In the nineteenth century , city were grimy position , where thousands of people last in overcrowded tenement building and walked streetspollutedwith trash , sewage , and thecarcassesofdead creature . Unsurprisingly , these cities were also hotbeds of infectious disease .
One of the direct causes of demise wastuberculosis , which spreads from person to person in the tiny droplets that spray through the gentle wind when an infected mortal coughs or sneezes . " In the 19th century , TB [ was ] the greatest single cause of death among New Yorkers , " explains Anne Garner , the conservator of rare rule book and manuscripts at the New York Academy of MedicineLibraryand the co - curator of the Museum of the City of New York ’s newexhibition , " Germ City : Microbes and the Metropolis . "
In the 19th century , tuberculosis kill one inevery sevenpeople in Europe and the U.S. , and it was particularly deadly for city dwellers . Between 1810 and 1815 , the disease — then commonly known as pulmonary tuberculosis , or the blank plague — was to charge for more than a quartern of the register deaths in New York City . While New York was n’t alone among urban nub in have startlingly high rates of T.B. , its quest to eliminate the disease was pioneering : It became the first U.S. city to ban spitting .
“BEWARE THE CARELESS SPITTER”
In 1882 , Robert Koch became the first to find the cause of T.B. : a bacterium later namedMycobacterium T.B. , which he isolated from samples taken from infected animals . ( Koch won the Nobel Prize in 1905 for his oeuvre . ) He determined that the disease was disseminate through bacteria - infected sputum , the mix of phlegm and tongue coughed up during a respiratory infection . That meant that rampant public spit — often referred to as expectorating — was circulate the disease .
In 1896 , in response to the growing understanding of the threat to public wellness , New York City became the first American urban center to ban spitting on sidewalk , the floors in public buildings , and on public theodolite , yield officials the ability to slap perverse spitter with a fine or a jail sentence . Over the next 15 years , almost 150 other U.S. cities trace case and banned public expectoration [ PDF ] .
The New York City health department and private groups like the National Tuberculosis Association , the Women ’s Health Protective Association , and the Brooklyn Anti - Tuberculosis Committee generated anti - spittingsloganssuch as " Spitting Is Dangerous , Indecent , and Against the Law , " " mind the Careless Spitter , " and " No Spit , No economic consumption . " They madepostersdecrying spitting ( amongotherunhealthy substance abuse ) and cue hoi polloi of the ban . member of the public wereencouragedto face defiant spitter , or , at the very least , give them the stink oculus . While there were many other factors to blame for the spread of tuberculosis — like perilously overcrowded , ill vent tenement housing and widespreadmalnutrition — public spitters became the literal poster nestling of infection .
New York City officials followed through on the scourge of punitory activity for errant spitters . More than 2500 masses were arrested under the legislative act between 1896 and 1910 , though most only meet a small fine — on average , less than $ 1 ( in 1896 , that was the eq of about $ 30 today ) . Few other cities were as attached to enforcing their phlegm - related laws as New York was . In 1910 , the National Tuberculosis Associationreportedthat less than half of urban center with anti - spitting regulations on the books had actually made any arrests .
Despite the constabulary , the problem remain intractable in New York . Spitting in streetcars flummox a particularly far-flung , and disgusting , issue : Men would spit straight onto the story of the enclosed car , where pool of phlegm would gain . woman fall apart long dresses were at risk of nibble up phlegm on their hemline wherever they cash in one’s chips . And the constabulary did n’t seem to block off most spitters . As one sick trolley passenger write ina letterto the editor program ofThe New York Timesin 1903 , “ That the law is ignored is evident to every passenger upon these public transport : that it is maliciously violated would not in some cases be too strong an asseveration . ”
The situation was n’t much better two decade later , either . “ Expectorating on the sidewalks and in public places is probably the superlative menace to health with which we have to argue , ” New York City Mayor John Francis Hylansaidin a 1920 appeal for citizen to help clean up the city streets .
THE BLUE HENRY
spew law were n’t the only agency that health authorization tried to rein in the spread of TB at the turn of the 100 . Anti - tuberculosis effort of the time also featured their own accessory : the phlegm bottleful .
Faced with the fact that sick masses would cough up phlegm no matter what a poster in a streetcar told them , in the late nineteenth century , doctor and health authority all over the world began instructing the great unwashed with tuberculosis to spit into pocket - sized container , then deport it around with them . “ A person with tuberculosis must never spit out on the trading floor or pavement or in street gondola , but always into a cuspidor or into a newspaper cup , which he should have with him at all meter , and which can be burned,”advisedthe New York City Department of Health ’s 1908 publicationDo Not Spit : Tuberculosis ( Consumption ) Catechism and Primer for School Children . These containers were known as spittoon , spittoons , or simply sputum cupful or phlegm bottles .
Among the most well - known of these sputum - carrying receptacle was the “ Blue Henry , ” a air hole flaskful made of atomic number 27 - patrician glass that was originally fabricate by the German loony bin pioneer Peter Dettweiler , who himself had suffer from tuberculosis .
“ The sputum bottleful was like a portable flask that could be used to collect this mucilaginous phlegm that was produce by the irritated lungs of a soul suffering from tuberculosis , ” Garner sound out . While they came invarious shapes , sizes , and material , the fancier adaptation would have a spring - loaded palpebra and could be opened from both side , so that you could pitter-patter into a funnel shape - like opening on one side and then unscrew the bottleful to clean out the phlegm receptacle later .
Dettweiler ’s twist and thesimilar devicesthat followed became popular all over the world as doctors and government sought to contain the spread of TB . These receptacles became a secureness in infirmary and at sanatoriums where TB patient went to go back , and were a common bridge player - out from anti - tuberculosis charities that worked with TB - smite patients .
In the early 1900s , the New York Charity Organization Society was one of them . Its Committee for the Prevention of Tuberculosis raised money to buy its New York City - base client better food , new bed , and of grade , phlegm cups . ( in all likelihood the theme kind , rather than the glass Dettweiler flasks . ) The generousness was n’t categoric , though . The society would potentially perpetrate its aid if charity proletarian show up for a surprisal dwelling house review to discover unsanitary condition , like brim over sputum cup that were not being properly disinfected [ PDF ] .
finally , the city itself began handing out sputum cup . In an effort to quash the contagion , by 1916 a big numberof cities — such as Los Angeles , Seattle , and Boston — consecrate part of their municipal budgets to pay for tuberculosis supplies like paper sputum cups that would be handed out to the public for free .
Though paper sputum cup could be burned , glass or alloy flasks had to be cleaned on a regular basis . Doctors recommended that the sputum bottles contain a strong disinfectant that could vote down off the tuberculosis bacilli , and that the receptacles be clean anddisinfectedevery morning and even by rinsing them with a lye solution and boiling them in water . As for the sputum itself , burn was the preferable method acting of sanitizing anything contaminated with TB at the time , and phlegm was no exception — although rural consumptives wereencouragedto bury it in the garden if burning was n’t practical .
In an era where infective disease was often associate with poor , immigrant community of interests , sputum bottles made it possible to go out in public without drawing the sameattentionto your condition that cut up up languor into the street would . “ You could discreetly carry them around and then take them out and people would n’t inevitably bang that you were suffering from the disease , ” Garner explains . Or at least , moderately discretely , since they presently became widely associated with lunger . A Dr. Greeley , for one , contend that average sputum bottles were “ so blatant as to be objectionable , " andsuggestedpeople expectoration into toilet newspaper and put that in a pouch or else . That approximation did n’t quite take off .
And while hide your infectious position is not dependable for public health , the sputum flasks did lower the risk that you were infecting the people around you as you coughed and sneezed . “ As long as you were doing it into the bottle , you probably were not infecting other people , ” Garner says .
Not many of these sputum bottles have survived , in part because it was standard practice to burn everything in a tuberculosis affected role ’s room after they died to prevent germ from spread . Those that continue are now gatherer ’s items , held in the archive of institute like Australia’sMuseums Victoria ; theMuseum of Health Carein Kingston , Canada ; and the New York Academy of Medicine Library .
TUBERCULOSIS TODAY
Unfortunately , neither anti - spitting propaganda nor sputum flask managed to arrest the spread of tuberculosis . veridical relief from the disease did n’t come until 1943 , when biochemist Selman Waksman discovered that streptomycin , isolated from a microbe find in territory , could be an in effect antibiotic drug for tuberculosis . ( He won theNobel Prizefor it , 47 twelvemonth after Koch won his . )
And while carrying a cute flask to ptyalize your disease - ridden flatness into sounds quaint now , tuberculosis is n’t a relic of the past . Even with aesculapian progress , it has never been exterminate . It remain one of the most devastating infectious agents in the domain , and kills more than a million hoi polloi worldwide every year — the accurate number isdebated , but could be as high-pitched as 1.8 million . And , like manyinfectious diseases , it is evolving to becomeantibiotic resistant .
Sputum flasks could come in back into mode yet .
