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Report of the Medical Officer of Health. 79
some other complaint before the gravity of the case
is realised.
(b) Those suffering from the disease neglect to seek
medical advice till it is well established, thinking, perhaps,
that they are suffering from a slight ailment, or fearing
lest they should be told by their doctor to give up work.
(c) There is a definite type of case, not by any means
uncommon, in which the disease comes on suddenly, takes
on a very acute course, and rapidly becomes advanced.
By the time the illness is recognised as tuberculosis, the
case is already advanced, and all hope of benefit from treatment
has gone.
Dispensary practice shows many cases belonging to one of
these categories, and until the importance of early diagnosis and early
notification is more fully recognised, and until patients realise
the necessity of seeking medical advice sooner, notification cannot
produce the best results towardi eliminating tuberculosis.
TUBERCULOSIS DISPENSARIES.
I have to report a further increase of work in all branches of
the work at the Dispensaries during the year, as shown by Table
XLIX., which gives the new cases and total attendances at each
Dispensary for 1919, and for each year since the scheme was started
in 1913.
The number of new cases examined was 1,722, 380 more than
in 1918, and is the largest increase so far noted, compared with
any previous year. The figures show that the work has increased
at the Balham Dispensary to a greater extent than at East Hill.
Though the former was started as a branch Dispensary, it serves
roughly half the area of the Borough, so it is natural that the
numbers attending should be nearly as large as at East Hill.