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33
"The question of the special treatment of tuberculous cases in the Infirmary has already
engaged the attention of your Committee, upon the request from the Medical Superintendent
for the provision of a glass verandah, under which he could try the experiment
of the effect of such open-air treatment as may be possible in the neighbourhood of the
metropolis, upon the female patients in the Infirmary suffering from tuberculous disease,
and they recommend that such a verandah or screen be fixed on. the south side of
Ward IX., and that this ward be set apart, so far as its accommodation admits, for
the separate treatment of women and children suffering from these diseases.
"The suggestion of Dr. Dudfield is a very large one, necessarily involving a very large
expenditure in the provision of special institutions in suitable selected localities, and
until the result of the experiment proposed to be tried on a small scale here, as well
as of other experiments which your Committee believe are in contemplation, for the
separate and ' open-air' treatment of tuberculous diseases has been ascertained, your
Committee do not feel justified in recommending the Guardians to proceed further in
the direction indicated by the Medical Officer of Health.
"Should the results of the experiment proposed to be made with the female patients prove
satisfactory, your Committee will consider how far it may be practicable to make a
similar provision in connection with the men's side."
The ward selected for the experiment has a south aspect and is light and sunny: the value
of pure air, light, and sunshine, in the treatment of consumption, cannot be over-estimated.
Combined action of the London Poor-Law Authorities.—On October 15th, 1900, a Poor Law
Conference was held at St. Martin's Town Hall, " to consider the general question of establishing
hospitals for the open-air treatment of consumption." No fewer than 77 delegates were present, 26
out of the 32 Poor Law Authorities of the Metropolis being represented ; Kensington, among them,
by Mr. Rutherglen, Clerk to the Guardians, and Dr. Potter, Medical Superintendent of the
Infirmary. Sir William Broadbent, chairman of the National Association for the Prevention of
Consumption, took part in the proceedings, as did (but unofficially), Dr. Downes, Medical Inspector
to the Local Government Board. Correspondence was read showing that the Local Government
Board, on the matter having been brought before them, expressed sympathy with the Managers of
the Poplar and Stepney Sick Asylum District (to whose initiative the holding of the Conference was
due) in regard to provision being made for the open-air treatment of Phthisis, but intimated their
opinion that such provision, if made at all, should be for the Metropolis as a whole, and be under
the management and control of a Metropolitan authority. The Board also suggested the holding of
a conference of Metropolitan Poor Law Authorities.
An interesting discussion took place, in which Mr. Rutherglen took part, stating that
" Kensington had arrived at the conclusion that separate treatment of consumption was desirable " ;
expressing the opinion that "provision would have to be made for about 1,000 persons," for all
London, and suggesting that " the Local Government Board should be approached with the view of
obtaining from them the necessary Order for such provision." He pointed out, as the aforementioned
sub-committee of the late vestry had done, in March, 1899, that " by providing separate
sanatoria for consumption, the infirmaries would have a portion of their accommodation set free for
other purposes," and he recommended enquiry to be made by the Poor Law authorities in London,
as to " the number of cases of phthisis chargeable to them which would be fit subjects for treatment
in the way proposed," and that " the Local Government Board should then be asked to give to the
Asylums Board the requisite powers to carry the proposals into effect"; a suggestion which was
favourably received. Sir William Broadbent expressed his " admiration of the proposal," which
had brought the meeting together, and his " sympathy with the objects of the movement"; for
"nothing could be said that could exaggerate the importance of the project which, he hoped, would
be initiated at that Conference." He approved " a movement on the part of London as a whole,"
and cited what had been done at Liverpool, with the approval of the Local Government Board.
He also commended the system of house-to-house visitation by " Women Health Visitors, "
as at Manchester and elsewhere (a subject dealt with at page 52 of the present report), whereby
cases of consumption would become known ; he thought, moreover, that it would be necessary to have
some kind of voluntary notification of phthisis. " Everything," he added, " that tended to prevent
consumption, by removing the hygienic conditions which contributed to it, also tended to check
the prevalence of other diseases." Dr. Downes agreed with Mr. Rutherglen's figure of 1,000 cases
" as that for which separate accommodation of the kind suggested would probably have to be
provided," and should, I may observe, be provided in at least four or five hospitals. He said that
on July 7th last, there were 1,562 consumptive patients in Metropolitan institutions, of whom
1,000 could be moved to a sanatorium or sanatoria within 50 miles of London, and of the total
number 400 were in the initial stages of the disease. The meeting unanimously resolved—
"That this Conference of Poor Law Authorities, having discussed the question of the
open-air treatment of Consumption, are of opinion that the time has come when provision
should be made for the treatment by this method of the sick poor of the
Metropolis suffering from phthisis, and it recommends the matter for the consideration
of the Local Government Board with a view to the necessary steps being taken by that
Board for the carrying out of the proposal."
A deputation was appointed to bring the matter before the President of the Local Government
Board; but, so far as I am aware, nothing has yet been done to give practical effect to the
decision of the conference. Time is necessarily required for preliminary enquiry and organisation,
and possibly legislation may be necessary.