Observations Gleaned from Clinical and Radiological Chest Examinations of Recruits

Abstract

WITH the advent of the World War Number II the British Empire, of which Canada is a part, has been forced to defend the principles of democracy. The manhood of our sparsely populated land is rallying to the colors. From these men we are striving to build a force free from physical defects, and the radiologists are playing an important rôle in this constructive program. They are the national watch-dogs, looking for the unfit recruits who would be a handicap and an expense to the country. It has been computed that each man connected with the Army, Navy, or Air Force who becomes incapacitated while in the service, and later is a pensioner, costs the country thousands of dollars. To date, the radiologists of Canada have been responsible for the rejection of fifteen men out of every thousand recruits who have passed the first medical examination at the time of enlistment. Not only have the radiological examinations been a saving to the nation, considered financially, but also from the angle of efficiency, for the presence of the incapacitated within the war machinery is a tremendous handicap to progress. The recruit, also, is saved the humiliating necessity of being demobilized later, when he fails under the strain of arduous duties. The films, moreover, constitute a record of the recruit's chest condition at the date of enlistment, and will be valuable in determining whether an existing condition is aggravated by service, or is a new development during service. The medical examination of the recruit, as relates to radiology, includes (1) medical examination upon application for enlistment; (2) radiological chest examinations of those considered to be physically fit, conducted in the postero-anterior standing position, with films 14 × 17 inches, x-ray target at 6 feet distance from the film, exposure a tenth of a second or less, focal spot of the tube approximately 4 mm. or less; (3) when the films cast doubt upon the recruit's fitness, a clinical examination by a specialist in heart, lung, or surgical diseases as the case may require; (4) a review of the doubtful films by the consultant radiologist, who meets with the clinical specialists for classifying the recruit. The photo-fluoro-radiographic method has not been used in our survey, though I understand that the U. S. War Department has considered this method favorably. In addition to the consultant radiologist for Canada, each province has a consultant radiologist, as well as lung, heart, and surgical specialists, men who have been selected for their proved ability. The provincial consultant radiologist, working in collaboration with the clinical specialists, has been of inestimable value to all concerned. The recruit of doubtful chest fitness is examined by the clinician, and with his findings and the x-ray film as evidence, the clinician and radiologist weigh the results, pro and con, and the recruit is classified into one of the following categories: Fit for active service: Can undergo severe strain. Has no serious body defects.