T.B. RESEARCH.

Press, Volume LXIV, Issue 19251, 5 March 1928, Page 10

T.B. RESEARCH.

DR. M'INTYRE returns. AMERICAN SANATORIA. Dr. I. C. Mclntyre, Assistant Medical Superintendent at the Cashmere Hills Sanatorium, returned to Chrisv church yesterday from a tour abroad. In an interview accorded a representative of The Press, lie gave many illuminating details of the methods being used overseas to combat the enemy tuberculosis. Dr.* Mclntyre visited England, Scotland, and several European countries, and later on Canada and the United States. In Denmark he saw the Finsen Institute, where the ultra-viokt light treatment originated. °ln Canada he visited many of the leading sanatoria, such as Saraana Lake, probably the most famous institution of its kind in the world. It was the Mecca of consumptives from most of the eastern states of Canada. There were many fine institutions in California, which was reputed to have the finest and most equable climate in the world. Results Compared. The various States and private institutions which Dr. Mclntyre visited were very substantially built and well equipped —much better than they were in England and in New Zealand, but he did not think that, in spite of all the money spent on them, they got results even as good as those obtained at Cashmere. Where America. Leads. "Money is very plentiful in the United States," lie said, "and one can see evidence of unnecessary expenditure in many directions, but one development in which they do put us to shame is in their kitchen and domestic equipment. Even the meanest and poorest institution does its cooking by electricity or gas. Laboursaving devices are seen on all sides, such as dish-washing machines and potato-peelers, etc." Every American looked upon a refrigerator as an absolute necessity, and not only was it found in every hospital kitchen, but also a small one attached to each ward kitchen. They were found in most private houses and in new apartment buildings they were lieing installed as standard equipment. They undoubtedly spelt economy in the long run, for there was absolutely no waste from food going bad, a source of considerable loss at Cashmere in the hot summer months. No American could conceive of an institution of the size of Cashmere without several refrigerators in which to keep milk, fruit, meat, etc. The inclusion of such appliances along with scrupulous care in the preparation and serving of food gave the visitor the impression that America led the world in that direction. All the meals in the sanatoria abroad were served on the "help yourself system." All milk was supplied in sealed bottles from tuberculosis-tested cows. The Americans were great milk-drinking people. They took about four times as much per head as did the English people. A Disgusting Habit. But anything that might be gained from this care of food was lost by the disgusting habit of spitting, which was very prevalent in the United States, said Dr. Mclntyre. It originated largely from the chewing of tobacco and chewing gum and cigar smoking. Much disease and especially T.B. was probably spread in this way. Good Staffs and Good Pay. Their institutions were well staffed a- " well paid—too well staffed in many cases. There was one large institution on Staten Island which served New York City, where they had 1000 patients "and 850 employees to look after them, including 23 doctors. The cost of running that place was nearly one pound per day per patient. The average cost of most of the American institutions was probably about 14s or 15s per day, whereas Cashmere was only Bs. Considering what was being done at Cashmere, Dr. Blackmore could not be charged with extravagance. Surgery and T.B. As for the treatment of tuberculosis, probably the most striking advance in recent years was in the domain of surgery. Up till a few years ago tuberculosis of the lungs was one of the few diseases that was purely medical in its treatment. At a conference of chest surgeons in San Francisco he heard the remark made by an eminent authority from McGill University that 10 per cent, of all cases of T.B. were suitable for surgical treatment. He would hesitate to confirm such an opinion, especially in this country, where patients could be kept under sanatorium treatment over prolonged periods.^ Rest was the main function in the treatment of a disease like tuberculosis whether it was applied surgically or medically. In some cases where operations were used the same result could be obtained by rest in bed in a sanatorium. This was much better for the patient. Operations were undoubtedly a useful means of treatment in some cases, and what was looked upon as a dangerous operation wheal he was in London in 1921 had now come ipto the realms of practical surgery. No Specific Cure. "There is as yet no specific core for pulmonary tuberculosis —we must stiil rely upon prolonged sanatorium treatment and may 1 emphasise the word prolonged?" continued the Doctor. "We had, unfortunately, in New Zealand some people who advocated only a short stay of, say, three months, in a sanatorium to teach the patient how to live in his own home. This method i 3 quite useless, and is one of expediency only when it is a question or shortage of beds, or money, as existed in England to-day. Everv authority on tuberculosis in Great Britain and Canada and in the U.S.A. advocated a minimum stay of one year in a sanatorium, although many of them found it impracticable at the present time. Early Diagnosis. Prevention of massive infection from parent to child, early diagnosis of the disease when it did appear, and ample provision in sanatoria for all cases were what we should aim at in New Zealand. A Good Beginning. In Christchurch we had made an excellent beginning in our efforts to prevent infection in childhood by the establishment of the Fresh Air Home for children, on Cashmere Hills. _ There were many similar institutions in [J.S.A., where they called them preventoria. Open-air schools would also be of great benefit, and he was pleased to see that the general public was beginning to recognise this fact. Further education of the publio -in the dangers of infection in early childhood was needed along with the establishment of T.B. dispensaries or out-patient departments in many parts of the country to which general practitioners might send their patients for an expert opinion. M. Spahlinger's Treatment. "I had a talk with M. Spahlinger in London. He is still full of optimism, but has made no progress since I saw him some years ago," concluded Dr. Mclntyre "He is at present concentrating his efforts on the prevention of tne infection in cattle. Time' will tell whether he will meet with any success but I am afraid from present indications, we might not look for too much from M. Spahlinger.".