View report page

Domiciliary treatment. Particulars regarding the domiciliary
treatment of tuberculous patients are given in Table
XXIII.
The following suggestions may explain the decline in the
number of reports received. In the past when a patient was
referred to his panel doctor for domicilary treatment he would not
attend at the dispensary again until twelve months had elapsed,
or until his doctor sent him or recommended his re-examination
on the quarterly report G.P. 36. In recent months this practicc
has been modified by recommending, in addition to domicilary
treatment, dispensarv supervision—i.e., the patient attends the
dispensary at intervals of two to four weeks or longer. In such
cases the quarterlv report is not required.
The object of this change in procedure is twofold. In the
first place, it is an attempt to ascertain whether the patient is
pursuing the regime of life commenced in the sanatorium, and
more particularly whether he has established the sound dietetic
habits recommended. These consist mainly of the eating of a
breakfast before commencing work, and the eating of fat with
meat. The patients are advised to have, at least once a day, a
meal of meat or fish, with vegetables, including green vegetables,
and to eat green salads, summer and winter, three or four times a
week. They are also advised to take wholemeal bread and a pint
of milk daily. When the patient is not able to purchase the necessary
food, a grant is made.
In the second place an attempt is made to discover how the
patient thinks about the complaint, which he commonly refers to
as "It." Some patients worry about their condition, and others
try to forget it. A few, only a small number, learn to face and
accept facts and to make the disease a part of themselves and
their way of life. Most patients realise that worrying is harmful
and even fatal, and endeavour to try to find things to do to take
their mind off their condition. There is evidence that this method
is only partially successful, and leads to unsatisfactory results.
An attempt is made to persuade the patient to face realities by
doing daily those things which help him to overcome the disease.
Dispensary treatment. Children and non-insured persons,
able to attend at the dispensary, have been given treatment. At
the end of the year 575 patients were under treatment.
During the year 748 sputum tests were made, and 304
X-ray examinations were carried out at Whipps Cross Hospital.
200