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which are necessary for their own well-being. Much is done by the
Medical Officers and Health Visitors when visiting the homes, but it is
impossible for the staff to visit each home as often as might be desirable.
Contacts.—Every effort is made to get contacts to attend the
Dispensary, where examination can be made as a rule, under more
satisfactory conditions than obtained in the homes. Little difficulty is
experienced in getting the juvenile contacts to attend, but it is to be
regretted that more of the Adult contacts do not see the necessity of
submitting themselves to examination.
Domiciliary Cases.—During the last quarter of the year, 56 cases
receiving domiciliary treatment at the hands of their panel doctors were
visited and reported on by the Tuberculosis Officer at the request of the
London Insurance Committee. The condition of these patients, many
of whom were bedridden was as satisfactory as could be expected. The
panel doctors concerned were notified beforehand by the Tuberculosis
Officer.
Diagnosis.—Formerly the only criterion of definite Pulmonary
Tuberculosis was the finding of Tubercle Bacilli in the sputum, but
in addition to this we have now in Tuberculin a very valuable and
trustworthy guide in the diagnosis of consumption.
During the latter part of the year where no bacilli were found in the
sputa, the Tuberculin test was always applied and with satisfactory
results, both by the subcutaneous method for adults and by the cutaneous
(Von Pirquet) method in young children. During the year 438
specimens of sputa were examined in the Bacteriologcial Laboratory
at the Dispensary, with 103 positive results.
TREATMENT.
(a) Routine.—There are of course many cases where treatment by
Tuberculin is not admissible, and these are treated as far as possible
by the familiar "Routine Method," viz., advice as to good food, fresh
air, and the administration from time to time of tonic and other mixtures.
Drugs should play a very minor part in the treatment of phthisis, but
as the education of the patients is not sufficient for them to grasp the
importance of hygienic measures in their treatment, mixtures of some
sort have frequently to be prescribed in order to secure their continued
attendance at the Dispensary. During the year, no fewer than 5,376
prescriptions were dispensed in the treatment of these patients.
Incidentally it may be remarked that dental treatment is urgently
required for all classes of patients attending the Dispensary. It is
surprising to find what a large number never think it necessary to clean
their teeth, and as few of them can boast of a sound set of teeth, it is
evident that the health of the majority is bound to suffer from this cause