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72
Co-operation with Thoracic Surgical Units at London Hospitals.
The number of cases who received specialised thoracic
surgical treatment during the year was twenty-five. The bulk
of our cases are treated at the Thoracic Surgical Unit at the
London Hospital and the Brompton Hospital, to whom we are
particularly indebted. A limited number of cases have bean referred
to the Royal National Hospital, Ventnor, and Papworth
for such treatment. All our cases have had the great advantage
of being treated by one of the Thoracic Surgeons at Brompton.
The closest co-operation has been maintained with them and
special points peculiar to individual cases have been discussed
in detail. This co-operation between physician and surgeon is
of the utmost importance and makes for continuity of treatment
and the best possible results.
Co-operation with Harts Sanatorium.
Close follow-up of all treatments of patients initiallyseen
and diagnosed at the Chest Clinic is possible by reason of
the close association between the Medical Superintendent and
myself. This is found to be of enormous advantage to the
patients and to the ultimate results of treatment. In this connection
we may not unreasonably claim that this close contact
by the same physicians with the patient throughout his "tuberculosis"
career i.e. in an institution and in the out-patient follow-up
department, is of the greatest value.
Rehabilitation and the Tuberculous Subject—
The Relapse Case.
It would be a wise plan, in addition to considering the
tuberculous patient's lungs, to consider also his livelihood. This
often causes him, not unnaturally, so much anxiety as to affect
his progress. Failure to give adequate consideration to the
economic position of the patient must also hold some responsibility
for relapse, after so much has been spent on his treatment
in the Sanatorium. It is well known that once a patient is
labelled tuberculous, this may be responsible for loss of his employment,
and this often spells financial ruin. The tuberculous