Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
voluntary body, and the staff then consisted of a lady doctoran assistant tuberculosis officer, two tuberculosis nurses, a dispenser and a clerk. Shortly after the Council taking it over, the lady tuberculosis officer resigned, and her post
of insured persons. (10) Acting as tuberculosis consultant to Bermondsey and Rotherhithe Hospital. The Tuberculosis Officer visits the hospital once a week. Special Facilities at Hospitals, etc.—The Tuberculosis Dispensary has been
IV. TUBERCULOSIS. TUBERCULOSIS DISPENSARY. SCHEME FOR THE TREATMENT OF TUBERCULOSIS FOR THE FINANCIAL YEAR COMMENCING 1st APRIL, 1928. The Ministry of Health and the County Council have requested this Council
Age Periods | 0 to 1 | 1 to 5 | 5 to 10 | 10 to 15 | 15 to 20 | 20 to 25 | 25 to 35 | 35 to 45 | 45 to 55 | 55 to 65 | 65 and upwards | Total Cases |
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4.—Mr. J. W. Wood TUBERCULOSIS DISPENSARY. Clinical Tuberculosis Officer and Deputy Medical Officer of Health—Dr. D.M. Connan, M.B., B.S., D.P.H. Assistant Tuberculosis Officer—Dr. C. H. C. Toussaint, M.R.C.S., L.R.C.P. Tuberculosis
devote much more time to specialization in this disease. There were two tuberculosis nurses at the time when we took over the work, and a second whole-time assistant Tuberculosis Officer was not appointed until 1927. In May 1924, a lecture was
after investigation of the conditions by the Dispensary Nurse. (4) The period for which extra nourishment is given is fixed by the Tuberculosis Officer and decided on medical grounds. Open-air School. The Tuberculosis Officer will devote one
there is little doubt about the value of light treatment in surgical tuberculosis if given cautiously over a considerable period. With regard to pulmonary tuberculosis more experience is required before any definite pronouncement can be made.
Disinfection 35 Cleansing of Persons 36 Mortuary 36 Street Markets 36 Overcrowding 37 TUBERCULOSIS- Tuberculosis Dispensary 43 Light Treatment 46 Levsin Patients 49 Work of the Tuberculosis Dispensary 50 Summary of Notifications 51 Cases on the Register
fall of twenty in the total number of deaths from all forms of Tuberculosis, and deaths from Pulmonary Tuberculosis are sixteen less than last year. The death rate for Pulmonary Tuberculosis was 1.03, and apart from 1929 when the rate was the
Sub-District | Bermondsey | Rotherhithe | St. Olave | Whole Borough | London | ||
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Year | No. | No. | No. | No. | Rate | No. | Rate |
HEALTH (TUBERCULOSIS) REGULATIONS, 1930. Summary of Notifications during the period from the 28th December, 1930, to the 2nd January, 1932. Formal notifications Age Periods Number of primary notifications of new eases of Tuberculosis 65 and
treatment and the tuberculosis patients 8.13 per cent) All patients attending for treatment are recommended by general practitioners or by medical officers of the Maternity and Child Welfare Centres, the Tuberculosis Dispensary or Hospitals.
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DISPENSARY. Deputy Medical Officer of Health and Clinical Tuberculosis Officer —C. H. C. Toussaint, M.R.C.S., L.R.C.P., D.P.H. Assistant Medical Officer of Health and Assistant Tuberculosis Officer—E. J. MacIntyre, M.B., Ch.B., D.P.H. Lady Almoner—Olive
PAGE Public Health (Prevention of Tuberculosis) Regulations, 1925 28 Work of the Tuberculosis Dispensary 29 Summary of Notifications 30 Cases on the Register 31 LIGHT TREATMENT— Work done
Primary and Acute Influenzal) 113 126 53 234 125 243 119 110 119 167 Tuberculosis 317 250 226 Respiratory System 245 206 231 184 194 208 175 Other forms of Tuberculosis 96 86 90 76 59 65 54 40 46 40 1,420 1,580 1,408 1,599 1,585 1,478 1,536 1,494 1,083
133 26 168 75 1813 Women 1203 1263 2227 1170 132 253 19 139 76 1 2267 Men 1530 1577 2902 1635 42 194 36 230 92 2820 Tuberculosis Cases 103 78 173 45 43 61 6 11 187 — Children (Table I.) 913 902 2888 160 720 208 4 2152 - - 1449 4613 10294 3775 1130 849 91 548 243
—Pulmonary Tuberculosis—Sputum positive R.C. F. Miliary Tuberculosis Yes 8115 J.Y. M. 7 mths. Miliary Tuberculosis No Mother —Pulmonary Tuberculosis 8161 Yes Refused examination M. Miliary Tuberculosis S.H. 13 mths. E.S. F. Tuberculous
which the whole tuberculosis scheme at present founders, and is well brought out by the following figures of adult cases of pulmonary tuberculosis referred to the Tuberculosis Officer during the past year:— Percentage of Class of case. Number.
Register No. | Initials of Child | Sex | Age at Death | Certified Cause of Death | Post Mortem Examination | Particulars of Contacts |
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her death the elder sou A is notified as a case of pulmonary tuberculosis, and a positive sputum appears three years after notification. B is a younger son who developed pulmonary tuberculosis with a positive sputum three and a half years after
Laboratory 22 Cases Notified in 1928 23 Cases Notified for last ten years 24 TUBERCULOSIS- Tuberculosis Officer's Report 25 Lady Almoner 36 Public Health (Prevention of Tuberculosis) Regulations, 1925 37
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III.- TUBERCULOSIS. In submitting the report on the Tuberculosis Scheme for the year, I have to point out that this has been written by Dr. C. H. C. Toussaint, who, previously Assistant Tuberculosis Officer,
year 16 were referred to the Tuberculosis Dispensary by general practitioners and of 58 T.B. +2 cases 37 were so referred. Through the hands of the general practitioner therefore the majority of pulmonary cases pass before reaching the Tuberculosis
necessary. It might appear that the co-operation of the two services had contributed to this resistance and low incidence of pulmonary tuberculosis in the age groups mentioned, but this phenomenon was observed before the school and tuberculosis
Sub-District | Bermondsey | Rotherhithe | St. Olave | Whole Borough | London | |||||
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Year | No. | Rate | No. | Rate | No. | Rate | No. | Rate | No. | Rate |
3. The Tuberculosis Officer. An efficient, full time Tuberculosis Officer, backed by a capable dispensary staff, should be the mainstay of the tuberculosis scheme. It is essential for him to have
and the dispensary nurses. Advice can be given with regard to the alteration of existing accommodation so that infective persons can be provided, where possible, with a room, or at any rate a bed, to themselves. In suitable cases the Tuberculosis
Respiratory System | Other Forms | |||
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M. | F. | M. | F. |
moment and by impressing on them the rules of hygiene. The Tuberculosis Officer must be prepared to take his full share in this work —but a word of caution is needed. In Tuberculosis —as perhaps in cancer also, it is an easy matter to defeat one's
very large part in the spread of tuberculosis. In an industrial district overcrowding and poor housing conditions are highly conducive to the occurrence of multiple cases of tuberculosis in a family. Not only are several people forced to
DIAGRAM I. MORTALITY IN PULMONARY TUBERCULOSIS IN LONDON.
Pneumonia (Acute Primary and Acute Influenzal) - 81 37 234 125 243 119 Tuberculosis :— 119 Respiratory System 369 376 317 250 226 245 339 Other forms of Tuberculosis 131 99 79 96 86 90 76 1,924 2,490 2,496 1,420 1,408 Totals 1,296 1,580
Toussaint, Clinical Tuberculosis Officer. There has been a further fall in deaths from Pulmonary Tuberculosis, and the death rate for this type of disease, 0.86 is again the lowest ever recorded in the Borough. The fall in the number of deaths from
Sub-District | Bermondsey | Rotherhithe | St. Olave | Whole Borough | London | ||
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Year | No. | No. | No. | No. | Rate | No. | Rate |
the matter of diagnosis by preparing a morning and evening temperaure chart for the Tuberculosis Officer. In advanced cases of tuberculosis where the patient is living at home, it has been our practice for a long time now to arrange for daily
Tuberculosis Officer's instructions, for supplying extra nourishment to persons suffering from tuberculosis, and the loan of open-air shelters, beds and bedding. Where necessary treatment is arranged in convalescent homes for contacts
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Age Periods | Formal notifications | ||||||||||||
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Number of primary notifications of new cases of Tuberculosis | Total Notifications | ||||||||||||
0 to 1 | 1 to 5 | 5 to 10 | 10 to 15 | 15 to 20 | 20 to 25 | 25 to 35 | 35 to 45 | 45 to 55 | 55 to 65 | 65 and upwards | Total (all ages) |
DISPENSARY. Deputy Medical Officer of Health and Clinical Tuberculosis Officer—C. H. C. Toussaint, M.R.C.S., L.R.C.P., D.P.H. Assistant Medical Officer of Health and Assistant Tuberculosis Officer—E. J. O'Keeffe, M.R.C.S., L.R.C.P., D.P.H.
work done at the Tuberculosis Dispensary are set out on page 33, and there has been no material change in this work during the year. Radiological examinations have slightly increased and facilities in this direction are of the utmost importance
PAGE Public Health (Prevention of Tuberculosis) Regulations, 1925 32 Work of the Tuberculosis Dispensary 33 Summary of Notifications 34 Cases on the Register 35 LIGHT TREATMENT— Work done
- - 1 - - - Influenzal) - - 113 126 53 110 119 167 119 102 136 121 245 206 231 184 194 Tuberculosis:— Respiratory System 208 175 177 182 Other forms of Tuberculosis 141 76 1,408 59 1,599 65 1,585 54 1,478 46 1,494 40 1,536 40 1,083 35 1,149 34 1,512 32 1,371
PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. Summary of Notifications during the period from the 1st January, 1934, to the 31st December, 1934. Formal notifications Number of primary notifications of new cases of Tuberculosis Age Periods
tuberculosis workers in most other districts, to the unfortunate fact that a large number of cases first come to the notice of the Tuberculosis Officer at a stage when disease has already secured a firm hold on the patient. Tuberculosis of the lungs,
Tuberculosis Officer for an opinion. The London County Council has continued the arrangement, whereby the Tuberculosis Officers act as honorary consultants to St. Olave's Hospital. In cases of urgency, and an early case of pulmonary tuberculosis
Sub-District | Bermond sey | Rotherhithe | St. Olave | Whole Borough | London | ||
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Year | No. | No. | No. | No. | Rate | No. | Rate |
tuberculosis, in its early stages, has not kept pace with the new methods of treatment. The Borough Council has provided a complete tuberculosis service which now includes a modern X-ray equipment. This makes it possible for the Tuberculosis Officers
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Age Periods | Formal notifications | ||||||||||||
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Number of primary notifications of new cases of Tuberculosis | Total Notifications | ||||||||||||
0 to 1 | 1 to 5 | 5 to 10 | 10 to 15 | 15 to 20 | 20 to 25 | 25 to 35 | 35 to 45 | 45 to 55 | 55 to 65 | 65 and upwards | Total (all ages) |
Medical Officer of Health and Clinical Tuberculosis Officer—C.H.C. Toussaint, M.R.C.S., L.R.C.P., D.P.H. Assistant Medical Officer of Health and Assistant Tuberculosis Officer—E.J. O'Keeffe, M.R.C.S., L.R.C.P., D.P.H. Tuberculosis
Dwellings 8 Rateable Value 8 Population 8 Births 8 Deaths 9 Marriages 9 Infantile Mortality Rates 10 Deaths from Tuberculosis 10 Vital Statistics of District 11 Causes of Deaths 14 Deaths from Zymotic Diseases 16 Infantile Mortality, Causes of Deaths
PAGE Public Health (Prevention of Tuberculosis) Regulations, 1925 42 1925 42 Work of the Tuberculosis Dispensary 43 Summary of Notifications 44 Cases on the Register 45 LIGHT TREATMENT— Work
167 102 136 Whooping Cough (under 5) - - - - - - - Measles (under 5) - - - - - - - Tuberculosis:— Respiratory System 231 184 194 208 175 177 182 Other forms of Tuberculosis 65 54 40 46 40 35 34 1,585 1,478 1,536 1,494 1,083 1,149 1,512 Totals
treated, together with the number of patients who completed treatment during the year is given below:— TUBERCULOSIS. Glandular 4 .eritonitis 1 Sacro Iliac Joint 1 MATERNITY AND CHILD WELFARE. Ante-Natal 4 Bronchitis 25 Cervical Adenitis
122 14 1571 2068 131 Women 1021 1135 1949 949 175 104 101 119 15 1897 Men 1536 1686 2813 1688 57 235 37 185 142 2871 Tuberculosis Cases 24 28 20 7 25 1 13 2 104 66 Children (Table I.) 801 770 2410 235 564 288 - - - 1781 Totals 4029 4315 9306 3389 931 777 433 367
and Child Welfare 46 Health Visitors 52 Municipal Dental Surgeon's Report 53 TUBERCULOSIS— Tuberculosis Dispensary 57 Care Committee 61 Clinical Tuberculosis Officer's Report 65 Sun Cure 67 Leysin Patients 77 APPENDIX TABLES— Ministry
further the incidence of tuberculosis. The whole then amounts to this—that for the prevention of tuberculosis one must enlist the intelligent co-operation of not only the patients but the general population. As far as surgical tuberculosis
that any great improvement in these conditions will be achieved in the near future. In last year's annual report mention was made of Tuberculosis milk as a factor in the cause of Surgical Tuberculosis. During this year there has been a considerable
also includes Tuberculosis of the skin, commonly known as " Lupus," Tubercular Peritonitis and Scrofula or glandular Tuberculosis. Dr. Rollier does not undertake the treatment of cases of Pulmonary Tuberculosis, as these are much more
B, C. and D, and keeping a register of these. (2) Keeping administrative and clinical records of all cases and suspected cases of Tuberculosis in the Borough. (3) Supervision and periodical examinations of all cases of Tuberculosis, including
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Association on information from T.O. Guardians and Invalid Children's Aid Association on information from T.O. Guardians and Invalid Children's Aid Association on information from T.O. Tuberculosis Officer. Guardians. Tuberculosis Nurses.
967 636 463 117 450 221 1 4,400 100 TUBERCULOSIS DISPENSARY. Scheme for the Treatment of Tuberculosis for the Financial Year commencing 1st April, 1925. The Ministry of Health and the County Council have requested this Council to submit a scheme
Officer's report upon the question of unifying the treatment of tuberculosis in this Borough. Since this period nothing fresh has been done, and the Interim Tuberculosis Care Committee has been functioning up to the present time. In July, 1920,
contacts, and although they seem frail and delicate, and possess many symptoms which makes one suspect Tuberculosis, no definite evidence of the actual disease can be found. It is these cases which very often after a year or two present definite
contacts, and although they seem frail and delicate, and possess many symptoms which makes one suspect tuberculosis, no definite evidence of the actual disease can be found. It is these cases which very often after a year or two present definite
at Guy's Hospital on Heliotherapy and Tuberculosis. This lecture was attended by Dr. Alfred Salter, M.P., Dr. D. M. Connan, and myself, and we were all so impressed by the wonderful
on the recommendation of the Tuberculosis Officer, after investigation of the conditions by the Dispensary Nurse. (4) The period for which extra nourishment is given is fixed by the Tuberculosis Officer, and decided on medical grounds. It
results of PostMortem Examination, if obtainable 1 Premature TUBERCULOUS. Tuberculosis Dispensary. The following reports conce1rning the Tuberculosis Dispensary were submitted to the Council in July of last year, and January of the
protracted, and people may go about for a considerable portion of their lives suffering from the more or less crippling effects of Tuberculosis. The following table will give some idea of the general prevalence: — 1919. 1. Number of Primary Notifications
and " Contacts," who, though apparently healthy, are living with tuberculosis patients, and require to be kept more or less under observation. At the present day, no scheme for the control of Tuberculosis is complete without a Tuberculosis
District Nurse 39 Municipal Lying-in Hostel 39 TUBERCULOUS — Tuberculosis Dispensary 40 Tuberculosis Scheme 40 Prevalence of Tuberculosis in the Borough 40 Tuberculosis Dispensary 43 APPENDIX TABLES— Local Government Board Tables 54-60 Outworkers
Medical Officer of Health be the Chief Tuberculosis Officer. (3). That Dr. Darroch be Assistant Tuberculosis Officer at the Dispensary, and have the status of an Assistant Medical Officer of Health. (4). That Dr. Connan be Second Assistant Tuberculosis
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contacts, the Dispensary would serve a much more useful purpose. The present staff consists of a Tuberculosis Officer and Assistant Tuberculosis Officer, two nurses, one dispenser, one secretary, and one caretaker.
by the Interim Tuberculosis Care Committee, who act as an Assessment Committee, the weekly payments ranging from 2s. to 10s. 6d., according to the ability to pay of the persons responsible. For the institutional treatment of Tuberculosis
their duty to receive notifications and to visit the patients at their homes. The Tuberculosis Officer will also act as general consultant in cases of Tuberculosis for private practitioners, and the question of sanatorium and special treatment,
lower Section is shown the number of houses in which three, four, five, etc., cases of Tuberculosis have been notified: thus, three cases of Tuberculosis have occurred in each of 143 houses, four cases in each of 27 houses, and so on. Setting
all of which things take up a considerable amount of the time of a Tuberculosis Officer. The character and the population of the Borough, the prevalence of Tuberculosis, and the importance and the desirability of continuing the work at the very
Examination of contacts and 'following up' of patients. (11) Personal acquaintance of Tuberculosis Officer with practitioners of the neighbourhood. (12) Tuberculosis Officer should visit the home of each patient at least once. (13) Adequate clerical
of the girls had Tuberculosis for some years before living in the Hostel, another girl had a family history of Tubercle, and two others lived in the hostel at the same time. Four cases.—Four cases of Tuberculosis have been notified as occurring
WELFARE— Health Visitors 21 Municipal Lying-in Hostel 23 Municipal Dental Officer's Report 24 TUBERCULOSIS— Assistant Tuberculosis Officer's Report 28 APPENDIX TABLES— Ministry of Health Tables 53 Outworkers 59 Deaths from Zymotic Diseases
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member of a family is suffering from Tuberculosis, there must be a separate notification for each member. But, arising out of this observation the question has been asked, " Is it possible to contract Tuberculosis merely through living in a house
1922. Prevalence of Tuberculosis. The following report was drawn up jointly by the Assistant Tuberculosis Officer, Dr. D. M. Connan and myself in January, 1922:— "Prevalence of the Disease in Bermondsey.—lt is extremely difficult to form an
as not suffering from active Tuberculosis. Experience, however, has shown that it is most desirable to keep these cases under observation, as a considerable number of them, though not suffering from active Tuberculosis at the time of their
of Tuberculosis, or cases about which there is some suspicion of this disease, but is intended rather to co-ordinate the treatment which is available by Institutions and Practitioners in or near the Borough, and to see that cases of Tuberculosis
Tuberculosis Officer, after investigation of the conditions by the Dispensary nurse, to necessitous cases well known to him. (4) The period for which milk is given to be limited by the Tuberculosis Officer, and be decided on medical grounds.
of the notification form, together with change of address not reported, accounts for the remaining part of the error. It appears to be impossible to obtain under the present system an accurate estimate of the total number of persons actually
time he will be protected from unnecessary notification if he is not suffering from Tuberculosis. Recently a case was sent to the Bermondsey Dispensary as Tuberculosis of the Cervical Glands, peeling freely all over, and having a history of a
knowledge as to the extent (i.e., number of cases) and distribution of Tuberculosis in his area. The present system is too rigid. The doctor must notify a case of Tuberculosis as soon as his diagnosis is made. He hesitates to do so because he feels
insured persons. (10) Acting as tuberculosis consultant to Bermondsey and Rotherhithe Hospital. The Tuberculosis Officer visits the hospital once a week. Special Facilities at Hospitals, etc. —The Tuberculosis Dispensary has been linked up
Age Periods | 0 to 1 | 1 to 5 | 5 to 10 | 10 to 15 | 15 to 20 | 20 to 25 | 25 to 35 | 35 to 45 | 45 to 55 | 55 to 65 | 65 and upwards | Total Cases |
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TUBERCULOSIS DISPENSARY. SCHEME FOR THE TREATMENT OF TUBERCULOSIS FOR THE FINANCIAL YEAR COMMENCING Ist APRIL, 1927. The Ministry of Health and the County Council have requested this Council to submit a scheme
sent up for treatment. Thus we have had many varieties of Tuberculosis, e.g., Tuberculosis of bones and joints and glands, Tuberculosis, enteritis, Tuberculous abdominal glands, and many cases of enlarged bronchial glands, numerous cases
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No. 4. —Mr. J. W. Wood TUBERCULOSIS DISPENSARY. Clinical Tuberculosis Officer and Deputy Medical Officer of Health —Dr. D. M. Connan, M.B., B.S., D.P.H. Assistant Tuberculosis Officer—Dr. A. H. Kynaston, M.R.C.S., L.R.C.P. Tuberculosis
Trades 23 Disinfection 23 Cleansing of Persons 24 Mortuary 24 Street Markets 24 TUBERCULOSIS- Tuberculosis Dispensary 26 Light Treatment 29 Leysin Patients 36 Work of the Tuberculosis Dispensary 37 Summary of Notifications 38 Cases on the Register
resigned, and Dr connan took her place. A second part-time Assistant Tuberculosis Officer was not appointed until 1925 In 1923 Dr Connan was appointed as consultant in tuberculosis to the Bermondsey and Rotherhithe Hospital, and this provides for
insured persons. (10) Acting as tuberculosis consultant to Bermondsey and Rotherhithe Hospital. The Tuberculosis Officer visits the hospital once a week. SPECIAL FACILITIES AT HOSPITALS, Etc. The Tuberculosis Dispensary has been linked, up
TUBERCULOSIS. Between 1911 and 1921 the work of the Tuberculosis Dispensary was carried on by a voluntary body known as the Central Fund for the Provision of Tuberculosis Dispensaries in the Metropolis.
35 tons 17 cwts and 431 van loads. V. TUBERCULOSIS. TUBERCULOSIS DISPENSARY. SCHEME FOR THE TREATMENT OF TUBERCULOSIS FOR THE FINANCIAL YEAR COMMENCING 1st. APRIL, 1926. The Ministry of Health and the County Council have requested this Council
Trades 37 Disinfection 37 Cleansing of Persons 38 Mortuary 38 Street Markets 38 TUBERCULOSIS— Tuberculosis Dispensary 49 Light Treatment 53 Leysin Patients 60 Work of the Tuberculosis Dispensary 62 Summary of Notifications 63 Cases on the Register
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Number of | Under observation at the Dispensary on Jan. 1st pending diagnosis. | Examined for the first time during the year. | Total. | Found to be | Under observation at the Dipensary on Dec. 31st pending diagnosis. | Ceased attendence before completion of diagnosis. | ||||
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Suffering from Tuberculosis. | Not suffering from Tuberculosis. | |||||||||
Pulmonary. | Non-Pulmonary, |