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the large number of lectures given in this Borough during the
past year there was not a single one devoted solely to tuberculosis.
2. The General Practitioner. Of 21 T.B.+ 1 cases
during the past year 16 were referred to the Tuberculosis Dispensary
by general practitioners and of 58 T.B. +2 cases 37 were
so referred. Through the hands of the general practitioner
therefore the majority of pulmonary cases pass before reaching
the Tuberculosis Officer. The Dispensary is primarily a centre
for diagnosis and general supervision and the Tuberculosis Officer
has at his disposal every facility for the early diagnosis of the
disease. Many of the practitioners of the district make use of
this service and are supplied with full reports on the cases sent
for investigation. In some instances, however, there is a tendency
to disregard the patient's symptoms and to delay action until
finally a sputum test is made and the result found to be positive.
Fifty-three sputum positive cases were referred to the Dispensary
by general practitioners in 1928 and 29 of these were notified
beforehand, the majority of them only after a positive sputum
result had been obtained. Eleven cases were not notified until
after a positive sputum result and yet they all had pronounced
physical signs when seen by the Tuberculosis Officer. It must
not be forgotten that a thorough examination of the chest is
essential in these cases. It will be seen therefore that, although
there may be no delay in notification once a case has been diagnosed
as tuberculosis, there has been in some instances a definite
delay in arrival at the true diagnosis. In an early active case,
particularly in a young adult, any such delay makes a great
difference to the prognosis. It is generally regarded as a crime
to keep a child with a tuberculous hip on his legs, yet a child with
a disorganised hip joint may live, although he be crippled, but
an adult with extensive and active infiltration of his lungs will
invariably die at an early date.
It is the aim of the Tuberculosis Officer to work in the closest
harmony with the practitioners of the district. It is his duty to
investigate fully every case referred to him, and it is to be hoped
that all practitioners will co-operate by referring to him at once
any case presenting symptoms suggestive of early tuberculosis.