THE COMBATING OF TUBERCULOSIS. 471 



we had special hospitals for consumptives, and if the patients were 

 taken care of there for nothing, or at least at a very moderate rate. 

 To such hospitals they would willingly go ; they could be better treated 

 and fed there than is now the case. I know very well that the execu- 

 tion of the project will have great difficulties to contend with, owing 

 to the considerable outlay it entails. But very much would be gained 

 if, at least in the existing hospitals, which have to admit a great num- 

 ber of consumptives at any rate, special wards were established for 

 them in which pecuniary facilities would be offered them. If only a 

 considerable fraction of the whole number of consumptives were suit- 

 ably lodged in this way a diminution of infection, and consequently 

 of the sum-total of tuberculosis, could not fail to be the result. Permit 

 me to remind you in this connection of what I said about leprosy. 

 In the combating of that disease also great progress has already been 

 made by lodging only a fair number of the patients in hospitals. The 

 only country that possesses a considerable number of special hospitals 

 lor tuberculous patients is England, and there can be no doubt that 

 the diminution of tuberculosis in England, which is much greater 

 than in any other country, is greatly due to this circumstance. I 

 should point to the founding of special hospitals for consumptives and 

 the better utilization of the already existing hospitals for the lodging 

 of consumptives as the most important measure in the combating of 

 tuberculosis, and its execution opens a wide field of activity to the 

 State, to municipalities, and to private benevolence. There are many 

 people who possess great wealth and would willingly give of their 

 superfluity for the benefit of their poor and heavily afflicted fellow- 

 creatures, but do not know how to do this in a judicious manner. Here 

 is an opportunity for them to render a real and lasting service by 

 founding consumption hospitals or purchasing the right to have a 

 certain number of consumptive patients maintained in special wards 

 of other hospitals free of expense. 



As, however, unfortunately, the aid of the State, the munici- 

 palities, and rich benefactors will probably not be forthcoming for a 

 long time yet, we must for the present resort to other measures that 

 may pave the way for the main measure just referred to and serve as a 

 supplement and temporary substitute for it. Among such measures I 

 regard obligatory notification as specially valuable. In the combating of 

 all infectious diseases it has proved indispensable as a means of 

 obtaining certain knowledge as to their state, especially their dis- 

 semination, their increase, and their decrease. In the conflict with 

 tuberculosis also we cannot dispense with obligatory notification; we 

 need it not only in order to inform ourselves as to the dissemination of 

 this disease, but mainly in order to learn where help and instruction 

 can be given, and especially where the disinfection which is so urgently 



