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Prevention.
Contact work has continued as usual, and the increasing number of
children coming forward for B.C.G. vaccination is a good augury for the
future extension of this form of protection of the whole population. In
June 1954 the L.C.G. commenced their scheme for the vaccination of school
leavers with B.C.G.
After-care and Rehabilitation.
A scheme for domiciliary diversional therapy as an adjunct to
domiciliary rest and chemotherapy was commenced by the Voluntary AfterCare
Committee of the Clinic in May 1954, when we had an offer of the
services of a fully trained artist and occupational therapist. This
provides a useful recruiting ground for the Meekly Handicraft class.
Future Trends in Chest Clinic Work,
The increasing success of our clinical attacks on Pulmonary
Tuberculosis and the gradual disappearance of the untreatable case, is
causing Chest Physicians to pause and consider the future of the service.
Ever since their inception, chest clinics have unearthed, investigated
and treated a very large number of cases of lung diseases other than
that caused by Tuberculosis.
The returns of the Ministry of National Insurance for 1950 showed
that 16,500,000 working days were lost in that year due to Chronic
Bronchitis alone. Impaired function due to Pulmonary Fibrosis as a
sequaele to Pulmonary Tuberculosis, and following extensive chemotherapy,
is another problem that has to be faced in the near future by chest
clinics.
The increase in deaths from cancer of the lung from 5,000 in 1939
to 16,656 in 1954 is a very urgent problem that chest clinics up and down
the country can play a very useful part in helping to solve
Finally the industrial hazards of dust in the lung is a problem that
has only just begun to be appreciated; we know something about the
hazards of dust in mines, foundries, mills and in china clay and cement
works, but very little about the other 90% in industry, where the
symptoms are less dramatis, and the onset of disability much slower;
nevertheless the loss of function by the time 60 years of age is reached
may be considerable. As the increasing tempo of modern scientific
medicine engulfs and sweeps away one section of social diseases after
another, it is necessary for the organisation of the medical services
to become more elastie, always ready to adapt itself to deal with the
fresh problems exposed more clearly by the removal of the old ones."