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each health visitor of the council having a district in which she was responsible for the whole of the
health services. The new arrangement allows the two health officers to specialise in the tuberculosis
visiting and leads to a greater interest in the tuberculosis service than was possible under
the former arrangement when the visitor had so many other calls upon her time. It also allows
closer co-operation between these visitors and the tuberculosis officer who accompanies them on
many of their visits. The number of home visits has increased as a consequence of the change from
2,324 in 1936 to 3,395 in 1937.
Ancillary Services.
Dental Treatment.
Mr. A. Dreaper, L.D.S. (R.C.S.), who was appointed by the council in 1927 as dental officer
continued to act in this capacity during 1937. The following table shows the work carried out
during the year :—
Number of patients treated 13 Number of extractions 12
Patients'attendances 62 Number of dentures 10
Number of fillings 1
Artificial Pneumothorax Treatment.
When patients return home after a period of institutional treatment a certain number require
specific forms of therapy to be continued. The most common form in this category is the refills
necessary with artificial pneumothorax treatment. This treatment entails the collapse of the
affected lung by introducing air into the pleural cavity and thus enables the lung to be temporarily
put out of action and rested until firm healing has taken place, when the lung is once more allowed
to re-expand and function in a normal manner. Air has to be introduced in this fashion at intervals
of approximately once a fortnight, to maintain the collapse. Most of the patients attend Brompton
hospital for their refills, but arrangements are entered into with other hospitals when there is
some difficulty about time and travelling. The borough council accept financial responsibility for
the cost of this treatment.
During the year 34 patients were undergoing this treatment and received 659 refills.
Gold Therapy.
Sanocrysin treatment is frequently used in certain cases which are unsuitable for collapse
therapy or in patients who have had one lung collapsed and whose other lung shows infiltration.
It enables the clinician to treat the disease in the contralateral lung whilst the collapsed lung is
healing. The council accept financial responsibility for the cost of this treatment in out-patients.
Artificial Light Treatment.
Artificial light therapy is available for any cases which will benefit by it. The cost of such
treatment is borne by the council.
Housing.
Tuberculosis has always been associated with bad housing conditions ; and, with the general
improvement in the housing standards, there has been a concurrent reduction in the incidence of
the disease.
When tuberculous persons are found to be living in unsuitable conditions, and especially where
there is any difficulty in the patient having a room to himself, every endeavour is made to re-house
the family. These families are referred either to the council's housing department or to the London
county council for alternative accommodation, and preferential treatment is given to them.
Bed and Bedding.
The council provide a service of decided value which temporarily alleviates border-line housing
conditions by the loaning of bed and bedding. This encourages the home isolation of the patient,
the object being to provide the patient with a separate bed and bedroom as this is a factor in preventing
the spread of infection in the home. This service is of great benefit while the patient is awaiting
residential treatment, or in cases where the family are awaiting the provision of better housing
accommodation.
In 1937, 39 patients had assistance under this heading for varying periods. The following
is a list of the articles lent :—
Bedsteads 29 Mattresses and covers 30
Pillow-slips 61 Pillows 59
Blankets 77 Sheets 94
Quilts 29
On 31st December, 1937, the following articles of bedding were on loan to 19 patients :—
Bedsteads 14 Mattresses and covers 14
Pillow-slips 32 Pillows 29
Blankets 38 Sheets 40
Quilts 16