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21
And this is followed by a visit from myself in the course of the next week or two. The object of the
visit is to make enquiries into the history and circumstances of the patient, to amplify the
recommendations on the leaflet and recommend disinfection.
Two registers are in use, one for the patients and one for the houses where phthisis cases
have occurred.
In the former the information concerning each patient is put down under the following
headings : —
No., Date of Notification, Name, Age, Sex, Addresses during Illness, Occupation, Place of
Employment, Date of beginning of Illness, Personal History of Patient, Family History, Result
of Illness, Sources of Infection (probably—possible), Milk Supply, General Condition of
Premises, Bacteriological Examination Eesult, Action taken.
In the House Register of Phthisis the information is placed under the following headings :
House in which case of Phthisis has occurred, Room occupied, Length of Residence during
Illness, Age, Sex, Date of Notification or Death, Removal of Patient (Address and Folio if
necessary), Remarks.
These Registers are indexed to tit in with one another so that a particular patient who
changes his residence as well as a house which changes its tenants can be followed up.
The following Table gives the occupations and ages of the cases visited. The figures, at
present are too small in number to draw any reliable conclusions as to the influence of occupation
in the spread of the disease : —
OCCUPATION.
1
to
5
5
to
15
15
to
25
25
to
35
35
to
45
45
to
55
55
to
65
65
to
75
ALL
AGES.
Under
1
...
...
...
...
1
...
...
...
...
1
Barmaid
Collar Ironer
...
...
...
1
...
...
...
...
...
1
Compositor
...
...
...
1
...
...
...
1
...
...
1
Char woman
...
...
...
...
...
1
...
...
...
Clerk
...
...
1
...
1
...
...
...
...
...
...
1
1
...
...
Cook
...
...
...
...
...
Cork Cutter
...
...
...
...
...
...
1
...
1
...
...
...
...
1
Dressmaker
...
...
...
1
...
...
...
1
Domestic Servant
...
...
...
1
...
...
...
...
1
Engine Driver
...
...
...
1
...
...
...
...
...
1
17
Housewife
...
...
...
2
5
5
3
1
...
1
In Cold Store
...
...
1
...
...
...
...
...
1
In Confectioner's Shop
...
...
...
...
...
...
...
...
1
Grocer's Assistant
...
...
1
...
...
...
...
...
1
...
1
Fitter
...
...
...
...
1
...
...
...
...
1
Printer's Warehouseman
...
...
...
...
...
1
...
...
...
1
Jam Factory hand
...
...
...
...
1
...
...
...
...
Labourer
...
...
...
2
...
...
...
...
2
...
...
1
Lighterman
...
...
...
...
...
1
...
...
...
3
Machinist
...
...
1
1
...
1
...
...
...
...
1
Mat Weaver
...
...
...
...
...
1
...
Night Watchman
...
...
...
...
...
...
1
...
1
...
Office Cleaner
...
...
...
...
...
1
...
...
...
1
Printing Machine Minder
...
...
...
1
...
1
...
...
...
...
...
2
Stevedore
...
...
...
1
1
...
...
...
...
...
1
...
...
1
...
Scackmaker
...
...
...
Seamstress .
...
...
...
...
1
1
...
...
...
2
Scholar
...
4
...
...
...
...
...
4
...
...
Tinsmith
...
...
...
...
1
...
...
1
...
...
Telegraphist
...
...
1
...
...
...
...
1
...
...
Warehouseman
...
1
1
...
1
...
3
...
...
...
...
...
...
1
...
...
...
Waitress
...
1
...
Woodchopper
...
...
...
...
1
...
...
1
...
...
No Information
...
2
...
...
3
3
...
...
8
...
Totals
...
2
4
12
18
15
10
4
2
67
In the case of 14 there was a family history of phthisis in near relatives, in 7 of these
was a similar history in distant relatives, in 2 cases the patient's husband was said to be phthisical,
and in 37 there was no evidence of phthisis in the family, while in 8 patients no information
could be obtained as to their families. On the whole my short experience is in favour of
voluntary notification. It is a step towards compulsory, which would be much more useful,
especially if we can get sanatoria for the treatment of suitable cases.
It is difficult to put the advantages of voluntary notification into numbers, but it is
impossible to think that the literature on the prevention of consumption followed by visits in
which attention is still further drawn to its infectivity among notified patients, is productive of
no good.