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6
You are aware that, at present, we arrange for the
retention of three beds at Mount Vernon Hospital and
the Northwood Sanatorium for our most necessitous
cases. These are usually occupied but not quite
so continuously as I should desire, the supply of
patients depending for the most part on the recommendations
of our local medical men. In effect, we
do not obtain, in a considerable proportion of these
cases, patients who are in an incipient stage of the
disease, and who would be likely to receive permanent
benefit, or even cure, from the treatment. Not a few
of the candidates are in a somewhat advanced stage,
and consequently, their residence and treatment when
admitted are somewhat disappointing, and even discouraging
in results. I therefore hold strongly the
opinion that until compulsory notification of Phthisis
is in force we shall not readily acquire knowledge of
the earlv existence of the disease among the class of
patients for whom Sanatorium treatment is essential
and necessary. I am quite aware objections exist
regarding this proposal, but I am convinced the practical
good results will outweigh them. There must
be a considerable number of persons in every locality
with a large population who are afflicted with consumption
in an early stage, and who would come under
the notice, or to the knowledge, of their Sanitary
Authority, if notification was compulsory. An estimate
of recognisable cases of Phthisis in proportion to
the mortality has been made by various Authorities.
Dr. Newsholme, the Medical Officer of the Local
Government Board, states, " In adults the proportion
is usually given as three to one, though this is probably
too low." Dr. Young, the County Medical Officer,
in a recent report states, " On the assumption that
the proportion of three cases to each death is too low,
the proportion has, by some Authorities, been taken
as five to one, with the object of arriving at a working
basis, and if for the purpose of this report this proportion
be taken, the number of definite or recognisable
cases of consumption in Middlesex is about
4,000." In a healthy residential district such as this,