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43
families, in many of which the members are so crowded together as to
give the sick ones small chance of recovery, while condemning the
healthy to an unfair risk of infection.
In reviewing the work of the past five years, a definite improvement
both in method and results is to be seen. The number of new notifications
has shown a steady and fairly rapid decline since the abnormal
war years and those immediately following. So far as the Dispensary
is concerned, the number of definite cases discovered in 1925 is the
smallest in any year since it opened in 1912. This may fairly be taken
to mean that there is less tuberculosis in the borough. That it is not
due to any lessened activity on the part of the dispensary service is
apparent in the records, where the figures relating to investigation and
supervision, e.g., physical and bacteriological examinations, visits of
Doctors and Health Visitors, correspondence with practitioners, etc.,
are larger, indicating that more time and attention have been given to
individual cases. This has been facilitated by getting rid of a large
number of chronic chest cases, not definitely tuberculous, from the dispensary
books.
There has been an improvement in regard to the number of contacts
examined, while the scheme of co-operation with the School Medical
Service has brought about better supervision of child contacts already
examined at the dispensary, and makes use of the specially favourable
position of the School Medical Officer to secure the examination of those
whom the Tuberculosis Officer has not been able to get hold of.
There has been a marked increase recently in the proportion of
insured to uninsured cases, both in attendances and in new cases coming
for examination. This would seem to imply that insured persons are
being given more careful consideration in relation to tuberculosis, and
that co-operation between panel doctors and the dispensary is closer—
due perhaps to the recent elaboration of the scheme.
The provision of dental treatment at the Council's Clinic has been
a decided step in advance, and there is no reason now, outside his or
her predilection, why any tuberculous patient should suffer the
additional handicap of septic teeth.
The adoption by the Council of the Ministry of Health's proposals
with regard to the provision of extra, nourishment has been the means
of giving valuable help to special cases, where the patients have remained
at, or returned to work, and are consequently not in receipt of any
grant from the Guardians.