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glands, have been referred to the hospital and admitted as in-patients.
Also a very few cases have been referred for general surgical treatment,
e.g., for cancer.
The relations of the tuberculosis officer with other hospitals have been
most cordial. "Westminster is better supplied with hospitals than almost
any city in the world, and it is found that the families of the older
residents have their favourites among the hospitals. Generations of one
family prefer St. George's Hospital for all conditions ; others, St. Thomas',
and so on. No difficulty has been experienced in obtaining admission for
cases of acute illness in patients who came to the tuberculosis dispensary
but were found not to be tuberculous.
Diseases of special regions: eye cases, gynaecological and genitourinary
cases, &c., have been referred to and have been treated at the
various special hospitals in and around the City. A letter of introduction
is written by the tuberculosis officer for the patient to take to the hospital.
This always ensures attention from the hands of the appropriate physician
or surgeon. In this way the Tuberculosis Dispensary has been a clearing
house for many ailments not necessarily connected with tuberculosis.
School Clinics.—Defects of a minor nature found in school children,
e.g., dental caries, errors of refraction and throat conditions, are notified
at once by letter to the local organiser of the L.C.C. School Care Committees.
She refers the cases to the school doctor, who decides as to whether treatment
is necessary. Treatment is provided at the school clinics at
Rochester Row, Gerrard Street, &c. There is, however, sometimes
considerable delay in obtaining treatment and occasionally the school
doctor does not agree that treatment is necessary. There is need for
closer co-operation between the school medical service and the tuberculosis
service. Towards the end of 1920 the education authority
evolved a scheme by which children who were deemed by the tuberculosis
officer to be no longer in need of dispensary treatment or supervision
were referred to the school medical officer for supervision and
if necessary, general treatment, such as cod liver oil, milk in school, &c.
A special form of transfer card giving the medical history is filled up at the
dispensary and sent to the school doctor.
Oilier Institutions.—The loss of the Infirmary at Hendon has been
markedly felt in dealing with certain types of cases of tuberculosis.
Advanced and infectious cases of tuberculosis now tend to remain and die
at home. Sir Arthur Newsholme has for many years laid great stress on
this very point as a cause of the spread of infection. Patients in an
advanced stage used to be willing to apply to the Guardians for treatment