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of an acute nature. If such provision could be obtained for the civilian
consumptives, both male and female, the death rate from phthisis might
well be halved.
Dispensary Treatment.—The only special method of treatment which
has been used during 1920 is that of tuberculin inoculation. Fifteen
patients received tuberculin injections. Eleven of those were nonpulmonary
cases, glands, skin and joint. Four were lung cases. The
periods of treatment varied from 8 weeks to 1 year. The preparation
used was Bacillary Emulsion. Marked results were obtained in the
gland cases, four of whom have been discharged cured. Four cases were
not proceeded with after a few weeks on account of poor tolerance. Of
the four lung cases, two have shown continuous and satisfactory improvement.
Insured patients, except for a few on tuberculin inoculation, are
not treated at the dispensary. Uninsured patients who cannot otherwise
obtain prolonged routine treatment are treated there. Many proprietary
preparations have been tried in former years, but no striking results can
be recorded. Colloidal Iodine by the mouth and intravenously has been
tried. Nascent Iodine has also been given and many other antiseptic
preparations. Again, it must be said that no accurate investigation of
any therapeutic measure can be conducted unless patients are under
constant and skilled supervision—in observation beds. The dispensary
is mainly a consultative rather than a treatment centre. In 1920, 1,153
individual patients were attending, but only 525 of those actually received
treatment at some period during the year.
(viii) Relative Value of Forms of Treatment.—This has been discussed
in the preceding paragraph. A few general remarks only need be added.
Tuberculin is of wider application and of greater benefit in non-pulmonary
than in pulmonary cases. In pulmonary cases it benefits selected cases,
particularly those in whom a certain degree of resistance is already established
and without evidence of much systemic disturbance, e.g., night
sweats. Antiseptics offer a promising field of research both by inhalation
and intravenous administration. This cannot, however, be thoroughly
investigated at a dispensary. Graduated labour also can only be properly
practised at a residential institution. The measures of treatment which
appear to have yielded the best results are those which follow the dictates
of common sense, but are unfortunately available only to the few—freedom
from the anxiety of having to earn, freedom from the physical and
mental efforts of earning and the enjoyment of a generous diet in which
there is an ample proportion of animal fat.
(ix) Dental Treatment.—A dental clinic was established by the Council
in the latter part of 1920, and one day per month is set aside for