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72
the patient had not primarily been referred to the clinic by the private
doctor, the diagnosis being made as the result of investigation for some
other purpose. Of the 193 pulmonary cases, 32 had been diagnosed
elsewhere, 24 by the mass X-ray unit and 27 were contact cases (that is
contacts of a case in the family or elsewhere), 11 were recognised because
of the taking of routine X-ray films including four of ante-natal mothers.
99 cases were diagnosed amongst the 4,868 persons referred by doctors or
attending the open X-ray session. This session is discovering 25 cases
in every thousand men and 22 cases in every thousand women examined,
and seems to bring to light a higher proportion of cases amongst those
examined than other means.
Preventive Inoculation. Although in some countries much use
is being made of B.C.G. vaccination, little progress has been made in
this country. There is, of course, as yet no scientific evidence of the true
value of B.C.G. An enquiry by the Medical Research Council is even
now being undertaken. Even though the trial shows the practice to be
sound, there would be no case for the immunising of the general population,
and anything done will probably be limited to such groups as those
who are close contacts of infection, or those of ages who are especially
prone to develop the disease, or those whose occupation renders them
especially liable to infection. One group which it is generally felt would
benefit are school leavers as it is desirable to protect them before they
enter on the special hazards facing them when they will perhaps be more
exposed to infection than they had been. The Ministry of Health has
now authorised local authorities to arrange to offer B.C.G. vaccination
to older school children.