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14
death, the room previously occupied by the patient and also the
bedding should be disinfected by the Sanitary Authority.
Sanatoria.— At the present time there is a disposition to
overrate the value of Sanatoria and some people consider that these
are being constructed and equipped on extravagant lines. It should
be borne in mind that without Sanatoria Phthisis has been reduced
in this country some 70 per cent, during the last 65 years. Institutions
are wanted not primarily for the benefit of patients but for
the isolation of the patient for the benefit of others and which may
therefore be fairly supported out of pnblic funds. So far as I am
aware there are no such institutions in London or Surrey if we
exclude the provision made by the Poor Law Authorities for pauper
patients, and until these are provided one of the essential provisions
for coping with the disease is lacking.
Whatever the extent of the provisions made in the Sanatorium
or Isolation Hospital the majority of the sufferers from Phthisis
would remain at home with their families, and work until the latest
stages of the disease is reached, rather than enter an Institution for
several months.
Consumption then must be dealt with in its different stages, in
the first stages education and open-air treatment for those able and
willing to avail themselves of it is wanted; in the later stages
isolation is needed, as every cough is the cause of the dissemination
of the Tubercle Bacillus.
Regarding the treatment of Expectorating Pulmonary Tuberculosis
away from home there are three classes of cases to be
provided for, Incipient, Pronounced and Advanced. This means for
the incipient cases Sanatoria proper, for the pronounced cases Consumption
Hospitals, and for advanced cases Homes for Incurable
Consumptives or Homes for the dying.
The provision may be made either by separate institutions or
within the precincts of the same institution in separate structures as
has been done in connection with some Workhouse Infirmaries.
In the homes of the poorest, the advanced cases are by far the
most dangerous. For pronounced or intermediate and incipient cases
Sanatorium treatment affords the most promising and permanent
results.
For the well-to-do their means enable them to get suitable
treatment and they need not be considered by the Local Authority,