WHITE PLAGUE.

Dominion, Volume 3, Issue 927, 21 September 1910, Page 8

WHITE PLAGUE.

CRUSADE AGAINST THE BACILLUS. ,A PROBLEM FOR EUGENICS.. V DR. HARDWICK SMITH'S PROPOSALS. ->?■.■: At the. mooting of the,: Hospital. and Charitable Aid -Board yesterday,, tliero was a -lengthy debate" on tho report w - from, Dr. Hardwick Smith, laid on tho i' ', : r table; at ,the previous meeting, •iii ;,refer/"y enco to Otaki Sanatorium aiid to tho S;";; ; control and; treatment, of -. consumption. Scathing Criticism. ' : Mr.-.8. R. Gardener, ill moving that tho roiwrt bo. received, strongly erit-ic- ? iscd; tho existing oontrol of cousuinp: tion -as - inadequate .'and inefficient.v. : A sum or; £20,000 had been spent in ,"• .. erecting Otaki(Sanatorium, the present "( (' , cost of upkeep was £3000 .a year, and . last year .127 : patients 5 r had:; passed . '• . 'through' the sanatorium at an -average • ; ' cost, of -£80 per head. 110 very,, much ri"i'..-'o';vqnestk)iied-;rfother : l the\rMults:'attamed, justified; this, expenditure. ..From experience. in his- own.: district',. ho could , give illustrations which were a disgrace . to -the Health Department and. to'tho ■■.; medical, persons concerned, in - coiinec- ... tion with this'disease. ;'://;/::'/Tlra. chairman: Are you not reflecting . . on.'a Government Department? . V:.';: //a.: ; /(Mr: Gardener said ho ' took ■it they ■ were a ' Board ■of Health, and had a //perfect right .to. express ah 'opinion:.on .., tho 'administration of a sanatoriumand - . on- pa-st results obtained there. He re- !//;/-/ pcated'that the results .were not sufii- ■ ' ciont .to justify tho expenditure. A / case within his*, knowledge was that of '.' a woman who was permitted to leave : the sanatorium without being cured.; ' - A member: A , sanatorium is not a i,; Mr. Gardener: No, but it should be in cases like this. : The chairman here again intervened.: • ' ■; "I take it,"-.-he said, "that, these are • ,'.-:refleetions upon a Government . Department. I don't, think that I,',as chair- ", , man of this board, should ' allow reflctv ,'] tions of the kind to bo' made in this, . : ; puilic meeting. 1' should like to know - .if Mr. - Gardener has \ referred ; these matters to .tho Department. : ; I tliiuli that .would be a right and proper course : , - < to . take." . . ThG chairman further : re- • . marked that he- understood Dr. Hard- : : wick: Smith, in conjunction-with Dr. '■ ',; yalirLtine, had' a staiiemcnt to ma,k&, • Md recqminohdations to! lay before tho ■j ■ -board ' n reference to this matter. , .He ;: . idid /^not; think \ih 4.he. ;inter--i'.'Mts .feither -tKe board' 1 or ;ofinpatients i; i that reflections of .the kind to-which , he had objected, should be ;made: in.this /•- .• pnblic meeting. .' ;::Mr; iwliat /.. ho wanted to'. kuow was whether, the sanatorium • was going to ,bo under a - • certain , amount ;'of'-supervision.-by tho medical officers of/-this, board, or were •' -: they going to frame. rules and • deviso / • some method of; improving the control .' .- '■noW 'exorcised over, consumption pa.iiV v '~tients?:. , 'Were.they-.going: to, keep., pa-, i^;,V4tients forthree.- months,, and then let V. them go homej have.throe or four'.child- ; ren aiid dieP . -Tho. position he' wais .that the-board was not doing its v'~ duty, in .cases 'of this. kind. It should bring thembefore^^;the:,,pro^r!,aulmority.; A Danger Ignored. ■ He knew, as a- matter of fact, -..that s:i ; In many country districts- consumption never reported t-o; the ;Health;;su- ■::•'■ .thorities until such time as tho patient iiad died. There ;was no notification .' 'a?Mii . the case ;of 'typhoid ,' fever -or • . -. plague; but ; they learned only. from offices. how .;. -. ; m'ainy •. persons . had.'. ' died; of con-' ;.''■ ; : 'sumption.',", ;.He : could cite' • : most tpitiM;;;.casesyO. 'TOey f''should> :Hot ij sit :'— _.around-their table-and: practically .see • murder.'.oommitted. ' Numbers .of con- . ■ ' sumptivO 'patients wexo ' permitted te 'marry andvdie.''' The curses .-of,- their i; -'i' children- must surely fall both upon their, parents and upon tbat : board wnich was i'-}-"■ f a cont'rolling authority.. It• was all very, si"-"weirfor Dr. Hardwick'Smith -andother, 5--.v ■■;. medical officers to say, "wo will keep, a-patient for three, months, and if he • 'g®? s no better tlirow him back on tho world.'' .. That board- should prevent;a* . person'. going out to, spread contagion - - and ;disease... "I'.kr.ow. right enough," • ::..' 'remarked-- Mr:• Gardener, "that v.somebody has to speak up, and every ono • •• is frightened- to say so: (Hear,' hear.). "J[ could give you cases from my own if'V' : (/,■:,. that ever a: man . or. ' woman .. looked iv - npon. " Another question, Mr. ■ Gardr . . ..'ener . pursued, was as. .to whether /. •' . 'Otaki Sanatorium 1 .was in :a suitable ftJ«r:Vspot: ' InJhis.'opinion it should bb taken 55 ■!''; to a more ; elevatecl site.; These were ;• ; . things which he maintainedthe-;board' ... .'should take into;very d«jp_ : '' i* tion; • Children of parents should be taken up by the' Department , and cured, if, possililo,: while young: ' \ ;.' • . -Tlie Itev. B. Van Staveren- doubted ' ~wiiether the board• was capable',, in a ; \ statutory-sense, of dealing .with wiat % was a, grave social' question. He would fladly assist in any moyeinent - which ad for its object' rth'e' ari^ting'';of,;the .' '. ' propagation of this terrible .disease., He .• -, seconded tho motion._ ' : ' ' - Mr. F. T. Moore &id that tho'lxKird , 'would ,be lacking in-a sense of its re-bMk-upywhat .. .; Mr. Gardener had said. ' If the question. was fought • out •in a . systematic ;. . .. way, tho Minister would .bo.forced to ; : : take action, v'; ■-;f.fe.', r-; y : : >:■ , The Solution: Eugenics. ; Mr. R. C. Kirk.- congratulated Dn : : ;v. Hardwick Smith upon . his . report-, and , v ' - ■ especially: complimented him upon hav-: ' iii'g placed tho; emphasis upon. ; tho. «s- ---. sential point. It seemed te liim .that problem was; or.o which could-best ,- • -be solved, in its social aspects, by . tho r^applicatioii of principles'of eugenics. . . .It would only ':bo. when t-h'o : Government had doyised'somo means'of-pre- ",- -„venting persons sulfering from- this or ther diseases; of, si milar ; gravity !c and -. ' '.danger to tho community from marry- - ~ ' ing awl propagating their : . species. He ;,:was ,' convinced;from many • years'- e'x-' .perienco' of hospital administration in • ' relation to this particular disea.s<?; that ■i:;■ ;-.■ : the. salvation;of sanatoria.lay in the -inX'. .;;: stitntion of a rigid discipline of work. The;■ mostextraordinary results had : : ':M - been obtained in the best sanatoria in -England, wherein the principlo of liardening the systems by healthy labour in the.open was closely followed. 'It was •, - only thus that the resistive powers, of .. 'the patient 'could be strengthened. Tree was -.cited, as an example of • . • what might;; be',. regarded as suitable . work for consumptive patients. He >, •. hope<l to see in the:.near, future an extension of the sanatoria' system, with . ~ adequate provision for the care of in- -- curables. .- ' Mr. A. H. Hindmarsh remarked that - : society was hardly yet in a cbhditipn' of mind to face the rigid discipline' which must necessarily accompany the development of an ■ effective system 1 for ,' ;;•; ;.... arresting tho ramifications. of the dis-. ease.-.' ....•: . •• ■ A Scheme Outlined. Dr. Hardwiok Smith, medical superintendent at the hospital, then gave a rough outline of a suggested, scheme » which,. he thought, . should commend itself to the board for its simplicity, .' V. ; ; efficiency, and ease of, administration, both medically and financially; ' He. had been in touch.with the Inspe.ctor- ■ General of Hospitals (Dr. Valint-iiie) on the subject,, and the,. scheme was . the outcome , of .their^v deliberations. ' . Simply, he would provide for: . "(a)-.The' compulsory notification of all phthisical cases. (b) A dispensary for dealing- with tuberculous cases, as an adjunct to the hospital. This disoensary would be

I under .(tlio control of tlio Hospital Board. . All cases would bo notified, to tho; Health Department, and, wlien necessary, treatment by tuberculin injection -would bo administered:, There would also bo ; the work of ..drafting tho cases,to sanatoria,, ete., to be arranged for, and tho treating of cases in patients' .homes,, jf tho. houses 'wore sanitary .and tho cases in a very early stage, in connection'.with this, district nurses should bo appointed, to visit and keep in . touch: with tho patients,' and advise them as to their methods of living:. Literature .on tho subject of tlio diseaso' and its infection would be distributed,-and steps taken to 'see, that/the' advice ' given , is'. duly carried out. .■■(e) Sanatoria for early cases. .(d) Hospital sanatorium for late cases (chronic), all of which should bo isolated. ; ''It.is a-recognised fact that a/pationt .dying : ati\hpflio-'',will ; practicallyfalways pass'ori. his'?ii)fection to at least' one individual." -) ; ; ::'(e) : !;Farms .and' out-door work for. cured cases, and for convalescents and thoso suffering from other chest diseases. ;.;•■/ '■-:/, .; / ■//'-, . . Tho chairman conveyed to the; doctor tho thanks of tho board for his labours .tiji-.tho;subject;'.and,i'asfcunidv liiiri/ of their/desire that, m'~-his' -.consultations' with Dr. Valintino ho would be.-, able to still further develop tlio. scheme. When all.'the details, : wore 'complete, a fill] report on tho subject would bo laid before the board. /The report by Dr. Hardwick Smith on the Otaki Sanatorium was then "received." •''(;':■':/