THE OTAGO DAILY TIMES THURSDAY, APRIL 9, 1908 PROVISION FOR CONSUMPTIVES.

Otago Daily Times, Issue 14184, 9 April 1908, Page 6

THE OTAGO DAILY TIMES THURSDAY, APRIL 9, 1908 PROVISION FOR CONSUMPTIVES.

The members of the Hospital Board who formed a deputation this week to the Minister of Public Health received no encouragement from him in respect of their request that the Government should establish in the South Island—in Central Otago for preference—aii institution for consumptive patients such as serves the North Island at Cambridge, and thus relievo the Board of the task of erecting a sanatorium in its own district. Mr Fowlds made it very clear that any hope that the Government would entertain such a proposition might be definitely abandoned. The' Waikato Sanatorium, he explained, is to be regarded as a kind of experimental or demonstration station in connection with the treatment of consumption, and the experience gained there is to serve as a guide to some extent to other similar institutions in the Dominion. It was plainly indicated by the Minister that the policy/ which the Government has adopted in. the matter is to throw upon the Hospital Boards of the various districts the- onus of providing, whether out of rates or through private subscriptions, supplemented in either case by State subsidy, sanatoria for the treatment of, consumptive cases. There will be no establishment by the Government itself of another sanatorium. This pronouncement must be accepted, we presume, as conclusive, even though, as is to be inferred from what Dr Batclielor said as a member of the deputation, there may be grave doubts respecting it? wisdom. The magnitude of the problem, upon which he partly relied as an argument in favour of the direct State control of the measures for arresting the ravages of tuberculosis, was emphasised in the statement by Dr Batclielor that from 20 to 25 per cent, of the cases that are treated in the hospitals present symptoms of tubercular trouble, though, of course, it is in a much smaller proportion of, cases that the disease is manifested in the acute form known v as consumption. Moreover, it is a 1 melancholy fact that in the great majority of the cases which terminate fatally the victims are > of ages ranging from 20 to 45 years, when - fclieii*.productive capacity, should,'in favourable circumstances,. be at or about its and that consequently their deaths involve the community in a severe economic loss. Dr Batclielor argued that, in view of these considerations and in view of the additional fact that, as medical science lias ascertained, tuberculosis may be stamped out, it is of the highest importance that the most effective steps which can be devised should be taken to check the spread of the disease and eventually to eradicate it. And it is because it is believed by them that a sanatorium can be more efficiently conducted if the State undertakes its control than if it is managed by a district board that the members of, the local -Board resolved to make' to the Government the application .which was .the subject of the deputation on Monday last. What weighs with the Hospital Board is the knowledge that, if a sanatorium is to produce the best results, there must be, in ,the fullest sense, scientific supervision of the cases by-. a resident medical officer who. is specially qualified for the office. A plaii under which a practitioner visits a sanatorium at intervals only, and then probably treats the patients for the ailments of a common kind tliaj; may have attacked them, is unscientific and unsatisfactory. • There should be constant supei-vision of each and all of the patients, a supervision which should not be confined to seeing that the inmates of the sanatorium obtain a sufficiency of fresh air and that 'their meals are frequent in number and generous in volume, but which should be directed also to a systematic recording of the weight of, the patients, of their capacity of resistance, and of their response to the other tests that have been recognised as desirable and necessary if reliable opinions are to be formed regarding the progress of the respective cases. If a sanatorium were established by the Government in Central Otago, where the climate is suitable and where, moreover, employment might be provided in the open air for the patients whose condition admitted of their being put to work, and if the institution were conducted on scientific principles under the management of a competent medical practitioner, who should be a resident officer, we have little doubt that, as Dr Batchelor anticipates, results of a gratifying kind would bo secured in so far as sanatorium treatment forms a part of the means which should be employed in any national endeavour to combat- the disease. It would, moreover, be a humane step which should, in any such scheme, make special provision for the treatment of private patients, whose relatives find the greatest difficulty under existing conditions in securing accommodation for them. The argument in favour of the establishment of a sanatorium in the South Island under direct State control is, upon the whole, so weighty as to have been entitled to a greater amount of consideration than it has received from the Government. The members of the deputation had, however, the pleasure of listening to an outline of what had been doiie by Hospital Boards in other districts in regard to making provision for consumptive cases, and their attention was directed to a comparison which was designed to place the local Board in a distinctly unfavourable light. Mr Fowlds indicated that the Otago Hospital Board was unenviably distinguished among the more important bodies in the Dominion that are burdened with similar responsibilities, as having so far done practically -nothing in the way of: making necessary provision

for consumptive cases. We need not trace back the circumstances which have made it possible for such a> reproach to be made against the Otago Board, but, in view of the Minister's statement, it now unquestionably remains for the Board to see to the removal of the stigma with as little delay as possible. The Board has nob been altogether inactive, for it has examined various sitea and has otherwise faced in a preliminary way the task which lies before it. It is not at all likely, we imagine, to err oil the side of extravagance in establishing a sanatorium, especially since, in any case, the exhaustive investigations upon which the recent and comprehensive report by Dr Timbrell Bulstrode, one of the medical inspectors under the Local Government Board of England and Wales, was based, lead to the conclusion that the liability to direct infection of tuberculosis through the respiratory passages, and therefore by inhaling the bacilli expelled by patients, has beeli seriously exaggerated, and that tuberculous milk and meat, more especially milk, may after all be the chief, source of danger to mankind. And the inspection of the milk and food supply rests with authorities other than the Hospital Boards— with tlie authorities, in fact, which, in the opinion of the local Board, should undertake the responsibility of the cure, as well as of the prevention, of the disease.