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for recent cases. He referred to the victory achieved by medical science in the abolition of typhus
fever, the scourge of Ireland in former days, and predicted that, if proper measures were adopted,
the far more terrible scourge of tuberculosis—the cause of nearly one-sixth of the deaths in Ireland
in 1904—would in one or two generations be in like manner exterminated.*
Subsequently the " Consultation Committee," formed by Lady Aberdeen, held a meeting, her
Excellency presiding, and delegates from all parts of Ireland being present, when a resolution was
adopted urging the need for powers enabling the County Councils to erect and maintain hospitals,
sanatoria, and dispensaries for the treatment of consumptives. The Chief Secretary, moreover,
received a deputation from the County Councils' General Council, which laid before him the views
of that body as to the measures which the Government should take for dealing with the problem of
tuberculosis. Mr. Birrell, in reply, said, in effect, that the time had come when all right-minded
people must do all in their power to combat consumption. Sanatoria were to be established in Belfast,
Cork and Dublin. There was a considerable number of workhouses occupying healthy and isolated
sites which might be utilised for sanatorium purposes, and he would suggest to the Local
Government Board that they should ascertain what workhouses, no longer needed as such, might be
so utilised. It was eminently desirable, moreover, that there should be a statutory obligation on
medical men to notify consumption, and he would base a representation to the Treasury for assistance,
on the necessities of the situation, and the urgency of destroying this dreadful disease, which,
if allowed to continue at the present rate, would reduce Ireland to a very awful condition. He
thought that a measure authorising the erection of sanatoria, and providing for notification would
have to be introduced in the next Session of Parliament, and he hoped that, with the aid of all
gentlemen of position in Ireland, they might soon be able to begin the campaign against the shocking
state of affairs.
[A Bill has been drafted to give effect to these views, and is to be introduced into the House of
Commons during the current Session.]
The Movement in Scotland.—The Local Government Board for Scotland, in March, 1906,
issued a circular to Local Authorities on the " Administrative Control of Pulmonary Phthisis," in
which they dealt with the necessity for provision of sanatoria, and announced their willingness to
give favourable consideration to any application for their approval to compulsory notification, provided
they were satisfied that the Local Authority making it were in a position, and were ready, to
deal effectively with the cases notified to them; i.e., by provision of sanatorium accommodation
for isolation and treatment of sufferers in. the different stages of the disease. In their annual report
for 1906 the Board refer to various gratifying results consequent upon the issue of the circular—
including sanatorium provision by iocal authorities, and the giving of their approval to applications
for compulsory notification powers. With reference to this circular the Board observe that—
" The most important point to which the attention of the Local Authorities was directed, was that
' pulmonary phthisis (that is tuberculosis of the lungs or consumption) is an infectious disease within the
meaning of the Public Health (Scotland) Act, 1897;' and that ' the sections of that Act applicable to
other infectious diseases are equally applicable to pulmonary phthisis, and the obligation resting on the
Local Authority to deal with and control infectious disease extends to pulmonary phthisis.' For the
effective application of the Public Health Act to pulmonary phthisis, it was pointed out that a system of
notification is essential."
The question in Scotland, as in Ireland, is attracting popular attention, and the opening (in
October last) of additional accommodation at the Royal Victoria Hospital for Consumptives at
Craigleith, gave occasion for an important speech by the Right Hon. A. J. Balfour, M.P., who performed
the ceremony. In the course of his observations, Mr. Balfour said that—
" If they could not destroy and expel the tubercle bacillus from among them, they could reduce its
power to do evil to a degree which might seem to them at the moment incalculable. Referring to the
case of typhus, he doubted whether there was a single case in Edinburgh at the moment, and it might
be that their ohildren would live to see the time when consumption would be as little known in their
midst as typhus was now. They had made the conditions of infection with regard to typhus so fmall
that the power of resistance of the community at large was amply adequate to prevent its making any
lodgment of a serious kind in their midst. That was the ideal to which they looked forward with regard
to tuberculosis. Consumption was a disease which could be dealt with successfully, if taken early, but
if, through ignorance or neglect, it was allowed to get a fatal grip upon the organism, all that could
be done was to smooth the dving months or years of the sufferers. Sanatoria which provided something
more than a personal benefit to the sufferer, ought to be regarded as a great social gain to the
community at large. Poor men when attacked by this insidious maladv, were almost inevitably induced
to go on with the work on which their families depended, until weakness and the progress of the
disease rendered further struggle hopeless and impossible. Then came misery and bankruptcy, and
society found itself charged with the maintenance of the family in relative degradation. Could any
* An abstract of the address was published in the British Mcdical Journal, October, 19th.