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purpose. At the present time large numbers of cases of phthisis or consumption, at a
stage of the disease when much good might be hoped for with appropriate treatment,
are compelled to live under conditions which are not only most prejudicial to their
chances of escaping death from the disease, but also render them sources of danger
to their friends and relatives and to the general public. In such cases it is' easy
to advise the friends as to the danger of infection and the steps which should be taken,
but where the accommodation is insufficient and there is a lack of means, as is unfortunately
the case to a very large extent in the poorer districts of the Metropolis,
such advice is for all practical purposes futile. In many cases the patients eventually
drift into public institutions, usually poor-law infirmaries. In them they are well
looked after, but it is in the vast majority of cases too late for the sufferers to derive
any permanent benefit. Moreover these institutions were not constructed with the
idea of affording a special treatment for consumption cases, and other inmates who are
not afflicted with the disease may be more or less exposed to danger. It seems to me
that the time has come when proper sanatoria for the treatment of the disease should
be provided for the use of the people of London, and with its years of experience in
hospital management the Metropolitan Asylums Board is in my opinion the most
appropriate authority for this purpose.
The Managers of the Metropolitan Asylums Board have had the matter under
their consideration. They regard the question of the proposed establishment of
sanatoria for consumptive persons, as one of vital and far-reaching importance to the
community. The proposal is, however one, which, if adopted, would entail a considerable
extension of their duties and responsibilities, and a large increase in their
expenditure. Before taking action, therefore, the Managers have called for some
authoritative expression of opinion on the part of the Local Government Board.
TETANUS.
Five deaths from tetanus, a disease more generally known as lockjaw, were registered
during the year. This disease is common to man and certain animals, especially
horses, sheep and oxen, and is most frequently met with amongst persons employed on
farms, in gardens, and in stables. It is due to a micro-organism, which obtains
entrance to a wound through want of proper attention to cleanliness, or through
infected soil contaminating wounds, or through inoculation with discharge from an
animal suffering from the disease. The disease is extremely fatal. Of the 5 deaths
2 were of infants five days old. One occurred in March, and the other in August, the
former being registered as due to tetanus neonatorum, and the latter to umbilical
irritation, trismus, and traumatic tetanus. The other 3 cases are interesting and
worthy of note:—
(1.) Richard L., aged 29, a brass turner, living at No. 44, H-Street,
punctured his left foot under the ball of the big toe, on May 10th, with