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placed on the Borough Councils as the local sanitary authorities. Under these
Regulations, all forms of Tuberculous diseases are to be notified to the Medical
Officer of Health of the district. Until this time persons suffering from Consumption
of the Lungs or Pulmonary Tuberculosis only were to be notified.
There are four different forms on which a case may be notified, Forms
A. B. C. and D. Notifications to be made by medical practitioners may be divided
into two classes which are described for convenience as " Primary" and " Supplemental
Notifications." "Primary Notification" is required of every case of
Tuberculosis unless the practitioner has reasonable grounds for believing that the
case has already been previously recognised and notified as such to the Medical
Officer of Health of the appropriate district. A " Supplemental Notification " is
an additional notification of a case which has been previously notified. Except in
the case of notifications by School Medical Inspectors all Primary Notitications are
to be made on Form A. School Medical Inspectors notify on Form B.
Supplemental Notifications are to be made on Form C. and D. by Medical
Officers of Poor Law Institutions and Sanatoria. The majority of the patients at
these Institutions will have been notified before their admission, and Supplemental
Notification is to be made on Form C., to be completed after the end of each week
of all cases admitted during the week and believed by the Medical Officer to have
been previously notified. Supplemental Notification is also required to be made
after the end of each week on Form D. of all cases discharged from the Institution
during the week.
Upon the receipt of a notification the Medical Officer of Health or an officer of
the Local Authority acting under the instructions of the Medical Officer of Health,
shall make such inquiries and take such steps as are necessary or desirable for
investigating the source of infection, for preventing the spread of infection and for
removing conditions favourable to infection.
The circular of the Local Government Board, dated December 20th, 1912, on
the same subject stated that it is contemplated that, for the purpose of carrying
out these requirements, a visit to the home of the patient will generally be
necessary, and inquiries should be made to ascertain the state of health of all other
members of the household (this refers, of course, to the examination of contacts).
A record should be kept of the inquiries or investigations made in each case, into
the cause and antecedents of the disease and of the conclusions reached by the
Medical Officer of Health as to the factors which combine to produce it.
These inquiries are set out on forms which I have had printed, a copy of which
is given as Appendix B. The results of the inquiries are entered on these forms by
the Assistant Medical Officer of Health and Sanitary Inspectors in all cases where
they visit as a result of receiving notifications under these Regulations. This
information is again copied on case sheets and indexed.