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The conditions thus found bespeak wanton carelessness, and
show a callous indifference on the part of the patients concerned
to the health and welfare of their families.
The Kitchens.—In 248 instances, or 57 per cent, of the whole
number of cases the kitchen was being used as a living room
and a sleeping room. This is one index of poverty, and shows
the difficulties of accommodation and the facilities for infection
which accrue in these poor households. Sometimes the patient
himself occupics the kitchen by day and night. Many of the
kitchens were dirty, verminous, or damp. In 10 houses the
kitchen and feeding utensils were extremely dirty.
The presence of dirt or vermin may be taken to connote carelessness,
and carelessness in the family of a consumptive means
increased risk of infection for the rest of the family.
The Houses and Streets.— Sixteen houses in which cases
occurred were being used for the purpose of sale or manufacture
of food as follows:—Restaurants, 4; food preparation, 5; milkshops,
3, and 4 public-houses.
Notifications of phthisis had been previously received from 140
houses, or from 33 per cent, of the whole number of houses
affected. From two such houses, five and four previous notifications
had been received; from each of 15 houses, 3 prior cases
had already been notified. Deaths from phthisis had occurred in
62 houses, or in 15 per cent, of the houses concerned. It is
possible that in both these groups the subsequent cases may have
been due to family infection or to house infection. The demand
for cheap tenement accommodation is often so urgent in the
borough that very soon after a tenement is empty, it is sought by
a prospective tenant, and occupied before the rooms have been
disinfected or scoured out. Disinfection is offered in all eases,
and a special soap provided free of cost by the Public Health
Department. There is, however, no power to enforce compulsory
cleansing or disinfection.