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37
TUBERCULAR DISEASES.
Two hundred and seventy-two deaths were referred to phthisis
and 118 to other forms of tubercular disease. The death rate from
phthisis alone is equal to 2.1 per 1,000 in Bethnal Green, whilst
that for the whole of London is 1.7. This disease, which is the
curse of large towns, caused the highest mortality in the Central
and East districts of the Metropolis, where the density of the
population is the greatest. The death rate in Central London from
this cause is 2.6, and in East London 2.0. This disease has been
proved to be infectious, and the time has arrived when Sanitary
Authorities must seriously consider what means can be adopted to
check its spread. It has been proposed to make pulmonary phthisis
a notifiable disease, but to this course the medical advisers of the
Local Government Board are opposed. The disease seems to hang
about particular houses, and is undoubtedly communicated by dried
sputa in the form of dust. In order to prevent the spread of phthisis,
proper methods of isolation and disinfection are indispensable, but
the practical difficulties in the way of isolation are enormous. An
open-air life affords the consumptive the best prospect of recovery,
and most sufferers have sufficient health and strength during the
greater portion of their illness to earn their own living. Under
such circumstances, phthisical patients would naturally resist any
restrictions in the way of isolation, and we have no compulsory
powers. I am afraid all we can do at present is to distribute
precautionary handbills and to proffer disinfection after fatal cases.
Ordinary fumigation is nearly useless, as the dried sputa which
contain the germs of the disease are not disinfected by sulphur
dioxide in the absence of moisture. Formaldehyde is much better;
but the most effectual method is to scour all woodwork of the
infected rooms with soap and hot water, strip the paper from the
walls, &c., and afterwards brush all exposed surfaces with some
wash containing perchloride of mercury. The paper removed
should be burnt at once, and all carpets, curtains, rugs and bedding
should be removed and disinfected in the Washington Lyon steam
apparatus, as is done in the case of other infectious diseases.