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The intermediate class of case, comprising those who are too
advanced for sanatorium, or cases of high fever, haemoptysis, etc., in
which the prognosis is doubtful, though not necessarily hopeless, is
recommended for admission to Hospital for observation and treatment,
and later sent to sanatorium if suitable.
It often happens that it is impossible to make a definite diagnosis
on the first attendance. If these cases are in the least suspicious, they
are advised to attend the Dispensary at regular intervals until the
diagnosis is cleared up. Should they fail to put in an appearance they
are written for, or the Visiting Nurse is asked to look them up.
Cases in which the above forms of treatment are contra-indicated,
usually of the advanced type, or those who refuse admission to institutions,
receive domiciliary treatment under the care of their own
doctor, but are still under the supervision of the Tuberculosis Officer.
The class of case treated at the Dispensary itself includes those of
doubtful diagnosis, patients awaiting admission to sanatorium or
hospital, and uninsured cases who cannot afford a private doctor.
No specific form of treatment has been used, such as vaccines or
serums, while our best results appear to have followed the use of
creosote in increasing doses.
Quite a large proportion of the positive cases received institutional
treatment during the year. On the whole, the length of time the patients
are kept on the waiting list has not been unduly long, but there is
still great difficulty in securing admission to Hospital for those suffering
from advanced disease except in the case of ex-service men.
There has been no improvement as regards the question of securing
suitable employment for patients who are not fit to resume their
ordinary occupation. We have a large number attending the department
who, though not well enough to do full-time heavy work, would
benefit by some light, suitable employment; the absence of any official
body to help the men in obtaining this is a great handicap.
The after-care of tuberculous patients remains in the hands of the
Borough Care Committee, of which the Tuberculosis Officer is a member.
We are indebted to various charitable societies, including the Invalid
Children's Aid Association, the Jewish Board of Guardians, and the
Charity Organization Society, who have been of great assistance in
providing convalescent treatment for necessitous cases. Tuberculous
children can receive institutional treatment through the L.C.C., but
those who have not been definitely diagnosed as such, but who are
in a state of ill-health and may be predisposed to the disease, are unprovided
for. It is in this class of case that such good work is (ione