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On diagnosis these patients are informed that they can be treated and advised
at the Dispensary or transferred to the Tuberculosis Officer of their own Borough.
The majority decide to remain patients at the Dispensary. The number so treated
was 67.
(b) Who do not work in the City.
On diagnosis these patients are transferred to the Tuberculosis Officer of
their own Borough, so none are treated here.
TOTAL ATTENDANTE—
Insured. Non-Insured. Total.
Residents 288 517 805
Non-Residents 650 626 1,276
2,081
THE TUBERCULOSIS NURSE.—The work of the Tuberculosis Nurse has
been continued on the same lines as former years. 72 homes have been visited
and 591 visits made in connection with after care and following up. In addition
to the above, patients, some of whom were in an advanced stage of the disease,
have been nursed in their own homes. Three of these cases terminated fatally.
For nursing purposes 15 visits were paid. (These figures are lower than usual as
the official Tuberculosis Nurse was away on sick leave for three months and in
addition no cases at home needed daily visits over long periods).
The following information is supplied in accordance with the requirements of
the Ministry of Health. The paragraph numbers correspond with those in Circular
168, and where a number is omitted the subject matter does not concern City work:-
(i.) The Tuberculosis Dispensary is at St. Bartholomew's Hospital; the Tuberculosis
Officer is Dr. F. H. Young, O.B.F. ; one Tuberculosis Nurse is engaged in the work. Treatment
in residential institutions is provided for insured and uninsured persons by the London
County Council.
(iii.) Patients are referred to the Tuberculosis Dispensary from hospitals, school clinics
and other institutions, with all of which there is close co-operation.
The services of the Staff and all the resources of St. Bartholomew's Hospital are available
for diagnosis and treatment. Many patients are referred to departments of the Hospital
for these purposes.
(iv.) The Tuberculosis Officer is in constant consultation and communication with
general practitioners, so that there is close co-operation between them and the Dispensary.
He reminds them when reports are due on insured patients under domiciliary treatment
and provides them with copies of the form with names and addresses inserted.
(v.) When the diagnosis is in doubt and the patient is under the care of a practitioner,
arrangements are made with him for re-examination ; in other cases arrangements are made
with the patient, but should he fail to attend, either the Tuberculosis Nurse calls upon him
or he is reminded of the appointment in writing.
(vi.) The Tuberculosis Officer explains to the patients the importance of the examination
of home contacts, and in addition to the necessary visits of the Sanitary Inspectors the
Tuberculosis Nurse visits the homes of City residents periodically for the same purpose,
and arranges for the attendance of the contacts at the Dispensary at times convenient to them.
The supervision of these contacts and the re-examination of suspects among them, is
secured by the home visits periodically made by the Nurse.
(vii.) X-ray photographs of 42 patients have been taken during the year, and have
proved of value as an addition to the usual methods of diagnosis.
The usual methods of treatment have been continued in the Dispensary. Tuberculin
has been used in a few cases. In addition, two cases of pulmonary tuberculosis are attending
for the continuation of their treatment by artificial pneumothorax. It is hoped to use this
very promising method of treatment in suitable cases as they arise.
(viii.) Experience shows that when the disease is active, residence in an institution
more quickly and certainly brings about arrest than when treatment is attempted at home
on sanatorium lines, and that the lessons learnt in the sanatorium are sometimes put into
practice by the patient on his return home to his permanent advantage.
(ix.) Dental treatment is provided by the Dental Department of St. Bartholomew's
Hospital, and the Corporation defrays the whole or part of the cost of artificial dentuies
. for necessitous cases.
(x.) Nursing in their own homes of patients resident in the City is one of the duties
of the Tuberculosis Nurse. Milk has been provided for necessitous persons requiring extra
nourishment and in this connection the sum of £20 has been expended.
(xi.) Patients suffering from Non-pulmonary Tuberculosis receive advice and treatment
from the Surgeons of St. Bartholomew's Hospital, to whom they are referred from the
Dispensary. Treatment in residential institutions is provided as for pulmonary cases. The
Corporation supplies surgical apparatus free of cost for necessitous residents in the City.