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a state as possible by due regard to questions of sewerage,
drainage, and general municipal cleanliness, including the systematic
flushing and cleansing of all courts, alleys, and narrow
streets in populous districts. Notifications will materially assist
in this direction, showing where the disease principally lurks,
and the special conditions under which it is likely to spread.
All cases of tuberculosis (for tuberculosis affects different
organs and parts of the body) need not be notified, nor even all
cases of tuberculosis of the lungs (i.e., consumption or phthisis),
but only those attended with tuberculosis expectorations, i.e.,
those that are sources of danger to others, owing to domestic
conditions. Such limited notification must be optional or
voluntary. That such notification will lead to increased preventive
action must be admitted when it is remembered that the
Lambeth Borough Council is equipped with the necessary efficient
sanitary administrations to adopt the consequential
measures. The machinery for preventing the disease extending
is ready and in proper working order; all that is wanted
is the knowledge as to where the disease exists. Such a method
of voluntary or optional notification of phthisis has been already
tried in New York and in Brighton and Manchester, etc., and with
success in limiting the spread of the disease, not only by enabling
preventive measures to be taken, but also by teaching the people
by leaflets left at the house and instruction given, the danger of
the disease, and the simplicity of the methods required to prevent
an infected person being a danger to others. The notification
may in this way be controlled through the medical attendant
either by the relatives of the patients, or by the patients
themselves, and no case need be notified unless the medical
attendant is of opinion that good will accrue therefrom.
That the Local Government Board will acquiesce is practically
assured, as they have already stated that the Board is advised
that a Local Authority may pay to medical practitioners a
reasonable fee for the voluntary notification of phthisis, or other
infectious diseases.
I have no hesitation in recommending the Committee to advise
the Council to apply to the Local Government Board for confirmation
(if necessary) of a voluntary or optional system of notification
of phthisis (or consumption), with tubercular expectorations,
with the payment of a fee of 2s .6d. to every medical
practitioner, for each notification certificate sent in to the
Borough Council's medical officer.