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Assistant Physicians and a specially trained nurse, for the double purpose
of treatment and investigation into the state of the dwelling, the
general conditions of life, the risk of infection to others, and opportunity
is taken to see the other members of the family with the view of
detecting cases in the early stages, and of suggesting measures whereby
any members of the family who seem predisposed to the disease may be
protected and their health strengthened, so as to be able the better to
resist it. Records of all these matters are prepared by the Special
Visitor under the superintendence of one of the Medical Officers.
There had been some difference of opinion as to whether a Special
Phthisis Dispensary, with a Eesident Medical Officer and Resident
Nurses, should be provided in Westminster, such as is now established
in Paddington mainly by the munificence of a private donor, or whether,
in view of the number of Hospitals and Dispensaries already existing in
Westminster, it would be better to endeavour to secure a more complete
co-operation between the City Council, the Health Society, the various
Hospitals and Dispensaries, and private medical practitioners dealing
with cases of Tuberculosis.
In October, 1909, at the suggestion of the Health Society, a conference
of representatives of Hospitals and other Charitable Institutions in
Westminster was held at the City Hall, at which the matter was fully
discussed. Eventually, in view of the heavy cost of establishing and
maintaining a Special Dispensary, the Society resolved to try the
method of co-operation between existing agencies.
This scheme has now been placed on a good working basis.
A special Tuberculosis Committee of the Society has been appointed,
on which the City Council and the Boards of Guardians are represented.
A Visitor (Miss Sanders), who thoroughly understands the
system, has been appointed. She compiles the records in a
methodical manner on the card system, and has prepared useful indices
whereby important facts and details are available, such as the frequency
of disease in various houses and streets; its association with varying
insanitary conditions of dwellings; the frequency with which one or
more persons share a room, or even a bed, with a consumptive patient;
the varying amount of fresh air admitted into the dwelling by day and
by night; the frequency with which the consumptive patient changes
his house, thus multiplying the infection again and again; the frequency
with which a previous family or house infection can be traced; and the
effect of the disease in producing physical and financial distress in a
more or less wide family circle.
The information thus filed is confidential, and is used solely for the
information of the Medical Officer of Health, Hospitals, Medical Men
and Health-workers who require special knowledge re environment and
health of particular families who are under their charge.