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105
In requesting the assistance and co-operation of medical men, it was
pointed out that no official interference with the patient was contemplated
as the result of notification, either at his home or in connection
with his employment. The measures taken on behalf of the Council
are confined, mainly, to inspection of the house, disinfection and the
distribution of information with reference to the disposal of sputum,
and the general precautions proper to be observed with a view to
prevent the spread of disease, and no visit is paid where the medical
attendant considers it unnecessary or inexpedient.
Notification began on 6th April, 1903, and in the twelve months
128 notifications were received relating to 124 cases. With the exception
of 23 cases, the notifications were received from 28 medical men
at a cost of £8 1s. 6d. Investigation was made by myself into each
case, but in a number the amount of information, for various reasons,
was small; several persons had only been lodgers in the City for a few
days or weeks and had then gone into hospital, others were in the
Infirmary and had no relatives who could furnish information. However,
from the others information of a useful nature has been obtained.
The facts elicited bear out conclusions arrived at from previous
experience. These may be shortly stated:—
Tubercular disease may be regarded as a disease which is communicable,
but it appears only to be so within confined quarters, such
as the house or work-place, and moreover before the organism on
which it depends can develop the disease, the persons attacked by it
must be in such a state of health that he or she cannot resist.
Ordinarily the human body is able to resist and destroy the tubercular
organism, and we know this because it is found after death that a
very large proportion of persons show signs in their lungs of the damage
inflicted there by this organism. The knowledge of this fact is
encouraging, as showing definitely that consumption may be cured in its
early stages, and it indicates that in order to do this, it is necessary
to strengthen the forces of the body by the removal of all the conditions
tending to weaken it, and the supply of such means as will tend to
improve the physical standard.
Inability to resist the invasion of the tubercular organism may be
(1) inherent or (2) acquired.
(1) Inherent want of resistance.—At one time consumption was
believed to be hereditary, that is to say, if parents died from it the
children would very probably also have it. We know now that where
parents have died from consumption the children may be less able to
resist inl'ection than others, but so much importance is not now attached
to heredity in relation to consumption as was at one time the case, for
this reason, that in so many instances the disease has been communicated