THE WHITE PLAQUE.

Dominion, Volume 4, Issue 951, 19 October 1910, Page 4

THE WHITE PLAGUE.

PREVENTION AND CURE,

AN IMPORTANT SCHEME

The combating of consumption and related questions 'wore, brought prominently .under, the notice of thp Wellington Hospital and Cbaritablo Aid Board at. its meeting yesterday. A lengthy: report from' the■ medical superintendent (Dr. Hardwick Smith) on tho treatment of consumption was laid on the table,; and the sanie subject was incidentally raised in a communication, from the Canterbury Hospital and Charitable Aid Board. In this a proposal was raised that a/conference of representatives of the .various, Hospital .and■. Charitable Aid Boards should bo held, with a view .to the discussion of the best means of'.combating consump-; tiori, and others matters connected with the work of. Hospital .and .Charitable Aid Boards. As. the affairs '.' : of . the boards were being administered under a new Act, and they wore being elected on a new basis, the Canterbury ■ Board deemed;.it. desirable that' a ' uniform course of action should be decided upon. It was suggested'"thajE'lhe.GfoVernment he asked to : again promote l a conference in.the near middle of November.. Information was'sought .'as to whether' the; Wellington\ ; Board, in the-event of the.-.Government *■ refusing to: .take the action":desired,. would join in •:. /■jsendi'ng: . representatives/ •''■■' to a mutually-promoted .'conference; ; ,to' .'be held,: probably,, ; jn AVcllington, at as early a date as Could be ■arranged. "Dr. Hardwick Smith's Scheme. ; In his report, the Medical Superintendent observed "that"'"when':'the In-spector-General drew up the provisions of the new Health /Act,, he. had. one prominent idea in "his mind, 'hamely, that the Hospital and Charitable Aid Boards should take , under their control both the' prevention and cure of disease, .and-".also co-operate with: other;charitable institutions in this .work. '■Now, as to the', scheme itself, I propose:. . ..;:'.: . .;■;.." ■ ..■'-. ■ ■-.../ "■ ."That a dispensary.should;, be..:built as .a- part .of. the outpatient, department; .and consist of four;;rOTnis, well lighted, ventilated, and; easily cleaned. .A certificated liurse "shall : be in attendance.,': She will bo taught'the methods of. prevention of the disease,' arid' shall visit the homes of-those' suffering, .and give, them advice "and reassurance and practical help in the carrying out of'tlio treatment. _ She will. be practically a district nurse acting under, the board. •'.'Necessities, such as drugs, sputum mugSj'disinfectants, and dressings, shall be given to those needing themj and patients treated .shall be those who cannot ;afford private medical, advice and. attendance.. - ,-.. .; :■.. ', :

"Popular literature'oii;the. subject of prevention," diagnosis, and treatment, be published'-by, .the Health Department, and. distributed by the dispensary'and other:charitable -institutions.: All: the m'edicar : .practitioners'"o'f Wellington district/be enabled to oßtain this literature./■/.' '.'•■■.''■'■' .''...,. '•'■■■ •',--.

"Tuborculin for injection bV provided fry -the- Health Department, v ;f or :..by that moans 20 per cent, duty will be saved.V The' .purpose, i,the •' dispensary shall be to make! periodic examinations' of.;' the: physical /condition - ; of ; thV. patients;- 1 and. also bacteriological examinations/of thesputunu ■' ■.;/'. -,- •..'.'Statistics be kept, of .the condition, weight,,',and. progress..of each- patient. Those;attending the; dispensary shall be, drafted; when necessary, , : to ' Otaki, the: Seddon Shelters, .or the Government, working 'colonies.' :'. ;,}' .;,;,;;.' ■•-.■ f'As/I-.have previouslyWstated, , ' ;it;:ismost ■' important that :the late/.case bo treated with every.' kindness and care, but isolated,■; as this is the case whicli causes the spread ':oi the dis-; ease. ;; In ; the near future, I think it will he necessary to , have further -accommodation for these cases. / . '.:■ ;

1 '"It , is not necessary to .treat consumption by staffing the patients, and.allowing .them to lead lazy* ■ indolent .i lives; The best treatment, is.'healths-surround-: ings,: combined .with suitable, ••' ' .-'■. ■'; - Y ■■'■■. . ■

5 ; "A Valuable Report.' , .■ ;Mr.;;R. : ,'iC.- Kirk., nioyed that .the re-, pprt be received, over.fofYco'n-' ' sideration.; ttntil l next' meeting, z- It ■' was far, ibb important ,tq be' discussed; by members- af. a ■moment's notice. 'Its adoption would involve, among- other things, an expenditure of several thousand pounds on the out-patients' department." It was essential that members of-tlie board and.'of.,the,.Hospital.Committee should, have, an' * 'opportunity'.of considering the.:.,.very- valuable 'Report brought down' by: the medical Buperin-/ tendent.; . . ~ ■ • ~.-..!

Jhr. F,-T. Moore endorsed what" the previous' speaker.'had said as. to :' the value;pf the report.. : It was a'.splendid answer to the request standing in,his (Mr. Moore's)'-'name'-.on the order paper, "that 'the medical' superintendent .report upon the heed; or .otherwise of , effective measures for; the; 'isolation of all cases of .pulmonary , consumption in the community." ■ ■■:The:'so6'ner. the report was adopted and gut into operation the'better. ■". ■;■■'■, ."'.'■ ■.'■ ,'C/ ......••'...■•.■'."-',■.:'■ .' '-<" ■ v ;:;Thß Work of : the Rast. p r At the chairman's invitation Dr. Valentine briefly ■ addressed the bdard.! He .disclaimed any intention of dealing comprehensively with the subject in ha : nd, .but.stated that there we're one or two matters connected with the report : to which, he would like. to. refer. A question had been , raised as to , whether' anything was being done at all iii regard to the treatment of consumption, and,, further,, it had been stated that the death :.rate from consuniption had been; rather increasing. : He did not propose to detain the board with any long statement , as to what had been done in the past by the Department he had the honour to control, but. a great deal had.been done, although lately it had not perhaps been brought so prominently under public notice as in tlie past. Within the last few mouths they had opened two new sanitoria, one at' Christchnrch and another at Palmer-tfoh-South. They had now four excellent sanitona in the Dominion, ■ whereas five years ago they had none at all Jji .addition to this, the officers of the Department had been taking all possible precautions in regard to cases that had been reported. TheyJad exerted to the utmost their persuasive powers with a view to inducing people suffering from consumption to enter a samtonum, where they could obtain proper, treatment, or else, in ca ses where cure was impossible, to ge't patients to enter some such place as the chrome ward of an hospital, so "that the dissemination of disease might be prevented. In the Dominion, 160 beds wre now available for curable cases of the disease. As regarded its prevalence, the number of ' deaths from consumption, per hundred thousand of the population, in the quinquennial period from 1890 to 1894, was 82 2 From 1895 to 1899, inclusive,' the mortality per hundred thousand was 79.3 from 1900 to 1904 it was 73:9, and from 1904 to. 1909 the mortality rate was 62 per hundred thousand. Therefore in the last 20 years, the number of deaths from consumption had diminished from 82.2 to 62 per hundred thousand. This, Dr. Valintino claimed, was a practical answer to statements that had been made in tho press and in other placos. One thing was absolutely true, and in this tho Department was to blame, and was willing to bear its share of the bkme. The.medical superintendent of the board had. pointed out that the existing machinery was verx

defective as regarded getting at the early oases. The maohinery for dealing with chronic and iucurablo cases was also very defective. Accommodation Required. ; Accommodation was wanted badly for those people who had no prospect of ultimate cure. So far as 'the speaker could gather from going round' the country and meeting the various boards they recognised the necessity of this work, and were prepared to undertake it. They must get at' the early case, and they must got at the chronic and incurable cases. By adoptiug the report before it, anil giving it effect, the 'Wellington Board! would be giving an example to boards in other parts of the Dominion. Referring to the letter received from the Canterbury Board, Dr. Valiutine heartily approved the proposal to hold :i conference at which £he question'of dealing with" consumption could be brought up. Such a conference would be!; an excellent thing. The Hospital Conference'of ;three years ago had been of; enormous value,, and it would bo a goijd thing if a'similar conference , could be held .every - three or four years. The speaker had informed the Canterbury Board that he hoped the conference they proposed' would be held at tlio end of the-session, or, at any tato, during the recess,- so that he would have more time to devote to the deliberations of the conference. If it were held in June of next year, there would be afforded an additional opportunity of observing the working or the present: law, and hospital boards would: then be! in, a; better position to' indicate \ such improvements as might prove necessary, than, if their sentatives ' met during next November,', after, '''the Act had been only a few months in operation; .Finally, VDi. Valintine said, lie felt f[uite' confident that the board, would, give -.this, report of their medical; superintendent's every consideration when; it was brought up.

:.. In ...terms {of jVIr;. Kirk's , {suggestion, :it.. was...agreed ..to;,hold over consideration'of the report for a "month. . • '.-■ The secretary, was instructed to reply to the Canterbury communication, that the board was quite willing, to fall in with the, idea of holding, a,conference if rit could be arranged, and would recommend that it'be. held at. some time between >larch and June of nest year.