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9
Though one often hears these days of the decreasing urgency of the
tuberculosis problem, we feel here that it will be a long time before there is
any room for complacency. Tuberculosis mortality has certainly fallen but
morbidity figures do not seem to get less. Cases are seeking advice more
readily and general medical practitioners given every encouragement to send
their cases early.
Apparatus for taking miniature chest X-ray films has been installed,
greatly reducing the cost, and with the additional advantage of helping to
solve the problem of storage and filing of records. All local doctors have
been told of this service and supplied with appointment forms giving details
of times and place where X-ray examination may be carried out without prior
appointment. Patients requiring full investigation are, however, referred
in the ordinary way All children under sixteen years of age are Mantoux
tested in addition to clinical and X ray examination The immediate contacts
of children Mantoux positive are offered X ray and response on the whole has
been good The Chest Qinic seeks the fullest co operation and stresses the
importance of notification of all tuberculous conditions Only in this way
is it possible to continue supervision for the requisite period of time and to
arrange examination of contacts Liaison on the whole is excellent but sometimes
one finds a reluctance to notify, for example, a case of simple
tuberculous pleural effusion but any ”stigma” attached to notification is
far out weighed by the importance of adequate supervision for a period of at
least five years and by necessary attempts to trace the source of infection
During the year we have acquired charge of one hundred and twenty beds
for cases of pulmonary tuberculosis in the St Ann's General Hospital,
Tottenham, Many local cases are treated there making it convenient for relatives
visiting them A thoracic surgeon attends and undertakes any necessary
chest surgery at the hospital Later it is hoped to increase the number of
tuberculosis beds.
B.C.G. vaccination has been limited by official sanction to contacts of
known cases, though the department is willing to co operate in any extended
scheme as for children in the school leaving age group
As elsewhere, the number of cases presenting themselves at the Chest
Clinic with lung cancer has increased Those suitable for surgical treatment
are dealt with expeditiously at the North Middlesex Hospital Deaths from
this condition in males is now much in excess of those from tuberculosis
In conclusion, I am happy to acknowledge the co-operation of the Medical
Officer of Health and members of the Area medical staff in helping us to
achieve our common task of eliminating the most important infectious disease
from both personal and social points of view