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68
Duration of the Disease.—The presumed duration of the
disease when the case was first notified is given in the attached
table, which records the results in 349 patients :—

It will be seen that comparatively few cases are recognised
in the early stage—83 per cent., or 5 out of every 6 had been
ill for periods over one year before notification—14 had actually
been ailing for 20 years and more.
The early signs of phthisis may be so slight and may appear so
unimportant to the general public that their suspicions are not
aroused. Further, phthisis, even when well marked, is often
characterised by quiescent periods which lull suspicion. This
explains why it is so difficult to deal with the disease from a
public health standpoint, and also why it is so very important
to search for slight, missed, and suspicious cases amongst the
contacts in the households of notified and recognised cases.
Previous addresses in the Borough.—Out of 386 cases—
172 had lived in 2 or more Finsbury addresses while definitely
known to be consumptive. Sixteen had lived in four different
houses in the Borough during their illness. Out of these 172
cases—66 lived in houses from which cases of phthisis, numbering
82, had already been notified, and in which 54 deaths from
phthisis had occurred prior to their occupation.
Owing to their poverty and inability to pay rent, these very
poor phthisical patients are continually moving from one tenement