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"Including the 'contacts' examined at home, 723 persons in relation to
patients were examined, and of these 420 were found to be healthy, 290 infected
with tuberculosis of the lung, and 13 with other forms of the disease. In all 41.9
per cent. were found to be infected. Of considerable interest, however, is the relation
of the amount of infection to the actual conditions under which the patients are living.
An analysis of the figures indicates that it is exposure to infection plus that lowered
general resistance to disease which is the usual concomitant of advanced disease in
the working classes to their dependents, which is the determining factor of infection
rather than any seeds of disease implanted before birth. Of our original patients,
some were infectious, having the tubercle bacillus in the sputum, while others were
non-infectious at the time, since no tubercle bacilli were found. In the families of
those in an infectious stage of the disease, 60 per cent. were infected with tuberculosis.
In the families of non-infectious patients 75.5 per cent. were found to be healthy.
" In compliance with your wishes, I have notified you of all cases of the disease,
whether they be in an infectious stage or not. In this way alone is it possible to
approximate the actual amount of tuberculous infection in this Borough. Moreover,
my experience here has led me to believe that many cases may pass
to the normal limits of life without knowing they were ill, but having a
definite history of periods of infectivity, so that many other persons succumbed to
infection. During the present year, I hope to investigate some of these 'carrier
cases,' which are of considerable importance to the public health.
"During the past year the Medical Officer paid 1,318 visits to the patients in their
own homes, and the Nurse paid 2,813 visits. In conclusion I would like to express
the appreciation of the staff here, for the very great assistance we have received from
the Public Health Department."
Work of the Voluntary Health Visitors. The voluntary workers of the St.
Marylebone Health Society follow lines practically similar to those of the women
inspectors.
Several of these ladies in addition to co-operating with the Public Health
Department pay a certain number of visits to patients who are under treatment at the
Dispensary.
The number paid on behalf of this Department was 482 and the work done was
greatly to the advantage of the patients, many of whom were put in the way of getting
Sanatorium and other treatment and also relief where this was necessary, the
co-operation between the Society and Charitable Organizations in the Borough being
very close.
Sanatorium and hospital accommodation. The following statement is introduced
by the directions of the Local Government Board. Up to the present no provision
has been made by the Council, entire reliance being placed upon the charitable agencies
and the Board of Guardians to supply the needs of patients in this respect.