the disease in childhood. When we send our children to school year in and year out, and keep thera there without sufficient exercise and fresh air, we are inviting them to be physical weaklings. There is a great deal of attention at the present time given to calisthenics, physical culture, etc., but this is not equal to old time "cat" and open air romping. As cne eminent mau has said, we should treat our children as we do our linen, wash them, hang them out in the air, and iron them. As to diet, give |