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lassitude or loss of weight, to the Dispensary. How best to bring
home this realisation to each individual constitutes a problem
which the effective prevention of tuberculosis must solve.
Indeed, some solution ofi the problem is vital to the health of the
nation, and particularly if the decline in tuberculosis is to be
maintained. For it is highly improbable that the progress of
sanitary reform even as one of the factors in the decline of the
disease will be of such importance in the next half-century as it
was in the last. Hence to the individual must we look for the
maintenance of the decline, and not to social or medical measures.
A social scourge the disease has been; and such it remains, but
social measures have reduced its proportions to well-defined limits.
For the future, however, social measures alone will not suffice.
The intelligent co-operation of the individual—be he "patient"
or citizen—must be sought, and utilised in the prevention of the
disease. Bearing this in mind, "Health Week" affords an excellent
opportunity, by means of lectures, talks and films, of arousing
the interest and developing the co-operation of the inhabitants of
the Borough. Since the inception of such a week in East Ham,
three years ago, much good has been done by the dissemination
of knowledge of the disease and of the ready availability of consultation
and co-operation with the Dispensary Staff.
In as far as children within the area are concerned, the local
organisation of the Invalid Children's Aid Association has given
the Dispensary Staff very valuable assistance throughout the past
year, and we would thank Mr. Metcalf (the local Secretary) and his
staff cordially, and express the hope that our happy relationship
will continue.
As with the individual on the lay side rests the duty of cooperating
with the Dispensary in the prevention of the disease,
so on the professional side there rests with the private doctor the
duty of notifying every tubercular patient. But were the private
doctor's interest to extend only the length of his statutory duties,
there would not be much hope for any great strides in the direction
of prevention. In the matter of notification there has been great
improvement of recent years. There is also a readiness to send
cases to the dispensary for opinion. Rarely is there delay in returning
the reports on domiciliary patients, and consultation with the