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The permanency or otherwise of the results achieved by Sanatorium
treatment depend in large measure on the life lived by the
patient after returning home, and this in turn depends largely on
economic conditions beyond our control. It is of the highest
importance that these persons should be encouraged and helped to
regulate their lives in accordance with what they have been taught
at the Sanatorium, and in this connection I think the work of the
two nurses deserves favourable comment. Another most important
function of the Dispensary is the examination of contacts. The
number of contacts examined was 658; the proportion of contacts
examined to each new case attending the Dispensary being 1.92.
While this compares favourably with the results of other dispensaries
in London, there is much room for improvement, and an endeavour
has been made to increase the number of contacts examined.
Mothers sometimes object to bringing their children for examination
when there is nothing obviously wrong with them, and in other cases
the objection sometimes raised is that the child has recently been
examined by the School Medical Officer. The School Medical
Officer is informed at once of the names and schools of all contacts,
and I suggest that he might in turn inform the Tuberculosis Officer
when he has examined any of these contacts, at the same time giving
the result of his examination. Tuesday and Saturday mornings are
reserved for the examination of school contacts, adult contacts being
seen on Monday evening. Many children cannot get permission
from school to attend on Tuesday, and it is proposed during this
year to concentrate upon the examination of school contacts during
the school holidays, and as far as possible examine school contacts
every morning during that interval.
The provision of institutional treatment except in Guardians'
cases, is now entirely in the hands of the London County Council.
So far as I know, the London County Council makes no provision
whatever for the institutional treatment of female cases of advanced
Tuberculosis, and very little provision is made for similar cases
amongst non-insured males. Such cases must go to the Bermondsey