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tuberculosis may be regarded as having been induced by working for long
hours in badly ventilated workrooms and offices. A previous attack of
influenza appears to have been responsible for four cases; poverty and
want of proper nourishment for three cases ; alcoholic excess for two
cases; living in damp basements for two cases ; and one case each is
attributed to association with a consumptive fellow-workman at work, to
nursing a case of pulmonary tuberculosis, and to a previous attack of
measles.
Of the 92 cases on the register, 47 were found on the date of the first
visit by the Lady Sanitary Inspector to be sleeping alone (with a bed to
him or herself), and 44 were sleeping in bed with some other person. In
about half of the latter cases the patients were induced subsequently to
make arrangements to sleep alone. Three beds with bedding have been
provided for this purpose by the Chelsea Borough Council, and are lent
to necessitous cases as occasion arises. About two.thirds of the cases
visited are found to be able and willing to carry out proper sanitary
precautions as regards disposal of sputa, burning of infected rags, having
the windows open, and keeping the rooms clean and free from infected
dust. About one.third of the cases are somewhat unsatisfactory to deal
with owing to carelessness, scepticism as to infection and the necessity
for fresh air, and general laziness. But in nearly every case some
improvement is effected as the results of the personal visits of the Lady
Sanitary Inspector.
Arrangements were made for the domiciliary treatment by local
medical practitioners of six cases under the sanatorium provisions of the
National Health Insurance Act, these being "insured persons,'' and one
insured person was sent by the Insurance Committee for Loudou to an
open-air sanatorium.
The Chelsea Borough Council has made no arrangements for the
reservation of beds for cases of phthisis in any sanatorium or hospital,
nor have any arrangements of any kind been made for the dispensary
treatment of phthisis cases in the borough. No portable open-air shelters
or tents have been provided by the Chelsea Borough Council for the use
of phthisis patients in the borough.
The number of new cases of phthisis visited in the course of the year
was 175, and the total number of visits in respect of phthisis cases in the
year was 756. Five of the patients were sent to open-air sanatoria
through the agency of the Charity Organisation Society, and four eases
were sent by private charitable effort. Sixteen patients were sent to
convalescent homes in the country through private sources. Fourteen
out.patient letters were given to patients for the Brompton Hospital, and
five for the Victoria Hospital for children. Twenty-three pocket spittoons
were given to patients requiring them. Three iron truckle beds with hair
mattress and hair bolster were obtained by the Borough Council, and
have been lent out to necessitous cases, where the phthisical patient was
not sleeping alone, and could not afford the expense of an additional
bed.
Of two tubercular children reported by the School Medical Officer,
one was referred to the Invalid Children's Aid Society, who provided
convalescent treatment in the country. Two tubercular children were
reported by Poor Law Medical Officers.
Five " contacts " were sent to the Brompton Hospital for examination,
and three of them were found to have received the tubercular infection.