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nomically desirable, to compulsorily deprive such persons of opportunities for
gaining a livelihood, always provided that they take proper precautions against
spreading infection.
We are, however, of opinion that for advanced cases publicly managed
institutions with power to detain patients should be established. These cases
are not generally dealt with at the Poor Law Infirmaries on account of the disinclination
of the patients to enter such institutions, and unless these establishments
have special facilities for dealing with this disease, we do not think them
suitable places for consumptive persons. The special hospitals also do not
seem to welcome advanced cases for treatment as in-patients, their energies
being mainly confined to those cases which they are of opinion they can cure
or materially benefit.
The course which it appears to us should betaken is that contained in one
of the suggestions of the Medical Officer of Health of the London County
Council. This suggestion is that the London County Council should ask the
authorities of all Metropolitan Hospitals and Dispensaries to send lists of the
names and addresses of all phthisical patients attending such institutions to
the Medical Officer of Health of the London County Council, who should
ascertain the districts in which such patients reside, and send particulars to the
Medical Officer of Health of such districts.
It appears to us that it would be convenient that such lists should be sent
to the London County Council as the information and clerical staff at the
disposal of the hospital authorities (who treat cases from all parts) would be
insufficient to enable them accurately to decide the respective Metropolitan
Boroughs in which their patients reside and to act accordingly.
When the information is received by the Medical Officer of Health of
Stepney, we propose that the patient's home should be visited by a Sanitary
Inspector, a printed list of instructions for patients and friends left on the
premises, disinfection should, where permission is given, be carried out if
necessary, and always in the event of a patient's death or removal, and that
particulars of the case should be given to such voluntary societies as exist in
the Borough for dealing with the prevention of consumption.
Before submitting our recommendations we desire to express our thanks
to Miss Blewitt, one of the lady health visitors of the Board of Guardians for
the Jewish Poor, who with the consent of the Board kindly attended our meeting
and gave us the benefit of her practical experience in connection with the
Board's efforts to combat the spread of this disease.