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Dr. Sykes, the medical officer of health, has analysed the notifiers in the year 1908 as follows :—
Medical officers of Infirmaries (North and South) and of Workhouse 204
District medical officers 8
Staff of Mount Vernon Hospital 3
Staff of other Hospitals 5
Private practitioners 25
Other persons 4
249
On the receipt of a notification a visit is paid to the home (subject to what ia said below) by a
woman sanitary inspector, who is able not only to make a sanitary inspection of the premises, but
also to give personal attention to the individual needs of the patient. The medical officer of health
is prevented by administrative and other business from visiting such cases himself. Elaborate
measures are taken to obtain voluntary notifications from private practitioners, whose convenience
and that of their patients is carefully studied.
An outfit is supplied for forwarding sputa to obtain the results of a bacteriological examination.
Books of medical certificate forms are sent out for notifying the disease. Copies of the leaflets which
are handed to patients have been distributed to medical practitioners for their information ; and notice
is sent that the notification is treated as confidential, that no sanitary inspection or other action will
be taken unless it is requested, except that certain leaflets as noted will be posted to the patient. The
leaflets mentioned include an offer of disinfection, an untearable card of general precautions and
instructions, and a very useful list of societies, hospitals and other institutions concerned with the
amelioration and prevention of the disease. This list supplies information which is not readily accessible
to the general public.
The woman sanitary inspector makes careful inquiry into the sanitary and other circumstances
and reports fully thereon. She is instructed to make the inquiry with a view to helping
the patient, the family, and the medical attendant. She is further warned that no
action as to segregation, disinfection, or sanitary inspection (except on complaint) must be taken
without the desire of the patient or family and the advice of the medical attendant; and that it is
preferable to fail to get statistical evidence than to lose friendly relations with the patient. It
is found that to get arranged a cleanly room, open windows, a supply of food for the children, a change
of occupation or of residence for the patient, perhaps removal to an infirmary or hospital or a rest
at a sanatorium or other home occupies, in even one case, a great deal of time and thought. But in
the result valuable work is done by the sanitary staff, and is of the kind that is likely to be of
the greatest use in the prevention of the disease. The patient is befriended, and encouraged to help himself,
at the same time that help is being sought for him.
There is no Health Society in St. Pancras ; recourse is often had to the Children's Care Committees,
to the Invalid Children's Aid Association, to various religious bodies and to the Charity Organisation
Society. But the want is greatly felt of additional help for visiting homes, of money help, and of some
means of co-ordinating the efforts made by the various agencies scattered in the field of preventive work.
Endeavour is made to keep the patients and houses under observation and to ascertain any secondary
cases that may be ailing. No systematic medical examination of contacts is possible. The
Borough Council does not itself retain any sanatorium beds, or provide sputum flasks for patients.
Borough of Shoreditch.
In an estimated population of 115,227 there were during the year 1909, 234 deaths from phthisis.
No form of notification had been in use in the Borough prior to the year 1909, and the
above cases, i.e., the deaths, were all that had come to the notice of the sanitary authority.
Dr. Bryett, the medical officer of health, is not able personally to visit the cases now disclosed
by the Public Health (Tuberculosis) Regulations, 1908, but to every private dwelling where a case is
found to exist, a sanitary inspector is sent to inspect; he makes a report, and a copy of a pamphlet
is left which sets out the special risks of the disease and the means of avoiding and preventing
it; disinfection is performed when thought desirable, and after every removal or death it is offered,
and the offer is usually accepted. There is no medical examination of contacts. It is not possible
to keep cases under continuous observation. There is no local charitable institution to which cases
are referred. The sanitary authority retains no sanatorium beds. The bacteriological examination of
sputum is arranged for medical practitioners by the Borough Council free of charge. Sputum flasks
are not distributed by the Council to patients.
Year. Cases notified. Deaths from phthisis.
1902 — 217
1903 — 272
1904 — 254
1905 — 228
1906 — 233
1907 — 242
1908 — 234