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Some general observations should be made at this point :—
(1) Regular attendance for treatment is an absolute
essential if the treatment is to be carried out properly and
effectively. Progress is often delayed because this fact is not
appreciated.
(2) Children who come from very overcrowded homes,
and many such attend the clinic, make slow progress. Light
treatment is, no doubt, of special value in such cases; but
it will only counteract in part the results of bad housing
conditions and overcrowded homes.
(3) Many patients will not believe that they are getting
treatment of any value unless it is conveyed to the mouth
from a bottle. If all the bottles in Bermondsey were melted
up and converted into Grade A T.T. milk bottles, the health
of the Borough would be much improved.
(4) Improvement is slow, and prolonged treatment is
necessary in most cases. Patients too often look for dramatic
results, forgetful of the fact that the treatment requires the
exercise of patience and courage on their own part.
Most of the cases of surgical Tuberculosis come to the Solarium
having had treatment previously in an institution. The object of
light treatment under such circumstances is to prevent relapse,
which had hitherto been all too frequent, or to improve the results
obtained by institutional treatment. Insufficient time has
elapsed to speak with confidence of the results of light treatment
from a prophylactic point of view. So far only one patient has
been sent away for institutional treatment because progress under
light treatment was unsatisfactory. With regard to the improvement
of the end results of previous institutional treatment, one
case has been of considerable interest. This patient had Tuberculosis
of the knee, and on discharge from Sanatorium the knee
was antrylosed, there was considerable muscular wasting, and the
patient could only get about with the aid of crutches and a splint.
This patient can now walk without any adventitious support, and
there is a steadily increasing degree of movement in the joint. On
the whole, there has been a very satisfactory improvement in those
cases, which have been diagnosed as Tuberculous Bronchial
Glands. With regard to the treatment of Pulmonary Tuberculosis,
the number of cases is too small to allow of the expression