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operation during the year. Children in three categories, viz., (a)
"unsatisfactory children," (b) apparently healthy contact, and (c) unexamined
contacts, are referred to the Divisional School Medical Officer,
who arranges to have them kept under observation and periodically
examined—usually for six months—and to report the result to the
Tuberculosis Officer. During the Year 297 children have been dealt
with in this way.
In addition to the above, a number of children having defects—
aural, nasal, dental, etc.—have been brought to the notice of the
Divisional School Medical Officer with a view to treatment.
(iv.) Any special arrangements made to secure the co-operation of
medical practitioners and the working of the arrangements for periodical
reports on insured patients under domiciliary treatment.
The Tuberculosis Officer communicates with every local practitioner
who notifies a case of tuberculosis, offering to confer as to the best means
of dealing with the case. The practitioner is also invited to avail himself
of the services of the care committee for any case occurring in his
private practice in which he thinks they will prove helpful.
A number of cases have been sent to the dispensary by local practitioners
for investigation. In each case—usually after a short period
of observation—a report has been sent to the practitioner by the Tuberculosis
Officer. 523 such reports have been sent during the year.
A revised scheme for the co-ordination of the work of Tuberculosis
Officers and Insurance Practitioners (Memo. 286) was received from the
Ministry of Health, December 27th. This is to come into operation
on January 1st, 1924. It provides for the interchange of information
concerning definite or suspected cases of tuberculosis occurring in insured
persons, and for the closer co-operation of the Tuberculosis Officer ami
the Panel Practitioner in the treatment and care of such cases.
(v.) The arrangements for following up patients in cases where the
diagnosis is doubtful.
Cases of doubtful diagnosis are kept under observation at the dispensary.
If a decision as to diagnosis cannot be come to after a short
period, they are either referred to the London Hospital for an opinion,
or recommended under the L.C.C. scheme for admission to hospital for
further observation.
(vi.) The arrangements for securing the examination and systematic
supervision of "home contacts."