MEDICAL CONGRESS.

New Zealand Herald, Volume LXIV, Issue 19558, 10 February 1927, Page 12

MEDICAL CONGRESS.

TREATMENT OF CRIPPLES. LESSONS FROM THE WAR. THE PROBLEM OF THE CHILD[by telegraph.—press association-] / DUNE DIN, Wednesday. The treatment of cripples in times of war and peace was the subject of one of the most important discussions at the Medical Congress this morning. The surgical aspect of hydatid disease was the subject, of a paper given by Sir George Syme (Melbourne). The congress practically concluded its sessions this afternoon and a large number of delegates will leave by the express to-morrow. Dealing with the question of crippled soldiers and their treatment in war and peace, Dr. H. S. Newland (Adelaide) said it was made apparent early in the Great War that certain types of injury needed special treatment and segregation. At first 250 beds had been provided for those special cases requiring orthopaedic treatment, but at the end of the war the number had been increased to 30,000. The speaker demonstrated how during the battlo period orthopaedic service was responsible for the maintenance of man power. They had learned that the extensive application of the excision of contaminated tissue surrounding wounds had revolutionised the whole subject and had been the most important measure for th?i prevention of deformities. Ihe use of: the Thomas splint had resulted not only in better results in the healing of fractures but also ill the alleviation of pain. during transport. Before the employment of this splint had becomo general the mortality among men with fractured thigh, bonfis in the casualty clearing stations alone had been nearly 50 per cent. Later on they had reduced this mortality to 15.6 per cent. Dr. R. B- Wade (Sydney) dealt chiefly with the treatment of the crippled soldier in civil life. He spoke in terms of high praise of the work don© by Robert Jones, of Liverpool, and Hugh Owen Thomas, the devisor of the Thomas splint. According to American" statistics there were six cripples per 1000 of population, 40 per cent, of whom were,under the age of six years. Of the total number of case;s 70 per cent, were due to disease, 25 per cent were congenital, while 4 per cent, were due to. accident. Infantile paralysis and spastic paralysis were responsible for 67 per cent, of those cases of paralysis which were due to disease.. The speaker thought adequate medical and surgical facilities had been provided for treating these patients. The education of these children had to be considered as the illness usually occurred in the early years of life and persisted through the main school years, with the result that the majority of these children were partially educated or totally uneducated. A Campaign Advocated.

Continuing, he recommended the faculty to organise a campaign' to bring before the- public the importance of:—XI) The provision of adequate orthopaedic treatment. ' District "visitors sh'oujd be employed to encourage patients to take advantage of this treatment. (2) Provision for adequate academic training while the children were in hospital and-also while attending hospitals as out-patients. _ (3) Special schools 'for crippled children either connected with hospitals and out-patient departments or attached to general schools. (4) Convalescent homes with educational, facilities. (5) Vocational schools and that methods of transport to and fropi these schools should be provided. (6) Arrangements should be made by unions and arbitration bodies whereby the crippled slow worker might be allowed to obtain - a living. (7) Legislation should be introduced to enable the State to provide money needed for the surgical treatment, academic and vocational education,. and for convalescent homes and also legislation to enforce that all such children should have aecess to these facilities.

Major-General Barber, Director General of Medical Services in the Commonwealth, called attention to the fact that the Thomas splint which had been so very valuable during the war was now in universal use in the mining and timber districts and on the railways in Australia.-

Public Being Educated. . Colonel D. S. Wylie (New Zealand), described the orthopaedic unit which had been sent to Europe, from New Zealand after the war. As soon as the soldier patients had been discharged from the orthopaedic hospitals in Christchurch, Trent-ham, and Rotorua,crippled children were admitted into these places. In the South Island the children had been sent to the public hospitals in Christchurch and Dunedin, In all 150 children had been treated. Facilities for the education of these children were provided and vocational training was introduced at a later stage. He did not think any special propaganda was necessary as the relatives of the patients had been impressed by the results and had done all the necessary propaganda to educate the public. Dr. A. Owen Johnston (New Zealand), blamed the insurance companies for the present position of the industrial cripple. Much of this was preventable, but the insurance companies kept on paying and were not concerned whether the patient was being well treated or for that matter whether he was being treated at all. In Vienna there was a special hospital for this work, which was subsidised by the insurance companies. The treatment of industrial injuries at this hospital was compulsory and the saving of a sum of approximately £IB,OOO hlO resulted.

Value of Blood Transfusion, Professor Garmalt Jones (Dunedin), spoke of the value of blood transfusion' in pernicious anaemia. 'Gullan had stated most positively that arsenic bv the month was the best treatment and that blood transfusion was only an aid to help a patient round a critical corner. He described the treatment of 16 typical cases in the Duaedin Hospital during the last seven years. Five patients had had nn transfusions. Of these three had died in a short time, one had been some* what relieved, and one had improved very considerably. Of the eleven treated with transfusions one an old woman of 77 was in a desperate condition and the treatment had not afforded any relief. A second failure was recorded in the case of a young man of 27, who had had a high fever and some acute infection One woman had improved to such an extent that she considered herself cured. Another patient had regarded himself as well since the transfusion while a third was v?ry considerably improved Still another was much improved by the first treatment but had relapsed. He added that repeated transfusion of small amounts of blood was of the highest value in pernicious aneair.ia."

Disease in the Infancy. Dr. Jefferis Turner (Brisbane), dealt with the prevention of disease in infancy and childhood. He pointed out thai much ground still remained to be covered before principles of pretention could be applied to specific cases of diseases in children. Ante-natal supervision and treatment of the mother should save a great dead of infant wreckage and parental misery, Premature birth,, injuries daring birth, and eclampsia also left their trace. In regard to the first and second yearssof life much progress had been made especially in New Zealand The mortality in the second year of life was largely due to infective disease such as diphtheria, scarlet fever, measles, whooping cough, etc. He thought much illhealth could be prevented by treating defects due to removable causes such as adenoids.