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102
Great importance is also attached to having a few really
good voluntary helpers, who will act as almoners, and be the
means of providing certain cases with good food and helping
in other ways. The value of good nourishing food must
always be borne in mind. There often arises, in the course
of a case of consumption, a period when the question as to
whether the patient can have a few weeks rest and good food
to build up his resisting powers, and the answer to this question
will decide whether or not he will be able to throw off the disease.
Many of the patients in Deptford will be found in this category.
In Deptford, during 1909, we received 538 notifications of
phthisis relating to 172 cases. In 1910 we had 209 notifications
relating to 96 cases, and during 1911 we have had 507 notifications
relating to 335 cases. Under the system of compulsory
notification during 1912 we may expect to receive about 1,200
notifications.
It is encouraging however to note that since tuberculosis
has become notifiable in poor law institutions and hospitals the
death rate has already decreased in the Borough, but it is still
higher than the rate for the whole of London and for England
and Wales.
Finally, it is generally recognized that the work in each
Dispensary is proceeding satisfactorily, although there is an
indication that sometimes the work is hampered by having a
voluntary Committee.
From what we know of public affairs, and from what we
have seen concerning the institutions we have visited, we have
arrived at the conclusion that the Public Health of Deptford
will be better served by the Council undertaking this valuable
work, and building or renting a suitable house and providing it
with the necessary fittings and appliances. As regards staff, we
believe that a more experienced and zealous medical man will
be obtained by attaching him to the Health Department as an