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from tuberculosis, and in other cases which cannot be considered free from
infection, a certificate to the effect that he is no danger to others if employed
under certain conditions specified in the document. It is extremely doubtful
if these certificates will help in any way to relieve the situation, as the number of
patients seeking employment who have remained free from signs and symptoms
for five years is very small, as in all probability the majority have obtained work
before this, while the certificate of " no danger to others " which the employment
exchange is bound to present to the employer may alarm rather than reassure.
It would appear that the only solution of the problem of unemployment among
tuberculous persons is the adoption of local workshops, subsidised by the State,
where they could work at suitable occupations under direct medical supervision,
and where they could obtain a living wage, even if unable to do a full day's work.
The present moment, when the call for economy is so insistent, may be rather an
inopportune time for such a plan, but it is possible that eventually the scheme
would be practically self-supporting, and it would certainly be less costly for
the State and better for the patient than continuous unemployment.
The scheme for the supply of extra nourishment to patients suffering from
tuberculosis, adopted by the boroughs in 1921, is still in operation. The expendi.
ture sanctioned must not exceed £2 per 1,000 of the population, so that the sum
available is rather limited. The additional diet given takes the form of milk
and eggs, and there is no doubt that it has been of great value to those patients
who, after leaving sanatorium, are unable to obtain suitable nourishment for
themselves pending their return to work.
As pointed out in last year's report, I was appointed Honorary Consultant
to the Bethnal Green Hospital in the latter part of 1923. I have visited the
Hospital one afternoon a week during the year, and have found the work most
interesting. Everything has worked exceedingly smoothly, and I have received
every courtesy from the Medical Staff, who freely adopt any suggestions I make.
As was mentioned in last year's report, a trial was given to Dreyer's Vaccine
in the treatment of some of our cases. This has now been abandoned, as we felt
that the results obtained did not justify us in continuing with it further. We
still rely very largely on the usual non-specific remedies, but in view of the
successful results claimed for the " artificial sunlight" treatment of tuberculous
glands and the fact that the Victoria Park Hospital had recently installed the
necessary apparatus, I unofficially approached the hospital authorities with a
view to their treating some of the dispensary cases. This they kindly consented
to do, but it is early at present to form any independent opinion as to the success
or otherwise of the treatment.
The statistical tables given below give particulars of the work of the
department for the year. The number of new cases is definitely smaller, but
it will be seen that the decrease is entirely accounted for by the falling off of
contacts. To a considerable extent this decrease is due to a diminution in the