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(v) Central Dispensary,
Where diagnosis is doubtful, such patients are kept under
observation until the diagnosis has been cleared up. A special
register is kept of such doubtful cases, and examination dates and
times are recorded in appointment diary for such cases and follow
up letters are sent to the patients or their medical practitioner in
order to prevent the patients lapsing before completion of
diagnosis. No cases, therefore, lapse except at refusal of patient
to re-attend, or at his removal from the Borough. In the latter
event, if the new address is known, the tuberculosis officer of the
new area is advised of the case as one of? tuberculosis.
Branch Dispensary.
Cases presenting special difficulty can be admitted to the
Tuberculosis Ward of the Hospital for a period of observation.
Occasionally this period of observation is arranged through the
London County Council at one of the Chest Hospitals. Cases
regarded at the Branch Dispensary as provisionally non-tuberculous
can attend in the Out-patient Department of St. Thomas's
Hospital if they have symptoms needing treatment; otherwise,
periodical enquiries by the Lady Almoner or visits by her Visitor
are made at the homes of such cases.
(vi) Central Dispensary.
When a case has been notified, the home is visited and
special appointment for examination given to "contacts," either
at the time of such home visit or afterwards through the patient,
when attending at the Central Dispensary. All such appointments
are booked and followed up, if not kept. When a "contact" has
been examined, if suspicious, such "contact" is followed-up in
manner stated under heading No. (v), but, if not suspicious, the
case is booked for re-examination at a later date, 3 or 6 months,
and then again at a later date still.
Branch Dispensary.
The examination of "home contacts of patients attending
the Branch Dispensary and found to be tuberculous is advised.
It is urged strongly in the cases of "home contacts" who appear
to be delicate and such cases are followed up for several years, by