1 8 QUATERCENTENARY STUDIES IN PATHOLOGY 



feel justified in approving of the compulsory notification of cases of the 

 disease." 



Long ago, when laymen and very few medical men were agitating for 

 the notification of the ordinary infections, the same arguments were 

 heard : the " liberty of the subject " always " blocked the way." To-day, 

 the subject's liberty is secured by the very Acts that seemed certain 

 to destroy it. The apparent coercion of the Notification Act of 1889, 

 and its precursors, was only the civil instrument for unveiling to the 

 citizen mind a new social duty, namely, the duty to save his fellow and, 

 therefore, himself, from the dangers of preventable infection. In the 

 Statute-book there is no Act that works with greater smoothness or 

 greater effect. And its application to Pulmonary Phthisis is only a 

 matter of detail. The principle is everywhere accepted. But Notification 

 is only one step. It is right to take it. It will be taken. But it must 

 be prepared for, it must be followed, by effective action in every case. 

 Meanwhile, cases are waiting in thousands to be received, and, for 

 the moment, compulsory notification is a secondary point of tactics. 

 In Scotland, compulsory notification of the common infections did not 

 become general until 1897. It does not yet, except in one or two places, 

 apply to whooping-cough, or measles, or diarrhoea. But when methods 

 of controlling those diseases are revealed, notification will be swiftly 

 invoked. In Phthisis, methods of control are obvious and effective, and 

 notification will soon be asked for everywhere as a simple necessity 

 of administration. 



X. Organisation and Administration. 



" It has been shown above that the Public Health Act applies to 

 Pulmonary Phthisis ; that, for a successful campaign against the disease, 

 the Local Authority must employ the various institutions and agencies 

 suited to the various types of patients ; that sanatoria, hospitals, and 

 dispensaries must be worked always in concert, and that a system of 

 notification, voluntary or compulsory, is indispensable. It remains to 

 add that an organisation so highly specialised demands the services of a 

 special Sub-Committee of the Public Health Committee. 



This Sub-Committee — the Phthisis Committee — should have charge 

 of the Dispensary, which, as indicated above, should be the Administrative 

 Centre of the whole Organisation for dealing with Phthisis. The 



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