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Two changes of some importance have taken place during
the year. In January the Tuberculosis Officer was appointed
Consultant for tuberculosis cases to the Bermondsey and Rotherhithe
Hospital. This appointment has been of very great value
to the work of the Dispensary. A considerable number of the
patients who would probably not have otherwise entered the
Hospital have been persuaded to do so, and timely rest and
treatment have been of great help to the patient. Under the
London County Council scheme, a patient awaiting sanatorium
treatment may. enter the local hospital and be removed from
there to sanatorium when a vacancy occurs. The accommodation
for patients at the Bermondsey and Rotherhithe Hospital
has been improved recently by the erection of verandahs. This
is a very satisfactory arrangement, since patients are very often
reluctant to enter the hospital because they fear to lose their
chance of sanatorium treatment. In January also the Care
Committee was given a room at the Dispensary, it being thought
that the work of the Committee might be more fully co-ordinated
with that of the Dispensary by this means. Unfortunately, the
arrangement has not worked very well, and the whole question
of the relation between the Public Health Department and the
Care Committee is under discussion at the time of writing.
Tuberculosis is, of course, an infectious disease caused by the
tubercle bacillus. There are two principal ways in which the
bacillus is spread—(1) the expectoration of persons suffering
from pulmonary tuberculosis, i.e., tuberculous sputum, and
(2) tuberculous milk.
Tuberculous Sputum.—Attention should be drawn to the prevalence
of spitting in the Borough. The expectoration of persons
suffering from pulmonary tuberculosis almost always contains
the tubercle bacillus; this expectoration dries owing to the
action of the sun and air, and the bacilli then blow about in the
dust which thus becomes a source of danger to others. It may
be argued that the risk is small because most of the germs die
during the process of desiccation, and because many people who
spit are not suffering from tuberculosis. This, no doubt, is true,