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(b.) As the arrangements for the treatment of cases of Pulmonary
Tuberculosis are under the management of the Tuberculosis Department of the
Middlesex County Council, subsequent visits are not paid by the Medical Officer of
Health, unless requested by the Tuberculosis Officer of that Authority.
(c.) The arrangements for the detection of unrecognized cases of
Tuberculosis associated with notified cases of the disease are under the direction of
the Tuberculosis Officer of the Middlesex County Council.
(d.) The arrangements made for utilizing the services of the Tuberculosis
Officer or Nurses are as in (c.).
(e) Disinfection is performed when necessary by the Officers of the Hayes
Council. The arrangements made by the County Council of Middlesex for the
visitation and treatment of cases of Pulmonary Tuberculosis (sanitorium and
domiciliary) are working satisfactorily, and, I am of opinion, will in the future tend
to produce a considerable diminution in the number of cases of this dire malady.
F.—INVESTIGATION OF OTHER DISEASES.
Owing to the nature of the subsoil Rheumatism in all its forms has been
very prevalent.
I am of opinion there has been considerable neglect on the part of some of
the occupiers of land in allowing the ditches and watercourses to become silted up;
many of the ditches by the sides of the roads are not properly attended to, which
must contribute to the land becoming waterlogged and to increased dampness in
dwellings, a fertile cause of Rheumatism and Tuberculosis.
Once more I wish to express my sincere thanks to Mr. D. C. Fidler, your
Sanitary Inspector, for his valuable and ready assistance at all times in the
performance of my duties as Custodian of the Public Health.
I am, Gentlemen,
Yours faithfully,
EDWARD J. PARROTT.