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66
Diagnosed subsequently as suffering from respiratory tuberculosis 9
Diagnosed subsequently as suffering from non-respiratory tuberculosis 4
Discharged finally as non-tubercular 93
Discharged finally as having ceased attendance 15
Remaining on books on 31st December, 1925 27
Cases came to the Dispensary of their own accord or were sent up through one of the following
agencies: the Public Health Department of the Council, the Ministry of Pensions, Hospitals, School
Medical Officers, the Kensington Board of Guardians, the Invalid Children's Aid Association, the
Charity Organisation Society and private practitioners.
The treatment recommended for the cases diagnosed at the Dispensary as suffering from
tuberculosis, which numbered 136 (102 pulmonary and 34 non-pulmonary), was as follows:—
Sanatoria, 59; Domiciliary, 20; St. Mary Abbot's Hospital, 18; Dispensary, 33; Hospital, 1.
No special treatment was required in 5 cases beyond general advice and instruction to report at
the Dispensary if necessary.
The total number of attendances by patients at the Dispensary was 3,804 and 1,981 systematic
physical examinations were made.
The number of home visits by the Tuberculosis Officer was 95, of which 20 were consultations
with the doctor in charge of the case.
Written reports on cases to Public Authorities numbered 1,477 and to doctors, 349.
The total number of sputum examinations was 511 (including 44 specimens sent up by doctors)
from 424 individual cases. One hundred and fifty-four (30.1 per cent.) specimens showed tubercle
bacilli to be present and 357 (69.9 per cent.) gave negative results.
It is of importance to draw attention to the positive or negative condition of the sputum in
the new cases diagnosed as suffering from pulmonary tuberculosis. These cases totalled 102 (93
definite cases on first examination and 9 "suspects" subsequently found to be pulmonary cases),
and 71 had a positive sputum, giving a percentage of 69.6. This must be regarded as unsatisfactorily
high and suggests that efforts must be continued to discover cases of the disease at an
earlier stage if possible. This inference from the sputum specimens is borne out by the clinical
findings.
Records.
During the past two years an attempt has been made to trace all the patients infected with
tuberculosis who had attended either the North or South Dispensary from the time of their inception
up to the date when the Council assumed control of all Dispensary treatment for the Borough.
This work, which involved a review of the records of over 9,000 patients and entailed many
visits to homes, was rendered necessary by the introduction of the Public Health (Tuberculosis)
Regulations, 1924, which require the Medical Officer of Health to furnish the Medical Officer of
Health of the Administrative County within which his District is situate, as soon as practicable
after the end of each quarter, a statement, compiled from the Register of Notifications required
to be kept by him by Article XI of the Regulations of 1912, showing :—
(a) The number of cases of tuberculosis on his register at the commencement of the quarter ;
(b) The number of cases notified to him under the Regulations of 1912 for the first time
during the quarter ;
(c) The number of cases removed from the register during the quarter (giving the reasons
for such removal) ; and
(d) The number of cases remaining on the register at the end of the quarter.
The collection of tuberculosis records commenced in 1909, when the North Kensington
Dispensary first opened, and many changes have occurred in the interval. Many of the patients
notified in the earlier days have left the Borough, others have died and others have been found to
be in good health. The registers have now been completely overhauled and the result has been a
very beneficial clearing up of the records both at the Dispensary and in the Public Health Department
at the Town Hall.
Residential Institutional Treatment.
Under the scheme for the treatment of tuberculosis in London, the London County Council
provide all the beds required for residential institutional treatment except those available in Poor
Law Infirmaries.
When the Tuberculosis Officer is of the opinion that a patient should be admitted to a sanatorium,
appropriate recommendations are forwarded to the County Medical Officer of Health, who,
in due course, informs the patient, the Tuberculosis Officer and the Borough Tuberculosis Care
Committee of the sanatorium where a bed is available and the date on which the patient should
present himself for admission.