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TUBERCULOSIS.
17
and found free from tuberculosis was 57.6 per cent., the percentage for 1922 being 63.7. Last
year 76.7 per cent. of all examined were found to show no signs of the disease. Among insured
adults the percentage was 65.1, and among uninsured, 79.3.
Another striking change was in the number of "suspect" cases remaining undiagnosed at the
end of the year. During the years 1918-22 this class constituted 15.1 per cent. of the total number
examined, the percentage in 1922 being 15.4. Last year the proportion fell to 3.4 per cent, of all
examined, 1.6 in the case of adult males, 3.6 in adult females, and 4.1 in children. Among insured
persons the percentage was 3.5 in 1923, as compared with a mean (1918-22) of 15.6, and among
uninsured persons, 2.0, mean, 16.2.
The patients referred to the Dispensaries for diagnosis numbered 205 last year, as compared with
162 in 1922. A smaller proportion of patients were referred by the Tuberculosis Officers to the "linked"
hospital, viz., 133 in 1923, 144 in 1922. In 134 instances last year patients were under observation
for periods exceeding two months before a diagnosis was made (136 in 1922). Reports on 11 cases were
received from medical practitioners (8 in 1922) and 34 consultations were held with them, 22 patients
being insured and 12 uninsured. In 1922 the consultations numbered 33 (insured, 23; uninsured, 10).
The Tuberculosis Officers made 544 home visits last year (486 in 1922) and the Tuberculosis
Nurses, 3,786 (3,625 in 1922). Two hundred and forty-two sputum tests were made last year, of
which 40 (16-5 per cent.) were positive. In 1922, 299 specimens were examined, 67 being positive
(22.4 per cent.).
The examination of "contacts"—being members of the families of patients found to be suffering
from tuberculosis—is an important part of the work of the Tuberculosis Officers. The contacts
due for examination during the year numbered 462, of whom 338 (73.1 per cent.) were examined.
At the close of 1922 there were 45 contacts awaiting examination, the total number examined during
the year being, therefore, 383, among whom 19 cases of tuberculosis, 3 pulmonary, and 16 other forms,
were found. The total proportion of contacts found to be tuberculous was 4.9 per cent. Two of
the cases were found in adults, one pulmonary and one other form, and 16 in children, equally divided
between the two forms of the disease.
At the close of the past year there were 628 patients under treatment at the Dispensaries (395
in 1922) and 114 under domiciliary treatment (107 in 1922).
Dental Clinic.—By agreement with the British Dentists' Hospital a Surgeon Dentist attends at
the Dispensary (20, Talbot Road) each Tuesday afternoon. During the year he saw 297 patients
(men, 46; women, 123; children, 128). In 51 instances "advice and inspection" were all that
were necessary. Two cases of pyorrhæa (women) were treated. The following surgical treatment
was given—scalings, 4; fillings, 33 ; and extractions, 109 (208 teeth)—all with anæsthetic (local
or general) except one. Eight upper and 7 lower dentures were supplied, grants towards the cost
of the same being made by the Council to 8 patients. The total amount of the grants was £14 14s. Od.
Institutional.—This designation covers treatment in residential institutions provided by the
County Council.
At the end of 1922, 47 patients were under treatment in these institutions. During the past
year 198 applications for treatment were received, 89 from men, 86 from women, and 23 on behalf
of children. Of the total applications, 162 were carried through, 36 not so maturing, 19 on account
of refusal by the County Council, 9 by refusal of the applicants of the form of treatment offered by
that Council and 8 by the death of the applicants. In 86 instances the applicants were given treatment
in hospital, of whom 36 were transferred to sanatoria; 73 were admitted to sanatoria, 1 being
subsequently transferred to a "colony," and 3 to training colonies.
Among the 209 patients who were treated in residential institutions during the year there
were 15 deaths and 116 discharges, leaving 78 under treatment at the end of the year, including 9
who had been admitted in 1922.
Although not a residential institution it may be noted here that 36 children, other than those
mentioned above, were admitted to Kensal House School during the year.
Tuberculosis Care Committee.—In the Report for 1922 the history of the formation of the
Interim Care Committee was briefly set out and the decision of the Council to appoint a Borough Care
Committee recorded. The latter Committee was duly appointed by the Council on February 27th of
last year. The Committee comprises representatives of the Council, the Guardians, War Pensions
Committee, Charity Organisation Society, the Executive Committees of the Dispensaries, three
specially selected members who were not representatives of any societies or organisations, and the
Officers of the Public Health Department and the Dispensaries (as ex-officio members), there being
altogether upwards of 30 members. Miss Dorothy Warren was appointed to be part-time Secretary
to the Committee on February 27th, 1923, and whole-time from 30th October, 1923. The Committee