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restaurants and clubs come next. Large private residences and hotels
are numerous in Westminster ; there is, therefore, a large population of
servants, waiters, &c.
(xvi) Measures Adopted or Proposed for the Prevention of Tuberculosis.—Westminster
has always been in the van in the adoption of
preventive measures. The medical officer of health on his appointment
some twenty odd years ago obtained sanction for and put into force the
following measures, which have had a distinct influence in the decline of
tuberculosis in the City from 1902 to 1914.
(1) Free examination of sputum by skilled bacteriologists at the cost
of the Council.
(2) Voluntary notification of pulmonary tuberculosis which was well
supported and carried out by the practitioners until the compulsory
notification regulations of 1912.
(3) Printed cards of information and advice on tuberculosis were
distributed to the homes of patients and "suspect" cases by sanitary
inspectors and later by health visitors, who were appointed specially
for the purpose of visiting and assisting consumptives.
(4) Disinfection of rooms and bedding on the departure or death of
patients.
(5) Free distribution of sputum flasks, or pocket spittoons, to
patients.
(6) Provision of bed and bedding, clothing, &c.
The above measures have been in force for almost 20 years. The free
examination of sputum specimens sent by medical practitioners has been
of more far reaching importance than most people realise. By its means
the disease could be diagnosed in cases who otherwise would have been
labelled "chronic bronchitis" even unto death. Measures of isolation
and treatment could be undertaken which were bound to have an influence
in the limitation of infection in the succeeding years.
(7) The greatest measure of pre-Insurance Act days was the lease of
sanatorium beds by the Council. Westminster residents were sent to
sanatorium free or on a contributory basis according to their means.
Only the curable types of cases were eligible for the Council's scheme.
This was a thoroughly sound, economic principle in dealing with the
treatment of tuberculosis. Finally, the Guardians of Westminster had a
large institution of modern. construction situated in the open country
beyond Hendon. Tuberculous cases were drafted from the infirmary
in London to this more suitable institution with its sunny aspect and open
surroundings. Patients seldom offered any objection to going into the
infirmary when it was pointed out to them that they would be transferred