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55
INSTITUTIONS FOR CONSUMPTION.
The General and Special Institutions dealing with Consumption were
enumerated in last year's Annual Report, and the St. Pancras scheme
described.
During the year under review questions as to Institutions for Consumption
have been raised on various occasions in various quarters. One
of the most persistent questions has been that of providing accommodation
for far-advanced and incurable cases which are such a danger to other
members of poor families.
The St. Pancras Guardians have provided at the North Infirmary four
wards specially for Consumption, three of the wards containing 33, 33, and
20 beds respectively for men, and one of 16 beds for women ; a total of
102 beds.
But it is interesting to consider generally the classes of institutions now
provided for Consumption.
Broadly speaking, the course of Pulmonary Tuberculosis is naturally
continuous, but for convenience of classification it is generally divided into
three or four stages, according to the period at which the disease is under
treatment. The first stage embraces the doubtful and incipient cases; the
second, the distinct and pronounced cases; the third, the established and
advanced but partly or wholly arrested cases; and the fourth, the far-advanced,
unarrested, uncured, and incurable.
Several kinds of institutions exist for treatment away from home, exclusive
of ordinary convalescent homes and health-restoring institutions, for those
temporarily debilitated, with or without predisposition to pulmonary feebleness.
The special residential institutions range themselves into three classes.
Firstly, those admitting by preference early cases with incipient signs, or
some with distinct, or perhaps pronounced, symptoms of the disease,
embracing the two first classes mentioned above, and generally termed
sanatoria; secondly, those admitting temporarily the more established or
advanced cases, and either in the nature of, or expressly designated, hospitals;
and, thirdly, institutions under various designations, such as poor law
infirmaries, homes for the dying, and homes under the names of Saints or
founders, admitting unarrested, uncured, and incurable cases.
A good plea may be made for the use of the generic title " incuratoria"
for institutions admitting far-advanced and chronic cases of Pulmonary
Tuberculosis, unarrested, uncured, and incurable. Just as the term sanatorium
is derived from sano, sanatum, to heal or cure, so the term incuratorium may
be derived from incuratun, a, urn, uncured. We are all well aware of the
fact that classification and the use of generic terms immensely facilitates the
discussion and consideration of complex subjects, and one is struck constantly
by the confusion of thought and expression in discussions upon the provision
•of institutions for various classes of cases of consumption.