This study was initiated in 1928 in Bellshill and Shotts Dispensaries. The area served by those dispensaries extends to 83,500 acres and has a population of 150,000, including a number of Lithuanians and a large proportion of Irish. Coal-mining, Iron and Steel manufacture are the industries of the district, and in all three unemployment has reached its "peak" figures during the year under review. Living conditions, therefore, have been bad, and out of this distress has been established a more intimate relationship between the dispensaries and the community as a whole. The unemployed and poorer classes generally, also those more happily situated but feeling the pinch of long continued economic stress, now resort to the dispensaries in search of general medical advice, medical comforts or assistance in some other ways. The actual cases of tuberculosis are few amid a surfeit of minor ailments, nutritional and general medical disorders. The children among them are representative of the average family in a "depressed" area, but in so far as the investigation has been conducted entirely in dispensaries, the figures are still short of being typical of the district as a whole. They are capable of comparison only with figures obtained under similar conditions. Throughout the investigation the routine dispensary procedure was adhered to, and no endeavour made to provide data in support of any pre-conceived hypothesis. Domestic particulars and weight in ordinary clothing were recorded by the clerkess in attendance. An enquiry into the previous and family history, and physical examination, either complete or with reference to the locus of disease as suggested by the symptoms, was undertaken by myself. Tuberculin skin tests were applied by myself or by the nurse assistant. The Von Pirquet and Moro tests were used in each case and every effort made to obtain uniform results by the employment of one simple technique. X-Ray photographs were taken by arrangement with the physician superintendent in the X-Ray department of the County Fever Hospital. An established diagnosis was reserved until all relative information quot;was complete. The Moro and Von Pirquet methods of applying the tests have been used throughout and have not been abandoned in favour of the more delicate intradermal method of Mantoux. Fishberg (1) uses the Von Pirquet test in preference to the quantitative method which, he holds, offers no advantages, but it is generally accepted that the Mantoux test is a more exact method where sensitivity is low. Hamburger and Monti (2) were the first to demonstrate discrepancies in results due to different technique, and more recently, Austrian (3) and Myers (4) and others have recorded positive reactions with the intra-dermal test in children whose Von Pirquet hadpreviously diminished to negative. However, the tests employed are simple and better suited to dispensary practice where scientific accuracy must of necessity be sacrificed for convenience. Moreover, these tests have been widely used in other similar surveys and their results will be more exactly comparable
