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49
It may be noted that there are only minor variations in the numbers
referred from different sources. The table shows a regular supply of
new cases to the Dispensary from these different sources in fairly constant
proportion. The annual totals vary in definite relation to the
number of cases of Tuberculosis notified in Westminster. As in previous
years, the Dispensary has been in constant touch, by letter, telephone
or personal interview, with the practitioners in the district and with the
officials of the various hospitals and charitable organizations which
deal with Dispensary patients.
The months of February and March, 1929, were characterized by
extremely severe weather, and the effect of this was definitely noticeable
in the work of the Dispensary. A larger proportion than usual of new
cases during the year showed definite signs of acute active Tuberculosis,
and, with few exceptions, these patients dated the onset of their symptoms
from these severe months. Two hundred and forty new cases were
considered tuberculous, as compared with 201 in 1928. Many of the
patients with disease of longer standing showed some degree of loss of
ground during, or soon after, this period. Seventy-one patients on the
current Dispensary register died during the year, as compared with
52 in the previous year. These deaths were divided between new cases,
with rapidly spreading disease, and old cases, some of over 10 years'
standing, who had maintained fair health for a number of years but
were apparently unable to stand the strain of an unusually hard winter.
There does not seem any ground for believing that the increase of cases
with active disease was anything but a temporary increase, or that the
general tendency to decrease in Tuberculosis which has been noticeable
in recent years will not continue.
Although there was an increase during the year of new cases, and
especially of cases that were definitely tubercular, there was a decrease in
the total attendances at the Dispensary. This figure depends largely on
the number of old cases who remain in regular attendance at the Dispensary.
As has been pointed out, an unusually large number of these
old patients died. The decrease, however, is probably due even more to
the number who leave the district. This migration has been particularly
noticeable in the last two or three years, and it may be that families
with members who are tuberculous are particularly anxious to take
advantage of any opportunity to move to the country or to the new
housing estates on the outskirts of London. Eight per cent. of the cases
who attended the Dispensary for the first time during 1929 had left
Westminster before the end of the year, and over 10 per cent. of the
old cases on the current Dispensary register were definitely known to
have left the district. Xo doubt a corresponding proportion of old