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onset the patients only too often put off seeking medical advice until
the symptoms have become very severe or the disease has interfered
with working capacity. It was found in some of these cases that a
negative diagnosis had been made previously by the practitioner on the
strength of one physical examination followed by one examination of
sputum in which tubercle bacilli was not found. The patients, relying
on this negative diagnosis, had not sought further medical advice until
the disease was well established.
Every effort is made by consultation and co-operation with the
practitioners to encourage them to avail themselves of the assistance
which the Clinic offers in the diagnosis of doubtful cases. During
the year 42 consultations were held with local practitioners.
Of the 633 new cases who attended the Clinic during the year, 131
were sent by local practitioners, 25 were referred by hospitals, 27 were
referred by school medical officers, 284 attended on their own initiative
and 166 (contacts) on the advice of the Clinic staff.
The examination and re-examination of those in contact with
positive cases has been persistently advised. During the year 194
contacts were examined at the Clinic. Under the arrangement with
the London County Council, by which contacts of school age are
examined by the school medical officer instead of at the Clinic,
144 contacts have been examined at the schools. In 45 cases the
examination of the contacts was carried out by the practitioners
notifying the cases. The transfer of the examination of contacts of
school age to the school medical officer has naturally resulted in a
decrease (91) in the total number of contacts examined at the Clinic.
Of these contacts 14 adults (7 male and 7 female) and 2 children
(1 male and 1 female) were found to have contracted Pulmonary
Tuberculosis.
82 deaths occurred among cases attending the Clinic during 1924.
The period which elapsed between first attendance and death varied
between one month in one case and 11 years in another.
12 cases attended for the first time within 3 months of death.
20 do. do. do. 6 do.
11 do. do. do. 12 do.
10 do. do. do. 24 do.
29 do. do. do. more than 2 years before.
The following table summarises the work of the Clinic during
1924:-