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34
for the infection of many fresh units; for there is no malady to which
the dictum "Prevention is better than cure" applies more aptly.
In short, institutions are wanted which are not provided primarily
for the benefit of the patient, but for the isolation of the patient for
the benefit of others, and which may therefore fairly be supported
out of public funds. There are no such institutions in London, and
until they are provided we lack one of the most essential provisions
for coping with the disease.
It is a provision strictly comparable to our present fever hospitals,
which are constructed primarily to check the spread of disease, and
therefore the same authority should provide isolation homes for
consumptives; moreover, having regard to the enormous pecuniary
loss which the disease annually entails upon the State, some State
assistance should be obtainable where necessary.
Of course it is almost entirely amongst the poor that the sanitary
authority requires the information of the existence of cases and the
powers to limit the spread of infection, because the danger of the spread
of the disease amongst this class of the community, owing to the conditions
under which they are housed, is very great indeed. Happily,
the disease is declining in this and many other countries, in consequence
apparently of general hygienic measures and the improved social
conditions of the people; and having regard to the fact that the communicability
of the disease is but slight, a little more knowledge and
care on the part of the general public would have the effect of reducing
the number of cases infected from pre-existing cases almost to a vanishing
point.
With reference to the compulsory notification of this disease,
Sheffield has, under a local Act, succeeded in obtaining such powers
from Parliament. It is necessary, however, to point out that, under
the Sheffield Act, the disease is not added to those comprised in the
Notification Act, and that the subjects of pulmonary tuberculosis are
expressly exempted from the disabilities affecting those suffering from
the acute fevers.