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53
understood that the notification in this case is to be sent to the Chief
Medical Officer of the Ministry rather than to the District Medical Officer
of Health, so that those concerned can feel that the notification will
be handled in strictest secrecy. It seems that when the notification
of certain infectious diseases was first required, some opposed the practice,
more especially those medical practitioners who felt that by notifying
they were being obliged to commit a breach of confidence by their disclosing
facts which they learned from their patients. There was further
agitation some years later when it was suggested that tuberculosis should
be notified, agitation which was sufficiently strong that the full notification,
as required at present was introduced only in stages. Periodically,
the question of the notification of those suffering from venereal diseases
is raised, and some authorities have by means of local Bills tried to have
these conditions notifiable in their areas. Up to this, none has been
successful so that these conditions are nowhere in this country notifiable,
though they are in some places abroad. There were, of course, special
provisions during the war by which those who were suspected to be
spreaders could be got into touch with. Apart from the controversy
of the notification of those suffering from venereal infections, there seems
to have been little opposition to the very wide extension by means of
regulations of the list of conditions required to be notified. This makes
it all the more strange that this most unusual procedure should have been
decided upon in regard to the notification of leprosy. Local Authorities
have particulars of the most intimate nature of many persons living in
their district: the behaviour of those suffering from mental disorders;
the pregnancy of unmarried girls; during the war information about some
of those suffering from venereal diseases or infested with vermin or by
scabies. They know of many of those in their district suffering from
tuberculosis and at times they are made aware that there is a smallpox
patient ; but they are not to be allowed to know of the perhaps only one
case of leprosy in their areas.
Aids to Diagnosis.
(1) Laboratory service (see page 28).
(2) Services of a consultant—
(a) Ordinary infections : Dr. Livingstone, of the Hendon
Isolation Hospital (Tel. No. Colindale 8182).
(b) Smallpox and typhus fever : The patient's doctor can be
put into touch with one of the Ministry of Health's
panel of consultants by means of the Public Health
Office, or the Hendon Isolation Hospital.
(c) Tuberculosis : Physicians at the Chest Clinics.
Isolation in Hospital.
(a) The usual infectious diseases: Most patients removed to hospital
are admitted to the Hendon Isolation Hospital, Goldsmith Avenue,
Hendon. When there is no accommodation here patients may be admitted
to one of a number of isolation hospitals around London, arrangements
being made either by the staff of the Hendon Isolation Hospital or by the
patient's doctor applying to the Emergency Bed Service.