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Persons neither resident nor working in the City are usually transferred immediately to their
own Tuberculosis Officer, and subsequent arrangements are made by him. This system has
worked satisfactorily.
Persons Treated and Supervised at the Dispensary:—(A) Patients resident in the City.
All persons suffering from Tuberculosis who are resident in the City may be supervised and
treated at the Dispensary. The total number of cases so treated was 79.
In addition, a large number of contacts are kept under observation.
(B) Patients non-resident in the City.
(a) Who work in the City.
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.
(b) Who do not work in the City.
On diagnosis, these patients are usually transferred to the Tuberculosis Officer of
their own Borough. The total number of cases so transferred was 141.
Total Attendances:- Insured. Non-Insured. Total.
Residents 185 177 362
Non-Residents 567 607 1,174
1,536
This number shows a decrease as compared with last year. This is owing to the fact
that a number of chronic cases had to visit the Dispensary frequently, and now have moved
outside the City area, owing to the demolition of the Hutchison Avenue area property.
In view of the fact that the cases in the last stages of the disease are extremely infectious,
especially in crowded houses, the Corporation have made arrangements to pay for the maintenance
of selected City cases at St. Columba's Hospital, Swiss Cottage. Two such cases
were admitted in 1928.
Artificial Pneumothorax.—Artificial pneumothorax treatment has been used to a larger
extent during the year. Artificial pneumothorax was induced in one case, and 230 Refills
done in connection with the Dispensary.
The Tuberculosis Nurse.—As an adjunct to the work at the Tuberculosis Clinic, the
outside work of the Tuberculosis Nurse has been continued on the same lines as former years.
Fifty-one homes have been visited, and 233 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. One of these cases terminated fatally.
For nursing purposes, 53 visits were paid. The number of visits in connection with aftercare
has diminished in a similar way to the attendances. The Hutchison Avenue Area
contained a number of houses of a very bad type, tenanted by people who, by only constant
visiting, would be persuaded to obey the ordinary rules of hygiene.
General.—The following information is supplied in accordance with the requirements
of the Ministry of Health:—
(i.) The Tuberculosis Dispensary is at St. Bartholomew's Hospital; the Tuberculosis
Officer is Dr. F. H. Young, O.B.E.; one Tuberculosis Nurse is engaged in the work. Treatment
in residential institutions is provided for insured and uninsured persons by the London
County Council.
(ii.) 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.
(iii.) 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.
(iv.) 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.