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" The proportion of deaths from phthisis at the Workhouse Infirmary*to deaths from this
cause in the Borough, as a whole, was, as usual, large : 77 out of 174 (44.3 per cent.); males 47 and
females 30. Sixty of these deaths (77.9 per cent.) were of North Kensington persons and 17 of South
Kensington persons.
"The notified infirmary cases were 144; males 81, females 63:115 of North Kensington
persons and 29 of South Kensington persons. Thirty-eight cases were notified by the district
medical officers; the majority of which were subsequently removed to the Infirmary. There was
a decrease in private notifications during the year; 12 cases only (all of them in North Kensington),
as against 31 cases in 1906, having been reported by other than Poor Law Medical Officers. In
addition, 7 private cases were reported by Poor Law Medical Officers. Fourteen cases were brought
to our knowledge from other sources—Hospital Almoners, the Charity Organization Society, the
Jewish Board of Guardians and the Military Authorities. Thirteen additional cases were found by
ourselves when visiting houses for other purposes.
" Patients residing at home (averaging 54 in number) were kept under observation, and
visited as frequently as practicable. Disinfection after death or after removal of a patient from one
abode to another, was offered, and usually accepted; it was done in 139 cases, out of 265 infected
rooms: in 127 by the Council's officer, in 12 under the medical attendant's direction. There were
only 38 absolute refusals, on the ground that disinfection was considered " unnecessary." In 88
cases the room was in occupation. In a large majority of cases the disease was in an advanced
stage when notified, the sufferers having continued to work for the support of their families, and
rarely having seen a doctor till absolutely compelled. We are deeply impressed with the need for
a sanatorium to which sufferers could be removed in the early stages of the disease, a course which
would generally involve provision being made for the support of families during the period devoted
to treatment of the breadwinners. We noted continued improvement in the ventilation of sick
rooms by open windows, and an increased appreciation of the value of fresh air to phthisical persons,
and of the danger arising from indiscriminate spitting.
" The Council at the end of 1906 sanctioned the free distribution of sputum bottles to sufferers
residing at home, and 51 were given out during the year, much to the comfort of the recipients and
to the benefit of the community. Six of these bottles were subsequently returned by the relatives
on the death of the patient. The comparatively small number of bottles issued, compared with the
number of notified cases, was due to the fact that at about the same time the Guardians started free
distribution of bottles to phthisical inmates of the Infirmary, and thus many of the cases visited were
found to be already supplied.
" Attention may well be drawn to the final table appended to this report which bears eloquent
testimony to the fact that consumption is mainly a disease of the poor. Of the 347 cases investigated
fourteen only were of persons in a more or less well-to-do position—their illness had not been
notified, and all of them died—the remainder belonging to classes of the population able to contribute
little, if anything, to the cost of sanatorium treatment. It appears to us hopeless to expect any
material benefit when the sufferer is compelled to live with others in one or two rooms; and the
' advice ' to sleep alone is a counsel of perfection very rarely capable of being followed.) "

* I am indebted to Dr. Potter for an interesting account of the work at the Borough Infirmary in relation to the treatment
of tuberculosis in 1907. At the beginning of the year there were 81 patients (males 57, females 24) under treatment. The
males admitted were 127, the females 95 (total 222) so that in all 303 cases were dealt with in the course of the year. All
phthisical cases are isolated, but cases of local tuberculosis are treated in the general wards. The beds set apart for isolation
are 85 in number (males 56, females 29). Dr. Potter observes that "the incidence of consumption in males appears in his
statistics to be decreasing, in females to be increasing."