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conditions under which the patient is living. If the patient is an
insured person (National Health Insurance), and in some instances
although the patient is not an insured person, if he is not receiving
proper medical attention, a copy of the "Environmental Conditions
is sent to the Tuberculosis Officer for the district. The Tuberculosis
Officer is then put into relation with the patient and acquainted with
the nature of the patient's surroundings at the earliest possible moment;
for the M.O.H. is more likely to have the earlier intimation of the
occurrence of the disease: the Regulations require that "every medical
practitioner attending on or called in to visit any person shall, within
48 hours after becoming aware that such person is suffering from
Tuberculosis, make and sign a notification of the case, and shall transmit
the notification to the Medical Officer of Health. Weekly returns of
the notifications received are transmitted by the District Medical Officer
of Health to the County Medical Officer, who instructs the Tuberculosis
Officer for the district.
By an arrangement between the County Medical Officer and your
M.O.H. the enquiries made by the Tuberculosis Officer and the District
M.O.H. are identical, so that the results are interchangeable, and
duplication of work in this particular is avoided.
The "following up" of the cases is mainly conducted by the
Medical Officer of Health., From time to time, as opportunity affords,
he calls upon the patients and ascertains what progress is being made.
He makes suggestions for the better isolation of the patient when
that is necessary, and endeavours to ensure that the patient lives under
conditions most favourable to himself and least harmful to others.
During one of the early visits the names of the children from the house
attending school, and the schools to which they severally belong, are
noted, and on the first occasion thereafter when the school is visited
by. one of the Medical Officers the list of "contacts" is gone through
and the children examined for possible lesions. An offer is made to
examine any of the elder contacts. Disinfectants are supplied to all
patients who will use them properly, and advice is given how discharges
may be disinfected or otherwise destroyed. Sputum flasks are provided
by the Sanitary Authority for such patients as ought to use, but cannot
afford them. A leaflet is left at the house giving simple precautionary
advice, and attention is particularly drawn to the paragraph asking that
intimation of change of address shall be given to the M.O.H. in
order that the premises may be cleansed and disinfected before they
are again inhabited. It is regrettable that so little attention is paid