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views of the Royal Commission on Tuberculosis, as to the degree of tubercular disease which
should cause a carcase, or part thereof, to be seized. The principles to be observed in the inspection
of tuberculous carcases of cattle—whether the whole or part thereof should be seized—were
set out in their Report (1898). In view of the greater tendency to generalisation of tuberculosis
in the pig, the Commission considered that the presence of tubercular deposit in any degree
should involve seizure of the whole carcase, and of the organs ; and in respect of foreign dead
meat, that seizure should ensue in every case where the pleuræ have been "stripped." The
Board advised the Council to direct those of their officers employed as meat inspectors to act
in accordance with the principles laid down by the Royal Commission, as expounded in
their circular letters addressed to the councils of boroughs, etc., on the 11th March, 1899. The
qualifications, legal and technical, proper to the office of a meat inspector were set out, and
the Board trusted that, in making appointments of officers on whom would devolve the duty of
acting as meat inspectors, the Council would satisfy themselves that the person appointed possesses
adequate knowledge on the subjects specified. The circular letter concluded with a reference
to the duties of a sanitary inspector in relation to the inspection and seizure of meat, as set out in
the Board's Sanitary Officers (London) Order, 1891.
The Action of the late Vestry.—In this place mention may be made of the action of the
lat Vestry with reference to measures for the prevention of consumption. The matter had been
dealt with in my first monthly report, 1899. The report was referred to the Sanitary Committee,
who appointed a sub-committee to deal with the reference. The sub-committee's report, after
material modification by the Committee, was adopted by the Vestry, and is printed in the minutes
of the meeting held 22nd March, 1899 (page 1,037).* Briefly it may be stated that the report
dealt with the causation of consumption and other forms of tuberculosis ; referred to the evil
influence of insanitary surroundings, and stated that the means of prevention were largely
within the power of sanitary authorities, by—
(a) Enforcement of the provisions of sanitary law for the prevention of overcrowding, and the
abatement of nuisances generally, so as to secure healthy homes for the lower classes ; and
by systematic inspection of tenemented houses and houses let in lodgings.
(b) Education of consumptives as to the danger of spitting about rooms, or in public places,
vehicles, etc. ; and the necessity of the destruction of expectorated matters by disinfection,
or preferably by fire; viz., by the issue of a circular of advice in which also might be
explained the necessity for thorough cooking of meat and boiling of milk.
(c) By advising, and in suitable cases carrying out, disinfection of rooms in which consumptives
have died, or from which they may have removed.
The Committee in their report recommended—" That the vestry be advised to adopt means
for the prevention and cure of consumption and tuberculous disease generally—
(1) By spreading information as to the nature and cause, the preventability and curability of
tuberculosis, and especially of consumption ; and by inculcating the necessity for thorough
cooking of meat and the boiling of milk.
(2) By disinfection of houses after the occurrence of fatal cases of consumption, and after
removal of consumptives to new abodes.
[A further recommendation, contained in the draft report prepared' for the sub-committee,
but which was not adopted, read as follows—■
" By provision of a hospital or hospitals, or by making other arrangements, so as to enable poor
consumptive persons to be isolated and treated under the best attainable conditions, and to
secure restoration to health."]
The report, after adoption by the \ estry, having been remitted to the Sanitary Committee
to " draw up a detailed scheme for giving effect to the suggestions embodied1 therein," I was
requested to state mv views as to the action that should be taken. Briefly, I advised the preparation
and circulation of a leaflet on the subject ; disinfection of houses, a procedure which
would involve " further assistance in the disinfecting department ;" a voluntary system of notification
of consumption ; and, especially, enforcement of the provisions of sanitary law for the
prevention of overcrowding, and the abatement of other nuisances, so as to secure healthy homes
for the working classes. The leaflett was prepared and circulated, and1 in a few cases disinfection
of houses was carried out, upon request of medical practitioners.
The Action of the Kensington Guardians.—In my first monthly report for 1900, the subject
of tuberculosis was again dealt with. The Local Government Board had refused an application
by the Guardians for authority to provide further accommodation at the workhouse, on the ground
that there were already a sufficient number of persons on the site ; and as it appeared to me that
• See also Minutes June 14tb, 1899 (p. 204). Other details of the proceedings of the Vestry and the Sanitary Committee,
will be found in the Annual Report of the Medical Officer of Health for 1899 (pp. 113—130). The subject is further dealt
with in the Report for 1900 (pp. 31—33).
f The leaflet is printed in the Annual Report of the Medical Officer of Health for 1899, p. 125.