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89
Home Visitation.
Our scheme includes provision for home visitation of patients and
examination of suspects and contacts by the Dispensary Medical Officer
or the Medical Officer of Health.
Homes visited by Dispensary Medical Officer and the
Medical Officer of Health 465
Contacts examined by Dispensary Medical Officer and
the Medical Officer of Health 736
* Visits of the staff of the Medical Officer of Health to
the homes of patients on first notification 546
Revisits of Staff 1439
Special cases referred to the staff by the Dispensary
Medical Officer 162
Total 3348
*(The staff includes 3 Health Visitors with nursing and special experience in
Tuberculosis work.)
Treatment by Tuberculin.
I have in the following table endeavoured to submit a fairly detailed
account of the clinical records of 53 patients who have had a prolonged
course of Tuberculin treatment.
The Tuberculin used, with the minimum and maximum doses, are
noted in the table recording the results and increase in dosage is usually in
geometrical progression. There has been a continuity of treatment all
through,and this defirite system of dosage has been adhered to in so far as
has been compatible with individual treatment of the patient, thus showing
that the tuberculin administration has been in no sense haphazard.
The table has been compiled under difficulties owing to a change of
medical officers at the dispensary, but I have endeavoured personally
to make it as accurate as possible. Where the disease has been
pulmonary I have selected as many cases as possible whose sputum at
the commencement of treatment was found to contain tubercle bacilli
and who have completed a long course of treatment, as there may
always be raised the criticism of diagnostic error, or at least diverse
opinion as to what signs and symptons are sufficient to warrant the
diagnosis of early phthisis.
I can only speak of the present, but on the whole the records are
encouraging. Under the heading "Treatment at a Sanatorium" are
included cases which have received such treatment either before or
during treatment at the Dispensary.
It is obvious that the economic importance of tuberculin treatment
will be enormous if unbiased and carefully controlled results as to the
success of such dispensary treatment can be furnished, which I shall
endeavour to do in future years.