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48
REPORT BY THE TUBERCULOSIS OFFICER
(Dr. SULLIVAN) ON THE WORK OF THE
TUBERCULOSIS DISPENSARY.
The death rate from all forms of tuberculosis in
Fulham has fallen from 1.63 per 1,000 of the population
to 1.0 per 1,000, which is a decrease of over 39 per
cent. in 10 years. There can be little doubt that this
decrease has been due largely to the intensive campaign
against the disease which has been going on for many
years and of which the Dispensary is the centre.
The objects of the Dispensary have been described
in detail in previous reports, but it should be noted
that it stands first and foremost for prevention. One
of the most important responsibilities is the supervision
of infectious cases which are under treatment in their
own homes, and the great object of the supervision is
to prevent infection of other persons living in close
contact with these patients.
The actual treatment is in most cases in the hands
of private or hospital doctors. There are at the present
time on the Dispensary books 248 cases of pulmonary
tuberculosis with tubercle bacilli in the expectoration;
195 of these are under treatment at home and 53 are
in institutions. Many of the former cases are in the
later stages of the disease and ought to be in institutions.
There is no doubt that a considerable number
could be induced to accept treatment and remain away
from home if suitable accommodation were available.
From previous experience one knows that no matter
how many visits are paid by doctors and nurses and
others, these cases are certain to infect other people
and thus produce a fresh generation of consumptives.
Another important factor in dispensary work is the
detection of early cases, and in this connection it may
be mentioned that cases are now coming under treatment
at an earlier stage than formerly and that a larger
number are being sent by doctors each year. During
1924, 376 of the new patients were sent by medical
men, and of these 287 were recommended by private
practitioners; in 1923 the numbers were 298 and 231.