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supporting, by a charge for maintenance of, say, thirty shillings per week for each patient? This,
for 800 beds, would amount to a total of £62,400 ( =⅓d. rate)—a sum which, surely, the great
Friendly Societies could well afford to pay, if they cared to secure the beds. For this expenditure,
allowing for an average stay of three months (the term contemplated at Benenden), upwards of 3,000
patients might be treated in the course of the year; but the labour of the patients, in cultivation of
the land, should, whilst benefiting them, reduce the cost of maintenance considerably. In
the alternative, the suggestion of the Special Committee, to allocate beds to each of the
Metropolitan Unions and Parishes should be considered; but not on the basis suggested, for that
would involve giving more beds to Hampstead, with its phthisis death-rate of 0.67 per 1,000 persons
living, than to Holborn, with a rate (2.37) nearly four times as high. It may be pointed out that the
Public Health Authorities could maintain beds under the provisions of section 75 of the Public
Health (London) Act, 1891; and lastly, if from the design of the buildings, for a special purpose,
it should be thought undesirable to admit adults, the hospital might be utilised for children suffering
from tuberculosis. The adoption of either of these courses would be better than allowing the institution
to lie idle. But supposing it were decided to treat patients suffering from consumption—as
patients suffering from other infectious diseases are treated—without charge, a rich return would
be assured by the many lives saved, and the many more prolonged, by " cure," or arrest, of this fell
" white plague."
I will only further say, that, in my opinion, the use of the institution should be restricted to
bona-fide inhabitants of the Metropolis, and for the benefit of non-chargeable sufferers in the early
stages of the disease. In other words, it should be regarded as a hospital for cases admitting of
"cure" or alleviation of the disease; and not at all as a refuge for incurable patients. For advanced
chargeable cases, large, and probably adequate, provision has been made at the Poor
Law Infirmaries. For non-chargeable sufferers in advanced stages of the disease provision
might be made in country retreats, at a cost which need not exceed £100 per bed to judge from
what is being done for that amount at the Benenden Sanatorium.
The Movement in Ireland.—In 1901, and again in 1903, the Local Government Board for
Ireland, by the circulation of advisory letters, posters, and leaflets, impressed upon the Boards of
Guardians, and all others whom it concerned, the necessity of isolation for persons suffering from
consumption, and their annual report for 1906 describes a " systematic plan consisting of four elements,"
on which, " in the opinion of the Board's Medical Department, the prevention of consumption
should be dealt with." It may be summarised as follows; viz.—(1) By segregation of advanced
cases in hospitals, (2) By provision of sanatoriums for the treatment of the disease in an incipient
stage, (3) By establishment of tuberculosis dispensaries, for advice and treatment, in large centres of
population, and (4) By the appointment, by Sanitary Authorities, of local educative committees, and
the circulation of leaflets, etc., relating to the disease.
Last year important measures were taken for supplementing official action; a "Tuberculosis
Exhibition " was opened at Dublin (in October) by the Lord Lieutenant, who was accompanied
by the Chief Secretary; many eminent members of the medical profession and other distinguished
persons from various parts of Ireland being present. The exhibition, which had for its object
spread of knowledge of the means for bringing about arrest of the progress of consumption, was
promoted by Lady Aberdeen, as President of the Women's National Association of Ireland, and
was taken to various parts of the country, where lectures were delivered in connection with it.
His Excellency, referring to the importance of improving the sanitary conditions and conveniences
of the homes of the people, as a means for preventing the spread of consumption, stated that
under the Labourers' Dwellings Acts, 20,000 cottages had been built in the last twenty years ; and
that, arising out of recent legislation, there were applications for an additional 50,000—a splendid
opportunity being thus furnished for local authorities to grapple with an important part of the great
problem of the tuberculosis plague. Among the subjects which interested King Edward, one to
which he gave special attention was this question of Consumption, and he read a message from
His Majesty as follows:—
" I am commanded by the King to express his good wishes for the success of the Tuberculosis
Exhibition, the first of the kind ever held in Great Britain and Ireland, on the occasion of its being
opened by you to-day. His Majesty is greatly interested in the problem of checking the progress
of this disease, and he trusts that the exhibition may be the means of attracting the attention of the
public to the terrible ravages caused by this scourge, and to the efforts which are now being
made to arrest its progress.—Knollys."
In connection with this interesting event an adress on "What the Public can do in the -fight
against Tuberculosiswas delivered by Dr. William Osier, F.R.S., Regius Professor of Medicine at
Oxford, his Excellency the Lord Lieutenant presiding. The lecturer emphasised the necessity for
compulsory notification of consumption—" the only possible way to get at the disease being to know
where it was; " the provision of separate wards for isolation of advanced cases, and of sanatoria