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majority are not in a position to compete with healthy labour, and
in order to make their work self-sufficient some form of endowment
or protection is necessary. Sickness benefit under the National
Health Insurance Act for Tubercular persons could serve as a form
of subsidy and, in those medically certified as fit to do work of some
kind, should be given conditionally on the patient endeavouring to
do suitable work. A modification on these lines would act as an
encouragement towards the formation of after-care occupation
schemes such as is being carried out, to a limited extent, in Croydon.
It is gradually becoming recognised that Sanatorium treatment
of Pulmonary Tuberculosis requires to be supplemented by other
methods of treatment. These include artificial pneumo-thorax
treatment, i.e., the collapse of the diseased lung or the part of the
lung that is diseased, cauterisation of adhesions, phrenic avulsion
and thoraco-plasty, either partial or complete. Eventually it will
probably be necessary to have a Surgeon who has specialised in
thoracic surgery as a Consultant on the staff of every sanatorium.
The Tuberculosis Dispensary and Home Visiting.
Tables LXY. and LXXIY. give a summary of the work done in
connection with the dispensary. Ninety-five notified cases were
examined for the first time and 276 were sent for an opinion. Five
hundred and ninety-three contacts were examined, of whom 15 were
pronounced tubercular. This is an important preventive measure,
and it is regretable that so few contacts avail themselves of the
facility. Patients attending the Dispensary made 5,520 visits during
the year. One hundred and ninety-four were on Domiciliary
treatment. The Tuberculosis Officer paid 308 home visits, and the
health visitors or nurses 4,170 visits for Dispensary purposes. In
addition the district health visitors made 1,069 visits for the purpose
°f the Notification register. Patients requiring home nursing or
surgical dressings are attended T» by nurses from the Croydon
Nursing Service, by arrangement with that organisation.
The number of contacts examined and the number of patients
visited in their homes by the Tuberculosis Officer shew a decided
nicrene over those for 1930. Next year will shew a considerable
falling of in both these branches of the Dispensary's activities
owing to the absence of any help from other members of the medical
staff in consequence of the reduction in the medical staff under the
economy measures it has been found necessary to introduce. As
mentioned previously contact examinations are held to be essentially
inventive and play an important role in any Tuberculosis scheme.