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treatment now attend as out-patients at St. Alfege's Hospital, your
Tuberculosis Officer visiting one afternoon per week to carry out
this work.
Sputum Examinations, Etc.—These examinations have been
carried out at the Seamen's Hospital Laboratory as in previous years.
213 specimens were sent in connection with Dispensary patients of
which number 36 were positive. In addition other examinations
were made including blood, urine and pleural fluids.
Blood sedimentation tests were carried out at the Dispensary
on 16 patients. This gives a useful indication of the progress of
some patients. It is unfortunate that more time could not be given
to carrying out serial examinations in special cases.
One patient was being given gold treatment at the year end.
The treatment was commenced in sanatorium and continued at the
request of the Medical Superintendent. It is a useful form of
therapy in certain types of the disease, but does not lend itself to
wide application, because close supervision is necessary on account
of frequency of reactions.
• Tuberculin.—Tuberculin has been used during the year as an
aid to diagnosis only, Mantoux tests were carried out on 121 cases.
Ill of these were children and 75 were under 10 years of age. The
children were either contacts to known cases and examined for this
reason, or were sent in the ordinary way by practitioners, School
Medical Officers, Maternity and Child Welfare Departments, etc.
Of 33 children who gave definitely positive reactions, 29 were
contacts to known infectious cases. In only 4 was the source of
infection in doubt. The majority reacted strongly to the weakest
dilutions, i.e., 1/10,000 O.T. In only one case were the concommitant
X-Ray or physical signs definite enough to warrant a
diagnosis of active tuberculosis at the time of investigation.
One of these cases, in which the only physical abnormality,
discovered in January, 1934, was the positive tuberculin reaction,
died of broncho-pneumonic Tuberculosis in October. The father of
this child was found to have " open " tuberculosis in January, 1934,
and was sent to Hospital. He took his discharge in May, although
still expectorating large quantities of sputum containing tubercle
bacilli. It is probable that this child had completely arrested the
primary infection but could not resist the massive doses received
between June and October. In this case efforts to isolate the infective
member of the family were only partially successful. For a
time during the summer months the patient was sharing a bed with
the child in question.