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occurred. Consumptives frequently infect the persons with whom they
live, and a systematic medical examination of the family of a consumptive
patient will frequently bring to light other cases in the
incipient stages, when a cure may be confidently expected if proper
treatment be adopted. Efforts are made by the health visitors, in cases
where infection is suspected, to induce the suspected patient to be
medically examined, but usually without success, for he is often too poor
to consult a private doctor, and the out-patient departments of Mount
Vernon and the Brompton Hospital are too far off to be readily
available for Hampstead patients.
Provision is required, not only for the discovery of cases, but also
for the regular medical supervision of the patients. It was formerly
thought that proper supervision could only be secured in a sanatorium,
and that the most effective means of prevention was the establishment of
sanatoria. It has now been shown that consumptives can be successfully
treated at home, provided that they are subject to systematic
medical supervision, and that sanatoria are chiefly of value as affording
the patients a preliminary training in the habits and ways of living
necessary for their own recovery and for the prevention of infection to
other persons.
The most effective and inexpensive method of attacking consumption
is by means of the dispensary system. The work of the tuberculosis
dispensary consists in the supervision of the open-air treatment of
consumptives in their own homes, and the detection of cases of consumption
in persons who have been exposed to infection by living with
a consumptive patient. The dispensary requires no elaborate buildings,
an ordinary house can readily be adapted for the work, and in a district
like Hampstead the staff need not consist of more than a doctor and a
nurse. The dispensary can readily co-operate with other organisations,
such as sanatoria and relief agencies, and is, indeed, necessary for their
proper development. Tuberculosis dispensaries are now being established
all over the country. A dispensary was started in Paddington two
years ago, one began work in St. Marylebone last year, and others
are on the point of beginning work in other parts of London. It was
of consumption that King Edward asked the question: "If preventable,
why not prevented?"— a question that has never been answered—and
I think the Borough Council could set up no more appropriate or useful
memorial to his late Majesty than a tuberculosis dispensary,