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138
and contacts, this gives the very low figure of 68 per cent.,
a figure below the London average, which, in 1927, was
only 75. It is not fair, however, to make this comparison
because in Woolwich the circumstances are somewhat exceptional
in that owing to the absence of an out.patient
department of a hospital, many cases are referred to the
Dispensary who normally would be sent to a general hospital.
In this way a high percentage of negative cases results. Even
after making allowance for this it is obvious that the sputa
of a large number of new cases are not examined. There are
several explanations of this. In the first place it is very
difficult to get specimens of sputum from children ; secondly,
a large number of new cases, especially those coming to the
Dispensary on their own initiative, have no sputum, and,
thirdly, it would be a waste of time to examine sputum
already found to be positive through the general scheme
arranged in the Borough. In this connection it is as well
to bear in mind that 348 specimens of sputum were sent by
private practitioners for examination at the Seamen's Hospital.
(6) X-Ray Examinations. The number of X.ray examinations
has risen from 78 to 235. If these patients had sputum,
negative results were obtained before an X.ray examination
was made. X.ray examination is, of course, valuable, both
for confirming suspicious physical signs where the disease is
suspected and as a means of excluding a diagnosis of tuberculosis.
If the number of examinations continues to increase
in this manner it would be well for the Council to consider
the advisability of providing an X.Ray outfit at the Dispensary.
(c) Reports on Insured Persons. Only 13 copies of form
G.P. 17 were received, and 337 of form G.P. 36. Under the
National Health Insurance Acts there is an obligation on
medical practitioners to complete these forms. The former
should be completed by panel practitioners when first