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Tuberculosis Regulations, 1908.—These Regulations, under which all cases of consumption
in " poor persons " have been made compulsorily notifiable, came into force on 1st January,
1909. " Poor persons" are defined as persons in receipt of relief from the Poor Rate and it is only
to this class of patient that the Regulations of 1908 apply. Boards of Guardians through their
officers are required to furnish to Medical Officers of Health the following information in respect to
consumptive persons in receipt of relief, namely:—
1. On form A the addresses from which consumptive persons have been admitted to the
infirmary.
2. On form C the addresses to which consumptive persons go on their discharge from the
infirmary.
3. On form B the addresses of consumptives who are being attended in their homes by
the District Medical Officer, and
4. On form D any change of address by a poor person who has been previously certified
as suffering from consumption.
For the purpose of preventing the spread of infection from pulmonary Tuberculosis, sanitary
authorities are empowered to disinfect rooms, to disinfect or destroy infected articles, and to provide
sputum bottles and disinfectants for the private use of consumptives in their homes They are also
authorised to afford such "facilities" and to supply such "articles" as will diminish the risk of
infection arising from the use of any room which is occupied by a poor consumptive as a sleeping
apartment.
Article IX provides that no Medical Officer of Health or Council shall put into force any enactment
which subjects any persons notified under these regulations to any restriction or disability
affecting himself, his employment or his residence on the ground that he is suffering from consumption.
Compulsory powers of removal to or detention in hospital are thus deliberately withheld,
neither will it be possible to forbid the employment of consumptive persons on premises, such as
dairies, where their presence is a danger to the community. Nevertheless a large field for useful
work remains, and public opinion will no doubt approve the provision of reasonable safeguards
against the excessive hardship which might otherwise result from compulsory notification.
The Regulations are silent on the subject of the institutional treatment of consumption because
" any Sanitary Authority may provide hospitals for the use of the inhabitants of their district "
under the powers conferred by the existing Public Health Act (v. Sec. 75 Public Health (London)
Act, 1891, for London). And for this purpose they may themselves build hospitals or enter into an
agreement with any person in charge of a hospital, for the reception of the sick inhabitants of their
district on payment of such a sum as may be agreed on. The expression "hospital" means any
premises for the reception of the sick (v. Sec. 141 of the above Act). The Sections quoted are
important since they authorise sanatorium treatment and the segregation of advanced consumptives
in institutions at the expense of the rates. It is also understood that the Local Government Board
is prepared to recognise tuberculosis dispensaries as hospitals within the meaning of the Public
Health Acts, but should technical difficulties stand in the way of such an interpretation, special
sanction for the establishment of a Dispensary would no doubt be granted under Sec. 77 of the
London Act which permits sanitary authorities with the permission of the Board to provide a
temporary supply of medicine and medical assistance for the poorer inhabitants of their districts.
Tuberculosis Regulations (Hospitals).—The Public Health (Tuberculosis in Hospitals)
Regulations, 1911, came into force on May 1st, 1911. Broadly speaking they extend the system of
the compulsory notification of phthisis to consumptive persons receiving medical treatment whether
as out-patients or in-patients in any hospital, dispensary, or similar institution for the treatment of
the sick which is not wholly supported by the contributions of the patients themselves. Poor Law
institutions are excluded because they are already subject to the Regulations of 1908. Notifications
from the medical officer of any hospital are required to be sent to the Medical Officer of Health for
the area in which the hospital is situate and to contain a note of the home address of the patients
to whom they relate. Article IV. (2) provides for the distribution of the notifications received in the
following terms: "A Medical Officer of Health who receives a notification relating to a patient
whose residence is not within the area for which he is Medical Officer of Health shall . . .
transmit the notification to the Medical Officer of Health for the area in which the patient's
residence is situate, and shall at the same time inform the Medical Officer of the Hospital that he
has done so and shall give to him the name and address of the Medical Officer of Health to whom
the notification has been sent." In London the Medical Officer of Health for each Borough is also