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33
Temperature Observations.
Full use is made of this procedure wherever possible but
patients on the whole are not to be relied upon to take sufficiently
accurate readings, and although the nurses help in this direction
it is impossible to carry this out as fully as one would like without
the assistance of another trained nurse.
Contact Examinations.
It is found from experience that the greatest benefit, in so
far as preventive measures are concerned, is derived from the
examination of adolescent contacts, i.e., between the ages of 14
and 21, for it is they who are particularly prone to infection and
often of an acute nature.
Children of school age rarely develop pulmonary tuberculosis
and it would be of greater advantage if our contact examinations
were more especially concerned with adolescents, whilst those of
school age be examined in the first instance by the School Medical
Service and then, if suspicious, referred to the Tuberculosis
Officer. It is only in this way that concentration on the prevention
of this acute form of adolescent pulmonary tuberculosis can be
made.
Source of Infection.
Finally, it is very desirable in all cases suffering from the
disease to endeavour to ascertain the source of infection. In
some instances we meet with seven or more cases of tuberculosis
in one house where the source of infection was in the old resident
of the house. The view held by the general public that these
old people never get tuberculosis is quite fallacious. They are
often, in our experience, the direct source of infection. As a
rule they are careless and unhygienic in their habits and as their
disease is generally of a mild nature they often have much energy
and are therefore unsuspected; and invariably, where repeated
cases occur in a family, the old people are the last whom we are
able to induce to come for examination, whereas, had they been
examined first the trouble might have been prevented.
Shelters.
In view of the present state of overcrowding which exists in
so many of the patients' homes, I am of the opinion that a larger
supply of shelters would greatly assist us in solving the problem
of isolating the patient from the other members of the family.