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93
During the year, with one exception, we have not made use of any new or
specific forms of treatment in our own work here. We have carefully followed
up such treatments as described in the medical Press, and have also had the
advantage of discussing them with members of the Hospital staff who have been
able to test them under conditions which entail no risk to the patient, but which
cannot be fulfilled satisfactorily except when patients are under the strictest and
most expert observation in a residential institution.
Under these circumstances the only new therapeutic measure which we have
adopted has been that of artificial sunlight. The Hospital has a carbon arc lamp
installation suitable for all forms of ultra-violet radiation, and arrangements have
been made with the Hospital authorities whereby we are enabled to refer cases to
the department concerned. It is not easy to arrive at a correct estimate of the
value of such treatment, but we have made a very careful selection of cases, and
no ill-effects appear to have ensued. Glandular cases have predominated, and the
results in bulk would indicate a certain measure of improvement, though this has
been variable in different individuals, but two cases of advanced surgical disease
in children in which the outlook was very bad seem to have derived considerable
benefit. We hope to continue our observations during the ensuing year, and, as
experience accumulates, to make further reference to this subject in a future
report. So far the application of this treatment has been perforce mainly limited
to children, since it entails a considerable amount of time which adults of the type
likely to benefit cannot afford.
In other respects, too, attention has of recent years become more and more
concentrated on the question of tuberculosis in childhood, and it is now possible
to review briefly measures which have come into more permanent use in this
direction.
Possibly the most valuable of these is the introduction of open-air schools,
which have now passed the experimental stage and have become so firmly established
that additional schools are being opened.
We are fortunate in this district in having had such a school for the last six
years. Situated on Hackney Downs, it is within reasonable travelling distance
for the three boroughs it serves—namely, Hackney, Bethnal Green, and Stoke
Newington. The school has accommodation for 75 children, which appears to
be sufficient for the area, as, although it is always full, the waiting-list is never a
long one.
The progress of the children has been maintained during the year, 13 being
discharged as fit for work, while 12 were considered as fit to attend an elementary
school, and were accordingly transferred.
As previously, I cannot pass this aspect of my report without a reference to
the very great assistance which we have received from the branches of the Invalid
Children's Aid Association in Hackney and Bethnal Green. They have once more
been kind enough to provide for convalescence at the seaside or in the country for
many of our children who, debilitated in themselves or recovering from acute
diseases, are still further endangered as regards the liability to tubercular infection