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Hospital has installed one which is available for anyone in its catchment area;
this is a good step in the right direction. I do not think it is outrageous to suggest
that we should make it compulsory for everybody over the age of say 15 to
attend once a year for X-rays at times convenient for them. Some elderly
people might need assistance in getting to the unit, but no doubt this could be
arranged. In this way we should find our infectious spreaders and then try
to put into effect the other important control measure, namely the prevention
of infection by an infectious person to others.
One of the greatest disabilities we have always worked under is the shortage
of places in sanatoria for infectious patients. A newly discovered patient
with open tuberculosis may have to wait months and months before being
admitted to a sanatorium, certainly for treatment, but more especially to
prevent the spread to other persons. We need to increase the number of places
available and to try our best to persuade infectious individuals to make use
of them. We also need enough houses with the right accommodation in them
to rehouse all those families with open cases of tuberculosis, so as to provide
the infectious person with facilities for isolation, especially a separate bedroom.
Twickenham Council has been very good and has been most sympathetic in
its approach to this problem, but there are still many cases where children are
running the risk of infection by their close proximity to an infected person.
Rehabilitation.
Many people hesitate to seek medical advice or to submit themselves for
X-rays because of the fear of being branded tuberculous and running the
risk of losing their jobs and running into poverty. This fear is very real. We
need to make sure that a person with an arrested disease can return to employment
at full trade union rates, without fear of poverty. Sufficient places in
Remploy factories or posts elsewhere should be provided for all who need them.
Vaccination.
There is one further measure of protection, which has been the subject
of controversy for many years. This is the vaccination of susceptible individuals
by B.C.G. The letters stand for Bacillus Calmette Guerin. Calmette and
Guerin were two Frenchmen who have given their names to a preparation of
tuberculosis organisms which have been sub-cultured many many times and
which have lost their original virulence. A live vaccine is prepared from this
culture which when injected in a suitable dose can give rise to a reaction in a
susceptible person in which the person goes through the primary reaction, and
probably develops a certain amount of immunity to tuberculosis, as we all
have done some time in our lives. The reason this course of action is proposed,
especially for young adolescents entering work for the first time, is that sometimes
when they have an uncontrolled primary lesion, by reason of infection
from an open case, the effect may progress to a serious post-primary infection
with clinical tuberculosis. However the very great doubt at present is whether
those young persons who have received B.C.G. are in reality protected to any
greater extent than those who have not. It is still the case at present that
there is no reliable scientific evidence to enable the use of B.C.G. to be properly
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