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them at the beginning of 1922, experience not having shown need for material alteration in the
original scheme. During the year, however, the scope of the work has been considerably increased
by the decision of the Council to centre the Dispensary treatment for the whole of the Borough at
Ladbroke Grove, instead of for the North area only, as from the 1st April, 1923, with the view to a
closer union of the curative and preventive work. Though some of the patients from the South
Kensington area have remarked on the increased distance and time involved in consequence of this
change, the majority seem to be able to attend without undue inconvenience or any complaint
being made. The marked increase in the number of patients and attendance figures may largely
be accounted for in this way, but a contributing factor must be the increasing use of the Dispensary
made by the doctors in the neighbourhood.
Another development has been the adoption by the Board of Guardians, with the concurrence
of the Council and the support of the London County Council, of the proposal that the Tuberculosis
Officer should be appointed Visiting Medical Officer for Tuberculosis to St. Mary Abbot's
Hospital. In consequence of this, the Tuberculosis Officer has visited the Tuberculosis Wards at
St. Mary Abbot's Hospital one morning weekly since the beginning of October. The Medical
Superintendent and the Medical Officers of that Institution have cordially welcomed this arrangement
and have assisted the Tuberculosis Officer in carrying out his new duties.
These changes have materially added to the work of the Tuberculosis Officer and his
responsibilities, and the marked success which has attended Dr. Picard's efforts could not have
been achieved without the loyal support which has been freely given by the internal Dispensary
staff and the Women Health Officers.

If this table is compared with the one for 1922, the percentage of definite cases shows a
decrease, which is mainly due to the examination of a larger relative and absolute number of
"contacts" in whom the incidence of the disease is naturally smaller.
The total number of new cases, 786, is considerably greater than in 1922, when 607 were seen
(in both cases "contacts" are included). The increase can be accounted for by the greater area
covered by the Dispensary and other reasons already mentioned, and, therefore, does not necessarily
mean increased prevalence of disease.
"Suspect" cases, whether "contacts" or otherwise, have long been a source of trouble in the
Dispensary by remaining on the books with the diagnosis undetermined from one cause or another,
and efforts have been made during the year to obviate this. A large measure of success has been
achieved as, with 46 cases left over from last year and a further addition of 133 of these cases
during the twelve months of 1928, there were not more than 26 doubtful cases outstanding at the
end of this year and some of these are, of course, quite recent cases which had only just come
under observation.