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abundantly justified. It has enabled people who work in the vicinity of the
Hospital or who pass it on their way home but who live at a considerable
distance, especially in the Borough of Hackney, to visit us while returning
from work, and has saved them loss of time and also an additional journey
back late in the evening.
For the third year in succession the personnel of the department has continued
unchanged. In any branch of medical work the spirit of team work
is highly desirable, but in units engaged in the anti-tuberculosis campaign
which presents so many and diverse phases—clinical, pathological, and
sociological—all demanding special attention, it becomes an urgent necessity
if proper co-ordination of the different branches is to be successfully accomplished.In
this connection it may be permissible to digress for one moment
and point out the distinction which exists between the work of a Hospital outpatient
department and that of a Tuberculosis Dispensary. It might be
thought that during an actual session the difference would be slight, but this
is very far indeed from being the case, as can be shown by a reference to the
additional considerations that have to be taken into account by the Tuberculosis
Officer while he is engaged in examining and interviewing a new case.
In ordinary circumstances a medical man's duties are in the main limited to
making a diagnosis and prescribing suitable treatment, but he who is engaged
in tuberculosis work under the present scheme has constantly to keep the
following in his mind in addition : (1) In taking out the history of the adult
male cases he must ascertain whether or not they have been in the army; if
so, the dates of their enlistment and discharge, the reason for their discharge,
the illnesses from which they may have suffered in the service, their previous
health, the exact duration of symptoms, whether or not they are in receipt of a
pension for any disability, for a knowledge of these points may be necessary in
order to give an opinion on questions subsequently submitted by the Ministry of
Pensions; (2) The conditions of the man's occupation must be investigated
if he is tubercular, and if his work is deemed unsuitable the Tuberculosis
Officer must communicate with the local Labour Exchange, and in the case
of ex-service-men, with the local Pensions Committee also; (3) A list of
examinations for the day has to be made out and names entered therein;
(4) The patient must be informed of the date of his next attendance and a
record of the appointment entered in a special diary kept for the purpose, in
order that he may be communicated with if he should fail to appear; (5)
Advice must be given with regard to the collection of samples of sputum for
examination; (6) Arrangements must be made for those who need dental
treatment and their names entered in a register; (7) A positive case must be
urged to send up his family as contacts for examination; (8) If the case is
that of a child, special information must be obtained for the filling up of a
report required by the London County Council to be sent to the school Medical
Officer; (9) The question of whether the patient needs additional diet or not,