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ful continuation of artificial pneumo-thorax treatment.
Certain cases do not function properly owing to
adhesions, etc., and their presence and situation can
only be accurately demonstrated by skiagrams.
Institutional Treatment. The London County
Council is the authority responsible for the provision of
sanatorium treatment and such cases considered to be
in need of this are recommended by the Tuberculosis
Officers. In the great majority of cases such recommendations
are accepted, though it occasionally happens that
a heavy waiting list at Headquarters may defer or cause
non-acceptance of recommendation for some special
institution. This may either refer especially to those
with disease of a certain type or stage, or to such patients
who have already completed a course of sanatorium
treatment within a recent period. During 1929 Institutional
treatment was provided for 223 cases (an increase
of 20 on the preceding year) and reference to Table IX
will show that the London County Council sent away to
sanatoria and other places 141 of these; the remainder
being dealt with through the valued assistance of various
voluntary agencies, namely the Invalid Children's Aid
Association, the Children's Country Holiday Fund, the
Charity Organisation Society and the United Services
Fund, etc., and by the late Fulham Board of Guardians.
It should be mentioned also that during 1929 three children
were boarded out by the London County Council
under their contact scheme. Sanatorium treatment still
remains the best one for tuberculosis from which any
permanent benefit may he expected, specialised treatments
as Artificial Pneumo-Thorax, Sanocrysin injections,
etc., being ancillary. But to be of any "permanent"
benefit it must be undertaken at an early stage of the
disease and for as prolonged a period as possible. It
may be perhaps emphasized that the period after return
from a sanatorium is a most critical one; for unfortunately,
it is during this stage that the average working
class patient sooner or later breaks down, no doubt
owing in a large measure to the necessity of holding his
own with other workers in the same field, but being less
fitted for the struggle in having an impaired constitution.