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Were one able to concentrate specially on young adults exposed
to infection from an open case, and secure their examination and
periodical re-examination at regular intervals, one would bo able
to tap a source from which doubtless one would obtain many
early cases. Special efforts are made in this direction, but so
long as we have to rely on second hand communication via the
member of the family originally interviewed it is not likely that
the advisability of a medical overhaul will be sufficiently stressed
to be appreciated by the fathers of families, and those who are going
out to work. In spite of these drawbacks, I believe that contact
examination as at present carried out has very definite advantages
since it enables one to detect ill-health due to causes other than
tuberculosis, and it also emphasises the position of the Dispensary
as a centre which has as its concern not only the welfare of the
patient but that of his family as well.
(3) Health Visiting.—Last year I had to point out that this
work was being carried out with unusual difficulty in Stoke
Newington, owing to the frequent absences from duty of the
Tuberculosis Nurse, brought about by the fact that she had to
deputise for any other member of the Borough health-visiting staff
who might be incapacitated. I am glad to be able to report that this
defect has been to a large extent remedied, and that in February, 1938,
the provision of an additional visitor has made it possible for
the Tuberculosis Nurse to devote practically the whole of her time
to tuberculosis work. In May last, Miss M. I. Greenwood was
appointed as Tuberculosis Nurse, and has already by her energy,
tact and enthusiasm been successful in winning the confidence
of the patients, and in re-establishing touch between them and
the Dispensary. It is a pleasure to pay a tribute to the admirable
work which she has done in Stoke Newington during her first
year, as well as to that done consistently for many years in
Hackney by Miss Servanti. Closely bound up with the que.-tion
of health visiting is that of the social work which is performed
through the agency of the Tuberculosis Scheme in which the
Care Committee and the Dispensary each has a part to play. The
functions of the Care Committee commence immediately a diagnosis
has been made, continue while the sufferer is under treatment,
persist after his return from sanatorium, and include responsibilities
both to him and to his family.
They are undertaken in the face of many handicaps, sir to
be effective they entail the provision of an adequate standard
of living, efforts to secure him work which will be within the
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