THE WHITE PERIL.

Dominion, Volume 5, Issue 1500, 24 July 1912, Page 2

THE WHITE PERIL.

HOSPITAL BOARD TAKES ACTION. FARM COLONIES ADVOCATED. Proposals for chocking the spread of consumption came before the AYellington Hospital and Charitable Aid Hoard at its meeting jesterday afternoon. The following report was presented by tho special committee appointed to consider tho question:— That in order to prevent diseaso from ntlacking the healthy and predisposed: Tho general public must be educated concerning facts pertaining to the comnmmcabilily ot consumption. In order ■° W'T this out, the committee suggests: that popular literaturo on tho subject of prevention, diagnosis, and treatment of consumption bo published by the Health Department, and that sucli'litcratura be distributed through local bodies and the dispensaries. , That notices oY "Not to Spit" be posted up 111. tramcars, trains, and other public places, such notices giving the reasons >vhy spitting is dangerous, and that the Government and local bodies be asked to freely post such notices both in tho English and Maori languages. That local anti-tuberculosis societies, comprised of women, be formed, with the object of educating tho public, more especially tho mothers of children. 111 order to prevent tho disease from increasing, the coiumitteo suggests the following:— That compulsory notification bo insisted upon; bj this means tho Health authorities will bo ablo to trace tho sourco of infection, ond so help and educate those who suffer and others who come in contact .with tho disease. That the Government be asked to make a more rigid inspection of emigrants prior to their departure from Homo ports, aa well as on landing in New Zealand. Statistics of the patients in tho Seddon Hospital prove conclusively that many peoplo land in New Zealand suffering from consumption, and in many cases at an advanced stago of tho disease. Tho total number of patients treated in tho Soddjn Hospital since its commencement is 242; 108 of theso patients were born in Now Zealand, and Wt were emigrants; 18 per cent, of the latter, or 10 per cent, of the total number treated eutbred tho hospital within two years of their arrival in New Zealand. The committee also recommend tho bvilding of one or 111010 Convalescent Homes for children in tho Dominion to enablo the weakly and predisposed to overcome their tendency and' become healthy citizens. Methods of Treatment. The committee discussed the best methods of treatment of the early ease of consumption, and suggest the .following:— 1 That a dispensary bo provided for the treatment of chest complaints. By this means suitable cases can be treated in their own homes. (This has already been approved by the board, and will bo given elfcct to when the new out-patients' block is oomplctod.) That necessities such as dings, sputum mugs, disinfectants, and dressings should be given to those needing them. That instead of a health inspector reporting on these cases, a certificated nurso be appointed who shall be taught the methods of prevention of tho diseaso, and shall visit the homes of tlioso suffering and givo advice and leassurance, as well «s practical help, in carrying out tho treatment. (N.B.—So far as our district is concerned, this has also l>een approval as part ot tho dispensary; scheme.) That full statistics bs kept at tho dis,pensa.ry of the circumstances, condition, and progress of the patient. That when the home is not suitable, then such patients must bo dratted to sanatoria, in order to cducate them and givo them a chance to get well. . That farm colonics should bo instituted by the Government, where, trades such as gardening, tree-planting, poultry keeping, and beo keeping are. taught.. Theso would afford the incipient and recovering cases a chance to work under favourable openair conditions. ■

The couiniitteo recommend:— That tho chronic and late cases of consumption must be.sent to suitable modified sanatoria, or if they remain in their own homes, then tho people in contact .with tliein must thoroughly understand tho nursing of such cases. That the Government take more stringent measures re consumption and other infectious disease amongst tho Natives, and that the notification of all forms of tubercular diseases bo carried out more rigidly. That legislation Ixs passed by the Government to compel treatment 'and segregation of the refractory consumptive who will not submit to treatment or voluntary self-discipline, and is a source of great danger to the community. Reports and memoranda submitted from time to time by the medical superintendent are appended to this report, and give in greater detail reasons for the concrete recommendations now brought down, by tile committee.

Points for Discussion, Dr. Hardwicke-Smith, superintendent of tho hospital, supplemented the report with some valuable points for discussion oa tuberculosis. These are as follows: — . Though the treatment of consumption m New Zealand has checked the diseaso and diminished-it to a certain extent, it is still very haphazard mid inefficient. Further and more complete steps must be taken (o -really gTapplc with every aspect of the disease. Several links in the chain are missing, and unless those links are forged and welded to.the rest, the chain will bo ineffective anil useless. For the effective treatment of consumption, preventive and otherwise, all these mutters mentioned mwlor must bo taken into consideration and brought'iuto force: Prevention of the disease amongst the healthy; prevention of tho disease in tho predisposed; treatment of the early cases of tuberculosis; treatment of tho chronic and late case of tuberculosis; treatment of the refractory case cf tuberculosis. Lach of those subjects can bo further subdivided- for discussion Prevention of Disease in the Healthy. By more rigid inspection of -emigrants; by education of tho general public concerning facts pertaining to tho communieabilily of consumption; by local antituberculosis societies; by instruction imparted through the medium of tho home, tho schoolroom, publications, tho public platform, the family physician. Tho public should bo told about:—Tho procreation of predisposed children; tho marriage of tuberculous people; dangers of postnatal infection; character and preparation of •food and frequent contauiinaation of milk; tho proper ventilation and construction of tho home; tho proximity ,of a consumptive f iu the household anil the precautions necessary to bo taken; prophylaxis in tho schoolroom; importonce of proper nutrition; calisthenic exercises, particularly correct breathing exercises; employment of young adults in confined rooms; offects of alcohol and indulgence. There should be rigid administrative oontrol regarding the suppression of promiscuous expectoration; inspection of milk anil food supply, aiid insist on a clean milk supply; hygienic construction and sanitary supervision of public buildings, conveyances, factories, tenement houses and commercial establishments; co-operation of operatives; financial assistance to employees when incapacitated by disease; the abolition' of. congested areas; inspection and restrictions in trades ; which conduce to chest diseases, particularly 3!*!! dust-producing trades.

Prevention of Tuberculosis in the Predisposed. All that has been staled in No. 1 ap. plies with more force to those predisposed to tho disease. Added to the above rules, others may be of interest for discussion. Compulsory notification must be insisted upon, and,' when notification has been given, a complete family history, with, if necessary, examination" of all contact cases nmst be carried out. If this is done,, statistics will be available of most, ii not all, Cases Of pulmonary disease, together with those predisposed by birth and environment to such disease. Those so predisposed can be watched, and periodically examined and advised about the best method oT ordering their lives by literature or vi-its. Jn coliisC'l!ion with lho.se children prodisposed to the disease, most of them, if properly taught and placed in suitable surroundings, will outgrow thai tendency, and become healthy citizens. To suable this to be done Hubbl" con. ralesceut homes fox children ought to ba

built. Then- are practically 110 .such moans of heating children in "tho incipient stages of disease in Now Zealand. Wo are spending money 011 the old and (hose about (0 depart from this life, but children who are going to 110 the fathers and mothers of our race are neglected; by so doing we are burdening ourselves anil our children with a debt-which becomes greater every year. At Hie some time, as citizens responsible for the health of the community, we are allowing a. weakly stock to remain weak, when by the spending of a small capital lives and money can be saved to the State.

Treafnient of the Early Cases. The public must be educated by tho means sugge-ied to report themselves to a doctor in (lie early stages. \\ hen tho matter has been reported, the Public Health Department must either through the family doctor or their own medical officers obtain an extensive family history, as suggested above. The patient then can be treated in several ways—(a) By treatment in bis own home if the environment and bis trade aro suitable. This ran be done l>y means of tuberculous dispensaries, where the patient may report periodically, and be examined and treated, and be taught how to live and lio\v to protect otherfram catching his disease. (b) If the home is not convenient or the trade injurious then he must be drafted to a suitable-placed sanatorium for a time, not. lo cure him, but to edueatc him and give liim n chance to get well, (c) From there he should bo passnl on lo a colonv, where all healthy trades are taught, including farming, gardening, tree-plantimr, poultry-keeping, and l>ee-keeping. (d) is north while the board considering whether, if these people ate taken nway from their work, and tliev have families to support, tho State should support, thoso fajnilies whilst tho wngc-pnrncr is mvay. Manv a waee-earner hnngs on to his work because he cannot afford to leave his wife and family, nnd be conies into the hospital (o die. This is not right, both from an economic and humanitarian. and a health .standpoint, (c) Again, after the patient has recovered, and has learnt a trade or occupation in tho colony, if tho fitai<* should Old him to start afresh in his new work.

Chronic and Late Cases. The patients, who are always infectious, and every time they cough cast tuberculous bacilli broadcast into the air, must bo segregated in suitable, modified sanatoria, or, if they remain in their homes, then the people in contact with them must thoroughly understand tile nursing of such These oa??? should ho treated under tho best conditions ill a warm, dry climate in the country, and bo allowed to occupy their time with light work and cxercise when able to do so. Treatment of the Refractory Consumptive. By this is meant the patient who: (1) Will not submit lo the rules in an institution. (2) Will not. come tinder treatment, but remains a monaco to the community at large. (3) Those who aro chronic alcoholics,, who persistently break tho bounds in an institution in order (o obtain drink. The only solution is for tho Stato to deal with such people, and by law compel treatment and segregation. In conclusion, there must be a concerted campaign, and completo harmony must reign amongst, all tlioso who wish to help in the movement. "When the report eanio l>eforo tho board at yesterday's meeting, Mr; B. R. Gardiner said that ho thought this was ono of tho matters in which there should bo an understanding with other boards, and that they should bo supplied with copies of tho report of the sub-committee. Tf it was intended to try and get anything of a legitimate character through this year, ho pointed out that tho time was limited. Mr. E. C. Kirk moved that as the report had only just b?«?n laid upon the tablo it should bo considered at tho next monthly meeting of the board. With regard to what Mr. Gardiner had said about supplying copies of the ronovt to other boards, that could be done if denied necessary after tlio renort was adopted. The motion was carried.