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49
THE PREVENTION AND TREATMENT OF CONSUMPTION: SANATORIA.
Matters relating to the prevention and treatment of tuberculosis continue to engage public
and medical attention in a high degree. The National Association for the Prevention of
Consumption continues its beneficent work of diffusing information as to the nature and cause of
the disease, and the measures necessary for its prevention and cure, and in many parts of the
country sanatoria for open air treatment have been established. The Kensington Sanitary
Authority have since the establishment of the Association taken interest in its objects, as testified
by the many references to the subject in my reports, from the first in 1899. In that year, in a
draft report for the Sub-Committee of the Sanitary Committee of the late Vestry, appointed to consider
the subject, I recommended among other means for prevention and cure of consumption, the
"provision of a hospital or hospitals, or other arrangements to enable poor consumptive persons
to be isolated and treated under the best attainable conditions." Power in this respect is given
by Section 75 of the Public Health Act, 1891, which reads:—
(1) Any sanitary authority may provide, for the use of the inhabitants of their district,
hospitals, temporary or permanent, and for that purpose may—
(a) Themselves build such hospitals, or
(b) Contract for the use of any hospital or part of a hospital, or
(c) Enter into any agreement with any person having the management of any hospital
for the reception of the sick inhabitants of their district, on payment of such
annual or other sum as may be agreed upon.
(2) Two or more sanitary authorities may combine in providing a common hospital.
The report of the Sub-committee, as modified by the Committee, having been adopted and
referred back for the preparation of a "detailed scheme for giving effect to the suggestions
embodied therein," I advised the preparation and circulation of an instructional leaflet; disinfection
of infected houses, voluntary notification, and enforcement of the law for the prevention
of overcrowding, and the abatement of other nuisances, with a view to secure healthy homes for
the working classes.
The leaflet was prepared and circulated but no further action was taken.
In the first report in 1900 the subject was again dealt with. The Local Government
Board had refused an application by the Kensington Guardians for authority to provide additional
accommodation at the workhouse, there being already a sufficient number of persons housed on the
site; and as the needed accommodation could have been obtained by removal of consumptive
inmates to a separate establishment in the country, I called the attention of the Guardians to
the action taken by certain provincial Boards "to secure separation of consumptives from other
sick persons," and recommended that, alone or in combination with other Poor Law Authorities,
they should adopt this plan. Subsequently the Guardians fitted up and set apart a sunny south
ward for the treatment of tuberculous women and children, 24 in number, which was brought into
use in November, 1900. In July, 1901, a ward for men was opened, but proving inadequate for
the number in need of isolation and treatment, the Guardians decided to allocate two wards,
with accommodation for forty persons, in the new infirmary, for the separate classification and
treatment of this class of patients.
In October, 1900, a Conference of Metropolitan Poor Law Authorities was held at St. Martin's
Hall "to consider the question of establishing hospitals for the open-air treatment," at which the
following resolution was unanimously adopted by the 77 delegates representing 26 out of the 32
Boards of Guardians :—
"That this Conference of Poor Law Authorities, having discussed the question of the
open-air treatment of consumption, are of opinion that the time has come when provision
should be made for the treatment by this method of the sick poor of the Metropolis suffering
from phthisis, and it recommends the matter for the consideration of the Local Government
Board, with a view to the necessary steps being taken by that Board for the carrying out of the
proposal."
A deputation appointed to bring the matter before the President, designated the Metropolitan
Asylums Board as the most suitable Authority for providing the desired accommodation. No
action, however, was taken—a remarkable fact, seeing that correspondence read at the Conference
showed that the Local Government Board were in sympathy with the proposal to provide for the
open air treatment of phthisis; had intimated their opinion that such provision, if made, should
be for the Metropolis as a whole, and under the management and control of a Metropolitan
Authority, and with this view had suggested the holding of a Conference of the Metropolitan Poor
Law Authorities.