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disease of the adult type, owing to the phenomenon known as "immunity," which may be
natural or acquired.
The Mantoux Tuberculin test carried out at the Dispensary is useful in determining
if this infection or tuberculisation has taken place. A positive Mantoux test, however, should
not be taken invariably to indicate that the child is suffering from a notifiable tuberculosis,
though a strongly positive reaction in certain suspicious cases might help to clinch a diagnosis.
Particular significance, however, attaches to a definite positive reaction occurring in a Contact
infant under the age of two years, as the state of natural resistance or immunity has hardly
sufficient time to develop, and an X-ray taken at this period may demonstrate a primary
focus with some adjacent glandular inflammation at the lung root. The reaction may not
prove positive if the test should happen to be taken within about six weeks of infection, as
the body has to develop a certain tuberculin "sensitiveness," so repeated Mantoux tests are
always advised for negative reactors. As yet, owing to considerations of time and
practicability, only yearly tests are done. Special observation of doubtful cases and treatment
for notified children is very readily provided by the L.C.C. on those cases recommended by
the Tuberculosis Officer, or by hospital out-patient departments.
The period away is invariably of great benefit for the children, and on their return to
town a certain proportion are admitted to the Elizabethan Open-air (Special) School in
Broomhouse Lane. At this institution the children go daily for school under "open-air"
conditions, where hours of work, rest and exercises are regulated and under supervision of
the Head Mistress, and where a good and varied mid-day meal is served, together with the
usual supply of milk in the morning.
The Tuberculosis Officer is also Medical Officer to the School and pays a weekly visit,
at which an average of about twelve children are examined; the school accommodates 60,
thus it will be seen that each child is examined about once in every five weeks, or more often
if medical reasons so indicate.
Extra medicaments are also prescribed in many cases (malt and oil, cod liver oil
emulsion, Haliverol, Virol, Irradex and Radio-Malt) according to the special needs of the
child.
Under this regime, the children do remarkably well, both at school and in their after
"working" life.
Cases requiring Ultra Violet Light treatment are (as before) referred to the physicians
in charge of these special departments at general or children's hospitals.
Dental Scheme. A routine examination of the teeth and throat is made in all cases
attending the Dispensary, and, as might be expected, a large number of defects are found.
A good many patients are referred to their own doctors for the necessary attention; but
notified cases can be dealt with—if they are willing—under the dental scheme in connection
with the Dispensary.
Thirteen patients were recommended for treatment under this scheme in 1935. Of
these, eleven were supplied with dentures, one had extractions and scaling, and the other
eventually did not take the treatment.
The Tuberculosis Care Committee. This Committee has met at the Dispensary every other
week. An agenda, comprising a number of items concerning tuberculous patients and their
families, questions of help and extra nourishment and other matters relevant to the
Tuberculosis Scheme in general, is gone through.
Extra nourishment is recommended through the Borough Council for cases coming
under certain headings—especially those going to and returning from Sanatorium—where
a weekly provision of milk, butter and eggs is a sufficient supplement to the patient's normal
nourishment: but those cases already on out-relief, are referred to the Public Assistance
Committee, as extra nourishment on the lines laid down by regulation would not be adequate.
During 1935, the total number recommended for extra nourishment was ninety-four,
and seventy-one invalid dinners were also provided.
Gloving Class. During the year thirty-eight lessons were given and attendances totalled
203. The size of the class remains small and varies between twelve and six, but the quality