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43
Contacts. Contacts are seen at the Dispensary at any of the Sessions,
chiefly by appointment and according to sex. Their attendances during the
year under review totalled 705, of which 249 were new cases. As in previous
years the Dispensary Staff have endeavoured to secure the attendance of as
many contacts as possible. There is, of course, no compulsion to attend, and
individuals vary greatly in their outlook,—some being most willing to come
up for examination, and without being asked to do so; whilst others (possibly
through apathy, or fear of being found to be consumptive) fail to do so.
General Attendances. There were 4,920 attendances at the Dispensary
during the year, and of these 2,689 were primarily for the purpose of physical
examination; other attendances were either for special tests, advice, or aftercare.
There were 204 notifications of Tuberculosis, a slight increase of 21
over the figures for 1933; there is, however, very little to comment on in regard
to the statistics for this year.
Sanatorium Treatment. Patients in need of Sanatorium treatment are
recommended to the London County Council, which is the authority responsible
for providing same. In 1934, 187 patients were sent away to Sanatoria and
special hospitals on the recommendation of the Tuberculosis Officer from the
Dispensary. In addition many cases seen in consultation at Fulham Hospital
were referred to Country and Seaside Sanatoria, or special hospitals. The
problem of dealing satisfactorily with advanced cases has always been one of
considerable difficulty, as on account of their condition, they are unsuitable
for sanatorium treatment, and the accommodation in hospital wards for cases
of this type is limited. It has always, however, been possible for the Tuberculosis
Officer to obtain a bed in hospital for an urgent case: accommodation
being usually found in one of the hospitals in adjacent Boroughs, if no vacant
beds have been available in the Tuberculosis wards of the Fulham Hospital.
Hume Visits. The Dispensary Staff made a total of 4,330 Home Visits
during 1934, of which 435 were made by the Tuberculosis Officer, either for
consultation with private practitioners and hospital Medical Officers, or for
supervision and inspection of home conditions. The nursing staff, in addition
to their Clinic Duties, carry out excellent supervision of patients and hygiene
in their homes. If defective sanitary or housing conditions are found a report
is sent to the Medical Officer of Health for the attention of the Sanitary
Inspector.
Co-operation of Medical Practitioners. The Tuberculosis Officer reports
with great appreciation that the same friendly understanding and co-operation
continues between the Tuberculosis Dispensary service and the general Practitioners
in the Borough. It is recognised that the main object of the Dispensary
is to carry out special observations and tests of cases where diagnosis presents
difficulty and, when necessary, to arrange for appropriate treatment. At the
same time the interests of the Doctor are safe-guarded in every possible
manner, as it has always been the invariable rule that no new patients are
seen, where there is already a doctor attending, without a communication from
the latter, either by card, letter or telephone; and it is obvious that considerable