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DR. PHILIP ELLMAN, Consultant Physician, reports on the work of
the Chest Clinic, as follows:-
Once again during the war period the necessity to be brief
enables me to deal with essentials only and to forego our peacetime
practice of dealing with many other fundamental problems.
ATTENDANCES.
Not only are the number of attendances the highest of the war,
but they are, in fact, increased by nearly 1,000 over 1938. This
Increase is to some extent due to the increase in the number of
cases (male and female) being referred by various medical recruiting
boards for the Services.
This year there has been a marked increase in the number of
examinations of new cases, including contacts. The figures for tils
year are the highest on record and 50% higher than in 1938.Another
interesting feature is that the percentage of these new cases
proving tuberculous is 15.65, the lowest we have yet recorded. It
follows, therefore, that some 85% of our new cases prove to be nontuberculous.
Chronic bronchitis, emphysema, bronchiectasis, cancer,
and simple growths of the lung, heart disease with secondary lung
changes, thyrotoxicosis, acute anxiety Scates and other functional
nervous disorders being among the cases encountered. It will,therefore
be seen that the diagnostic service provided by the Chest
Clinic is being fully utilised by the local practitioners.
Contact Examinations. As I have previously stated, this is an
extremely important" aspect of our work. For the war years the percentage
of contacts proved to be tuberculous Is as follows:-
1939 1940 1941 1942
11.3% 6.87% 7.59% 7.33%
Active. Inactive . Active. Inactive. Active. Inactive. Active.Inactlve .
5.02% 6.28% 2.57% 4.3% 1.68% 5.91% 1.83% 5.5%
making an average for the war years of 8.27% of which 2.77% were
active cases and 5.5% inactive cases.
It will therefore be seen that this group of the population
forms an extremely important and unfortunately all too fruitful
source in the detection of the disease in its comparatively early
stages.
It is noteworthy that the actual percentage of contact cases
proved to be tuberculous has decreased during the war years. The
exact significance of this is difficult to assess, but it must be
remembered that quite an appreciable number of our cases have heen
evacuated to other areas during the war period.
COLLAPSE THERAPY AND THORACIC SURGERY.
Artificial pneumothorax refills are now, as in pre-war years,
being done at the Clinic in ever-increasing numbers. These cases
are all carefully controlled with X-Ray examinations.
Thoracoscopy with adhesion section and several thoracoplastic
operations have been done during the year.
X-RAY EXAMINATIONS OF THE CHEST.
The number of these examinations, 1575 for 1942, is the highest
recorded since the war. We continue to lay the greatest stress on
the Importance of first class technique for correct interpretation,
as it is impossible to interpret a chest film which is not technically
satisfactory. These X-Ray examinations, In conjunction with
careful clinical, bacteriological and ancillary examinations, have
greatly assisted us In classifying the various pulmonary diseases
26.