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41
The report stated, as "evidence of the importance of the subject, that in Kensington, consumption
alone—apart from all other diseases of the tubercular class—destroys, year by year,
very many more lives than small-pox, scarlet fever, diphtheria, and 'fever' combined'': the
fact being that the deaths from these diseases in the three years, 1898-1900, aggregated 183 only,
whereas those from consumption were 210 in 1900 alone.
The report having been unanimously adopted by the Council, (13th November, 1901), was
sent forthwith to medical practitioners, together with the Council's leaflet on "The Prevention of
Consumption," and an explanatory letter (printed in the Annual Report of the Medical Officer of
Health for 1901, page 41) setting out the scheme, which provided for voluntary notification;
for bacteriological examination of sputa, and for disinfection after deaths, and upon change
of abode of persons suffering, from consumption. The scheme was put into operation at the beginning
of 1902.
The recommendations of the Committee have been carried out as fully as practicable, and
it may be interesting to show now, after an interval of four years, with what results, With respect
to—
Bacteriological Examination of Sputa, there is nothing to report, save failure; only one
application for this important aid to diagnosis having been received during the four years 1902-5,
although it was intimated in the explanatory letter—
"That the Council have entered into an arrangement with the Jenner (now Lister)
Institute for the examination of expectoration suspected to be tuberculous, and will when
necessary defray the cost of such examination."
It is probable, however, that medical men may have submitted specimens for examination
to private assocications or individuals who undertake work of this description.
Disinfection.—Eleven hundred and fifty rooms in private houses were known to be infected
during the four years, but only in 611 cases (531 per cent.) was disinfection done; in 494 cases (43
per cent.), 138, 112, 129, and 115 in the consecutive years, by the Council's officer, and in 117 cases by,
or under the direction of, medical practioners. In 539 cases (57 per cent.) the premises were not
disinfected, proffered assistance having been refused on the ground that disinfection was deemed
unnecessary (in 194 cases), or on the ground of anticipated inconvenience (345 cases).
Whatever difference of opinion there may be in regard to other precautionary measures for the
prevention of consumption, there is none as to the desirability of disinfection,* which was carried
out in little more than a moiety of the cases; it being open to the parties interested to accept or
decline—for whatever reason or none—the offered services of the Council's staff. This fact points
to the necessity for making disinfection compulsory, which could be effected by an order, under
Section 58 of the Public Health (London) Act, 1891, applying to consumption the provisions of
Section 60 [ss. (1) and (2)], which provides for the cleansing and disinfecting of infected premises
and articles therein. These provisions have been extended to another non-notifiable disease,
measles, which proved fatal in the metropolis, last year, to only 1,714 persons (1,641 of them
tinder five years of age), whereas the deaths from consumption were 6,662; including 2,871 between
20 and 40 years of age, and 2,559 between 40 and 60. Thus, 5,430, or 81.5 per cent., were of
persons at the working period of life, whose deaths (each life being valued at £200) involved
a loss to the community of more than a million sterling.
Notification.—During the four years 1902-5, cases to the number of 1,494 were investigated,
of which 889 (59.5 per cent.) were notified; the remaining 605 (40.5 per cent.) being cases the
occurrence of which became known only after registration of death (517) or otherwise (88). Of
the 889 cases notified (247, 221, 203 and 218 in the four years consecutively) 766 (86 per cent.)
belonged to North Kensinton, and 123 (14 per cent.) to South Kensington; in three of the
northern wards there were 692 cases (St. Charles 104, Golborne, 187, Norland, 401) or 78 per cent.
of total notifications; and in the remaining six wards 197, or 22 per cent. Between the ages 20-40
years there were 366 notifications; and between 40-60 years 393. At all other ages the
* The Conference of delegates of the Borough Councils held at the County Hall, Spring Gardens, "On the Administration
of the Public Health (London) Act, 1891," (July, 1904) unanimously adopted a resolution in connection with " Precautionary
Measures against Phthisis "—"That the sanitary authority should disinfect the premises in which a person suffering from phthisis
has died, or from which such a patient has removed or has been removed."