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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 One case was
admitted in 1934
During past years a certain amount of difficulty has arisen in connection with the
residential treatment of cases who were residing at the place at which they were employed,
when diagnosed as having pulmonary tuberculosis In order to meet this, the Corporation
have made an arrangement with the Brompton Hospital whereby urgent cases can be
admitted within 48 hours under Dr Young's personal care, under a Certificate from the
Medical Officer of Health Two cases have been admitted under this scheme during the year
Artificial Pneumothorax—Artificial pneumothorax treatment has been used again
during the year Artificial pneumothorax refills were done in 23 City and 275 non-City
patients, in connection with the Dispensary
The Tuberculosis Sister—As an adjunct to the work at the Tuberculosis Clinic, the
outside work of the Tuberculosis Sister has been continued on the same lines as former years
Sixty homes have been visited, and 184 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 4 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 OBE ; one Tuberculosis Sister 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 Sister 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 sister 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 Sister
(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,
4 City and 24 non-City cases of pulmonary tuberculosis attended 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