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by the Invalid Children's Aid Association, the Hackney branch especially
being responsible for the convalescence of a large number of
our cases.
The Tuberculosis Officers have continued to act as Medical Referees
for the Local Pensions Committees on tuberculous or doubtful cases,
and a considerable number have been referred to the department for
an opinion by Pensions Medical Boards. This has entailed a good deal
of additional work, but it has kept us in close touch with all discharged
men of both services.
The statistical tables showing the work done are given below. A
comparison with last year's tables will show that there was a slight
increase in the total number of new cases.
From Table 2 it will be seen that there has been a marked increase
in the number of contacts from Bethnal Green. The majority of the
contacts examined consists of children, as there appears to be great
difficulty in persuading adults to attend for the purpose of examination.
The total number of patients sent by local practitioners has remained
high, and it is satisfactory to see that they continue to make
use of the department as. a consulting centre for cases suspected of
having tuberculosis.
Our relationship with the neighbouring doctors has always been
of the most cordial nature. I was asked recently by the local branch
of the British Medical Association to read a paper on the diagnosis of
early Pulmonary Tuberculosis, and as we take every opportunity of
meeting the General Practitioners, either individually or collectively, 1
was most pleased to do this.
The general work of the Dispensary has increased considerably in
amount, as instanced by the increase in the total number of attendances
to 5,056, the number of letters written to 1,480, and the number of
systematic examinations to 1,670.
With regard to the number of attendances, attention was drawn to
this in a recent survey of the dispensary treatment of tuberculosis in
London made by the Ministry of Health. It was pointed out that " the
provision of routine treatment as distinct from consultative work has
at some dispensaries been developed to an undesirable extent," and that
" treatment at dispensaries should as a rule be limited to patients whose
continued treatment requires special knowledge or technical skill, or
to those who are unable to obtain other adequate medical attendance.
Patients who require treatment which can consistently with the best
interests of the patient be properly undertaken by a general practi-