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CHEST CLINIC, DEPTFORD
I am indebted to Dr. J. P. V. Rigby for the following report concerning the Chest
Clinic at Harton Street, of which he is consultant physician: —
Despite threats of extinction, the Deptford Chest Clinic still continues to prosper
and the attendance figures have, in fact, increased during 1971 despite an attempt
to reduce the numbers. Thus the total attendances went up from 5,358 to 5,744
and the total number of new patients from 1,330 to 1,350. Most of the latter consisted
of consultations by general practitioners, cases sent to me for an opinion on
the chest for the most part. The total number of cases of tuberculosis on the
Deptford Register has decreased from 969 to 862. Of these, the deaths of cases
on the Tuberculosis Register was down from 31 to 18 in 1971. There were 44 newly
diagnosed cases of tuberculosis, 23 of whom had tuberculosis germs in the sputum
when first seen. This is less than 1970 but still quite a large number of new cases
of tuberculosis.
Deptford has been the seat of a number of striking changes in the last few years,
as a result of wholesale destruction of older housing properties and the replacement
of these old houses by large blocks of new flats, often in skyscraper form, reminiscent
in parts of New York's Manhattan area. These housing changes have had
marked secondary effects on the tuberculosis cases in the area as many of them
have become rehoused elsewhere, not always in Deptford. No less than 80 cases
left the area last year compared with 69 in 1970.
I have also been going through the Tuberculosis Register in detail and decided
that many of the previous sufferers can now be regarded as having recovered from
tuberculosis. Some years ago, before the powerful drug treatments for tuberculosis
were introduced, it would have been unthinkable to remove so many cases from the
Register as recovered, but last year I was able to remove no less than 40 cases.
Despite systematic home visiting by the tuberculosis visitors, however, there are
still a number of cases who manage to apparently disappear and become lost from
sight. Where cases of tuberculosis occur in Carrington House, contact is not infrequently
lost with individuals. Consequently Carrington House continues to
occupy a good deal of my time as far as tuberculosis is concerned.. Tuberculosis
is still the main reason for which I am consulted about these men. When found,
most of the tuberculous cases in this lodging house are of severe degree and need
admission to hospital forthwith and many months of treatment. I am pressing the
Mass X-ray authorities to increase the number of times that they visit this house
with their equipment. I understand the visits may be increased to three-monthly
before long. My firm impression is that, quite apart from chest diseases among the
inmates of Carrington House, there is a quite extraordinary amount of illness and
decrepitude among the people there. Most of the men are single, unattached elderly
males, not skilled in the art of looking after themselves as far as health matters are
concerned. There would seem to be a need for daily attendance by a medical
practitioner at the house, and there is, of course, considerable scope for social
welfare activities. I understand these are already being attended to systematically
and in a way which is unbelievable compared with the state of affairs which existed
some years ago at this house, but much remains to be done.
I am still collecting data about heavy tobacco smokers, narticularly those addicted
to cigarettes. In 1971 I see there were 108 males and 61 females who were smoking
more than 20 cigarettes each day regularly, sometimes as much as 30 or even 40
or more cigarettes daily. The threat to health from such a practice is quite incalculable
and the money expense to the smoker must make quite a big hole in the
family budget. As a result of this and other factors, bronchitis is still a great problem
in this part of the Thames Estuary. Many patients who attend here obviously
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