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107
The Arrangements for securing the Examination and Systematic
Supervision of Home Contacts.
The Tuberculosis Officers urge the importance of the examination
of the home contacts on the appropriate members of the
patient's family. They may be able to arrange dates. The
Tuberculosis Health Visitors follow this up when visiting the homes
of the notified cases. The convenience of the contacts is studied
by offering to examine them at home or at the Dispensary, whichever
may be more convenient. An evening hour at the Dispensary is
arranged for those who are at work.
As mentioned before, the systematic supervision of home
contacts of school age is carried out by the school medical service
in co-operation with the Dispensary. The systematic supervision
of home contacts who are over school age is not an easy matter.
Young people at work and enjoying their evenings after work
would naturally resent periodical re-examinations. We may and
do advise any who get symptoms of ill health to return for reexamination.
Here again the value of full co-operation with the
panel or family doctors is obvious. The Tuberculosis Health
Visitors make enquiries as to the health of all the contacts at each
visit to a home in which there is a notified case. Contacts of cases
who died without notification are always offered examination, and
this is especially pressed in the case of children.
Information as to Special Methods of Diagnosis and Treatment in use
and the number of Persons to whom these Special Methods have been
Applied.
We have placed chief reliance on accurate history taking,
careful reading of symptoms, temperature charting and pulse study,
physical examination and repeated sputum testing in tubercle
negative cases. When the above methods are not neglected in the
diagnosis of a case the use of X-rays is of the highest value. Special
arrangements exist with King's College Hospital for X-ray examination
of Dispensary patients. During 1932 423 patients were sent to
King's College Hospital for X-ray examination.
Artificial Pneumothorax treatment is available for suitable
Dispensary cases and may be carried out while the patient is in a
residential institution or later while on home treatment. By
arrangement artificial pneumothorax treatment can be given at
the following hospitals to patients who are on general treatment at
home:—Brompton, St. Thomas's, Guy's, King's College Hospital,
Charing Cross, The Miller Hospital, Grove Park and Colindale.
During 1932 46 Dispensary patients had artificial pneumothorax
treatment at one or other of these hospitals. This does not include
Dispensary patients who were on artificial pneumothorax treatment
in Sanatoriums at December 31st, 1932. Such surgical methods as