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Attention has been drawn to this, and failure to notify must be
largely attributed to the fact that the doctors know well that little in
the way of institutional treatment or after-care will be carried out for
their patients.
The Public Health administration as applied to Tuberculosis is lame
and halting and unsatisfactory. The Medical Officer of Health receives
the notification, a sanitary survey of the home is made, then copies of
both are sent to the County Council, and practically here the local
Medical Officer of Health finishes with the case until death occurs.
Some years ago I made an effort to have the homes disinfected when
vacated by Phthisical patients, and to do this I had to ask the
co-operation of the landlords, which was readily given. Such a
procedure was declared by the Local Government Board as ultra
vires, and a breach of faith as to the secrecy which was supposed to
be attached to every notification.
Is it surprising that notification of Tuberculosis is inefficient?

Twenty-one cases were very slightly and 13 seriously affected in one
or both eyes. The latter had treatment at the Public Health Offices,
and were visited at their homes by the Nurses.
4. CAUSES OF SICKNESS
Apart from the epidemic prevalence of Scarlet Fever there were no
outstanding features calling for special comment. During the first five
months of the year Influenza was fairly prevalent, and 29 deaths have
been attributed to this cause.
5. HOSPITAL PROVISION AND NURSING
ARRANGEMENTS.
Nursing.—There is no provision for home nursing by the County
or the Local Authority. The local branch of the Essex Cottage
Nursing Association employs 12 nurses who are largely occupied in
Midwifery practice. They also do a considerable amount of nursing
among the poor, but they do not attend, as a rule, on cases of Fever,
Measles or Whooping Cough.
Midwives.—There are 15 practising in the District.