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81
knives, forks, spoons, cups, saucers, and glasses; when the
utensils of the household are all washed together in the same bowl
and dried with the same cloth, the spread of infection from the
patient to his family is greatly favoured. When, in addition to
these drawbacks, the tenement is overcrowded and the patient
careless, the conditions for promoting the spread of the disease
are as pernicious as they possibly can be.
Ninety-one tenements were on the list of houses let in lodgings;
29 tenements were in the so-called "model" buildings, which,
with their small restricted common landings, and their many points
of close contact between the families who occupy them, are only
too well adapted for the spread of phthisis.
Homework was carried on in eighteen homes. Seven of the
houses occupied by the patients were used for the sale or preparation
of food products. In 226 instances, or in 66 per cent. of the
whole number of cases, the kitchen was being used as a living
room and a sleeping room.
This is one index of poverty, and shows the difficulties of
accommodation and the facilities for infection which accrue in
these poor households. Sometimes the patient himself occupies
the kitchen by day and night. Many of the kitchens were dirty,
verminous, or damp. In seven Houses the kitchen and feeding
utensils were extremely dirty.
The presence of dirt or vermin may be taken to connote carelessness,
and carelessness in the family of a consumptive means
increased risk of infection for the rest of the family.
A sanitary survey was made of every tenement, and the
nuisances found were made the subject of subsequent notice and
amendment. The following defects were ascertained: Insufficient
head room, 88; dark kitchens, 49; dirty rooms, 27; damp rooms,
6; broken or dilapidated walls or roofs, 12; insufficient ventilation,
9; and verminous rooms, 10 tenements.
A Summary of the Difficulties Encountered.- A brief
summary of the difficulties encountered in dealing with Finsbury
cases of tuberculosis and with home contacts is annexed.