NELSON AND CONSUMPTIVES

Nelson Evening Mail, 7 June 1917, Page 5

NELSON AND CONSUMPTIVES

CLIQUATE NOT SUITABLE. REPORT BY HOSPITAL SURGEON. A valuable seport on the conditions existing at Nelson for the treatment of consumptives was presented to the Hospital and. Charitable Aid Board yesterday by the Resident Surgeon (XJ'r. Jamieson). The report was as follows: — The present provision consists of oae central administration block', with a general open-air dining-room, and a sittingroom, and five sleeping shelters, two of four beds each and three of two 'beds each, giving eight beds available for males and six for females The whole department is in charge of a sister, who lives in the administration block, and is assisted by a day nurse and a night • nurse. The annexe has its own kitchen, bath and lavatory accommodation, acsd. its own cook. The question of the suitability of the ■provision made is 'best considered by reference to the results, obtained. I keep' an accurate record of the condition of each patient on. admission, and classify the admissions for record purposes into three groups—hopeful, unfavourable and chronic. I further make a ■weeklyi examination and note of the course of each case. The following data are from the record I have kept since I have been in charge:— ..„-.' ,I>uring the past 22 months 38 cases have been .treated iri the annexe. Of these 4 (roughly 10 per cent.) are classed hopeful. 12 (32 per cent.) unfavourable, and 22 (58 per cent.) hopeless or chronic. 'Of the hopeful 4, 3 Rave 'been discharged recovered, of whom 2 have remained well, and 1 relapsed after some months from want of care. One- did not improve satisfactorily, and removed) at niv suggestion to a more* suitable climate. -"" Of the unfavourable 12, 1 returned home in statu quo, 4 improved and returned homo for further treatment under instruction, 3 markedly improved and returned home able to work, 1 recovered, and 3 are improving. O'f the chronic 22. 12 died, 3 returned home in statu quo, and 1 improved and returned home to continue treatment under instruction. % A consideration of these results shows two things: (1) That where so large a proportion as 90't>er cent. of. admissions fall into the chronic and unfavourable classes, and only 10 per cent, into the hopeful class, it is impossible to expect f good results, no matter what the conditions ox: treatment. (2) That an astonishing number of the unfavourable class—-practically all, indeed—show improvement, and if that improvement could- be taken., advantage of by removal to a more bracing climate, much better results might be expected. 'ln percentage the results work out thus: —Recoveries, 8 per cent, (remember only'lo per cent, were hopeful); improvement, 29 per cent.; ho improvement, 3i per cent, 32 per cent. (remember 58 per cent, were chronic or hopeless). 'lt has o'een rhy experience,, and that of my predecessors, that apart from the chronic cases, the majority make considerable initial improvement: but very frequently a point is reached! beyond which improvement is not maintained, and there is apt. to be retrogression. When, or before this point is reached, ifc is m.v ( opinion that such patients should be' moved to a highfer "altitude and more bracing climate, i-n__order to give~'thehi the best chance of continuing their improvement. Ifc has long been a popular 'belief that the climate of Nelson is particularly favourable for consumptives, and Nelson is suffering from that reputation. While thei-p are undoubtedly many who have benefited by the liberal sunshine, I personally dissent from the view that it is. in. general a '^suitable, climate-. In this opinion I liaye the concurrence. of Dr.. ■Blackmore, of tlie 'Cashmere 'Hills Sanatorium. He jayS":'r"l think' ihe climate o. ' Nelson is quite unsuitable' 1 for cases of pulmonavyv tuberculosis. There is a widespread belief, on the part of the public that a climate such as. you possess in Nelson is.the,one best suited for consumptives, and no .belief could ""be more jrrroneous. The, best climate for these cases, is one.weli away -frqjn the sea, at a good elevation, dry,;'and. as dust-less as possible,.sufiny, i?ut on. the cold side' rather :tHan. warm. ' For ' i really successful treatment', I think a dry, cold, .bracing climate is. far ahead of any..other." ' The annexe is, in my opinion,; a,,necessary . and successful place for - the segregation of chi'onie cases, a'hd for providing, the first'initial start toward improvement in doubtful cases, out to deal adequately with the treatment of the disease, arid encourage sufferers to come under treatment at a. sufficiently early" period to make'treatment hopeful I coi)sider. Jurther provision necessary.. I therefore recommend that the board should consider,making sucl>'further pro : vision by~ establishing: a sanatorium- for favourable cases at a suitable "place. TJiis. c.orild 'be done by a conjunction of boni-ds with Government sanction and assistance. The annexe then v.^ould l serve P,> as- a classifying* centre wnence hopeful cases and cases showing .imtn-ovement could be drafted to the sanatorium, and >(2) as a segregating institution whiVh would retain' chronic eases and diminish' the liability to to spread the disease from such cases being looked after haphazard in their homes. As regards the suitability of the present buildings, these are suitable for the purposes I have, indicated, but a' considerable amount of and painting throughout are urgently required. ■ A motion was passed, thanking Dr. Jamieson for his repoit, and it was resolved to discuss the matter at the special, meeting to' be hejd next month. I 'i ' • •