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attending the Dispensary are instructed, both at the Dispensary
and at their own homes, as to hygienic methods of disposal of
sputum, etc. Bedsteads and mattresses are, also, loaned in order
that the patient may sleep alone. Every effort is made to cooperate
with the Lambeth and the London County Council Housing
Schemes, to ootain better housing for tuberculosis patients. Close
co-peration with the Council's Public Health Department and the
Sanitary Inspectors is also maintained to ensure the remedying of
defects that may be found to exist in houses of tuberculosis
patients.
(xvii) Central and Branch Dispensaries.
Special Difficulties Encountered
(a) Early diagnosis of cases of tuberculosis and sanatorium
treatment for such early cases (prolonged treatment).
(b) Homes for advanced cases of tuberculosis—to be provided
within the Borough, so as to be readily accessible for
visitation by friends and relations (as opposed to Institutions
outside the Borough), the beds provided by the L.C.C. being
too small in numbers, and patients disliking the idea of entering
Poor Law Hospitals.
(c) The pressing need for a new, more adequate and up-todate
Central Tuberculosis Dispensary.
(d) Shortage of housing accommodation and relative height
of rents (to incomes of patients) necessary to be charged, on
economic grounds, for Borough and L.C C. houses and flats.
APPENDIX III.
0
An Unusual Case of Insect-Infestation.
A house in West Norwood was found to be insect-infested, and
the infesting insect proved to be the Silver Fish, Lapisma Saccharina,
one of the Thysanura—a species that may be found in houses that have
been built for some time, but whose presence may not be suspected by the
occupants until a room is entered at night and the light turned suddenly
on, or until a specimen happens to get caught amongst food-stufifs or in
a cooking utensil. The usual hiding-places during the day of these