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140
The Medical Officer of Health for an area within the Administra
tive County of London is required to send to the Medical Officer of
Health for the County a weekly statement of the notificatoins received
by him under this Order.
Poverty, drink, ,a.nd ignorance of the laws of hygiene are largely
responsible for the prevalence of Consumption, and it is not easy to
exaggerate the influence of badly-ventilated, dusty and over-heated
rooms, whether in the dwelling or the factory, in inducing the disease
and favouring its spread. Having regard to the considerable decline
in Consumption during past years, which decline is to be attributed
tc better wages, better dwelling-houses, and increased temperance, we
must attach a prime importance to the provision of more healthy
dwellings for the poorer classes and a more general practice of the
laws of health, and a subsidiary importance to the provision of sanatoria.
In my judgment, even more important than the provision of
sanatoria is the provision of the means for the removal to a place of
safety of advanced cases among the poorer people, for nothing can
exceed the danger of infection which comes from the advanced case
nursed at home in bad surroundings, to which he contributes a
maximum of infection day by day. The care of advanced cases is not
incompatible with the provision of sanatorio and other measures;
and, of course, the reco-very of a sufferer who is detected in the early
stages of the disease prevents the occurrence later on of one of these
active foci of infection. Indeed, logically, the attack must be a
combined one. It seems that the only prospect in the immediate
future of obtaining the isolation of advanced cases in London will be
through the Metropolitan Asylums Board, who may make the provision
of one or two thousand beds, as they did last year in the case of
Measles.
In his Last Annual Report, Dr. Newsholme concludes his reference
to the prevalence of this disease with the following weighty
words: “The continuing national loss of health and wealth still caused
by Tuberculosis is owing in large measure to the fact that Local
Authorities and others concerned have not yet utilised all available
means fcr its prevention.”