Prior to the general enforcement of notification of tuberculosis in England excellent local work had been done in a relatively small number of areas in direct efforts to control the spread of tuberculosis, in addition to the previous general measures, such as improved sanitation, better housing, more satisfactory nutrition, and especially the hospital treatment of a large proportion of advanced and acute cases of tuberculosis. The Report of the last Royal Commission on Tuberculosis appeared in 1911; and although precautions against human infection by tuberculous cows’ milk are still very incomplete, the pasteurisation or boiling of milk is more generally practised than in the past. Local Authorities prior to 1911 had power to build sanatoria or otherwise provide institutional accommodations for the treatment of tuberculous patients; relatively little had been done in most areas. In 1911 the Finance Act provided a sum of £1,116,000 for the erection of sanatoria in England and Wales, and this, with money provided by local rates, has led to rapid increase in accommodation for the residential institutional treatment of tuberculosis. In England in 1911 local authorities, other than poor-law authorities, had about 1300 beds for the institutional treatment of tuberculosis, while there were 4,200 beds in private sanatoria and voluntary institutions. In 1917 the total available beds numbered 12,441, of which about one-half had been provided by local authorities. In 1911 the National Insurance Act was passed and came into operation in July, 1912. This provided a special “Sanatorium Benefit.” The Departmental Committee appointed to make recommendations as to detailed direct measures against tuberculosis, reported in April, 1912, that any scheme which is to form the basis of an attempt to deal with the problem of tuberculosis should be available for the whole community, and that its organization should be undertaken by the large local authorities (the councils of counties and county boroughs). These recommendations were at once adopted by the Government, which undertook to provide out of the national exchequer one-half of the net cost of approved local schemes for the general treatment of tuberculosis. Local authorities were invited at once to prepare schemes for institutional treatment, residential and non-residential, domiciliary treatment remaining in the hands of private practitioners, of poor-law doctors, and of doctors engaged in the contract work under the National Insurance Act (“panel doctors”). The last named are in medical charge of the large mass of the wage-earners of the community, comprising roughly one-third of the total population, in so far as their treatment at home is within the power of a practitioner of average competence. The schemes proposed for each area comprised,