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4. A Centre for special curative treatment and supervision.
5. A Centre for examination of Contacts.
6. An Information Bureau and Educational Centre.
A scheme for the efficient control of all forms of tuberculosis
must be comprehensive in character, and the Clinic plays the
greater part in this organisation. It will be seen that adequate
supervision of the patient and close knowledge of his home circumstances
and of the many difficulties with which he has to contend
outside, are essentiol to the success of any such social service.
So much can be attained by a sympathetic interest in his everyday
existence and those difficulties, financial and otherwise, which
are encountered by patients suffering from disease of recent
origin, or often from chronic and incapacitating illness.
The Tuberculosis Officer should be the friend and confidant
of his patients, and much stress is laid by most Authorities, including
the London County Council, on the necessity for close
and personal association with the many factors that arise. The
arrangements should be such as will permit the Tuberculosis
Officer to visit the homes of his patients, at least once, in order
to become familiar with their environmental conditions, and to
enable him to augment and supervise the work of the Tuberculosis
Visitors.
Every facility should exist at the Clinic for diagnosis and
scientific investigation and periodical X-ray examinations aire
necessary, but this plays only a part in the prevention and control
of tuberculosis.
It will afford the patient little satisfaction to know that some
clinical manifestation of the disease is substantiated, or otherwise
by X-rays, or again that some extension is evident in one direction
or tendency to heal in another, if he is worried and anxious about
his home affairs, his wife and family, his job or his social relationship
with his neighbours and colleagues at work. He looks for
advice and instruction to the Tuberculosis Officer appointed for
the purpose who knows his condition, understands better than anyone
else his many difficulties, and whose duty is is to help him get
well and prevent other cases of tuberculosis occurring.
Where circumstances permit, there should be no break in the
continuity of observation by the Tuberculosis Officer, and it is in