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very carefully selected cases of pulmonary tuberculosis may prove
to be the patient's only hope of salvation. This has in fact been
the case in at least three of our patients. The operations have
been done by an expert Chest Surgeon at the Brompton Hospital.
PREVENTION.
The work of the Clinic from the preventive point of view is
never lost sight of. Early diagnosis and early treatment of pulmonary
tuberculosis are vital in the interests of prevention.
Contact Examination.
The importance of this subject especially in young adolescents
who have been in contact with a case of pulmonary tuberculosis,
especially if the sputum be positive, cannot be over-emphasised.
The high mortality rate, especially in female adolescents who have
been in contact with the disease, but have failed to come up for
examination, is especially noteworthy. These patients often
develop a peculiarly virulent form of disease. The slogan that
"Tuberculosis causes Tuberculosis—every case comes from
another"—is one which is constantly used by us. The necessity
of the preventive treatment of the whole family is urged whenever
a case of pulmonary tuberculosis is observed, and the source of
infection is especially sought. Only recently a child aged 4 years
was notified as a case of tuberculous meningitis. On examination
of the contacts the father was found to be suffering from advanced
pulmonary tuberculosis, and obviously the source of infection in
this case.
Dental Treatment in Connection with the Work of the
Clinic.
The harmful effects of a septic mouth on tuberculous processes
require no emphasis here. Hitherto it was only possible for dental
treatment to be obtained for insured patients; and children through
the School Medical Service. It is now possible for non-insured
patients to obtain dental treatment through the medium of the
Clinic. From the preventive point of view, attention to any sepsis
in the mouth or upper air passages is strongly urged for all patients
attending the Clinic. Attention to oro-nasal hygiene, as it is
called, is a great factor in the prevention of chest disease.