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"You will also be interested to learn that no less than 1,039 new patients
were seen at the Chest Clinic at the request of private doctors for an
opinion on the chest condition during 1955; in 1954 the figures were 841.
A relatively small proportion of these cases were, of course, found to be
tuberculous, but a wide range of conditions was found in those cases in
which abnormalities were discovered—these include cancer of the lung,
bronchiectasis, bronchitis and other chest conditions. A great deal of
individual study of cases is often required with many special tests to
determine whether or not a person has, or has not got say, cancer of the
lung. This condition is, of course, occupying a great deal of my attention
at present.
These observations may illustrate the change of trend in the work of the
Chest Clinic from one where the main work was supervision of treatment
of tuberculosis cases and their contacts, to a position where a large amount
of diagnostic consultative work is done at the clinic. i should add that the
work of supervision and treatment of a tuberculosis register of cases
approximately double now what it was in 1945, is in itself no light task in
the Borough of Deptford. This is owing to all the new advances in drug
treatment and chest surgery for pulmonary tuberculosis these days.
The number of deaths in 1955 directly attributed to pulmonary tuberculosis
was 14, compared with 20 in 1954, five of which occurred in
persons under the age of 45. On the other hand the number of deaths
occurring in persons on the tuberculosis register in 1955 was 23, compared
with 33 in 1954. This suggests that while there is still much morbidity
from pulmonary tuberculosis, the effect of treatment is that the patients
are ultimately dying of diseases other than tuberculosis. It may be possible
to attribute this to the beneficial influence of chemotherapy and other new
methods of treatment of tuberculosis. To bring this figure into perspective,
you have kindly informed me that 56 persons died from cancer of the lung
in 1955. (52 males and 4 females).
The tuberculosis cases in Carrington House have occupied a great deal
of my attention. 95 new cases of pulmonary tuberculosis have been
discovered in men residing there between the beginning of 1950 and the
present date. An additional 50% of cases have come to my attention as
inward transfers to the area making approximately 150 cases in all.
I am in the course of making a detailed study of these 95 brand new
cases of tuberculosis discovered in Carrington House inmates. Suffice it
to say at present, that their average age is 59 years and that as far as
severity of disease is concerned, eight had slight disease, seventy had
disease of moderate severity and the remaining 17 had advanced tuberculosis.
There have been 21 deaths among these cases to date. As would
be expected in persons in a common lodging house, two-thirds of these
men were single persons, of the remainder 13 were widowers, and 10 were
separated from their wives or else divorced. With regard to occupation,
over three-quarters of the men belonged to the labouring classes and the
remainder were in semi-skilled occupations, while comparatively few,
namely two, were in clerical occupations; 7 were kitchen or restaurant
porters.