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patient and the home condition. At this visit, the nurse may
discover that the patient or doctor wishes the treatment undertaken
by the dispensary, when suitable arrangements can be
made. If treatment at the dispensary is not desired, the nurse
gives advice on the preventive aspect, supplying a sputum
flask and disinfectant. The form filled up by the nurse is
returned to the Medical Officer of Health and any insanitary
conditions of the home are attended to.
Contacts.—The house of each case is to be visited at least
once each month, whether the patient is in a sanatorium,
attending the dispensary, or a private doctor. The contacts
are seen by the nurse who advises them to be examined by
his or her own doctor or at the dispensary. If the patient is
attended by a private practitioner, the latter will be sent a list
of the contacts and asked if he intends to examine them. In
this event he will notify any cases he may discover among the
contacts. If he has any doubts as to the diagnosis of any, the
services of the Tuberculosis Dispensary are at his disposal. If
the private practitioner does not intend to examine the contacts,
they will be urged to have it done at the dispensary by
the Tuberculosis Officer.
School cases.—A list of contacts who attend school will be
sent to the Divisional Medical Officer who will arrange for
their examination by the school doctor. Arrangements will
be made to examine doubtful cases at the dispensary. The
Divisional Medical Officer can arrange for the periodical
weighing of the contacts, and the result entered on records.
He can also arrange for the better or more suitable feeding of
such children, if they are poor, as well as for their attendance
at open air schools if possible.
5. Bacteriological Examination of Sputum.—This can be
done where and when necessary at the dispensary.
6. Disinfection.—Premises should be disinfected by the
staff of the Public Health Department, after the removal or
death of the patient.
7. Advanced cases.—Arrangements can be made for the
nursing of advanced cases whose removal to an institution is
not practicable, at the patient's own home, by fully trained
district nurses of the local district nursing associations.
8. Shelters, for the open air treatment of patients at their
own homes, where they have a suitable open space, can be
supplied by the Borough Council.