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26 TUBERCULOUS DISEASES.
particulars on the prescribed form and thus to certify the case to the medical officer of health.
In the case of persons in institutions the information is to be sent to the medical officer of
health of the district in which the poor person last resided before entering the institution.
The discharge of a consumptive person from an institution is to be reported by the superintending
officer thereof, and any change of address of a patient in receipt of out-relief by the
relieving officer.
It is expressly laid down that the Regulations do not empower any local authority, or
authority's official, "to put in force any enactment which renders the poor
person liable to a penalty, or subjects the poor person to any restriction, prohibition,
or disability affecting himself, or his employment, occupation or means of livelihood, or
residence, on the ground of his suffering from pulmonary tuberculosis." Subject to that reservation
the local authority is authorised to
(i) Use the legal enactments relating to other infectious diseases, to secure the proper disinfection
and destruction of infected articles, and the cleansing and disinfection of rooms;
(ii) take any steps deemed desirable to prevent the spread of infection by sputum;
(iii) "afford or supply all such assistance, facilities, or articles, as within such reasonable limits
as the circumstances of the case require and allow, will obviate or remove, or diminish the
risk of infection" in connection with the occupation of any room by a consumptive poor
person; and
(iv) "furnish on loan, or otherwise, any appliance, apparatus or utensil "suitable to
prevent the spread of infection.
Further, the authority is expressly authorised to issue "summaries of information and
instruction" respecting consumption in the form of placards, handbills or leaflets.
The Order does not deal with the provision of special accommodation for consumptives.
The Guardians possess sufficient powers to set apart wards and rooms in their institutions for
that purpose, and, by Sec. 22 of the Poor Law Amendment Act, 1867, they can detain any
person who, in the opinion of the Board's Medical Officer, cannot be discharged without
risk of spreading infection.
The Paddington Dispensarv for the prevention of Consumption is a voluntary institution
founded on the lines of the Royal Victoria Dispensarv in Edinburgh. The objects of the Institution
are the treatment in their homes of persons suffering with pulmonary consumption,
such treatment being coupled with special instruction as to the means to be adopted to
promote the cure of the disease and the prevention of the spread'of infection. These ends are
to be obtained by consultation with the Medical Officer at the Dispensary and by visits
of instruction at the patients' homes by the Medical Officer and the Nurse. Except when a
patient is too ill to attend at the Dispensary, the home visits are intended solely for
instruction in domestic hygiene and preventive precautions, the opportunity being taken to
note any specially undesirable circumstances of home life for remedy either by persuasion
(assisted by philanthropy if the case be a deserving one) and by the intervention of the
sanitary authority. No one under the care of a medical practitioner can attend the
Dispensary except with the consent of the practitioner.
The Dispensary is not, however, content with treating only those known to be
consumptive and seeking its assistance. Every member of the family of each consumptive
patient, his relatives outside his immediate family circle, and every other person living in the
same house with him is medically examined, if consent to do so can be obtained. By such
examination of "contacts" unrecognised cases of the disease are discovered—to the
advantage of the sufferers in that they secure a better hope of recovery bv immediate