HEALTH PROBLEMS

Evening Post, Volume CII, Issue 29, 3 August 1921, Page 15

HEALTH PROBLEMS

TUBERCULOSIS CAMPAIGN

discussion or Progress,

The eSiciency of the present machinery for dealing with tuberculosis was discussed at the recent conference-of the Koyal Institute of Public Health in London.

Sit Robert W. Philip (president of the Royal Coltoge of Physicians, Edinburgh.), who occupied tl» chair, referred to the; meafiures that had been taken for diaalm" with tuberculosis. Foi\lßßo years, he said, we were admittedly working in tho dark. Finally, in 1882, Koch submitted irrefutable proof that tuberculosis was an infective disease, dependent oa the entrance into c k°4'y °* th° .tubercle bacillus. It was manitestly a disease to be. dealt with on the same general principles as.had been successfully applied, to the control of other forms of infection. It was the practical realisation of that conception that led to the first diefmite more towards the control and, eradication of the disease. Tuberculosis was an infective process of slow, insidious nature for the most part. In its earlystages it was highly tractable. It was readily a '.Tested /under .suitable conditions of environment. It was correspondingly peisistent in the absence of tbeae. When once established it-tendied to continue indefinitely—it might be through-., out a long lifetime. Tuberculosis was widespread throughout Vh'e community. Everyone* was liable, aiid the great majority of persons became affected sooner or later in some degree. The programme for the control and eradication of the j disease had to be correspondingly, com- I prehensive. Th© first direct move towards ail effective campaign was made in Edinburgh in 1887 by the establish- ) ment of the Tuberculosis Dispensary. More recently the Inter-Departmental Committee oil Tuberculosis emphasised the desirability of implementing; the general, plan of the tuberculosis scheme, as recommended by the Departmental Oonxmittee. . ' - 1 In the opinion of both, committees it was imperative that" there shwuldi be a general adaption throughout til* country of a ea-ordanated scheme of anti-tuber-culosk institutions, which, ij\ order to be effective, must be linked together, and' be mutually interdependent. What had actually happened throughout the country ? To. begin with, there was frequently delay'from a variety of civusos ib. fvajnmg tuberculosis schemes, 'fhere was indecision and fumbling—both innocent and perverse—as to the purposes of the various institutions. The sanatorium was very largely allowed to become a d|utnp-ittg-ground) for every sort of case, the un-desirable—incurable-^being especially in evidence.. The recommendation of the Department Committee thai such advanced cases should have hospital treats ment was commonly lost sight of. The result had. been hopeless confusion, the piling up of long waiting lists, dlelay in admitting suitable cases, until, in many ! instances, the suitable case had become unsuitable, and correspondingly disappointment had been brought to everyone conoernedi, with endless waste of time and money. During five years of war everything was more or loss fceW up. Schemes in process of development wers badly crippled, and institutions whidh were ■planned or in course of building were closed down. As a result a satuifaci tory realisation of th« tubeToulosis Bch«ni9 as detailed and recommended "by the Departmental Committee had bsen hardly possible. Significant results had been accumulatihg from year to year in area* iv&ere a._ sustained effort on the lines of a co-ordinated scheme had been possible The mortality from tuberculosis was falling at an accelerating rate. , The type, of disease commonly met and dealt with had remarkably changed. The diagnosis oi tuberculosis had been shifted from the late case—now seldom Been for the first time^-to the determination of incipient manifestations. The object-lesson of the sanatorium was gradually and surely being earned to the homes and workshops of the country, and, let them hope, would serve to mould out policy and practice in relation to housing. Dr. 8. Lyte Cununios (Professor of .Tuberculosis in the University of Wales), (reviewing the policy that had been adopted, said a really great effort was being .made to afford the sufferers from j tuberculosis a large measure of h«lp. The Govarnment had done well in this reispect, and everything pointed to the probability that the new Minister of ■Health would add to the efficiency of I our machinery iv thie respect. 'The loounlTy was in advance of all others iv having produced th© Medical Research ! Council. Ho thought the time had come lor the granting of a diploma of tuber.culosia to men who bad taken, a special course of instruction and satisfied competent examiners that they lad gained a real knowledge of the disease.- There Was a hope that at some time, in the future a ohomics;! car© might yet be found for tuberculosis comparable to that found by Ehrlich for fey.philis. U had ■been .recently proved that certain fatty ncids were able to kill the l«puo»y baciJ- j Jus and cure leprosy. As leprosy was so closely allied to tuberculosis, the discovery justified the hope that sooner or Hater gome remedy on this or simikr I lines might bo found to kill the tubercle Ibacillus. .. '

Sir ■ German S. Woodhead (Professor of _ Pathology m the University of Cambridge) said it might bo accepted that ono of the main causes of failure in regard to tuberculosis had been the proneness of the medical. profession, and therefore those who relied upon it for advice, to accept panaceas and placebos as curatives, and to endow phrases and catchwords with a dignity and importance they- were, when put ■ to the tsst, incapable'of sustaining. Individuals were no doubt doing good work -in the various schools of the medical world and in private ajid public institutions, but with how little attempt at co-ordination. At the same time they had failed, and fail-, ed completely, to recognise that although' the work euch individual investigators were doing- mfght: be of importance in itself, its value might become infinitely .greater if compared and co-ordinated with the work of others. That it might help to fill a gap that might complete and form tho very keystone of an arch ■which, void of form or beanty in itself, might, wh«n examined, tested, and' fitted ■into the work of others, ha just what was required to oomplet* ijome great ■structure.

Dr. Jane Walker (medical superintendent of the East Anglian Sanatorium) urged the paramount importance of obtaining a. clean milk supply, tho value of education., and a better classification tof the disease. She advocated the splitting up of sanatoria into something like family parties. In an educational sense the cinema could Tender a great service. .No fool was ever cured of consumption, and it was their business to see that the fool ceased Ids folly. Dr. IJalliday, Sutherland (ex-president of the Tuberculosis Society) attacked some of the alleged consiuaption cures one of which he described as "harmful rubbish."

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