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47
Of the cases not notified, almost all were deaths occurring in
Institutions. Whatever the condition of the patient on admission, a
diagnosis of tuberculosis must have been arrived at before death and
ought to have been notified. It must be borne in mind that notification
is the only means of bringing the disease to the knowlege of the
Public Health Department, and that the earlier the notification the
more valuable the information.
During the year 384 notifications (292 pulmonary and 92 nonpulmonary)
were received of which 101 came from the tuberculosis
officer. The distribution of the cases is shewn below':—

This gives an incidence figure (pulmonary tuberculosis) of 2.6 per
1,000 on an estimated population of 111,205. With regard to the
patients attending the dispensary the same procedure and the same
methods of treatment were carried out as have been indicated in previous
reports. The lack of accommodation for advanced cases is still
urgent, but this question is at present under consideration, it being suggested
that a joint “ Home” might be established with the neighbouring
Boroughs of Lewisham and Greenwich. The Housing Conditions
of many of the patients are such as make it imperative to remove every
“ open case ”as early as possible. On an investigation of the sleeping
arrangements of 300 patients attending the dispensary it was found
that only 91 slept alone, 121 slept with one other person and the
remainder with two or mote persons. In this way infection spreads.
During the year a whole time tuberculosis nurse was appointed
who attends the Dispensary and visits all cases notified whether
dispensary cases or not. This was formerly done by the health
visitors. There is evidence that additional help will be required if revisits
are to be paid at reasonable intervals. A permanent Care
Committee has now been established in place of the Interim Committee
of previous years. The constitution of the Committee is practically
the same. The Committee is hampered by lack of funds but much
more so by lack of voluntary workers. Visiting, apart from the