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according to their means. When extractions are required, the usual practicc is to avoid too
extensive extractions at each sitting, and to spread the work done over as long a period as
possible, aiming at getting the mouth clear of diseased teeth before admission to Sanatorium,
the dentures being fitted and supplied on their return.
Special treatment.—Artificial Sunlight and Finsen Light Treatment can be obtained at
the London Hospital. Artificial Pneumothorax cases are sent to Brompton Hospital. Cases
with Tuberculosis of the Larynx are referred to the Specialist who attends at 39, Oakley
Square every Saturday morning.
Work outside the Dispensary.—All cases on notification are visited by the Health
Visitor, and at least once by the Tuberculosis Officer. These visits are invaluable in assisting
to control the spread of the disease, and in getting to know the needs ot each patient. Where
possible, patients are encouraged to occupy separate rooms, or at least separate beds, and
bedding and beds are loaned for this purpose by the Borough Council to necessitous cases.
Extra milk and eggs are supplied by the Borough Council on the recommendation of the
Tuberculosis Officer, and Invalid Dinners can be supplied to those who are at a convenient
distance to the Invalid Kitchen, 20b, Seymour Street.
Outside assistance can be obtained for many necessitous patients from the various
Charitable Associations.
Contact cases are encouraged to attend at the Dispensary for examination, and if the
original patient has a positive sputum, they are examined periodically. School children
contacts are seen at the Dispensary, and a report sent to the School Medical Officer classifying
them:—
(1) An unsatisfactory child whether contact or not.
(2) An apparently healthy contact.
(3) A contact that has not been examined.
Children who are contacts of cases who have positive sputums can be boarded out under
the London County Council Scheme. This means of prevention of the spread of the disease
has been found most helpful, and could be usefully extended to embrace delicate children of
parents with Pulmonary Tuberculosis whose sputums are negative. Delicate children can be
recommended for Open-air Schools. These schools are found most helpful, and could be
increased in number and size.
Patients who return from Sanatorium fit for light work are referred to the Local
Labour Exchanges for special consideration in accordance with the scheme for Employment
of Tuberculous Persons instituted in June, 1925.
Sanatorium and Hospital Treatment.
All eases recommended for institutional treatment are dealt with by the London
County Council, which is the authority for the purpose for the Metropolis.
The accommodation for advanced cases, to which attention was directed a year ago,
still remains inadequate. Such cases are usually the most dangerous from the point of view
of infection, and the position cannot be regarded as satisfactory until institutional accommodation
is available for every such patient who is willing to accept it.
The following table gives the number of eases of pulmonary tuberculosis notified