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purposes Of early diagnosis, and also as a curative agent. In the
latter respect it appears to be useful, and it is capable of curing a
proportion of the sufferers while remaining at their work.
Of course, such provisions are less effective than expensive sanatoria
; but we have to consider how we may obtain the greatest good
for the greatest number, and it is better to give a 60 per cent. chance
of life to 100 sufferers than a 90 per cent. chance of life to 10—for
a comprehensive scheme of sanatoria for the poorer people is too
costly to be entertained. Again, the educational results of occupying
these shelters is probably of even greater value than those obtained
by sojourn in a sanatorium, for in the former case the conditions more
approximate to the patient's home conditions.
In the absence of an invalidity insurance scheme among British
workers, sanatorium provision is robbed of much of its value for the
poorer classes, because of the great difficulty of getting them into
these institutions at a sufficiently early stage. This difficulty is in
some measure responsible for the disappointing results which sanatorium
treatment furnishes among the working classes. Nevertheless,
these institutions have a great educational value in respect of the precautions
which should be taken both in the patient's own interest and
in the interests of others. If the disease were made Compulsorily
notifiable, as it should have been made years ago, a more early selection
of cases suitable for sanatorium treatment would be possible, and
we should be able to advise more generally upon the precautionary
measures which are necessary.
In many parts of the country the empty Small-pox Hospitals are
being utilised for the isolation and education of some of the more
necessitous cases of Pulmonary Tuberculosis. At first sight it seems
that some danger and inconvenience might arise in connection with
such an arrangement, but the somewhat extensive experience now
available points to no drawbacks beyond the occasional need for the
sudden removal of the consumptive patients to their homes; but even
then the tuberculous patients have reaped the great advantage, not
only of better health, but also of a useful knowledge of how best to
regulate their lives in future,