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145
"A well organised tuberculosis dispensary becomes a
valuable aid in securing more general notification of cases of
tuberculosis; and its visitors can not only secure that domestic
precautions are taken, but also that the patients are brought into
touch with the different forms of domestic aid, or with the sanatorium
or hospital treatment that the needs of the individual
case indicate."
Most cases of tuberculosis are only notified at present when there
are well marked signs that the lungs are seriously affected, and the
patient has already become a centre of infection to others. To deal
with such a patient alone is not enough to prevent the spread of the
disease; an effort should be made to ascertain whether any other
members of the family are affected, and measures taken to deal with
them also. This can be best done by the help of a tuberculosis
dispensary working on the lines of the Edinburgh institution.
Tuberculosis in Hackney.
During the last ten years the deaths from tubercular disease in
the Borough of Hackney have averaged over 400 per annum. If we
were to apply to Hackney the ratio calculated by Dr. Philip, of
Edinburgh, between the deaths and existing cases of tuberculosis
in that city, viz., at least 20 cases to each death, it would appear
that there are about 8,000 cases of tuberculosis in the Borough of
Hackney existing at the present. I do not think that this is an
exaggeration when we consider the large number of persons dying
from other diseases who present evidence of having suffered at some
time from tuberculosis in one or other form and stage of the disease.
It must be remembered that a large proportion of these 8,000
cases are centres of infection. In the earlier stages there is not so
much danger of conveying infection, but the danger grows with the
disease; and when expectoration sets in then the most dangerous
stage of conveying infection is entered upon. Amongst 197 persons
notified to me as suffering from tuberculosis during 1910, I find on
inquiry that 102 expectorated profusely. The appearance of one
such case of consumption in a family, living in restricted accommodation,
as a large proportion of the population of Hackney lives,
k