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working order in both boroughs. It will be remembered that I gave details of
this procedure in my last report, and it will suffice if I draw attention to its
main provisions. The Tuberculosis Officer reports on a special form provided
for the purpose to the School Medical Officer as to the condition of all child
contacts whom he encounters in his work, and also on all "unsatisfactory"
children whether contacts or not. These children are definitely classified in one
of two divisions, and are weighed and examined by the school medical authorities
at varying intervals according to the class to which they belong. Certain of
these cases are also kept under supervision at the Dispensary. It cannot be
said that as a result of this system any fresh cases of tuberculosis have been
brought to light that would otherwise have escaped notice, but probably the
child of poor general physique and health receives more systematic and frequent
examination.
I should like also to draw attention to two recent innovations in
the work to which I referred briefly in my report for the year
10*22, namely, the arrangements for the dental treatment of tuberculous
patients and the scheme for granting additional nourishment. It is
always a difficult matter to convince patients, especially if they
suffer no pain from their teeth, of the necessity for availing themselves of the
services of the dentist, and it is to be feared that a mere perusal of the figures
may be disappointing. Every endeavour is made to secure that patients who
are about to enter hospital or sanatorium shall have their mouths thoroughly
overhauled and treated, and the resulting advantages are pointed out to them,
but at times our best efforts in this direction are unavailing. Also the school
dental service has often proved so efficient that it is by no means unusual to
see apparently perfectly healthy teeth in young adults in the present day,
while it is not thought advisable to refer for dental treatment patients with
advanced tuberculosis unless they are actually suffering pain. Moreover, the
Ministry of Pensions in most cases undertakes this duty in regard to pensioners.
These considerations will show that though on paper the figures may
not appear very impressive, yet the work done in this connection has been of
great benefit, and no patient in need of treatment has ever been refused it.
The same arrangements are in the main in force except that it has been found
possible for the cases to be seen by the Hospital Dentist during his ordinary
sessions.
The provision of extra diet by the Borough in necessitous cases has continued
throughout the year. Only a comparatively small sum has been available for
this purpose, but it has been, I think, a thoroughly satisfactory investment.
We have kept within the limits laid down by the Minister of Health in his
circular on the subject as far as possible, but we have often felt that there
are many other deserving cases to whom we should like to extend it. The
(act that it is limited to so few cannot, however, be taken as an argument