[Report 1924] / Medical Officer of Health, Fife County Council.

  • Fife (Scotland). County Council.
Date:
1924
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: [Report 1924] / Medical Officer of Health, Fife County Council. Source: Wellcome Collection.

    20/82 (page 20)
    On reviewing the new cases notified during the }rear, it does not appear to me as if there were more advanced cases than in previous years but more have expressed the desire to benefit by sanatorium treatment. It is, I think, inevitable that there will always be a certain number of advanced cases due to various causes— some altogether outwith the power of any medical practitioner to notify earlier. Occasionally some are missed till showing advanced signs but often they are of a type that to a cursory examination show little or no evidence of actual disease in the chest for a considerable time. It is often very difficult to examine such a case properly in the home but by having due regard to other things such as persistent cough, night sweats, langour, tachicardia or an evening temperature, it should lead to grave suspicion. Any patient showing such a combination of symptoms for any length of time should be regarded as a suspect even in the absence of any chest signs or of T.B. from the sputum. A single examination for T.B. giving a negative report is of no value and may be very misleading. When in doubt some practitioners ask the Tuber- culosis Officer to see suspect cases, and if doubt still remains they are kept under notice or sent to “ Glenlomond ” for observation. With a single examination in the home and under home conditions it is often very difficult or even impossible to give a definite decision, and neither the Tuberculosis Officer nor the general practitioner can give unlimited time to individual cases. But in the sanatorium they can be observed by a trained staff under ideal conditions and with facilities for diagnosis which are not available outside. Should a case turn out to be non-tuberculous no harm is done, while if found to be positive the early treatment is all the more likely to lead to an early recovery. It is only by such close co- operation between the general practitioner, Tuberculosis Officer and Medical Superintendent at the Sanatorium that the best interests of the patient can be upheld and the problem of advanced cases dealt with. The question of treating cases of lupus or skin tuberculosis was brought up this year by the application of several patients for a grant to cover travelling expenses to Sir Norman Walker’s Arc Tight Clinic at Edinburgh Royal Infirmary. In September,