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All cases are reported on by the Hospital radiologist, Dr. Rawlinson and his staff, and
the films and reports are sent to the Dispensary, where the patient's case sheets are
appropriately annotated and the films filed for reference after being examined by the
Tuberculosis Officer.
Specialised Treatments. Under this heading can be placed all those cases where surgical
measures are adopted for causing a diseased lung to have as much "rest" as possible-i.e.,
by "artificial pneumothorax," "phrenic evulsion," etc.—and where special injections of
Sanocrysin, Tuberculin and other preparations are thought advisable (possibly in addition
to surgical treatment).
All such treatments are usually commenced whilst patients are away in hospital or
sanatorium, and are continued on their return home, and may go on for months or even years,
the patients meanwhile being able in many cases to carry on normal working life.
For cases of lupus, arrangements are made with the London Hospital for Finsen Light
Treatment, and those patients with bone and joint tuberculosis are referred for periodical
examinations by the Surgeons of the Orthopaedic Departments at General or Special Hospitals,
and usually, after their period of Sanatorium, are seen at intervals by the London County
Council surgical specialists at County Hall.
During the year under review, 457 artificial pneumothorax refills and 22 Sanocrysin
injections have been given at Brompton Hospital to Dispensary cases, and 89 Finsen Light
Treatments at the London Hospital—the total cost being £266, approximately.
All patients having special treatments at Brompton Hospital or elsewhere are kept
under periodical supervision at the Dispensary; and it is the regulation that payment for such
treatments are all authorised in the first- instance by the Tuberculosis Officer.
Institutional Treatment. The London County Council is the Authority responsible for the
provision of Sanatorium treatment, and cases recommended for such are referred by the
Tuberculosis Officer.
There has in the past year been very little difficulty or delay experienced in getting
patients away for Sanatorium or other institutional treatment, 157 being provided for by
the London County Council, including six children boarded-out under the Contact Scheme,
whilst 49 were dealt with through the valued assistance of various voluntary agencies, namely,
the Invalid Children's Aid Association, the Children's Country Holiday Fund, the Charity
Organisation Society and the United Services Fund, together with the Public Assistance
Committee.
Sanatorium treatment still remains the best one for tuberculosis from which any
permanent benefit can be expected—provided that it is taken at as early a stage as possible
and for a prolonged period—and specialised treatments such as artificial pneumothorax, Gold
Salt injections, etc., are in many cases valuable adjuncts.
Unfortunately many patients break down sooner or later owing to the necessity of
working in competition with healthy workers in the same field, but being less fitted to do so
by reasons of an impaired constitution. The post-sanatorium period is in reality the most
difficult time in a tuberculous patient's life, and the recommendation so often seen, "capable
of doing light work" is unfortunately one which it is almost impossible to carry out in these
days of economic stress. The "light job" is almost a myth: occasionally some particularly
benevolent employer or firm will undertake to place a patient on a special job—or on a parttime
basis—but this is comparatively rare.
Co-operation with Medical Practitioners. As in former years, this has been well maintained.
Of the 505 new patients in the year, 176 were directly referred for diagnosis and treatment by
doctors practising in the Borough.
The Tuberculosis Officer is also in close touch with the School Medical Authorities,
to whom details concerning Contacts of school age are frequently sent, enabling those who
fail to come to the Dispensary to be kept under periodical observation by the School Medical
Officers.
Tuberculosis in Children. Most children in towns become infected sooner or later with
the causative organism of tuberculosis, but fortunately comparatively few develop tuberculous