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62
shall later refer under the heading " Prophylactic inoculation
against Tuberculosis."
Another outstanding feature of this year has been the introduction
of new chemotherapeutic measures in the treatment of
tuberculosis which may prove of quite exceptional importance
and which merit the detailed description I propose later to give
them.
At this juncture of time it would seem to me appropriate to
review certain statistical features presented by a survey of the work
of the Chest Clinic over the past twenty years and illustrated by
a series of graphs that are self-explanatory.
The actual number of cases notified, no less than the number
per 1,000 population, fell steadily until the outbreak of war. The
figures of the war years may be a little misleading owing to evacuation
and other emergency conditions entirely beyond our control.
Moreover, the increases in the post-war years 1946-47 represent
the effects of the war on account of the time lag before complete
restoration of normal conditions. The increase can also be partly
explained by the profitable examination of contacts, made easier
by the better co-operation of the general public, for to-day there
are few who refuse the opportunity for clinical and radiological
examination offered to every home contact. Furthermore,
wherever necessary, contacts, especially those of the 0-5 and 15-25
age groups, are kept under a period of supervision, over and above
the initial routine examination.
Mass radiography is a means of discovering early cases—and
ipso facto those more amenable to treatment—which would otherwise
have probably gone undetected until such time as the disease
had become advanced and was manifesting definite symptoms.
It will be seen that the increase is wholly in respiratory cases
and that non-respiratory cases have declined generally. The
figures for non-respiratory cases among female children during
the war are again misleading but the true state is shown by the
figures for 1947.
Deaths from pulmonary tuberculosis have not followed the
post-war upward trend. Here also, however, there must be a lapse
of time before the war-time increase in tuberculosis is reflected in
an increased number of tuberculosis deaths.