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117
This table illustrates how tuberculosis is most prevalent in the
young adult male and female between the ages of 16 and 35 years.
In men the incidence is still high in later decades but in women over
the age of 35 years and in young children, tuberculosis is now quite
rare.
The sources of these new cases were—
Referred by own Doctor 51 cases
Referred by Mass X-ray units 23 ,,
Referred by National Service Medical
Board 2 ,,
Discovered on routine contact 40 cases
examination 11 „
Discovered on routine ante-natal
Clinic X-rays 4 ,,
It will be seen that 40 of the new cases were discovered by case
finding methods. This emphasises the importance of adequate and
convenient X-ray facilities for patients, including the occasional
evening session for workers.
For the past two years a special session has been set aside for
ante-natal clinic X-rays. This arrangement has been most successful.
During the year 645 patients attended, of whom 4 were found
to have active pulmonary tuberculosis. This early diagnosis meant
that these four patients were able to have adequate treatment during
pregnancy. Each now has quiescent disease and a healthy baby,
which would certainly not have been the case if diagnosis had been
delayed.
The 51 patients who had consulted their own doctors on account
of symptons tended to have much worse disease on diagnosis than the
40 picked up by routine radiography.
Treatment
There have been no great changes in treatment during the year.
There has been no wait for admission to hospital or sanatorium for
treatment and no patient has had to wait for thoracic surgery. The
combined hospital-home treatment schemes have continued most
successfully in conjunction with Kettlewell (now Joyce Green) and
Bow Arrow Hospitals at Dartford. A very much smaller number of
patients are now being sent away to distant sanatoria for treatment,
and much greater use is now being made of the Chest Physician's
beds in St. Alfege's Hospital to treat local patients.