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Both these cases are progressing slowly but satisfactorily. A third case, however,
was cured after nine months' treatment by Finsen light.
The total number of attendances for Finsen light chargeable to the Dispensary
during 1938 was 81 and for general arc-light in lupus cases 146. The charge per
attendance for Finsen light is 5s. and for general arc-light Is.
Ear, Nose and Throat Cases.—Laryngitis is one of the most serious and distressing
complications of pulmonary disease. Eleven cases were referred during the year to
Mr. A. M. Zamora, F.R.C.S., consulting laryngologist to the Royal Chest Hospital.
Several of these cases were kept under supervision for a time by Mr. Zamora, whose
advice and assistance are very much appreciated.
Dental Treatment.—Patients are referred to the borough council's dental hospital
unless they prefer to make arrangements for treatment privately. In the case of
tuberculous patients or members of the patient's family, the assessment for payment
(for treatment at the hospital) is made by the tuberculosis care committee, subject
to aproval by the public health committee. A large proportion necessarily receives
treatment free.
Diseases of the Eye.—Tuberculous diseases of the eye, apart from occasional
cases of phlyctenular ulceration, are rarely met with at the dispensary as they usually
go in the first instance to an eye hospital. If they first come under notice at the
dispensary they are usually referred to the Royal London Ophthalmic Hospital.
Surgical Cases.—Patients with tuberculous disease of bones and joints or of the
abdomen usually go in the first instance to the out-patient department of one of the
voluntary general hospitals but a few first come under the notice of the dispensary
through admission to St. Leonard's hospital. They are rarely seen at the dispensary
until after their discharge from sanatorium. After-care in orthopaedic cases is
usually supervised by the surgeon who originally had charge of the case or by one of
the County Council's after-care clinics ; in the latter case they remain under the
supervision of the sanatorium superintendent. In either case the patient is usually
seen also from time to time at the dispensary.
In rare cases supplementary treatment in the way of artificial sunlight is recommended.
One case of a recurrent tuberculous periostitis with sinus was so recommended
early in the year and attended the Royal Chest Hospital for twenty treatments.
The condition cleared up completely and remained well healed at the end of
the year.
Residential treatment for tuberculosis in all forms is ordinarily provided by the
London County Council and the treatment is free.
Boarding-out of child contacts.—When for one reason or another pulmonary cases
with positive sputum have to remain at or return home, it is sometimes advisable—
especially if the home circumstances are poor—to arrange for the boarding-out of