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43
in too advanced a stage, and our administrative machinery should be
so devised that persons may be encouraged to seek medical advice and
other help at the earliest possible moment when they are affected or
threatened with the disease. There should be little difficulty in getting
earlier information, especially if the directions of the Memorandum
of the Local Government Board are followed, viz.: "The investigators
may not pursue enquiries in a manner or give information that
may prevent a consumptive patient from continuing to earn his
livelihood." The second matter is the necessity for increased provision
for sanatorium treatment of he disease when earlier and more
suitable cases can be drafted into such sanatoria for the poorer
people, far better results will be obtained from these institutions.
With really early and suitable cases the chances of restoration to
work for many years become very good. The patients themselves
will be able to do a little work in these institutions as a partial
set off" to the expense of their maintenance and they will be better
able, by a short residence, to learn some suitable work which they
can safely undertake on their discharge.
With the exception of six Boroughs, namely, Paddington in the
West, Stepney, Shoreditch and Bethnal Green in the East, and Deptford
and Cambenwell in the South, the voluntary notification of
Phthisis is now in force in all the Metropolitan Boroughs. As I have
so frequently pointed out in previous reports, the clamant need for
the isolation of advanced cases of this disease amongst poor people
was demonstrated in many cases which, were notified in Stoke Newington
during last year. Although the Workhouse Infirmary plays an
important part in providing isolation of this sort, it of course only
partially meets the needs. At the present time, in the great majority
of cases, we find it impossible to get advanced sufferers from surroundings
which are bad for themselves and highly dangerous to their
families. There are no Sanatoria available for these people and a
proportion of them prefer to die in their squalid surroundings than
enter a Poor Law Institution, Phthisis mortality occurs especially