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58
properties of the drug preparation itself, but at the end of the year and
the beginning of 1952 new drugs were reported on from America, which
drugs appeared to produce in some cases of advanced tuberculosis
almost miraculous effects. These drugs, one of which is isonicotinic
acid hydrazide, are still being investigated and it is too early yet to
say what their place will be, but there appears to be some reason to hope
that as a result of the various methods of dealing with tuberculosis
— hygiene, BCG, streptomycin, PAS and the newer drugs, together
with better detection and earlier treatment — the disease, like diphtheria
before it, may be on the way out. But just as diphtheria has been
many years in dying, so we must expect trouble with tuberculosis for
some time yet. It is essential, therefore, that all the effective weapons
we have shall continue to be used, and in this connection some alarm was
caused by the proposal (in new draft Regulations) to abolish the health
department register of tuberculous cases. No decision had been reached
by the end of the year.
The mass radiography unit visited the borough in May, June and
July and a report on it appears below. Recent review of the work of
the units over the last few years indicates, according to Dr. Tattersall,
a well known chest physician, that mass radiography should deal above all
with household contacts of cases. All such contacts should be tuberculin
tested and offered vaccination with BCG where necessary. Tuberculin
testing is cheap and the testing of school entrants will disclose positive
reactors whose earlier environment has been mainly within the home and
family circle ; hence this approach gets at the unsuspected infectious
case. With regard to BCG vaccination, Dr. Tattersall says, the clinical
evidence in support is such that few clinicians favour withholding it until
scientific trials have given more significant results. Since lung tuberculosis
in teachers, besides affecting their own prospects, may have
serious consequences among children, teachers should be offered
vaccination. The era of the open-air sanatorium, he goes on to say, is
over, and the notion that tuberculosis is most treatable in such
surroundings is rapidly being disproved; treatment should increasingly
be the responsibility of chest clinics supported by beds in local hospitals
and by the relatively few major chest hospitals.
The number of primary notifications of new cases of tuberculosis
received during the year 1951, and deaths, together with comparative
figures for the previous year, were as follows:—