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(vi.) The Tuberculosis Officer explains to the patients the importance of the
examination of home contacts, and in addition to the necessary visits of the Sanitary
Inspectors the Tuberculosis Nurse visits the homes of City residents periodically for the
same purpose, and arranges for the attendance of the contacts at the Dispensary at times
convenient to them. Among City residents since the establishment of the Dispensary in
1914, the majority of adult contacts have been examined, and all except six of the infants
and children of school age who are home contacts.
The supervision of these contacts, and the re-examination of suspects among them,
is secured by the home visits periodically made by the Nurse.
(vii.) X-ray photographs of 11 patients have been taken during the year, and have
proved of value as an addition to the usual methods of diagnosis.
No special methods of treatment have been adopted in the Dispensary. Tuberculin
is rarely used.
(viii.) Experience shows that when the disease is active, residence in an institution
more quickly and certainly brings about arrest than when treatment is attempted at
home on sanatorium lines, and that the lessons learnt in the sanatorium are sometimes
put into practice by the patient on his return home to his permanent advantage.
(ix.) Dental treatment is provided by the Dental Department of St. Bartholomew's
Hospital, and the Corporation defrays the whole or part of the cost of artificial dentures
for necessitous cases.
(x.) Nursing in their own homes of patients resident in the City is one of the duties
of the Tuberculosis Nurse. Milk is provided for uninsured necessitous persons requiring
extra nourishment.
(xi.) Patients suffering from Non-pulmonary Tuberculosis receive advice and
treatment from the Surgeons of St. Bartholomew's Hospital, to whom they are referred
from the Dispensary. Treatment in residential institutions is provided by the London
County Council and the London Insurance Committee. The Corporation has supplied
surgical apparatus free of cost for necessitous residents in the City.
(xii.) The arrangements for "care" and "after care" are carried out by a
sub-committee of the Sanitary Committee, on which two ladies are co-opted members. It
receives detailed reports on all cases of Tuberculosis occurring among City residents.
(xiii.) No local arrangements exist for providing employment for patients.
Ex-service men have been offered training in suitable trades in institutions approved
by the Ministry of Pensions, but as this has involved absence from home no City resident
has yet availed himself of the offer.
(xiv.) No opportunity has arisen for the use of a shelter, but arrangements would
be made for any suitable case if a site were available.
(xv.) No special points have been noted as to the incidence of Tuberculosis; the
records do not show that the disease is specially prevalent among any class of workers
in the City.
(xvi.) The usual methods for preventing the spread of infection are adopted, and
pocket sputum flasks are provided free of cost.
(xvii.) The principal difficulty encountered occurs on the discharge of a patient
from a sanatorium with the disease arrested. The home environment to which he
returns is often unsatisfactory, suitable occupation near his home may be practically
unobtainable, even when remuneration is not the main consideration, and the very
considerable benefit gained is in some cases soon lost and the treatment in the sanatorium
largely wasted.
CONSUMPTION—SPITTTNG.—The objectionable habit of spitting in the streets
and other public places, and also the corridors of large buildings occupied by a number
of different firms, is still a source of nuisance, and during the past year the demand
for copies of the precautionary notice issued by the Corporation drawing attention
to this practice has necessitated a reprint of such notices. These notices, which in the
past were supplied on enamelled tin, have in the interests of economy been reprinted
on stiff card, and are distributed to bonâ-fide applicants.