PREVENTION & CURE.

Evening Post, Volume LXXX, Issue 95, 19 October 1910, Page 3

PREVENTION & CURE.

FIGHTING CONSUMPTION. SUGGESTIONS FOR TREATMENT. WHAT SHOULD BF. DONE. The following interesting report on. the treatment of consumption was presented to the Wellington Hospital and Charitable Aid Board at its meeting yesterday, by BY. H. Hardwick Smith, medical superintendent of the Wellington Hospital:— "As a result ot further communication with the Inspector-General of Hos : pitals re the treatment of consumption in the Wellington district, I have formulated, with his co-operation, a scheme, the working of which shall be carried out and controlled by the Hospital and Charitable Aid Board. The scheme proposed is not an elaborate one, and will not involve the board in much expense, other than the initial one of a few hundred pounds. Neither will further legislation be necessary to carry it out. Th© public must be educated, in the first place, concerning their responsibilities to themselves and their neighbours; and my proposition is to show the public of Wellington, in so far as I can, the dangers ot infection of consumption and its control. There is no need to preach scare sermons on the subject, but it is a disea&e which can be practically stamped out of the land by common sense and public spirited co-operation. And you, as a Health Board, should assist in this co-operation, not only with the public you represent, but also with the medical men, of the district, and myself, on whom will devolve most of the work in carrying out this scheme. When the Inspec-tor-General drew up the provisions of the new Health Act, he had on© prominent idea in his mind, namely — that the Hospital and Charitable Aid Boards should take under their control both the preven, tion and cure of disease, and also cooperate with other charitable institutions in this work. You have an opportunity of leading New Zealand in the grand •work of conquering this disease, which, « through ignorance, passes from house to house, causing misery and suffering. "In bringing down this report, I don't ■wish the people of Wellington to feel that they have a new dread disease amongst them ; but that the evil which has been with them so long can be stamped out once and for all. I want to show them that, by following a few simple rales relating to hygiene and health, they need have no fear of infection, but can give those who are suffering practical sympathy and help. As people live in their homes to-day, however, there is every fear of the disease spreading. The idea is, mainly, to treat in their own houses, people suffering from consumption. Some argue, that, as the deathrate from this disease is decreasing, there ie no need for further movement in the matter. But this is the case only in those countries where public-spirited boards have undertaken the education of the people, with the h«arty co-operation of the medical faculty. In a new country like this, with an almost perfect climate for the white race, it is a shame that such a disease should exist as a continuous epidemic. THE SCHEME. "Now, as to the scheme itself, I propose: — "^1) That a dispensary should be built es a part of the out-patients department. " (2) That this building should consist ' of four rooms, well lighted, ventilated, and easily cleaned. ' " (3) A certificated nurse shaft be in attendance. She will be taught the methods of prevention of the disease, and 6hall visit the homes of those suffering, and give them advice and reassurance, and practical help in the carrying out of the treatment. " (4) She will be practically a district nurse acting under the board. " (5) That necessities such as drugs, sputum mugs, disinfectants, and dressings shall be 'given to those needing them. " (6) The patients treated shall be those who cannot afford private medical advice and attendance. " (7) That popular literature on the subject of prevention, diagnosis, and treatment be published by the Health Department, and distributed by the dispensary and other charitable institutions. " (8) That all the medical practitioners of Wellington district be enabled to .obtain this literature. " (9) That tuberculin for injection be provided by the Health Department, for by that' means 20 per cent, duty will be Eaved. " (10) That the purpose of the dispensary shall be to make periodic examinations of the physical condition of the patients; and also bacteriological examinations of the sputum. " (11) That statistics be kept of the condition, weight, and progress of each patient. " (12) That patients attending the dispensary shall be drafted, when necessary, to Otaki, the Seddon Shelters, or the Government working colonies. "As I have previously stated, it is most important that the late case should be treated with every kindness and care, but isolated, as this is the case which causes the spread of the disease. In the near future, I think it will be necessary to have further accommodation for these cases. "It is not necessary to treat consumption by stuffing the patients and allowing them to lead lazy, indolent lives. The best treatment is healthy surroundings combined with suitable occupation. I will quote some remarks of Dr. Paterson, of Frimly Sanatorium, England, .who has been more successful in his treatment of sanatorium cases than any other man at Home. He says : — 'It may be taken for granted that the theory of Wood-spitting as the result of work is a superstition. The only thing is that the work has to be gradual. When a batch of consumptives arrives, if any are very weak, I occupy their attention by Betting them mop -making or flag- making, 8i that they don't have to move about. 'As they get a little stronger, I set them .walking, beginning with a mile a day. ■When they can do seven miles a day I put them at various kinds of work. For instance, transferring in baskets the sand thrown up from the excavations for the reservoir. Then they get to shovelling the sand or ballast. At first they only have small shovels, like ,toy ones, and they are made to work for five minutes, then rest for five minutes. As time goes on they are enabled to use an ordinary big shovel, and to use it continuously. X do not try to make a man fat. as is done in many sanatoria; but having strengthened him with plenty of good food to begin with I get him into muscular condition and keep him there. I try to fit him to go back to work when he leaves the sanatorium.' "I have quoted these remarks, taken 'from the daily press, which has done so much towards the education of the public on health matters through its columns. Dr. Paterson's remarks prove that, for the early stages at any rate, hard work under good surroundings are the two essentials in the curing of consumption. There is no fear of the patient in the first stages imparting the disease to others if proper rules are carried out. These rules should be carried pnt in every home in New Zealand, 'jrhether it -contains djae^jpr-go^Jfega

consumption will be soon stamped out. It is in your power, as a health board, to aid # the medical faculty by your cooperation in preventing this disease. It is the prime object of this scheme to teach prevention and help those who have already contracted consumption." DR. VALINTINE'S REMARKS. In the course of a brie? supplementary address Dr. Valintine, InspectorGeneral of Hospitals, said the question had been raised as to whether anything was being done at all in connection with the control of consumption, and it »vas also intimated — an intimation which was practically taken up by the Press — that the death-rate from consumption had been practically increasing. He did not propose to make a long statement as to what had been done by the department in the past, but he thought a great deal had been done, although, perhaps, the department had not made itsejf so apparently active as was, possibly, the case in the past. Even in the last few months they had opened two new sanatoria — in Christchurch and Palmerston South. Now they had four excellent sanatoria in the colony, while five years ago they had none at all. In addition officers of the department had been taking all possible precautions with regard to those cases that had been reported. They had used their persuasive powers to get people suffering from consumption either into sanatoria, where they would receive the benefit of the open-air treatment, or else to get them into some place such as a chronic ward, where they could be kept from disseminating the disease in any way. Now they had 160 beds in the Dominion for curable cases. For the quinquennium 1890 to 1894 the death rate per 100,000 from consumption was 82.2 ; from 1895 to 1899, 79.3 ; from 1900 to 1904, 73.9 ; from 1904 to 1909, 62— so that in the last twenty years the deathrate had fallen from *82.2 to 62 per 100,000. He thought that was an answer to the statements that had been made. There was, he went ont to say, one thing that was absolutely true, and for which the department was willing to share the blame. As the Medical Superintendent recently pointed out, the machinery was defective for getting at at the early cases, and Dr. Hardwick Smith had dealt with that class of case lin his report. They were also defective •as regarded accommodation for chronic and incurable cases. They certainly needed accommodation for those people j for whom there was, unfortunately, no I prospect of cure. They must have that accommodation, and, as far as he could gather from going round and meeting the Hospital Boards throughout the Dominion, they were all unanimous that they must get at the early cases, and must provide for the incurables. By adopting the report now brought down the Wellington Board would be setting [ an example to the other boards of the ! Dominion. ! The board deferred consideration of the report to its next meeting. It also decided to write to the Canterbury Board (in reply to a letter received), stating that it was willing to send representatives to a conference on the subject of the treatment of consumption, suggesting that the conference should be held be.tween March and June next.