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Ameliorative measures in regard to individual cases are carried out by means of one of the
special sanitary inspectors, Mrs. Fisher. Dr. McCleary writes as follows in his annual report for 1908:
"The homes of the patients are visited by Mrs. Fisher, the lady sanitary inspector, who leaves a card
of instructions as to the prevention of consumption, supplementing the printed directions with oral
advice. An inspection is made of the premises and any defects discovered are remedied. As far as
possible the notified patients are revisited from time to time and advised as to the precautions they
should take, and in this way many patients have been kept under observation for years. Mrs. Fisher
is very successful in establishing cordial relations with these consumptive patients and their families.
They look on her as a friend and welcome her vsiits. The work Mrs. Fisher is doing in Hampstead for
the prevention of consumption is of great value and deserves high commendation." The medical
officer of health finds that his administrative and other duties preclude him from personally visiting
patients. Arrangements are made by the Council for the examination, free of charge, of specimens of
sputum sent by medical practitioners. Sputum flasks are distributed by the Health Society.
The Borough Council does not itself retain sanatorium beds, but refers suitable cases of the
disease to a charitable association known as the Joint Phthisis Committee of the Hampstead
Health Society and the Charity Organisation Society, a committee which owed its formation to Mr.
Councillor T. Hancock Nunn. This committee employs a number of voluntary visitors who assist the
lady sanitary inspector in visiting cases, and in inquiring into the health of contacts who show signs of
ailing. The committee also arranges with certain medical men specially to examine such
contacts free of charge, and in this way early cases are brought to light which otherwise
would have escaped recognition. Material assistance is also granted and efforts are made to get
patients into sanatoria or convalescent homes. The total number of cases assisted in 1908 was 67, of
which about half were brought to notice through notifications sent to the Public Health Department.
The committee and the Health Department work in close co-operation.
Borough op Holborn.
There were, in the year 1908, 117 deaths from phthisis, the estimated population being 54,460.
Voluntary notification has been in force since 1904. and the cases so notified are as follows.
The deaths are given for comparison.
Year.
Cases notified.
Deaths from phthisis.
1902
—
179
1903
—
181
1904
344
163
1905
208
160
1906
191
132
1907
171
142
1908
152
117
On receipt of a notification a sanitary inspection is made of the patient's home, and
his circumstances inquired into. The medical officer of health is unable himself to visit cases, and no
medical examination of contacts is made. Printed general instructions are given to the patient
regarding infection and his own regimen, but it is not found practicable to keep patients or their homes
under observation by the sanitary staff. Disinfection is offered in every case after removal or death
of the patient, and was carried out in the year 1908 in 70 cases. There is no charitable society to
which the Council hands over cases to be dealt with and no sanatorium beds are retained. Arrangements
are in force for having specimens of sputum bacteriologically examined, free of charge.
Sputum flasks are not distributed. Dr. Bond, the medical officer of health, points out that 85 of the
152 cases notified in the year 1908, or 57 per cent., were inmates of common lodging houses.
Borough of Islington.
440 deaths were recorded as having been due to phthisis during the year 1908, the population
being estimated at 349,091.
Voluntary notification has been in force since 1905 and the figures show as follow:—
Year.
Cases notified.
Deaths from phthisis.
1902
—
513
1903
—
472
1904
—
526
1905
81
432
1906
64
422
1907
68
456
1908
59
440
In addition to the above cases voluntarily notified by medical practitioners, there were,
in the four years 1905-1908, 223 cases notified by the relieving officers. On receipt of a
notfication, a visit is paid to the house by a sanitary inspector, a sanitary inspection of the
premises is made, and a report handed in upon a number of personal circumstances of the
patient. Dr. Harris, the medical officer of health, is unable personally to visit the patients. A
card of instructions is left at the patient's house, and disinfection is offered; on removal or at death