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return to school. The adult patients are more difficult to deal with on
these lines, as in most cases the disease is too far advanced to be
arrested; but even in these cases an effort is made to keep in touch with
the patients, and to see that the advice given is being carried out as far
as circumstances permit.
The Anti-Tuberculosis Campaign.
It is evident that if any great advance is to be made in the reduction
of tuberculosis in London it will be necessary to introduce a system by
which patients will be induced to present themselves for treatment in the
initial stages of the disease, and which will yeadily lend itself to the
detection of "contacts" in the homes of the people. Such a system is
that of the Anti-Tuberculosis Dispensary, which has for so many years
been established in Edinburgh with the most gratifying results, and
which has now been inaugurated in Paddington and in St. Marylebone.
It also seems probable that with advancing knowledge of its proper
administration and its necessary limitations, the tuberculin treatment of
tuberculosis will do much to arrest the disease in suitable cases; and, as
this method of treatment can be carried on while the patient is living at
home, and indeed in most cases doing his usual work, it would appear to
be especially adapted to the needs of the working classes. This system
has been carried on for nearly a year at the Tuberculin Dispensary, 263,
Kennington Eoad, S.E., under the personal charge and direction of Dr.
Camac Wilkinson, and appears to have proved of immense benefit to
many of the patients treated.
Where treatment, and especially successful treatment of tuberculosis
is offered to the working classes free of cost, experience shows that the
disinclination to seek medical advice on the part of the working people,
now so commonly encountered, is no longer a hindrance. By means of
visits to the homes of the patients who present themselves for treatment,
undiscovered cases, many of which are in an early stage, may be found; and
thus prompt measures may be taken to arrest the malady in the actually
affected, and to prevent its spread to the healthy, which no other system
of dealing with tuberculosis affords in anything like the same degree.
The Anti-Tuberculosis and Tuberculin Dispensaries already established
in London are maintained by charitable contributions, but having regard
to the benefit to the public health that may be expected to ensue from
their operations, it is a question whether this is not a work which should
be undertaken by municipal effort and paid for out of the municipal
funds. It seems certain that if anti-tuberculosis dispensaries are to be
founded and maintained by voluntary effort alone, they will be established
only in the wealthier parts of London, and that those districts which are
the poorest and have the highest prevalence of tuberculosis in their midst,
will, from want of funds, be unable to avail themselves of the latest
developments in science and administration that are possessed by their
richer neighbours.
The opinion is now gaining ground that the anti-tuberculosis
dispensary system is better adapted to the social needs and economic
necessities of the working classes than the provision of open-air
sanatoria on a large scale. The cost of the latter is prohibitive on any
extensive scale as a means of combatting tuberculosis; and the