BRITISH MEDICAL ASSOCIATION.

Evening Star, Issue 11675, 6 February 1902, Page 3

BRITISH MEDICAL ASSOCIATION.

SANATORIA TOR • CONStTMPTTVM. In conjunction with Dr Ogston's paper on the above subject, read at yesterday morning's meeting of the New Zealand Branch of the British Medical Association, Dr Hudson road a paper on the climatic conditions of the Upper Moutere, with special reference to its suitability as a site for a consumptivo •anatorium. . Moutere was fifteen miles south-west of Nelson. The soil was porous, composed of sand and loose clay. The atmosphere was bracing, and the temperature excellent, the thermometer on the coldest day registering not more than fifty in the shade. There was less wind than in any place in Now Zealand, a vast number of sunny days, and a very limited rainfall. Dr Mason (Health Officer), while complimenting Dr Hudson, upon his paper on the Moutere, remarked that he had neglected to •ay anything about its accessibility, and raised a laugh by stating that during four days he spent in the rainless region it rained all the time. The difficulty in selecting a site for a sanatoria was not altogether a climatic one. From that point of view there were hundreds, but they were not readily accessible. Anyoue who knew anything about the Naseby climate must be satisfied it was excellent for the purposes of a sanatoria; but here also, as at Moutere, they had the difficulty of accessibility. The intention of the Government was to have one sanatorium in each island for all classes of consumptives, and not only for those who were incurable. What he thought was wanted in regard to consumption was that the hospital authorities should be forced to take in aud treat all persons who were sick, consumptives as well as others. It seemed to him that the treatment of consumptives could essily be carried out. In country districts an annexe could be attached to hospitals, where this class of patients could be treated. The great danger to be avoided was from spitting, and when that was properly controlled* a very important point in the solution of stamping out consumption was accomplished. Hospital authorities seemed to think they had to keep out one class of patients and admit another, -whereas their duty was to provide for nil.

Dr Hendry wished to draw attention to the suitability of bis district (Tnvercargill) for the treatment of consumptives—especially near Wallacetown ; and. he urged that the hospital authorities in each district should be assisted by fJovernment to do something for incurable consumptives. These patients required special provision for thejr housing, ;is they were most' undesirable patients for a general hospital. Hospital authorities, in refusing to take in consumptives, were only carrying out tho law. The Health Department was doing good work, but it would not be doing its public duty if it rested content with establishing two central sanatorhims for consumptives who were incurable, and did nothing for the enrables and incurables in all districts. If each hospital were assisted with Government funds, tents and sheds for treatment of consumptives could be erected in the grounds or at suitable places. Not much could be accomplished by merely saving a few lives in if there were no check upon the spread of the disease in every district. Dr Steven (Kotow) eulogised the Hakateramea aa a moat suitable locality 'for a sanatorium. When Dr Mason was speaking of Mooter© he really thought, he was talking of Hakateramea.—(Laughter.) They didn't get enough rain at Hakateramea, and it had the advantage of being accessible. Its only objection could be the heat in summer, and there was practically no winter. Of course he didn't refer to the winter of 1895, when all the water jngs in the districts were burst with the frost.— (Laughter, and a Voice: " Wha,t about the whisky jogs?") He could assure them the district was an excellent one for consumptives, and numbers of people came there for treatment One of the results of the introduction of consumptives to the district wan an outbreak of tuberculosis in the public school. One girl who died had been sweeping out the schooL After an examination of 113 patients in the school, he jfound a large proportion of the children had been affected, and he hoped that now the Government were taking this matter np they would stop their own school manufactories for consumptives. He urged that all school children should be medically examined at stated periods, and that overcrowding should be avoided and the sanitation of schools better attended to. Dr Whitton (.Oamaru) endorsed the remarks of the previous speaker in regard to Hakateramea. He, however, contended tb»t what was wanted in consumptive treatment was ah: —pore open air. Given that, they would get good results almost anywhere. Public attention having been specially directed to consumritives, it was becoming increasingly ham and difficult for those persons afflicted to get accommodation in places reputed to be suitable, and employers of labor would probably refuse to employ consumptives. He suggested shelter sheds in each and every district, wlbere there were pure air and shelter from the winds. Dr W. M. Macdonald didn't wish it to go abroad that' if they stamped out spitting and erected sanatonuins they were going to stamp out consumption. All they could hope to do was to reduce the number of cases.

Dr Muffin (Roxburgh) also came from an ideal locality for a sanatorium, but they didn't want or expect one in his district. It was too far away, ami was difficult of access. Many consumptives came to Boxburgh and Central Otago for treatment, and it would be better for them if they Btopped at their own homes and erected shelter sheds in their own yards. In his district such persons were finding it increasingly difficult to find homes or lodgment, and he Tiad traced at least one local case of tuberculosis hi his town to the visit of a patient from another district. There was always a danger in any district being used as a consumptive resort. Dr Micklo thought that more than two sanatorium* were necessary, and that there should be one convenient to each of the four centres. He spoke highly of the Hanmer Plain*—not rear the springs— q& suitable for a consumptive sanatorium. He inclined to the opinion that a change of air was beneficial in most cases. Dr Poraare said in Colorado a number of the hospitals are connected with hospitals for treatment of special diseases, and there were special hospitals for the treatment of consumptives. Among the Maoris considerable agitation and interest had been aroused over the placards the Government had issued in regard to consumption, and the native race were taking the precautions recommended to avoid the spread of the disease.

Dr Coffins was very pleased to hear that the Health Officer hoped to stamp out consumption. He did not think they could do that, but they could do much to limit its spread. What they wanted to do first of nil was to ascertain the extent, of it in Ihe principal centres. Let them ascertain the number of <ases, and then get them removed, to tents, away from their infected homes and surroundings. That was the first essential step, ai>d when that was taken they could then fix upon th<« amount of accommodation that was necessary. He had been surprised to learn the number of cases that had been sent to Naseby. He did not think that there was a great deal in the Health Officer's objection to that locality—that it was not accessible.

Dr Roberts Raid that their knowledge of tuberculosis was mainly confined to the fact that they knew iti arose from previ-ously-infected cases. Their endeavor should be to prevent its snread. In selecting sauatoriums they should take care that the poor who could not go to places far away were considered. It had been shown that day that it was becoming increasingly difficult for persons' afflicted to get treatment Sr ijaitable districts. One or two sanatoria would perhaps be sufficient t<? commence with, and thev could then be increased.

Dr Colquboun said that they were all asrreed upon the necessity for sanatoria. Nothing could be more unsatisfactory than the present condition. When patients came to the doctors they were unable to do anything for them, and whatever was to be done required to he done quickly. Before deciding what their sanatorinms ■herald be like, he suggested that one

should be established at, say,/ Wellington, w,here it would be under the direct and special supervision of the authorities. Meanwhile, they must treat their, own consumptives in their own districts as they had been doing. Before they searched abroad for suitable climates let them do what they could with their own. Con*sumptives were not being treated any, differently now from what they were five years ago in Dunedin. The local hospital authorities' refused to give them one or two special wards for treatment of these cases. He considered it was t scandal and a shame that twenty-four hours should be allowed to elapse before the authorities did something to improve matters. When the Congress met in the afternoon Dr Ogstoh briefly replied to the criticisms upon his paper. Dr Hudson also replied, and a unanimous vote of thanks was accorded to both gentlemen. TUBERCULOSIS THEORIES. Dr Stenhouse read a vigorous paper condemning the new theories and practices for the prevention and cure of tuberculosis. Drs Roberta and Mason and the president briefly discussed and combated the contentions raised. A vote of thanks for the paper was recorded. CONCLUSION OF BUSINESS. The remainder of the afternoon and evening sitting* was taken up with the discussion of general business and the consideration of technical subjects of no public interest. EXCURSIONS. The members of the, Congress drove to Waitati to-day to inspect the Home for Inebriates, and to-morrow a visit is to be paid to Seacliff and Puketeraki. On Saturday the visiting members proceed to Lake Wakatipu by the 9 a-m. train.