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To supplement the medical treatment and advice given to patients by the Chest Physician
and his Assistant, an Assistant Health and Welfare Officer is in attendance to provide health
education and social advice for City residents and City workers. All other patients are referred
to the Hospital Medical Social Worker.
Examination and screening of City workers who have been in contact with the disease in their
workplaces continues to be a preventive function of the City of London Chest Clinic.
Dr. Neville C. Oswald, the Chest Physician, has reported as follows:-
"During 1968 we have had referred to us seven newly diagnosed patients with active tuberculosis
in City offices, six of whom were either infectious or potentially so.
In connection with these patients, we examined 138 contacts altogether and found no fresh
case of tuberculosis although one man had a haematoma which was surgically removed in St.
Bartholomew's Hospital.
During 1968 we have had 14 new referrals of cases of tuberculosis from the Salvation Army.
All of these had been diagnosed previously and two had active infectious disease and were
admitted to hospital. It is extremely difficult to follow up this migrant population. We do our
best to treat them as long as they arepreparedto attend, but sooner or later we lose sight of them."
The men resident in this hostel continue to present a problem in so far as adequate follow-up
care and supervision is concerned. The period of residence in any one area is usually too brief
to complete a course of treatment.
All referrals from the hostel had attended other clinics at some time, two had active tuberculosis
and were admitted to hospital and one was admitted to hospital for observation and found
non-active.
Mass x-ray examinations revealed the need for further investigation of seven men, four of
whom could not be traced, two were given appointments at the Chest Clinic. One attended, was
non-active and failed appointments after a second visit. One other man, who was probably active,
was seen in the Emergency Medical Department and referred to the Chest Physician but did
not attend.
Ma ss Miniature Radiography
A Mass Miniature Radiography Unit of the North East Metropolitan Regional Hospital Board
is now well established at Milton Court. Dr. D.J. Lawless, O.B.E., the Director of the Unit
reports as follows:—
"INTRODUCTION
In the year under review Unit 6D continued to serve the City of London as heretofore. The
total number examined in the year was 52,429, of which 40,906 attended at the Unit's centre in
Public Services Building, Milton Court, E.C.2. The remaining 11,523 were examined at their
places of work (six organisations were visited for this purpose).
Male examinees numbered 31,622 and females 20,807 the usual proportions in our experience.
There were no major interruptions of work through mechanical breakdowns, reflecting the high
standard of day to day maintenance achieved by the technical staff.
MEDICAL PROCEDURE
As in former years, abnormal cases were referred to the appropriate Chest Clinic through the
examinee's own doctor. Cases outside the purview of a Chest Clinic were referred to St. Bartholomew's
Hospital, and the ready co-operation of Dr. N.C. Oswald and Dr. Graham Hayward is
gratefully acknowledged.
Tuberculosis:
Tuberculous infection was detected in 400 examinees. Eighteen (11 males and 7 females)
had significant lesions requiring treatment giving an overall rate for active disease of 0.343 per
1,000 compared with 0.453 per 1,000 for the previous year. The rate for males was 0.348 and for
females 0.336. Equivalent figures for the previous year were 0.593 and 0.217 respectively. The
highest incidence (though representing few cases) was noted in the 60+ age group (1.423 per
mille). It is again noted that the incidence of active tuberculosis in those not previously X-rayed
is significantly higher than in those previously examined i.e. 0.673 per 1,000, compared with
0.213 per 1,000.
LUNG CANCER
Nine cases of carcinoma of bronchus were disclosed, all in males of the 45 and over age
groups, giving a rate of 8.8 oer 10,000, for the 10,297 examinees in this category. The majority
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