l6 QUATERCENTENARY STUDIES IN PATHOLOGY 



Medical Officer of Health, is capable of being organised, on some scale, 

 at trifling expense, wherever there is a vacant Hospital Ward and an 

 adequate medical nursing and public health service. 



F. Hospital Wards for Isolatio7i of Advanced Cases. 



Many patients are too advanced in the disease to leave their beds. 

 Their homes may be entirely unsuitable for safe nursing. Such cases 

 should be isolated. For this purpose, vacant wards of an Infectious 

 Disease Hospital may be utilised. Here, palliative treatment is possible. 

 There will be adequate medical supervision and nursing. Under very 

 simple precautions, friends and relatives may have access to the patient. 



In many localities, notably in Lanarkshire, much has been done in 

 this direction. The isolation of such dangerous cases is a primary duty 

 of the Local Authority. By Professor Koch and many other investigators, 

 these advanced cases are regarded as the principal sources of infection. 



It will thus be seen that every variety of case may be suitably dealt 

 with by the Local Authority. 



VIII. Dispensaries for Pulmonary Phthisis, 



" In towns and other thickly populated localities, where the number 

 of phthisical patients is large, the Local Authority will find it advisable 

 to institute a Dispensary or Dispensaries. In Edinburgh, the Royal 

 Victoria Dispensary for Tuberculosis, organised by Dr. R. W. Philip, has 

 worked successfully for eighteen years, and the suggestions here made 

 are largely based on the experience of that Dispensary. (See paper by 

 Dr. R. W. Philip, Edin. Med. fournal^ January, 1906.) On the Continent, 

 notably in France and Germany, Dispensaries have been of immense 

 value in the discovery of insanitary conditions, and in the organisation 

 of nursing service. 



The work of a Phthisis Dispensary would include the following : — 



A. Medical Examination of Patients — either at the Dispensary or 



in their own homes. 



B. Inquiry by a medical man, or qualified nurse, into the history 



of the illness, the home-conditions, the economic condition 

 of the family, the occupation, the suitability or unsuitability 

 of the accommodation for home-treatment, &c. 



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