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78
The early diagnosis and treatment of patients
is important, though the difficulties connected therewith
are well known, e.g., the insidious onset of the disease,
the reluctance of workers to stop work until the disease
is too far advanced for cure or arrest, etc. Sanatorium
treatment is being provided for some of the suitable
(early) cases of pulmonary tuberculosis (consumption), but
no proper provision, outside Poor Law Institutions, has
yet been made at all for “advancing” or “advanced”
cases, which are the chief cause of the spread of the
disease (in the “commencing” form) to others. Satisfactory
arrangements should be made for the segregation of
such “advancing”or “advanced”cases as may be found
necessary, and for their proper treatment in institutions
other than those of the Poor Law, having regard to the
infectious nature of such cases. Everything depends
upon concentrating administrative (including remedial)
efforts upon these cases: indeed, it is only in this
way that tuberculosis will finally be eradicated.
Taking the generally accepted lay classification of the
disease into the usual three stages—stages i. (commencing),
ii. (advancing), and iii. (advanced)—it is clear that, if
patients suffering from stage i. of the disease are dealt
with radically, and the disease in them is cured or
arrested, so that there will be, eventually, practically
no patients suffering from stage i. of the disease, stages ii.
and iii. of the disease must also disappear, as these stages
(ii. and iii.) are fed from stage i. Medical men and others
should be encouraged to refer their patients at once to the
Dispensaries for diagnosis or treatment, and all "contacts"
found in infected houses should be encouraged to attend,
and to continue to attend from time to time, at the
Dispensaries for advice. The Tuberculosis Medical
Officers are always ready to give expert assistance to
medical men and others who require it, in connection with
not only the diagnosis, but also the treatment, of the
disease, both in its early and later stages.
The remarks of the Tuberculosis Medical Officers on
the subject of tuberculin (both in diagnosis and treatment)
are noteworthy, their opinions, as the result of experience,
coinciding with those of other experts, viz.: that
tuberculin is only one of the forms of treatment and, as
such, was used in 71 out of the total 486 tuberculous
patients treated during 1913 in connection with the
Lambeth Tuberculosis Dispensaries under the Scheme.
Joseph Priestley.