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141
Home visiting of patients is carried out every Wednesday morning
by Dr. Rusby, but any additional cases are seen by Dr. Pritchard on
other days during the week.
Every effort is made to keep in close touch with the general practitioners
in the Borough, and to give them every assistance in the diagnosis
and treatment of their cases which are referred to the Dispensary.
Dr. Pritchard continues to act as Honorary Consultant in Tuberculosis
at St. Giles's Hospital, Camberwell, and attends there every
Friday morning and is in this way enabled to keep in touch with the
Southwark patients in the Hospital.
Figures showing the work of the Dispensary are on page 154. Th:s
is a copy of the form which is sent to the Ministry of Health and the
London County Council.
DIAGNOSIS.
In most cases new patients are referred to the Dispensary for an
opinion by their own Doctors, but sometimes patients present themselves
for examination on their own initiative. The examination of contacts
is a further source of new patients and in every case the examination of
contacts is as thorough as that of a new case.
Early diagnosis of tubercular troubles is important if the results
of treatment are to be successful. 348 patients were sent up by general
practitioners for an opinion during the year.
During this, the second year of its installation, the X-Ray plant
has given even more useful service, and it is felt that the X-Ray plant
has done a great deal towards the Dispensary now being recognised as
the diagnostic centre for chest conditions in this Borough.
The examination of sputum is carried out by the Public Analyst as
it has been done in the past, and the number of examinations made have
been 476. Of this total 149 were positive and 327 were negative.
In addition to the usual physical examination which is carried out
in every case, the Mantoux Test is also employed in the examination of
children. This test is performed by an intra dermal injection of a
solution into the forearm which produces a mild local reaction in a case
which has been infected with the tubercle bacillus. It must be emphasised
that infection with the tubercle bacillus does not necessarily mean that
the patient is suffering from tuberculosis as it has been proved that
nearly every town dweller has been infected with this bacillus by the time
he attains adult age. It will be seen, however, that this test provides
valuable information in the case of children who present symptoms which
might be ascribed to tuberculosis. The younger a patient with a
positive reaction the more importance can be attached to it. A Mantoux
reaction can vary in degree and sometimes may give an indication of
the efficiency or otherwise of the isolation of the infectious patient in the
home.
During the year 10 Mantoux Tests have been carried out on children.