138. The details above show that there was a marked increase in the number of patients who failed to complete examination and this is in part accounted for, without doubt, by the fact that X-ray facilities were not available in the Hung Kong clinic and patients had, perforce, to be referred to the Queen Mary Hospital, 5 miles distant, for this examination. This difficulty has now been overcome with the transfer of the tuberculosis clinic to the new building which was completed at the end of the period under review.
Out-patient Treatment.
139. During the year there was a very substantial increase in the amount of out-patient work undertaken and by the end of the year the capacity of the clinics was taxed virtually to the limit. The following are details of out-patient investigations and treatment carried out in the clinics as compared with the previous year.
Blood Sedimentation Rate
1952
1954
28.019
34,241
Artificial Pneumothorax-
Initial
A
Retils
3,016
1,307
Completed treatment -
14
+
7
Abandoned (unsatisfactory)
accept this alternative and, in doing so, pressed such treatment to the limit of its resources, Nevertheless only cases in which
It was considered that the disease was largely reversible were selected for this treatment, it being the intention to deal with the irreversible component later by short term admission to hospital. Also efforts were made to avoid the occurrence of drug resistent strains of the tubercle bacillus by careful selection of the cases and limited dosage of the particular drug, Observ- ing these criteria results of treatment were good.
Radiological Eraminations.
141. All X-ray work throughout the Department is under the control of the Senior Radiologist, but it is intended that in due course when all medical staff in the tuberculosis clinics are competent to interpret their own X-ray films this work, as far as it concerns tuberculosis patients, will become the responsibility of the Tuberculosis Service with the Senior Radiologist con- tinuing to be available in consultation.
142. New patients were examined on 35 millimetre film in the first instance and, later, on large plates, either film or paper. Towards the end of the year the use of 4" by 5" films was commenced with a view to eliminating the necessity for the larger films. Details of the X-ray work carried out are as follows:
Artificial Pneumoperitoneum--
Jast
JDSS
Initial
Hong Kong Clinic-
Refilla
7,286
2.765
48,822
31.854
Completed treatment
19
Large film or paper
23.183
18,866
Abandoned (unsatisfactory)
16
PANAUDINGO
Kowloom Clinic—
Pleural Aspirations
106
G4
$5 m.m.
16,866
15,111
140. Although out-patient treatment of tuberculosis with specific drugs is considered to be an unsatisfactory alternative to hospital treatment the Tuberculosis Service having an inade. quate number of hospital beds at its disposal had perforce to
36
Large film or paper
18,978
15,137
107,799
81,258
37