[Report 1931] / Medical Officer of Health, Lanark County Council.

  • Lanarkshire (Scotland). County Council.
Date:
1931
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: [Report 1931] / Medical Officer of Health, Lanark County Council. Source: Wellcome Collection.

    41/396 (page 35)
    years after the initial illness was arrested. If a person is not tuber- culous he should be told so ns soon as a thorough examination has been completed. He should not be retained under indefinite obser- vation merely because he has been notified or because lie might contract the disease at some later date. These suspects should not be oppressed by the fear of tuberculosis for any longer than is absolutely necessary, nor should they be permitted to develop a morbid interest in their own ill-health. They should not have their prospects of employment jeopardised, nor should they and their families be exposed to the reproach of being consumptive.” An overloaded register has serious administrative drawbacks, apart from disadvantages to patients. Nurses visit all cases and give advice for the prevention and treatment of tuberculosis. They will waste valuable time if their lists have not been regularly supervised and kept up to date. Moreover, their visits will not bring credit to the scheme. They will be giving -advice to people Avho do not need it, and nurses and patients will soon suspect this. Because they do not know which are or are not genuine cases, nurses will modify or omit their instructions. Their visits will tend to become perfunctory and their advice half-hearted. At the same time, the patients who did not require the advice will discredit it and those who gave it. An inaccurate register also leads to overcrowding at the dis- pensaries. Patients with chronic non-tuberculous ailments present themselves for re-examination and persist in trying to get nourishment” or institutional treatment. Some of them are so tenacious in their demands that they succeed. There are several reasons why the lists become overcrowded. Cases are entered in the register on receipt of a. notification. Changes irv the personnel of the medical staff are fairly common. A new Tuber- culosis Officer does not know the doubts that existed in the mind of his predecessor, nor at first has he the confidence to alter the diagnosis of a general medical practitioner. For some time he accepts every case that is notified and reviews old cases with great reservation. If he leaves the staff in a year or so, his list will have grown, and his successor will repeat the process. Another explanation is that X-ray examination has become a routine procedure only during the last few years. Cases were formerly diagnosed on clinical grounds, and the bias was always in favour of tuberculosis even when physical signs of the disease were absent.