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140
As well as the possibility of exacerbation of the tuberculous
disease another serious problem which arises in many of these
patients is their disability due to breathlessness caused by permanent
damage to the lung by the tuberculous disease or by surgical treatment.
Many of these patients are also more susceptible to bronchitis
which further increases their disability. This problem is
liable to increase as time goes on because more patients are surviving
their tuberculous disease and they are living longer. Besides
the need for medical supervision and assessment of these patients
social problems arise of which the most important is their difficulty
in finding suitable employment. Some form of sheltered work
would be of great value to these disabled persons and although it
would need to be partially subsidised it would greatly improve their
morale.
Two hundred and eighteen ante-natal patients were X-rayed
during the year and one was found to have tuberculous disease.
Two hundred and fifty-five persons were examined as contacts, one
man and two children were found to have tuberculous disease.
During the year a number of children were referred to us from
the school tuberculin test team because they were found to have
positive tuberculin tests at school as part of the routine testing
prior to B.C.G. None of these were found to have active tuberculous
disease but it was felt worth while to keep some of them
under further supervision for a time and to examine their family
contacts. The numbers of school children with a positive
tuberculin test are decreased now so much that all positive ones,
and their families, may be sufficiently significant to examine. One
hundred and twenty-six children and young adults, mainly tuberculous
contacts, have been given B.C.G. inoculation.
We have continued to admit tuberculous patients to Vanbrugh
Ward at St. Alfege's Hospital for treatment. These patients have
been mainly those who are infectious and unable to be adequately
cared for at home. As treatment has now improved many of these
patients stay for one/three months only and we have no "long-stay"
patients except for two who are in Sanatoria.
Disability due to breathlessness resulting from chronic bronchitis,
emphysema and asthma is still a very serious problem and
an increasing number of these forms of respiratory disease are being
referred to the Clinic. Efforts are being made to investigate the
various aspects of this kind of chest trouble and to try and prevent
it. Certain persons appear to be more susceptible, or allergic,
than others to dusts and other irritants in the air, in their homes
or at work. It is felt that the best way of preventing such disability