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counteracted by the benefit to the patient himself, inasmuch as he is being treateu
in better surroundings, especially as regards atmosphere. The hospital stands
in an open space, and is not hemmed in by other buildings nearly to the same
extent as other infirmaries and general hospitals. In no part of St. Marylebone
except Regent's Park, and perhaps St. John's Wood, could the hospital enjoy
such open environment as it does in its present position. Visitors must be struck,
especially on a fine day, with the rows of cots in the spaces between the pavilions
full of infants basking in the sun, and the beds on the balconies containing adults
suffering from consumption.
" Few, if any, of the other hospitals can provide this for the inmates. The
large and airy wards with which the building is supplied tend to disperse the
gloominess of illness so obvious in the hospitals in the more crowded parts of
the metropolis.
" Since my appointment to the hospital I have been able to observe the kind
of case of tuberculosis which seeks refuge in its wards, and regret to find it is
the more advanced case which is beyond sanatorium treatment, and for which
little can be done except to relieve the more distressing symptoms as they arise,
and thus mitigate the sufferings of the patient approaching the end.
" If possible, it would be an advantage if one could persuade patients waiting
admission to a sanatorium to commence treatment at the hospital, but as a rule
they will not, in the earlier stages of the disease, generally not feeling sufficiently
ill to believe hospital treatment necessary. Further, of course, it is a disadvantage
for an early case to be in the same ward with the advanced cases, since the
association is apt to produce a gloomy outlook on the personal condition instead
of an optimistic view and a feeling that the patient himself is going to get
better. This being so, one feels that it would be a great advantage if arrangements
for keeping the cases separate could be made, the ward for the advanced
cases being distinct and apart from that for the early or less advanced cases.
" Recently there has been installed an X-ray apparatus, which is now in full
working order, and which adds to the equipment, especially for the diagnosis of
tuberculosis.
"It is pleasing to know also that one can give patients, as they are continually
under the supervision of the resident physician and the sister of the ward, the
advantage of new forms of treatment, a thing it is impossible to do in the dispensary,
where continual observation cannot, of course, be maintained. One has
hopes of testing the efficacy of more modern treatment under very much better
conditions than hitherto.
"In my opinion, the people of the borough of St. Marylebone should be thankful
that they have such an excellent institution to which they can be admitted so
easily, and where they can be treated so well. Most of all, I think, the unfortunate
sufferers from tuberculosis are to be congratulated, and feel sure that as
time goes on the hospital will be more used by these to their own and the general
advantage."
Bacteriological Diagnosis of Consumption.—The number of specimens of
expectoration sent by medical men for bacteriological examination, from cases in
which there was some doubt as to the diagnosis, was 655, as against 413 in 1923.
Of these, 105 were found to contain the bacillus of consumption, while the remainder
were free.
Non-Pulmonary Tuberculosis.—The great bulk of the total notifications—46,
as against 34 in 1923—in the case of this form of tuberculosis came from institutions
where the patients were undergoing treatment. -Visits were paid to the
homes and, where necessary, advice with regard to the obtaining of treatment was
offered.
Particulars as to the parts affected by the disease w ill be found in the table
on page 52.