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Treatment
Chemotherapy is the mainstay of treatment - taken at home after perhaps
two or three months initial assessment and treatment in hospital. A ward for
male cases under the Chest Physician's supervision is available in Dulwich
Hospital. Female patients may be admitted to Grove Park Hospital. Beds
for both male and female cases are also immediately available in country chest
hospitals. Long term treatment is now the rule with a minimum of two years
Usually advised. At any one time an average of 150 chest clinic patients
Were receiving chemotherapy.
B.C.g. Vaccination
This is now an established procedure in the general scheme for tuberculosis
prevention. Vaccination is offered to all school children approaching
school leaving age under arrangements by the London County Council.
Children showing a positive reaction at school to the preliminary skin tuberculin
test are referred to the Chest clinic for routine investigation including
chest X-ray examination and examination of contacts to discover any possible
source case of infection. B.C.G. vaccination is arranged at the chest clinic
for contacts at special risk, for new born contacts andhospital staff; 120 such vaccinations were performed during the year.
Notification
In the Ministry's recognition of tuberculosis cases "whether notified or
not'' is implied a modification of the regulations governing the formal notification
of such cases under chest clinic supervision. It must be stressed
owever that this does not in any way relieve General Practitioners, Hospital
Medical Officers and Chest Physicians of the obligation, under the Tuberculosis
Regulations, to notify cases on diagnosis to the Medical Officer of
Health. Failure to do so could only result in breakdown of arrangements
for examination of contacts and paralysis of the Tuberculosis Health Visiting
service dependant as they are on information received through this channel
and would lead to a regrettable increase in the number of non-notified deaths
and posthumous notifications.
Health visiting
y The London County Council provides two fufll time Tuberculosis Health
visitors, based on the chest clinic at St. Francis' Hospital, to cover duties in
the South Lambeth area. Visits are paid to the homes of cases when newly
notified and as a routine to all cases on the notification register whether
attending the chest clinic or not. Other visits are made on instruction from
the Chest Physician to patients who-are not notified but who are under chest
clinic advice. On the Health Visitor's report an opinion can be formed on the
Problem of housing adequacy and suitability and during the year the Chest
Physician continued to make medical recommendations for preferential rehousing
in selected cases.
The Health Visitors paid 3,982 visits to patients homes during the year,
Welfare
With few exceptions the needs of patients are adequately met by the
National Insurance and the National Assistance offices with whom close liason
is maintained. Extra provision is made on the Chest Physician's recommendation
for those suffering from respiratory tuberculosis.Necessitous patients may