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86
TUBERCULOSIS DISPENSARY.
Report for 1913
by
Lytton Maitland, M.D. Lond., D.P.H. Camb.
Royal Hospital for Diseases of the Chest,
City Road, E.
January 1914.
To the Medical Officer of Health, Town Hall, Shoreditch.
Sir,
Since October 1912, there has been instituted at the Royal Hospital for
the Diseases of the Chest, City Road, situated within the Borough of Shoreditch, a
department for the prevention of consumption. This department has been
developed so as to fulfil as far as possible the objects comprised within the sphere
of work of a Tuberculosis Dispensary. Of the patients attending the department
a large majority was resident in Shoreditch, and as the result of negotiations it
was decided that this department should form the basis of the Shoreditch
Tuberculosis Dispensary. It has, therefore, been arranged that the medical officer
in charge of the department and the visiting sister shall act in close co-operation
with the Medical Officer of Health in regard to cases under the care of the
dispensary and that they shall be officers of the Local Authority, acting under the
instructions of the Medical Officer of Health, in accordance with the provisions of
Articles XI. and XII. of the Public Health (Tuberculosis) Regulations 1912 of the
Local Government Board. This section requires such enquiries to be made and
such steps to be taken "as are necessary or desirable for investigating the source of
infection, for preventing the spread of infection, and for removing conditions
favourable to infection."
As regards the clinical side of the work of the dispensary, the Medical
Officer, working as he does, in the hospital buildings has the advantage of ready
access, not only to members of the staff for consultation in difficult cases, but also
to the X-ray department for very helpful assistance in diagnosis, and to the dental
department for a highly important side of the treatment of tuberculosis. These
advantages are only some of those which the intimate association with a hospital
gives to a Tuberculosis Dispensary held in such an institution.
The objects of an anti-tuberculosis dispensary, as it should preferably be
called, are by this time fairly recognised. Foremost should be placed the
recognition of the disease in its earliest stages, when it has far and away the best
prospect of being cured or rendered inactive either permanently or for a long
period. To this end potential patients must be encouraged to seek advice and
submit to examination at the dispensary; and all those living in close association
with tuberculous persons should be overhauled and classed as " contacts."