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38
THE PREVENTION OF CONSUMPTION ; AND THE FIGHT AGAINST
TUBERCULOSIS.
The prevention of consumption, a subject in which during the last eight years the Kensington
Sanitary Authority have, on various occasions, manifested considerable interest, engaged much
public attention last year; especially, as we shall see later on, in Ireland, where the disease is
relatively far more fatal than in England. Of the matters which occupy the thoughts of public
health administrators, none exceeds this in importance, for the " great white plague," as consumption
has been well called, whilst being the cause of a vast number of deaths—forty thousand yearly
in England and Wales—is both preventable and curable. A cause of untold misery to its victims,
and those dependent upon them, it involves an immense drain upon the rates for the relief of the
sick, the support of widows and orphans, and otherwise. The question therefore is one of National
concern, and all right-thinking persons must desire that no effort should be spared to stamp out so
devastating a scourge.
As regards Sanatorium provision, much has been done by private enterprise to supply the needs
of well-to-do persons, able to pay, and not a little by local authorities in different parts of the
country. But hitherto nothing approaching a National system for coping with a National need, has
been evolved. Such a system for the benefit of the chargeable poor, could be created by the
classification of Poor Law Institutions, and the setting apart of some of them, in each county, as
refuges for advanced, incurable cases, so dangerous to the community, and of others, as hospitals,
for the treatment of recent cases in the initial stages of the disease when it admits of alleviation or
cure. I do not know whether the adoption of this plan would necessitate an application to
Parliament; or whether it may be within the competence of the Local Government Board : in any
case, however, it would appear to be within their power, as regards the Metropolitan District,—by
Section 5 of the Metropolitan Poor Act, 1867, which enables the Board " by order [to] direct that
any building for the time being in use as a workhouse be, with such alterations as the Board think
fit, used for [an] asylum, [i.e., for sufferers from an infectious disease, or otherwise] and thenceforth
that building shall be for the common use of the district accordingly." But the simpler course
would be for the Board to issue an order making section 5 applicable to the case of poor persons
suffering from consumption, who would then be legally admissible to the Managers' asylums. To
enable the Managers to admit non-chargeable persons legislation would be required.
So much premised I propose in what follows to submit some account of the state of the
" fight " against consumption as now going on in the three Kingdoms—with an ever-increasing
intensity which presages ultimate victory to the cause of humanity.
And first with respect to England, and as regards the official aspect of the matter, this is the
least satisfactory of all. The Local Government Board, though satisfied that pulmonary phthisis (or
as I shall for brevity hereinafter call it, Consumption) is an infectious disease to which the provisions
of the Hospitals Isolation Act, 1893, are applicable* and that an inmate of a Poor Law establishment
in a late stage of the malady with copious expectoration, being a danger to the community,
may be lawfully detained by the Guardians,f nevertheless are not yet satisfied that it is one
to which compulsory notification is properly applicable, or that they should sanction the establishment
of sanatoria for poor inhabitants of London by the only body that could under present conditions
undertake the duty, to wit, the Metropolitan Asylums Board—the only ground of
objection alleged being the expense it would entail.J
THE WORKERS' SANATORIUM.
When we pass to the region of private effort the prospect is more hopeful, and last year I
had to chronicle a very notable event—the opening of the first sanatorium erected by the National
Association for the Establishment and Maintenance of Sanatoria for workers suffering from
Tuberculosis. The ceremony was performed, on the 30th April, by Princess Christian, the President
of the Association, Her Royal Highness having laid the foundation stone in July, 1906. The
Sanatorium, at Benenden, in the County of Kent, is designed for 200 patients ; the part opened provides
for about 40. The cost of the site (£5,800 for some 250 acres), and of the buildings which
are of a permanent description, (£20,000 = £100 per bed) has been defrayed by voluntary subscriptions;
the maintenance of the patients will be undertaken by the Friendly Societies, who have not
only guaranteed expenses, by endowing beds, at a cost of 25s. per week each, but will also hand
over the members' sick pay for the support of wives and families; and thus will " overcome the
anxiety of working men to leave the institution before complete arrest of their malady." A notable
part of the scheme is an " after-care farm colony."
* Letter from Local Government Board to the late Sir William Broadbent. Vide page 42.
† Letter from Local Government Board to the Bath Union Board of Guardians. Vide page 42.
‡Letter from Local Government Board to the Metropolitan Asylums Board. Vide page 42.