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The work of the Bronchitis Register has continued in Bethnal Green, and we are
very grateful to the local general practitioners for the co-operation they have
shown in participating in this scheme. Much interesting social knowledge is being
obtained and we hope our social report on the first 200 bronchitic patients we have
seen, to be published later in 1967, will prove most useful."
Dr. R.M. Orpwood, Chest Physician at the Poplar and Stepney Chest Clinics, reports:
"The work of the Poplar and Stepney Chest Clinics has continued during 1966
along the well proved lines that have been followed in the past. The function of
the clinics remains unaltered and, although there is a continuing and significant
reduction in the number of newly notified cases of tuberculosis, this disease
remains the primary concern.
The follow-up of cases for many years after treatment is an important aspect
of the work. Reactivation of the disease has been found in patients who have been
considered inactive for a period in excess of 5 years. This underlines the importance
of continuing follow-up of treated cases and the need for adequate staff to see that
such patients do not default on their routine attendances for check-up.
It has been noted for some years that tuberculosis-formerly a disease most
common in girls and young women of 15-30 age group - is now predominantly a disease
of middle aged and older men. The "problem" cases arise mainly amongst those who
live in lodging houses, or who have no proper home or relatives to care for them,
and also amongst immigrants, particularly those from Asiatic countries. The numbers
of the latter group are, however, beginning to decrease (20% of all new notifications
at the Stepney Clinic in 1966, compared with 37% in 1965). This is due, no doubt,
to the new regulations for health checks now applying to all new immigrants. This
group remains a problem and will need to be kept under constant review.
New cases come to the clinics either via a reference for investigation by the
family doctor, or from one of the hospitals. X-ray facilities are also available
for the general practitioners' patients at Mile End Hospital X-ray Department, the
films being reported by the Chest physician, and abnormalities reported are subsequently
investigated at the chest clinics. This has proved a valuable and increasingly
popular form of investigation during the past four years: —2,282 patients were
examined in this way during 1966; 11 cases of tuberculosis and 9 cases of carcinoma
of the lung were discovered (a rate of 4.6 per 1,000 and 2.6 per 1,000 respectively.)
The elimination of tuberculosis may become a possibility during the next decade.
It should then be possible for the chest clinics to direct all their energies to
the alleviation of other chest conditions, many of which are as disabling to the
patient as tuberculous disease has been in the past."
22.