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During the year doubtful cases of Consumption in recruits have been
referred to the Dispensary for opinion, and 11 were examined and
reported on to the Military Authorities. Of these, six were found
tuberculous and five non-tuberculous.
The preventive work of the Dispensary is the chief factor in the
campaign against Tuberculosis for after all, the cure of a few individuals
is a small matter compared with the prevention of multiple infection of
others, and to this end we are working, the prevention of the spread of
infection by those already diseased.
In considering prevention, the attention of public authorities has
largely been directed towards the children, and a great deal of good work
can be done in increasing their resistance to the disease. As 25 per cent.
of all cases in children under 5 years of age are caused by the bovine form
of the bacillus, and 45 per cent. of the cases of abdominal, glandular and
joint tuberculosis of the same age period are caused by the same strain it
is probable that the milk supply is largely responsible for much of the
disease in early childhood. It has been found that 10 per cent. of
samples of mixed dairy milk entering London is infected with the tubercle
bacillus.
As far as adults are concerned, the chief source of infection must be
looked for among the advanced cases, who daily expectorate incalculable
numbers of germs both in their sputum and in the droplets of moisture
expelled in coughing, and until the difficulty of satisfactorily and permanently
isolating and segregating dangerous advanced cases is surmounted,
so long will these cases infect others.
Another prolific source of infection is the handing on, or selling of
clothes worn by infected patients, and the old clothes shop or stall must
often harbour garments spotted with sputum and reeking with germs.
In spite of all advice the sputum flask is unpopular, and often discarded
for rags and handkerchiefs carried in the pocket which becomes a certain
danger to any future owner of the garment.