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TUBERCULOSIS. (continued).

I am indebted to the Chest Physician, Dr. J.P.V. Rigby, for the following
report concerning the Chest Clinic at Harton Street, which is of great interest:-
Cases on Chest Clinic Register at 31.12.58:-
Definite ... ... ... ... ... ... 1,121
Observation ... ... ... ... ... 44
Number of new contacts examined. ... ... ... 376
Total attendance at the Chest Clinic. ... ... 7,352
Total attendance at the Refill Clinic ... ... 25
TUBERCULOSIS CARE COMMITTEE.
Interviews by Secretary ... ... ... ... ... 984
Cases assisted by Care Committee ... ... ... 70
Sums raised by Christmas Seal Sale, 1958.. ... £118.18.0.
"You will notice that the attendance figures are slightly higher than .1957
which was 7,278. You will note that there are also a few attendances at the
Refill Clinics. The figures are greatly reduced in the last few years and are
likely to remain at zero in the years to come. Air collapse measures in the
treatment of pulmonary tuberculosis have now been superseded by a combination
of the anti-tuberculous drugs, mainly Streptomycin,PAS and Izoniazid, combined
in some cases with major chest surgery which nowadays mainly aims at removal of
the area of lung disease by resection. This is rather a different matter to
an operation previously extensively used called thoracoplasty, where.the chest
wall was collapsed inwards and the tuberculous lung allowed to heal by relaxation
This procedure is still done at times, but less frequently nowadays when the
tuberculous lesions in the lungs can be more safely operated on without risk of
spread if the anti-tuberculous drugs are given at the same time. In such cases
the drugs act as a sort of "umbrella", preventing the spread of tuberculous
disease after the operation. This was, in fact, why resections were impossible
before the era of anti-tuberculous drugs.
With regard to chest diseases in general, the last winter was a severe one
and the Chest Clinic services were at times strained to cope with the flow of car
for investigation and'treatment of bronchitis, pneumonia, bronchiectasis, new
growth of the lungs and other disorders. I feel that the dust laden atmosphere
of Deptford exaggerates the tendency to lung diseases in these parts, especially
when combined with dampness and exhaust fumes from vehicles and machinery. The
addition of a personal factor of tobacco smoking, particularly cigarettes, see
render the lungs more liable to the diseases I have mentioned, particularly in
excess of 15 to 20 cigarettes daily.
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