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54
conclusion that the Woolwich Borough Council in providing the
treatment has set an example which might with advantage be
followed by other authorities.
90. At the same time, the necessary limitations of the Sanatorium
treatment must be clearly recognised. There are a certain number
of cases which appear to go progressively from bad to worse in
spite of any treatment, and it seems to be impossible to recognise
at the outset the fatal tendencies of such cases. In the first year
the Council retained beds at Peppard, a series of five such cases
occurred. In none of them did the physical signs or symptoms
point to advanced disease, but they all died within a few months
of admission to the Sanatorium. On the other hand, some cases
in which the disease had made considerable progress have done
remarkably well.
Again, the Sanatorium can in most cases re-establish the health
of early cases within at least six months; but it cannot generally
make them resistant to all the injurious influences to which they
are exposed on returning to work. The education in open-air
treatment, and the practising of this on the return home certainly
helps very much to the maintenance of health, and accounts for
the continued progress of several who left the Sanatorium only
partially restored. But there are many who are unfit for the strain
of their daily work under the conditions existing in Woolwich,
whereas, if they can get work in the open air, in the country,
whether at home or in Canada, they do well.
91. Educational Sanatorium Treatment. Three consumptive
patients are now receiving educational treatment every month, by
passing at least one month at the Sanatorium. The fact that 36
consumptive patients are there trained, every year, how to preserve
their own health and how to avoid infecting others, will undoubtedly
do much to diminish the tuberculosis death-rate, and
the figures of last year indicate that it has already done so.