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129
At present the preventive measures practised in the Borough
are insufficient—more especially in regard to the detection of early
cases and the isolation and supervision of the dangerous advanced
cases. The measures that we have been able to adopt up to the
present are the following: The cases notified to us are mostly in
an advanced stage of the disease, and the majority are unsuitable
for admission to a sanatorium. An inspection of the dwelling
of the person notified is made and an inquiry is instituted
as to the family and personal history and present occupational and
home circumstances of the patient. I personally visit all cases
and give verbal instructions and suggestions, but at the same
time a printed handbill of advice is given to some member of the
family. In necessitous cases the Borough Council supplies a disinfectant
gratuitously, and the premises are disinfected, occasionally
during their occupancy by the patient but always on removal or
death. Assisted by the official woman health visitor, and occasionally
by voluntary health visitors, it has been possible to keep
some of the worst cases under a limited degree of observation;
but it has not been possible to undertake systematic visitation and
observation of the patients, nor the clinical examination of all
those who have been in close contact with the sufferer.
Thus the notification of Consumption has impressed upon all
those who have thereby been brought in contact with many cases
of this disease among the poorer people, one outstanding circumstance
demanding remedial measures, viz., that a large proportion
of those notified are suffering from the disease in too advanced
a stage for sanatorium or other treatment to afford much prospect
of success; and an essential development of our campaign against
the disease is to do what is possible to provide for the early
discovery of infection, so that persons may be given the benefit of
medical supervision and advice and other help at the earliest
possible moment. With the early detection of the disease the
chances of restoration to work for many years becomes very good,
even with the poor; so that in our campaign against the disease
among the poorer classes it is important that these very early cases