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INSTITUTIONAL TREATMENT. 73
In addition to the 11 who left the Borough before their applications were finally dealt with,
23 other applicants, nearly all of whom had been admitted to sanatoria, were known to have left
their original addresses before the end of 1913. Most of the patients have been lost sight of, as
their new addresses are not known. With regard to some of these patients inquiries have been
made to the Insurance Committee for the new addresses, but without result.
Seventeen of the 180 applicants were found to present no signs of tuberculosis when
examined by the medical referees. Three other cases were marked off as "errors" before the
end of 1913.
At the beginning of this year special enquiries were made about the patients who were discharged
before the end of 1913, numbering 68 in all. The reports received were classified under
four headings as regards health conditions, viz., (a) Health good: fit for work; (b) Health fair:
can do light work only; (c) Health indifferent: can do no work; and (d) Health progressively
failing. Such division can be regarded as of the roughest description only, but it will give an
approximate idea of some of the results of institutional treatment. Of the 68 persons here dealt
with, 1 was found to have died, 1 could not be seen being always out (at work), and 21 had
removed and could not be traced. Of the remaining 45, 21 were placed in group (a), 9 in group
(b), 4 in group (c), and 11 in group (d). The further history of these patients will be recorded
in future reports so long as they can be traccd.
Schemes are in preparation by the County, City and Borough Councils for providing
treatment for the whole of the tuberculous population of the Metropolis, other than insured
persons. In examining the records of the patients dying from pulmonary tuberculosis during
the past year, it has been found that in no fewer than 107 instances, representing 79.2 per cent.
of all deaths from this form of tuberculosis, the interval between the first notification of the
disease and death was less than one year. In 17 instances the interval was from one to two
years, and in 11, over two. On analysing the 107 instances more closely it was found that in
4 death preceded the notification, in 22 notification and death occurred during the same
month, and in another 26 death took place during the month succeeding that of notification.
In 40 instances the interval between notification and death was from 0-3 months, in 17, 3-6,
and in 12 from 6-9, and the like number from 9-12. These figures should be compared with those
relating to the duration of the disease given on page 76. The conclusion which is obviously
deducible from the figures just given is that the proposed schemes are not likely to meet with the
hoped-for success unless the disease be diagnosed at much earlier stages of its progress. As the
profession can only deal with cases coming before them, the success of the schemes will rest with
the public at large, who require to be educated to an appreciation of the importance of seeking
advice without delay.
In connection with this subject it will be of interest to quote some figures with reference to
the work of the Paddington Dispensary for the Prevention of Consumption since the inception
of " Sanatorium Benefit."*
During the eighteen months covered by the return 1,428 persons were examined by the
Medical Staff, that total including 274 insured persons. The patients treated during the same
period numbered 2,164, including 586 insured persons, there being on the Register of the
Dispensary at the end of March, 1914, 449 patients (resident in the Borough) who were definitely
tuberculous, including 91 insured persons and 243 who were "under observation" as suspected
to have the disease, of whom 49 were insured.
In their circular letters on the formulation of schemes for treatment, the Local Government
Board laid considerable emphasis on the need of dispensaries being able to refer cases of
difficult or doubtful diagnosis to the staffs of the large hospitals. During the period under
* The figures have been extracted from a return prepared for the information of the Local Government
Board relating to the period 15th July, 1912, to 31st March, 1914. The return includes a number of patients
living outside Paddington. Such patients have been excluded from the figures here quoted.
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