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159
[1909
Prevention of Phthisis.—A very strong feeling has possessed the public
of late years that everything possible should be done to prevent the spread of
this disease and to save the lives of those who have been attacked; and consequently
public authorities and some private institutions have made considerable,
and not unsuccessful, efforts in these directions. But possibly one of the best
means hitherto adopted has been the establishment of Tuberculosis Dispensaries,
such as were founded in Edinburgh and Paddington, at which
persons in the very earliest stages of the disease are encouraged to seek
advice, and where they receive instructions of great educational value as to how
they should behave in their relationship with the public, with their relatives,
and with others living in their own homes. It is believed that the knowledge thus
disseminated has proved of great educational value, and that there is a possibility—nay,
a probability—that many persons, who would otherwise be removed
to sanatoria, are now able to adopt curative measures in their own homes. After
all, if the public would oply recollect that fresh air and the open-air life
diminish tuberculosis, while dampness and darkness increase it, many people,
who now die, would live; and also that caution in intercourse with consumptives
should be exercised, although it is doubtful if most people follow this course of
action, at all events in England.
It has already been noted that there has been a continual decrease in the
number of deaths during the last 10 years. It is very difficult to say that
this has been due to educational propaganda, but that it is rather to be ascribed to
methods of sanitation, e.g., the reduction of overcrowding; increased cleanliness
of houses—their better drainage and sewerage, which have led to a dryer subsoil;
and the improvement in the general sanitation of the borough. All
these have caused a decrease in the death-rate from 1.70 per 1000 in 1893, to
1.21 in 1909, or nearly 30 per cent.
There is one point to which allusion should be made, which is that
the improved sewage and drainage of the towns throughout England has undoubtedly
resulted, as first pointed out by the late Sir George Buchanan, in a
diminished death-rate by removing the dampness of the soil, which was due
to the pipes acting as vehicles for the carriage of the underground or subsoil
water, for in those early days it must be remembered that drains and sewers
were not jointed with cement as they are now, and so, the pipes not being
tightly jointed, very frequently not jointed at all, allowed an ingress
to the sub soil water, and thus the land, under and about the houses, was