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Children occasionally swallow coins, pins, etc. Usually these can be removed at once before
any damage is done to the surrounding tissues if an X-Ray apparatus and screen are available at
the hospital to which the children are brought.
Renal Calculus.—In such cases where the patient is suffering excruciating pain, it is undesirable
for him to be moved any distance to be X-Rayed.
Bone Work.—A considerable amount of bone work is done at the Hospital in connection
with diseases of children and an X-Ray apparatus on the spot to see how a bone graft (for example)
is progressing, is necessary.
It is equally important when a fracture has been set under X-Rays to have a subsequent
X-Ray examination done to see that the position remains satisfactory.
Where bone plating has been done, a subsequent X-Ray examination is necessary to see that
the proper relationship of the bones is maintained. Such work can be done properly only on the
spot.
Tubercular Diseases of Spine, Hip, Ankles, etc., in Children.—Early diagnosis of these conditions
in children is very important so that treatment may be applied before bone or tissue destruction
has taken place.
Medical Work.
Recently there was in Hospital a boy with liver abscess which for a time baffled diagnosis—
the patient was extremely ill and emaciated. X-Rays would have been able to define this condition
and would probably have detected the pus at an earlier date and possibly saved this patient's life.
The patient would not have stood removal any distance.
Subdiaphragmatic Abscess.—The same remarks apply here as to Liver Abscess above. It is
important in cases of this description to watch the movement of the diaphragm on the screen under
X-Rays. This can only be achieved by having the apparatus on the premises.
Tubercular Bronchial Glands and Tubercular Chests.—Doubtful cases of these diseases in the
early stages are often diagnosed solely by X-Ray examination. The apparatus requires to be strong
so that the necessary print is obtained within the period of a breath. If a longer period elapses the
various organs in the chest and the condition of these organs are ill-defined.
Dyspepsia, Gastric Ulcer, Intestinal Growths, etc.—In the medical diagnosis of these conditions
for possible subsequent operative interference or otherwise, X-Rays are now largely made use of.
Bismuth is given and the variations, movements, and dispositions of the stomach are traced
on the screen immediately after the taking of Bismuth and at regular stated intervals thereafter
according to the information the physician wants to elicit.
It is not possible to carry out work of this kind by moving the patient continually to and fro.
Other Conditions.—There are other conditions which require the use of X-Rays and the number
of these conditions is rapidly increasing owing to the increasing use of X-Rays in connection with
medical and surgical diagnoses but the above are probably sufficient to indicate to the Committee
the need of the establishment of an apparatus of this kind in their hospital.
Radiographer.
It is essential that the radiographer should be a man who has got a medical degree and is
familiar with pathological conditions. If he is not so familiar he is unable to produce the radiograms
necessary to prove the existence or absence of the condition which may be thought to exist.
GEORGE F. BUCHAN,
Medical Officer of Health.
APPENDIX 0.
To the Finance Committee.
16th November, 1920.
SCARLET FEVER AND DIPHTHERIA IN WILLESDEN.
The Present Epidemics.
Between January 1st and November 13th, 1920, 532 cases of Scarlet Fever have been notified
and it is likely that at least 650 cases will be notified before the end of the year. It is 6 years ago
since as big an epidemic of Scarlet Fever occurred in Willesden and 6 years before that again since
an epidemic of like proportions.
569 cases of Diphtheria have already been notified this year up to November 13th, 1920,
and it is likely that 700 cases will be notified before the end of the year. This is the largest epidemic
of Diphtheria that has ever occurred in Willesden and unfortunately it occurs at a time when an
epidemic of Scarlet Fever is also raging. It is not common to have an epidemic of Diphtheria coincident
with an epidemic of Scarlet Fever. A similar coincidence occurred in the year 1919, but the