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121
During the year 104 patients were sent away for institutional
treatment under the London County Council's Tuberculosis Scheme.
Of this number 64 were discharged during the year and 40 were
still in institutions on the 31st December. Four patients who
were admitted to hospital for observation for diagnosis were discharged
as non-tuberculous, and one patient suffering from NonPulmonary
Tuberculosis was discharged "much improved" after
the completion of treatment. The remaining 59 patients were all
suffering from Pulmonary Tuberculosis. The results of treatment
are set out in Table VI. The average waiting period between
recommendation for and admission to institution was 14 days,
as in the previous year, and the average length of stay 124 days;
17 patients took their own discharge—a high percentage. The
immediate results of Sanatorium treatment are markedly better
in the early stages of Pulmonary Tuberculosis. The object of
sanatorium treatment is to secure quiescence of the tuberculous
disease, and this cannot reasonably be expected in Group III.
cases, whilst in Group II. the tendency to relapse on discharge
from Sanatorium is great; this group, in fact, constituting the
large number of patients who are so frequently in and out of institutions.
From the point of view of treatment, therefore, it is of
the utmost importance that Pulmonary Tuberculosis should be
diagnosed whilst the disease is limited in extent, and in its early
stages, and one of the main functions of the Tuberculosis Dispensary
is to assist the General Practitioner in arriving at a diagnosis of a
suspicious case at the earliest possible moment. In this connection
doubtful cases of Tuberculosis are sent to St. Thomas's Hospital
for X-ray examination and for a further opinion. The London
County Council, also, on the recommendation of the Tuberculosis
Officers is prepared to admit patients, in whom the diagnosis is in
doubt, to Brompton Hospital or some similar institution with a
view to closer observation.
During the year an increasing number of patients received
Artificial Pneumothorax treatment. This form of treatment is
available for suitable patients under the Tuberculosis schemes of
local authorities, and is employed in order to ensure the maximum
amount of rest for the diseased lung. The cases are selected, and
the most suitable are those in whom one lung only is diseased,
although bilateral Pneumothorax is carried out in certain cases.
Artificial Pneumothorax is usually induced in Sanatorium or other
institution, and the patients receive "refills" as out-patients on
their discharge. The majority of the Dispensary patients get their
"refills" at Brompton Hospital. Artificial Pneumothorax treatment
is, as a rule, continued for a period of two to three years, and in
some cases for a longer period, "refills" being given at intervals
of two or three weeks. During the year 37 Dispensary patients
received this form of treatment, the number of "refills" given being
448 and the cost approximately £235.
Treatment of patients suffering from Non-Pulmonary Tuberculosis
by Artificial Light has been continued during the year.