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74
The Chest Clinic and Home Visiting.
It would appear that we have concentrated too much on the
results of sanatorium treatment and too little on the methods of
domiciliary and dispensary care, accompanied by adequate
environmental hygiene. The tuberculosis scheme has probably
come to depend too much upon residential institutions and too
little on the building up of personal resistance in the home surroundings.
The subjoined table gives a summary of the work done in
connection with the Clinic.
967 new cases were examined during the year. This is
equal to 912 for each 100 deaths from the disease. 218 or 206
for each 100 deaths were found to be definitely tuberculous.
The total number of attendances at the Clinic was 8,865. The
Tuberculosis Officer paid 156 home visits and the District Health
Visitors 1,864 visits for Clinic purposes. In addition, the Health
Visitors made 459 primary visits for the purpose of the Notification
Register.
The Tuberculosis Officers paid 150 visits to Mayday Hospital
in a consultative capacity, and there examined 865 patients.
Patients requiring home nursing or surgical dressings are
attended to by the nurses from the Croydon Nursing Service, by
arrangement with that organisation, and 508 such visits were
made during the year. Their assistance is a valuable adjunct in
the care of domiciliary cases.
Contact Examination.
The contacts of definite cases are urged to attend the
Clinic for examination (and subsequent supervision). This is an
important preventive measure. During the year 350 contacts
were examined, equal to 330 for each 100 deaths, compared with
294 in 1946, 153 in 1945, 181 in 1944, 267 in 1943, 238 in 1942,
227 in 1941, 278 in 1940, 325 in 1939, and 301 in 1938. Of these,
10 were considered to be tuberculous. This is equal to a tuberculosis
rate per 1,000 contacts of 28.5 compared with 1.46 per
1,000 of the general population.
474 appointments for examination were offered to new contacts
during 1947, but only 350 new contacts attended and were
examined.