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54
condition. Some of the children have also been treated at the throat and eye
departments.
"The children take a real interest in the gardening which is taught at the
school and the benefit derived is obvious; this will probably be a useful hobby
in later years. One of the former pupils secured a post in the country as a
result of his training in gardening at the school.
Dr.
Bardswell's
report on
after
histories of
adult
tuberculous
patients.
"The fortnight's holiday in the country was a source of great benefit to
the children, 28 of whom were sent away; all of them gained weight."
Reference was made in the report for the year 1923 to investigations which
had been made into the after histories of adult persons treated in residential
institutions for tuberculosis during the years, 1914, 1915 and 1918. The statistics
based upon the information available could only be considered approximate, since
the data had been noted and recorded by many physicians and tuberculosis officers,
who, apart from their varying experience of tuberculosis, used different standards
of classification, and it was recognised that the results could only be regarded as
affording a useful general impression rather than accurately ascertained facts.
Certain modifications which were made in the Council's Tuberculosis Scheme
came into operation in 1921. These included the provision of "observation"
beds, examination of patients by medical officers at County Hall, the use of uniform
method of classification of cases, and a closer personal contact of the Council's
officers with the patients. These factors have resulted in a greater accuracy and
uniformity of records than it has hitherto been possible to attain, and it was
decided, therefore, that it would be more advantageous to investigate these patients'
after-histories rather than to make a further study of those of patients discharged
in the preceding years.
On the new basis of selection of patients for residential treatment the sputum
positive cases (i.e., cases in which tubercle bacilli have been found in the sputum)
are classed separately from sputum negative cases (i.e., cases in which tubercle
bacilli have not been found in the sputum). The last mentioned cases form Class A,
while the sputum positive cases comprise class B. These latter are divided into
three groups according to the severity of disease, viz., group 1, cases with slight
constitutional disturbance (if any) and with obvious signs of limited extent, group
3, cases with profound systematic disturbance or constitutional deterioration, and
all cases with grave complications, and group 2, all cases not falling in groups 1 or
3. This new classification includes under the new groups A and B1 the cases
formerly recorded as "early cases," under the new group B2 the "moderately
advanced " cases, and under B3 the " advanced " cases.
The after-histories of adults discharged from residential institutions during
1921 were traced up to July, 1924, a period ranging from 2½ to 3½ years after the
date of discharge. These cases include the first group of pulmonary cases classified
on the new basis. The number of cases definitely diagnosed as pulmonary tuberculosis
was 3,060.

The results of this further enquiry again demonstrate the great importance
of treatment of tuberculosis being provided as early as possible after the onset of
the disease. Efforts have been made with a view to securing earlier "notification"
of cases, thus enabling more prompt provision of treatment.
Voluntary
care
committees.
In the Interim Report of the Departmental Committee on Tuberculosis, 1912,
the opinion was expressed that the effectiveness of the work of tuberculosis dispensaries
could be greatly increased by the organisation of voluntary care committees