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in the treatment of Tuberculosis. It must also be remembered
that sanatorium treatment, in addition to the part it plays in
restoring a patient's health and working capacity, serves a
most important educational function in teaching patients the
proper methods of personal hygiene and so helping in the prevention
of the spread of infection on the patient's return to
his home. I would add, however, that the length of stay is
usually too short in most cases to effect a permanent cure.
From many years of personal experience of the tuberculous
in London my criticism would be concentrated not on the results
of sanatorium treatment but rather on the after care of patients
on leaving these institutions. Abandoning the sheltered life of
the sanatorium with its abundance of good food and fresh air,
they return home to face overwhelming economic conditions—
loss of work and inability to provide adequate nourishment
for themselves or their families, overcrowding of the home,
etc. It would take a strong and healthy man to face such conditions
for any length of time with equanimity. It is not surprising
therefore, that relapses are common, and I would appeal
for improvements in the present tuberculosis scheme on the
following lines :—
1. Extension of Village Settlements on the lines of Papworth
and Preston Hall. In these colonies patients with their
families live under strict medical supervision and in ideal
hygienic conditions until their diseases has been arrested
for a period of five years and they are able once more to
live normal lives.
2. Provision of municipal workshops. Here again, patients
would work under strict medical supervision but would
continue to live at home. The hours and class of work
should in each case be governed by the patient's physical
capacity. A minimum living wage, irrespective of the
man's earning powers, should be paid with additional pay
to those working full time.
3. A greater measure of financial assistance to those patients
totally incapacitated with tuberculosis, and to their families.
4. A speeding-up of building -schemes for the re-housing of
the tuberculous. The London County Council, and I
believe, most Boroughs, give preferential consideration to
the tuberculous, but this does not adequately meet the
situation.
We have a large number of families with one or more tuberculous
members who have been waiting for better accommodation
for some considerable time. Under the new Housing Act of
1935 the number of occupants per room is definitely limited.
This has rather added to the difficulty of providing accommodation
for large families, as none of the new flats have more than
three bedrooms.