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unfortunately by those persons who although they have
phthisis, a diagnosis of this disease has not been made.
The disease also is spread, in the case of young children,
by the specific organism in cow's milk: it has been proved
over and over again that in tuberculosis of the udder of a cow
there are tubercle bacilli in the milk, and it is to this fact that
the extensive prevalence of tuberculosis of the intestinal tract,
otherwise known as consumption of the bowels, is due in
young children.
Another means of dissemination but secondary in importance,
is the consumption of tuberculous meat. This, of
course, acts to a much less extent, because it is the custom to
cook meat, although perhaps imperfectly, whereas milk is
taken raw.
The Vestry has already adopted a circular letter setting
forth the causes of consumption, and the means that should
be adopted for its prevention, and it is only necessary for me
to point out again and to urge the paramount importance of
the following rules:—All houses to be as light and as well
ventilated as possible, and means taken to have an abundant
supply of fresh air in every room; all milk to be boiled; and
all meat to be thoroughly cooked. Besides these there are
other measures which may with good results be adopted, the
disinfection of the sputum, and the disinfection of the rooms
after death or removal. This is now offered in all cases of
consumption directly we get to know of a death having taken
place. At the same time, I think it will be some time before
we get people to adopt this universally; public opinion has to
be educated, and all that can be done is to keep pegging away
at the measures designed for its prevention indicated above,
and also in the circular sent out by the Vestry.
The registration of lodging houses has been again before
the Vestry, with, I regret to say, no more satisfactory result
than before. I have before pointed out that the limit of
exemption in Camberwell is too low, particularly in regard to
unfurnished apartments. The Sanitary Committee surveyed
some of the houses which are above the present limit, and
agreed with me that these houses were eminently suitable for
registration, and they recommended the raising of the exemption