TUBERCULOSIS CASES

New Zealand Herald, Volume LXIX, Issue 21293, 21 September 1932, Page 11

TUBERCULOSIS CASES

REORGANISED TREATMENT HOSPITAL BOARD'S PLANS COMMITTEE'S RECOMMENDATIONS Proposed extensions in the treatment of pulmonary tuberculosis in Auckland were considered by the Auckland Hospital Board yesterday. Recommendations were contained in a report made to the board earlier this year by Dr. Chisholm McDowell, the board's tuberculosis officer. These were considered by the advisory committee of the honorary staff, together with board members, and the committee's report on the recommendations was considered yesterday. This report stated that the work of the tuberculosis dispensary embraced diagnosis and supervision of cases. It was vitally important that an early diagnosis should be made and it was recommended that all medical practitioners in the district should bo circularised, pointing out that specialist opinion was provided at the dispensary, free of cost, for patients unable to afford private consultations. Cases discharged from hospital, the shelters and sanatoria should be carefully supervised. Doctors, district nurses and public health officers should be encouraged to send cases under their care to the dispensary for regular examination. Such supervision was most necessary. Resident Medical Officer The care and treatment of tuberculosis in-patients would be improved by the appointment of a resident medical officer, who had completed two years' service at the Auckland Hospital, at a suggested remuneration of £250 a year, plus board and residence. This would relieve Dr. McDowell of much routine work, such as the preparation of records. He could carry out Dr. McDowell's instructions for the care of patients and could also act as an assistant to the medical superintendent of the infirmary. If the work increased to any appreciable extent, it might bo advisable to consider the appointment of an honorary physician. The appointment of an assistant to Mr. J. Hardie Neil in the ear, nose and throat department was necessary. Many cases of pulmonary tuberculosis developed throat trouble. There was more work of this character than could be done by Mr. Hardie Neil, and Mr. Graeme Talbot, who had recently commenced practice in Auckland, was eminently suitable for the post of assistant. Tribute to Doctor Cases of pulmonary tuberculosis were mostly highly infectious. At present they occupied beds in general medical wards in the main hospital and were an undoubted source of danger to other patients. They should be assembled in some special part of the hospital and nursed separately. The committee also stressed the necessity for the isolation of all types of infectious cases. The total number of artificial pneumothorax cases under treatment was constantly increasing. Dr. McDowell had commenced a clinic at the hospital qn Saturday afternoons to attend to these cases. As time went on, he would require assistance and the proposed infirmary resident officer would be suitable. "We would like to express our high appreciation of Dr. McDowell's work," the committee added, "and recommend that he be appointed tuberculosis officer to the board at ah increased remuneration of from £4OO to £SOO a year." Several members stated that the recommendations in the report would mean increased expenditure if they were adopted. However, they agreed that early action was necessary regarding reorganisation in tuberculosis treatment, and the matter was referred to - the Finance and Infirmary Committees to report to a special meeting of the board. SERIOUSNESS OF DISEASE GRAVE ECONOMIC WASTE -POSITION IN NEW ZEALAND The attention being given by the Auckland Hospital Board to the treatment of tuberculosis cases in its district is welcomed by members of the medical profession in Auckland. They hold that more modern treatment is vitally necessary, and that the whole matter should be considered by the Health Department on a Dominion-wide basis. "In recent years, tuberculosis treatment has been pushed into a more or less unimportant place by discussions of the cancer said one Auckland doctor. "Actually, tuberculosis is responsible for greater economic waste than cancer and, from the point of view of cost, to the community, should be placed in a, position of greater importance. It is an established fact that, cancer generally attacks only those beyond middle age, whereas quite young people can Buffer from tuberculosis and be a charge on the commAity practically for the rest of their lives- The duration of tlie illness and of the treatment necessitated is generally a much more lengthy matter in the case of tuberculosis." Ncav Zealand was considerably behind the times in its provision for the treatment, of tuberculosis, the doctor added. In the Auckland district, for instance, there was no sanatorium to whicfi patients could be sent. At least one of the southern centres to which Auckland patients were admitted for treatment was quite unsuitable, quite apart from the factor of distance. It was essential that, Auckland should be provided with sanatorium accommodation as soon as possible. Ideal situations could He obtained either in the Bombay Hills, or the Waitakeres, and this end should be kept steadily in view, although existing financial circumstances might stand in the way at present. Meanwhile, steps fo provide more modem and complete treatment, at. the Epsom shelters were timely and necessary. "The question of climate does not figure so largely in tuberculosis treatment | as some are led to imagine," the; doctor added. '.'lt is true that the ideal is a dry climate, obtained in high altitudes, but more important than climatic conditions is the question of proper discipline. Excellent, work can quite easily be done at the Epsom shelters, if proper staff arrangements are made. Tuberculosis as a disease is so widespread, and is responsible foi; so much economic waste, that money spent on its prevention or cure is money well spent."