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because the accommodation for tuberculous cases of this sort was complete
and satisfactory at the Hendon institution. During 1920 it has been
almost impossible to suggest to a patient that he should seek admission
to the infirmary. Tuberculous patients have been boarded out in other
institutions and the treatment received has been complained of by the
patients, so that they now refuse to seek admission to the Infirmary
unless they are destitute.
(iv) Co-operation of Medical Practitioners, <£c.—Practitioners throughout
the City were circularised when the dispensary was established in
1916. They were informed that the chief functions of the dispensary were
(1) to be a consultative centre, where doubtful cases might be sent for
diagnosis; (2) for the examination of the contacts of notified cases;
(3) a centre of information as regards obtaining sanatorium treatment,
and where special methods of treatment such as tuberculin injections,
&c., could be demonstrated. They were also informed that the services
of the tuberculosis officer were freely available to them for the purpose of
consultation at the homes of patients. It was stated clearly that it was
not the intention to usurp the place of the general practitioner as medical
attendant of the consumptive.
Medical practitioners in the district have shown confidence in the
dispensary from the beginning. Most of them are on intimate terms
with the tuberculosis officer and it is a common custom for practitioners
to call at the dispensary in order to talk over the various cases in which
the tuberculosis officer is also interested. Case records are shown and the
progress of patients is discussed. Many of the patients have been coming
to the dispensary for periodic examination for several years. Practitioners
occasionally bring patients to the dispensary for examination, but
more frequently they telephone asking the tuberculosis officer to meet
them at the patient's* home, when the consultation can take place at
the bedside. The number of persons sent to the dispensary by practitioners
for the opinion of the tuberculosis officer has steadily increased.
In 1919 it was 129, in 1920 it was 150. This is remarkable, in view of the
fact that the total number of new7 cases examined at the dispensary
has been declining since 1918:—
New Cases.
1916 553
1917 718
1918 779
1919 607
1920 592