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encountered and have afforded a means of selecting them for
appropriate treatments. Control by serial skiagrams is part and
parcel of treatment by collapse therapy or surgical methods and
an integral part both of diagnosis and treatment of the disease.
It must, however, be remembered that even today radiology is not
infallible. The exact interpretation of chest radiographs
requires experience. Nor, be It remembered, Is radiology a diagnostic
aid that rules out the stethoscope the X-Ray and the
stethoscope are, in fact, complementary.
MASS X-RAY EXAMINATIONS OF THE CHEST.
I do not propose to go into details regarding this important
method of examination of large numbers of presumably healthy
citizens, as I have referred to it in detail in my previous
reports since 1940, particularly with reference to symptomless
cases of pulmonary tuberculosis. The method is the greatest
contribution which radiology has made to preventive medicine.
To be done successfully it will obviously require a special
organisation with a team of radiographers and secretarial assistants.
It must, therefore, be carefully differentiated from the
examinations of individual subjects performed at the Chest Clinic.
Mass radiography has tremendous social and economic implications
and will be of immense importance in the medicine of the future.
The early discovery of disease in the presumably healthy subject
Increases the possibility of cure, always providing that, as a
result of the discovery, the worker is not victimised.
THE PROPOSED MEW FINANCIAL ALLOWANCES IN TUBERCULOSIS.
This Scheme 13 closely linked to the discovery of the early
case of pulmonary tuberculosis. It should assist enormously in
our work and prove a valuable Incentive to the patient to accept
treatment at an early stage and be free from anxiety and worry
instead of, as in present conditions, continuing to work at the
risk of complete breakdown. As a long term programme it should
greatly assist in restoring patients to health and to their
normal working capacity.
DIET AND TUBERCULOSIS.
The dietetic history of most of our cases is now being made
an important feature of our work both at the Clinic and in the
homes of the patients, where the visiting nurses lay the greatest
stress on a well-balanced, nutritious diet, compatible with wartime
possibilities. Any obvious vitamin deficiency is dealt with,
advice about the correct cooking of vegetables being frequently
necessary and persuasion to replace liquid milk and shell eggs
with powdered milk and eggs, both of first class food value. We
are greatly indebted for their help in this work.
WAR AND TUBERCULOSIS.
Pulmonary tuberculosis is the most important chronic infectious
disease affected by war and in spite of all recent advances,
is still responsible far the highest death rate in young adult
life, The influence of under-nourishment, overwork, prolonged
physical or mental stress or strain are responsible for the
infected becoming the clinically tuberculous. In war the disease
affects two main groups of the population; those engaged on
active military service and those remaining in civil life whether
as industrial workers or merely carrying on, as far as is possible,
In their ordinary occupations.
We are more particularly concerned with young women called
into industrial services, who have proved, in this war, as in the
last, the principal victims of pulmonary tuberculosis.
The increase in adolescent and childhood tuberculosis as
well as tuberculosis in older men has been fairly general
27.