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56
WOMAN INSPECTOR'S REPORT UPON CONSUMPTION.
To the Medical Officer of Health.
Sir,
TUBERCULOSIS.
I submit a Report upon the work done in St. Pancras during the year
1911, in connection with the notification of Consumption.
During that year the system of Notification was extended, by the order of
the Local Government Board, making Notification compulsory in the case of
Hospital and Dispensary patients.
The number of cases increased considerably, in consequence, during the past
year, and the result of increasing the number of cases to which some attention
has been paid, has been that less attention has been given to each individual
case. The thoroughness of the investigation has naturally suffered. I have
endeavoured to secure that the interests of the patients have not suffered by
using as fully as possible the valuable help of local voluntary visitors in
suitable cases, but investigation is necessarily a matter for officials and their
place, in certain directions, cannot be filled by outside agencies.
The visitors of the Public Welfare Association dealt with 175 families, and I
estimate that about one thousand visits must have been paid by these visitors
during the year in this work. This is a valuable addition to the educational
resources of the Department, and we are deeply grateful for the assistance
which has been given to our cases in this way. These visitors are valuable,
not only in educating the actual patients, but also as spreading information
among the general public, and in helping to form a sane public opinion which
shall tend neither to panic nor to carelessness with regard to health matters.
The general co-operation with the Social forces of the Borough has continued
happily. The Organizers of London County Council Care Committees and of
the Labour Exchange Juvenile Department, Miss Nussey and Miss Phenix,
are among our new and much valued allies.
The St. Pancras Dispensary, although hampered by changes during the
year, has continued to give most useful help in examining and reporting upon
cases referred, and in advising our helpers wherever necessary. We are also
indebted to Officers of the Mount Vernon Hospital, and of the General
Hospitals of the Borough for kind co-operation in various directions.
There has been no alteration in the general plan of our work, and it seems
only necessary to offer some general observations on points which emerge on
examining about one thousand of our enquiry forms.
As to the controversy which has at times raged during the year as to the
part played by heredity and by infection in the causation of consumption we
can only, on the evidence of our enquiry forms, take up a middle position. It
has not been possible to check and sift our evidence with care sufficient to
justify us in putting forward statistics. We have cases in which we can get
no history of previous cases in the same family, but in which we have some
evidence of infection; we have other cases in which the family history is
apparently the dominating factor; and we have still other cases in which
cancer, insanity, heart disease, nervous affection, and deformity appear in the