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some localised chest Infection, must be so suspected until complete
investigation has negatived this.
Our experience at the Clinic has been no exception to the
rule, and several cases have occurred of late where lung tuberculosis
had originally been suspected. Numerous theories with
regard to the causation of the supposed increase of the incidence
of lung cancer have been suggested, but they are all, at the
moment, highly problematical.
Advances in Thoracic Surgery.
Advances in thoracic surgery are proceeding; by leaps
and bounds. The approach to the chest by surgery is now made
almost as readily as the approach to the abdomen. It must be
very strongly emphasised, however, that only the expert Thoracic
Surgeon should be relied upon to make such an approach.
Cavities in the lung, which are potential dangers to any existing
healthy lung, can now be collapsed in a variety of ways. One
patient with a cavity in the apex of the lung, about the size of a
small apple, has had his cavity successfully collapsed by an open
operation, the remaining space between the compressed lung- and
the chest wall having been filled in by paraffin wax. This operation
of "apicolysis" has been most successful in his case, and
he has had no recurrence of previous large haemorrhages.
Thoracoplasty of a more localised nature promises great
hope for the future welfare of the tuberculous subject, and advances
are taking place so rapidly in the realm of thoracic surgery
that it is not unlikely that where tuberculous disease is limited
to one lobe it may even prove to be possible to remove the offending
lobe by " lobectomy " as in the case of bronchiectasis and
new growths of the lung.
I would once again wish to express my deep sense of gratitude
to the nurses and the clerical staff for their loyal and constant
help and co-operation, which have played no little part in the
successful working of the Clinic during the year.