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44
misunderstanding might arise if such a rule were not adhered to. In all cases
the results of examination, X-ray, etc., are communicated to the family doctor
by letter.
X-ray Examinations. As in previous years, all X-ray work is carried
out at the Brompton Hospital by special arrangement—the Borough being
responsible for the cost. In 1934, 159 patients were sent for X-ray at a cost of
15/- per case. In all cases a special report is sent from Dr. Rawlinson, the
Radiologist in charge of the department at the hospital, together with the
negative, to the Tuberculosis Officer. These films are examined and filed, and
the report entered on the case sheet, so that in future years reference can
always be made to it. It may be said that X-ray examinations are of the
greatest value, both as an aid to diagnosis and as a means of determining the
nature and progress of the disease. The arrangement between the Borough
Council and the Brompton Hospital has always worked satisfactorily, and the
quality of the negatives is excellent—a matter of paramount importance.
Artificial Pneumo-Thorax. Of all the operative measures for helping
to put the diseased lung at rest, Artificial Pneumo-Thorax (or A.P. as it is
familiarly called), is perhaps the most usual. The operation is comparatively
simple, and consists in causing the lung to deflate by the periodical admission
of a measured quantity of air into the intra-pleural region, which more or
less surrounds it. There are certain other measures which can be adopted,
according to circumstances and which may be used in conjunction with A.P.
treatment—such as the stretching, or division of certain nerves (Phrenic
evulsion, or phrenictomy). Usually these measures are initiated in sanatorium
or hospital, and the refill treatment is carried out at Brompton Hospital—
with which Institution a close touch is maintained by the Tuberculosis Officer,
who also keeps the patient under supervision at the Dispensary. The Borough
Council pay at the rate of 10/6d. for each A.P. refill, and during 1934, 391
refills were given at a cost of £205 15s. Od.
Under the heading of special treatment may also be mentioned the
injection of Sanocrysin, or other gold salts in solution; and this treatment
is frequently given in conjunction with A.P. treatment. In 1934 there were
60 injections of gold salts given to Dispensary patients in Brompton Hospital
at a cost of £9 0s. Od.
The treatment of skin tuberculosis (Lupus) is carried out by Finsen
Light Irradiation at the London Hospital, 76 treatments being given during
the year, as a cost of £18 4s. Od.
Dental Treatment. Many of those patients attending the Dispensary
suffer from defective teeth, ranging from slight cases of decay to severe dental
caries and Pyorrhoea. In all cases the teeth and pharynx are examined, as
the importance of oral hygiene cannot be over estimated. Many patients are
referred to their private doctors for dental treatment, and through the latter
the condition is in most cases attended to very promptly. The Dispensary,
however, deals with a certain number of necessitous cases through its dental
scheme; this, of course, only becomes operative if the patient is definitely a
"notified" case of Tuberculosis. In 1934, 13 cases were recommended for
dental treatment, and seven were supplied with dentures; and a certain number
of minor dental repairs (extractions and fillings) were also carried out under
capitation fees.