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63
Finally, the co-operation of general practitioners in utilising
the consultant and other facilities of the Chest Clinic has contributed
greatly to the early detection of disease. On the other
hand this same co-operation has produced the following interesting
and encouraging result : namely that although nearly three times
as many contacts and new cases now come to the Chest Clinic the
percentage of cases notified as tuberculous has dropped by half.
Here can be seen in operation the important psychological factor
that a visit to the one-time " T.B. dispensary " is no longer dreaded
but is even welcomed and the value of the manifold investigations
carried out on the many types of chest disease encountered there
is appreciated.
The number of X-ray examinations has in 20 years risen from
negligible proportions to some 4,000, all of which are now made
in the Chest Clinic. These figures illustrate dramatically the
astonishing rise in importance of radiology as a part of the work of
the Clinic.
It will be seen that the number of medical examinations has
increased annually, particularly since the war. During 1947
there were nearly three times as many examinations as in 1928
while the actual figures for attendance were multiplied fourfold.
Despite advances in radiology and its extended use, thorough
clinical examination remains of paramount importance.
Unfortunately our record of artificial pneumothorax refills
remains incomplete as, prior to 1939 and again from the outbreak
of war until October, 1942, clinic cases received this treatment at
Hart's Sanatorium. However, the rapid rise during the years
for which we have a record illustrates how collapse therapy has
come to occupy an increasingly important position in the work of
the Chest Clinic.
Some Newer Drugs in the Treatment of Tuberculosis.
Whilst the sulphonamide era marks the beginning of modern
rational drug treatment, we may take it that the sulphonamides
have been of negligible activity in experimental tuberculosis, and,
although such sulphonamides as promin and diasone have been
carefully investigated they are, speaking generally, regarded as
too toxic for humans. That, at least, has been our experience in
the Sanatorium.