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of Guardians to make special provision for housing such cases away from other inmates,
and, preferably, in establishments quite distinct. Different Boards might be enabled
to unite for such a purpose, and also for the purpose of providing country hospitals for
the treatment, with a view to the cure, of the disease. Expenditure for such purposes
would probably be a profitable investment of public moneys. The Kensington Guardians
might be approached on the subject by the Vestry, as Sanitary Authority. The present
time would seem to be an appropriate one to do so, as the Guardians are contemplating
the erection of an additional block (at an estimated cost of £13,000) to provide improved
and increased accommodation for women and children at the workhouse. It is just
. possible that, by making provision for consumptives away from the workhouse and
infirmary, the additional accommodation thus set free would, in part at least, obviate
the necessity for the proposed expenditure. But, apart from this point altogether,
the matter is one in regard to which the sanitary and the poor-law authorities might
take counsel together with advantage."
The recommendations of the committee, in the report, as finally settled, were to the effect
that the Vestry" do adopt means* for the prevention and cure of consumption and tubercular
diseases generally, e.g.:—
"(1) By spreading information as to the nature and cause, the preventability and curability
of tuberculosis, and especially of consumption; and by inculcating the necessity of
thorough cooking of meat, and the boiling of milk.
"(2) By disinfection of houses after the occurrence of fatal cases of consumption, and after
removal of consumptives to new abodes."
The report of the committee having been referred back, in order to give effect to these
recommendations, the sub-committee requested me to state my views as to the action that should be
taken by the Vestry. Briefly, I advised the preparation of a leaflet for distribution to medical men,
clergymen, head teachers of schools, &c. I also advised disinfection of infected houses, and a
system of voluntary notification (vide Report, in Minutes of the Vestry, June 14th, page 204).
A leaflet (" The Prevention of Consumption ") was duly prepared and circulated (vide Minutes of
the Vestry, page 206). I estimated that disinfection would be required in from 200 to 300 cases
annually, at an average cost of one pound per case, and stated that "further assistance would be
necessary in the disinfecting department." I also expressed the hope that an effort would be made
to secure, as recommended by the sub-committee, " enforcement of the provisions of sanitary law
for the prevention of overcrowding, and the abatement of nuisances generally, so as to secure
healthy homes for the poorer classes." But beyond circulation of the leaflet nothing was done.
The subject of "Tuberculosis" was again dealt with in the first monthly report in 1900
(January 31st, page 7); the following paragraph referring to the matter dealt with in the deleted
par. 6, in the sub-committee's report above cited :—
"No additional accommodation has been, or is to be, provided at the workhouse, the Local
Government Board having refused their sanction to the projected extension, on the
ground that already there was a sufficient number of persons on the space occupied
by the workhouse and infirmary. Possibly the Guardians, if their attention were called
to the subject by the Vestry, as sanitary authority, might entertain favourably the
suggestion to provide, apart from their present infirmary, requisite accommodation
for consumptive persons dependent on their assistance."
No action having been taken on this report, I addressed a communication to the Clerk to the
Board of Guardians (February 15th, 1900), as follows :—
" I am sending you a copy of my report submitted to the Vestry yesterday, and desire to
call your attention to par. 7, page 7, on the subject of ' Tuberculosis.' I also send you
a copy of the report of a sub-committee of the Sanitary Committee, dated March, 1899,
dealing with 'The prevention of Consumption and other forms of Tuberculosis.' I
think it would be well to invite the attention of the Guardians to the subject. In
some parts of the country, I believe, action has been taken by the Poor Law Authority
to secure separation of consumptives from other sick persons. I should be glad if the
Kensington Guardians, alone or in combination with other Boards, could see their way
to adopt this plan. I dealt with the subject in two of the monthly reports last year,
and should the Guardians take up the matter, than which I can conceive of none other
more important, I shall be pleased to furnish copies of the reports, and to assist them
in any way within my power."
This communication was referred to the Infirmary Committee for consideration, and their
report thereon was adopted by the Guardians as follows:—
"Report of the Infirmary Committee with respect to the separate treatment of Tubercular
diseases.
"Your Committee have had under consideration the letter from the Medical Officer of
Health for Kensington upon the subject of the prevention of Consumption and other
forms of Tuberculosis, together with his suggestions as to the treatment of tuberculous
cases separate from other patients, either by the Guardians in their own Infirmary,
or in combination with other Boards in separate Institutions specially provided for the
purpose.
* The sub-committee recommended " all practicable means." The words in italics were deleted by the committee.