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Artificial Pneumothorax.—Artificial pneumothorax treatment has been used again
during the year. Artificial pneumothorax was induced in three cases and 144 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.
Seventy-six homes have been visited, and 637* 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. For this purpose 88 nursing visits
were made.
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.
(v.) 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.
(vi.) Considerable use is made of X-rays from the point of view of diagnosis and decision
as to method of treatment to be recommended. The usual methods of treatment
have been continued in the Dispensary. Tuberculin has been used in a few cases. In addition,
18 cases of pulmonary tuberculosis are attending for the continuation of their treatment
by artificial pneumothorax and inductions of the treatment have been performed
in several cases in the wards of the Hospital.
(vii.) Experience shows that when the disease is active, residence in an institution
more quickly and certainly brings about arrest than when the 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.
(viii.) 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 dentures
for necessitous cases.
(ix.) 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 about £31 has been expended.
(x.) 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 for as pulmonary cases. The
Corporation supplies surgical apparatus free of cost for necessitous residents in the City.
(xi.) The arrangements for " care " and " after-care " are carried out by a subcommittee
of the Sanitary Committee, on which two ladies are co-opted as members.† It
receives detailed reports on all cases of Tuberculosis occurring among City residents.
* It will be apparent that the number of visits paid by the Tuberculosis Nurse in 1930 are considerably higher than in previous years. This is
accounted for by the fact that during the early part of 1930 a Locum Tenens was appointed in consequence of the illness of the Tuberculosis Nurse,
and this Officer, in order to make herself acquainted, with as little delay as possible, with the City Patients, concentrated on home visitations. On
the Nurse's return to duty, a further concentration was made on visits in order to pick up the work again.
† The present lady members of the Committee are Lady Cooper, O.B.E., Miss Crosby, M.B.E., and Lady Smith.