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104
TUBERCULOSIS DISPENSARY
REPORT FOR THE YEAR
By P. L. T. BENNETT, M.C., M.R.C.S., L.R.C.P., D.P.H., T.D.D.
Tuberculosis Officer and Medical Officer, Borough Bacteriological Laboratory.
Staff Changes.
Under new arrangements which came into operation in April, the Tuberculosis Care Committee
was dissolved by the Borough Council and the Care work carried on from that date by an acting
whole-time Almoner. Miss Sargent was definitely appointed in this capacity in July and her appointment
confirmed later by the London County Council.
To carry on the clerical duties connected with the Dispensary, statistical returns, etc., previously
done by Miss Sargent as Clerk to the Dispensary, and Miss Maiden, part-time Clerk, Mrs. Mary
Austin was appointed, taking up duty in May.
Miss Maiden, who had been appointed temporarily in November, 1937, ceased her duties at
the Dispensary in April.
Holiday duties were carried out efficiently by Dr. J. T. Crowe and Major C. Cassidy, M.C., the
latter (since his retirement from the Army) having for some years done tuberculosis work in sanatoria
and municipal dispensaries in London.
Renovations and Repairs.
Certain items of repair and redecoration were completed during the summer months without
any dislocation of services.
Statistics.
The year's returns do not show any marked variation from those of the previous year and do
not call for any special comment. Cases referred to the Dispensary, contact examinations and
attendances for supervision, examination or specific testing, keep up to the mark, and I am again
very pleased to record the excellent co-operation of local practitioners with the Dispensary.
It is unfortunately true that the great majority of new cases are found on examination to
have disease which cannot be described as early, although actually it is a very difficult thing to define
"early" disease. A personal conception of an early case is one which, although definitely diagnosed
as tubercular, shows no marked evidence of toxic disturbance or physical signs, and is confirmed by
certain appearances in the X-ray picture relative to type, and particularly, limited extent of shadowing.
This matter has had the attention of tuberculosis workers for years, but it seems to be almost
impossible to secure early attendances of patients. Dr. Lissant Cox, in his admirable report on
Tuberculosis in the County of Lancashire for the year 1937, has gone very carefully into this matter.
He has analysed the statistics obtained in two ways, viz.:—
(1) The time between occurrence of first symptoms noticed, to the first consultation with the
private practitioner, both in patients with or without a positive sputum.
(2) The period patients were kept under treatment by the private practitioner before being
referred to the Tuberculosis Officer, also in the two groups as above.