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Report o] the Medical Officer of Health. 81
The total attendances were 18,222, an increase of 804 on 1918.
These have not increased to the same extent as the new cases, and
while there were 1,157 more attendances of tubercular patients,
those of non-tubercular patients were 353 less. In the past, many
patients have been kept under treatment for considerable periods
complaining of symptoms which were not definitely tuberculous.
It has been necessary to curtail this treatment, and these patients
are encouraged to attend periodically for re-examination. Those,
however, who are strongly suspected of the disease, are still kept
under treatment.
Many children come up for examination, either on their
parents' own initiative, or on the recommendation of doctors and
school authorities, and are in need of treatment for conditions
generally non-tubercular. These cases are thoroughly examined
and many of them are disappointed when told they cannot continue
to attend. It is hardly the role of a Tuberculosis Dispensary to
treat them, and they are advised to go elsewhere. Many are unable
to afford continuous treatment under private practitioners, or to
go to hospitals, which are mostly a long way from their homes,
and it appears that local clinics are needed for the treatment of
numerous minor ailments.
With regard to the definite cases of the disease, many of them
are still under treatment at the Dispensaries, while those who have
their own medical attendants are treated by them and attend from
time to time for re-examination. In this way the Dispensaries
act, as they should do, largely as centres for diagnosis and for determining
the form of treatment best suited for each individual case,
and less as centres for treatment. The tuberculous patient spends
most of his life at home, and not in an institution, and in nearly
every case domiciliary treatment can equally well be carried out
by the patient's private Doctor as at a Dispensary.
Two classes of case should be treated at Dispensaries, viz. :—
(i) Those who have no regular doctor of their own,
i.e., the large majority of the non-insured, and
(ii) the cases in which the diagnosis is doubtful.