The Anti-Spitting Campaigns Designed to Stop the Spread of Tuberculosis

A Dr. Dettweiler sputum flask, circa 1910
A Dr. Dettweiler sputum flask, circa 1910

In the 19th century, cities were grimy places, where thousands of people lived in overcrowded tenement buildings and walked streets polluted with trash, sewage, and the carcasses of dead animals. Unsurprisingly, these cities were also hotbeds of infectious disease.

One of the leading causes of death was tuberculosis, which spreads from person to person in the tiny droplets that spray through the air when an infected person coughs or sneezes. "In the 19th century, tuberculosis [was] the greatest single cause of death among New Yorkers," explains Anne Garner, the curator of rare books and manuscripts at the New York Academy of Medicine Library and the co-curator of the Museum of the City of New York’s new exhibition, "Germ City: Microbes and the Metropolis."

In the 19th century, tuberculosis killed one in every seven people in Europe and the U.S., and it was particularly deadly for city dwellers. Between 1810 and 1815, the disease—then commonly known as consumption, or the white plague—was to blame for more than a quarter of the recorded deaths in New York City. While New York wasn't alone among urban centers in having startlingly high rates of tuberculosis, its quest to eradicate the disease was pioneering: It became the first U.S. city to ban spitting.

"BEWARE THE CARELESS SPITTER"

Anti-tuberculosis pamphlets
Tuberculosis warnings from the Committee on Prevention of Tuberculosis that appeared on New York City streetcar transfers in 1908, reprinted by the Michigan Board of Health in 1909

In 1882, Robert Koch became the first to discover the cause of tuberculosis: a bacterium later named Mycobacterium tuberculosis, which he isolated from samples taken from infected animals. (Koch won the Nobel Prize in 1905 for his work.) He determined that the disease was spread through bacteria-infected sputum, the mix of phlegm and spit coughed up during a respiratory infection. That meant that rampant public spitting—often referred to as expectorating—was spreading the disease.

In 1896, in response to the growing understanding of the threat to public health, New York City became the first American metropolis to ban spitting on sidewalks, the floors in public buildings, and on public transit, giving officials the ability to slap wayward spitters with a fine or a jail sentence. Over the next 15 years, almost 150 other U.S. cities followed suit and banned public spitting [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-spitting slogans such as "Spitting Is Dangerous, Indecent, and Against the Law," "Beware the Careless Spitter," and "No Spit, No Consumption." They made posters decrying spitting (among other unhealthy habits) and reminding people of the ban. Members of the public were encouraged to confront defiant spitters, or, at the very least, give them the stink eye. While there were many other factors to blame for the spread of tuberculosis—like dangerously overcrowded, poorly ventilated tenement housing and widespread malnutrition—public spitters became the literal poster children of infection.

New York City officials followed through on the threat of punitive action for errant spitters. More than 2500 people were arrested under the statute between 1896 and 1910, though most only received a small fine—on average, less than $1 (in 1896, that was the equivalent of about $30 today). Few other cities were as committed to enforcing their sputum-related laws as New York was. In 1910, the National Tuberculosis Association reported that less than half of cities with anti-spitting regulations on the books had actually made any arrests.

Despite the law, the problem remained intractable in New York. Spitting in streetcars posed a particularly widespread, and disgusting, issue: Men would spit straight onto the floor of the enclosed car, where pools of phlegm would gather. Women wearing long dresses were at risk of picking up sputum on their hemlines wherever they went. And the law didn’t seem to stop most spitters. As one disgusted streetcar rider wrote in a letter to the editor of The New York Times in 1903, “That the law is ignored is evident to every passenger upon these public conveyances: that it is maliciously violated would not in some cases be too strong an assertion.”

The situation wasn’t much better two decades later, either. “Expectorating on the sidewalks and in public places is probably the greatest menace to health with which we have to contend,” New York City Mayor John Francis Hylan said in a 1920 appeal for citizens to help clean up the city streets.

THE BLUE HENRY

A blue sputum flask
New York Academy of Medicine Library

Spitting laws weren't the only way that health authorities tried to rein in the spread of TB at the turn of the century. Anti-tuberculosis campaigns of the time also featured their own accessory: the sputum bottle.

Faced with the fact that sick people would cough up sputum no matter what a poster in a streetcar told them, in the late 19th century, doctors and health authorities all over the world began instructing people with tuberculosis to spit into pocket-sized containers, then carry it around with them. “A person with tuberculosis must never spit on the floor or sidewalk or in street cars, but always into a cuspidor or into a paper cup, which he should have with him at all time, and which can be burned,” advised the New York City Department of Health’s 1908 publication Do Not Spit: Tuberculosis (Consumption) Catechism and Primer for School Children. These containers were known as cuspidors, spittoons, or simply sputum cups or sputum bottles.

Among the most well-known of these sputum-carrying receptacles was the “Blue Henry,” a pocket flask made of cobalt-blue glass that was originally manufactured by the German sanatorium pioneer Peter Dettweiler, who himself had suffered from tuberculosis.

“The sputum bottle was like a portable flask that could be used to collect this sticky phlegm that was produced by the irritated lungs of a person suffering from tuberculosis,” Garner says. While they came in various shapes, sizes, and materials, the fancier versions would have a spring-loaded lid and could be opened from both sides, so that you could spit into a funnel-like opening on one side and then unscrew the bottle to clean out the sputum receptacle later.

Dettweiler's device and the similar devices that followed became popular all over the world as doctors and governments sought to contain the spread of tuberculosis. These receptacles became a fixture in hospitals and at sanatoriums where tuberculosis patients went to recuperate, and were a common hand-out from anti-tuberculosis charities that worked with TB-afflicted 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-based clients better food, new beds, and of course, sputum cups. (Likely the paper kind, rather than the glass Dettweiler flasks.) The generosity wasn't unconditional, though. The society would potentially pull its aid if charity workers showed up for a surprise home inspection to find unsanitary conditions, like overflowing sputum cups that were not being properly disinfected [PDF].

Eventually, the city itself began handing out sputum cups. In an effort to reduce the contagion, by 1916 a large number of cities—such as Los Angeles, Seattle, and Boston—dedicated part of their municipal budgets to paying for tuberculosis supplies like paper sputum cups that would be handed out to the public for free.

A ad for anti-TB supplies from the Journal of Outdoor Life
An advertisement that ran in the Journal of Outdoor Life—which billed itself as “the anti-tuberculosis magazine"—in 1915

Though paper sputum cups could be burned, glass or metal flasks had to be cleaned regularly. Doctors recommended that the sputum bottles contain a strong disinfectant that could kill off the tuberculosis bacilli, and that the receptacles be cleaned and disinfected every morning and evening by rinsing them with a lye solution and boiling them in water. As for the sputum itself, burning was the preferred method of sanitizing anything contaminated with TB at the time, and sputum was no exception—although rural consumptives were encouraged to bury it in the garden if burning wasn’t practical.

In an era where infectious disease was often associated with poor, immigrant communities, sputum bottles made it possible to go out in public without drawing the same attention to your condition that hacking up phlegm into the street would. “You could discreetly carry them around and then take them out and people wouldn’t necessarily know that you were suffering from the disease,” Garner explains. Or at least, somewhat discretely, since they soon became widely associated with consumptives. A Dr. Greeley, for one, argued that ordinary sputum bottles were “so conspicuous as to be objectionable," and suggested people spit into toilet paper and put that in a pouch instead. That idea didn't quite take off.

And while hiding your infectious status is not good 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 patient’s room after they died to prevent germs from spreading. Those that remain are now collector's items, held in the archives of institutes like Australia's Museums Victoria; the Museum of Health Care in Kingston, Canada; and the New York Academy of Medicine Library.

TUBERCULOSIS TODAY

Unfortunately, neither anti-spitting propaganda nor sputum flasks managed to stop the spread of tuberculosis. Real relief from the disease didn’t come until 1943, when biochemist Selman Waksman discovered that streptomycin, isolated from a microbe found in soil, could be an effective antibiotic for tuberculosis. (He won the Nobel Prize for it, 47 years after Koch won his.)

And while carrying a cute flask to spit your disease-ridden phlegm into sounds quaint now, tuberculosis isn’t a relic of the past. Even with medical advances, it has never been eradicated. It remains one of the most devastating infectious agents in the world, and kills more than a million people worldwide every year—the exact number is debated, but could be as high as 1.8 million. And, like many infectious diseases, it is evolving to become antibiotic resistant.

Sputum flasks could come back into fashion yet.

Hard Sell: A History of the Pet Rock

Amazon
Amazon

You may have heard the story of the Pet Rock, the Mexican beach stone that could be purchased in bulk for less than a penny, retailed for $3.95, and made inventor Gary Dahl a millionaire during a kind of novelty gift hysteria in late 1975. But Dahl didn’t really get rich off of the rock.

He got rich off of a cardboard box.

Dahl was working as a freelance advertising copywriter in California that year when, while having drinks at a bar with friends, the conversation turned to the destructive nature of pets. Dogs and cats ruined furniture. Worse, they required constant attention, from being walked to being fed to cleaning up after them. Dahl said that he didn’t have to worry about any of that because he had a “pet rock.”

It was, of course, a joke. And it got a laugh. But Dahl decided there could be more to it than that. He went home and began writing an owner’s manual for this hypothetical pet rock, which detailed how best to handle it, the tricks it could perform (“play dead” being the most popular), and how it could remain a faithful companion due to its “long life span.” The gag was not so much the rock itself but the way it was presented. In addition to the manual, Dahl conceived of a cardboard box with air holes that resembled the kind used by pet shops. It also bore a passing resemblance to a McDonald's Happy Meal container.

 

Dahl's motivation in making a serious effort to monetize his pet rock idea was due in large part to his precarious financial situation at the time—he was struggling to keep up with his bills. He recruited George Coakley and John Heagerty, two colleagues, to come on as investors. They both signed on, with Coakley investing $10,000—a not-inconsiderable sum in 1975, especially when the intention was to sell virtually worthless rocks.

The Pet Rock packaging is pictured
Wikimedia Commons // Public Domain

Dahl, however, knew what he was marketing. Like chattering teeth, the Hula Hoop, and other fads, the Pet Rock was the beneficiary of good timing. Vietnam had ended but Watergate was still fresh; the country’s mood was slightly downcast, and Dahl believed people would see the inane nature of the Pet Rock and recognize the humor of it. He boxed the rocks with the manual and packed them in excelsior, which may be best known as comic book legend Stan Lee’s catchphrase but also means a softwood shaving pile meant for protecting fragile items. The rocks were purchased from a local sand and gravel company, which sourced them from Mexico’s Rosarita Beach. Dahl debuted the rock at a gift show in San Francisco in August of 1975, then waited for a reaction.

He got one. People understood the appeal right away and he began taking orders. Neiman Marcus wanted 1000 rocks. Bloomingdale’s later signed on. Newsweek did a story with a picture, which spread the word. Dahl had retail and media credibility for what was superficially a nonsense product. His bar joke was turning into a national phenomenon.

When the holiday season arrived, Dahl estimated he was selling up to 100,000 Pet Rocks a day. Ultimately, he would sell between 1.3 and 1.5 million of them within a period of just a few months. Coakley made $200,000 back on his initial $10,000 investment. Dahl gifted both Coakley and Heagerty with Mercedes. Making 95 cents in profit on each Pet Rock sold, Dahl earned over $1 million. He launched his own firm, Rock Bottom Productions, which was itself another joke. “You’ve reached Rock Bottom” is how the receptionist answered their phone.

 

The fad did not last—by definition, they’re not designed to—but Dahl was satisfied. His two investors were not; they "claimed they had received too small a share of the profits" and later sued Dahl for more revenue. After a judgment in the investors' favor, Dahl wrote them a six-figure check.

The Pet Rock is pictured
Amazon

There were attempts to prolong the life of the rock by offering a Bicentennial version in 1976—it had the American flag painted on it—and mail-order college degrees for them. Dahl sold Pet Rock T-shirts and Pet Rock shampoo. There were also copycat gifts, since Dahl could not really patent a rock. (He might have been able to obtain a utility patent because of the rock’s particular purpose as a companion, but he did not.) The humor was transient, however, and people had moved on.

Dahl had other ideas. There was the Official Sand Breeding Kit, which claimed to provide guidance on growing sand, and Canned Earthquake, which consisted of a coffee can that had a wind-up mechanism that caused it to jump around on a table. Neither was particularly successful. Dahl’s real passion, though, was buying and renovating a bar in Los Gatos, which he named Carrie Nation’s Saloon.

This was not without its problems, as people who believed they had the next Pet Rock would often stop by the bar to try and secure an audience with Dahl for his insight. Many times, their idea consisted of packaging bull or elephant excrement. There were also proposals to market a pet stick. Dahl had no patience for these inventors, believing the Pet Rock could not be duplicated. Later, he went back to advertising after taking what he described as an “eight-year vacation” following the success of his project.

The Pet Rock can still be found online, though it’s no longer Dahl’s business. He died in 2015. Of the unsold rocks he had left over at the end of the fad, he was indifferent. If they didn’t sell, he said, he would just use them to repave his driveway.

Submarine Expedition Reveals Parts of the Titanic Have Fully Decayed

NOAA/Institute for Exploration/University of Rhode Island
NOAA/Institute for Exploration/University of Rhode Island

In 1985, oceanographers Robert Ballard, Jean-Louis Michel, and their crew located the wreck of the RMS Titanic at the bottom of the Atlantic Ocean. Images of the shipwreck have since become as iconic as photographs of the ocean liner taken before the 1912 tragedy. But the ruin's time in the ocean is limited. As part of an upcoming documentary, a crew of scientists carried out the first manned expedition to the wreck in 14 years and discovered the Titanic is rapidly decaying, BBC reports.

After it sank, the Titanic settled in two parts on the seafloor about 370 miles off the coast of Newfoundland, Canada. Most of the wreck is still intact, but a lot has changed since 2005, when it was last visited by a human-occupied submersible.

While working on a film for Atlantic Productions London, an exploration team from Triton Submarines visited the wreck five times over eight days and discovered that entire sections of the ship have disappeared. The starboard side of the officer's quarters has deteriorated, and the captain's bathtub is totally gone. The deck house on the same side and the sloping lounge roof of the bow are also on the brink of collapse, according to the crew.

Unlike other artifacts and historic sites, there's no way to preserve the wreckage of the Titanic for future generations. Churning ocean currents, corrosive salt, and metal-eating bacteria will continue to break down the steel behemoth until it becomes part of the sea. Some experts estimate that by 2030, it's likely that no part of the wreck will remain.

Whether that projection is off by years or decades, these findings suggest that every new team that visits the Titanic may find something different than the team before them. On this most recent expedition, the Triton Submarines exploration team was able to film the wreck in 4K for the first time. That footage may end up being some of the last ever captured of many elements of the ship.

[h/t BBC]

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