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REPORT OF CONSULTANT PHYSICIAN,
CAMBERWELL CHEST CLINIC.
The work of the Chest Clinic has shown no appreciable
falling off during 1956. New cases examined during the year,
numbered 5,836, only 217 less than the previous year. The
tuberculosis register now stands at 1,886 due to the removal of
455 cases whose disease was considered to be arrested. However,
during the same period 324 new cases have been added which
is only 10 less than in the previous year. There has been very
little evidence to suggest that the new cases added to the
register have been significantly different from both the clinical
and pathological points of view than those cases added during
the previous five years. The majority of new cases have been
among the older age groups, especially among males.
The mortality rate continues to show a satisfactory fall—
21 deaths of males, 19 of whom were over the age of 44; there
were only three female deaths from this cause.
In previous reports attention has been called to the very
high prevalence of tuberculosis among the inmates of a
Reception Centre. In conjunction with Dr. Morgan of the
South East Metropolitan Mass Radiography Unit, quarterly
visits have been paid to the Centre. It has been found that the
prevalence rate of new cases varies between 50 and 57 per 1,000
which compares most unfavourably with the prevalence rates
for South East England and London which is 1·39 per 1,000 for
the 45-64 age group. During the past year a register of men with
tuberculosis who visit reception centres, common lodging houses
and similar institutions, has been compiled, and it has been of
considerable assistance to chest physicians in other parts of
the country in tracking down the records of men in social class V
who, although they know they have tuberculosis, neither take
treatment nor remain under the observation of any particular
clinic.
Another aspect of the change in the treatment of tuberculosis
is shown in the fall from 2,562 to 1,215 in the number of refills
for collapse therapy given to patients with the disease. Collapse
therapy is considerably less popular than hitherto, due in great
part to the introduction of various chemotherapeutic substances
and the large number of patients who are considered suitable
for surgical treatment. At any one time there are still over
100 patients receiving ambulatory chemotherapy. As experience
accumulates so it is likely that the most commonly used form
of treatment involving the taking of two separate lots of tablets