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69
Occupation for the patients is also a pressing difficulty, and unemployment is
often the end as well as the beginning of the disease.
Some valuable work in relation to consumption has been done by the School
for mothers. Miss Colles as Superintendent has taken great interest in mothers
in danger of developing the disease, and Miss Potty's work as Assistant Superintendant,
in teaching in the homes of the people the making of nourishing
and inexpensive dishes, goes near to the root of this and many other health
difficulties.
This year's work has confirmed the experience of previous years, but has
given few new points of interest. Two cases occurring in cleaners and attendants
at places of amusement may be noted. Both complained of the effects of
dust inhaled during work, and it seems probable that this was an active cause
of their illness.
Improved methodsof cleansing, both domestic and general, seem much needed.
Almost every form of cleansing involves the inhaling of dust or the contamination
of the hands.
The domestic doormat is probably a potent spreader of infection, and the
ordinary broom, in street or house, does the same work.
Some cheap and destructible form of sputum flask is desirable. The ordinary
glass bottle approved for cleanly and careful patients is less suitable for the
careless and unintelligent, whose lack of fastidiousness must he noted in their
unguarded moments to be fully understood. The compressed paper box
distributed by the Manchester Health Department seems preferable to the
glass bottle, as being destructible together with is contents.
Two cases of consumption in caretakers in unoccupied premises were found.
In both cases the rooms occupied were disinfected after the patients' removal.
The regulations relating to Poor Law Notifications prohibit any action which
directly or indirectly subjects the person notified to any disability affecting his
employment, occupation, means of livelihood or residence. The wisdom of
this caution is evident, and every care has been taken in dealing with the cases
to comply implicitly with its requirements. Any action consequent on notification
which may tend to deter other sufferers from availing themselves of
medical care will necessarily do harm, even though the action in the single case
may seem to be desirable. Although 110 immediate and direct action may be
taken with reference to the place of employment of a patient, information of
much value relating to industrial conditions will be obtained, and, with proper
proper caution, acted upon. A further valuable contribution to the improvement
of industrial conditions will be the education of the patient and
household as to the value of fresh air and general cleanliness. Too often, at
present, the employees object to the full use of means of ventilation provided in
workshops, anil persist in undesirable practices which can only be stopped by
themselves.
I am, Sir,
Your ole lient Servant,
M. E. Bibby,
Sanitary Inspector.