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36
THE VOLUNTARY NOTIFICATION OF CONSUMPTION IN KENSINGTON.
I beg to submit the annual report of the two lady inspectors (Miss de Chaumont and Miss
Looker) with reference to the cases of consumption notified during 1908:—
"During the year 1908 we enquired into all cases of phthisis (pulmonary consumption)
voluntarily notified by medical practitioners, 229 in number (compared with 231 in 1907), of which
68 proved fatal. We made enquiries also with regard to 22 deaths of persons whose illness had been
notified in previous years, and of 91 deaths of persons whose illness had not been notified. The
cases investigated during the year were thus 342 (males 195, females 147); the number of visits
paid being 868.

"One hundred and eighty-eight of the 229 notifications and 139 of the 181 deaths, were of
persons belonging to North Kensington; whilst 165 of the notifications were from three wards
viz.:—St. Charles (29), Golborne (54), Norland (82): 118 of the deaths 25, 43, and 50, respectively)
belonged to the same wards, the population of which is but little over 73,000.
"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: 80 out of 181. Seventy-three of these
deaths were of North Kensington persons and 7 of South Kensington persons.
"The notified infirmary cases were 139; males 90, females 49: 112 of North Kensington
persons and 27 of South Kensington persons. Forty-one cases were notified by the district
medical officers; the majority of which were subsequently removed to the Infirmary. There was
a slight increase in private notifications during the vear; 18 cases, as against 12 cases in 1907 having
been reported by other than Poor Law Medical Officers. In addition, 11 private cases were reported
by Poor Law Medical Officers. Seventeen cases were brought to our knowledge from other
sources—Hospital Almoners, the Jewish Board of Guardians and the Military Authorities. Three
additional cases were found by ourselves when visiting houses for other purposes.
"In the month of November a fresh step was taken by the Authorities at Brompton
Consumption Hospital; the Medical Officers now notifying (with the patient's consent) to the
Medical Officer of Health of the London County Council, all out-patients residing in London.
These notifications are forwarded to the respective Local Medical Officers of Health. In Kensington
they numbered 13 of the cases received through Hospital Almoners mentioned above.
"Patients residing at home (averaging 86 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 126 cases, out of 249 infected
rooms: in 105 by the Council's officer, in 21 under the medical attendant's direction. There were
only 19 absolute refusals (as against 38 in 1907), on the ground that disinfection was considered
"unnecessary." In 104 cases the room was in occupation.
"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 1907. An additional 27 bottles were distributed in
1908, much to the comfort of the recipients and to the benefit of the community.
"In a large majority of the 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.
"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 342 cases investigated
fifteen 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."