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The measures at present in force include inspection of the patient's home, and an inquiry into
the circumstances of each case so notified and a report thereon. Instruction is given as to regimen and
on such matters as disposal of the sputum. Disinfection is arranged for in as many cases as possible.
The bacteriological examination of sputum is undertaken by the Borough Council for medical
practitioners, free of charge. Sputum flasks are not distributed to patients. No examinations of contacts
is made, nor is it possible to provide for the personal amelioration of the patients. The Council
retains no sanatorium beds, and there is no local health society. The medical officer of health, Dr. A. E.
Thomas, who has recently been appointed, has the whole subject under consideration, and has not
completed the arrangements which he has in contemplation to recommend to the Borough Council;
among other matters under consideration is the appointment of a health visitor specially to visit cases
of phthisis.
Borough of Fulham.
In an estimated population of 171,562, there occurred, during the year 1908, 199 deaths
from phthisis.
Voluntary notification has been in force since the year 1902, and the figures
since that year show as follow, the deaths being placed by their side for comparison.
Year.
Cases notified.
Deaths from phthisis.
1902
137
200
1903
171
204
1904
165
217
1905
152
191
1906
148
182
1907
151
198
1908
164
199
The medical officer of health, Dr. Charles Jackson, is able to visit the homes of most of the cases
notified, and inquire into their circumstances and give advice as to regimen. But he finds that little
real good can be done for them at present; no sanatorium or other treatment can be offered, no medical
attendance or amelioration of their social condition. The lady sanitary inspector is prevented from
visiting these cases by the pressure of other work. Very few secondary cases have been discovered
among contacts. Disinfection is performed at death or on removal according to the circumstances of
the case. 181 specimens of sputum were examined from patients suspected to be suffering from tuberculosis,
the specimens being forwarded by medical practitioners and examined at the Lister Institute
free of charge. With the exception of the district committee of the Charity Organisation
Society, there is no non-official society with which the sanitary authority co-operate. There is no
systematic medical examination of contacts. Sputum flasks are supplied by the Council.
Borough of Greenwich.
In an estimated population of 109,110 there were, during the year 1908, 122 deaths from
phthisis.
Voluntary notification has been in operation in the Borough since the year 1902, and the
cases notified and deaths since that year show as follow:—
Year.
Cases notified.
Deaths from phthisis.
1902
59
119
1903
51
111
1904
123
135
1905
109
130
1906
112
125
1907
107
116
1908
107
122
As soon as a notification is received, a visit is paid by the male sanitary inspector whose duty it
is to attend to cases of infectious disease. An inspection of the premises is made and an inquiry into
the circumstances of the patient. A printed leaflet is left of "Instructions to Persons Suffering from
Consumption," as well as a cartoon of instructions to be fixed to the wall.
Dr. Annis, the medical officer of health, visits certain cases when necessary. It is not found
possible to pay regular visits of inspection to all cases; there is no special officer for the
purpose; as far as possible they are kept under notice, and are provided with postcards to notify any
change of address which they may make. After death or removal disinfection of the premises is always
offered and often performed. It is not found possible to adopt measures of personal amelioration, but
the Borough Council has under consideration the question of retaining a certain number of sanatorium
beds, and it is possible that the newly formed Greenwich Health Society may deal with cases
forwarded to it by the Borough Council Public Health Committee. There is no system of examining
contacts for secondary cases. Sputum flasks are distributed to patients, and specimens of sputum
are bacteriologically examined for medical practitioners free of charge.