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58
Problems in Diagnosis.
The problems which present themselves at the Clinic in
differential diagnosis have been outlined in previous reports.
It must again be emphasised that at least 50 per cent. of
new cases coming to the Clinic prove, after complete clinical,
radiological and bacteriological examinations, to be nontuberculous.
Among the common conditions that are particularly
encountered which closely resemble pulmonary tuberculosis are :—
1. Cancer of the Lung (now increasingly common).
2. Bronchiectasis.
3. Heart Disease (especially mitral stenosis) with congestion
of the lung.
4. In this Area Industrial Lung Disease—pulmonary
asbestosis—an account of which was given in last year's
report.
We now know that Tuberculosis complicating pure Pulmonary
Asbestosis is now not infrequent, several such cases having
occurred in the Borough. Hence the necessity of keeping every
patient with pulmonary asbestosis under the closest possible
scrutiny. Several deaths from the disease have already occurred
in the Borough.
Special Methods in the Diagnosis and Treatment of
Tuberculosis.
X-ray Examinations in connection with the work of the Clinic.
The following table shows the increased use that is being
made of X-ray examinations year by year :—
1928. 1929. 1930. 1931. 1932.
29 97 302 352 454
The importance of X-ray examination in diagnosis and treatment
was emphasised in last year's report. During the last 10
years more particularly, with modern apparatus for radiography
at a distance of two metres, improved radiological technique, and
facilities for almost instantaneous exposures (1/10th of a second
or less), it has become possible to standardise the quality of