30 T H E B R I T I S H J O U R N A L O F T U B E R C U . L O S I S

THE EQUIPMENT OF A TUBERCULOSIS INSTITUTE.

BY H O R A C E W I L S O N ,

M.D. I B.S. (LOND.), M.R.C.S., L.R.C.P.,

Tuberculosis Physician to the Welsh National Memorial to King Edward VII.

AT the present juncture, when so many tuberculosis institutes or dispensaries are being started all over the country, it may be of some utility to discuss the minimum outlay necessary to establish and equip one for the commencement of work, and the following requirements may be taken as a minimum standard to commence with, which, though sufficient, can be further amplified at the will of the tuberculosis officer as necessity arises or funds permit. At the outset it must be clearly understood that this article is not for a moment supposed to deal with the ideal dispensary where expense is no object, but to be of practical assistance to those entrusted with the formation of a dispen- sary on a limited allowance.

The absolute minimum of accommodation required is two good ground-floor rooms having water and gas laid on, and it should have lavatory accommodation available. Both rooms should be well lighted, and have heating facilities. I t is found that gas is all round of more practical utility than electric light, as the former can be used for heat- ing, lighting, boiling water, illuminating laryngological lamps, and for use with Bunsen or Argand burners. The walls should be painted with a washable distemper, and the floors covered with a plain linoleum, which shows any presence of dirt, and can be kept cleansed and preserved by using one of the antiseptic floor-polishes. The rooms are used respectively as waiting and consulting rooms, and it would obviously be of great advantage to have an additional room communi- cating with the consulting-room for use as a dressing-room ; but in the minimum scheme under consideration the difficulty is surmounted by screening off two suitable corners of the room with large, folding screens of American cloth, which are easily cleansed, and putting a chair behind each, thus permitting two patients to dress or undress at the same time while a third is being interviewed. The plainer the rooms are, the freer the walls from notices, and the mantelpieces and "ledges from odd bottles and appliances, the better.

The only absolute necessities in the way of furniture are a good table with drawers, chairs, two screens, a good cupboard, a case for filing case-sheets, and a weighing-machine. In the waiting-room it is necessary to provide chairs only; fire-guards are also required if the rooms are heated by open grates.

E Q U I P M E N T O F A T U B E R C U L O S I S I N S T I T U T E 3 I

T h e fo l lowing is a fa i r ly a c c u r a t e s c h e d u l e of t h e cos t o f t h e

a r t ic les needed , a n d a re b a s e d on t h e w r i t e r ' s p e r s o n a l e x p e n d i t u r e s :

;~ s. d. x table with drawers . . . . . . . . . . . . 2 o o

arm.chair . . . . . . . . . . . . . . . to 6 i roomy cupboard . . . . . . . . . . . . . . . 2 ,o o 8 kitchen chairs, at 3s. 6(t . . . . . . . . . . . . . x 8 o x weighing-machine . . . . . . . . . . . . x 5 o * waste-paper basket . . . . . . . . . . . . z 6 2 screens (fourfold) . . . . . . . . . . . . . . . . 2 *o o I case for case-sheets, on castors . . . . . . . . . x *o o z e n a m e l w a s h s t a n d . . . . . . . . . . . . 15 o Linoleum for floors . . . . . . . . . . . . . . . 3 o o

Total ~'5 *t o

A s far as t h e e q u i p m e n t w i t h s m a l l e r a r t i c l e s is c o n c e r n e d , s u c h

t h i n g s a s s p u t u m f l a sks a n d c u p s a r e f r equen t ly so ld or l en t to pa t i en t s ,

as also a re t h e r m o m e t e r s , a n d the cos t a n d p a t t e r n of t h e s e w o u l d v a r y

w i t h t h e i nd iv idua l f a n c y of t h e phys ic i an , a n d wi l l d e p e n d on the l ines

on w h i c h the d i s p e n s a r y is to be run ; b u t t he fo l l owing a r t i c les a r e

n e c e s s a r y and suff ic ient for a w o r k i n g b a s i s p r o v i d e d t h e t u b e r c u l o s i s

officer m a k e s h is o w n d i lu t ions of t u b e r c u l i n , a n d will be found q u i t e

s a t i s f a c t o r y : , ~" s. d. 2 tubercdlin syringes . . . . . . . . . i '~ o 6 phials tuberculin ... iii . . . . . . . . . 9 o z dozen phials for dilutions (5 c.c.) . . . . . . . . . 6 x dozen rubber corks for ph!als ... . . . . . . . 6 x small spirit-lamp . . . . . . . . . . . . . . . i o I roll cotton-wool . . . . . . . . . . . . . . . x 6 i reel adhesive plaster . . . . . . . . . . . . 6 io ounces methylated spirit . . . . . . . . . . . . Io io ounces saline and carbolic for dilutions . . . . . . 6 x sterilizer (small fish-kettle, enamelled) . . . . . . 3 6 z sterilizer (for syringes and small articles) . . . . . . *o 6 6 towels . . . . . . . . 4 blankets ('cot) for patient's shoulders" ... ... 5 o • .. 5 o

Total ~2 I9 4

T h e a b o v e l is ts h a v e b e e n found b y t h e wr i t e r to be a m p l y suff ic ient

for f o u n d i n g a t u b e r c u l o s i s i n s t i t u t e , a n d t h e a m o u n t m e n t i o n e d t h e

a p p r o x i m a t e cos t , a n d t h o u g h it m u s t be b o r n e in m i n d t h a t t h i s is t h e

m i n i m u m on w h i c h w o r k can be done , it is n e v e r t h e l e s s e n o u g h to

m a k e a c o m m e n c e m e n t , a n d a l l owing for a f ew sma l l e x t r a s , / 7 2 o wi l l

suffice for t h e ini t ia l e q u i p m e n t .