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35
Osier is, apart from the confidence of the patient and the discreet
and stern management of the physician-—
"(1) Persistence—benefit is usually a matter of
months, complete arrest a matter of years, absolute cure a
matter of many years.
(2) Sunshine by day; fresh air by night.
(3) Rest while there is fever.
(4) Bread-stuffs and milk, meat and eggs."
The voluntary notification of this disease has been in force
now for about two and a half years. The notifications received
have had reference very largely to occupants of the Workhouse
or various Common Lodging Houses in the Borough. The total
number of notifications received has been during 1908—172, as
compared with 291 during 1907. The deaths from phthisis
during 1908 numbered 154, so that it is pretty clear that the
notifications do not cover, by a very considerable margin, the
number of actual cases existing in the Borough.
A very considerable number of cases have been forwarded
to the Infirmary for treatment. By the courtesy of Dr. J. R.
Lunn, the Medical Superintendent of the St. Marylebone
Infirmary, I am able to inform your Council that there are in
that Infirmary 32 beds set apart for consumptive females, and 62
for consumptive males. Dr. Lunn adds that cases are seldom
if ever received for treatment in the early stages of phthisis. The
cases which come into the Infirmary are advanced cases, and,
unfortunately, they come in and go out pretty much as they
choose. This bare statement forges another link in the chain of
evidence which goes to show that no amount of voluntary
submission to treatment is likely to be of any avail in the ultimate
stamping out of this disease.
In the cases reported to the Department, visits are paid both
by your Lady Sanitary Inspectors and by the voluntary workers
of the St. Marylebone Health Society. A card (reproduced
below) is explained to those interested, and is left at the house.
It is printed on cloth backed paper, so that it may be referred to
from time to time.
Disinfection of premises is carried out in a considerable
number of cases—always after the death of the patient, and
fairly frequently at periodical intervals during the continuation
of the illness, so as to prevent, as far as possible, re-infection of
the patient himself, and infection of those around him.