CONTROL OF CONSUMPTION.

Otago Witness, Issue 3662, 20 May 1924, Page 27

CONTROL OF CONSUMPTION.

OPINION OF AUSTRALIAN EXPERT. The ravages of tuberculosis have for many years given emphatic cause for concern. Many supposed cures have been discovered, and people have felt reassured, but upon testing the “cure” it. has proved to be without efficacy, and tuberculosis has continued its dread course. At the present time, in all parts of the world, there are sanatoria for the treatment of consumptives, and it is in these institutions that the work of curing the disease is meeting with success on a greater scale than that found to be the case with the discovery of sera by doctors and scientists. Dr 11. W. Palmer, who is touring the dominion on behalf of the New South Wales Government, inspecting the sanatoria of New Zealand, and who is medical superintendent of a large sanatorium in New South Wales, when interviewed on Friday last, gave an interesting account of the work done in the institution, and the conclusion which ho had come to during his visit to New Zealand. Dr Palmer stated that one of the objects of his visit was to gain an idea of how the sanatoria in New Zealand were conducted. The fourth highest cause, of death, said Dr Palmer, was tuberculosis, and it was a problem which had to be faced. There was also the dread disease of cancer, but as no definite cure had 30 far been found for thi3, it was essential that every effort should be devoted to the stamping out of tuberculosis, of which something was known, and which could be cured by proper treatment. The difficulty in New Zealand was practically the

same as that which confronted them in New South Wales, and that was the lack of co-ordination on the part of the Various hospital boards. The system in New Zealand at present was good, but it wanted to be extended, and the boards should coordinate and attack the disease as one body. There was no reason why New Zealand should not lead the way in the campaign against tuberculosis if this were done. In answer to a question, Dr Palmer said the difficulty with consumption was to get the cases early and to treat them specially. Such cases should be carefully cared for. He considered that the best treatment for convalescents was by means of a village settlement, where consumptives and their families could take up residence and work under the most favourable conditions. The basis of such a settlement would be an agricultural colony, with a village attached where employment could be found for a tradesman. Not enough interest was taken in the treatment of tuberculosis, and it was not sufficiently realised that early diagnosis and sanatoria treatment were of paramount importance. The treatment in sanatoria did not appeal to doctors because, for various reasons, including the economic ones, the doctor preferred to treat his own case in his own way, but it was a fact that £0 to 90 per cent, of oases when taken in hand early and treated at a sanatorium make a permanent recovery. Dealing next with the various cures which were said to have been found by doctors, the speaker quoted the use of Professor Dreyer’s vaccine. This had been tried in New South Wales, but it had been found to be unsatisfactory. Over 300 cases were treated, and 230 tested completely, but the 'results did not warrant a continuation of the treatment. With regard to the much talked of Spahlinger treatment, he expressed the opinion that this would not prove of any value. In 1913 M. Spahlinger had been written to by the New South Wales Government, and he said he would supply the serum in two years. In 1914 word was again sent, this time through the Agent-general in London, and the same reply was received. In 1919 M. Spahlinger was again communicated with, and the same promisein two years—was reported. He was offered £10,060 for the rights to test the serum, and a royalty. Later the offer was increased to £cO,COO. but M. Spahlmgei asked for £90,000. The matter was then inquired into by the Prime Minister of New South Wales, and finailv Colonel Howes, Director-general of Health lor tne Commonwealth, made investigations, and reported against the treatment. It had been proved that treatment in a sanatorium was the only known method by which a cure could be effected. Continuing, Dr Palmer said that in New South Wales they bad found that to dea satisfactorily with tuberculosis they requned notification of the disease (which was m force in certain areas) and that special steps should be taken to notify the consumptives as early as possible. When consumptives had been diagnosed they should have the opnortunity of at once entering an institution most suitable to their condition, or failing this, proper dispensary treatment. The cases going to sanatoria should be classified before admission so that they would not go to the wrong institution. This required a control receiving house where difficult cases could be observed and properly diagnosed. Different sanatoria were required for different types of the disease. In New South Wales there were three separate institutions —a sanatorium for early cases, a sanatorium or farm colony for chronic cases, and special wards for incurable and dying patients. The treatment of cases at a dispensary should be a secondary matter, and confined to those who were not in a position to undergo sanatorium treatment. To allow the dispensaries to do this -financial assistance had to be forthcoming, and in New South Wales the wife could obtain 30s a week for herself and 6s per child from the State Government 1 and this was quite apart from the Common-

wealth Government Invalid Pension of 17s 6d per week while outside, 3s per week while in an institution. This had, however, proved insufficient, and for the purpose cf the prevention and control of the disease in the future this assistance would have to be so that it would be an inducement to the patient to enter a sanatorium. Such assistance would, in all probability, be the deciding factor in a patient’s recovery as it would relieve him of all worry, and by removing him to a sanatorium it would give hie relatives or children a chance of resisting infection. When patients were admitted to a sanatorium it was often found that they were not improving as they should, and a change often improved their condition; —hence the necessity of several institutions. As New Zealand would soon have several up-to-date sanatoria close c-o-opei'ation between the different centres would become essential and especially so as regards matters of this kind. When a patient had recovered and had been discharged he should not be lost sight of, but should be kept under supervision. The scheme for such a purpose which was being considered by the New South Yales Government eras that of a farm colony. Such a colony would provide farm products. All heavy manual labour would, as far as possible be eliminated. The milking would be done by machines, and the village would provide work for men with special trades. In New South Wales 5000 acres had been set aside for this purpose, but before spending a large sum on such an undertaking it was proposed to test its value with a small farm in close proximity to their largest sanatorium. There was no notable co-opera-tion between medical practitioners dispensaries. and the sanatoria, and were this brought about the importance of the early diagnosis and treatment of such cases in ' sanatoria would be fully realised. The sanatoria themselves should be made attractive, and there should be plenty of amusement for the patients. In the largest sanatorium in New South Wales they had a kinema, concerts were given by visiting artists, regular church services were held, and there was a good library, as well as two billiard tables, croquet, and bowling greens, and games of all descriptions. The next aspect of the question dealt with by Dr Palmer was that of the care and treatment of the patients. A most necessary and vital thing, he said, was discipline, and it was because of the lack of discipline that so many people never recovered from the disease. There was also the question of routine nnd regularity, and it was only in an institution that such c-ould be obtained. He quoted instances in which men had left an institution with the disease arrested and as a result of heavy work, irregular hours, and worry, had died within a short time. In conclusion, Dr Palmer complimented the hospital boards of the South Island on the work they were doing in the direction of combating the disease. He emphasised the importance of the Government taking up the matter nationally in the way of providing pensions and financial assistance to the dependants of patients, as by so doing it not only enabled such patients to seek treatment at an early date, but by the segregation of the husband and father the ravages of the disease among his children would probably be checked. For the sake of future generations the granting of pensions w ould be a cheap insurance.