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effective treatment which can be carried out and because of the valuable instruction
the patient usually receives as to personal hygiene and the regulation
of his mode of living in order to build up and maintain his resistance to the
disease. These arrangements are made through the County Council on the
recommendation of the Tuberculosis Officer. Unfortunately economic or
domestic conditions often make it impossible for the patient to accept a sufficient
period of treatment, or in some cases any sanatorium treatment at all.
When tuberculosis is found, leaflets and instruction cards are given to the
patient at the Dispensary, and his family or other immediate contacts are
asked to attend for examination in order that infected cases may be discovered
or cases of debility (predisposing to infection) may be suitably dealt with.
When the patient returns from sanatorium or hospital he is kept under
regular supervision at the Dispensary and, if not already under the care of a
general practitioner, he is given any medicinal treatment that may be
required. Arrangements are made, wherever possible, for infected patients
to sleep separately, and beds and bedding are lent if necessary by the
Borough Council or obtained through other channels. In the rare cases
where there is sufficient room for the erection of open-air shelters these are
also provided by the Council on loan. In necessitous cases extra nourishment
is granted by the Borough Council, or if the patient is receiving relief application
is made to the Public Assistance Committee for special treatment to
be accorded to the patient in view of his condition.
The Tuberculosis Visitors carry out a regular visitation of all notified
cases, giving advice as to sanitary conditions in the home, arranging for the
attendance of contacts, and reporting on the condition of cases unable to
attend the Dispensary.
Special Facilities.
(a) X-ray.—Pulmonary cases are referred to the Royal Chest Hospital
for examination and report. Non-pulmonary cases are sent either to St.
Leonard's Hospital or to the Royal Northern Hospital. Most of the X-ray
examinations are in pulmonary cases, and I should like to specially to mention
the valuable reports supplied by Dr. Kerley.
(b)Artificial Pneumothorax Treatment.—Refills are usually carried out
either at the Royal Chest Hospital or at Victoria Park Hospital, but in a few
cases they are done at other hospitals approved by the London County
Council.
(c) Light Treatment.—Finsen light treatment is provided at the London
Hospital and general artificial sunlight treatment at either the London
Hospital or the Royal Chest Hospital. The former treatment is for cases of
lupus and the latter mainly for surgical cases with sinuses.
(d)Ear, Nose, and Throat Cases.—These are referred to Mr. Zamora at
the Royal Chest Hospital for examination and advice, and I should like to
express special appreciation of the reports received on these cases.