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not likely to be heeded if the patient doubts whether he is suffering
from the disease. In two cases the request was made that
I should not visit the case, because it was undesirable to acquaint
the patient of his condition. Where this is the wish of a medical
practitioner the request is, of course, complied with.
The diagnosis of the medical attendant was disputed by the
patients in 2 cases, but in both cases a bacteriological examination
proved the medical attendant to be in the right; the correctness
of the diagnosis was subsequently disproved in four other
instances. In practically all the cases the diagnosis was confirmed
by a bacteriological examination of the sputa. In 5 instances the
patients were dead within two or three days of notification, and
in 6 instances the patient had been removed to the Infirmary or
to Hospital by the time a notification certificate reached us. In
5 cases the patient had left the address from which they were
notified; and in two cases false addresses were given.
judging from the deaths from Consumption, which numbered
35, there must have been, at least, some 200 sufferers from the
disease in the Borough during the year, and of those 152 were
notified under the voluntary system and the Public Health (Tuberculosis)
Regulations of 1908 and 1911, combined.
It must be realised that a proportion of the approximately
200 sufferers in Stoke Newington are disseminating infection. In
the earlier stages of the disease there is relativly little danger
of conveying infection, but later the danger is very considerable,
unless the patient has been trained to take the necessary precautions
; for at no stage of the disease need the educated consumptive
be a danger to anyone. Therefore, in the absence of any provision
to isolate or even to adequately supervise the advanced cases
which are notified to me, the process of infection doubtless continues
to go on in dozens of homes in Stoke Newington, and this
will remain so until more comprehensive measures are adopted.