View report page

77
REPORT BY Dr. C. K. CULLEN, TUBERCULOSIS OFFICER.
I am glad to report that the number of new cases of tuberculosis seen at the
Dispensary continued to decline in 1936. Despite this there was an increase in the
number of patients who attended for observation and diagnosis. There has also been
a slight increase in the number of cases written off the Dispensary Register as cured,
a marked increase in the number of X-ray examinations and of cases treated by artificial
pneumothorax. The proportion of contacts examined at the Dispensary
remains fairly constant and averages approximately 2.5 per notified case. Every
effort is made by the Dispensary staff to secure the attendance of all contacts for
examination, but unfortunately a considerable number of them cannot be convinced
of the advisability of undergoing a thorough examination as soon as infection is
discovered in the family.
The appointment of tuberculosis officers to act as tuberculosis consultants
in the County Council's general hospitals has been extended for another period, and
I have continued to visit the tuberculosis ward of St. Leonard's Hospital fortnightly
during the year.
Special Facilities.
Radiological work:—When the opinion of an expert radiologist is desirable, pulmonary
cases are referred to the Royal Chest Hospital, and the reports given by
Dr. Peter Kerley, radiologist to the hospital, are of very great value and assistance.
Special facilities for X-ray work were accorded to the dispensaries during the latter
part of the year by the London County Council in their general hospitals, and cases
in which Dr. Kerley's opinion is not considered necessary are now X-rayed at
St. Leonard's Hospital and the films are interpreted by the Tuberculosis Officer. Nonpulmonary
cases are usually under the care and supervision of a surgeon at a general
hospital and any X-ray examinations required are usually carried out at the hospital
concerned; when this is not the case the patient is referred either to St. Leonard's
Hospital or the Royal Northern Hospital for examination and report. During the
past year the following X-ray examinations were made at the request of the Tuberculosis
Officer, viz.: 246 at the Royal Chest Hospital, 2 at the Royal Northern
Hospital and 20 at St. Leonard's Hospital. In addition, a number of examinations
of contacts were carried out under the auspices of the Prophit Trust.
Artificial Pneumothorax Treatment:—With further developments in technique,
the proportion of cases treated by artificial pneumothorax has continued to increase.
The treatment is almost invariably initiated while the patient is in sanatorium or
hospital and the refills are continued when the patient returns home at one or other
of the chest hospitals, the majority of them at the Royal Chest Hospital. If the
treatment has been commenced at the County Council Hospitals at Colindale or
Grove Park, arrangements are made, when desirable, for the patient to continue to
attend there for refills after discharge.