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The use to which the shelters are put has been subject to
periodic inspection by members of the staff.
5.—THE DIAGNOSIS OF TUBERCULOSIS.
(a) General Routine.
378 patients were kept under observation pending definite
diagnosis. 161 of these were adults and 217 children. Diagnosis
is, in particular, difficult in the case of the child, and it is felt wiser
;o keep many doubtful cases under supervision rather than to allow
them on the one hand to lapse or on the other hand to label them
prematurely as tuberculous. The procedure for diagnosis has been
as follows : —
1.—History of the patient.
2.—Physical examination of the patient.
3.—Microscopic examination of the sputum.
4.—A record of the morning and evening temperature
taken over a period of two weeks, and, when necessary, after a
stated amount of physical exercise. This record is made by the
patient, and is frequently most unsatisfactory.
The provision of observation beds,,to which patients can be
admitted for detailed observation, would be of great benefit to the
dispensary. It is hoped that it will be possible to utilise some of
the beds at Cheam Sanatorium for this purpose as soon as the proposed
extension of the accommodation has been completed.
(b) Examination of Sputum.
Specimens of sputum sent in by private practitioners or from
the dispensary are examined at the Borough Hospital Laboratory.
Particulars as to the number examined are given in the paragraph
of this report dealing with the Borough Laboratory.
(c) X-ray Examination.
Patients needing X-ray examination as an aid towards diagnosis
are referred by the Tuberculosis Officer to the X-ray department
at the Croydon General Hospital.
55 patients were referred for such examination during 1923, as
compared with 35 in 1922.