New Zealand Medical Services in Middle East and Italy
Chest X-ray Examinations
Chest X-ray Examinations
Early in September 1939 the Director-General of Medical Services discussed with the Director-General of Health the question of recruits who might be suffering from pulmonary tuberculosis. The necessity for X-ray of the chest of all recruits had been discussed in September 1937 at the Australasian Congress at Adelaide, at which the DGMS had been present. It was realised that the ordinary clinical medical examination probably would not detect early, latent, or quiescent pulmonary tuberculosis, and that an X-ray examination was the only sure means of detection, especially if the recruit, anxious to get away, withheld information as to present and past symptoms of the disease. Obviously, every effort had to be made to exclude infected recruits, and Cabinet agreed at once to the proposal for the use of X-rays of the chest.
In September 1939 Ministerial approval was given for a unit capable of undertaking chest photography to be purchased and installed in each of the three main military camps-Burnham, Trentham, and Papakura. The apparatus for each unit was to cost £800, and buildings had to be provided in which to house the plant and conduct examinations. The apparatus was available within a few weeks, but the authority to erect the necessary buildings was delayed and the X-ray apparatus could not be installed until it was too late to X-ray more than a few men of the First Echelon.
The Second Echelon was X-rayed in camp, but the operation of the system brought to light some cases of hardship where soldiers had been attested, had left their civilian occupations or sold their businesses, and had then been rejected in camp for tuberculosis. (As a result of the X-ray examination of chests up to 30 April 1940, 143 soldiers were found to be suffering from pulmonary tuberculosis and were discharged from military camps.)
It was later accepted that the X-ray of the chest was really part of the initial medical examination and a responsibility of the Health Department under the civilian medical board system. In April 1940, therefore, it was decided that all recruits should undergo the examination before they were called into camp, and arrangements were made by the Department of Health for this to be carried out at thirty-four hospitals, and the interpretation of the films made at the eleven largest hospitals. Thenceforth an X-ray examination of the chest was regarded as a routine for all recruits classified fit for active service. Army area officers made the best possible arrangements with the Medical Superintendents of hospitals, and every endeavour was made to have men who had to travel some distance page 31 for medical examination X-rayed immediately after that examination, so as to avoid a second journey with consequent expense and loss of time. This system operated fairly efficiently, but for various reasons many recruits entered camp before being X-rayed.
The institution of an X-ray examination for all recruits from the Second Echelon onwards was the means of detecting tubercular cases who might otherwise have been passed as fit, but who would undoubtedly have broken down under active-service conditions. Doubtful cases were referred to specialist chest medical boards for diagnosis and decision regarding grading. Calculations in 1940 rated active or latent cases among recruits at about 1 per cent, with figures for Maoris higher than those for Europeans.
The army authorities arranged for lists of all recruits for 2 NZEF to be supplied to the Health Department, and throughout the war officers of that department checked these lists to detect the names of those who were, or had been, on tuberculosis registers. Such recruits were specially examined.