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We are also grateful to the Hospital for providing immediate admission
in cases of emergency, and to the Staff for giving us every opportunity for
following up our cases while in the wards, thus enabling us to keep in
touch with the latest methods of treatment and diagnosis as they are brought
into practice.
The success attending the treatment of children in open-air schools is
being maintained, and this form of treatment has established itself as an
essential part of most tuberculous schemes. Stormont House School, situated
on Hackney Downs, admits children from the Boroughs of Bethnal Green
and Hackney. Both pulmonary and non-pulmonary cases of either sex are
eligible for admission, and the ages range from 6 to 16 years. The classes
are held in the open air, special shelters being provided in the grounds
for this purpose. Ample accommodation is also available in the permanent
building during bad weather.
This class of school serves a dual purpose: its primary function of
treatment and education of tuberculous children, and also the relief of
pressure on sanatorium beds, as quite a number of the scholars would
otherwise require prolonged institutional treatment. Records of temperature,
weight, etc., are kept by the Nurse, and the Medical Officer visits the
school weekly, making frequent examinations and directly supervising the
exercise and rest of each child. Hot mid-day meals are provided at a
nominal charge, but payment is not exacted in necessitous cases.
It had been the custom for some years to send such children as needed
it to the seaside for a period of convalescence. This year, however, it
was not found possible to arrange this, but an excellent alternative was
undertaken in the form of school journeys, one to Whitstable for 20 boys,
and another to Bognor for 21 girls, each for a period of two weeks. Under
this scheme the children—who are accompanied by their teachers—have still
to continue their lessons, but as these largely take the form of nature
study they spend practically all their time in the open air, and accordingly
get the full benefit of their stay at the seaside. The progress of the
children during the year has been entirely satisfactory, and from a roll of
89, 10 were discharged as fit for work and 9 had so improved as to permit
of their transfer to an ordinary elementary school.
The system inaugurated for the co-ordination of the work of School
Medical Officers and Tuberculosis Officers in the supervision of contacts
and delicate children is still in force. A report of all contacts and " unsatisfactory
" children whom the Tuberculosis Officer encounters in his work
is forwarded to the School Medical Officer. These children are examined
and weighed at regular intervals by the school medical authorities, and
should a case fail to make satisfactory progress, or later reveal any suspicious
symptoms, it is referred back to the Dispensary for a further
opinion. I do not think it can be claimed that any fresh cases of tuberculosis
which would otherwise have escaped notice have been brought to
light by this system, but it certainly ensures a more systematic supervision,
and probably prevents a breakdown in certain cases by the timely provision
of treatment, which frequently takes the form of a period of convalescence
at the seaside or in the country.
One hundred and seventy-two cases were admitted through the L.C.C.
to hospital or sanatorium during the year. The interval between the date
of recommendation and that of the patient's admission is still longer than
is desirable, but not so great as formerly, the average waiting period being
about 18 days. This at first sight would not appear to be excessive, but
I feel convinced that a matter of days at this stage in the early case is of
the utmost importance, and immediate admission to sanatorium would, I
believe, save weeks or even months later on, and thus, instead of adding