WAR AGAINST DISEASE

New Zealand Herald, Volume LX, Issue 18566, 26 November 1923, Page 11

WAR AGAINST DISEASE

CONTROL OF TUBERCULOSIS.

METHODS AND RESEARCH.

DISCUSSION BY DOCTORS.

The control of tuberculosis formed a subject of long discussion : n the section of preventive medicine at the Medical Congress held in Melbourne last week. . Dr. Cumpston, Commonwealth Director of Health, gave a statistical review of the incidence and death from tuberculosis in Australia, and compared it with that of other parts of th-% world. The death rate in the Commonwealth was lower than in any other country but New Zealand, he said. In 1835 it was 175 per 100,000 of the population; in 1912 it was 61 per 100,000 of th* population. _ The mortality had increased among children under five, but had decreased in the case of both boys and girls between 5 and 14. The highest mortality in women was between 25 years of age ard 27, in men be tweon 45 and 49 years of age. In men the mortality remained high till 65. Of all the capital cities of Australia Adelaide had the ■ highest tuberculosis mortality, while Hobart and Launceston also had high rates. In Queensland the death rate from tuberculosis other than that of lung tuberculosis had fallen to the extraordinI arily iow figure of three per 100,000.

Results of Biological Tests. Dr. Perrfold, Director of the Commonwealth Serum Laboratory, reviewed the question of the frequency of tuberculosa as revealed both in the post-mortem room and in tho general population by the application of biological teste. This v*>rk had been carried on in various hospitals in all the States. 01 all the people who had died, and on whose bodies post-mor-tem examinations were made, tuberculosis was found in 25 per cent, of adult males and 22 pur cent, of adult females. In 90 par cent, of these individuals the disease attacked the lungs and the other respiratory organs. Persons between 11 and 20 appeared to be the most susceptible, the next most susceptible period being from 41 to 50. It was rarely met with in the first year of life. The biological tests, which had been carried on on a large scale on persons in hospitals had revtaled the fact that 60 per cent, of the patients in Victorian and Sooth Australian hospitals gave no evidence of the disease. In Sydney hospitals a biological reaction was obtainei in 31 per cent, of the patients. , . In two large suburban schools m Melbourne 70 per cent, of the scholars reacted to the tests. Similar results were obtained in a limited number of medical students. He had instituted an inquiry into the irequency of tuberculosis among dairy cattle. In herds aggregating 600 hea.d three per cent, were infected, while, in other dairy herds which supplied milk for human consumption nearly 17 pet ceut. were infected. At the abattoirs between 4 per cent, and 7 per cent, of the "cattle slaughtered were infected with tuberculosis, and between 3 and 10 per cent, of" the pigs. ' Dr. G. M. Headon, Government Bacteriologist at Rabaul, stated that amongthe natives in the mandated . territory 30 per cent, of those examined after death were found to have suffered from tuberculosis. Biological tests carried out on natives showed that 29 per cent, of the natives over 15 years of age gave evidence of infection, while 13.6 per cent, under 15 were also infected.

Danger of Tuberculous Cows. Dr. E. W. Ferguson (N.S.W.), pointed out that the examination of the milk supply of Sydney, chiefly -from ■ suburban sources, had revealed very little milk contaminated with the germs of tuberculosis on the market. This result, it was said, was curiously at variance with the experience in other parts of the world. A paper was read' by Dr. Penfold on an investigation into the sources A infection of children at the Children's Hospital in Melbourne. During the first four years of life 26 per cent, of the tuberculosis, infection was by bovine oacilli. The lesson to be drawn from this was that it was imperative to eliminate the tuberculous cow. ;"'.■■•/' V ; > • In *he section of medicine, another aspect of tuberculosis was discussed. Dr. S. A. Smith, of Sydney, opened a discussion upon the early" signs of consumption and the means of its detection. lie elaborated a hypothesis according to which the disease depended upon two patholocical changes, the one tending toward core and the other toward an advance of the disease. He claimed that < there should be careful co-ordination between the various specialists, the physician, the radiologist, and the biologist. This was" necessary for the earlv detection of consumption. He said that physicians ■■'.;' thought; that it was extremely difficult to diagnose pulmonary tuberculosis .at an early stage, holding that the X-ray picture did not distinguish between active disease : and latent infection. .-•*.■.;- • ' > Dr. F. Guy Griffiths (N.S.W.) put forward the view evolved by French physicians, that .. the tuberculosis process started as a primary sore hidden/ from sight in a bronchial tube. The secondary stage of the disease occurred in-the glands concerned with the bronchial ' tubes, and the third stage" was when the lungs were attacked. * »'."V * • ' •'