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62
his expectoration and to acquire a taste for an open air life. For this
purpose the sanatorium is an essentia) feature of a complete scheme of
prevention, and it has the additional advantage that it can, in a
considerable number of cases, bring about a complete cure and restore
the patient to active working life.
In addition to the Clinic and the Sanatorium a complete scheme
of prevention should provide hospital accommodation for advanced cases
who cannot be treated at home with advantage to themselves or with
safetv to the members of their families. Such cases are often dangerous
sources of infection both from the enormous quantities of infection
they produce and from their inability to attend to themselves properly.
The institutions for the reception of such cases are often terme 1
" Homes for the Dying," bat this term is unfortunate, and it is
preferable to substitute " Consumption Hospital."
Turning now to the practical steps that the Council can take to
prevent consumption, in addition to the work that is already carr ied out
I would recommend the adoption of the following measures:—
1.—The establishment of a Tuberculosis Clinic. This would involve
the services of a whole-time medical officer, a whole-time
nurse, and either the engagement of a part-time dispenser,
or preferably an arrangement with a local chemist to supply
the necessary medicines.
The establishment of a Tuberculosis Clinic need not
involve any capital outlay, for the accommodation required
will, I understand, be available at the Health Institute which
it is hoped will shortly be established by the Ilampstead
Council of Social Welfare, and the annual expenditure would,
I estimate, fall well below £750.
2.—I would also recommend that the Council make arrangements
with one of the sanatoria in the country that now receive
patients from other metropolitan boroughs, for the reception
of a number of Hampstead consumptives, chiefly in order that
they might be trained in the precautions against infection.
The cost of such accommodation at these sanatoria is 30s. per
week per patient. At the present time 5 Metropolitan Boroughs
provide sanatoria accommodation in this way,—one borough
provides 10 beds, three boroughs provide 6 beds each, and one
borough provides 3 beds.