Nelson Evening Mail. THURSDAY, NOVEMBER 7, 1912. TUBERCULOSIS.

Nelson Evening Mail, Volume XLVII, Issue XLVII, 7 November 1912, Page 4

Nelson Evening Mail. THURSDAY, NOVEMBER 7, 1912. TUBERCULOSIS.

EXTRACTS from the annual report of the Chief Health Officer, published in these columns yesterday, give some indication of the scourge tuberculosis is in this country. It' was shown that the deaths last year amounted to 738; but large as these figures are, they convey no conception o'r magnitude of the n vil. The majority of fatal cases (fully threefourths) are from lung disease; but there are at present 110 statistics to show the number of cases of tubei'cnlosis of bones, joints, glands, a:id organs , which, though less fatal, aio very numerous, and aggregate a forni-d----able total of suffering and ill-hea'th. And, in addition, it must be remembered that as the disease generally lasts for several years, the annual number of deaths gives no conception of the total number of cases existing at one time. But a pleasing feature of ihe figures quoted above is that tuberculosis is on the decrease, and it requires on?y the adoption of more effective mei-nads. bv Hospital Boards, and greater care exercised by the people as a whole, to decrease still further the deadly effects of tile disease. So far, the resea.ches of the past thirty years, during which the cause of the disease has been Known, have failed to yield any specific remedy, although great advances ha/e been made, both in respect to preve it'.'in and treatment; and as experience of modern methods and remedies increases, then- it> good ground for a hopeful attitude towards the future. * * * * It is well to inquire into the probable causes of the disease. It is considered that the most frequent- source of infection in adults is the inhalation of tubercle baccilli derived from the diied sputum of those already suffering. This makes it perfectly clear that every effort should be made to', prevent' spitting in the streets. At the present time it is possible for a consumptive to wa.lc about the town spreading the disease broadcast, and no notice is taken of the

offence. The time has arrived either j for more careful watching of those 'vlio err in this direction, or for the fixing of severe penalties on those who are caught. Segregation of all cases in infective stage would no doiiit lie the ideal remedy; but for given in these columns on a former occasion, is likely for a long time to' be merely .mi ideal. It has been recognised that, especially in children, infection is frequently derived from milk, and undoubtedly inspection of d.»iry cai 4l e, dairies, and milkers should be rigorously carried out by competent men. Apart from public dairies, it is qua'.ly important that every cow, the m:.k of v iiich is used fo'r human consumpii .w, or in the production of butter ?id cheese, should be free from the liseai:. It may be questioned whether this is always the case, and it is a point requiring careful attention, and, perhaps, legislate j. ;. * * * * Doctors are of opinion (hat i i.en better results would follow if a lar;_;.-?r number of incipient cases took advantage of the sanatoria. A system .of visitation of cases in their own homes by trained nurses, under the supe 'vi:scn of doctors, would be of some but it is clear that it would be mu -h to living in a proper institution. For the great point to be • memb-?recl is, that besides checking the disease in himself, the patient, if he profit by his training, is able to become rraCi.-ahv harmless to others. In Ell.5 1 r>l dis pensaries have recently been ostrililifhe r1 where patients can be treated by tn'.frculin injections, and continue their ordinary avocations, merely calling at the •dispensary at stated intervals for Ibe injections. But tuberculin a? a remedy for tuberculosis is considered to be stiU to some extent on its trial, though a ' number of medical men hold that i_ is a. remedv of undoubted value >n many cases. * * * * But the real aim is the removal of the causes of disease. In the case of tuberculosis the causes have been put down as follows : (1) The exciting cause is the tubercle bacillus which is disseminated chiefly by the expectoration of consumptive individuals, a less important source being the milk from cows with tuberculous udders. The tubercle bacillus is readily killed by sunlight (especially direct sunlight) and fresh air. It can be killed, too, by the tissues of healthy individuals; but this germicidal power of the human tissues is limited, and no't always to be relied on, even in apparent health, and (as the prevalence of tuberculosis shows), it is deficient'in a'large proportion of the population in existing circumstances. « (2) , The "predisposing" causes of tuberculous ' disease are those conditions which favour the continued life and multiplication of tubercle bacilli, outside or inside the body, and their transmission from one individual to another. The mo3t important of these are : (a) Overcrowding, bad ventilation, want of sunlight,, and deficient cleanliness in surroundings. _ (b) Lowered vitality of individual due to hereditary influences, chill, overwork, worry, bad feeding, or other causes. There seems to be no sure escape from the tubercle bacillus, arid therefore one of the most effective .ways o"f : preventing infection is by strengthening the diseaseresisting powers of the body, and sunshine, fresh air, exercise, and hygienic "habits, will prove most helpful. The schools and colleges do much in the direction of promoting physical fitness in their pupils; but it is obvio'us that parents do not, especially in the case of girls, place enough importance on fresh air, exercise, etc. It is absolutely certain that a very large extent of illhealth and suffering is readily avoidable; but the knowledge of how to maintain a high level of health and avoid diseases, diffuses slowly, and the practice of -the community lags many years behind the knowledge available to it.