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57
same family us our consumptive patient. The number of cases in which we
have either 110 evidence or evidence of a kind which is reasonably open to
doubt is, however, so large as to vitiate any conclusions which might be drawn
from smaller groups. We have instances in which debility following measles,
or other infectious disease, seems to be a predisposing case of the later illness,
others in which early neglect, and still others in which constitutional weakness
seem to play the main part.
At this moment it may be useful to note th it we cannot solve our problem
simply by providing medical treatment for consumptive patients. Patients
return from Institutions, where they are perfectly comfortable, in order to meet
some domestic emergency, either of sickness or want of money; others refuse
to accept Institutional treatment because they are unable to leave their
dependents alone at home. Men who are still able to work cannot absent
themselves from duty at hours when doctors are accessible, and mothers of
young children cannot leave home for the time necessary to attend a Hospital.
An increase in the price of food neutralizes some of the advantages of the
supply of medicine, and the best advice 011 graduated labour is useless to the
person who must work or starve, and who cannot obtain work of an entirely
suitable nature.
I am inclined to think that one modification of the present practice might be
made with advantage, and that when parents refuse to enter an Institution
we might in occasional cases offer them the alternative help of temporary
provision for their children away from the danger of infection.
The recent Circular of the Local Government Board suggests special attention
to the needs of children. We still need some provision to break the
sudden change from the sea and Country Convalescent Home to the ordinarySchool.
An open air School is much needed, and, even preparatory to that,
our old project of a Day Convalescent Home. For delicate children who suffer
so much from the strain and excitement of the ordinary School, one would
like to see Froebel—or perhaps Montessori—methods in use to a much later
age. I have very little doubt that the strain of constant attendance at School
from too early an age, the recurring diseases which weaken School life, and the
excitement and anxiety of the children as to attendance and punctuality are
responsible for much of the ill-health of many of the children notified.
The Hon. Secretary of the Southern St. Pancras I. C. A. A. tells me that during
the year her Association dealt with 74 consumptives and pre-consumptiye
children; of these 18 were under five, and 56 between five and 14. It is
not probable that the number in the Northern half of the Borough would
be less, so that we probably need, as an initial step, to consider the needs of
from a hundred to a hundred and fifty children.
A recently initiated movement to provide for the proper care of the
permanently or temporarily motherless children should be of great use, and we
hope to give every assistance in our power to the project. The semi-parented
child is always likely to suffer in health, and any provision we can make for
its welfare is of importance.
The Shelter movement has not, so far, succe ded. For the two or three
cases who might use them 110 shelters are available, and no one so far has been