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TUBERCULOSIS
Services
provided
the services provided by the Council as local health authority and described in detail
in my report for 1955 for the care and after-care of tuberculous patients and the prevention
of tuberculosis continued to be available during the year. They are summarised
for the years 1952-1956 in Table T.10 (page 33).
Introduction
There were 455 deaths from all forms of tuberculosis in the County and of these 423
were attributable to pulmonary tuberculosis but of the 321 male deaths from this form
of the disease, 272 or 85 per cent. occurred in men over 45 years of age. No death was
recorded for a male person under 25 years of age for the first time on record. The steady
reduction in tuberculosis mortality in recent years has been one of the outstanding
features of health advance.
During the year there were 3,929 fresh notifications, 3,602 of pulmonary tuberculosis,
nearly a third of these being men of 45 years or over. The corresponding figures for 1955
were respectively 4,122 and 3,757 of which 25 per cent. were in respect of men of
45 years or over. The hard core of the tuberculosis problem at the present time persists
in this section of the population. Newly notified disease in middle aged and older men
is not due to fresh infection but to breakdown of existing lung lesions which have been
quiescent and apparently inactive for years. The causes of this type of relapse, so much
more frequent in men than in women, are not clearly recognisable. It is not a feature of
the present generation alone of middle aged men but has been high lighted by the
greater success of modern drug treatment of tuberculosis in young adults.
Persistent infective lung tuberculosis among older men is now the main source of
new infections in the younger members of the population. Unrecognised cases among
men over 40 must be assiduously sought by regular X-ray examination especially among
those who have close contact with children at home.
Home care
Specialist tuberculosis health visitors, who also act as chest clinic nurses, visited patients
in their homes to advise on matters of hygiene, to assess home conditions and needs, and
to persuade contacts to attend the chest clinic. The domiciliary nursing service provided
home nurses to give injections and nursing attention and undertake any other nursing
activities which the family doctor or chest physician requested. Nursing equipment, such
as back rests, air beds, bedpans, sputum flasks, etc., was made available on loan to
patients in need. Patients too ill to make their own way to the local chest clinic for
consultation, X-ray, pneumothorax treatment, etc. were conveyed by ambulance or
sitting-case car provided through the Council's ambulance service.
Home helps employed by the Council performed domestic duties for bed-ridden
patients and assisted in the home care of children whose mothers were undergoing
treatment.
The Council provided extra nourishment (milk, butter, eggs) for necessitous patients
within a prescribed scale of maximum quantities, when recommended by the chest
physician.
Diversional
therapy
During the year handicraft classes continued to be held for tuberculous patients at
several chest clinics. The Council employs trained handicraft instructors for this work
and gives fmancial assistance towards the cost of tools and materials. Instruction is given
in a variety of arts and crafts, e.g. basketry, dressmaking, leather-work, weaving, rug
and toy making. Provision is also made for the instruction by occupational therapists or
home handicraft instructors of home-bound tuberculous patients in some form of
diversional therapy. A patient who wishes to continue a craft learnt while in a sanatorium
is encouraged and enabled to do so. Patients may either retain the articles they
make by paying the cost of materials or, at the discretion of the care committee, offer the
article for sale at a sale of work arranged by the care committee and receive the profit.
The articles are, of course, disinfected before sale.
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