20 QUATERCENTENARY STUDIES IN PATHOLOGY 



of " social ostracism," thinking a great deal of the treatment they need 

 and can secure only at the hands of the public organisations. Indeed, 

 the fear of social hardship is rapidly vanishing before the verifiable facts 

 of the open-air treatment and the growing evidence of anti-toxic cures. 

 The powers of our Acts are now, when cases are being handled by the 

 thousand, found to be after all nothing but the simple necessities of the 

 administrative problem. The Acts are strong, but the clauses are elastic. 

 The highly developed Public Health Service of Scotland has, for fifteen 

 years in the counties and for a longer period in the large towns, been 

 finding its way into the most intimate recesses of social life. What ten 

 years ago presented itself to the lay mind as a " medical fad " is now the 

 commonplace of every town council and every district committee. The 

 demand for isolation, for disinfection, for hospital treatment, comes no 

 longer from the medical side ; it comes imperatively from the side of 

 the patient. By the systematic administrative handling of the other 

 infections, the public mind has been educated to accept a similar treat- 

 ment of phthisis. The time has now come when the executive 

 authorities, who have many of them been doing a little, may, with 

 safety and the certainty of universal assent, make a great concerted 

 movement to limit the spread of the disease. 



No longer is it necessary to deal with private organisations alone, 

 with charitable societies, infirmaries, or dispensaries. It is possible, it is 

 necessary, that we should put in motion the statutory organisations at 

 present charged with the control of infectious diseases. True, it is easier 

 to agitate for new legal powers than to execute in detail the powers we 

 have. It is easier to stir opinion than to superintend spade-work. The 

 one requires only an interest in the subject ; the other demands 

 systematic action day by day. But as the case stands, the general 

 conviction of the medical profession has at last found a response in the 

 general conviction of the lay mind. The public authorities are ready. 

 The vastness of the work to be done has somewhat appalled those 

 unaccustomed to handle so great a movement. But the necessity for 

 handling it has become irresistible. And, after all, when the campaign 

 is thought out, when the organisations available are contemplated, the 

 problem, in passing into detail, passes easily into practice. We cannot 

 at one stroke undo the work of centuries, but in a single generation we 

 can make an effective beginning. 



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