HEALTH NOTES

Evening Post, Volume CXII, Issue 3, 3 July 1926, Page 12

HEALTH NOTES

TUBERCULOSIS

IMPORTANT PREVENTABLE

DISEASE

POSITION IN NEW ZEALAND.

TESTS AND TBEATMENT,

vsi (Contributed by the Department of t; ' Health.) Tuberculosis in all its forms or the "Great "White Plague" has throughout the world shown a considerable decline •since 1860. South Africa, Australia, : and New Zealand have very much lower : death rates from this disease than most • other countries. In 1920 there were 851 from this cause in New Zea- -■ land, or 7.21 per 10,000 of mean population. The number is steadily reduc'.,ing year by year, and last year fell to I 684, or 5.14 per 10,000 of mean population; Tuberculosis, however, takes fourth ';: place as a death-dealing factor in New First place is taken by heart '•'disease (all forms), the second by can- ■ cor, and the third by violence (acci--1 dent, suicide, and homicide). Last year 684 persons died from tub- .. erculosis; just over 2000 were under ; treatment for the disease (all forms) f in public hospitals and sanatoria, and S * great many more were domiciled pri- : vately. It ia a disease which in great j measure can be prevented, and many • cases, given early and thorough treatment, can be cured. . LOTTO TUBERCULOSIS OR CONSUMPTION. Of the total of 684 deaths in 1925, , 560 were due to lung tuberculosis. This ■■ disease can be conveyed from person rto person, by careless handling of sputum or by repeated and close per■sonal contact. Though infectious, it is not bo readily conveyable in acute serious form to persons of good natJural resistance, living healthy open-air i Jives, as was formerly supposed. Frequently, too, minor attacks are recovered from. Post-mortem examinations made in certain European counr.'tries of persons who havo died from [ other causes have shown in over 90 per r_ cent, of those examined, evidences of i, their having been attacked by and hav!;ing recovered from tuberculosis at some ;>,.period of their lives. These facts have ;served to strengthen our belief in early i treatment and in preventive measures. Unhealthy living is an important Lcontributory cause of tuberculosis. In- |, Bufftcient or improper food and clothing, pbad housing, particularly the overcrowding of persons in living-rooms with in- -; sufficient ventilation, alcoholism, and a "fiamp subsoil are important factors i:. which lessen human resistance to this '.disease. The children of tuberculous ' parents are often specially susceptible. THE TREATMENT. I Special consumptive sanatoria are rTalnable. They effect a fair proportion of cures, and when the patients •,are admitted early and are able to ■ make a long stay in the sanatorium the • proportion of cures is large. They proJ vent spread of the disease by isolation i of the patient and by the training he • receives in the care of his sputum. There has been considerable progress ; In the application of sanatorium treat- , ment in the Dominion during recent >yearg, particularly by the hospital boards of the South Island. Vaccines '. and sera by Spahlinger, Dreyer, and ;Biore recently by Smallpage of Australia have not proved curative enough to command continued use. PREVENTION. Medical practitioners are required by law to notify the district medical officer of health of the existence of cases ■ of consumption, and the observance of this law is increasing year by year, as shown by the regular increase in the . number of notifications, coincident with a steady reduction in the death rate from this cause. Medical officers of health and health inspectors, in co-operation with medical attendants, call upon and instruct , patients in precautionary measures in?.tended to prevent the spread of the disease. OTHER FORMS OF THE DISEASE. 1 In 1925 there were 124 deaths from tuberculosis of organs other than the lung, and nearly 800 such cases were .treated in public hospitals and sanatoria. The organs affected comprised • Mainly the joints, the spinal column, ithe brain and its membranes, the intestines and peritoneum, and tho neck ' glands. Investigation ia older countries has shown that whereas nearly all cases of Jung tuberculosis are of human origin a proportion of these latter cases, approaching half, owe their origin to inj lection, from tuberculous cow's milk. TREATMENT BT ULTRA VIOLET RAYS. These varieties of tuberculosis, sur--jgical as they are often called in contra ', [distinction to lung tuberculosis, respond to treatment by the ultra : ..violet lays of sunlight. Remarkable Tienrative results have thus been achievjed, notably in the Swiss Alps, where, "at altitudes of about 4000 ft., patients are wholly exposed to the sun's rays. More recently the artificial application of ultra violet rays by means of Wpecial apparatus, has been practised in many cities, and a few such treatment units have lately reached New 'Zealand. Both methods, natural and artificial, iare also highly beneficial in hastening 'convalescence from some other forms >f illness, and in the treatment of cerjtain intractable skin complaints. Whichever method, natural or artificial, of applying these rays is used in the treatment of surgical tuberculosis, a bracing climate, which is associated with high altitudes, is an added "|>enefit. This Bun cure, skillfully applied, gives promise not only to our cases of Burgical tuberculosis, but as an aid to .convalescence from many debilitating :jdieeases.

MILK SUPPLY.

:By inoculation of rabbits and by fether laboratory tests it is possible to .ascertain whether the causative germ i« of the human or of the bovine variety. Such, teats in New Zealand have up ..to the present been very few and con'ifined to the principal cities, and it is impossible at the momont to say whether or not in this Dominion a like pro•iportion of these cases owe their origin •;to tuberculous milk. These tests, given the needed facilities, could be carried out on a larger rbcale by the - bacteriologists of the jtfour principal cities, and would not :bnly be useful as a general guide to measures, but could be apiplied to individual cases and the milk" j supply investigated when a case was Fmroved to" be of'cow origin. This has factually been done in isolated instances 'in the Dominion. Beports received from the Department of Agriculture based upon the post-moitem examination of cows and upon bacteriological tests of mixed samples of milk state that cow tuberenlosis is not common in the Dominion, In some English cities, tuberculosis jjenns were found in 10 per cent, of

of local milks made in Dunedin failed to demonstrate any tuberculosis germs in bulk samples. Although, however, New Zealand dairy herds are apparently freer from tuberculosis than are those of most other countries, thoy ara by no means immune from this disease. The herds supplying milk for consumption in New Zealau3 are subject to inspection by officers of the Department of Agriculture, and tests of milk from individual cows made from time to time owing to suspicious circumstances have in occasional instances shown tho germ of tuberculosis in the milk. In respect of milk supply control, it may be said that when for any reason regular inspection of dairy herds and dairies is impracticable, pasteurisation, provided it is carefully performed, affords considerable protection from mii fection, but though it may accompany it can never replace efficient herd control. Good food, a healthy environment, and the isolation of infected animals, are means for preventing tuberculosis in dairy herds, just as important as with human beings. TREATED IN SANATORIA. The following table, which gives for a five-year period the number of tuberculosis cases (other than lung), treated in the public hospitals and sanatoria of the Dominion, is of interest: — Year- 1920. 1021. 1922. 1923. 1924. Cases': 674 729 - 686 745 775 In gauging the importance, however, of this apparent increase, allowance should be made not only for increasing population, but also for the steadily increasing proportion of the public admitted to public hospitals.