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and (3) " unexamined contacts" *270 children have been referred to the
Divisional School Medical Officer to be kept under observation. At the
end of a period, usually six months, the cards referring to these children
are returned to the Tuberculosis Officer with the School Medical
Officer's notes and a record of the child's weight and general progress.
This enables the Tuberculosis Officer to pick out for attendance and reexamination
at the Dispensary those cases in which a suspicion of
tuberculosis appears to call for further investigation.
(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.
Local practitioners have referred a number of patients, both insured
and uninsured, to the dispensary for investigation and diagnosis. In
each case, usually after a short period of observation, a report has been
sent to the practitioner by the Tuberculosis Officer. 791 reports of this
kind have been sent during the year.
The new, or rather, revised scheme of co-operation between the
Tuberculosis Officer and Insurance Practitioners in respect of insured
patients came into use on 1/1/24. By the interchange of numerous
forms and progress reports, the Tuberculosis Officer is kept informed
of the condition and progress of all insured tuberculosis patients and
conversely sends to each Panel Practitioner information concerning those
patients on his panel list. All these patients fall into one or other
of five groups, viz. : (1) " Dispensary Observation " (for investigation
before diagnosis, or with a view to possible sanatorium treatment), (2)
" Sanatorium Treatment," (3) " Domiciliary Treatment " (by the panel
doctor), (4) " Dispensary Treatment," (5) " General Supervision
(cases in whom the disease is quiescent and no active treatment is
required).
All cases are considered to be under the immediate care of the
Tuberculosis Officer except those in group (3), for whose welfare the
Panel Practitioner is directly, and the Tuberculosis Officer only indirectly
responsible The scheme entails a considerable amount of
" form filling " on the part of the practitioner and the Tuberculosis
Officer. It appears, however, to have worked fairly well during the first
year and to have brought about some improvement with regard to the