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49
NOTES.
(N.B.— Notes 1 to 5 below repeat definitions (d) to (h) on p. 7 of Memorandum 37/T.)
(1) Public Medical Treatment.— Treatment at a dispensary or residential institution
or " general supervision," under a scheme approved by the Minister of Health
for the treatment of tuberculosis, of a person who has been diagnosed to be suffering
from tuberculosis. (Note.— A patient under domiciliary treatment should be regarded
as also under " general supervision " by the Tuberculosis Officer.)
(2) Patient.— A person who has been diagnosed to be suffering from tuberculosis
and is under public medical treatment for tuberculosis.
(The term does not include a person who is kept under observation pending
the establishment of the diagnosis, and who is referred to in the Memorandum
as an " observation case," but includes all persons on the Dispensary Register
who are under " general supervision," even if not in receipt of any treatment.)
(3) Dispensary Treatment.— Treatment by a Tuberculosis Officer in cases where
the patient is seen not less frequently than once in every month, and is examined not
less often than once in three months.
(4) Domiciliary Treatment.— Treatment of an insured patient by his Insurance
practitioner on the recommendation of the Tuberculosis Officer.
(5) Year.— The calendar year ending on the 31st day of December.
(6) Adults.— For the purposes of Tuberculosis Records all patients of 15 years
and upwards should be classed as adults.
(7) New Cases—
(a) All persons examined for the first time at, or in connection with, the Dispensary,
except definite cases of tuberculosis transferred from the areas of other
local authorities. Persons seen in consultation, who will subsequently be dealt
with by their own private practitioners, should be included.
(b) Persons who have been dealt with previously by the Dispensary and discharged
as "cured," or provisionally diagnosed as not, at that time, suffering
from tuberculosis, who return to the Dispensary as suspected cases of
tuberculosis.
(8) Observation Cases.— Persons attending at, or in connection with, the Dispensary,
in whose cases the Tuberculosis Officer cannot, within a period of one month
from his first examination of the case, come to a definite diagnosis after physical examination
and the application of the necessary tests. In completing sections A and B,
such cases should be entered under sub-head (b) in each section.
(9) Dispensary Register.— List containing names of all persons attending at, or
seen in connection with, the Dispensary for diagnosis or for treatment for tuberculosis,
including patients under "general supervision" (whether or not accompanied
by domiciliary treatment), and patients or observation cases in residential institutions,
and "contacts." (This must be distinguished from the Notification Register kept by
the Medical Officer of Health.)
(10) Cured.— Patients with tuberculosis should not be deleted from the Dispensary
Register as "cured" until in the case of non-pulmonary tuberculosis, 3 years,
and in the case of pulmonary tuberculosis, 5 years, have elapsed without any symptoms
of active disease (i.e., arrest has been maintained for 3 years).
(11) Cases "lost sight of."— Patients who have failed to submit themselves for
examination during two consecutive calendar years notwithstanding all efforts to trace
them. These should be written off the Dispensary Register at the end of the year.
(Patients who are known to have left the district permanently but who cannot be
transferred to another local authority because their destination is not known, and
patients seen only in consultation for the purpose of diagnosis, and others who desire
no further assistance under the tuberculosis scheme for public medical treatment, may
be marked off at once.)
D