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showed some signs of Fibrosis at one or other base of the lung. These children,
though generally delicate and requiring care, in tbe absence of definite evidence
should not be classed definitely as Tuberculous.
Any scheme for the prevention and treatment of Tuberculosis should make
provision for both these classes, to which some Authorities have applied the term
"Pretuberculous."
For some considerable time I have watched many cases of Suspected
Tuberculosis in children, and have seen nothing but good results from judicious
treatment, if continued for a length of time.
The main problems with regard to the prevention of Tuberculosis in
children are:—
1. To determine whether the child approaches the physiological normal, or
is below par.
2. If the child is below par, to determine the cause.
3. To use every means to improve their conditions and surroundings.
Two facts stand out prominently:—
1. That the incidence of Tuberculous disease and the death rate therefrom
are always higher amongst those living in crowded and unhealthy
surroundings.
2. The quick improvement in these children when they are given sufficient
nourishment, and placed in healthy surroundings.
It is a matter for regret that there is no Sanatorium for these
"Pretuberculous" cases.
The London County Council propose establishing an Interim Committee to
deal with the Tuberculous children in this district, and I hope that some
provision will be made for those cases which, while not Tuberculous, are very
likely to become so if allowed to drift.
The London Insurance Committee have made use of this Dispensary since
April, 1915, to a much great extent than formerly, and this has naturally entailed
an increase of work and correspondence.
Since the 1st April, 1915, 72 patients residing in the Borough of Shoreditch
have been sent to this Dispensary to be examined and reported on as to their
suitability for Sanatorium, Hospital, or Domiciliary treatment. Of these cases
33 (27 males and 6 females) were recommended for Sanatorium treatment; 21
(15 males and 6 females) for admission to Hospital, and 11 (7 males and 4 females)
for Domiciliary treatment. 7 (4 males and 3 females) were found not to be
Tuberculous.