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20
18 of the deaths from Consumption occurred at the Isleworth
Infirmary, and of the many factors influencing the prevalence of
tuberculosis, poverty stands out prominently above all others.
Though it is a matter for dispute which elements of poverty are
mainly operative, there is no doubt that poverty as a whole, with
all that it comprises and implies acts as one of the most potent
predisposing causes of the malady. The ward distribution of the
deaths would also suggest this view. 33 of the deaths, or exactly
one-half belonged to the South-West Ward. It is this aspect of
the question which constitutes the chief difficulty in obtaining
information Of early cases. Of the number investigated during
the year, only 10 were considered likely to derive any permanent
benefit from sanatorium treatment, and results proved that some
of these were not suitable cases ; two died within a few months of
their discharge from the sanatorium.
In the report on Sanatoria presented to the Local Government
Board, it is pointed out " that Germany seems to be in advance
of this country in securing early cases for sanatorium treatment
; a circumstance due, no doubt, in no small degree to the farreaching
system of compulsory insurance of work people against
sickness and incapacity which is in force in the German Empire.
By means of this system the workman, when attacked by tuberculosis,
has a legal claim on insurance funds for medical treatment
and maintenance in his own case, and for the support also of his
own family. Thus it comes about that he can, without social
disqualification, such as is associated with Poor Law relief or charity
—without, that is, forfeiting in any degree, his sense of self-respectprocure
at once at the very onset of his malady treatment requisite
for himself, and at the same time maintenance of those belonging
to him.
Although residence at the sanitorium has not resulted in "curing"
the disease of the persons sent there from Acton, the effects
from an educational point of view have been considerable. The
patients have learnt by what means the disease is spread and what