[Report 1942] / School Medical Officer of Health, St Helens.

  • St. Helens (Merseyside, England). Council.
Date:
1942
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: [Report 1942] / School Medical Officer of Health, St Helens. Source: Wellcome Collection.

    31/34 (page 29)
    Further investigation under the scheme is, of course, primarily to discover v^hether the child is actually suffering from Tuberculosis of the Lungs, or whether the abnormalities shown by the miniature X-ray are of any clinical significance from the point of view of Tuberculosis. Such cases should obviously be in¬ vestigated by Dr. Griffel, and could be absorbed into the ordinary routine work of the Tuberculosis Dispensary. Other lung conditions would also be dealt with by Dr. Griffel. It has been suggested, however, that this method of X-ray examination will show, in certain cases, abnormalities of the heart. For the further investigation of these, it appears to me essential that a heart specialist should be employed. Only a suitably qualified heart specialist is, in my opinion, competent to say definitely whether the abnormality, or suggested abnormality found in the X-ray film is of any clinical significance, and to advise regarding treatment and super¬ vision where necessary. The necessity for the engagement of a heart specialist for the further in¬ vestigation of these cases, immediately suggests the desirability of establishing in St. Helens a “Heart Clinic,” to which would be referred, not only suspected cases discovered through miniature radiography, but to which would be sent every case of known or suspected heart disease, and also cases of rheumatism. There is no doubt that such a clinic would be a most useful and beneficial addition to the School Medical Service. It is estimated that there are in St. Helens at present approximately 300 “ heart ” cases amongst children of school age. As a com¬ mencement it is suggested that one session per fortnight might be desirable to review all the present known cases and deal with new cases, but that one: session per month might be sufficient later. I would suggest, therefore, that, apart from the adoption or otherwise of a scheme for miniature radiography, application be made now to the Board of Education for their approval to the establishment of a Heart Clinic. 4. Interpretation of Findings. I have no knowledge at present of any records of any scheme of miniature radiography of school children. The nearest I can get are the results obtained recently by the examination of 2,000 employees of Messrs. Pilkington Bros. Amongst these employees were 476 aged 14-15 years. Of these, Drs. Jones and Griffel reported, as the result of viewing the miniature films, the following ab¬ normalities or suspected abnormalities :— Chest abnormalities or deformities . 2 0.4% Non-T.B. Pulmonary conditions . 6 1.3% Non-Pulmonary T.B. conditions . 1 0.2% Old Apical lesions and Pleurisy 11 2.3% More extensive tubercular disease . 2 0.4% Cardio-vascular changes . 33 6.9% Total . 55 11.5% Not all of these cases have, however, been fully investigaged. It is impossible, therefore, to state in what proportion of them the findings of the miniature radiography are of any clinical significance. An attempt has been made to assess the clinical significance by comparing the findings of the miniature radiography with (a) school medical findings, (b) reports of the examination by the Factory Surgeon, and (c) reports of the routine medical examination by Messrs Pilkington Brothers Medical Officer. The results of such comparison cannot, however, be considered altogether satisfactory. Whilst 4 out of the 6 cases classed