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114
where more elaborate and detailed investigations are being carried
out are not yet to hand, but the general conclusions of the reports
already received by the Ministry are that ultra-violet light forms a
useful accessory therapeutic weapon in the treatment of a certain
number of diseases, but it is by no means the "general specific" for
all forms of disease, and he deprecates its indiscriminate use by the
public. The best results appear to be obtained in lupus, certain skin
conditions, rickets, superficial lesions and surgical tuberculosis. Unfavourable
results are reported in febrile pulmonary tuberculosis, and
it is found that some patients, especially children, are constitutionally
unfitted for the treatment. The Medical Officer of the Ministry
further gives the following observations extracted from the report of
the Assistant Medical Officer of the Borough of Croydon:—
"Furthermore, it must be borne in mind that amongst the
group 'not improved' there were a few cases which appeared to
have actually become worse as a result of treatment. . . . .
The very debilitated, anaemic. chronically delicate child appears
to react adversely to the treatment; . . . it appears that it is
just the class of child whose social environment is poor, or whose
constitution is much debilitated, that fails to respond to treatment,
or that is definitely harmed by it . . . the children who have
derived most benefit are those who are well nourished and who,
apart from their local lesions, are comparatively well. . . Local
Lesions.—It is evident that synthetic sunlight is practically without
effect so far as improvement in this direction is concerned."
The provision of extra diet by the Boroughs for necessitous
cases has been continued throughout the year. The number
receiving such benefit is necessarily small, as the expenditure
sanctioned by the Ministry of Health must not exceed £2 per
1,000 of the population. It has been of great value to those
patients who on leaving sanatorium are unable to obtain suitable
nourishment for themselves pending their return to work, and we
have often felt that there are many other deserving cases to whom
we should like to extend this benefit.
I continue to act as Honorary Consultant to the Bethnal Green
Board of Guardians. I visit the Hospital weekly, and I regard the
time as well spent, as it enables me to keep in touch with patients
whom otherwise I should lose sight of indefinitely, and also to
examine suspected cases of tuberculosis.
I submit at the end of my report a statistical summary of the
work of the department for the year. The figures show no striking
variation and call for no special comment.
Previously it was our custom to regard all patients who had
been living with a definite case of tuberculosis, irrespective of the
origin of its attendance at the Dispensary, as "contacts." As