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64
by appointment to the latter institution. The number
of patients so referred in 1929 was 109, being an increase
of 39 over the previous year. Such examinations are
always reported upon by the Hospital Radiologist, and
the films are sent to the Tuberculosis Dispensary where
they are seen by the medical officers, and the patient's
case sheet suitably annotated: they are then filed for
future reference. X-rays form a most valuable adjunct
to the physical examination of patients and are essential
in dealing with suspected disease in bone and joint cases,
which is sometimes impossible to diagnose with accuracy
by external means alone.
Artificial Pneumo-Thorax Treatment. This is
a highly specialised form of surgical treatment for
pulmonary disease, and consists of the gradual admission
of filtered air under suitable pressure into the pleura!
sac, i.e. that part of the thorax which lies between the
covering or lining of the lungs and the internal lining
of the chest wall. This causes by degrees a collapse of
the affected lung, and its ultimate object is to put the
diseased organ into a state of rest which is favourable
to healing.* This treatment has naturally to be very
carefully considered before being initiated, for there are
many factors which may contra-indicate such procedure.
It is usually commenced whilst the patient is in a
Sanatorium and can have constant observation and X-ray
examination; after the lung is fully collapsed the treatment
may be continued on return from the Institution
by periodical refills of air which keeps the lung in a
state of collapse. Such out-patient treatment may go
on for many months if considered advisable, the patient
meanwhile being able to carry on a normal working
existence. Under arrangements made between the
Council and certain of the London Hospitals (chiefly the
Brompton Hospital for Consumption and University
College Hospital), such re-fill cases are dealt with at the
institutions after having been seen and the treatment
approved by the Tuberculosis Officers. It may be
pointed out that X-rays are indispensable in the success-
The writer has also successfully used this procedure in
dealing with otherwise uncontrollable haemorrhage.