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tuberculosis, making a total of 53,782. In 1935, although the
population had increased by a third in the interval, the number
of deaths had fallen to 24,603 from pulmonary, and 4,598
from non-pulmonary tuberculosis—or less than 30,000 in all.
Looking at these figures in another way, the standardised
death-rate from tuberculosis per million has fallen from 1,915
to 687 in less than forty years. Even in the past twenty-five
years the annual deaths from pulmonary tuberculosis have
come down by over a third, and from non-pulmonary by not
far short of three-quarters."
Surely there are justifiable grounds for encouragement here.
In the supervision of children under the age of fourteen we
work in close co-operation with other health services. The
Maternity and Child Welfare Centres of the Borough Councils
consult us, both in the case of mothers and infants, whom they
may suspect of having tuberculosis. We, on the other hand, refer
all cases of pregnancy to the Centres where, while still attending
the Dispensary at regular intervals, they are kept under observation
during the child bearing period, and suitable arrangements
are made for the confinement.
A satisfactory arrangement with the School Medical Service has
been in operation since 1922. All healthy contacts and those who,
after a period of observation at the Dispensary, show no evidence
of tuberculosis, together with other children whose health is not
entirely satisfactory, are transferred to the School Medical Department.
The Tuberculosis Officer forwards a report on each child
to the School Medical Officer, who provides special observation
for such cases, arranges frequent periodic examinations and the
keeping of accurate records of weight, etc. Should the School
Medical Officer later suspect tuberculosis in any of those children
they are immediately referred back to the Dispensary for further
investigation. The scheme is working smoothly.
In addition to our co-operation with the Borough Health
Services, which are mainly concerned with the care of children,
our works brings us into close contact with the Public Assistance
Committee and the General Hospitals of the London County
Council.
I have acted as Consultant to the Bethnal Green Hospital for
the last 14 years. The Hospital admits most of our advanced
cases, with occasionally, patients requiring urgent Artificial
Pneumothorax treatment. On the fortnightly visits I am able to
follow up these cases, of whom we would otherwise lose sight for
prolonged periods. I make a routine round of the tuberculosis
wards, supervising treatment generally, selecting cases for
Artificial Pneumothorax, and other special forms of treatment.
I also examine suspected cases of tuberculosis in other wards of
the Hospital, thus helping to secure earlier diagnosis.+