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the spread of infection, and for removing conditions favourable to infection.''
At the present time no officers suitable for this purpose are available in
Islington, and hence in order to carry out this regulation, which is not permissive,
but is mandatory, it will become necessary, even if there be no
dispensary established, to provide them, because it is clearly impossible that the
Medical Officer of Health unaided could himself undertake such a duty in
addition to the innumerable duties which recent public health legislation has
imposed on him. In the circular letter which accompanied the Order of the Local
Government Board it is pointed out that " either the Medical Officer of Health
himself or an officer acting under his instructions is required to make such
inquiries and take such steps as may be necessary or desirable for investigating
the source of infection; for preventing the spread of infection, and for
removing conditions favourable to infection. It is contemplated that for the
purpose of carrying out the requirements of this Article a visit to the home
of the patient will generally be necessary, and the Medical Officer of Health
will doubtless avail himself of the co-operation of the notifying practitioner.
When a case is notified, inquiries should be made to ascertain the state of
health of all the members of the household. A record should be kept of the
inquiries or investigations made in each case into the causes and antecedents
of the disease, and of the conclusions reached by the Medical Officer of Health
as to the factors which combine to produce it." From all this you will see the
important part these trained nurses will play in the fight against tuberculosis.
I have dwelt at length on the provision of nurses because the educational
value of trained women is not as yet recognised as fully as it should be;
although I am happy to think that this failure on the part of the public, who
invariably look upon a new movement with suspicion, has almost passed away.
There are, however, other members of the staff who must be provided,
viz., a clerk, a dispenser, and a caretaker.
Clerk.—A clerk will be required because the dispensary will become the
central bureau to which everything relating to tuberculosis will be sent to be
dealt with or recorded. Thus notifications will be inquired into by the nurses,
correspondence with medical men will be sent there and replied to from
there ; records required by the Local Government Board will be kept there ;
the result of inquiries or investigations into the cause of the disease will be
tabulated there; the results of treatment will be recorded there ; the discharges
of all cases from sanatoria or removals from one district to another
will be reported there, and all inquiries respecting the disease will be answered
there. Clerical assistance is consequently clearly indicated, and, indeed, is
essential.
Dispenser.—The services of a dispenser will be required, but he may be