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obtainable, and we are particularly grateful to the Larvngologists
and Radiologists for the ready response to our numerous requests
for consultation.
1,171 cases were referred for X-ray examination. Previously
our use of X-rays was limited, but it is now recognised that no
Dispensary can successfully fulfil its function under such a
restriction. Not only are X-rays indispensable in diagnosis,
but they also tell us the extent and progress of the disease, and
consequently are invaluable in deciding the correct form of
treatment.
Treatment by Artificial Pneumothorax without X-rays would
be impossible. They are an essential guide in the choice of
suitable cases for this form of treatment, and later, in ascertaining
the degree of collapse of the lung and the necessity or otherwise
of a refill. Moreover they enable us to keep a constant check on
the sound lung—a matter of great importance. In this connection
I am pleased to report that a new X-ray screening apparatus is
being installed for the sole use of the Out-patient department.
This will greatly facilitate our work in the Artificial Pneumothorax
Clinics.
The arrangements for Artificial Pneumothorax refills are
working smoothly, and the times of the sessions appear to be
convenient and adequate. The attendances at these clinics
number 988 for the year, and the refills 702. I am convinced
that this form of treatment affords the quickest means of a return
to working capacity, reduces the possibility of a relapse, and offers
a greater hope of ultimate recovery. Especially is this the case
with the class of patient attending the Dispensary.
Tuberculosis is very largely a disease of the poor. A patient
in comfortable circumstances, who can stay in a sanatorium, if
necessary, for a year or more, knowing that his family will not
suffer want and with no financial worries to retard his progress,
has a good chance of obtaining a cure and retaining his health on
discharge.
The prospects of the average working class man with whom
we come into contact at the Dispensary are distinctly less favourable.
He and his family have probably been in straitened circumstances
for some time, possibly with insufficient and unsuitable
diet. In his debilitated condition his resistance must necessarily
suffer. He, too, may go to a sanatorium, but with a family dependent
upon his earnings he is never free from worry, makes unsatisfactory
progress, and leaves before a cure is effected. After discharge,
if he has not already lost his employment, he returns to
work, while still unfit.