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much of the debility in various forms occurring in childhood
is due to Tuberculosis of small amount, which is unrecognised
by clinical examination, and from which in the majority of
cases the child makes a perfect recovery, and in 50 per cent.
of the cases direct infection was to be traced to Tuberculosis
then in the home, or to a case having previously lived there.
In the majority of cases, as they at present come within
the purview of the Authority, practically all hope of cure is
gone, so that it would appear that the present point of attack
must be rather the prevention of infection than the cure of
the actual sufferer. To treat the sufferer in Sanatoria with
nothing left when cured but the life of an invalid unable to
support his family is extremely costly to the community.
On the other hand, if we realise that infection in Consumption
is entirely by means of the expectoration, it is a comparatively
simple matter to educate the sufferer in the ritual of
the consumptive, whereby he can continue to live at home
without infecting the rest of the family.
At present Wimbledon is paying as an eleventh part of
the Poor Law expenses £3,200 a year for the relief of Consumption
without benefiting the patient or attempting to
control the spread of infection. Roughly speaking, the
death-rate from Consumption is practically 16 times that of
Scarlet Fever.
It is a matter for regret that so little use is made of the
Department with regard to the microscopic investigation of
sputum in suspicious cases of Phthisis. There were only 25
cases in which examinations were made by the Department,
and when it is realised the large number of cases there must
be in existence, together with the doubtful ones, it seems
that much more could be done in the way of confirming the
diagnosis in doubtful cases. Moreover, it would appear
that one examination is taken as conclusive, whereas
it is found in the early cases and the doubtful ones, which
are the only ones where the microscopic test is of use in
helping the diagnosis, that repeated examinations have often
to be made before the bacillus is found.
In two-thirds of the cases examined the result was negative,
so that one may take it the majority of these patients
are not much better off for having had one examination
made.
Cancer.—During the year 39 deaths have been registered
as due to the different forms of malignant disease or Cancer,
16 males and 23 females.
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