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Dr. Philip Ellman, Consult ant to the Chest Clinic, reports on the
work of the Clinic, as following:-
The Report this year, apart from the war-time necessity of
it having to be brief, follows so closely on the previous annual
report, that it calls for very few additional comments, and the
features outlined then still hold good. A few further comments,
however, are indicated.
Attendances.
With regard to the attendances and medical examinations it
will be noted from the figures that although the attendances and
examinations are less than in the previous year, the number of
new cases and contacts has, in fact, increased by about 20%.
over the figures for the last year. The number of secondary
cases examined has been considerably reduced by reason of the
fact that many of these cases are evacuated to safe areas and
are therefore not being seen and supervised by us.
There are also a number of what might be called "fleeting
cases" which come into the area, but these may stay only a comparatively
short time in the district. The reverse also obtains
that is, some of our patients go out of the area and return
again after a short period.
X-Ray Examinations.
The number of X-ray examinations is well maintained,despite
the critical year through which we have passed. Economy is, however,
being encouraged as far as possible and paper films
described in last year's Report, with their marked reduction of
cost, are being utilised wherever it is compatible with efficiency.
Mass X-Ray Examination of the Chest.
This was dealt with in considerable detail in last year's
Report and advances are proceeding with this important war-time
measure, which makes one hope that its value as a practical
public health and preventive measure will be fully utilised in
the future peace-time service.
The most Important,practical and reliable method of mass
x-ray examinations, namely, by miniature screen photography, is
now being used as a means of examining recruits to the services
and it is hoped that in the near future it will be available for
the examination of female adolescent recruits to war industry,
especially in view of our experience in the Great War, when
statistics showed that a larger number of deaths,mainly confined
to young people, occurred during that period,and according to the
annual report of the Ministry of Health for 1920, tho greater
industrial employment of women was partly responsible for this
increase. As in the Groat War, we must be constantly on our
guard against the influence of under-nourishment associated with
the food problem, overwork and prolonged physical and mental
stress and strain, which may be responsible for the infected
becoming the clinically tuberculous.
The possible extension of miniature screen photography in
peace-time, to include periodic health examinations of adolescent
industrial workers, those engaged in certain trades where the
pneumokonioses are common, groups of the population where tuberculosis
is high and ospecially a contact service, raises a new
and extensive problem in the domain of public health. Its
significance will be appreciated by the record of the examination
of 2,681 of our contact cases, wherein 6.75$ showed
evidence of pulmonary tuberculosis in subjects who were presumably
27.