| dc.description | In the early 20th century tuberculosis became the concern of social reformers because of its links with poverty and new medical knowledge about its infectiousness. Although reform might have taken several directions, the one chosen prior to 1914 was in line with the essentially conservative character of the reform movement, which revered scientific expertise as a solution to many social problems. Voluntary organizations were established to deal with tuberculosis, but generally accepted the leadership of physicians, who successfully promulgated a "cure" in the form of the fresh-air sanatorium regime. Tuberculosis and public health became quasi-specialties in medicine, with the role of the laity sharply reduced. Nova Scotia's sanatorium opened in 1904 as the first provincially-established tuberculosis facility in Canada. Although it could take in only a tiny fraction of cases and left those who could not pay completely unprovided for, it represented virtually the only action taken by the medical profession or the provincial government until the 1930s to cope with a disease which affected thousands. Voluntary activities, which had taken on a bureaucratic character by the 1920s, helped shape a public health system which was designed to function as a clearing-house for the sanatorium and the new tuberculosis annexes at general hospitals. The system was non-threatening to private practitioners at the cost of being inaccessible and unhelpful to many people. No action was taken toward provision of non-institutional care until the tuberculosis death rate had declined so much as to make this almost irrelevant; nor was any government action taken to alleviate the circumstances of the indigent tuberculous until federal money became available after the second world war, at which time treatment became compulsory. The steady decline of tuberculosis helped justify a variety of programmes, yet probably owed little to any of them. | en_US |
