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Group 3.—Cases with profound systemic disturbance or constitutional
deterioration, with marked impairment of function, either local or general,
and with little or no prospect of recovery.
All cases with grave complications {e.g., diabetes, tuberculosis of intestine,
etc.), whether those complications are tuberculous or not, should be
classified in this group.
Group 2.—All cases which cannot be placed in Groups 1 and 3.
IV.—Patients suffering from non-pulmonary tuberculosis should be
classified according to the site of the lesion as follows : —
(1) Tuberculosis of bones and joints.
(2) Abdominal tuberculosis (i.e. tuberculosis of peritoneum, intestines
or mesenteric glands).
(3) Tuberculosis of other organs.
(4) Tuberculosis of peripheral glands.
Patients suffering from multiple lesions should be classified in one subgroup
only, viz., in that applicable to the case which stands highest in the
immediately preceding list.
An important report on Tuberculosis by Dr. A. S. Macnalty of the
Ministry of Health (No. 64) was issued by the Ministry of Health for official
use in the early part of the year.
This report deals in a comprehensive manner with the problem of
Tuberculosis. Certain aspects of this problem do not directly concern the
work for which a Borough Council is responsible, but the following brief
quotations are given as indicating conclusions affecting our work.
The normal principles of Sanatorium treatment are summarised as
follows: —
(1) The diagnosis of pulmonary tuberculosis at an early age.
(2) A proper selection of patients for sanatorium treatment.
(3) Full co-ordination between the tuberculosis officer and the medical
superintendent of the sanatorium.
(4) Correct co-ordination of hospital and sanatorium treatment.
(5) Study of the individual patient bv the medical superintendent of the
sanatorium.
(6) A proper sanatorium regime.
(7) Prolonged duration of stay in the sanatorium.
(8) The ideal to be aimed at is the discharge of the patient with the
disease quiescent and in fit condition to resume an occupation.
Considerable space is given to the discussion of the examination of
contacts. From the examination of statistics obtained from Worcestershire,
the following conclusion is reached : —