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Has not the time arrived when a similar organisation against
phthisis is possible? International co-operation—as in the case
of cholera—is obviously necessary, and the interests concerned
are, of course, enormously large. But the evil is world-wide and
deeply rooted, and no half-hearted reform will ever have a
chance of success.
"Medical science cannot cope alone and unaided with this
difficult and prodigious world problem; many forces—economic,
legislative, sociological, humanitarian—must be enlisted."
(J. B. Huber.)
Sir John Moore has proposed the following excellent scheme
of administrative control of phthisis :—
"(a) (1) Compulsory notification; (2) verification of
diagnosis by bacteriological examination of sputum;
(3) removal of patients to hospitals ; (4) periodic inspection
and disinfection of the homes of the tuberculous.
(b) The provision of hospital accommodation (isolation
hospitals, sanatoria, consumption wards, etc.) for
(1) early cases; (2) advanced cases, to provide comfort for
the dying and to secure safety for the living.
(c) The vigorous and absolute segregation of tuberculosis
cases in workhouses, asylums, and other public
institutions.
(d) Education of the public concerning the prevention
and management of tuberculosis.
(e) Improvement of the housing of the working classes
and of the very poor, especially in towns."
This is a big programme and means the free spending of
money. But in England and Wales during the year, 1907,
11,299 males and 8,069 females died from tuberculous phthisis
of the lungs, whilst 31,166 males and 24,935 females died during
the same period from various kinds of tuberculosis including the
pulmonary form. The number of sufferers and crippled workers
is probably three times as large as the figures given. The battle
is thus worth fighting and we have Pasteur's dictum to encourage
us—'C'est dans lepouvoir humain de faire disparditre du monde
tous les maladies parasitaires.'
So far as home treatment is concerned, the necessary fresh
air and sunlight are only obtainable in undiluted form in small
towns and country places. For such cases the advice given by