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133
The Examination of Home Contacts.—On the occurrence of a new case of
tuberculosis every endeavour is made to get the other inmates of the house to attend
for examination. The most difficult contacts are the young adolescents, who cannot
always be persuaded of the necessity for attendance. In cases of non-attendance
the efforts of the tuberculosis visitor are supplemented by a visit from one of the
medical officers. During the year 555 contacts were examined.
The result of the Mantoux test on 269 children again shows a very much higher
percentage of positive results where children are in contact with a positive case.

Extra Nourishment.—Adequate nourishment is now generally recognised as
being the basis on which other assistance to tuberculous patients must be founded,
and extra nourishment in the form of butter, eggs and milk is supplied when required
on the certificate of the Tuberculosis Officer. The expenditure on this service is
limited to £2 per 1,000 of the population, and under the regulations it is supplied
to such cases where it will definitely help progress and it is not supplied where there
is no reasonable prospect of improvement. Those who are in receipt of Public
Assistance are not dealt with as regards extra nourishment under the Borough
Council's scheme, but by the Public Assistance Committee, and it is a great pleasure
to record the whole-hearted co-operation given by this Committee and its officers.
X-ray Examinations.—Every new adult patient examined at the dispensary is
also X-rayed as a matter of routine. The importance of this procedure cannot be
over-stressed, and it is possible that in the future neglect to take an X-ray where
the diagnosis is in doubt will be considered by the Courts as negligence, as is the
present position with regard to bone injury where a fracture may be present. The
supervision of definite cases of tuberculosis necessitates the taking of X-ray films
at intervals, and during the year 1,050 X-rays were taken. The examinations are
carried out at the War Memorial Hospital and at St. Nicholas Hospital, Plumstead.