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22
CARCINOMA OF THE BRONCHUS
Early diagnosis and a quick decision as to the most suitable form
of treatment, associated with the minimum of delay before its
implementation remains the only rational policy in this disease at the
present time.
With the co operation of the Mass X ray Department, the Local
General Practitioners and our surgical colleagues, patients can in the
majority of cases start their treatment with radical surgery or
radiotherapy within ten days of their first abnormal x ray, Normally,
after this first x ray a new patient is seen at the clinic and referred
to our bronchoscopic clinic all within the space of a week. It is the
long delay in obtaining diagnostic confirmation and a surgical opinion
and treatment which is one of the causes for the bad results for this
disease in many centres.
PHYSIOTHERAPY
The sole form of treatment available for the average patient with
bronchitis is chemotherapy of the acute relapse associated with tipping
and graduated breathing exercises. Breathing Exercise Classes have
continued throughout the year interrupted from time to time by the
shortage of a full time physiotherapist. This state of affairs will
be remedied in 1961 with the appointment of further staff in this
Department,
IN PATIENT TREATMENT
The old tuberculosis wards are now at last undergoing radical
upgrading into single, double and larger cubicles, and one such ward is
to be air conditioned for the treatment of chronic respiratory disease.
These wards should be completed and open for the reception of patients
during the summer of 1961.
The Chest Clinic is still one of the few units of the National
Health Service where the clinical, preventive and social medicine
aspects of health are combined in one unit. The fortunate accident
that prevented the dichotomy that afflicts the other sections of the
Health Service was not extended to tuberculosis, and this has allowed
the old tuberculosis dispensary to develop into the modern chest clinic
of today, where the patient can be treated as a whole and not simply
the diseased portion, and disease can be seen in its true perspective
as a variation of the normal, due to various adverse environmental
factors.
Many misguided individuals hope that as tuberculosis wanes so the
necessity for chest clinics will decrease, so that this unfortunate
accident of the Health Service Act of uniting treatment and prevention
aspects of the health service can be quickly forgotten. It is to be
hoped that sane councils will prevail, and the policy that guides the
chest clinics will spread to other aspects of our curative services.