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serious source of infection, and as their home conditions are
nearly always unsuitable, undoubtedly the Infirmary, or some
similar institution, is the best place for them. The difficulty
is to get them to stay there for any length of time. The
whole subject is coming before the Public Health Committee
at no distant date, and it is hoped that some comprehensive
scheme may be evolved capable of dealing with the problem.
Then, if other local authorities will do the same, I have no
doubt a very marked reduction in the incidence of Phthisis
will be the result.
With regard to the best means of dealing with Phthisis
in this district, I am convinced that some such scheme as the
following would give the best results, both from a financial
point of view and also as a means of dealing with the disease
in detail. The County should provide a central Sanatorium
for the treatment of curable cases, and to this Sanatorium
should be attached a sufficient number of experts to provide
skilled advice to local authorities. The problem of Consumption
is so large, and the type of case so various, that
the majority of cases could be dealt with locally. But the
early cases and the ones suitable for admission to the central
Sanatorium should be selected by an expert attached to the
Sanatorium. I should suggest that the local Medical Officer
of Health should communicate with the County Medical
Officer of Health, or direct with the Sanatorium, that he has
so many cases more or less suitable for admission. By
arrangement the expert then sees and examines these cases
at the local centre and decides accordingly.
The Poor Law will still take a certain number of the
more advanced cases as heretofore. In this district, at the
Isolation Hospital, which stands in a favourable position and
where extra accommodation could easily be provided, as
there are some six or seven acres of land still not utilised,
provision should be made for dealing with more advanced
cases, and these as a rule do not like to go far from home.