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110
Pulmonary tuberculosis in children.
The medical superintendent of High Wood hospital for children (Dr. Reade)
has reported an increase in the number of positive sputum cases being admitted.
Whereas, on 31st December, 1933, there were 62 children in the hospital with
tubercle bacilli in the sputum, on 31st December, 1934, there were 100 such cases
(excluding those in which the presence of tubercle bacilli was only demonstrated by
the gastric lavage method), and on 31st December, 1933, there were 38 cases undergoing
artificial pneumothorax treatment, while on 31st December, 1934, there were
50 such cases.
During 1934 a larger number of operations have been performed. For instance,
in 1933, there were only four operations of phrenic evulsion, whereas in 1934 there
were 11. In 1933 there was' one operation of thoracoscopy and division of adhesions
and in 1934 there were four. For this operation a new type of thoracoscope, of
small bore suitable for children, was designed and used during the latter part of
1934 with great success. There was also an increase in the number of ear, nose and
throat operations, viz., 54 in 1934 as against 19 in 1933. Double artificial pneumothorax
was done in five children with beneficial results, and it was found that the
children stood the reduction of pulmonary ventilation very well.
Research in tuberculosis.
The medical superintendent of King George V sanatorium has collected data
for about 300 cases treated at that sanatorium by sanocrysin in recent years, from
which, he states, the main fact emerges that about 50 per cent. of those having
complete courses of gold treatment lost the tubercle bacilli from their sputum. He
hopes to submit details when he has examined a control series. He adds that his
colleagues in the other tuberculosis hospitals who have collected statistics find a
similar result and are convinced of the value of gold salts in treatment.
The following researches have been carried out at King George V sanatorium
during the year, viz.:—
(a) Correlation of the blood sedimentation rate, the Von Bonsdorff count
and the differential leucocyte count;
(b) Analysis of the results of treatment by sanocrysin ;
(c) Survey of acquired pigmentation and its relation to prognosis ;
(d) Investigation of the value of tuberculin in treatment;
(e) Characters of tuberculous pleural effusions.
The medical superintendent of Colindale hospital (Dr. Heaf) has reported that
research has been continued at that hospital along the same lines as indicated in
the last annual report. He adds that the value of Houghton's blood index is
becoming more evident by increased use, and expresses the opinion that the relation
of streptococcal infection to tuberculosis may have an important bearing on
treatment.
The work on cadmium therapy referred to in the last annual report has advanced
and a non-toxic preparation is now ready for the treatment of patients in place of
gold salts.
The consulting ear, nose and throat surgeon (Mr. R. Scott Stevenson) has
reported that at Colindale hospital during the year the researches into the value of
local application of chaulmoogra oil and of the local application of ultra-violet light
to the larynx were continued. It is still too early to make a definite statement of
these methods of treatment, but promising results were obtained, and it is hoped
that the improvements shown in many cases will be maintained.
Chaulmoogra oil was applied 437 times, and the Kromayer ultra-violet light
applied locally to the larynx and tuberculous ulcers of the tongue on 403 occasions.
Eight cases had the larynx cauterised by the galvano-cautery, and five cases had the
superior laryngeal nerve injected. One case had a sub-mucous resection of the
nasal septum done and one an intra-nasal antrum operation.
The consulting ear, nose and throat surgeon (Mr. R. Scott Stevenson) has
reported that the routine method of anaesthesia for operations on children at High
Wood hospital for children has been evipan by the intravenous route. In eight cases