London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Paddington 1924
[Report of the Medical Officer of Health for Paddington]
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27
The Arrangements for Co-operation of Medical Practitioners, and the working of the arrangements
set out in Mem. 286 have not worked very successfully up till now. Many forms have been sent
out to doctors, but very few are returned unless constantly written for. Also from the patient's
point of view, " He objects to being bothered." Consultations are willingly held, but the forms
seem to be ignored.
Cases in which the Diagnosis is Doubtful, who cease to attend before the diagnosis is completed,
are followed up by the sister with a view to clearing the register.
Home Contacts.—So far we have found the examination and supervision of home contacts fairly
simple, the patients and their relatives falling in with the wishes of the Tuberculosis Officer willingly.
Special Methods as to Diagnosis and Treatment.—X-rays, Complement Fixation tests, bactericidal
and serological tests, inoculation into guinea-pigs are special methods used in diagnosis. In treatment
Tuberculin (B.E.), secondary vaccines, X-rays, artificial sunlight, induction of artificial pneumothorax
are all exploited in suitable cases. In this connection very valuable help is given to us by
the Inoculation Department in lending the Tuberculosis Officer beds when required for such cases.
Sanocrysin was used in one case during the year, which is doing well now, though the treatment was
very strenuous and apparently dangerous at first.
In the Treatment of Non-pulmonary Tuberculosis special apparatus has been installed in the
dispensary for the making of spinal jackets, hip-plasters, etc. Beds are often required for these
cases, and are lent through the courtesy of the Inoculation Department as before mentioned. The
patients are afterwards transferred as a rule to Lowestoft or Margate by the L.C.C.
Splints and other surgical requirements can usually be obtained through the lady almoner.
A Light Department was started a year ago and much good work has been done in the surgical
cases both in improving the general condition of the patients and in the treatment of ulcers, sinuses,
lupus, etc.
Incidence of Tuberculosis locally.—In this district no special occupational incidence of Tuberculosis
is noted, except the general one that the indoor and sedentary worker is more liable. It has
been observed that many of the cases reside in basements, and also that further cases are not uncommon
in the same rooms even after disinfection having been carried out, new tenants have come in.
The Tuberculous Mother.—Six cases of pregnant women were admitted into the maternity wards
of St. Mary's Hospital for their confinements during the year.
R eturn as to W ork carried out in connection with the S t. M ary's H ospital T uberculosis D ispensary for the Y ear 1924.
(The return relates only to persons residing in the area which is served by the Dispensary.)
| Number of | Under observation at the Dispensary on Jan. 1st pending diagnosis. | Examined for the first time during the year. | Total. | Found to be | Under observation at the Dispensary on Dec. 31st pending diagnosis. | Ceased attendance before completion of diagnosis. | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Suffering from Tuberculosis. | Not suffering from Tuberculosis. | |||||||||||
| Pulmonary. | Non-Pulmonary. | |||||||||||
| (a) All persons (including "Contacts") | Adults. | M. | 3 | 68 | 71 | 24 | 8 | 38 | 1 | – | ||
| F. | 10 | 95 | 105 | 14 | 9 | 76 | 5 | 1 | ||||
| Children under 15. | M. | 3 | 69 | 72 | 1 | 10 | 56 | 5 | — | |||
| F. | 5 | 37 | 42 | – | 3 | 36 | 3 | — | ||||
| Total | 51 | 269 | 290 | 39 | 30 | 206 | 14 | 1 | ||||
| (6) "Contacts" included in (a) | Adults. | M. | – | 17 | 17 | – | – | 16 | 1 | – | ||
| F. | 2 | 35 | 37 | — | — | 35 | 2 | – | ||||
| Children under 15. | M. | 2 | 40 | 42 | — | 2 | 40 | — | – | |||
| F. | 2 | 26 | 28 | – | 3 | 23 | 2 | – | ||||
| (c) Insured persons (included in (a) ) | M. | 2 | 51 | 53 | 19 | 6 | 27 | 1 | – | |||
| F | 5 | 26 | 31 | 5 | 5 | 19 | 2 | — | ||||
| j. Number of patients under treatment or supervision (excluding persons under observation or domiciliary treatment) on the 31st December* | 262 | 6. Number of reports received from Insurance Practitioners in respect of insured patients under domiciliary treatment during the year | 21 | |||||||||
| 2. Total number of attendances of patients at the Dispensary during the year | Insured | 1,901 | 7. Number of persons referred to affiliated hospital for consultation | 76 | ||||||||
| Uninsured | 3,116 | 8. Number of consultations with medical practitioners at the homes of patients | Insured | 3 | ||||||||
| 3. Number of persons placed during the year under observation at the Dispensary for the purpose of diagnosis | 63 | Uninsured | 2 | |||||||||
| 9. Number of other visits paid by Tuberculosis Officer to the homes of patients | 120 | |||||||||||
| 4. Number of cases in which the period of observation at the Dispensary exceeded two months | 18 | 10. Number of visits paid by Nurses or Health Visitors to the homes of patients for dispensary purposes | 1,477 | |||||||||
| 5. Number of insured patients under domiciliary treatment on December 31st† | 12 | 11. Number of specimens of sputum examined in connection with the work of the Dispensary | 115 | |||||||||
* Insured persons under domiciliary treatment by Insurance practitioners are excluded, even though they may attend the
dispensary at intervals for examination or consultation. Such cases are included under Head 5.
f All insured persons in the dispensary area who are actually receiving domiciliary treatment from Insurance practitioners
are included, irrespective of the date upon which they were placed under domiciliary treatment and of any attendance
at the dispensary.