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manhood and womanhood, when men should, in the fulness of their
strength, be advancing the work of the home and of the nation,
and when women should be strong to bear and rear healthy children.
Yet a mere glance at the world's record of those celebrated in
science, art, literature, and the like, suffices to show how those
who have cut their niches highest in the rock of fame have succumbed
at an untimely hour to this still potent and still omnipresent
death-dealing agency. Schiller, Keats, Chopin, Laurence
Sterne, Robert Louis Stevenson, Moreau, Spinoza, Weber—
these are some of the world's luminaries who have been claimed
as victims by phthisis at the noontide of their fame. What
of the tens of thousands of obscure honest workers who merely
swelled the ranks of those engaged in keeping the everyday
world going and who have gone under from the same cause ?
These are facts as true to-day as they have always been.
The man in the street knows these facts. The specific
cause of the disease and the main avenues of infection are known ;
the influences both pre-natal and post-natal affecting its
development have been demonstrated; the fundamental
principles, at all events, on which prevention and cure are to be
based, are agreed upon by all whose word is of any weight; yet
our hands are still in our pockets and our coats upon our backs.
Localised and fitful attempts are being made—praise be
to their originators—to deal with this, probably the largest
problem to which public health has ever set its hands, but
in the absence of State aid, these will probably die of
inanition before long. Small urban and rural districts, local
authorities cramped by expenditure which would in many
cases have been better left to private enterprise, cannot afford,
forsooth, to spend money on the prevention and cure of phthisis !
What seems to be required is the establishment of a special
tuberculosis department of the Local Government Board on the
lines of similar departments now existing in some of our large
cities, and closely co-ordinated with what we shall before long
know as the Public Assistance Authority. Such a department
might be empowered to put into force regulations such as those
authorised by Section 134 of the Public Health Act, 1875,
which outlines the action to be taken whenever any part of
England is threatened with or affected by any "formidable
infectious disease." Regulations under this Section may be
made for house-to-house visitation, the provision of medical aid
and accommodation, the promotion of cleansing, ventilation and
disinfection, and, generally, for guarding against the spread of
disease. These powers have only been rescued from oblivion on
the occurrence of an outbreak of cholera; their operation has
certainly been the occasion for the free spending of money, but
their effect has been the prompt stamping out of the disease.