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administration of the injection, and a full day's rest was insisted upon. The
vaccine was prepared by Dr. S. Roodhouse Gloyne, Pathologist to the Hospital,
who also very kindly gave us the benefit of his experience in dosage, of which
we gladly availed ourselves. It would not be appropriate in this place to give
details of results, but they can be summarised by saying that though at times
there appeared to be temporary periods of improvement, these were not sustained
and did not differ from those which frequently occur during the progress
of any prolonged chronic disease even if untreated.
While on the subject of treatment, it may not be out of place to mention
that in the latter end of the year the Minister of Health issued a circular con-
taining details of a new method of procedure for co-ordinating the work of
the Insurance Practitioners and Tuberculosis Officers. Criticism of it is
somewhat disarmed by the statement of the Minister that in order to secure
its success the cordial co-operation of Tuberculosis Officers and Insurance
Practitioners is necessary, but a brief reference to some of its main features
will serve to show that it will at least very considerably increase the amount
of clerical work, already heavy, which devolves on the staff of the Tuberculosis
Dispensary and on the Insurance Practitioner. Briefly put, it is required that
the Insurance Practitioner shall forward a report on the condition of every
insured patient under his care to the Tuberculosis Officer every three months,
the Tuberculosis Officer being responsible for sending him a request for such
reports, while there is a further form wherein the Tuberculosis Officer must
acknowledge the receipt of the same; these alone will entail a new card index
system in the Tuberculosis Dispensary. As regards new cases, the Insurance
Practitioner is to report on a prescribed form any case which he has diagnosed
as tubercular, filling up details of age, occupation, sex, etc., of the patient,
the history of the illness, his clinical findings, and his recommendation for
treatment. A reply to this must be sent by the Tuberculosis Officers on an
appropriate form, giving the details of his clinical examination and his recommendations
as to further disposal. It is also to be noted that even if the
Tuberculosis Officer and Insurance Practitioner have seen a case together in
consultation, the Insurance Practitioner must send in the form aforementioned
to the Tuberculosis Officer, who then sends back his reply, even
though it may have been verbally communicated beforehand. There are also
introduced forms for Insurance Practitioners to be used if they so desire when
sending up a doubtful case for an opinion, and forms for the Tuberculosis
Officer to send informing the Insurance Practitioner of his decision to alter a
patient's form of treatment, e.g., from domiciliary to institutional, to terminate
treatment, etc. In all, eight new forms have been introduced, and it is
argued that this innovation will exclude the possibility of any doubt as to who
is responsible for the treatment of a patient at any paticular time. In
former years, as again this year, it has been my pleasant duty to comment
in my annual report on the courteous and cordial treatment which we have