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31
If the fear of infection has gained too great a hold of the public
mind, and there is a tendency to exaggerate the comparatively slight
infectiousness of the disease, doubtless this is better than to err in the
other direction. There is the risk, however, that it may lead to unnecessary
hardship in the treatment of the patient; consequently
it is most desirable to point out to all concerned, as is usually done in
a handbill, that, if a few simple precautions are taken, a consumptive
patient need not be a source of danger to anybody.
The effect of compulsory notification would be not only to increase
the number benefited, but also to bring about earlier notification.
Under voluntary notification I have found nearly all the certificates
received were of advanced cases, either attended by the parish doctor
or seeking assistance from the public dispensaries; many notifications
referred to patients in extremis or dead. The patient who at
the start of his illness is in fairly comfortable circumstances is rarely
notified until, owing to prolonged illness and consequent lack of work,
he falls within the above category.
Too much, however, must not be expected of even compulsory
notification. It is only one of our weapons in fighting the disease.
The hope of extirpating phthisis is impossible to realise. The exigencies
of life do not permit the vast majority of people to live under
ideal conditions, and selfishness, ignorance, or poverty will always
maintain sources of possible infection. But no reasonable step should
be neglected that will lead to a lessening of these sources of infection.
There is no doubt that much good results in many instances, both
directly and indirectly, from notification, and some occasional inconvenience
or annoyance to the individual who is a probable source of
infection must not be allowed to stand in the way. At the same time,
one has no right to interfere with the individual's liberty of action so
long as it does not jeopardise the health-interests of others, but when
others are thereby exposed to considerable risks it should be possible
to secure isolation of the patient.
Notification is mainly beneficial in the case of those who, owing
to lack of means, are unable to adopt the necessary measures to protect