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76.
The admission of certain chronic cases, (or limited
periods is, however, of considerable benefit, as the rest,
fresh air and routine under supervision tends to encourage
and inculcate good habits; and in those patients
with a fair amount of resistance creates a fresh lease
of working life.
During 1930, institutional treatment of all kinds
rj > •
was provided for 228 cases (a slight increase of five
over the previous year), and reference to Table IX will
show that the London County Council sent away to
sanatorium, etc., 148 of these, and one child through
their "contact" scheme : the remainder being dealt with
through the valued assistance of various agencies,
namely, the Invalid Children's Aid Association, the
(late) Board of Guardians and the Public Assistance
Committee; the Children's Country Holiday Fund, the
Charitv Organisation Societv, and the United Services
Fund/
Sanatorium treatment still remains the best form
of treatment from which any permanent benefit can be
expected; other special treatments such as Artificial
Pneumothorax, Sanocrysin injections, etc., being ancillary.
However, such treatment must be undertaken at as
early a stage as possible and for a prolonged period : and
this emphasizes the need for early diagnosis. The period
after return from sanatorium is perhaps the most critical
one in the whole course of the disease; for unfortunately
it is during this stage that the average working class
patient tends to "break-down"' sooner or later, no doubt
owing in a large measure to the strain imposed by unrelaxing
effort in the struggle for existence, in a competitive
labour field at a time when the constitution is
impaired, and the powers of recuperation lessened by
illness.
It can be readily understood that with early
diagnosis and treatment, there is a lessened tendency
to breakdown after leaving sanatorium as both constitutional
"recuperative" power and working capacity
are greater; and this is a most important aspect of the
tuberculosis scheme, which can be amply illustrated by