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12
These are the people, therefore, who must be reached and taught the measures
to adopt to prevent the spread of tuberculosis among their kith and kin, their
friends, and the public.
The Cost of Tuberculosis.—To prevent tuberculosis is to save
money. This is a strong statement, but it is a true one. For tuberculosis
means poverty; and poverty means pauper relief; and pauper relief means
Poor Rates. In support of this contention I find it stated in the Minority Report
of the recent Royal Commission on the Poor Laws that "the very great mortality
from phthisis—a disease to which no less than one-seventh of the total cost
of the Poor Law is said to be directly or indirectly ascribed—is to be attributed
in no small degree to the fact that the sufferers are not encouraged to present
themselves for treatment in the early stages of the disease."
In the same Report it is recorded that the Superintendent of a Poor Law
Infirmary told the Commission that " he had carefully examined 4,000 cases of
consumption, and that of these people approximately 60 per cent, could not
have come within the range of the Poor Law had they not had the disease.
In short, as Mr. Joseph Chamberlain once said ' Preventable disease is the
great agent for filling our Workhouses.'"
If the figure of one-seventh the cost of the Poor Law be nearly correct,
it is clear that in Islington, where the expenditure last year for Poor Law
administration amounted to £203,810 (not inclusive of the amount paid in fees
for the Notification of Infectious Diseases) the cost of pauperism through
tuberculosis must have amounted to £29,115, or 3.8 pence in the £ on the
rates.
In a recent Report I showed that for many years this Borough had paid
some £40,000 (in 1911 it was £43,534, equal to a rate of 5¾. in the £) for
isolation and treatment of certain notifiable diseases (mainly scarlet fever and
diphtheria) the prevention of which is far more difficult than that of tuberculosis,
because in the former the agency whereby the spread of the infection
is accomplished is sometimes subtle and mysterious, while in the latter it is
much more obvious; that if the milk supply were protected by the Government,
as it is about to be, and the tuberculous patients educated by the Sanitary
Authority, the annual national holocaust by the disease would be prevented.
I am entirely of this opinion still, and in support of it I would quote Sir Lauder
Brunton, one of our greatest authorities, who says " if the whole people of this
country would only awaken to the mischief which is being wrought by this
dreadful disease, and would bestir themselves to remove it, in the course of
one generation consumption woidd be as rare among us as leprosy is now ....
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and yet we allow consumption not merely to decimate the people, but to kill
every seventh person. Nor are we guiltless if we say that we have only allowed