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28
TUBERCULOSIS AND CONSUMPTION.
This disease will henceforth be compulsorily notifiable.
Hitherto the Poor Law Medical Officers and Hospitals, only, have
notified ; and such cases, only, are referred to here.
Under the Insurance Act the Commissioners will shortly issue
regulations concerning the provision of Sanatoria by Local
Authorities. It will be necessary for you to consider this subject
very carefully, as the two questions of Prevention and Treatment
may both of them be dealt with under the Act. As a Sanitary
Authority Prevention has the first claim upon you and it is for
this reason that the term Tuberculosis is used rather than
Consumption. Tuberculosis may apply to the disease in any
stage, affecting any part of the body, and it will be by observing
commencing cases. particularly amongst the young, that the
prevention, and it is hoped the extermination, of this disease may
be achieved. The term Consumption is usually applied to definite
Tuberculosis affecting the lungs. A few of these cases may be
benefitted by sanatorium treatment and in nearly all cases life
would be prolonged by continued residence in such institutions.
It will however be hardly possible to treat all cases and it will
therefore be necessary to consider what is most beneficial considering
the means likely to be placed at our disposal.
Sanatorium treatment can be carried out, as at Benenden and
elsewhere, in quite inexpensive shelters when the cases are in early
stages likely to reap permanent benefit. This of course, from a
preventive point of view, is of great importance, but we shall hav®
also to consider what is to be done with the more advanced cases.
Persons with the disease fairly well advanced can receive great
benefit by a change to fresh country air and pleasant surroundings,
but such cases cannot be treated in light shelters, they need the
care and attention of a hospital, and this implies great increase in
the expenses of upkeep and management. It must also be borne
in mind that such cases have little or no hope of permanent health
when they return to their old surroundings after discharge from
the hospital sanatorium in apparent health. This as you will see