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57
Authority as to the necessary developments of the Tuberculosis
Scheme unless information as to the existence of the disease be
made reasonably accurate. A communication drawing attention
to this and requesting the personal co-operation of the medical
profession has been sent to each medical practitioner in the
Borough. This (lack of notification unquestionably, to a considerable
extent, is due to the indefinite wording of the Tuberculosis
Regulations.
Attendances at Dispensary.
During 1921 the total number of attendances made at the
Dispensary was 7,576 as compared with 7,050 in the previous year.
New Cases Seen at Dispensary.
During the year 712 new cases were dealt with as compared
with 805 in 1920. 325 cases were referred to the Dispensary by local
practitioners as compared with 298 in 1920. Fewer cases were
referred by the School Medical Service—94 as against 171—and
by the Ministry of Pensions—33 as against 116 for these respective
years. 292 of the new cases were diagnosed definitely as tuberculosis,
76 were diagnosed as non-tubercular. 344 cases were kepi
under observation as suspicious. The apparent discrepancy
between the total cases notified and the new cases diagnosed is due
to the fact that a large number of old cases under observation were
diagnosed and notified.
Contacts.
Of the 712 new cases—
161 were contacts as against 102 contacts examined in 1920.
Of these
15 were diagnosed as tubercular.
58 were diagnosed as non-tubercular; and
88 suspicious and kept under observation.
This is a very small number of contacts as compared with newcases.
The examination of contacts is by far the most valuable
means of discovery of cases of tuberculosis in the early curable
stage and it is essentially the very pivot of the present preventive
medical work in this section. The contacts examined should
number several times the number of new cases. It is exceptionally
difficult work and requires skill and experience of a very high
order. There is no doubt that more good could be done by the
systematic and continuous observation of contacts than bv any of