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7
No age is altogether exempt from the disease, though it is generally considered
to be rare at the two extremes of life. In our district, however, 31 per
cent. of the total deaths were above 45 years of age, and 7 per cent. were above
65 years of age in 1925. During some years the figures have been higher.
There has been more co-operation during the last two years between the
Dispensaries and various other authorities. In addition to the arrangements
with the School Medical Officers, the three Tuberculosis Officers have been
appointed for consultative purposes—so far as tuberculosis is concerned—to
the visiting staffs of the Hospitals under the care of the Stepney Guardians.
This arrangement has proved most useful, as it introduces personal contact
between the Hospital Medical Superintendents and the Tuberculosis Officers,
without which proper co-operation is impossible.
The co-operation between the general medical practitioners in the Borough
and the Dispensaries is very satisfactory, and is better than it has ever been.
A larger number of patients is being examined at each Dispensary at the
request of private doctors, either for assistance in diagnosis or for advice and
help, regarding suitable treatment. The assistance of the Tuberculosis Officers
for consultation at the homes of patients, when required, is also more widely
known, and appreciated, by the doctors.
There is still an urgent need for the after-care of patients who have undergone
a course of treatment. Many of these cases benefit considerably from
Sanatorium treatment, but on discharge, they have to return to unsuitable
occupations, and poor home conditions, with the result that the disease again
becomes active. Nearly all the benefit obtained whilst under treatment is
thereby lost. These cases would often profit if suitable work of a comparatively
light nature, was provided for them and, no doubt, in some cases the
disease would eventually become arrested entirely. Many are fit for such light
work, but they are not fit to compete with healthy men and women in the
open market. There is not yet any adequate organisation for dealing with
the after-care problem, although there are two or three " colonies " in existence
for the purpose.
Another great problem remains, in the persons of the chronic and infective
patients. Many of these cases are comparatively fit, but they are, none the
less, a source of danger to others. Permanent institutional treatment for isolation
purposes is, in most cases, out of the question, on account of the long
period necessary. Assuming the necessary accommodation to be available,
most patients would not remain in an institution, in some cases possibly, for
years.