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66
It is pleasing to be able to record that the large
number of 351 patients were sent to institutions or to
the country through the Dispensary, this figure representing
an increase of 74, approximately 23 per cent.
Institutional Treatment arranged through the Dispensary.—The
London County Council is responsible
for the residential treatment of tubercular persons
domiciled in London. In the past this work has been
criticised on several grounds, and mainly on the
following:—
(1) The inadequancy of the number of beds
able for all cases, and especially for those
with advanced disease, and
(2) The prolonged period of waiting that has
elapsed between the recommendation of the
patient and his admission.
Fortunately, both these drawbacks have been less
in evidence during the past year, though it cannot yet
be said that one is able to offer to every patient the
opportunity of sanatorium or hospital treatment with
the certain knowledge that he will be accepted, and
discretion has still to be exercised in the selection of
cases for recommendation, especially if the person
has been away at some previous date. Apart from
actual treatment, one very important function of the
London County Council scheme is the provision made
for the observation of doubtful cases, in which the
tuberculosis officer does not feel justified in making
a diagnosis with the facilities at his command. Such
observation carried out by skilled physicians in an
up-to-date hospital is bound to result in the detection
of early cases, with the possibility of the immediate
provision of appropriate treatment, or, equally important,
in the discharge of others in whom the diagnostic
criteria adopted have proved freedom from
disease. Such persons have not only been saved much
mental anxiety, but they have also been spared the
grave inconvenience resulting from unnecessary notification.
Table VI. sets out in detail the number of cases
sent away through the London County Council and