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39
Home Supervision.—1,664 visits were made by the
Medical Officers of the Dispensary and 4,043 by the
nurses, who visit at the request of the Medical Officer
of Health all notified cases in the Borough, in addition
to those attending the Dispensary. The Tuberculosis
Officer states that his colleague, Dr. Murphy, has
devoted a large part of his time to visiting, and has
done most valuable work in keeping in touch with
tuberculous families, recording the progress of all
notified cases and generally systematising the methods.
A great deal has been done by the nurses to bring about
improvements in home conditions and enable treatment
to be carried out on hygienic lines and a number
of insanitary houses were reported to the Medical
Officer of Health, with the result that the necessary
alterations were made in 88 houses during 1919.
Advanced cases which had to be treated in their
homes were referred to the Fulham District Nursing
Association.
Examination of Contacts.—When a case is notified
as tuberculous, arrangements are made for the examination,
if possible, of the other members of the family.
Of 381 contacts examined seven, or 1.8 per cent., were
notified as tuberculous, and 47 were placed under
observation. The Tuberculosis Officer points out
"that this percentage gives no indication of the actual
prevalence of the disease among contacts because the
examinations are made immediately after notification,
that is, when tuberculosis is first discovered and is in
many cases early and not infectious." As illustrating
this he states that 30 of the 265 new tuberculous
patients were contacts with old dispensary patients and
that many others gave a history of having lived with
a near relative suffering from consumption, and he
points out the necessity for the following up and
supervision of the entire family and not being satisfied
with a single examination of contacts.
Interim Tuberculosis Care Committee.—It was intended
that in connection with Tuberculosis Dispensaries
voluntary Care Committees should be
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