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health, is also the means of bringing to light unsuspected lesions
which can promptly be given treatment through an appropriate
agency, e.g., general hospital, or panel or private practitioner.
Again, especially in the case of contacts, one has the opportunity
of offering periodical medical examination which, if accepted,
cannot fail to result in the detection of any mischief that may
be developing, at an earlier date than would otheiwise be the
case. I have again to thank the local practitioners for their
co-operation, and with them I have had 396 consultations during
the year.
(2) The Dispensary as a Means for arranging Treatment
for Tuberculous Persons.—As a matter of actual fact, comparatively
little formal treatment is carried out by the Tuberculosis
Officer, but it is his duty to arrange this through the London County
Council and other bodies. Treatment may be divided into three
main categories.
(a) Residential Treatment.—The object of this is partly
curative, e.g., in the early incipient case who has a good
prospect of recovering a sufficient degree of health to
enable him to return to his old occupation ; or at the
other extreme mainly preventive, e.g., in the patient with
advanced disease, whose chances of cure and even of
improvement are remote, but whose presence in his
home is a danger to others, especially to young children
residing in the same house. There is an intermediate
class comprised of individuals who cannot be regarded
as early cases, but who by reason of a good constitutional
resistance, fortified by attention to and observance of
rules laid down for a general hygienic regime, are able
to maintain fair health, and perhaps working capacity,
but need from time to time a spell of treatment away
from home. With all these varieties the London County
Council deals, the early cases being sent to sanatorium,
the advanced to the local general hospital, and the
intermediate to sanatorium or hospital, according to the
degree of recovery or otherwise likely to ensue.+