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61
The wave of prosperity amongst the poorer classes during and
immediately succeeding the war, which did much to keep down the
incidence of tuberculosis has passed away, and with the depression now
ruling we are faced with further difficulties in the treatment of this
disease. The head of the family is unwilling to give up his work to
enter sanatorium and lose his occupation; the same applies to the
wife; whilst the scarcity of work makes it increasingly difficult to
transfer the patient and family to the country.
I may well conclude this report by some reference to the changes
about to take place in the working of the Tuberculosis Dispensaries,
Sanatoria, &c. The liason with general hospitals is to be dropped ;
nevertheless the not inconsiderable number of patients who come to
the dispensary with disease other than tuberculosis, either because they
have been said to have tuberculosis or they think they may have, and
who are not able to afford a doctor, must still be referred to a general
hospital in the district, as presumably must cases of surgical tuberculosis
requiring operative treatment.
There is another point that has arisen ; not in connection with our
liason with the Hampstead General Hospital, as they have not yet the
Finsen light installed, and that is in connection with cases of lupus.
Some of the hospitals are making a charge of 5s. a sitting for
Finsen light. The treatments may be up to three a week, and arc
usually beyond the means of the patient. I believe this fee in some
districts is being arranged for by the Borough Council in whose area
the dispensary lies.
I have only had one case of lupus to refer for treatment, and this
was kindly undertaken by the Dermatologist at University College
Hospital, but as the cost of treatment is considerable to the hospital it
is a point for consideration in future cases.
It would appear that the new suggestion may be rendered
schematically, as follows:—