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the additional accommodation required could be obtained by the removal of consumptives to a
separate establishment for isolation and treatment, the view was expressed that ''the Guardians,
if their attention were called to the subject by the Vestry, as sanitary authority, might entertain
favourably the suggestion to provide, apart from their present infirmary, requisite accommodation
for consumptive persons dependent upon their assistance." No action having been taken,
I addressed a communication to the Clerk to the Guardians, calling attention to the action taken
by certain provincial poor law authorities, " to secure separation of consumptives from other sick
persons," and stating that I should be glad if the Kensington Guardians, "alone or in combination
with other boards," should see their way to adopt this plan. Subsequently the Guardians fitted up
and set apart a sunny south ward for the separate treatment of tuberculous women and children : *
it contains 24 beds, and was brought into use in November, 1900. At this institution the proportion
of tuberculous males to females is four to one, so that there is a difficulty in finding sufficient
accommodation with facilities for open-air treatment. A ward for males (No. x) was opened
in July, 1901, and it having proved inadequate to receive the number of inmates requiring separate
treatment, the Infirmary Committee appointed a sub-committee to consider and report to them
on the whole question. The medical superintendent having stated that forty beds would be
required for the segregation of men suffering from tuberculous disease, the sub-committee (after
referring to the costliness of alterations, which would be necessary to adapt old wards for the
treatment of infectious cases, and the disadvantages attending the use of such wards) pointed out,
in their report, that "in the new portion of the infirmary certified for men, the wards with their
teak floors, cement walls, and latest structural improvements, are already well adapted for the
separate classification and treatment of cases of tuberculous disease." They recommended, therefore,
that " the whole (of these) cases be removed from the general wards, and classified in Wards
xxx. and xxxi., in the new pavilion nearest to the Marloes-road, which will afford accommodation
for 40 men, with the increased cubic-space required, and that the necessary arrangements be
made for keeping the airing court on the east side entirely for the inmates of that pavilion."
The Committee approved the report, and at the meeting of the Guardians held on the 8th
October, advised—
" That the recommendations of the sub-committee be carried out, and that a letter
to that effect be now addressed to the Local Government Board.'' *
The recommendation was adopted, and carried out forthwith. "Open-air treatment" can
hardly, in any effective sense, be carried out at this institution, but it is a great point gained
to have secured the segregation of phthisical cases from other cases treated in the general wards.
The Action of the Borough Council.—The Council having received, and referred to the
Public Health Committee, certain communications (mentioned below) on the subject of the
prevention of consumption, a sub-committee was appointed to consider and report thereon. The
report of the sub-committee (Alderman Canon Pennefather, Chairman of the Committee, Councillor
Dr. Alderson, and Councillor Dr. Vinrace) was adopted by the Committee, and is as
follows: —
"The Public Health Committee on appointing us a Sub-Committee to report as to any further
action which may be desirable on the part of the Council, referred to us certain documents
recently received by the Council, viz. : —
(1) The report of the Council's delegates at the Congress on Tuberculosis submitting certain
resolutions unanimously passed at the last meeting of the Congress. (See report of the
Medical Officer of Health, No. 8, August 15th, page 110.)
(2) A letter from the Local Government Board with reference to the views of Professor
Koch relative to the question of the transmissibility of tuberculosis from animals to,
man.
(3) A letter from the Council of the Borough of Battersea relative to the letter from the
Local Government Board above cited, expressive of that Council's views as to the inadequacy
of the powers vested in sanitary authorities with regard to prevention of
disease through the agency of the milk of tuberculous cows, and the flesh of tuberculous
animals, and recommending the provision of public abattoirs in lieu of private
slaughter-houses.
(4) The eighth report of the Medical Officer of Health, dated August 15th, 1901, para. 7,
page 108; subject: 'The Congress on Tuberculosis.'
(5) The ninth report of the Medical Officer of Health, dated September 14th, 1901, para. 7,
page 126, subject 'Tuberculosis—A new Royal Commission.'
* In this connection it may be mentioned that the President of the Board, in October, 1901, when laying the first stone
of the Sanatorium which the Guardians of Liverpool and the neighbourhood are erecting for consumptives, eulogised the work,
and commented on the benefits science had conferred in minimising the prevalence of the disease, and by providing, by improved
sanitation, and open-air treatment, for the chances of recovery in the early stages. He also promised that, so long as he
presided over the Local Government Board, the Guardians might be sure there would be no restrictive red tapeism influence,
but every encouragement of this kind of work.