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a mortality upon the estimated population of young children of 5.3
per 1,000.
PHTHISIS.
(Deaths, 259).
The death rate from phthisis alone is equal to 2.0 per 1,000 in
Bethnal Green, whilst that for the whole of London is 1.6.
It is only within the past ten years that the infectious nature of
tuberculosis has been generally recognised, and even now very few
sanitary authorities take any steps to check the spread of a scourge
which is more fatal to youth and middle age than all the seven
principal Zymotic diseases put together. The Local Government
Board will not sanction the inclusion of phthisis amongst the (compulsory)
notifiable diseases, but voluntary notification has been
attempted in some districts and has met with a modified amount of
success. Its chief use is for the purpose of enabling Public Health
Authorities to issue instructions to phthisical persons pointing out
how they may best avoid communicating the disease with which
they are affected to others. It would be impossible to isolate every
case of phthisis, for the early stages of this disease do not preclude
the sufferer from being a useful member of society and earning his
own living with safety to others, provided he adopts certain precautions.
It is the later stages of the disease that are so dangerous to
others. A man whose lungs are riddled with cavities sprays everything
around him with germs each time he coughs. The mucous he
expectorates is deadly, and unless received in proper vessels and
subsequently destroyed, dries and forms infectious dust.
Those who have command of money can and do take proper precautions
under medical advice, but my experience is that in the
humbler walks of life a sufferer from the later stages of consumption
will haunt the out-patients' rooms of hospitals until he is too feeble to
walk. He can rarely be admitted, as hospitals are not asylums for
hopeless cases, so the poor fellow (perhaps until recently the support
of a family) remains at home to die. Soon his circumstances become
more straitened, the three rooms occupied in happier days can
no longer be afforded and are exchanged for one, with the result