2 PREVENTIVE MEASUKKS AGAINST THE SPREAD OF TT'BERCULOHIS 



footsteps of European hygienists, as the vastly different climatic 

 conditions of a sub-tropical and tropical country demand that 

 the subject be dealt with, if I may express myself so, from a 

 local standpoint, based upon our practical experience of the 

 effects of the climate, social conditions, alteration of the qualities 

 of the race, ttc. I therefore propose not to enter into an 

 exhaustive discussion of the prevention of pulmonary consump- 

 tion, and retail to you the stock of knowledge contained in the 

 most recent handbooks of preventive hygiene, but limit myself 

 to those aspects of the question which have presented themselves 

 most strongly to my mind during a ten years' experience of the 

 disease in Queensland. 



Is Compulsory Notification Necessary ? 



The trend of public opinion of medical men in Great 

 Britain, and especially in the United States, has been towards 

 some form of compulsory notification of every case of pulmonary 

 consumption. The opinion expressed by German authors at the 

 last Tuberculosis Congress at Berlin, eight months ago, was less 

 decisive in the matter. If carried out in its entirety, it would 

 mean that the medical man who was called to see a consumptive 

 patient would have to report the case to the authorities, as we do at 

 present with scarlet fever. They (the authorities) would then take 

 the proper measures believed to be required against the spread of 

 the disease. At the first view the suggestion seems to commend 

 itself. The duties are delegated to a central authority equipped 

 perhaps with the most modern knowledge and the most modern 

 means of aealing with the spread of infectious diseases. But as 

 far as pulmonary consumption in Queensland it concerned, I see 

 most serious obstacles in the way of carrying out such a measure 

 of compulsary notification. In the first instance we must 

 remember that we have to deal not with an acute disease like 

 scarlet fever, which is over in a few weeks, but with an illness 

 that lasts for many years. To place all the patients so afl'ected 

 under constant supervision for a number of years would entail 

 an enormous expense ; besides it would be absolutely contrary 

 to the instincts of every free man. Moreover, Queensland is so 

 large, the population so scattered, that an eflScient supervision 

 could not be carried out. Notification would interfere with the 

 consumptive earning his living. During the greater part of his 

 illness he is able to follow^ his occupation. Eeportinghim to the 

 authorities would brand him as dangerous, and he would most 

 likely lose his employment. 



