338 THE BRITISH J O U R N A L OF TUBERCULOSIS

THE THIRD INTERNATIONAL CONGRESS OF PHOTOFLUOROGRAPHY

Stockholm, August 20-23, I958

BY OWEN CLARKE

From the Chest Clinic, Canterbury

THIS Congress was organised by the International Society of Photofluoro- graphy and the International Union against Tuberculosis.

In his Presidential Address, Professor Carl Wegelius welcomed the delegates from thirty-five countries who represented many important national organisa- tions and various branches of medicine.

He hoped that the term RadiophotographyuRP--would become stan- dardised for this branch of roentgenology which was developing rapidly along its own lines. Radiophotography, of course, had its origin in tuberculosis work and this was still its most important role both for surveys and clinical work in connection with chest diseases, but it was becoming increasingly important in cardiology, gastro-enterology, and study of diseases of the skeleton.

These aspects were enlarged upon by the speakers in the Congress, although the greatest emphasis lay upon chest diseases and many papers were devoted to descriptive and statistical accounts of survey work in different parts of the world.

DIscussioN OF PAPERS Professor M. de Abreu (Brazil) and Professor G. Babolini (Italy) opened the

Congress with stimulating accounts of their work and of the wider possibility of RP in non-pulmonary disease; Professor Etienne Bernard (France) described its diagnostic value in pulmonary tuberculosis, and Dr. Owen Clarke (Great Britain) summarised the advantages of this technique for outpatient work in chest clinics and emphasised the criteria which must be fulfilled if RP were to supplement full-size films.

In the session dealing with radiation hazards, Dr. A. Nelson (Sweden) discussed the recent U.N. report and other speakers confirmed the relatively small dosage due to radiophotography. The figures of Dr. L-E. Larsson (Sweden) were of particular interest. Dr. B. Hauson (Germany) and Dr. C. Buckheim (Germany) both described new techniques using high K.V. and special contrast developers by which the skin dosage was greatly reduced.

A discussion on the use of Radiophotography for tuberculosis and other chest diseases concentrated too much on survey work, but the reports of Dr. F. T. Jarman (Great Britain) and Professor R. Griesbach (Germany) covered long periods of survey. Dr. Jarman described fourteen years' survey work in Wales and pointed the lessons to be learned from the results.

Dr. K. Liebschner (Germany) reminded members that the cost of detection was much less than of treatment, and an interesting paper by Dr. Ch. Couhy (France) outlined the valuable work done in Professor Bari~ty's clinic in Paris.

Lung cancer was first considered by Dr. F. A. Nash (Great Britain), who did not consider that an annual X-ray was frequent enough to be of great value in this disease.

A N D DISEASES O F T H E C H E S T 339

Among the many papers dealing with diagnosis, Dr. Philip Ellman (Great Britain) dared the sharp reminder that diagnosis is the duty of a clinician and cannot rest on radiology alone. He showed many chest films associated with various connective tissue pleural and pulmonary lesions which could easily be described as due to pulmonary tuberculosis unless the whole clinical picture were known.

Naturally such a Conference also discussed the human factor in X-ray reading, so dependent upon good technique. The excellent display by many firms gave a background to these papers, and also to the use of radiophoto- graphy in cardiac disease, bone diseases and gastric investigation. These ideas, relatively untried in this country, are already widely used abroad.

HOSPITAL VISITS In addition, the Congress included visits to the Karolinska Thoracic Unit

and many other clinics and sanatoria as well as a most hospitable and interesting social programme. These visits showed a standard of hospital design and equipment which is still almost unknown here, and indeed there is little evidence that our plans even aim at such a high target. Much of it would be considered extravagant and admittedly is not essential for good medicine, but it indicates an adventurous and progressive state of mind.

ATTENDANCE AT CONFERENCES

There were more than 5oo delegates at the Conference: only six doctors were from Great Britain. O f these, four had been invited to contribute papers and one of us had the privilege of being chairman for a session.

There were more than sixty delegates from both Germany and Italy. Many of our Swedish hosts much regretted that Great Britain was so

lightly represented at such international congresses, especially since the opinions and work of our doctors is so highly respected. Representatives of other countries, too, expressed the wish to hear more of British medicine.

Of course, the question of cost arises: so too in other countries. Much credit is due to those authorities who recognise a responsibility to help ensure that British representation abroad is maintained: their example should be more widely followed.

But, in addition, a responsibility rests on British doctors themselves to accept the cost and to attend international conferences, even if not invited to read a paper. I f we are proud of a Health Service and of our own work other countries should hear of our pride and meet our representatives.

How many of our doctors or administrators have in fact seen and known the standards established in Sweden, Canada, France or Germany? How many of our doctors are prepared to deliver a paper in a foreign tongue or publish in a foreign journal ? How many know the excitement and stimulus of discussion with experts of other countries, and the value of these friendships ?

The Stockholm Conference showed an international approach and a variety of ideas from which we could benefit: we too have much to offer to international thought. Doctors of all nations should think with a world mind: but that involves contribution and absorption of world views which can only be done by the personal contacts which stimulate understanding, adventure and vision.