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5. In some families, the housing conditions are unsatisfactory
—the head room, light, and ventilation are insufficient. And the
home conditions are such that the provision of a separate room or
of a separate bed for the patient is impossible. Some boroughs
lend out beds and bedsteads to the poor inhabitants free of
charge.
6. Many of the patients have to work hard over long hours,
and are quite unable to take the rest in the fresh open air
which is now considered to be an important part of the cure.
Many are homeworkers.
7. The use of shelters is often rendered difficult because there
is no flat roof, because the back yard or forecourt is small, or
because these places are much used and frequented by other
occupants for various purposes.
8. Many cases live in common lodging houses and are apt to
resent instruction or supervision. As soon as enquiries are made
after notification, they move elsewhere and are temporarily lost.
9. Cases of tuberculosis occur in those who handle milk, or
other foods, and who are on that account possessed of extensive
facilities for spreading infection. Cases occur in the inmates of
houses used for the sale or preparation of food or food products
for human consumption.
10. Many patients are careless and negligent, and take no
special precautions to prevent the infection spreading to the rest
of the family. Many are apparently indifferent as to whether their
wives or children catch the disease or not.
11. Many patients do not know they have consumption even
after they have been notified, and their friends and relatives do
not wish them to know. There is a conspiracy of silence to keep
the patient in an idiotically blissful condition of mischievous
ignorance.
12. Some of the patients are illiterate. They cannot read or
write. They cannot read the leaflets of instruction left with them.
To take an actual example: a woman had been notified to have
phthisis on three separate occasions. She had been an in-patient