View report page

118
The errors of the Clinician are widely broadcast, but he is not alone in his
fallibility : the Radiologist must take his due share although not receiving the
same publicity. Like the Physician he is beset with numerous pitfalls.
Shadows on the X-ray film caused by diseases other than tuberculosis, yet
simulating it, are frequent, and it is not yet fully recognised that the correct
interpretation of an X-ray film is often extremely difficult. Radiology of the
chest is a special branch requiring years of experience, and while the opinion
of the Radiologist who has made a special study of this is of inestimable
value, that of his colleague with little or no experience in this particular branch
may not only be useless but misleading.
The use of X-rays is not limited to the diagnosis of early tuberculosis, but
is of the greatest value in the differential diagnosis of tuberculosis, bronchiectasis,
cancer of the lung, etc. X-rays will also show the extent of the disease,
and often enable us to form an opinion of its activity—invaluable information
in deciding the appropriate form of treatment. They will, further, help us to
estimate more correctly the results of treatment, and are an indispensable
guide in treatment by Artificial Pneumothorax.
We are grateful to the Hospital for providing immediate admission for a
number of urgent cases, and to the Staff for facilities in following up our
cases while in the wards. This arrangement adds considerable interest to our
work, as it enables us to keep in touch with all the latest methods of treatment
and diagnosis.
The local charitable organisations continue to give us their valuable support,
and we are specially indebted to the Invalid Children's Aid Association for
sending a large number of our debilitated children to convalescent homes in
the country or at the seaside. Both Tuberculosis Officers are members of
the local committees of this Association. The Charity Organisation Society
has provided dentures, surgical instruments, clothing, etc., when necessary,
while the United Services Fund has helped the families of ex-service men.
The children attending Stormont House open-air school have made good
progress during the year. It has previously been the practice of the London
County Council to allow only notified cases of tuberculosis in this class of
school, but recently it has been decided to admit in addition " suspect " cases
of tuberculosis. This innovation would, at first sight, appear to be undesirable,
and I was not very hopeful that the parents of suspect cases would readily
agree to their children working in such close association with definite cases of
tuberculosis. I was, however, able to assure these parents that no actively
infectious case was allowed to remain at the school and there has been little
difficulty in obtaining their consent. The school is full, and there is a large
number awaiting admission, but as preference is given to notified cases, it is
to be hoped that the increased waiting list will not materially delay the entry
of the definitely tuberculous child.
There are 90 children on the roll, with an average attendance of 74. With
two or three exceptions all the children come from the neighbouring boroughs
of Bethnal Green. Hackney and Stoke Newington, and are recommended for
admission either by Dr. Hamilton of the Metropolitan Hospital Dispensary
or by myself, and as Dr. Hamilton is a member of the Committee of Management,
we frequently meet at the school and consult one another on the progress
of the children. Both pulmonary and non-pulmonary cases of either sex are
eligible for admission, and the ages range from six to sixteen years. The
classes are held in special open-air shelters which have recently been renovated
and brought up to date. Records of temperature, weight, etc., are kept by
the nurse, and I visit the school weekly, making frequent examinations, and
directly supervising the exercise and rest of each child. Hot milk during the
morning and an excellent dinner mid-day are provided at a nominal charge,
but no payment is exacted in necessitous cases.
It is the aim of the London County Council that all children attending
open-air schools should receive a summer holiday. Accordingly, 57 of the