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58
the other present methods of defence against tuberculosis. To
carry this examination of contacts out thoroughly is impossible
with the present staff. Another Assistant Tuberculosis Officer
would be required to do anything like justice to this very important
branch of the work. It is to be remembered that the earliness of
the discovery of tuberculosis in these contact cases enormously
enhances the chances of effective and lasting good being derived
from treatment.
Sputum.
659 specimens of sputum were sent from the Dispensary for
examination for tubercle bacilli. 109 of these were positive and 550
were negative.
Extra Nourishment.
Owing to the transference of powers of Insurance Committees
in connection with tuberculosis which took effect on May 1st an
additional £500 had been introduced into the estimates for the purpose
of meeting the expenditure on extra nourishment which had
hitherto been given from Insurance Funds to necessitous insured
people. Upon receipt however of the Ministry's memorandum
limiting the grant earning expenditure in this respect to £2 per
1,000 of the population the Council resolved that the expenditure
on extra nourishment should be kept within that limit. The
number of people in receipt of milk consequently had to be very
greatly reduced and only exceptionally necessitous cases were so
supplied. There is no doubt that a great deal of actual want on
the part of patients had been considerably diminished in the past
by the milk grants which had been made, and that a large proportion
of these cases have consequently been deprived of such help
when it was in the physical sense most urgently needd. The
really ill tubercular person cannot earn a proper livelihood and the
less the nourishment available the less efficient does he become as
a working member of the community so that a vicious circle is set
up. This applies to a very large number of cases of tuberculosis
in the ordinary working-class population and it is undoubtedly
aggravated by any conditions which give rise to diminished means
of sustenance. The amount allowed in the estimates for extra
nourishment was £750. On the basis of the Ministry's approved
rate of £2 per 1,000 of the population, the amount worked upon
has been £380.
Consultations.
88 patients were seen in consultation in their own homes in
1921 as compared with 72 such cases in 1920.