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10
diagnosis is usually made. The result is that by the time the
first batch of notifications arrive, a larger number is incubating
the complaint and further propagating it in a wider circle, so
that the first question that arises is that of efficient isolation.
Is it possible? In my opinion1, the only way isolation can
possibly become effective is by the provision of accommodation,
not only for the sufferers but of all those who are probably
infectious. This latter is wholly impracticable, not only on
medical but also on legal grounds. So far as I am aware, I
know of no Sanitary Authority undertaking the isolation of
Measles in Hospitals on any large scale, and it is significant that
most of the authorities who have enforced notification have
given up the practice. The other important measure which
follows notification is disinfection. It is admitted by most
that purely domestic measures suffice in Measles, so that from
this point of view notification is unnecessary. But should
disinfection be attempted in the ordinary way the Council
would be faced with the necessity of providing additional plant
and help at all epidemic periods. Under the circumstances,
would it be justified?
During' the period under review I frequently visited the
Schools in the District to weed out the suspicious cases, but
1 was finally obliged to advise closure of the Infants' Departments.
Pamphlets were also distributed in the District.
PREVALENCE! OF, AND CONTROL OVER, PULMONARY
TUBERCULOSIS.
On receipt of a notification, the case is visited, and particulars
are taken as to the premises and where the patient sleeps,
the number of people, and general sanitary condition of the
house, etc.
Pocket spittoons are provided in necessitous cases, and
advice is given as to the methods by which danger of infection
to others can be avoided. The patients have been subsequently
visited.