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every effort is made to induce people living in the same house
as the patient to present themselves for examination. In
many cases, however, it is very difficult to persuade them of
the necessity for this examination. During the year under
review 545 contacts were examined out of a total of 731.
(g) X-Ray Examinations. An agreement was entered
into with the Seamen's Hospital Society in 1921 providing
for the X-ray examination of doubtful cases of Tuberculosis.
Payment is made on the following basis:—For screen and
report, 7s. 6d.; X-ray plate and report, 15s. No pulmonary
case is sent until three negative spit examinations have been
made. The number of cases referred for this examination
during the year was 67. Increasing use is being made of this
service. 42 cases were referred in 1923 and 65 in 1924. This
service is very useful, often enabling very early cases to be
diagnosed, but the maximum results will never be obtained
until the apparatus and the Tuberculosis Officer are under
the same roof. In this connection it may be as well to point
out that the increasing use of artificial pneumothorax treatment
and the necessity of refills for these patients over prolonged
periods is one for serious consideration, and it may be
desirable, in the near future, that refills should be undertaken
by Tuberculosis Officers themselves to relieve the pressure
on the hospitals concerned. Without X-ray apparatus it
would be difficult, and probably undesirable, to attempt
this.
(h) Observation Cases. Observation cases are those in
which no definite diagnosis of tuberculosis has been arrived
at during the first month. A number of these fail to continue
in attendance but a check is kept upon these cases by going
through their case papers at the end of each month, and, if
they are not attending, the Tuberculosis Visitor endeavours
to get them to visit again.