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treatment, which is obtained through other channels, the curtailment of outside
visiting tends to limit one's experience of social and economic conditions and
environment which is an important factor in the efficacy of the general supervision
of the tuberculous patient.
SPECIAL FACILITIES
X-ray examinations.—Increasing use has been made of the facilities for X-ray
examination provided by the County Council at St. Leonard's Hospital. In
pulmonary cases the films taken there are usually interpreted by the tuberculosis
officer, but in cases of doubt or difficulty the patient is referred to Dr. Peter Kerley
at the Royal Chest Hospital whose opinion in such cases continues to be of great value
and assistance. The supervision of non-pulmonary cases is usually in the hands of a
surgeon at a general hospital, but in the occasional cases in which an X-ray examination
is required by the dispensary the patient is referred either to St. Leonard's
Hospital or to the Royal Northern Hospital and a report is received from the hospital
radiologist.
During the past year, 341 patients were referred to St. Leonard's for X-ray
49 to the Royal Chest Hospital, and 2 to the Royal Northern Hospital. In addition
a number of examinations of contacts were carried out under the auspices of the
Prophit Trust.
Artificial Pneumothorax Treatment.—This treatment, invariably initiated while
the patient is in hospital or sanatorium, is usually continued for many months or
even two or three years after the patient has returned home. With modern developments
in technique, the number of cases suitable for this treatment has been considerably
increased and the number of refills carried out during the year 1938 is more than
double the figure for 1937. The total number of refills chargeable to the dispensary
in 1938 was 402, of which 251 were carried out at the Royal Chest Hospital, 44 at
the London Chest Hospital, 58 at Brompton, 20 at Grove Park Hospital, and 29 at
University College Hospital. In addition one patient receiving oleothorax treatment
received three refills at Colindale Hospital. The charge for pneumothorax or oleothorax
is 10s. 6d. per refill, which includes any X-ray examination required for control
of the treatment. As refills have to be carried out at fairly frequent intervals, usually
every two or three weeks, patients usually prefer to attend one of the neighbouring
chest hospitals, but in a few of the cases initiated at Grove Park or Colindale arrangements
are made for the treatment to be continued there after the patient's discharge
from residential treatment.
Finsen Light Treatment.—Cases of lupus are usually referred to the London
Hospital skin department where most of them are treated by Finsen light, occasionally
supplemented by general arc-light. The condition generally heals slowly and
treatment is often prolonged for many years and in the early stages often necessitates
daily attendance. One case at present attending has been under some form of light
treatment almost continuously for eighteen years and under Finsen light for nearly
seven years. Another case has been under continuous Finsen treatment for eight years.