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is not too ill to practise, elementary precautions. In these two respects the
disease is essentially different from the infectious diseases which are made
notifiable under the Public Health (London) Act, 1891. This difference is
affirmed by Article XIII of the new Regulations, and is the basis of the
administrative policy of the Board in relation to pulmonary tuberculosis, and
the reason for the issue of a special code of Regulations under Section 130 of
the Act of 1875. The fact that the patient may be trained and may as a
result cease to be a source of infection, in which case he need be subjected to no
disability, should be made clear both to the patient in the interests ot society
and to society in the interests of the patient. It is for this reason that
education must occupy an important place in the campaign against this disease.
It is, of course, unnecessary and undesirable that notification should involve
publicity. The Board have no doubt that local authorities and their officers
will avoid doing anything which could cause pain or annoyance to patients or
their friends. It cannot be too strongly emphasised that any records which may
be kept by a Medical Officer of Health in relation to persons notified should be
regarded as strictly confidential documents, for whose custody the Medical
Officer of Health is personally responsible. The register to be kept by a Medical
Officer of Health under the new Regulations is to be open to inspection only
by a person duly authorised by resolution of the Council, by t he Medical Officer
of Health for the County, by any School Medical Inspector acting within the
area of the Sanitary Authority, and by Officers of the Local Government
Board and of the Board of Education.
Article XIII. referred to above reads as follows : —
"Nothing in these Regulations shall have effect so as to apply, or so as to
authorise or require a Medical Officer of Health or a Council, or any
other person or authority, directly or indirectly, to put in force with
respect to any patient in relation to whom a notification in pursuance
of these Regulations has been transmitted to a Medical Officer of
Health, any enactment which renders the patient, or a person in
charge of the patient, or any other person, liable to a penalty, or
subjects the patient to any restriction, prohibition, or disability
affecting himself or his employment, occupation, or means of livelihood,
on the ground of his suffering from Pulmonary Tuberculosis."
The St. Pancras scheme for the control, treatment, and prevention of
pulmonary tuberculosis works out thus :—
1. -All cases diagnosed are medically certified to the Medical Officer of
Health.
2.—To all cases certified a card of advice is sent.
3.—Any person can apply to the Officers of the Public Health Department
for advice and as to the available means of assistance.
4.—At the end of every quarter the residences of all patients, both private
and public, are verified.
5.—The families of cases certified by Poor Law Medical Officers and
Officers of Hospitals and Public Dispensaries are visited for the
purpose of inquiry and advice by the Woman Inspector or her
assistants.