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tuberculosis and the problems that face our patients when they
leave the Sanatorium. These patients have many troubles—
social, economic and psychological as well as medical, and we wish
to help them all we can in these matters. Further, I wish to
develop and take an active part in the Occupational Therapy
Department and supervise this work more closely.
There is definitely too much work for one person to do in detail
as it should be done. Besides the clinical work there is a large
amount of administration of the various staffs, personnel and
grounds that must be done if the Sanatorium is to run smoothly
and efficiently. I therefore make a plea for the provision of a House
Physician in order that, in the light of present day conception of
tuberculosis, every detail of care and attention can be made possible
for our patients.
Thoracic Surgery.
The necessary surgical treatment is performed by Mr. Ivor
Lewis, Medical Director of the North Middlesex Hospital, and I
desire at this point, to record an appreciation of his work. The
patient requiring operative intervention has now only to wait a
few weeks instead of many months. The patient, in the case of
adhesiotomy and phrenic crush cases, is taken to the North
Middlesex Hospital in the morning, and if fit enough, is returned to
the Sanatorium the same day. More and more use is being made
of surgical intervention in the treatment of Pulmonary Tuberculosis.
Laboratory Investigations.
A routine monthly sputum examination is done on every
patient. When the direct smear is repeatedly negative, then
recourse is made to concentration and cultural methods and animal
inoculation. Gastric washings and faecal specimens are also
investigated when the sputum remains negative. During the year
187 specimens were examined for tubercle bacilli at the laboratory,
St. Margaret's Hospital, Epping, and I wish to thank Dr. Frank
Marsh, Pathologist, and his staff at St. Margaret's Hospital, for their
excellent work and keen and helpful co-operation. Monthly
E.S.R. estimations are also performed and are a definite help in
assessing progress.
Since the laboratory plays a vital part in the diagnosis and
treatment of Pulmonary Tuberculosis, the provision of a full-time