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130
should be sought out and taken in hand almost before they know
themselves to be ill.
There can be no doubt that the system which provides for the
detection of early unsuspected cases, which enables a man to continue
his work during his treatment (because his case has not
progressed too far), and which supervises his home arrangements
during his treatment, is the one which presents the most favourable
prospects for establishing such an amount of control over the
disease as may in future lead to a great reduction in the suffering
and death which it entails. Now that the disease in all its forms
has been made compulsorily notifiable, we shall be able to apply
the above measures far more generally than hitherto; and a scheme
for extending our work to better meet the requirements of the
situation is at present under the consideration of the Public Health
Committee
Consumption is not a disease the prevalence of which among
the masses can easily be reduced; but the reduction of the disease
in the past 50 years is encouraging—even when allowance is
made for the fact that the decline shown by the figures of registered
deaths is due in no small measure to altered nomenclature
and the influence exerted by migration, as pointed out by
Dr. Hamer, the Medical Officer of Health for the County of
London.
In my last Annual Report I indicated at some length the
object and scope of the work of the Tuberculosis Dispensary
system, which is now so generally advocated.
Local Authorities have powers under the Public Health Acts
to provide Dispensaries, etc.; and the Local Government Board,
in their Circular, dated March 22nd, 1911, states: "The Order
(of 1911) will allow the provision of appliances or apparatus, such
as temporary shelters, with the necessary furniture, and utensils
for the use of the patient; and by these means patients may