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led me to the conclusion that "Gore Farm was the more suitable locality, and the buildings
better adapted for consumptives." The two hospitals are separate and distinct, the "Upper"
(1,000 beds) being solidly constructed, for the most part of brick, and the lower (850 beds), of a
so-called "temporary" description, of iron and wood, but calculated to last 40 years. The
majority of the wards, when in use for small pox, afforded 2,000 cubic feet of air-space per patient.
So large an amount is, perhaps, unnecessary for consumptives, so that the buildings should provide
comfortably for, say, 2,000 consumptive patients, with room for extensions on the site of about 160
acres. The site itself is an admirable one, on high ground, in a beautiful country, near Dartford ;
the buildings—whether for patients, staff, or administrative purposes—excellent. Both hospitals
are empty, but the Medical Superintendent is in residence, and all that is needed, given the power
to use them for consumptives, is staff and furnishing.
An incidental advantage that would attend the use of Gore Farm for consumptives would be
that small pox patients would, in the future, be treated in a ring fence at the Orchard, the Joyce
Green, and the Long Reach Hospitals, which contain an aggregate of over 2,000 beds, more by
some four hundred than were in use at any one time during the late epidemic.
Owing probably to the number and character of the representations made to the Managers
in favour of the Council's suggestion, the matter came up again at the meeting of the Asylums
Board held on March 7th, 1903, in connection with a notice of motion to the effect—
" That, having regard to the communications recently received from the Metropolitan
Borough Councils and Boards of Guardians on the subject of the Managers providing accommodation
for cases of consumption, the General Purposes Committee be instructed to re-open
consideration of the question, and to report to the Board thereon at an early date."
The motion was rejected by 24 to 17.
It is to be hoped that when the subject comes on for consideration by the General Purposes
Committee in November next, it will receive attention commensurate with its importance.
NOTIFICATION OF CONSUMPTION.
Towards the close of 1901, the Council resolved, upon the recommendation of the Public
Health Committee, to make pulmonary phthisis voluntarily notifiable by medical practitioners as
from the commencement of 1902; and, subsequently, with a view to the utilisation of information
obtained, the Committee permitted me to employ, temporarily, the services of the lady inspectors
in an inquiry into the circumstances of the cases notified (the number was 247), and generally to
give effect to the recommendations of their Sub-committee, reference to whose report* has already
been made at page 50.
I desire to express my appreciation of the services in this connexion rendered by the lady
inspectors, whose work is still going on, and in the interests of public health should be continued;
but it is a question deserving of the consideration of the Council, whether the inspectors can be
permanently employed on it, having regard to the character and extent of the duties for the
discharge of which they were specially appointed.
With these few prefatory remarks I submit the report, only further premising that a
form was prepared to secure coherence to the inquiry by the inspectors, who, in regard to each
case notified, obtained information under the subjoined headings :—
Case or Phthisis.
Date of notification. Room occupied by patient.
Date of death if case not notified. How many sleep in patient's bedroom.
Patient's name. Has or had patient a separate bed.
„ age. Sanitary condition of habitation.
„ occupation. Sanitary condition of room.
Present address and length of residence. Light.
Previous residences. Ventilation.
Duration of illness. Sputa, how treated.
Number in family. Disinfection done by on
Any other cases in family, now or formerly. Cleansing done by on
Probable source of infection. Remarks
Number of rooms occupied.
* The report is printed in the Minutes of the Council's proceedings for 13th November, 1901, pages 19 and 20.