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67
"compelled to comply, any other form of notification might be
"considered a breach of trust on their part. This difficulty
"removed, voluntary notification would be encouraged and
"rendered more useful.
"As the cases we most desire information of are among the
"poorer classes, I think the Poor Law District Medical Officers
"and Medical Superintendents of Poor Law Infirmaries, Work"houses
and Charitable Institutions should notify cases direct
"to the Medical Officer of Health of the District, while the
"London County Council might usefully obtain information
"from the special hospitals in London, afterwards forwarding
"the names to the various districts.
"I think private medical practitioners might with advant"age
be invited to notify the Public Health Authority of any
"cases of consumption, when the patient consents, and where
"they are desirous of the patient having the benefit of advice
"from a specially-trained officer as to the precautions to be
"taken for their own comfort and benefit, and the protection of
"others.
"Expectoration being the chief means of disseminating the
"disease, all medical practitioners should be reminded of the
"facilities which are offered by your Council for the free
bacteriological examination of suspicious material (phlegm).
"An enactment to provide for disinfection of infected
"houses and their contents after a death from Phthisis or on
"the removal of the patient to Hospital or to another house, is
"needed.
"Every effort should be made to educate the public in
"regard to the special risks attending the disease, and of its
"infectivity.
"In conclusion I suggest that your Council agree to
"Voluntary Notification of Phthisis cases in which expectoration
"is present, although I fear that it will not be so generally acted
"upon as many suppose. I also wish to emphasise the
"necessity of returns from the Medical Officers of Poor Law
"Institutions and districts previously referred to."
Your Council having fully considered the matter decided
to adopt the voluntary system of notification of phthisis and the
following circular letter was addressed to all medical practitioners
in the district