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(v.) The arrangements for following up patients in cases where the
diagnosis is doubtful.
Arrangements for following up cases of doubtful diagnosis are
the same as in previous years. If a diagnosis cannot be arrived at within
a reasonable time at the dispensary, the patient, when pulmonary
disease is suspected, is usually recommended for admission to hospital
under the London County Council scheme for special observation and
investigation, or, if the character of the case does not require this, is
seen again at the dispensary after an interval of from three to six months.
Doubtful cases of surgical tuberculosis are sent to the London Hospital
for a further opinion, or admission to hospital is arranged for them in the
same way as for doubtful pulmonary cases. Doubtful cases amongst
school children in which there is no urgency, are kept under observation
for a further period in conjunction with the School Medical Officers as
already described.
In all such cases, the co-operation of the patient's own doctor is,
where possible, enlisted, and re-attendance at the dispensary after the
prescribed interval is secured by reminders in the form of letters or visits
to the patient's home.
(vi ) The arrangements for securing the examination and systematic
supervision of ''home contacts.''
Contacts are examined at the dispensary as soon as possible after a
case is notified. Arrangements for their attendance are made by the
Health Visitor when visiting the home or by letter, and the convenience
of the patients themselves is studied as far as possible with regard to the
time of attendance.
Child contacts of school age, whether already examined by the
Tuberculosis Officer and found to be apparently healthy, or unexamined,
are passed on to the Divisional School Medical Officer for observation, to
be reported on in due course. 336 contacts were examined at the dispensary
during the year, 142 being adults and the lemainder children.
In addition, a number of unexamined contacts were referred to the
Divisional School Medical Officer.
(vii.) Information as to special methods of diagnosis and treatment
in use and the number cf persons to whom these special methods have been
applied.
The X-Ray installation has continued in use for diagnosis
purposes. No other special methods have been employed.