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pretation of the films have made X-rays our most valuable aid in the
detection of early tuberculosis. It is not, however, generally recognised
that the value of radiology mainly lies in the correct interpretation of the
lillms, and that this requires considerable experience. The practice of
referring cases direct to Radiologists with little experience of chest radiology
is to be regretted, since it frequently results in the notification of cases as
tubercular when there is no real justification for such a course. It is now
exceptional, at least in this district, for a general practitioner erroneously to
notify a case as suflering from tuberculosis on clinical evidence alone. The
certainty of the error in diagnosis being detected later on by means of X-rays
has imbued the clinician with a healthy dread of hasty diagnosis.
The various charitable organisations in the district continue to assist us
in many ways. The Hackney branch of the Invalid Children's Aid Association,
of which both Tuberculosis Officers are members, has been particularly
helpful, and has sent quite a number of debilitated children to convalescent
homes at the seaside or in the country. In the past the work of this
association in Bethnal Green was carried out from Headquarters, but during
the year a local branch, run by a Committee with local interests, has been
formed. 1 was invited to join this committee, and was pleased to accept
the invitation. An energetic Secretary has been appointed, and we have
already had refcison to be grateful to the Committee for undertaking convalescent
treatment of many of our children.
The Charity Organisation Society has provided dentures, surgical
instruments and clothing, and has frequently found accommodation for the
children of mothers receiving sanatorium treatment. The United Services
Fund also provides accommodation for the children of ex-service men, and
gives financial assistance to the families of those who are unable to work.
The children attending Stormont House Open-air school on Hackney
Downs continue to make good progress. That open-air schools are
doing valuable work cannot be doubted. Among other things they ensure
(1) fresh air and sunlight for the children during school hours ; (2)
supervision of exercise and rest ; (3) proper and suificient diet (hot midday
meals and milk being provided at a nominal fee with no charge in
necessitous cases i; (4) medical treatment ; (5) individual attention both
educationally and medically which is not possible in larger schools, and
(6) an hygienic way of life,
with an equal zeal.
In schools of this nature, where of necessity the educational and!
medical work are very closely associated, there is always the danger of
iricticn from a clashing of interests, with a resulting loss of efficiency on
one or both sides of the work, unless there is perfect understanding and
mutual goodwill between the Medical Officer and the Head Teacher. We
are fortunate at Stormont House in having a Head Teacher whose first
consideration is the welfare of the children, and who welcomes and carries
out any suggestion for their benefit, be it educational or medical in aspect,
Tlie work of the school is closely associated with that of the twc*
neighbouring Dispensaries. Dr. Hamilton, the Tuberculosis Officer for
the Boroughs of Hackney and Stoke Newington, is a member of the Committee,
and I am Medical Officer of the school, visiting it weekly, while
the Dispensary Nurse is part time school nurse and visits the school daily.
During the year 12 children were discharged as fit for work, while 7
others had so improved as to enable me to recommend their transfer to an
ordinary elementary school.
The placing of the children in work on leaving school is in the hands
of the school after-care committee, and contrary to what one would expect,