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With few exceptions, the more advanced cases should not be
subjected to this treatment without very serious consideration.
Over a number of years we have had the opportunity of observing
the end results in the more advanced type of case. They were
far from encouraging compared with the results in those patients
who received prolonged conservative treatment. This method ol
treatment may be very valuable in a limited number of cases, but
the selection requires very careful consideration.
Gas replacement was done in one case; the result was
highly satisfactory.
Operative treatment. The present accommodation is not
entirely suitable for carrying out this type of treatment, and
where it is necessary arrangements are made for the transfer oi
the patient to hospital. Suitable cases are likely to be few, but
considering the satisfactory results which are obtained in many
cases, it is likely that surgical measures will be more frequently
adopted in the future.
Light. A carbon arc lamp has been in use for a number
ol years. As a method of treatment for pulmonary tuberculosis
we do not employ it, but it is a very useful adjuvant in the treatment
of special cases.
Some years ago a considerable number of the staff were
off duty with influenza. Each of the others were given 5 minutes'
exposure to the rays as a prophylactic measure, and there were
no further cases. This measure has been several times repeated
with success.
Results of treatment. The results are frequently disappointing.
There are many factors that contribute to this, and the
following suggestions refer to the particular patients who were
under treatment.
(a) The human element. The patient will often, for economic and
other reasons, not remain long enough in the institution, and he
imagines that he should, by medicine or some of the modern
methods of treatment, be cured in quite a short period. He is
ignorant of the fact that in about 90 per cent, of cases these
methods are contra-indicated.
(b) The return to conditions which in many instances are quite
unsuitable.
(c) Many patients would remain to complete their treatment to the
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