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"We have also had before us the two reports of the Sanitary Committee on 'The Prevention of
Consumption,' which were adopted by the late Vestry on March 22nd and June 14th, 1899,
respectively. (See Minutes, March 22nd, 1899, page 1,037, and June 14th, 1899, page 203.)
"We find that the action hitherto taken by the Sanitary Authority of the borough has been: —
(a) Circulation of a leaflet setting out the measures proper to be taken to prevent the
spread of consumption and other forms of tuberculosis ; and
(b) Disinfection of a few houses in which death from consumption had occurred.
"We now beg to report that the late Congress on Tuberculosis recommended (inter alia): —
(1) Voluntary notification of cases of consumption attended with tuberculous expectoration
—the main agent for the conveyance of tuberculosis from man to man ;
(2) The supply to consumptives, by hospitals and dispensaries, of pocket spittoons, with
a view to the suppression of the dangerous habit of indiscriminate spitting ;
(3) The supply to consumptives, by these institutions, of printed instructions with regard
to the prevention of consumption.
(4) The provision of sanatoria as an indispensable part of the measures necessary for the
diminution of tuberculosis ; and
(5) The provision of anti-tubercular dispensaries, as the best means of checking tubercular
disease among the industrial and indigent classes.
"It may be observed that the Congress advocated notification of cases of consumption only in
districts ' in which efficient sanitary administration renders it possible to adopt the consequential
measures including disinfection, which is now generally recognised as necessary
for the prevention of the spread of the disease. Disinfection, it may be mentioned, formed
the subject of one of the recommendations of the Sanitary Committee of the late Vestry,
but it has not yet, to any great extent, been carried into effect, nor can it be without further
assistance in the disinfecting section of the Public Health Department,—as the Medical Officer
of Health stated in a report to the Sub-Committee appointed by the Sanitary Committee, to
draw up a detailed scheme for giving effect to the recommendations of the Committee adopted
by the late Vestry, March 22nd, 1899. (See Minutes of the Vestry, June 14th, 1899, page 204.)
With regard to the measures suggested in (2) and (3) we entertain no doubt that the
authorities of public hospitals and dispensaries will, sooner or later, give effect to the
recommendations of the Congress.
"The provision of sanatoria (4) as regards the well-to-do classes, has already been taken in hand
in many directions. Provision for the poor may be made by the Sanitary Authority, in the
Metropolis, under the powers conferred by section 75 of the Public Health (London) Act,
1891; but on the whole we think it may be done better by a central authority, the Asylums
Board or some other, as recommended by the Conference of Poor Law Authorities referred to
in the eighth report of the Medical Officer of Health, dated August 15th, 1901, page 113.
"The action of the Board of Guardians in this borough in providing a ward for the treatment of
females and children suffering from tuberculosis, was referred to in the said report, and we
are glad to observe that the Guardians now propose to set apart accommodation at the
infirmary for men suffering from tuberculous disease, so that the sick poor in that establishment
will no longer be exposed to the risk of catching consumption whilst under
treatment on account of non-specific illness.
"We agree as to the desirability of the establishment of anti-tubercular dispensaries (5); at the
same time we think that this also is a matter which should be undertaken mainly by a
central authority.
"The late Congress expressed an opinion that 'overcrowding, defective ventilation, damp, and
general insanitary conditions in the houses of the working classes,' not only' diminish the
chance of curing consumption,' but also' aid in predisposing to and spreading the disease.'
With this view we concur; the malign influence of domestic insanitary conditions was, in
fact, insisted on in the report of the Sub-Committee of the Sanitary Committee of the late
Vestry on 'The Prevention of Consumption.' (See Minutes of the Vestry, March 22nd, 1899,
page 1,038.) It is to be hoped that with the increased staff of sanitary inspectors, and
through the other steps the Council have in contemplation in connection with the housing
of the working classes, much may be done to remove the causes and prevent the spread of
consumption.
"Time will necessarily be required, and must be allowed, for giving effect to the recommendations
of the late Congress. As regards action by the Council we recommend : —
1. (a) The adoption of a system of voluntary notification by medical men of cases of con-
sumption attended with tuberculous expectoration.
(b) Payment to medical men of the customary fee for notification of such cases ; and
(c) An arrangement for bacteriological examination of expectoration suspected to be
culous.
2. The further circulation of the leaflet on ' The Prevention of Consumption.' (See Minutes
of the late Vestry, June 14th, 1899, page 206.)
3. (a) The appointment of an assistant disinfector; and
(6) Disinfection of houses after the occurrence of fatal cases of consumption, and after the
removal of consumptives.