View report page

460
It is but logical to maintain that any scheme for the reduction
of Tuberculosis which neglects the fundamental need of either
removing such children from the danger of infection or of removing
the danger of infection from the children, is quite out of perspective.
It is because so little is done to protect those who are specially
exposed to infection that the death-rate from Pulmonary Tuberculosis
shows no greater decline since our special schemes were introduced
than that which was taking place for many years previously.
To deal with the disease more on the principles of prevention
is to face the problem on the lines of greatest resistance. It is admittedly
a difficult problem ; but if attacked it would prove far less
difficult than is generally believed. I am convinced that if suitable
provisions existed for removing the patient, or alternatively removing
the children, in most, if not all, of the 12 homes I refer to above,
those provisions would be gratefully availed of. The beds of most
centres for the isolation and treatment of advanced cases are at
all times occupied, and there is generally a demand for further
accommodation. Such a removal from a generally impoverished
family withdraws a member who is absorbing too much of a very
limited income; and where others are placed at grave risks there
should be powers for compulsory removal.
Probably resident institutions for children who are specially at
risk when the advanced case, poorly housed and cared for, cannot be
removed, would be one of the wisest provisions that could be made
for checking the onslaughts of this disease. In such institutions
they would be properly fed, clothed and housed, and suitably
educated and trained while the source of danger remains in the home—
a period which would not exceed an average of 12 to 18 months.
The early recognition of infection and the skilled treatment of
sufferers in sanatoria and outside of them is, of course, essential from
the preventive standpoint ; but I am convinced that next to
improved social and industrial conditions, which will always continue
to play the major part, must come the adoption of measures
of dealing with those who are running special risks in early life;
and until this is done no scheme for the reduction of tuberculosis
can satisfy.