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from the conditions affecting the use or occupation of any room, when used or occupied by the poor person
as a sleeping apartment; and
(iv.) furnish, for the use of the poor person on loan, or otherwise, any appliance, apparatus, or utensil
which will be of assistance for the purpose of any precaution against the spread of infection.
(3) A council, on the advice of their medical officer of health, may provide and publish, or distribute in the
form of placards, handbills, or leaflets, suitable summaries of information and instruction respecting pulmonary
tuberculosis, and the precautions to be taken against the spread of infection from that disease.
The Order therefore provides for pulmonary tuberculosis to be dealt with as an infectious
disease, and this view and the steps which should be taken in connection therewith are clearly expressed
in a memorandum by the Medical Officer of the Local Government Board, which points out the several
measures, educational and administrative, deemed to be necessary in respect of persons so suffering.
The provision (2) (iii.) of Article IX. of the Order quoted above appears to enable sanitary
authorities to exercise very wide powers in respect of the most necessitous class of the community;
such, indeed, as would tend to amelioration of the conditions under which such persons suffering
from pulmonary phthisis are now living. It would, for instance, probably be competent for these
authorities to provide hospital and sanatorium accommodation for such cases, or to give assistance
which would ensure that a separate sleeping room were provided for their use. In such way, if the
removal of the sick person to hospital or the infirmary were not feasible, the assistance might take the
form of provision of an additional room so as to prevent in future such conditions as those mentioned in
the annual reports relating to Hackney, Finsbury and Chelsea, which are referred to later.
The London County Council was not included in the Order of the Local Government Board,
and such information as is available is contained in the annual reports of medical officers of health,
which has been supplemented by periodical returns kindly supplied by the medical officers of health
of the following nineteen districts, viz., Kensington, Hammersmith, Fulham, Chelsea, St. Marylebone,
Hampstead, Islington, Stoke Newington, Hackney, Shoreditch, Bethnal Green, Stepney, Poplar, South.
wark, Bermondsey, Battersea, Camberwell, Lewisham and Woolwich.
The following table shows the number of cases of phthisis notified in the several districts of
London and the number of deaths occurring in workhouse institutions, the latter obtained from
tables contained in the annual summary of the Registrar-General:—

It must be remembered that the deaths in workhouse establishments shown in the table stand in
relation to a much larger number of sick persons than those whose illness had been notified in 1909, nevertheless
the number of cases notified in that year is probably larger than that which will be notified in
subsequent years, unless efforts are made to search in the homes of the poor for those who are affected.
The cases notified are, indeed, the majority of those poor persons whose illness has so far advanced
that they are driven by stress of sickness to seek the aid of the poor law medical officer. The figures of
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1 See footnote (2), page 6.
I