[Report 1954] / Medical Officer of Health, Dublin City.

  • Dublin (Ireland). City Council
Date:
1954
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: [Report 1954] / Medical Officer of Health, Dublin City. Source: Wellcome Collection.

    124/244 (page 118)
    CROOKSLING SANATORIUM. There is little of outstanding note to be reported in the transactions of this Institution, or in the tuber- culosis world generally, for the year 1954. No new methods of treatment came to light, and the usual recognised forms of treatment have been applied as for some years past. Such changes in trends as may be noted are due not so much to any improve- ment in forms of treatment, as to the changing pattern of the disease in so far as an increasing proportion of our cases have more limited disease, often so doubtfully active as to encourage the tendency to risk many of these cases on rather prolonged chemotherapy, often completed only after discharge of the patient to his home. This is obviously a line of treatment which may represent a welcome re-orientation for the patient by shortening his stay in Sanatorium, and in favourable circumstances allowing him to engage in his occupation for months which formerly would be spent in a Sana- torium. Mostly, these are cases in which the question of resection is doubtful, and the problem usually consists of deciding whether prolonged conservative treatment will prove so effective—i.e. prevent relapses over a sufficiently long period, in a sufficiently large proportion of cases as to justify this procedure in preference to surgery, which latter may prove to be unnecessary in a certain number of cases. If purely medical treatment, however, means a second or more frequent re-admission to Sanatorium for periods of upwards of six months or so at a time, for any consider- able number of patients, then this course would appear to be sufficiently distasteful and lacking in considera- tion for the patient as to make surgery in suitable cases a more reasonable course, even if a small per- centage of such operations will probably have been unnecessary. It is unlikely that any more firm grounds for decision in most cases will exist than that of trial and error, risking relapse at least once.