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115
known, many private individuals who have been out of sorts,
run down, overworked, suffering from coughs or blood-spitting,
attend these institutions on their own initiative, in order that if
they be not consumptive their fears may be allayed; whilst, if
tubercular, they know that they will receive appropriate treatment
at the earliest possible moment. For the better and
more systematic working of the Dispensary it will generally
be found advisable to provide some observation beds where
doubtful cases may be watched before specific treatment is
commenced or before they are drafted to an appropriate
institution. In some cases there can be no objection to a few
beds at a sanatorium or isolation hospital being reserved for
this purpose, provided they are sufficiently near the Dispensary
and under the medical superintendence of the Dispensary
Officer.
Of course the examination of sputum and other bacteriological
investigations constitute part of the routine work of a
tuberculosis dispensary, as helping in the diagnosis of doubtful
cases, and will be referred to later.
THE DISPENSARY AS A CENTRE FOR THE EXAMINATION
OF CONTACTS.
The examination of contacts of tubercular patients, both
at the Dispensary and at home, will prove one of the most
important functions of this institution, in the control and
prevention of Tuberculosis.
The visiting of the homes of patients by the Dispensary
Officer for this purpose, will be greatly simplified where, as is
the case in Deptford, this officer also holds the appointment of
Assistant Medical Officer of Health. The examination of
contacts of cases of infectious disease, of which, in these
islands at all events Tuberculosis is perhaps the most important,
is part of the duty of the Medical Officer of Health and his
staff, as laid down by the Local Government Board. By