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house, which provides me with most of the new cases of pulmonary tuberculosis
in this area. A modest number of 65 new tuberculosis cases was discovered in 1970,
and about half of these had positive sputum on diagnosis. In my opinion, the more
that pulmonary tuberculosis is sought in the common lodging house population, the
more new cases of tuberculosis will continue to be found. It must not be forgotten
that a number of persons continue to "sleep rough" in the Lewisham area. Sometimes
these men have been in a common lodging house, but owing to some misdemeanour
or other, have not been allowed to continue their residence there.
Alcoholic drunkenness and rudeness to staff and offences against other inmates
have been quoted as reasons for being barred from such institutions and I think
this fair enough. Individuals who "sleep rough" and neglect themselves may, of
course, become ill and even develop tuberculosis.
I did a survey on some of the Carrington House inmates that came to me here
for the first time during 1970, and of 57 cases no less than 30 were of Celtic origin,
namely born in Eire, Northern Ireland, Wales or Scotland—mainly Eire. Of the
remainder, 25 were from England, 2 from Poland and 47 of the total claimed to be
single. Twenty-four of them had pulmonary tuberculosis, 5 had pulmonary neoplasms,
6 had bronchitis, 1 had an hiatus hernia and the rest had normal chests. Twenty-three
of them claimed to have lived in Carrington House for over six months and some
had lived there for very much longer—as long as 10 or 20 years or more in some
cases.
I also did a study of heavy cigarette smokers, namely those who habitually smoke
over 20 cigarettes daily. I saw 70 women who came under this category, 6 were
under 20, but the majority of them, namely 38, were between the ages of 28-39 and
the remaining 26 were over 40 years of age. During the same time I saw 110 heavysmoking
males, one of whom was under 20, 41 were between 20-39 and the vast
majority (68) were over 40 years of age. It does seem that heavy cigarette smoking
has been much more recently acquired as a habit by womenfolk in the Deptford
area. I believe that this applies to many other parts of industrial England.
I also have records of 57 new cases of lung cancer seen in 1970, 47 of whom were
males. Thirty-eight of these were dead by the end of 1970, showing just how quickly
cancer of the lung can end existence, despite all efforts at treatment by surgery,
radio-therapy or drug treatment, which I tried. These figures are depressing, but
do indicate the dangers of cancer of the lung. This disease has been shown to be
associated with heavy cigarette smoking. Many of my cases discovered to have
carcinoma of the lung were indeed heavy cigarette smokers. Most of these cancer
cases came to me much too late and the disease was usually too advanced to be
susceptible to treatment by the time it was discovered. The main need is for regular
chest x-rays, especially in middle-aged smokers, and indeed in all who have a persistent
cough over a fortnight.
Once again we are living under the threat of closure as a clinic and transfer to a
nearby hospital, possibly the Miller Hospital. This is not such a radical change
as I feared when it was understood that the clinic would be moved two miles away
to the Greenwich District Hospital. Perhaps the move will mean much less pressure
on this Department and a more rigid control of the appointment system will be
achieved. This may yet prove a relief from attendance figures of overwhelming size
and from some demanding individuals, but when it does eventually move, the
unique spirit of the clinic may be hard to recreate elsewhere as it is a happy clinic
in its present surroundings. I think the move is not contemplated before the next
two or three years, so for the time being we can breathe fairly freely. In the meantime,
this clinic does appear to give an outstanding service to the public, to judge
from the happy attitude of many of the patients who have attended.
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