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room and lias only one ramshackle bed and insufficient bed-clothes
for himself, his wife, and his children.
In some instances, extra beds have been provided by the help
of employers and institutions at the suggestion of the Lady
Sanitary Inspector. This provision of extra beds and spare
bedding offers an excellent opportunity for voluntary and
charitable effort in the Borough.
5.—The free distribution of disinfectant soap to phthisis cases
in poor households would certainly help to achieve a higher
standard of cleanliness in their homes.
6.—The investigation of tubercle in the milk supplies is at
present undertaken by the London County Council. Unfortunately
the County Council does not inform the local
authorities of tuberculous supplies which come into their districts.
The Borough Council receive no information whatever on this
head. It ought to be possible to promote co-ordination of effort
and more active co-operation in this matter.
Now, when all this has been accomplished, shall we be able
finally to stamp out phthisis? Probably not. It must be
remembered that phthisis and its prevention are not solely matters
of public health. Phthisis is only too often an expression, one
of the protean manifestations, of poverty. The prevention of
phthisis is, in the main, the prevention of poverty, and is as much
a social and industrial problem as it is a public health issue.
Twenty years ago it was hoped that the notification of fevers,
the building of fever hospitals, and the isolation of patients
would, within a generation, abolish the common infectious
diseases.
The tardy recognition of extremely mild and missed cases, and
their infective character have now shown this hope to be illfounded.
In like manner, it is very probable that the many mild missed
cases of phthisis, and the cases with long quiescent periods, both
classes infective and easily overlooked, will prevent the ultimate
extinction of the disease.