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18
Venereal
diseases.
Tuberculosis,
Particulars of the Council's scheme for the treatment of venereal disease are given later
in Chapter XXV.
The Council's scheme for the treatment of tuberculosis is described later in Chapter XXV.
Details of treatment, etc., are as follows:—
The number of beds occupied in the winter season is always below the number occupied in the
summer season. The average bed occupation for the year is approximately equal to the figure provided
in the estimates, viz., 2,550. The total number of beds actually in use on 31st December, 1921, was as
follows:- Adults.
Metropolitan
Voluntary
Institutions.
Asylums Board
Insured.
Ex-service.
Uninsured.
Children.
Total.
Total
240 209 86 460 995
487 221 139 209 1,056
727 430 225 669 2,051
Dr. Bards-
well's Report
Residential
treatment of
adults
suffering
from
pulmonary
tuberculosis
First applications for treatment were received from—males (ex-Service men), 892 ; civilians,
1,765; females, 1,846 ; total 4,403. Applications for further treatment were received from—males
(ex-Service men), 443 ; civilians, 241 ; females, 182 ; total 846.
Of this total of 5,269 applications, 770, for various reasons were not proceeded with. Some
applicants preferred to make their own arrangements, others proved unsuitable, some were found not
to be suffering from tuberculosis, and others again were not London cases. The latter group were referred
to their own authorities. A considerable number of the patients (1,636 in all) were sent direct to
various institutions, without passing through observation beds. This group is made up largely of the
surgical cases for which no observation beds are available, and advanced cases, as to the best disposal
of which there was no doubt. The remaining applications, 2,863 in number, were passed through the
Council's observation beds. A stay of a few weeks in these beds allowed the exact condition of the
patients to be ascertained and the most suitable form of treatment to be determined.
As already noted, a large number of cases of advanced disease were sent direct to institutions.
The 2,863 observed include, therefore, the more favourable cases dealt with during the year. As a result
of the observation, pulmonary tuberculosis was not confirmed in 434 cases, and confirmed in 2,429. The
classification of the 2,429 tuberculous cases (including 12 surgical cases) was as follows:—
Group A 478 cases or 19.7 per cent. Group B. 2 .. 1,093 cases or 44.9 per cent.
,, B. 1 .. 331 „ ,, 13.6 per cent. „ B. 3 515 ,, ,, 21.2percent.
Thus of the total number observed, 809, or some 34 per cent, only, were "early cases"—the
"true sanatorium case." The moderately advanced group accounted for 45 per cent. Many patients
of this class were capable of substantial immediate benefit.
The disposal of the 2,429 observed cases was as follows :—
Further institutional treatment not needed 247 Transferred to training centres 3
Made their own arrangements for treatment 170 Died during observation 82
Transferred to institutions for advanced cases 195 Discharged for misconduct. 11
Elected to go to infirmaries 32 Transferred to sanatoriums 1,677
Transferred to surgical hospitals 12
Total 2,429
With respect to the distribution of the 1,677 patients sent to sanatoriums, the most favourable
cases—Groups A and B 1, were sent to Frimley (183), The Downs—M.A.B. (100), Pinewood—M.A.B.
(95), Winchmore Hill—M.A.B. (59), Great Baddow (34), Hermitage (28), Grosvenor (45), etc. The
moderately advanced cases were sent chiefly to—The Downs (M.A.B.) (342), Winchmore-hill—
M.A.B. (159), Pinewood—M.A.B. (62), Frimley (66), Great Baddow (67), Hermitage, Isle of Wight
(54) etc.

Included in this table are a considerable number of cases which, admitted for observation, were
subsequently retained for special treatment, such as artificial pneumothorax, operative measures, etc.
From time to time, also, patients after having been graded and marked out for disposal, had to be
retained owing to the sanatorium accommodation being fully occupied. Incidentally, it may be stated
that the observation beds arrangements have worked most satisfactorily.
Results of
sanatorium
treatment.
The results of sanatorium treatment are shown in the next table.
Attention is drawn to the definition of the terms expressing these results, namely :—
Q. Quiescent—i.e., no symptoms of tuberculosis and no signs of tuberculosis except such
as are compatible with a completely healed lesion and in which sputum if present is free from
tubercle bacilli.
M.I. Much Improved—i.e., the condition is not quiescent, but (1) the general health is
good; (2) working capacity is more or less restored ; (3) the signs and symptoms of tuberculosis
are materially diminished.
N.M.I. No material improvement.
Quiescent and Much Improved represent a highly satisfactory response to treatment. Of the
early cases, some 50 per cent, were discharged in these two categories, and of the moderately advanced
cases, 30 per cent.