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War Surgery and Medicine

[section]

BETWEEN the First and Second World Wars the development of mass radiography of the chest gave a new method of control of pulmonary tuberculosis in the forces. Chest X-ray of recruits during the Second World War ensured that a number were rejected who would otherwise have become centres of infection in the services, and themselves liable to hospitalisation and possible death. In 1 NZEF overseas there were 149 deaths from tuberculosis, whereas in 2 NZEF overseas there were only four deaths, two from miliary infection, and, as far as is known, only four deaths among the 8000 New Zealand prisoners of war.

Radiography of the chest has also removed the association of neurosis with tuberculosis. After the First World War, in addition to frank pulmonary tuberculosis cases, there were cases which physicians considered probably cases of tuberculosis, but as the physical signs were not definite and sputum was negative, they were classified as cases of ‘chronic pulmonary disease indeterminate’ (CPDI). These cases were often treated in sanatoria. They were warned against too much physical exercise until fit for it, and altogether it was impressed upon them that they were invalids. But they did not get progressively worse or change over the years, and when later radiography of the chest became possible it was seen there was little, if any, lung disease in these cases and these men might have returned to work long before. However, for too long they had been taught to be patients and had been in receipt of full pension. Many of them were still receiving pensions for neurasthenia after the Second World War. With servicemen of the Second World War there was nothing of this. Generally speaking, with modern X-ray and physical examination it is possible to determine whether a patient suffers from pulmonary tuberculosis or not.