THE TOLL OF RHEUMATISM.

Otago Daily Times, Issue 20448, 30 June 1928, Page 15

THE TOLL OF RHEUMATISM.

MODERN SCOURGE OF BRITAIN. ANNUAL BILL OF £17,000,000. - (From Our Own Correspondent.) LONDON, May 16. \s Chief Medical Officer of the Ministry of Health and of the Board of Education, Sir George Newman has unrivalled opportunities for gathering data upon which to base his diagnosis of the health of the nation. At Bath he presided at a conference on rheumatic diseases, and m his address he threw new light on the problem presented by an exceedingly common ailment. Rheumatism, it would seem, is as much the scourge of the twentieth century as smallpox and tuberculosis were the characteristic afflictions of the centuries preceding. It has, in Sir George s words, become a drag on industry, an evil incubus on the worker, a source of oppressive financial loss to the State, end a Protean cause of excessive mortality and ill-health. , The disease is less prevalent among the rich than among artisans, but more prevalent among artisans than among towndwellers. Why? This was one of those points on which the conference endeavoured to throw light. Rheumatism is prevalent in Eton town, but practically non-existent at the school. Is this because of the fact that 70 per cent, of Eton boya come up to the school with their tonsils already removed? Is it because they feed better? Is it because they are housed better, clothed better, live a more tagienic life, and have more recreation? *l£ so, why does the slum child, relatively speaking, escape, when the son of the railway guard is, relatively speaking, liable to infection? It was at the school age that there must be investigation with possible prevention. Medical men must, he said, explore and prevent. They must explore the obscure signs of invasion; they must prevent the subsequent polyarthritis, carditis and chorea. It was estimated that this infection was responsible for 80 per cent, of the deaths from heart disease under 20 years of age and 40 per cent, of the total cardiac mortality itself, the principal certified cause of death in England. Sir George went on to discuss chronic rheumatism, and declared: "In spite of the darkness which surrounds cronic rheumatim, there is some brief general counsel which may be given to ail persons suffering from any degree or form of chonic rheumatism. First, they should promptly seek medical advice for the discovery and removal of possible sources of infection in their own bodies, which are acting as generating centres of auto-infec-tion —such as infection of the tonsils, teeth, nasal sinuses, and intestinal tract. Wherever the sources of such infection may be, it is absolutely of paramount importance that it should be dealt with promptly and thoroughly. No effort should I spared to check it at its very earliest stage. It has been well said that it is ‘ perfectly futile to waste valuable time by palliative treatment, with antirheumatic or other drugs, local applications to the joints, and so forth, till the focus of infection has been eradicated.’ A stitch in time saves nine. “ Secondly, persons suffering from rheumatism should so order their lives as day by day to practise personal hygiene, and strict moderation and selection in food and drink, exercise, fresh air and rest. Thirdly, they should be vigilant to avoid any predisposing condition which conduce them to attacks of the disease, such as dampness and chill, unsuitable clothing, excessive use, misuse, disuse of the stricken joints, or a clogged alimentary system. Neglect in the early stages of their conditions is their supreme danger.” COST TO COUNTRY. Sir Walter S. Kinnear (Comptroller of Health and Pension Insurance) said that the Ministry’s Committee on the incidence of rheumatic disease (report published in 1924) found that approximately one-sixth of the total period for which sickness and disablement benefit was paid to men was due to rheumatic diseases. The corresponding figure for. women was one-seventh. In 1927 the total sicimess and disablement benefit payments made by the approved societies in England, Scotland, and Wales was about £20,000,000. This represented about 34,000,000 weeks-’ incapacity. Allowing for “ waiting days,” it was probable that the total was about 35,000,000 weeks. The proportion due to rheumatism was something over 5,000,000 weeks. If they added the wages lost to insured persons through rheumatism on the basis of an average wage of from 50s to 55s a week for men and from 25s to 30s a week for women, they would get a total loss of £17,000,000. This did not include the cost of the medical treatment of sufferers not totally incapable of work, of nursing in bad cases, or of necessary institutional treatment. Further, it did not cover fully persons over 70, or make any allowance for dependents of insured persons. Dr Reginald Miller, physician to the Paddington Green Children’s Hospital, said he had come to the conclusion that juvenile rheumatism might be regarded as environmental. One of the reasons of the immunity found among rich children was the practice of early removal of diseased tonsils. Seventy per cent, of the boys now joining Eton College had had their tonsils removed. NOT A “POVERTY DISEASE.” Lord Dawson of Penn deprecated the labelling of rheumatism as a " poverty diease.’ Many classes of workmen subject to rheumatism could not be considered as poverty-stricken. It was environment and other circumstances that were responsible. Improved housing and domestic life and more opportunn\3S for recreation would have a groat effect. Acuta rheumatism in childhood was on the steady decline. . Better clothes, ventilation of houses, and attention to dietary were important factors here. We were only gradually learning the value of recreation. It would be better, if instead of watching, more people were to take part in games. Now the fight for the eight-hours’ day had been won, he would suggest, from the medical and health point of view, that too great and strict an adherence to the formula should not be held. It was a question of the nature of the labour. There were many cases in which nine hours, or even, on occasion, 10 hours, a day would be to the advantage of the worker—provided he did not surpass the average. “ 1 do not, of course, say,” Lord Dawson of Penn added, "that longer hours would be of advantage in the more arduous forms of labour. The important thing is for the hours to be distributed. In many cases it would be to the advantage of the worker if he worked longer hours in the early days of the week, and thus accumulated for the week-end a period of leisure sufficient to enable him to do something of value. I suggest that this question of redistribution of hours, with that object in view, is worthy of the consideration of both workers and employers. I am not advocating a higher average than eight hours —not by any means—l am suggesting that hours might be redistributed.” CARE OF THE SKIN. Dr R. L. Llewellyn suggested that spas should be recognised as national asset* for the maintenance of health and efficiency. Prevention, according to Dr Llewellyn, is not an ideal impossible of attainment. The fact that rheumatism “ sensitizes’’ the skin to changes in the weather has, he stated, been used to develop a system of “ desensitization ” by means of alternating applications of hot and cold water. He declared that " our climate will not adapt itself to us, and we must therefore adapt ourselves to it. Our people need hardening, not ‘coddling.’ In the prevention of rheumatism the care of the skin is the beginning or wisdom.” His plan for the “ hardening ” of the nation, a? .ha outlined it, is of a very extensive character. He would train all children in the hygiene of the skin, and would secure for rheumatic children and for the children of rheumatic parents easy access to spas. He would further make extended use of the existing bathing establishments in mines and factories, and of municipal baths and marine health resorts.- In all these institutions alternating hot and cold sprays would be available for " skin training." In this way a national campaign for the prevention of rheumatism could, he believes, be begun. The campaign would not be concerned solely with bathing facilities, but with general hygiene, and more especially with the hygiene of daily work and play. Thu* the campaign against rheumatism would be brought into association with the campaigns against other ailments and with the efforts being made to develop the “ health conscience ” of the nation.