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54
Relationship to Tuberculosis.
In every industrial lung disease the risk of supervening tuberculosis
inevitably arises. In silicosis it is almost invariable. In
asbestosis the tuberculosis hazard has been regarded as an extremely
rare occurrence, but much further work on this subject
requires to be done before any definite opinion can be expressed.
More recent experiences are tending to show that tuberculosis in
conjunction with asbestosis are not quite so uncommon as one had
thought, for I have, more recently, seen several cases of both
diseases occurring in the same patient. It is therefore necessary
to keep all cases of asbestosis under close observation in case
tuberculosis should supervene.
Dr. Merewether's medical investigations establish the facts
that the inhalation of asbestos dust over a period of years results
in the development of a serious type of fibrosis of the lungs, that
the development of the disease varies in direct proportion to the
length of the exposure to dust, and that susceptibility to the disease
is not affected either by age or sex. The remedy is to be
found, as in the case of so many industrial diseases, in the suppression
of dust. Treatment, apart from that of a preventive
nature, by adequate local exhaust ventilations, is merely symptomatic.
Co-operation with Special and General Hospitals.
Co-operation with the Special and General Hospitals is being
utilised to the fullest extent with considerable benefit to the patients.
Such specialised Hospitals as the Central London Ear, Nose and
Throat Hospital for Diseases of the upper air passages, and the
Brompton Hospital for patients in need of specialised Chest Surgery
are utilised to the full, as, of course, are the General Hospitals,
both in the locality and the larger London Hospitals. Special
mention should be made of the constant help and courtesy received
at all times from Dr. Muir, Medical Superintendent of the Whipps
Cross Hospital, who is always ready to supply us with clinical
data of patients attending the Clinic who happen to have been inpatients
at Whipps Cross. Similar co-operation from the Staff of
the East Ham Memorial and neighbouring Hospitals is likewise
much appreciated. Furthermore, the assistance, ready help and
co-operation we obtain from Dr. Harrison for necessitous cases is
invaluable.