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THE COULSDON AND PURLEY, CATERHAM AND
WARLINGHAM CARE COMMITTEE
This is the 40th anniversary of the Coulsdon and Purley,
Caterham and Warlingham Care Committee. A 40th birthday is
quite an occasion and I am marking this by making an assessment
of the work the Care Committee has done in its lifetime. The
record is impressive. Both the case rate and the death rate of nonpulmonary
tuberculosis are a fraction of what they were forty years
ago and the death rate from pulmonary tuberculosis is also a
fraction of what it then was. The challenge of tuberculosis is still
with us, however, because the case rate of pulmonary tuberculosis
is still more than half of what it was forty years ago although there
has been a tendency for it to fall during the past two or three years.
The outlook for tuberculosis patients forty years ago was a
very unhappy one. Prolonged stay in sanitoria was the only
effective treatment and this gave rise to grave family and social
problems which the T.B. Care Committees were formed to deal
with.
Those were the days before the Welfare State and the work
that the Care Committee, the Care Almoner and the Tuberculosis
Health Visitors did in alleviating suffering, supporting patients and
their families and looking after the welfare of contacts was invaluable
in keeping up the morale of patients and relatives and in
keeping the disease in check. The Care Committee Officers have
given unsparingly their time and consideration to the cases and
our thanks are due to them.
A major contribution to the fight against non-pulmonary
tuberculosis before the War was the introduction of legislation
prohibiting the sale of milk from cows suffering from tuberculosis
and the general acceptance of pasteurisation of milk.
Since the War there has been a continuous improvement in
nutrition, housing and the standard of living. The outstanding
advance, however, was in the treatment of pulmonary tuberculosis
with the introduction of the antibiotic drugs. These have proved
an invaluable asset to the Chest Physician.
The next advance was in the prevention and control of the
disease with the introduction of Mass X-Ray and B.C.G. vaccination
and, later on, the B.C.G. vaccination of school children.
The result of these measures was that the non-pulmonary
death rate fell and the number of cases of pulmonary tuberculosis
probably fell also as there must have been a large reservoir of cases
of undiagnosed pulmonary tuberculosis during the years before
X-Ray examination was readily available for everybody. The
number of notified cases, however, did not fall because diagnostic
facilities such as Mass X-Ray and the tracing of contacts had improved
so greatly that a much greater proportion of all cases in the
community were being diagnosed than in previous years. The introduction
in 1959 of weekly visits of the mobile X-Ray unit to both
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