26,t PUBLIC HEALTH. AUGUST, 55. The Hygienic Aspect o] the Coal-mlning Industry, Milroy Lec- tures, 1914, F. Shultlebothana, lecture iii. THE WORK OF A TUBERCULOSIS 56. Monographie hygidniqua de la ]abricatiol~ d~ pldtraerle~ 1,'rance, DEPARTMENT.* H6bert, Maute, and Helm, 191~, Duruy et Cir., P ". 57. Report on the Prevalence of Fhthisis among ~uarry Workers and BY GEORGE JESSEL, M.A., M.B., B.Ch. taxon), Miners, S. Bar\vlse, i913. l)elfl~y (:aunty. 58, Royal Commission on MetalliJerous Mines aml Ouarries, Minute~ D.P.H. (Vict.), Tuberculosis Officer to Lancashire of Evidence, Vol. iii., Appendix P., 19I.i. Wyman & Sons, Ltd. County Council and County Borough of Wigan; now (Cd. 7478.) 59. Annual Report o[ the ChieJ Inspector o[ Factories ]or I9H. also Acting Medical Officer of Health of Wigan, PP. 203-$. Wyman & Sons, Ltd, (Cal. 6239.) 59a. Ibid. pp. 23o.i" 60. ]~hresberichte der Gewerbe-Aussichtsbe~lmten und Bergbehorden ]ur da's Jahr. 1oH, OD. q84-4~0. Berlin. 6I. On the Mortal[ty of'Fl~-l~'o'vhers, C. D. Purdah, 1873. HE following paper deals with the work 62. Jute, H. J. Wilson, Dangerous Trades, edited by T. Oliver, 19o2, T p. 66o. John Murray. "" now being carried out at the three tuber- 63. An Address on Pneumonia, Sit" James Barr. British Medical Journal, Jan. Ioth, 19i 4. culosis dispensaries, situated respectively in 64. Report to the Royal ColleGe o] Physicians o)) the l*lJettivity o] Pulmonary Tuberculosis. British Medical Jot r m , Ap- I iith the County Borough of Wigan and the Boroughs IqI4. 65. The EXperimental Production o] Pneumonia, R. B. Armstroug. of Charley and Leigh, and serving not only Supplement to British Me(ica Journal, July 18th. 19i 4. 66. The Lumleian Lectures, Dr. P~ Kidd. Lancet, Vol. i., 1912. these boroughs, but the surrounding town- 66a. Ibld. p. 159o. 66b. Ibld. p. x668. ships, comprising altogether a population of 68. Les Pneumonies A scories, Monnier. Gaz. Med. de Nantes, Nov. x2th, ~898' nearly 3oo,o0o persons. The staff, in addition 69. Les Pneumoaies c~ stories, Gatttret. Th~se de Paris, i899. to myself, consists of two assistants, five 7 o. Final Report o] Departmental Committee on Certain Miscellaneous Dangerous Trades, p. 13 , x899' Eyl-e & Spo|tiswoode. (C.-- nurses, and two clerks. 95090 7 ~. TheCause, Ef]ect, Incidence aml Prevention o] Pneumonoconiosi~ I have been fortunate in being allowed con- °l Lmartz Miners, J. S. Purdv The Practitioner February 1012 7 z. Melbourne.M ers" Phthisis r t Ben&go.• ~',~v~, Stlmnlons,- 19o7. ' Sttlhvell" • '& Co, siderable freedom in the organisation and 73. Report o] the Royal Commissioner on Pulmonary Diseases amongst management of these dispensaries, and I think Miners, p. 6% i91o. Perth, Western Australia. 74, Die Staubinhalations.I(~ankheiten, Dr. Ludwig Hh't. Die Krnnk- that some account of the methods and pro- heiten der Arbelter, Erster Thcil. 13reslau, 187*. 7S. Diseases o[ the Lungs, Powell arm l!artley, Fourth Edition, 19il. cedure adopted may perhaps prove of interest. H. K. Lewis, London. 76. Report oJ Departmental Committee upon Merionethshire ,Slate Although the functions of a tuberculosis dis- ~.I[nes, 1895' (C.-- 7692.) Eyre & Slmttiswoode, 77. lV**m~tes o] Evidence. Ro)al Commission on Metalll]erous Mines pensary as laid down in the interim report of a~d Ouarvi~s Vol. lit., *9xa,, p. 115. Wyman & Sons, lad. ¢C<1 7478.f " the Inter-departmental Committee in 1912 77a. Ibid. pp. 145_~M" 77 b. Ibid. 188. are fairly definite, there appears to be no little 77 c. Ibld. p. ~36. 77 d. I~bid. pp. 18iq89, and Appendix P. diversity of opinion as to the best means of 78. necnercnes experimentales sur Its conditions physiologiques du travail des ouw, iers sableurs, ~9 n. Brlault. Th6se du Paris. carrying these recommendations into effect. 79. Report o] Medical Officer o[ 1lealth ]or the City o] Aberdeen ~9o9, p. ~o7. This is not unnatural when the varying circum- 80. Report on the p ..... l ...... l Lung Di ................. g the Wortters a~ .t,rr*nsndl ~)uarries, J. Wheallev ~912. Shrewsbury. stances of the districts concerned, whether 8I. ~}epovt o] a Commission o t Miners ~ P] I isis a d P D o ary 'uberculosis in So~ h Alrica. ,gta, pp. 7-1o. Cape Towll. urban or rural, are considered. Apart from 8z. Report oI Medical Officer oJ Health o] loYmm~esburg ~st July. this, however, there are sharp differences both 1912, to 3oth June, ~9t3 . Charles Porter, M~I)., p. 2o. Johannes- burg. in theory or practice in areas apparently 83. Transactions oj the Pathological Sociely o~ London, Vol. xx., ~869. similar in character. 831. l!~[d., V(~I. xvi. ~865' p~ 59_60 84. .~cmnee 1ram an Easy Chair, a second serles, i912 , Sir Ray The tuberculosis dispensary enters into 85. La~kester, pp. 19 .... Adlard & Son, I.ond .... " , emm, A new translation, VV. F. Smith, ~893, VoI. i., chap relationship with-- xx]x.:, p.. 343. Alexander p. Watt. 86. ~e *Tygte~{e des Bergmannes Halle ~0o3 Goldman i. Public Health Department. 87 . • ne so-catted Anthracosis and, Phthisis, . in ~Coal-miners, . R. S. Trotter. British Medical Jourual, 23rd May, ~9o3. ii. General practitioners. .y ji, a. Wainwright and H J. Nic~os Ane'cal Journal ot iii. The general public. t~a,e ~vje,d~c91 Sciences, ~9o5 Vol. cxxx. ppj 403-4~4. 89. ~)tt)ters Phthisis, Sir T. Oliver, British Medical Join'hal, ~2(a iv. Other organisations. Sept., i9o3. 90. Weavers" Co gh Annual Report of the Chief Inspector of Fac- I.--RELATIONSHIP WITH PUBLIC HEALTH ~r~eeSsfe~rolg'3, P- 15o. ,Vy ..... & S ..... Ltd. (Cd. 749'.) 91' I the lungs Item Mechanical Causes, G. Calvert Hol- DEPARTMENTS, land, ~843, p. ~3. John Churchill, I,ondon. 9ra. Ibid. pp. 36_7. 9H). Ibid. p. 6o. This should be as intimate and cordial as 9 ~. Diseases o] Occupation, Sir T. Oliver, p. 294. ~9o7. Metbuen & Co. possible. The problem of tuberculosis is clffsely 9,3. Report. o] Departmental Commitlee on Compensation for ln ttls- trial Diseases, !]linntes el Evidence, pp, 197-2o2, ~9o7, (Cd. 3406 ) associated with questions of housing and sani- Wyman & Sons, Ltd. 94- Pneunlonoconiosis, Sir. T. Olivor. System of Medicine, Al!hutt tation, which are the concern of the medical and Rolleston, Vol, v., 19o9, p, 469. Macmillan & Co., Ltd. 94 a. Ibid. p. 462. officer of health. The latter has, moreover, 95. Staubi~lhalalion u)ld Staubmetaslase, Julius Arnold, 1885. 96. Erkrankunge.~ des Respiratio s pparates, E. Aufrecht Nothnagel's certain statutory obligations under the Tuber- Speclelle ~pathoh,gie u ~d Therap e B .... ' culosis Order, 1912. On this account there 97. ~,a :l~a~m,~a des Ardoisiers. la Schistose, Rehn% ~9oo. Imprlmcqb,. blatot-Bralne. should be a definite system for the prompt and 98' Pj°~ieo;;linvgs O]vi Royal Society o[ Medici .... Electro-Therapeutical Proc edi ' " " 1914' PP 93"98 ready exchange of information between him 99. e ..rigs at Royal Society o[ Medicine, PathologicM Sc~etion V~alttv~. :, part ....... 9'4, TuberculoM P .............. losls, S. G. and the tuberculosis officer. The former ~oa. The Relation o] Industrial a~d ga~ itary (ondilions to Pauperism, receives notifications as to persons suffering Mr. A%D. Maitland and Miss Rose Squh'e p. Io 9 and" pp. i25-6 '9o9 • Wyman & Sons, Lfd. (Cd. 4653 .) from tuberculosis of all forms, and also returns ~OL Annales de l'Institut Pasteur, Paris, ~914, xxvHi. xo2. Staubinbalationskraukheilen der Lungen, p. x7I, Zenker. * Read before a meeting of the North-Western Branch o[ the Society of Io3. Deutseh. Archly. fkh- kiln. Medic. 13d. 2, ~867. Ibhl. pp. ~t6-~72. Medical Ofilcers of ftealth on January iftb , 2915. 1915. PUBL fC HEA L TH. 265 of deaths. At Wigan such information is This is what obtains at Wigan, where it is transmitted daily from the Health Department proving successful. It appears, however, that as regards cases in the borough, while returns in many cases the administrative difficulties are sent weekly from the county medical due to local rivalries are proving a serious officer of health's department. In the latter obstacle to such joint appointments. case there is a certain amount of unavoidable II.--RELATIONSHIP WITH GENERAL PRAC- delay, as notifications are first received by the TITIONERS. district medical officer, and then transmitted to the county medical officer. To obviate this, The first essential is to enlist the support of arrangements have been made whereby local the local medical profession. This is not a medical officers transmit to the dispensary difficult matter when once it is realised that duplicates of their returns to the county the dispensary exists as a special centre, and medical officer. Stamped addressed envelopes is in no way in competition with private prac- are provided, and as a quid :~ro quo a copy of titioners; the latter are usually not slow in the tuberculosis nurse's report is promptly sent realising the advantages to themselves and to the district medical officer, who is thus their patients which result from close co- enabled to make use of same for his own operation. The dispensary not only affords purposes. assistance in diagnosis. It serves also as a One of the special tuberculosis nurses visits clearing-house for cases which are suitable for each case as soon as the notification is received institutional treatment, is a centre for special at the dispensary. It is her duty not merely forms of treatment, and is actively concerned to collect information, but to give advice arid in the supervision of patients while at home. assistance in improving the home conditions.