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It has been found that in order to follow up cases and trace
the progress of the patient as a result of treatment, serial photographs
at intervals of 3, 6 or 12 months according to the nature
of the case, are extraordinarily valuable.
The resolution of certain acute types of phthisis following
absolute rest, and other forms of therapy in this disease, are
sometimes very striking, and serve to give some indication of the
real value of serial radiography providing the radiograms are:—
(a) technically satisfactory;
(b) taken under exactly similar conditions.
It is more than likely that in the future serial radiography
will help to serve as a valuable guide to prognosis in this disease.
The correct interpretation of radiograms.
This is indeed a very wide problem It can truly be said
that the correct interpretation of shadows, often fleeting, often
permanent, requires as much, if not greater, experience than the
correct interpretation of the sounds heard via the stethoscope.
The interpretation, moreover, must be made with a full knowledge
of the history and clinical findings of the patient. Interpretation
divorced from these findings is almost worthless and
hence the clinician alone is in the most favourable position to
interpret and differentiate between the various shadows seen in
chest radiograms.
Catarrhal Chests.
The significance of minor chronic non-tuberculous lung infections
is not sufficiently realised. I refer to simple catarrhal
lung changes sometimes arising primarily in the lungs, but often
due to secondary involvement from catarrhal changes in the upper
air passages, with direct secondary involvement of the lower
respiratory tract, namely, the lungs. Such "catarrhal chests"
form a very large proportion of the new cases and contacts seen
at the Clinic during the year. The symptoms of these cases may
closely resemble those of pulmonary tuberculosis. Cough; expectoration,
not infrequently blood-stained ; loss of weight—often
associated with an anxiety state; digestive disturbances and the
like may all be present.