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84
of tuberculosis, are passed. The necessary arrangements
are made for the course of treatment, either (1) Routine
treatment, at one of the two Tuberculqsis Dispensaries,
connected with the Scheme; or (2) Institutional treatment.
Routine treatment includes the usual medicinal and
hygienic measures, including the use of open-air shelters,*
such as are in use at Tuberculosis Dispensaries throughout
the Country.
Institutional treatment includes that received at
Sanatoria (including Tuberculosis Hospitals), at General
Hospitals and at Poor Law Institutions. "Insured"
persons under the National Insurance are sent to
Sanatoria (including Tuberculosis Hospitals) through the
London County Insurance Committee, whilst "noninsured"
persons are, at present, dealt with by Charitable
Agencies. This provision, especially in so far as "noninsured"
persons are concerned, is limited, and great
difficulty is experienced in obtaining beds.
The importance of the function played by a General
Hospital in any Scheme for dealing with tuberculosis is becoming
increasingly evident. Not only are abundant
facilities offered for diagnosis of tuberculosis by special
methods, but the wards and special departments of General
Hospitals provide means for treating any case of other
disease or any emergency which may arise in connection
with the special tuberculosis work. The dental, X-ray,
and laryngological departments at St. Thomas's Hospital
have been used to the greatest extent in connection with
the Lambeth Scheme. This feature of the Lambeth
Scheme is specially noteworthy, and its value has been
proved, as shewn in this Report.
The problem of the treatment and segregation of
advanced cases is still largely unsolved, as far as the
Metropolis is concerned. No adequate provision has yet
been made, so that Poor Law Institutions have had to
be used as an alternative.
* Open-air shelters are in use in connection with the Branch
Dispensary (St. Thomas's Hospital) and have proved to be of
great use in certain cases. Similar shelters might, with advantage,
be provided in connection with the Central Dispensary
(73 Effra Road, Brixton).