The changing chest clinic

Abstract

Summary (1) The need for a wider conception of the future tuberculosis service based on the Chest Clinic has been emphasized, in the best interests of the tuberculosis sufferer, the community and medical and nursing education. (2) This envisages a Chest Service to include an Out-patient Chest Clinic and an In-patient Chest Unit, in pavilion form with an affiliated sanatorium, adequately equipped and staffed and with an adequate number of beds as a department of a general teaching hospital organized on a regional basis. (3) Details of the functions of such a service have been described. (4) Tuberculosis would be included as an integral part of the medical and nursing training curriculum. (5) In addition to the adequate control and treatment of all cases of pulmonary tuberculosis the treatment of all other disabling conditions of the lungs, hitherto outside the province of the ‘tuberculosis dispensaries’ must be comprehended in the future Chest Service. (6) A statistical department would integrate statistics of all forms of tuberculosis. (7) No chest physician can be a specialist in every form of tuberculosis and hence specialized forms of tuberculosis such as skin, eye, nose and throat, bone and joint tuberculosis are best dealt with by specialized departments. This is facilitated by the establishment of the tuberculosis service within the framework of a general hospital. (8) A full scheme of rehabilitation in all its aspects is an integral part of the care of the tuberculosis patient. (9) The social service department, comprising the functions of the Almoner and the Health Visitor forms an important link between the Chest Clinic patient and his home, both from the preventive and restorative aspects.