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24
The Chest Clinic and Home Visiting.
It would appear that we have concentrated too much on
the results of sanatorium treatment and too little on the methods
of domiciliary and dispensary care, accompanied by adequate
environmental hygiene. The tuberculosis scheme has probably
come to depend too much upon residential institutions and too
little on the building up of personal resistance in the home surroundings.
Owing to lack of beds and the large number of
patients in their homes, home visiting is steadily increasing, both
for the doctors and the tuberculosis visitors.
1,425 new cases were examined during the year. This is
equal to 1,516 for each 100 deaths from the disease. 214 or 227
for each 100 deaths were found to be definitely tuberculous.
The total number of attendances at the Clinic was 10,302.
The Clinic doctors paid 220 home visits and the Tuberculosis
Visitors 2,530 visits for Clinic purposes. In addition, the
Tuberculosis Visitors made 575 primary visits for the purposes of
the Notfication Register.
Patients requiring home nursing or surgical dressings are
attended to by the nurses from the Croydon Nursing Service, by
arrangement with that organisation. Their assistance is a valuable
adjunct in the care of domiciliary cases.
Contact Examination.
The contacts of definite cases are urged to attend the
Clinic for examination (and subsequent supervision). This is an
important preventive measure. During the year 415 contacts were
examined, equal to 441 for each 100 deaths. Of these, 13 were
considered to be tuberculous. This is equal to a tuberculosis rate
per 1,000 contacts of 31.3 compared with 1.22 per 1,000 of the
general population.
The Clinic Register of Cases.
The number of cases of Tuberculosis under the supervision
of the Clinic at the end of the year was 1,490. This is equivalent
to 6.0 persons per 1,000 of the population.
During the year 88 Clinic cases died. Of this number 15 or
16.8 per cent. were seen for the first time in 1949,