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NOTES.
(N.B.— Notes 1 to 5 below repeat definitions d to h on p. 7 of Memorandum 37/T.)
1. Public Medical Treatment.—Treatment at a dispensary or residential institution
or "general supervision," under a scheme approved by the Minister of Health
for the treatment of tuberculosis, of a person who has been diagnosed to be
suffering from tuberculosis. Note.—A patient under domiciliary treatment should
be regarded as also under " general supervision " by the Tuberculosis Officer.
2. Patient. — A person who has been diagnosed to be suffering from tuberculosis
and is under public medical treatment for tuberculosis.
The term does not include a person who is Kept under observation
pending the establishment of the diagnosis, and who is referred to in the
Memorandum as an "observation case," but includes all persons on the
Dispensary Register who are under "general supervision," even if not in
receipt of any treatment.
3. Dispensary Treatment.—Treatment by a Tuberculosis Officer in cases where
the patient is seen not less frequently than once in every month, and is examined
not less often than once in three months.
4. Domiciliary Treatment.—Treatment of an insured patient by his Insurance
practitioner on the recommendation of the Tuberculosis Officer.
5. Year.—The calendar year ending 31st day of December.
6. Adults.—For the purposes of Tuberculosis Records all patients of 15 years
and upwards should be classed as adults.
7. New Cases.—
(a) All persons examined for the first time at, or in connection with, the
Dispensary except definite cases of tuberculosis transferred from the
areas of other local authorities. Persons seen in consultation, who will
subsequently be dealt with by their own private practitioners should be
included.
(b) Persons who have been dealt with previously by the Dispensary and
discharged as "cured," or provisionally diagnosed as not, at that time,
suffering from tuberculosis, who return to the Dispensary as suspected
cases of tuberculosis.
8. Observation Cases.—Persons attending at, or in connection with, the Dispensary,
in whose cases the Tuberculosis Officer cannot, within a period of one
month from his first examination of the case, come to a definite diagnosis, after
physical examination and the application of the necessary tests. In completing
Sections A and B, such cases should be entered under sub-head (6) in each section.
9. Dispensary Register.—List containing names of all persons attending at, or
seen in connection with, the Dispensary for diagnosis or for treatment for tuberculosis,
including patients under "general supervision" (whether or not accompanied
by domiciliary treatment), and patients or observation cases in residential
institutions, and " contacts." This must be distinguished from the Notification
Register kept by the Medical Officer of Health.
10. Cured.—Patients with tuberculosis should not be deleted from the Dispensary
Register as" cured" until in the case of non-pulmonary tuberculosis,
3 years, and in the case of pulmonary tuberculosis, 5 years, have elapsed without
any symptoms of active disease (i.e., arrest has been maintained for 3 years).
11. Cases "lost sight of."—Patients who have failed to submit themselves for
examination during two consecutive calendar years notwithstanding all efforts to
trace them. These should be written off the Dispensary Register at the end of
the year. Patients who are known to have left the district permanently but who
cannot be transferred to another local authority because their destination is not
known, and patients seen only in consultation for the purpose of diagnosis, and
others who desire no further assistance under the tuberculosis scheme for public
medical treatment, may be marked off at once.