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33
Of the total 324 cases 60.8 per cent, were examined by the Council's
Tuberculosis Officer. Last year the corresponding percentage was 45.
It will thus be seen that there has been a very pronounced tendency for
the Dispensary to extend its activities in getting in touch with all cases
of tuberculosis notified for the first time in the city. If one may deduct
the cases which died within four weeks of notification, together with the
few asylum and military hospital cases, numbering in all about 50, the
Dispensary is found to have dealt with more than 70 per.cent. of the total
of new cases of tuberculosis in the city. It is extremely important that
the Tuberculosis Officer, although not necessarily responsible for the
treatment of individual cases, should have direct personal knowledge of
them. His duty should be to see that adequate treatment is being given
to all cases, whether by panel or private medical practitioners, or at hospitals.
It is therefore most satisfactory to record such an increased
proportion of the total new cases being examined by him. A type of case
which is difficult to follow up is found among the inmates of common
lodging-houses. Many of those seek treatment in the Infirmary when in
an advanced stage of the disease. Since May a very large proportion of
those cases has been examined in the Infirmary. A good deal of information
has been obtained concerning them, and in a few instances sanatorium
treatment has been arranged. In those few cases the possibility of cure
from sanatorium treatment has raised fresh hopes when the prospect
seemed to envisage a cycle of common lodging houses and casual wards.
In the report of 1922 a suggestion for closer co-operation with the
Guardians was alluded to. The Council, acting on the suggestion of the
Ministry of Health, made arrangements with the Guardians by which
the Tuberculosis Officer should act as consulting physician to the tuberculosis
wards of the Infirmary. He has visited the Infirmary once a week
since the beginning of May, and in consultation with Dr. Sandiland, the
Medical Superintendent, has examined cases there.
This may be considered to be the most important departure in the
Council's Tuberculosis scheme since it was established in 1916. Cases
requiring urgent hospital treatment are now admitted to the Infirmary
without delay. Formerly, matters would have had to take their course
at home whilst patients were awaiting accommodation under the County
Council. The County Council now arrange to transfer patients direct
to sanatorium from the Infirmary if their physical condition shows sufficient
improvement. By courtesy of the Medical Superintendent, the Tuberculosis
Officer has also been able to keep certain patients under personal
observation in the Infirmary pending diagnosis. Thus the period of waiting
for a sanatorium bed, which, is so trying for a consumptive, is largely
eliminated. It is found that patients are less unwilling to enter the
Infirmary than heretofore. Cases of advanced disease, with whom the