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99
During the year 81 new cases and 84 contacts were examined. Of the former
54, and of the latter three', were found to be tuberculous. Many, however, of the
contacts—particularly the children—were found to be weakly and were visited and
re-examined from time to time, and where necessary, appropriate treatment
arranged. In several instances among children, enlarged and diseased tonsils were
found and tonsillectomy was performed at the Royal Ear Hospital.
The number of deaths this year was 24. This increase—as compared with 13
of the previous year—was chiefly due to the epidemic of influenza which occurred
in January and February. To this epidemic the patients, already weakened by
tuberculosis, naturally offered less than normal resistance. It is noteworthy also
that several cases were encountered among the new patients in which the onset
of tuberculosis was attributed to an attack of influenza.
Local medical practitioners continue to make good use of the Dispensary, and
on several occasions have accompanied their patients. Co-operation is also maintained
with University College Hospital, whither several patients have been sent
for treatment, particularly in the special departments.
It is a pleasure to acknowledge once again the invaluable help received from
the Tuberculosis Care Committee in dealing with the numerous and varied needs of
the patients.
An investigation was made into certain aspects of the work of the preceding quinquennium.
Of the results, the most interesting was that relating to the incidence of marital tuberculosis.
A detailed study of the records of 14 patients, the wives or husbands or widows or widowers
of patients who had also suffered from pulmonary tuberculosis, failed to reveal any evidence
that the secondary cases were instances of infection by the husband or wife primarily affected.
On the other hand, investigations of family history of patients left no doubt as to the
importance of the familial factor in the incidence of the disease.
In view of the Report of the Joint Tuberculosis Council for the year 1928-29, in which
notification is advocated for "cases of haemoptysis or pleural effusion where other symptoms
and signs point to the existence of tuberculosis," the findings among cases at the Holborn
Dispensary are of interest. Of 246 patients suffering from pulmonary tuberculosis three were
known to have had pleural effusions previously while others had probably suffered similarly.
Of the six patients diagnosed as suffering from pleural effusion when first seen—and
subsequently followed up for periods varying from 18 months to seven years—all received
sanatorium treatment and none was found to be suffering from pulmonary disease. As
regards hæmoptysis this occurred in 30 per cent. of cases with positive,, and in 55 per cent.
of those with negative, sputum. On the other hand, there were 12 patients who had suffered
from haemoptysis, whose illness was eventually found to be non-tuberculous.
Annual Report of the Tuberculosis Care Committee.
The Committee has met 10 times during the year. The average attendance of
members at each meeting has been 7.8.
Sixty-two cases have been considered—38 new and 24 old cases.
Forty-nine cases—41 adults and eight children—were referred to the Committee
for assessment. Thirty-one were assessed to pay contributions, varying
from 2s. 6d. to 30s. per week, towards the cost of their treatment and maintenance;
18 cases were recommended for free treatment. Four cases were reconsidered
later owing to changes in their circumstances, and the assessments altered; three
were reduced and one was raised.