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(1) Pull sizcd X-ray filns.
(2) The use of sensitised paper instead of the X-ray film.
(3) Screening (fluoroscopy)
(4) Miniature X-ray Screen Photography
Methods 1, 2, and 3, are all being fully utilised in the
services of the Chest Clinic. Whilst the full sized film is
probably the most efficient from the point of view of mass work,
it has the disadvantage that it is costly and is a comparatively
slow process. The Paper Flim has been utilised by us during the
last few months, more particularly for the follow-up of cases of
artificial pneumothorax and for the serial examination of
secondary cases. The cost, compared with the X-ray film, is
extremely low and involves a considerable financial saving. This
method has, of course, its limitations, but in the selected
cases outlined it can serve the same purpose as the ordinary
film.
SCREENING (FLUOROSCOPY)
I have always found this to bo a most economical and practical
method for mass examinations. In an investigation of 3229
X-ray screen examinations which I have done at the Chest Clinic
during the last few years, with an equal number of control films,
the interpretation of 94% of cases has coincided with the interpretation
of the film. Whilst, therefore, the method is not foolproof
it can, in the hands of an experienced observer, be of
immense value in mass X-ray work. The risk to the examiner of too
much screening has, of course, always to be borne in mind.
MINIATURE SCREEN PHOTOGRAPHY.
The miniature film represents a new and efficient Public
Health instrument destined to be of the greatest value as an aid
to the detection of minimal disease in presumably healthy members
of the industrial population, The method involves the technical
combination of a satisfactory camera and X-ray Screen apparatus,
and the miniature film is made by focussing down the image on to
a fluorescent screen. Those small films are interpreted by
enlarging them almost to the full sized film on a projector.lt has
boon calculated that with an adequately trained staff and good
team work, some 200 subjects'can be examined per hour. The
extension of this method in the future to periodic health examinations
for the whole industrial community, may prove an invaluable
contribution to Preventive Medicine. The principal object of the
method in mass surveys is to detect early pulmonary disease before
the appearance of symptoms or signs, by which time, experience has
shown that the disease is comparatively advanced. Whilst the
method has its limitations and requires to be Used with discrimination,
it has the advantage of being very inexpensive, reasonably
accurate, expeditious and a rapid and efficient selector of cases
requiring full investigation.
OCCUPATIONAL THERAPY.
Tho Class at the Clinic was opened in October 1936. Crafts
taught have been so useful to patients that regular pocket money
has been earned by thorn, profits over costs of finished articles
being their payment. The patients have expressed their gratitude
at the opportunity given thorn of earning small sums, and in spite
of the exceptionally bad winter, attendances wore kept up. Men's
crafts include carpentry, basketry and stool seating: women's
crafts are dressmaking, embroidery of all types, knitting and
toy-making. The benefit of classes has been specially felt during
the black-out as creative work has provided an outlet of psychological
value.
27.