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APPENDIX.
TUBERCULOSIS DISPENSARY.
ANNUAL REPORT, 1932.
To the Medical Officer of Health.
I beg to submit herewith a report on the work carried out
at the Tuberculosis Dispensary for the year ending 31st December,
1932. There has been no change in the Dispensary Staff during
the twelve months and the routine work of the Dispensary has
been carried on as in previous years, the main object in view being
that no case of Tuberculosis in the Borough should go uncared for.
The number of new patients attending the Dispensary during
the year was 599, including 22 cases transferred from other areas—
4 less than in the previous year. The number of new patients
attending the Dispensary annually has been a fairly constant
figure for the last ten years, in spite of the fact that the incidence
of Tuberculosis in the borough as shown by the notifications received
by the Medical Officer of Health during that period has fallen by
over 25 per cent. How far the present economic conditions may
influence the incidence of Tuberculosis and the mortality rate
therefrom in future years is a matter of no little concern to tuberculosis
workers; but if we may judge from the experience gained
during the war years in this and in other countries, there may possibly
be a rise in both figures. Tuberculosis is essentially a poverty
disease, and whilst the exciting cause of active disease is often
obscure there can be little doubt that under-nourishment, anxiety
as to employment, worry and poverty—conditions more prevalent
to-day than for many years—by lowering the resisting powers
are predisposing factors of great importance. Moreover, the same
conditions are inimical to recovery. In no previous year has it
been so difficult to persuade patients to go away for institutional
treatment as in the period under review. The fear of losing his
employment and the realisation that, unless his job is kept open
for him during his absence, there is little or no prospect of finding
work under present conditions on his return, has made the tuberculous
patient reluctant to give up his work to undergo the period
of residential treatment which is so essential.
The number of "Contacts" examined during the year was
212 as compared with 209 in the previous year, and 153 in 1930.
Of the "Contacts" examined 112 were children and 100 adults.
Difficulty continues to be experienced in persuading "Contacts"
to attend the Dispensary for examination, more particularly in the
case of the young adult. Active Pulmonary Tuberculosis, at any
rate of the adult type, is a very rare disease in children of school
age, and the percentage of definite cases of Tuberculosis found as a
result of "contact " examination is small.