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experience of the few districts where such a system was
adopted. The pioneer work, which has been undertaken by
progressive sanitary authorities has had the result of awakening
the public to the urgent need of using every possible means
to control the scourge and has undoubtedly influenced the
Local Government Board in arriving at their decision.
The prevention of Tuberculosis is perhaps the most important
public health question of the present day, accounting
as the disease does, for about oue out of every ten deaths. It
is true that the death-rate from Phthisis has decreased
markedly during the past thirty years or so, and
this decrease has coincided with a marked increase
in the activities of Sanitary Authorities. Although
not directed especially against Phthisis, all the efforts
to control other infectious diseases and to obtain better
housing conditions and good sanitation have had a salutary
effect in this direction. It was felt, however, that the time
had arrived when the general measures directed against the
spread of Consumption should be backed up by attention to
the individual case and his immediate environment, and this
is the reason for notification.
The Local Government Board have arrived at this end
by stages which have given the public time to become accustomed
to the idea and has allowed Sanitary Authorities to
slowly organise the administrative machinery for carrying the
scheme into effect.
The control of Phthisis presents special features which
raise new administrative problems, and some of the measures
which are applicable to such diseases as Scarlet Fever or
Enteric Fever would be inappropriate to Phthisis. The
disabilities which involve no hardship in the former would be
intolerable in the latter. Moreover, unlike most infectious
diseases infection can be prevented by the patient himself when