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minimum incidence of notification and of phthisis deaths. In
other words this means that fresh streets are being invaded, and
that the disease is tending to spread into streets and parts of the
Borough hitherto unaffected.
This may possibly be associated with the lower standard of
living now prevailing in the Borough, with the increasing poverty
of many of its inhabitants, and with the conversion of houses
for human habitation into workshops, a change which forces the
former inhabitants to seek accommodation elsewhere.
In 1911, seventeen cases occurred in streets in which there had
been no previous notification, and 21 deaths occurred in streets
in which there had been no previous deaths from phthisis.
Disposal of Sputum.—Eighty-two, or nearly 20 per cent.,
used a special spit-cup ; 51 were said to spit into pieces of paper
or rag, which were subsequently burnt ; 12 spat into the Pre
or into the fireplace, whenever this was convenient, but were
stated to be very careless by the other members of the family.
The rest, 179 in number, about whom information was obtained,
may be confidently assumed to have taken few or no precautions
in disposing of their sputum.
As this is such an important matter, the Public Health
Committee have now sanctioned the purchase and distribution
of spit-cups to all suitable cases.
The Borough Council examines gratis the sputa of patients
suspected to have phthisis.
In 1911, 52 specimens were examined with positive results in
18 cases.
Search for missed and unrecognised cases.—As the
result of special enquiry, in 23 affected families, 24 suspicious
cases of chronic cough and wasting were discovered and put in
the way of obtaining treatment. By investigation into the other
families inhabiting the same houses as the consumptives, 12