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City of London Chest Clinic
The City of London Chest Clinic is incorporated within the St. Bartholomew's Hospital Chest
Clinic and so provides services for investigation and medical treatment for a wide range of
diseases of the chest.
To supplement the medical treatment and advice given to patients by the Chest Physician and
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 disease of the
chest 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 1969 we have had referred to us six patients with Tuberculosis; all these had been
seen elsewhere previously. Of the six, two required immediate Hospital treatment and were
admitted. Eight known cases have been seen regularly during the year.
One City child was given BCG vaccination because of close contact with a tuberculous
relative.
Ten other residents referred for investigation were diagnosed as follows, Asthma three,
Bronchitis five, Carcinoma Lung one.
We received nine notifications of infectious Tuberculosis among City workers. Follow up of
contacts resulted in fifty two examinations at the Chest Clinic and twelve attended the Mass
X-Ray examination. No defects were found. Six residents who had been in close contact with
Tuberculosis were examined and no defects found.
The total figures for 1970, were 74 first attendances and 56 follow up attendances."
Mass Miniature Radiography
A Mass Miniature Radiography Unit of the North East Metropolitan Regional Hospital Board
is established at Milton Court. Dr. R. Shoulman, 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 amounted to 56,803, an increase of 4,374 compared with the
previous year's total. The Unit operated for the greater part of the year at Public Services
Building, Milton Court, E.C.2. where a total of 50,692 persons were X-rayed. A survey was
carried out in Farringdon Street during the month of September, mainly for the employees of the
Newspaper groups, and a total of 6,111 individuals were X-rayed. Premises for this survey were
kindly lent to us by Messrs. C. & E. Layton Ltd.
Male examinees numbered 34,972 and females, 21,831. 303 persons were recalled for large
film examination, and of these 93 were referred on for further examination.
There were no interruptions of work through mechanical breakdowns, again reflecting the
high standard of day to day maintenance achieved by the technical staff.
Medical procedures
No alteration was made in procedure during 1969. 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
is gratefully acknowledged.
T uberculosis
Tuberculosis infection was detected in 439 examinees, of these 424 were healed lesions
requiring no further action — 5 requiring occasional supervision only. Ten (nine males and one
female) had significant lesions requiring treatment, giving an overall rate for active disease of
0.176 per 1000 examined, compared with 0.343 per 1000 for the previous year. The rate for males
was 0.229 and for females 0.092. The highest incidence rates fell in the males 60-64 age group
(1.172 per 1000) and in the male 65 plus age group (2.092 per 1000). As usual the incidence
rate of active tuberculosis was higher in those not previously x-rayed i.e. 0.218 per 1000 compared
with 0.156 per 1000.
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