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76
father, the provision of fares for relatives to visit patients in institutions,
and of clothes for patients, and help with advice in the
many social and economic problems that are constantly arising.
In addition, the Committee has been able to maintain the
Handicrafts Class for persons well enough to attend, but who are
not fit to resume their old employment. The raising of the necessary
funds has involved a great deal of work on the part of the Secretary,
but all liabilities have been met and there is a satisfactory balance
at the present moment. Valuable help has been received from the
National Association for the Prevention of Tuberculosis, the
Alexandra Rose Day Fund, the Inner Wheel of the Rotary Club, the
Hackney and Stoke Newington Chamber of Commerce, and the
Women's Section of the British Legion, while several successful
sales of the work made by members of the class have been organised
by the Secretary. Full use has again been made of the arrangement
by which the Tuberculosis Officer is privileged to refer patients to
the members of the Hospital Staff for an opinion or for treatment.
There are many difficult cases in which consultation is desirable,
especially those in which the lesion is not a tubercular one, or those
in which some non-tubercular complication has arisen. It is now
recognised that a correct diagnosis cannot always be made without
such additional methods of investigation as those which can only
be undertaken by a radiologist expert in chest work. This applies
more particularly to those cases where some special symptom such
as haemoptysis is under consideration, and where no cause can be
found clinically, and I am convinced that every such patient should
be X-Rayed. The great majority of the cases referred to the X-Ray
Department have been found to have no demonstrable lesion, but it
would have been quite unjustifiable to come to this conclusion
without such strong additional evidence as a negative X-Ray
report. One is thus able to terminate at the earliest possible moment
the suspense and anxiety always felt by persons who are under
suspicion of suffering from such a serious condition as Pulmonary
Tuberculosis. On the other hand, where clinically signs and symptoms
are equivocal, there may be no other means of making a definite
diagnosis of the presence of a small focus of tubercle. Valuable time
is thus gained, and treatment can be instituted when there is every
hope that it will be successful. I have once more to acknowledge