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30
Phthisis (Consumption).
As the result of about two and a half years' experience of the
voluntary notification of consumption in London, one is impressed with
the fact that, although some good has undoubtedly been achieved
thereby, there is a great need for the adoption of further measures.
The voluntary notification of the disease enables the sanitary
authority to deal with a very limited number of cases. During the
year 1903, for instance, we received only one notification of this disease
to about every 1,000 of population; whereas there must have been
in the borough several times as many cases, and the majority of these
would have derived some benefit from one or more of the following
lines of action taken when a notification certificate is received:—
1. An investigation of the surroundings of the patient, the conditions
of work, etc., with the object of detecting and removing those
conditions likely to favour the disease.
2. The leaving of a handbill of instruction and advice.
3. The gratuitous supply of disinfectant when necessary or
advisable.
4. Periodic visits to see if the precautions advised are carried out.
5. The compulsory cleansing and disinfection where necessary.
It is doubtless a great pity that the sphere of this useful work
should be limited to the few cases voluntarily notified, and it is, therefore,
very desirable that the notification should be made compulsory.
Voluntary notification is to a great extent a makeshift, but it has
served a useful purpose by educating public opinion so as to prepare
it for a measure of compulsory notification. The public is now ready
for such a measure. Nothing has been more surprising than the
circumstance that in every one of the houses visited the patient and
those about him were found to be fully aware of the communicabilitv
of the complaint.