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22
ENCEPHALITIS LETHARGICA.
The provision of 100 beds for cases of post-Encephalitis Lethargica,
recently made by the Metropolitan Asylums Board, will help
to meet a very real need.
TUBERCULOSIS.
Tuberculosis as a cause of mortality has been still further
reduced during 1921-25, when the mean death-rate from Pulmonary
Tuberculosis was 44 per cent. below that for 1901-5.
The circumstances which still operate against the reduction in
the prevalence of this disease are: the difficulty of securing accommodation
for advanced cases; the lack of proper housing conditions,
and the consequent impossibility in many cases of getting a separate
bedroom for the sufferer; the difficulties of securing a satisfactory
measure of after-care.
The amount and frequency of infection are greatest in consumptive
families with whom, owing to poverty and its associated
circumstances, the resistance to infection is often at its
lowest.
The supreme importance of protecting young children against
this infection is generally recognised, and of the circumstances
responsible for reducing resistance under-nourishment is the
chief.
The early recognition of infection and the skilled treatment of
sufferers in sanatoria and outside of them is, of course, essential
from the preventive standpoint; but I am convinced that next to
improved social and industrial conditions, which will always continue
to play the major part, must come the adoption of measures
of dealing with those who are running special risks in early life;
and until this is done no scheme for the reduction of Tuberculosis
can satisfy.
There is only one alternative measure to the removal of young
children who are at risk in their home, and that is a preventive