View report page

33
Infection of,children is derive^from two sources, directly from a
human source, indirectly from a bovine source through milk containing
the bacillus.
The report of the inspectors of the London County Council shows that
last year 913 samples from churns of milk consigned from 32 counties
to the various London railway termini were examined with the result
that 61, or 6-5 per cent., yielded tubercle bacilli as against 7-4 per cent, in
1918, 10-3 per cent, in 1917, and 8-7 per cent, in 1916.
Dr. Brownlee has for some time been making a statistical inquiry into
the epidemiology of tuberculosis on behalf of the Medical Research
Committee. He finds that the prevalence of bovine tuberculosis as
shown by the percentage of samples of milk, is highly correlated with the
standard death rate of the county of origin, and that there is a large
positive correlation between the milk infection rate and the death rate
under 5 from tuberculosis, especially with the death rates from tuberculosis
affecting the meninges and abdomen.
While a proportion of the cases are due to the bovine variety of the
bacillus, the greater number are due to direct infection.
Tuberculosis Dispetisary.—Dr. Chapman, Medical Inspector of the
Ministry and Dr. Menzies, on behalf of the County Council, have made a
survey of the dispensaries in London, and their report was issued during
the year and received the consideration of the Public Health Committee.
The report concluded with a number of recommendations to render the
dispensaries more efficient. The County Council adopted these recommendations,
which have also been approved by the Ministry. So far as
Westminster is concerned, only three points required to be dealt with.
(1) Home Visitation by the Tuberculosis Mcdical Officer.—"In order
to enable the officer to deal adequately with the individual patients and
also to afford him material for studying the relation of environmental
conditions of the disease in his area, home visiting is very important,
and it should be the recognised duty of the tuberculosis officer to visit,
at least once, the homes of the patients." It was considered that more
home visiting should be done and a re-arrangement of his duties was
effected to enable the tuberculosis officer to devote more time to carry
out this recommendation, with the result that the visits paid by him rose
from 21 and 20 in the first two quarters of the year to 54 and 70 in the
latter two. It should be pointed out, however, that in the years
previous to 1919 he was able to pay more visits to the homes (see below
under " Home Visiting ").
(2) Transference of school children attending for Observation.—In
order to give the tuberculosis officers more time for that intensive study