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58
immediate admission to a suitable Institution where
they would receive both treatment and instruction.
Only by prompt treatment of early cases and by diffusion
of knowledge of the means of preventing its
spread can real progress be made in dealing with
such a ubiquitous disease.
Early cases are curable in a very large percentage of
instances. When one examines great numbers of
cases post-mortem one is struck by the considerable
percentage that present signs of old healed
tubercle. At an Institution for the treatment of mental
diseases where almost all of the patients came from an
unhealthy manufacturing district, about 50 per cent.
of the cases on admission presented recognisable signs
of either active or obsolescent tubercle of the lungs.
When a census was taken of the patients after six
months treatment under very favourable conditions,
less than 10 per cent. had signs of active tubercle.
Both facts were verified post-mortem, for while upwards
of 50 per cent. presented cicatrices of healed pulmonary
tubercle, less than 10 per cent. had signs of tubercle in
the lungs of such a nature that one would have been
justified in registering Pulmonary Phthisis as the
cause of death.
With a view to securing diagnosis of early cases the
Public Health Committee provide for the gratuitous
examination of the sputum of suspects. It is highly
desirable that this provision should be generally remembered
by the medical profession in Bethnal Green
and especially in the case of the poorer class of patients,
who not only would be unable to pay a fee for a bacteriological
examination but are particularly liable to