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Cases were sent to the Dispensary through the following agencies:—The Public Health
Department of the Council, the Ministry of Pensions, the London County Council, Hospitals,
School Medical Officers, School Care Committees, the Invalid Children's Aid Association, the
Charity Organisation Society, Infant Welfare Centres, the Jewish Board of Guardians,
the Kensington Dispensary and Children's Hospital and private practitioners. The number
sent up by medical men still rises, and the co-operation and support of local doctors is a
great source of strength to the Dispensary.
The treatment recommended for definite cases, which numbered 167 (120 Pulmonary and 47
other forms), was as follows:—Sanatoria, 49 ; Hospitals, 17 ; Dispensary, 54; Domiciliary, 17 ;
Kensal House School, 2. In 28, no treatment, beyond advice on rest, work, recreation, diet, etc.,
together with observation of the progress of the case, was found necessary.
The total number of attendances at the Dispensary during the year was 5,159 and the number
of systematic physical examinations was 1,848, both showing a large increase on the figures for
1922.
The Tuberculosis Officer made 99 " home " visits and the Women Health Officers 2,821.
Reports on patients form an ever increasing part of the work. During 1923, 1,828 reports
were sent to public authorities, this figure being more than 800 above the number called for in
1922 ; 256 reports were sent to private practitioners, the corresponding figure in 1922 being 209.
The sputum examinations also show an increase. There were 578 examinations of sputum
from 463 individual patients in attendance during the year. The number of patients showing
tubercle bacilli present in the sputum was 117, or 25.3 per cent., the remaining 346, or 74.7 per
cent., giving negative results.
Apart from the routine examinations of new and old cases with consequent recommendations
for treatment, either at the Dispensary or elsewhere, special efforts have been made to secure the
examination of "contacts" of notified cases and the number examined, namely 328, compares
very favourably with the figure, 183, for 1922. A further number of 104 "contacts" were ascertained
to have been examined by their own doctors or by the School Medical Officer, making a total of 432
who could be satisfactorily accounted for. There were recorded a further 197 who either refused
examination altogether, or ignored repeated requests for attendance. Considerable tact and
repeated home visits are called for in persuading "contacts" to submit themselves for examination
and the figures for 1923 represent an enormous amount of painstaking work on the part of the
Tuberculosis Officer and the Women Health Officers.
It has been felt that the mere fact of one negative examination of a "contact " may give rise
to a false sense of security Though this one examination does from time to time show the source
of infection of the original case and may also discover an early case of tuberculosis among the
" contacts," yet it does not follow that all the "contacts" examined as soon as possible after a
definite case in the family is discovered and who show no disease are really uninfected—the
exposure to infection may have been too recent to give any indications. Efforts are being made,
therefore, to secure a second examination of "contacts" of definitely infectious cases after
approximately one year's interval, and it is hoped that this procedure may increase the chance of
detecting and curing cases in the early stage of disease.
South Kensington Dispensary.
In past years there has been in operation an agreement between the Borough Council and the
Brompton Hospital Authorities, under which one of the visiting physicians to the Hospital has
acted as Tuberculosis Officer for South Kensington, and all patients residing in that portion of the
Borough south of Kensington High Street, who were referred to the Tuberculosis Officer under
the Tuberculosis Scheme, have been dealt with by him.
It has been found difficult to co-ordinate the work of treatment at a large Hospital like
Brompton with the preventive work carried out by the Borough Council, and in this respect the
arrangements in South Kensington have not been as satisfactory as those in the northern area.
The Council's experience of the combination of the work of treatment and prevention at the North
Kensington Dispensary lead them to concentrate their work at the one Dispensary, and the agreement
with the Brompton Hospital Authorities terminated on 31st March, 1923. It should be mentioned
that the Brompton Hospital is a clinical unit, established primarily for the treatment of individual
patients, and has a reputation second to none in the country. Kensington patients who visited
that Institution received the best possible attention, and indeed they can still attend the
Hospital if they so desire, in spite of the fact that it has ceased to act as a Dispensary
of the Council.