704 



PROCEEDINGS OF SECTION I. 



primaril}' to general social betterment among the poorer classes 

 of society, and the operation of piibhc health Acts and other laws 

 which aim at the improvement of dwellings, the diminution of 

 overcrowding, and the enforcing generally of better sanitary con- 

 ditions, especially in towns. Add to these the active dissemination 

 of knowledge of the disease by the public health services and the 

 medical profession. Other special measures against consumption 

 have, I believe, played a part in the reduction of the mortality 

 which is but a secondary one to that of the influences I have just 

 referred to. 



But the time has come when measures directed more especially 

 against consumption must have a greater importance than they 

 have had liitherto, and it is evident that the various agencies must 

 be co-ordinated together, and their powersextendedif the question 

 of the abolition of tuberculosis is to be seriously attacked. There 

 are good reasons to hope that a movement in tliis direction is at 

 hand in Australia. Public attention has been directed towards the 

 control of tuberculosis, and public opinion is beginning to make 

 itself felt. 



The Governments of the various States would appear to be 

 the proper co-ordinating authorities. The State Governments have 

 most of the machinery at hand in their public health departments. 

 They have the financial means, they have the power of compelling 

 compliance ; and, in Australia, Governments have already acquired 

 the habit of dealing with questions of this kind more than in most 

 other parts of the world. 



The exact method which might be followed by Australian 

 Governments in carr3dng this policy into effect would no doubt 

 be governed by a variety of considerations ; but I venture to 

 suggest a trinity of measures which might be regarded as within 

 the sphere of any Australian Government. They are : — 



1. Compulsory notification of consimiption. 



2. The provision of a sufficient establishment of hospitals 



for advanced and incurable cases to meet present needs. 



3. The establishment in towns of consumption dispensaries. 



If these three things were carried out by the Government of 

 a State they would, I think, form a co-ordinating nucleus round 

 which any factors already working, or in future to be worked, 

 througti the agency of charitable societies or private persons, would 

 naturally group themselves. (To them one might add a fourth, 

 which, though probably not yet within the realm of practical 

 politics, will be -so, one would hope, in the future, viz., the pro- 

 vision of financial aid to distressed families whose breadwinner is 

 forced into a sanatorium by consumption.) 



The establishment of sanitoriums for the treatment of early 

 cases might probably well be left to private individuals and asso- 

 ciations. These institutions differ essentially from the segregation 



