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26
PREVENTION OF CONSUMPTION.
Value of Notification. Each year sees an addition to the
number of local authorities who have made phthisis a notifiable
disease. Compulsory notification under the Act of 1899 has, in
most cases, been preceded by a probationary period of voluntary
notification, during which the benefits of the system have become
apparent, and its opponents have been reconciled to the inclusion
of phthisis in its proper category, namely, that of the compulsorily
notifiable diseases.
It is only where a system of notification exists, either voluntary
or compulsory, that the sanitary authority can influence directly
the prevalence of the disease. In a district where most of the cases
are reported, each patient can be visited and the probable origin of
his infection ascertained. This first step is of the greatest importance.
It might be found, for instance, that several of those
affected had been employed in the same workplace, in which case
suspicions as to insanitary conditions existing there would be at once
aroused. The discovery of such conditions and their removal would
secure the prevention of other cases arising from the same source.
Actual instances of this kind are within my own experience and that
of every Medical Officer of Health whose work has lain in a district
where phthisis was a notifiable disease.
In addition to enquiries on the points alluded to, instruction
could be given at the time of the visit as to how the patient should
order his life so as to give himself the best chance of recovery and
reduce to a minimum the danger of his communicating the disease
to others. Disinfection of rooms, &c., where considered necessary,
could also be carried out.
In order to make the system complete, and to add to its popularity
and success, it is very desirable that provision should be made for
the sanatorium treatment of some, at least, of the cases that come
under observation. The Council, having entered into the Middlesex
Open-air Sanatorium scheme, will, I hope, before long have at