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under the prevailing conditions it has been inevitable, I am of
opinion that unless it can be remedied in the future, the success
of the work is bound to be affected. It is essential that one person
should be in charge of the visiting of the homes, and that she should
always be available except during her holiday or when she herself
is ill, so that she can thoroughly familiarise herself with the needs
and circumstances of the people on the register and arrange her
work accordingly, and also carry out these follow-up visits which
are necessary if the Dispensary is to continue to be the real
centre for anti-tuberculosis efforts in the Borough.
(3) The number of new cases sent up for investigation by
general practitioners is again high—89, and there is no doubt
that the department has the good will of the local doctors.
(4) The number of sputum tests made was considerably above
the average, namely, 319. These tests are all made in the Dispensary
and they take up a considerable amount of time, but as an adjunct
to clinical and X-ray findings they are of great value, and well
repay the labour involved.
(5) The number of letters, reports, etc., sent out totalled 972.
The brunt of this falls on the Secretary-dispenser, Miss E. M. Russell,
but it constitutes only a small proportion of her work, much the
greater part consisting of the keeping of records and the preparation
of the complicated statistics required by the Ministry of Health.
I have to thank her for the efficient and cheerful way in which
she has carried out her duties, which are always arduous and
not infrequently difficult and irritating.
The treatment of tuberculous persons may be divided roughly
into domiciliary and residential. Those who are not in institutions
for the most part receive their treatment from their panel doctors
if they come under the National Health Insurance Act, or from
private practitioners if they are able to afford the necessary fees.
The remainder are seen at the Dispensary and provided with
medicine, but all are under the supervision of the Tuberculosis
Officer and are examined at regular intervals if they agree to
attend, as the great majority do.
Residential treatment still has for its basis rest, fresh air and
good food, but there are other ancillary methods which can only
be used in special institutions adequately equipped and having
a fully trained staff. These methods comprise mainly Artificial
Pneumothorax and more definitely surgical procedures such as
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