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63
Tuberculosis.
This is the only notifiable infectious disease that does
not wholly come under the direct control of the local
Medical Officer of Health. From a Public Health aspect
the wisdom of this dual control is doubtful. In Bromley
we endeavour with some success to overcome this duplication;
primarily by the co-operation of the Tuberculosis
Officer, Dr. W. B. Martin, who attends the Bromley Dispensary
every week, and secondly by having one of our
Health Visitors to act us Dispensary Nurse and Tuberculosis
Visitor.
All notified cases are first visited by the Sanitary Inspector,
who makes the initial enquiry with regard to
housing conditions, source of infection, disinfection, etc.,
and the case is then visited regularly by the Tuberculosis
Nurse. We thus endeavour to carry out the advice given
in Circular 1107 issued in 1930. Nevertheless one feels the
lack of success in dealing with this infectious disease.
One person in every 125 of the population in
Bromley is on the register of Tubercular patients, and
knowing this one must realise that every possible effort
is needed to combat such an insidious infection. One can
now definitely say that in Bromley, with increased consumption
of pasteurised milk, that the milk infection has
practically been eliminated. Meat inspection shows that
5 per cent. of meat condemned was due to Tubercular infection,
and as now more than 91 per cent. of all meat is
inspected at slaughter, one can again eliminate this source
of infection. We are thus in Bromley left with the personal
factor as the main source of infection.
There is no doubt that Tuberculosis is a "family"
disease. The close contact of the family, especially of the
young baby of Tuberculosis parents, must indicate the main
line of attack, if one would lessen the incidence of disease
among our people. The following up of all contacts, and
the skilled and regular examination of all contacts should
be the main function of the Tuberculosis Dispensary and
its staff. Every infected and infectious person should
undergo a course of sanatorium treatment in order to learn
the practical methods of the safe mode of life to be adopted
by a tubercular patient, and be taught that close contact