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57
REPORT BY Dr. C. K. CULLEN, TUBERCULOSIS OFFICER.
The heavy increase noted in last year's report with regard to most aspects of
the Dispensary work has happily been checked a little during 1934, though the
figures have not yet fallen back to the 1932 level.
Whilst the economic problems of many of our patients have been eased a little
by the somewhat more generous scale of relief allowed by the Public Assistance
Committees and by the abolition of assessments towards the cost of treatment, the
general picture remains much the same, and the comments made in last year's report
call for no substantial modification. In particular, the problem of securing proper
housing accommodation for the majority of our patients remains unsolved. For those
few families whose employment and financial resources permit them to live outside
London applications to the County Council for re-housing have met with more
success. Most of our patients however are compelled to remain in surroundings which
present a serious barrier to recovery.
Though the use of the County Council's General Hospitals for initial treatment
of tuberculosis appears to have decreased during the past year, I am of the opinion
that too many patients are sent back to London for continuation of their treatment
in these hospitals when their condition has become stationary elsewhere. It is a
curious fact that many of these patients gain weight and improve in other ways in
spite of the environment of a thickly populated district such as Shoreditch and the
smoky atmosphere of London. This is possibly due to a change in dietary coupled
with a period of complete rest in bed. It suggests, however, that a pessimistic view
of the patient's chances of further improvement is too often taken in certain
sanatoria and a transfer to some other sanatorium outside London would probably
bring greater benefit in such cases.
The appointment of Tuberculosis Officers to act as Tuberculosis consultants in
the General Hospitals has been extended by the London County Council for a further
period and I have continued to visit the Tuberculosis wards of St. Leonard's Hospital
fortnightly during the year.
Special Facilities.
Radiological work.—Pulmonary cases are referred to the Royal Chest Hospital
and Dr. Peter Kerley's reports continue to be of very great assistance. Nonpulmonary
cases are usually under the care and supervision of a surgeon at a general
hospital and any X-ray examination required is usually carried out at the hospital
concerned; when this is not the case, the patient is referred either to St. Leonard's
Hospital or the Royal Northern Hospital for examination and report. Artificial
Pneumothorax Treatment.—Refills are usually carried out, by arrangement through
the Dispensary, at one or other of the Chest Hospitals, most of them at the Royal
Chest Hospital. When desirable, arrangements can be made for the attendance of
patients for this purpose at Grove Park Hospital or Colindale Hospital through the