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65
to this reasonable and necessary precaution. The M.O.H. frequently
finds when he makes his visits that the patient has removed from the
premises and another family is in possession, no intimation of the
removal having been given to the Public Health Department and no
disinfection carried out. The primary purpose of notification is to
safeguard the public health by bringing into operation preventive measures
against the spread of disease. Notification is a costly process and
sets a time-consuming machine into activity. It is obligatory upon
Medical Practitioners to notify cases coming to their knowledge, under
penalty; it is a considerable charge upon the public purse to pay for
these notifications. The pursuit of investigations into the source of
infection and the application of measures for the prevention of further
infection is a greater charge upon the public purse, and carelessness
on the part of patients who, heedless of the danger they cause to others
who may thereafter occupy their premises, vacate them without intimation
to the Sanitary Authoriiy, should not be disregarded. When it
does come to the knowledge of the Public Health Department that a
consumptive patient has changed his address, the vacated premises are
cleansed and disinfected, and new tenants may occupy them without
apprehension. Intimations of changes of address reach us (1) from a
few patients, (2) as the result of the Medical Officer's and Inspectors'
visits, (3) from Sanatoria, Infirmaries and Hospitals to which the
patients have been removed. The death returns give information of
fatal cases, and at as early a date as possible the premises are
disinfected.
Bacteriological examinations of sputum are made at the Town
Hall for doctors who wish to verify their diagnosis by that process,
and during 1914, 152 specimens were reported on.
Tuberculosis is widely enough disseminated to afford ample scope
for the energies of all who are engaged in coping with its ravages
without overlapping. It is unfortunate, therefore, that the Officers who
carry out the requirements of the Tuberculosis Regulations and those
who carry out the provisions of the National Health Insurance Act in
its relation to Tuberculosis should not be the same. The most wholehearted
co-operation between the two departments has not prevented a
certain amount of duplication of work on the one hand, and a certain
amount of laxity on the other ; some patients receive too much attention,
some too little. It requires that the whole system of dealing with
Tuberculosis shall be re-organised and adjusted, so that the function