THE DIARY OF A DOCTOR WHO TELLS

Evening Star, Issue 25168, 6 May 1944, Page 3

THE DIARY OF A DOCTOR WHO TELLS

A DANGEROUS STAGE

Monday, May 1

Eighteen months ago the authorities examined Bolb Henley for the forces and told him he had tuberculosis.

Beyond some indigestion and general tiredness (which lie thought was due to overwork), Bob had had no inkling that there was any trouble. When he came to see me, I put him under the care of a specialist, who sent him to the mountains.

"Well, 1 hardly expected you to know me, Doc," he said heartily when he walked in this morning. " I've put on a couple of stone, and I could push a house over. My last X-ray was very good, and I've got nothing further to worry about—except getting my weight down a bit."

" Whether you have nothing further to worry about,'' I said, " depends on your future haibits. Your disease lias been arrested, which doesn't necessarily mean cured. And for heaven's sake leave your •weight alone." "Gee!" said Bob. "I thought you'd be as pleased as I am about it all. If you don't inind me saying so, you're a bit of a wet blanket, aren't y° u? " "In my experience," I replied, " there are two special danger times in tuberculosis. The first is when the patient is told of the trouble and has to decide whether he'll get immediate treatment or not. If he delays, his chance of cure may go. The second occasion is when he thinks he's cured and feels so well' that he wants to go and push a house over. Just let him try, and a relapse is generally round the corner."

" But I'm all right now," protested Bob. "No temperature, a big appetite, and no feeling of tiredness.' "Yes, I know," I said, ",and the point is that you want to stay like that. Listen, old man, you've got to remember for many years to come that your chance of keeping "well depends on living a" disciplined life. No wild parties, no overdoing things, bed every night before midnight, and before 10 at least three nights a week, plenty of good food, and so on." " Mention of food reminds me of this weight business," said Bob. " When my friends see me now they just stand back and laugh.''

" Yes." I said. '"I know. You laugh with them. Laugh that you're healthy, that you're alive, in fact, for at one stage you mightn't have been." " But I only read the other day that too much fat was bad for you," protested Bob, not giving up the fight for ft youthful figure. " The Dutch have a saying that 'fatness is the cure for tuberculosis,' '* I replied. " I personally Ibelieve there's a great deal in it. Fatness is an outward and visible sign that you are beating, or have beaten, the tuberculosis germ. And there's a'difference between fatness and grossness." Another wisecrack, and a rather bitter one, which I am never tired of repeating to my tubercular patients is that " no fool was ever cured of tuberculosis." In few diseases does so much depend on the intelligent co-operation of the patient. With the latter many eases improve markedly and even become permanently arrested. Tuesday, May 2. " Anythiug in this story about increasing infertility in males? " asked the Junior Surgeon of the Junior Physician.

" Don't know," said the Junior Physician. "I've only seen opinions without supporting figures up to the moment "

" Spoke like a scientist," retorted the Junior Surgeon, in mock praise, "but just forget official figures for the moment and let me have your private thoughts." " Well," said the Junior Physician, cautiously, " there's always a certain amount of sterility—more than is realised—among the male population. 1 understand that in something like 30 per cent of sterility cases, normally the male is the deficient partner. But here's the Chief of the Women's Wards. Ask him." • The Chief of the Women's Wards was similarly cautious. ".I've heard some gossip," he said, " and, in my opinion, enough to warrant us checking up the nation's diet." " The sooner the better," said the Junior Physician, " because diet is undoubtedly involved in questions of sterility, and you know how long it takes to change diet charts. We're still trying to get our local hospital diet out of the Victorian era."

" Vitamin E is undoubtedly a powerful factor in sterility," said the Chief of the Women's Wards. " I've had success in certain types of female cases, with wheat-germ oil. We should examine by questionnaire all diets, of organisations, institutions, schools,' and colleges, to see if the Vitamin E is j present in sufficient amounts." j

"Are you an E-man?" giggled the Junior Physician.

Wednesday, May 3. There is probably enough purgative medicine taken each year to float the ships of the Allied navies. A contributor of more than a drop in that ocean is middle-aged Mrs Miller, who came to tell me of her woes this morning. As usual, I steered the story round to her general health and habits.

Mrs Miller confessed in what was almost a voice of shame that she suffered occasionnl constipation. She answered my questions as to detail, and I reassured her for what must be the hundredth time since she first came to me years ago that I saw no cause for alarm.

" You .always say that, of course, doctor," .she said, " but, after all, there must be daily regularity, mustn't there?',' " I'rm not convinced about that," I said. "We all have different noses, different faces, and probably different insides. What suits one person mightn't suit another." Recently two London specialists jointly attacked the once-a-day-or-else . . - theory. They wrote: "There is an ingrained belief in doctors and patients alike that manifold evils will result if the bowels are not opened at least once every 24 hours. This is not a natural law."

I like the story of the school teacher who received a note from a mother belonging to the onee-a-day-or-else .'. . school. It read:

Dear Teacher. — Willie couldn't come this morning becaiise when he went he couldln't go. I've given him something to make him go and when he's been he'll come. Thursday, May 4. " I'd be all right about this high blood pressure," said Alan Marlkson when he called ou me to-night, " it only ] could get rid of these peculiar noises in my ears'."

" What form do they take?" 1 asked. " It's just, one continuous noise," he replied " It's a sort of cross between a large factory and a raging torrent." "1 think you-might- improve if you were bled a little," I said, not choosing my words with particular care. " Here, hold hard! " said Alan in an alarmed voice. "What do you mean by being bled a little? "