[To THE EDITOR OF TEE " SPRCTATOR."1
have waited a week, hoping that somebody of higher authority than myself in matters of hygiene would correct the fallacy in Major M. Collie's reference to the work of the National Society for the Prevention of Tuberculosis, which appeared in the Spectator of October 4th :—
" The modern Crusaders," said he, "against our national scourge, tuberculosis, are going over ground already tilled, and either fail to see, or shirk acting on, the logical conclusion; they seek to cure the disease, not to prevent it ; they build sanatoria— which are simply sanitary buildings—instead of znski g every home sanitary," "cc.
Major Collie can be but very imperfectly informed about the object and work of our Society if that is his genuine estimate of it. The title of the Society plainly indicates that it was founded with the intention of prevention rather than cure, and if there is one principle which has been kept more constantly than another before the public in the literature disseminated by the Society, and by lectures delivered all over the country, it is that sanatoria are only palliatives, and that the true means of extirpating the disease is by universal sanitary conditions :— " Instead of presenting ideal hygienic conditions," proceeds Major Collie, "to the diseased, let those workers for the people's good seek rather for means to bring home to the people how it is possible to prevent disease, and aid the masses in protecting themselves from landlords who impose unhealthy conditions on them."
Our object could not be more completely stated, and the co-operation of Major Collie in the work would be more wel- come and useful than his sneer against our attempt to explain to people the danger of indiscriminate expectora- tion. As for sanatoria, we regard them as more than mere "sanitary dwellings." Every phthisical person is a centre and source of contamination to his healthy fellow-creatures. Science has proved that tubercular disease, once considered unmanageable and incurable, can both be controlled and, in its earlier stages, cured. Sanatoria are the necessary means of control and treatment, without danger of spreading infection ; it is not clear how Major Collie arrives at the conclusion that their encouragement by the Society is merely "going over ground already tilled." I came lately across an example of the old method of tillage among some original letters of Lady Holland. Writing to a friend at Brighton in 1812, she says : "Lady Jane has had a return of spitting of blood, and she was blooded thrice last week. The pain in her breast is very troublesome, and I much fear she is fast approaching to an untimely close of her innocent and valuable life." If sanatoria are useless, how does Major Collie propose to deal with curable cases of consumption, and how does he suggest that infection should be prevented ? The most sanitary dwelling in the world may be turned into a
regular death-trap by the presence of a consumptive person, unless the means of prevention sedulously recommended by the Society are adopted. Are no means to be provided to bring within reach of all the most hopeful means of recovery; no example to be provided of the system by which. those past hope of recovery may be rendered harmless to other persons ? Let it be understood that I heartily concur with all Major Collie says about the supreme importance of healthy homes and properly nourished children ; but I think he might have said it without dealing a backhander at a Society which has to deal with a condition of things in which a very large proportion of the people are suffering from tuber- cular disease. We cannot start with a clean slate ; the question is how to get it clean.—I am, Sir, &c.,
HERBERT MAXWELL, Vice-Chairman of Council of the Society for the Prevention of Tuberculosis.
[As we published Major Collie's allusions to the Society represented by Sir Herbert Maxwell, we feel bound in justice
to print the above letter ; but we cannot open our columns to any further correspondence on the subject.—ED. Spectator.]
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