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Lancashire
September-October
I94 5
I65
T U B E R Cl L E
accommodation for research work. Surely, reason suggests that this great association with all its clinical material a n d opportunities for field work should be provided with ample facilities for research. Nowhere else is there a wholetime Professor of Tuberculosis giving all his attention to research. Promin does not seem to be fulfilling its early promise; but other drugs of the same class are being tried.
DR F. R. G. H E A F C H A I R M A N OF T H E Tur~ERCULOSIS EDUCATIONAL INSTITUTE
Dr H e a f is Senior Administrative Officer in Tuberculosis to the London County Council, a n d serves on the committee of m a n a g e m e n t for Papworth a n d Preston Hall.
Lancashire PREVENTION AND TREATMENT OF TUBERC U L O S I S IN T H E A D M I N I S T R A T I V E C O U N T Y O F L A N C A S T E R . R e p o r t of the Central Tuberculosis Officer of the Lancashire C o u n t y Council for the Year 1943. Lancashire County Council, t945. This a n n u a l report is the thirtieth m a d e by Dr G. Lissant Cox, who c o m m e n c e d work with the coming into action of the national crusade against tuberculosis as established by Act of Parliament in x9t 3. He takes the opportunity of giving a brief survey of past a n d present, of the days when a few beds were occupied by Lancashire patients in smal! voluntary a n d pioneer sanatoria, like Aitken and Meathop, a n d of to-day with some 1,2oo beds a n d ~5 dispensaries distributed over the County; x-rays, unused in I9t3, provided 37,659 examinations in I943, a p a r t from mass radiography. In I9I 3 tuberculosis claimed i i 2 per too,ooo population as contrasted with 5 ~ in I943. Thoracic surgery has come to stay. But still the tubercle bacillus resists all direct attacks. T h e family has to be recognized as the unit on which measures for the prevention a n d treatment of tuberculosis are based. Ever longer a n d longer periods in institutions are found necessary for' treatment, setting u p a need of some three beds per two deaths. Rehabilitation is yet almost a virgin field. T h e population in the administrative county approaches two millions, which is divided into five large a n d three small areas, each with its own organized staff. Stress is laid upon combining the hospital, dispensary and domiciliary sides of the work. Notifications of p u l m o n a r y tuberculosis are rising from an average for I935-38 of 1,273 to an average of 1,414 for 194o-43. But the deaths in i943 were the lowest on record; a n d those from n o n - p u l m o n a r y equalled the lowest on record. T h e m a i n reduction took place a m o n g adult females, the male figures being nearly stationary; in I943 for every IOO deaths of females there were I88 deaths of males. This excess a m o n g males occurred after age 35, when, during the years i938-43 inclusive, there were 1,92i male deaths as against 773 female deaths. Interest attaches to the mortality rates since t913, a period which includes the first wartime a n d most of the second (see graph). T h e p u l m o n a r y rate in the first war rose sharply a n d thereafter fell a w a y rapidly; in the second wartime the decline which h a d halted at 3943 has shown no inclination to rise, rather the reverse. T h e n o n - p u l m o n a r y rate rose slightly early in the first wartime, b u t h a d started to fall before the war was over; thereafter the rate fell steadily till t935 since w h e n it has r e m a i n e d fairly constant. Mass radiography has established itself; the story of its use in four surveys including 19,24o miniatures, is told; 6 ' 8 p e r cent of the workers examined were recalled for a larger film; 93 per cent were normal; 69 cases of active tuberculosis were found, of w h o m 31 h a d positive s p u t u m . An agreement has been arrived at to combine the Blackburn tuberculosis scheme with that for the County, a n d the transfer took place J u l y i, t944. It m a y be the forerunner of more joint work with other county boroughs. T h e new scheme of m a i n t e n a n c e allowances has been a success as far as it goes; b u t it needs extending to advanced cases a n d n o n - p u l m o n a r y cases.
In our May-June N u m b e r we printed a n a n n o u n c e m e n t of the formation of the Tuberculosis Educational Institute. For some time the Joint Education Committee of the Joint Tuberculosis Council a n d the National Association for the Prevention of Tuberculosis has b e e n holding courses in different parts of the country for practitioners, tuberculosis officers, health visitors, a n d welfare officers. Encouraged by the success of these lectures, the committee recognized that there is a great d e m a n d for education in tuberculosis matters, and under the inspiration of Dr F. R. G. Heaf, decided to found a new Institute which would have m u c h wider terms of reference. These would include in addition to the work already undertaken by the committee, the awarding of scholarships, the issue of an index of tuberculosis literature, the formation of a panel of lecturers. T h e c h a i r m a n is Dr F. R. G. H e a f a n d the secretary Dr Harley Williams, who is also secretary of the N.A.P.T. n N NN NN I N
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James
Aitchison, H.D.D.(Glas.), L.D.S.(Glas), Assistant Lecturer on Dental Anatomy, Assistant Visiting Surgeon, and Dental House Surgeon, Glasgow Dental Hospital; Dental Surgeon to Royal Hospital for Sick Children, Glasgow. The author hopes that this book may assist the student on the threshold of his studies and, for that reason, he has kept the te~t and nomenclature as simple as possible. 93 illustrations. Demy svo. as/-Modern
Psychotherapy.
Noel
Harris,
M.D., Physician-in-Charge, Woodside Hospital; Physician for Psychological Medicine, The Middlesex Hospital. Psychotherapy is a term which has been somewhat loosely used. For the present purpose it is taken to include all methods of treatment which are dependent upon psychological processes for their origin, and which also aim at assisting the correct adaptation of the patient to his environment without the use of such physical methods of treatment as surgery, or the administration of medicine in whatever form. Crown 8vo. 9/-. Blind Intubatton and Signs of A n a e s t h e s i a . J. U.Human, M.R.C.S.(Eng.). Rewritten and considerably enlarged.
Second edition. F'cap. 8vo. 5/-.
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I94 5
I65
T U B E R Cl L E
accommodation for research work. Surely, reason suggests that this great association with all its clinical material a n d opportunities for field work should be provided with ample facilities for research. Nowhere else is there a wholetime Professor of Tuberculosis giving all his attention to research. Promin does not seem to be fulfilling its early promise; but other drugs of the same class are being tried.
DR F. R. G. H E A F C H A I R M A N OF T H E Tur~ERCULOSIS EDUCATIONAL INSTITUTE
Dr H e a f is Senior Administrative Officer in Tuberculosis to the London County Council, a n d serves on the committee of m a n a g e m e n t for Papworth a n d Preston Hall.
Lancashire PREVENTION AND TREATMENT OF TUBERC U L O S I S IN T H E A D M I N I S T R A T I V E C O U N T Y O F L A N C A S T E R . R e p o r t of the Central Tuberculosis Officer of the Lancashire C o u n t y Council for the Year 1943. Lancashire County Council, t945. This a n n u a l report is the thirtieth m a d e by Dr G. Lissant Cox, who c o m m e n c e d work with the coming into action of the national crusade against tuberculosis as established by Act of Parliament in x9t 3. He takes the opportunity of giving a brief survey of past a n d present, of the days when a few beds were occupied by Lancashire patients in smal! voluntary a n d pioneer sanatoria, like Aitken and Meathop, a n d of to-day with some 1,2oo beds a n d ~5 dispensaries distributed over the County; x-rays, unused in I9t3, provided 37,659 examinations in I943, a p a r t from mass radiography. In I9I 3 tuberculosis claimed i i 2 per too,ooo population as contrasted with 5 ~ in I943. Thoracic surgery has come to stay. But still the tubercle bacillus resists all direct attacks. T h e family has to be recognized as the unit on which measures for the prevention a n d treatment of tuberculosis are based. Ever longer a n d longer periods in institutions are found necessary for' treatment, setting u p a need of some three beds per two deaths. Rehabilitation is yet almost a virgin field. T h e population in the administrative county approaches two millions, which is divided into five large a n d three small areas, each with its own organized staff. Stress is laid upon combining the hospital, dispensary and domiciliary sides of the work. Notifications of p u l m o n a r y tuberculosis are rising from an average for I935-38 of 1,273 to an average of 1,414 for 194o-43. But the deaths in i943 were the lowest on record; a n d those from n o n - p u l m o n a r y equalled the lowest on record. T h e m a i n reduction took place a m o n g adult females, the male figures being nearly stationary; in I943 for every IOO deaths of females there were I88 deaths of males. This excess a m o n g males occurred after age 35, when, during the years i938-43 inclusive, there were 1,92i male deaths as against 773 female deaths. Interest attaches to the mortality rates since t913, a period which includes the first wartime a n d most of the second (see graph). T h e p u l m o n a r y rate in the first war rose sharply a n d thereafter fell a w a y rapidly; in the second wartime the decline which h a d halted at 3943 has shown no inclination to rise, rather the reverse. T h e n o n - p u l m o n a r y rate rose slightly early in the first wartime, b u t h a d started to fall before the war was over; thereafter the rate fell steadily till t935 since w h e n it has r e m a i n e d fairly constant. Mass radiography has established itself; the story of its use in four surveys including 19,24o miniatures, is told; 6 ' 8 p e r cent of the workers examined were recalled for a larger film; 93 per cent were normal; 69 cases of active tuberculosis were found, of w h o m 31 h a d positive s p u t u m . An agreement has been arrived at to combine the Blackburn tuberculosis scheme with that for the County, a n d the transfer took place J u l y i, t944. It m a y be the forerunner of more joint work with other county boroughs. T h e new scheme of m a i n t e n a n c e allowances has been a success as far as it goes; b u t it needs extending to advanced cases a n d n o n - p u l m o n a r y cases.
In our May-June N u m b e r we printed a n a n n o u n c e m e n t of the formation of the Tuberculosis Educational Institute. For some time the Joint Education Committee of the Joint Tuberculosis Council a n d the National Association for the Prevention of Tuberculosis has b e e n holding courses in different parts of the country for practitioners, tuberculosis officers, health visitors, a n d welfare officers. Encouraged by the success of these lectures, the committee recognized that there is a great d e m a n d for education in tuberculosis matters, and under the inspiration of Dr F. R. G. Heaf, decided to found a new Institute which would have m u c h wider terms of reference. These would include in addition to the work already undertaken by the committee, the awarding of scholarships, the issue of an index of tuberculosis literature, the formation of a panel of lecturers. T h e c h a i r m a n is Dr F. R. G. H e a f a n d the secretary Dr Harley Williams, who is also secretary of the N.A.P.T. n N NN NN I N
n1~ pm ~ ~
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nn
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an
nn
D e n t a l A n a t o m y for S t u d e n t s .
am
Iti tin iti
um
titi I,~ titi titi
lti titi tim
tiI tin II
James
Aitchison, H.D.D.(Glas.), L.D.S.(Glas), Assistant Lecturer on Dental Anatomy, Assistant Visiting Surgeon, and Dental House Surgeon, Glasgow Dental Hospital; Dental Surgeon to Royal Hospital for Sick Children, Glasgow. The author hopes that this book may assist the student on the threshold of his studies and, for that reason, he has kept the te~t and nomenclature as simple as possible. 93 illustrations. Demy svo. as/-Modern
Psychotherapy.
Noel
Harris,
M.D., Physician-in-Charge, Woodside Hospital; Physician for Psychological Medicine, The Middlesex Hospital. Psychotherapy is a term which has been somewhat loosely used. For the present purpose it is taken to include all methods of treatment which are dependent upon psychological processes for their origin, and which also aim at assisting the correct adaptation of the patient to his environment without the use of such physical methods of treatment as surgery, or the administration of medicine in whatever form. Crown 8vo. 9/-. Blind Intubatton and Signs of A n a e s t h e s i a . J. U.Human, M.R.C.S.(Eng.). Rewritten and considerably enlarged.
Second edition. F'cap. 8vo. 5/-.
In
Iti tim tiIt i t i
IN
~ ~ i u
JOHN BALE MEDICAL PUBLICATIONS LIMITED C A V E N D I S H P L A C E , W.1 tie iIti
~,~,~,
STAPLES
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