In June 1910, wishing to establish a tuberculosis prevention program in Oxfordshire, Osler sent a circular letter to all the
local branches of Britain's National Association for the Prevention of Tuberculosis, asking about their activities and
experiences. He received a number of replies, including this one, which provides one group's experience with the effort
and their main concerns.
R. H. Urwick
Item is handwritten.
Number of Image Pages:
6 (1,687,800 Bytes)
1910-06-09 (June 9, 1910)
Urwick, R. H.
Original Repository: Alan Mason Chesney Medical Archives. William Osler Collection
This item is in the public domain. It may be used without permission.
Medical Subject Headings (MeSH):
Sir William: Regius Professor at Oxford, 1905-1919
Jun 9 1910
You will see from the enclosed leaflet the main objects with which this association was formed last year. At present the organization
consists of President, Vice Presidents and General Committees. Chosen so far from the point of view of gathering in the whole
county and as much money as possible. The working Executive Committee consists of people who have been instrumental in starting
the association. The main point of the organization in the county is, I think, the formation of small local committees to
take over the management of districts within the county such districts consisting wherever possible of the existing local
districts, far example in this
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county, the Ellemere[?] rural district, Ludlow rural D. Wellington Road, etc. In cases where it is considered that such districts
are too large, they have been divided. The duties of such local committees have been said to be
1) to collect subscriptions (especially the small ones)
2) to assist in the selection of cases for the sanitorium treatment
3) to assist in the after-care of such cases
4) to assist in the help of their homes of those unfit for sanitarium treatment
5) generally to carry out the objects of the association.
Great stress has been laid when the necessity of working through those who know and are known by the people as being the most
likely of getting hold of the patients early and for the same reason, stress has been laid on the sanitarium being built in
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the county and for the county only. The difficulty of persuading early cases to go off to a distant sanitorium about which
they know nothing is one which is very great and which we hope to get over in this way -- by encouraging this my poor to give
something even one or two pence toward their own sanitorium.
There are no actual rules and regulations made at front as regard admittance and maintenance but I think I can find out the
feelings of the committee on several points.
1) There will be no letters of recommendation -- such systems causing delay in admittance and trouble in choosing the correct
2) All patients will be expected to pay what they or their friends can afford towards their maintenance up to the full sum
-- estimated at 20 to 25 shillings[?] per week.
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This gives us the chance of helping the class of poor clerks and higher shop people who at present are badly off. No difference
will be made in the treatment or accomodation.
3) The cases for admittance to the sanitorium will have to appear before a central medical board which will meet on convenient
dates. (once a week or fortnightly) and will have to be men from local communities in which the local medical men will serve.
In the county especially is very difficult for local medical men to decide upon the claims for admission especially from the
point of view of offending their own favorite patients who work to get dependents admitted. We hope by means of this central
medical board to get over this.
4) The question of reserving beds for certain districts or private members has been raised but I think will fall through owing
to the obvious disadvantages. People working to endow a bed will only have the privilege of giving it their name.
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5) Medical staff: we shall have a resident medical man with a salary of 200-250 pounds and the central medical board: some
one or more of whom will be visiting medical officers or committees. On this point I should be glad of your opinion as to
the best plan. It is difficult to avoid either multiplying the medical committee men at the at the sanitrorium and getting
no settled scheme of treatment, or giving offense to famous medical men in the county. My own opinion leans toward
1. Consulting or visiting man and then the medical board behind him.
I am afraid that this not a very clear description of our organization. The points which the committee
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consider the most important are the part that it is a county association and then local committees all working under the central
committee but as free a hand as possible. All payments are made from the central committee and all subscriptions paid to the
central fund: a good deal of discretion will be left to the local secretaries to disburse funds.
The work in people's own homes will consist of erecting shelters, where possible, suggesting alterations in living rooms,
obtaining more suitable work, etc. [ . . . ] the usual attempts at educating them in modes of cleanliness, etc.
I shall at any time be glad to give any information and shall be very glad of any suggestions.