[Report 1912] / Medical Officer of Health, Southampton County Borough.

  • Southampton (England). County Borough Council.
Date:
1912
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: [Report 1912] / Medical Officer of Health, Southampton County Borough. Source: Wellcome Collection.

    53/136 (page 49)
    Procedure Adopted when a Patient comes to the Dispensary. All visits are by appointment, and as far as possible the routine as stated below is followed in arriving at a diagnosis, prognosis and the line of treatment indicated. Forty-hve minutes are allowed for the first visit. The patient is hrst interviewed by a nurse, who records the name, address, age, height, weight and such other particulars as she can ascertain. The tuberculosis officer then goes into the history of the case. A careful physical examination is made and all facts are entered on a special form. At the end of this examination a Ouanti-ATn Pirquet test is performed. Before leaving, the patient receives a thermometer and a four-hourly temperature card, and the nurse teaches him how to record and take his temperature. He is given a sputum flask and urine bottle and instructed to visit the dispensary on the following day, bringing with him his temperature record and a specimen of sputum and urine. On the second day the temperature is recorded on charts specially drawn up for this work ; the \mn Pirquet papules are measured and recorded and the patient instructed to attend on the following day. After the second visit the urine is examined 1 in the ordinary way and the sputum is examined for tubercle bacilli and albumen. At the third visit the temperature and the Von Pirquet ; measurements are again entered up. If necessar\q further samj^les of sputum or urine are asked for or additional Von Pirquet tests performed. On one of these three visits the patient is X-Rayed and a ; photograph taken. The ascertained facts (history, symptoms, signs, including , temperature range', Wjn Pirquet results, X-Ray observations and I' result of sputum examination) are now carefully weighed. In i most cases a diagnosis and prognosis can be made and tlu' form ! of treatment decided u]mn. If the diagnosis be not complete a fourth visit is arranged, ■ when a subcutaneous injection of albuim^se-free tuberculin is ■given. In the absence of a sulhcientlv detinite reaction injections