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53
"In actual experience a large proportion of poor patients cannot be
cured at the stage at which their disease is first recognised without
treatment which is so protracted and so large in amount when attempted
for a number of patients as to be outside the range of present practical
administration. Many such patients, however, either recover, or without
complete recovery continue to be able to work indefinitely, even when
protracted sanatorium treatment cannot be secured. Their working
life can be extended, and their capacity to spread infection can be
stopped, by an occasional stay in a sanatorium, of limited duration, say,
for a month. It is on sanatorium treatment of this type for patients
still able to work that stress may be laid. The patient usually does not
lose his place by the short absence from work contemplated; he is
willing to come into a sanatorium for such a short stay, when he would
not accept more protracted treatment, and the improvement experienced
during such a short stay in a sanatorium is often most remarkable.
This, however, is not the only gain. When the patient enters the
sanatorium his dwelling is disinfected; his relatives are releived temporarily
from a source of anxiety; and the patient while in the sanatorium
is trained in the methods of disposal of sputum, and in the general
hygenic regulation of his life in a practical manner that is scarcely
possible at home. On his return home he is, therefore, no longer likely
to be a source of infection, and the general hygiene of his home is almost
certain to reflect the good influence of his stay in the sanatorium.
From the standpoint of the sanitary authority a much larger number of
patients can, in this way, be treated and prevented from becoming a
source of infection than if permanent cure of the individual patient
were made the only consideration."
Temporary arrangements have been made with the Maitland
Sanatorium at Peppard Common, Oxfordshire, and 6 patients
have been able to take advantage of residence there for a month
at a time.
Steps are also being taken to endeavour to secure an earlier recognition
of the disease, and the co-operation of the medical staffs of the
hospitals and dispensaries, and of members of the profession practising
in Westminster. Arrangements are being made that in all Poor Law
cases, and in such private cases in which the Medical Attendant desires
it, a properly trained Special Visitor from the Health Society shall call
upon the patient to give instructions as to measures of personal hygiene
and precautions against infection; to obtain information as to "contacts";
to endeavour, in cases requiring outside assistance, to obtain,
through the agency of the various charitable societies, better food,
clothing, separate bed, sanatorium or other treatment indicated by the
Medical Attendant, and to discover and take steps to obtain the