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Many of the children seen at the dispensary have been sent by the Medical Officers of
school clinics and child welfare centres for further opinion. On the other hand, use has been
made of the arrangements whereby the School Medical Service keep under observation
children referred to them, either as unexamined contacts (vide infra) or as being in an
unsatisfactory state of health.
Close co operation has also been maintained, both with the local medical practitioners
and with the Hospital, and it is from these sources that the majority of patients have come.
Full advantage has been taken of the valuable facilities offered by the Hospital for the
diagnosis of obscure cases, particularly in the matter of X-ray work, laryngoscopy and
pathological investigations. It is also a great help to have at hand an institution to which
tuberculous patients can be referred for treatment of non-tuberculous ailments to which they
may be subject, the treatment of which adds so much to their welfare. The dispensary is
also used by the Hospital as a channel for furnishing the various reports sent to the County
Councils concerning in-patients who come under their scheme for the institutional treatment
of Tuberculosis.
Patients referred to the dispensary from the out-patient department of the Hospital
are put in touch with the Tuberculosis Offier of their district and arrangements for their
removal to sanatoria, etc., thus facilitated.
Special mention must be made of the help given by the Tuberculosis Care Committee,
and the organisation which it represents, in the amelioration of home conditions and in
assisting the families of those who have gone to sanatoria, and in other matters, which,
though not strictly medical, are of the greatest importance in treatment.
All patients attending the dispensary are visited periodically by the dispensary nurse
and reports made.
Every effort has been made, through the agency of the dispensary nurse and otherwise,
to get into touch with contacts; but in this matter considerable difficulty has been
experienced, not only in securing primary examination, but in following the subsequent
history of the individuals concerned.
The arrangements under the heading of General Supervision, include :—
1. Periodic examination at the dispensary, when advice is given as to mode of
life and prevention of infection.
2. The supply of medicine to non-insured patients.
3. The supervision of home conditions by the dispensary nurse.
Treatment of Tuberculosis in Sanatoria and Hospitals.
All cases recommended for institutional treatment are dealt with by the London
County Council. Patients admitted to sanatoria are usually early or moderately early cases,
and there is little or no delay in their admission.
For advanced cases the accommodation is not so adequate, and it is regrettable that
the number of these who have been refused admission has increased during the past few
years. This is a grave defect, which should be promptly remedied, for these advanced and
generally highly infectious cases constitute a serious risk to others, especially children, living
under the conditions of close contact so prevalent at the present time.
A number of these advanced cases are referred to poor law institutions. Some
patients decline to accept this form of accommodation, and for these we endeavour to find
vacancies in homes for the dying or other similar institutions. Failing this, these cases must
remain at home.