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59
One has noticed in one's work about London, that whereas during
the war the general condition of the poorer class children materially
improved, both as regards nutrition and clothing, there seems a
tendency now to be getting back again to the pre-war conditions. This
wants careful watching, as it is a material factor in the incidence of
Tuberculosis on the child.
Our liason with the Hampstead General Hospital has worked very
smoothly ; not only am I indebted to the Surgeons at the Out-Patient
Department for valuable advice and treatment of cases, but also to the
Honorary Staff of the In-patients for taking into hospital urgent Nontubercular
cases as well as non-urgent cases which they have taken in
for observation and an opinion. I have also used the X Ray Department
considerably, and have to thank the Radiologist for his excellent
radiograms and reports.
The patients marked for Sanatorium and Hospital treatment under
the Insurance Committee and London County Council schemes have
been got away without any undue waiting ; moreover, these bodies have
been very good in advancing the position of one or two cases where it
was especially urgent that the removal of the patient should be
immediate.
1 have found my association with the City of London Chest
Hospital of great service to me, as. the Resident Medical Officer there
has been able on several occasions to arrange for the admission of cases
at once instead of having to place them on the rota, in an acute case
the advantage of this both to the patient and relatives is obvious.
Our principal problem remains the early cases who do not know
they are infected, and the advanced cases.
The former, owing to the assiduity of our sanitary inspector, Mrs.
Fisher, and health visitor, Mrs. Roche, for whose excellent work I am
grateful, we are keeping in check. The importance of this work of
following up contacts is well exemplified by a recent case at this
dispensary, three contact members of a family, one of whom lived in .
the countiy, being found to be badly infected.
In the latter case I am glad to say that there is now a beginning
of progress in the matter of providing beds for advanced cases.