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71
Artificial Pneumothorax.
The number of refills increased from 151 in 1931 to 185 in
1932. In addition to these, on two occasions it was necessary to
collapse a patient's lung as an " emergency operation " on
account of severe haemoptyses. In connection with this method
of treatment it is necessary to stress the importance of controlling
its course by means of the X-rays. At the moment the
patients have to be conveyed by ambulance to the Forest Hospital,
Buckhurst Hill, an arrangement which worked satisfactorily
when the amount of pneumothorax work was not so heavy. Now,
however, the increase is such than an X-ray apparatus is urgently
required at " Harts," moreover in addition to the collapse therapy
treatment, X-rays are of great assistance in gauging the progress
of ordinary uncomplicated cases, and in patients suffering from
acute pleuritic effusions a radioscopic examination is essential
before and after the operation of aspiration is performed, and the
smallest ambulance journey is absolutely contraindicated. However,
the new pavilion now in the course of erection contains an
X-ray room and dark-room, constructed in accordance with the
requirements of the National Physical Laboratory, so that when
that is equipped with a suitable apparatus the difficulties now
experienced will be obviated.
Bacteriology.
The number of specimens of sputum examined in 1932 was
251, compared with 236 in 1931. It was observed that three cases
having tubercle bacilli present also contained the fungus
" monilia," this however although of academic interest, was of
no practical pathological significance and disappeared under
appropriate treatment. Also a number of specimens of pus,
fasces, urine, pleuritic effusions, etc. (the last two after
centrifugalization), were examined microscopically, and six bloodsugar
estimations were obtained in cases of diabetes mellitus.
The Complications observed and treated were as follows :—
(a) Those directly due to tuberculosis—
Tubercular laryngitis 9 (3 died), pleurisy 2, tubercular
kidney 3, abdominal tuberculosis 4, cervical
glands 2, meningitis 1, epididymitis 1, " sanocrysin "
nephritis 1, spinal caries 1.