TUBERCULOSIS

Otago Daily Times, Issue 26214, 26 July 1946, Page 6

TUBERCULOSIS

WAR AGAINST DISEASE ADVANCES IN TREATMENT APPOINTMENT OF ENGLISH SPECIALIST After 12 years of specialisation in tuberculosis and four years as' tuberculosis officer in a district with a population of 212.000, Dr Brian Thompson has arrived to take up a position as tuberculosis officer at the Dunedin Hospital and as lecturer in this subject at the Otago Medical School. Dr Thompson, who is accompanied by his wife and three-year-old daughter, Sara, was for four years tuberculosis officer for the Ealing district in the county of Middlesex. In an interview with an Otago Daily Times reported yesterday afternoon. Dr Thompson told of the fight against tuberculosis in England and the progress made in spite of the war. Great advances in the treatment of the disease had been made, he said, and improved prospects of recovery had been brought about by modern methods. “We do not regard the present methods of treatment as other than a step on the way to the conquest of tuberculosis,” Dr Thompson said. “There is some hope that a specific drug will be developed which will kill the tubercle bacillus in the human body, but in spite of some encouraging results in the laboratory it should be definitely understood that no such drug has yet been found. A great deal of active research is constantly taking place into this and other aspects of tuberculosis, and our knowledge of the disease grows daily. “ But energetic application of this knowledge must be made everywhere,” he said, “ and efforts should not be spared in the hopes that a new universal remedy is just round the corner. This means that the expansion of tuberculosis services on lines that have already proved valuable must be pursued without fear of buildings, equipment and staff becoming suddenly redundant.

“When I took up specialising in tuberculosis 12 years ago,” he said, “my chief warned me that the disease might not last my medical lifetime, and he doubted whether I was wise to risk being soon unemployed.,. But ” he said. “ I have seen little sign of this prediction being fulfilled.” Progress in Spite of War

With the \yar the expected rise in the incidence of tuberculosis in all its forms and an increase in the mortality figures took place in England, Dr Thompson said, and there was a corresponding strain on the existing services—services that were depleted by war-time calls on doctors and nurses and the use of beds for other purposes. But, in spite of this, there was a steady and, in some places, an extraordinary expansion of tubercular services. This had been greater in some places than '4n others, and, Dr Thompson said, he had been fortunate in being in the service of a relatively rich and progressively-minded, local authority which recognised its important duties in combating tuberculosis and was prepared to take all the measures possible in difficult circumstances.

The result was that in Middlesex there was a considerable expansion in the tubercular service, Dr Thompson said, and there was a great expenditure of money that went on throughout the war. In the four years that he was there the staff had increased 400 per cent., and an immense improvement had been effected in the service. There had been a great development on the social service side, too, and several women welfare officers had been appointed to inspect home surroundings and see that there was not a want of money and food. During that time too, he said, there had been a great advance in the knowledge of how to treat tuberculosis, involving to some extent minor and major surgical procedure, either at the clinic or at a sanatorium. This, on the one hand, gave a greatly-improved prospect of recovery for the patient, and on the other hand, by reason of their intricate nature, threw an additional load on the medical and nursing staffs. Diagnostic services, of which the essential basis was the liberal use of X-ray, were also expanded very considerably so that tuberculosis cases were discovered in greater number and at an earlier stage of the disease. This naturally increased the prospects of good results in treatment for individual cases. An Unnecessary Stigma

“One of the most important things we have to bear in mind with tuberculosis in the community,” Dr Thompson said, “is the mental attitude both of the public and of the individual patient. The stigma of having suffered from tuberculosis has in the past clouded many people’s lives to a quite unnecessary extent. Even to-day this stigma prevents, people who suspect that they may have the disease from seeking medical advice. In New Zealand as well as in England there is an exaggerated fear of contracting tuberculosis, and in this fear the stigma plays some part. “This feeling of stigma can be conquered only by the public coming to realise that tubercular infection is very common.” Dr Thompson continued. “We know now that many people contract it and recover from it without any knowledge of having been ill. The mass X-rays of groups of supposedly healthy persons, such as members of the fighting services, often show healed tuberculosis in people who have no recollection of ever having been sick. The knowledge of this and of the increased number of cures obtained by modern treatment must inevitably 'impress the public that there is nothing to be ashamed of in catching the disease. “ Once a tuberculosis service has won the confidence of the residents of an area, they can feel assured that no patient in an' infectious condition will knowingly be allowed to leave off treatment,” Dr Thompson stated. “ Consequently, a patient discharged from a sanatorium, provided that he is known to be continuing under the care of the local clinic, need not be treated like a pariah. In England we regarded it as' our duty to return patients to a full and useful life, which included free association with others. It has been my experience,” he said, “that the great majority of patients understand their responsibilities and faithfully abide by any restrictions imposed upon them by their medical advisers”