A COUNCIL OF WAR.

Dominion, Volume 6, Issue 1578, 23 October 1912, Page 4

A COUNCIL OF WAR.

o 1 ON CONSUMPTION. 1 "'THE'DOCTORS IN CONFERENCE. Under the auspices of the Public Health Department, <i conference of medical officers opened at the Parliament Buildings I yesterday morning. The Hon. 11. ]'■]. , Rhodes, Minister in Charge of Hospitals and Charitable Aid, presided, and there were also present: The Hon. Dr. Pomare, Dr. Valintine (Inspector-General of Hospitals anil Chief Health Officer), Dr. Hardwicko Smith (Medical Superintendent Wellington Hospital), Dr. Ulnekmore (Director nf Consumptive Sanatorium, Christ-church), Dr. Lyth (Director cf Paluierston South Sanatorium), Dr. lieakes (Chief Veterinarian), Dr. Lewis (Medical Director To Waikato Sflnutor- • Hun), Professor Champtalolip (Bacteriologist, Dunediu), Dr. Finch (District ' Health Officer, Canterbury), and Dr. • I'rengley (Medical Secretary). Inaugural Remarks. Addressing the delegates, the Hon. Mr. Rhodes remarked that their presence was ■' an indication that the importance of the problem to be grappled with was fully appreciated, and ho felt sure that the result's of their deliberations would be the initiation of a scheme which would be .for the general good. "It is true," said the Minister, "thot the deith-rate is declining, but it is still sufficiently largo to demand our serious attention, especially in view of the favourable climatic conditions that.obtain 'in this country." It ought to bo quite practicable, ho added, to stamp out the disease, of Consumption, but to this end they would require to proceed on well organised lines. Past efforts in this and other countries had been of a more or less . spasmodic nature. In New Zealand, he thought, they had in existing legislation the majliinery 16 help them materially in line campaign, as both tlentment and preventive measures Were controlled bv , Jhesa-ne local authority in the hospital districts. 'They had a fair propor- ■• tiou or beds nt the various sanatoria for tho treatment of consumptive patients. Ot tho total of 3057 beds, no less than 300 vere S et asldo for Special cases-at Cambridge, Otaki, Cliristchurch, and Palmerston South—in addition to the annexes at the general hospitals, and this accommodation would be increased when the Auckland building was completed. Ihe recently instituted system of school medical inspection, also, .would provide .valuable .data with respect to the incipient stages of the disease. Takui» the existing machinery into account, New Zealand was better equipped for such a .campaign as was now contemplated than almost any other country in the world. Compulsory Notification. .-; , There were .several important points to be considered. They had to consider, for ■ example, how far they.could go in the direction of compulsory notification of ' £?,f S --\ o °t 7 ?8 dvntlls from tuberculosis, . only ,19 had been notified. In this con.nection it was necessary that the Department should have the co-operation of the medical profession. There was no intcntiou to interfere with tho doctors in any way, and he felt quilo certain that the : profession would co-operate in every way possible. Then there was the question of , ■ enforcing upon refractory patients tho discipline of the sanatorium, and with regard to this-a difficult question-he looked to the conference for guidance. With regard to the inspection of immigrants, there was no iloubt that cases had passed the Public Health officers. To e<d»Weh. a system;of thorough inspection" would mean, serious delay to the shipping comSV 1 !' 1 «""<> astern had to be de- ! used which would prevent cases slipping ' past the inspecting officers, without umini < interference with the business of the port. ' the remedy lay, Cabinet considered; in ■• ?\ 4,, a Ji tho .P 0 . rt of embarkation, and 1 ™L7?'m '"ro'ssionerhad discussed that ' point with the Hon. Mr. Bell, Minister < or Internal Affairs, before he left for £ hngland. The idea would probably bo to -• .appoint an inspecting officer in England. I In this connection, snid Mr. Rhodes, his colleague. ;21iv Bell, would be glad to t discuss the matter with anv of the dele- 1 gates who cared to meet him after the t session. endeih'-Then ngaiir,""contiriued 'the' J speaker, they had not sufficient beds for t advanced casjs. North Canterbury had t set a good example, which ho hoped Would b be followed, by making provision for such t cases. *

Farm Colonies.. With regard to the providing of light work for convalescents and those who desired to keep in touch with a sanatorium pending, the time when they would be fully restored to health, the conference would no doubt consider the question of farm colonies. It had been the intention to use the Cambridge Sanatorium as a form colony, but the lack of accommo(iatioii for consumptives at Auckland had lesulted in the Cambridge institution being strictly limited to the functions of a hospital. When the Auckland building was completed, Cambridge might then bo .used for (t farm colony. Such light employment as bee-keeping, poultry-farming, .tree-planting, fruit-growing, were quite practicable for such cases. . Then there was the question of educating the people. Many doctors now considered that patients could be treated in their own homos, as tho discipline of the sanatorium equipped them with a know, edge of how to manage. Then, there was I:he question of controlling the spread of tie diseass in the Native race. The Natives in latter years had absorbed many of theovils of civilisation. ' I , believe," concluded Mr. Rhodes, _ tnat we aro all agreed upon a plan. It is the details that require consideration. Whatever you decido will have the sympathetic attention of Parliament and of Uai)inet._ lhe whole question is a matter ot finance,, and this aspect "of it will determine how far it will lib possiblo for us Dr. Valintine's Address, Dr. Valentine, having been summoned to give evidence before one of tho Parliamentary committees, the address ho had prepared for the consideration of the conference was read by Dr. I'rengley The objects of the conference, prefaced Dr Valentine, were:— ".Firstly, to infuse new vigour into the can !P ttI S n against consumption. Secondly, to consider what legislative : or administratlvo details are lacking in our machinery. i "Thirdly, to obtain the opinions of : those who are actively employed in tho : treatment of the disease-i.e., tho medical superintendents of our sanatoria-as to ' those- particular forms of treatment ! •which, in the light of modern knowledge, may be adopted with advantage to tho '' community. And, ! "Fourthly, to obtain the views of mem- ' bcrs of the medical profession engaged in ' general practico as to what part they are ' prepared, to undertake in the campaign ! we have in view. . ' After Twelve Years. i "As is the case with all campaigns of ! a protracted character, there is at times a tendency to languish in the conduct of the campaign; and this may bo said with ■ some justice with regard to tho campaign against consumption, which has been conducted by tho Department since Its initianon'some- twelve years ago. Noverthe- • ess, during that time a good deal has l been accomplished. In addition to the \ establishment of sanatoria, and of an- , n ?. xe , s '? conile ction with our general hos- } pitals for the special accommodation of ! consumptives, many other measures havo , been undortaken by the Department ? which may be justly regarded as part i and parcel of tho campaign against con- r sumption—notably tho condemnation of \ houses unfit for human habitation, tho { enforcement of by-laws to prevent over- i crowding and to ensuro general sauita- . tion, the- supervision of our food supplies + under 'the Salo of Food and Drugs Act, ' the supervision of tho milk supply, and „ the disinfection of houses occupied by i consuuiptives-iu addition to the educa- ~ tional measures that have been undertak- j en either by pamphlets or lectures to , dlnw the attention of the public to tho v preventnbility of the disease. • Nor must -\ I omit to mention tho part that the Bac- « tenologist has taken in the campaign. ~ Again special dispensaries have been cs- i tnbhshed in connection with two of our ~ larger hospitals for tho special treatment ,l of the disease. Nor must I omit to men- i, hon the appointment of district nurses l tor' the country districts, especially for j work amongst the Natives, in whom the ~ disease is, unfortunately, only too rife. u And, finally, the recent appointment of medical inspectors for school children e should enable tho detection of the disease « in its early stages." i..

1 ministration was of grant advantage in the campaign they had in view. The boards had now nil the machinery necessary for an efficient conduct of the conipaigu against (he disease. They could erect institutions—hospitals, sanatoria, dispensaries—and appoint all those officers considered necessary, not only for the eonduct of these institutions, but for work throughout the hospital district—medical superintendents; bacteriologists, nurses (institutional or district), sanitary inspectors/ district visitors, etc., etc. I think you will admit that the powers of the boards are ample in this respect. The Immigrant Consumptive. ' "No, the only additional measures that I consider necessary are those to allow the detention of refractory consumptives nntl better means for preventing consumptives from other countries landing on ' our shores. There is no doubt that mnnv consumptives get past our Port Health Officers, but the public docs not; hear of tho numbers who are turned back. It was prnctioally impossible, Dr. Valintine added, for Port Health Officers, in the course of a short examination, to detect cases of chronic and internal disease. The time required for an inspection of this description would entail considerable dislocation of our commerce, and great, would be the wrath of the public accordingly. Inspection of passengers, to be efficient," had to be made at tho port of departure and during the voyage, and more liability had to be placed on tho shipping companies in this respect. The decision'of tho Government to ensure a rigid inspection of emigrants at the ports of departure would grently facilitate matters. No Compulsion. "It has been staled that we are greatly behind tho times because the Department has'not rigorously insisted on the notification of consumption and the following up of the cases. Personally, I nm strongly of opinion that little, if anything, will be gained by a rigid enforcement of such measures, fo enable a successful campaign to be conducted against this disease, wo must do oil that can lie done to encourage the patient in the early stages of the disease to seek treatment. The enforcement of measures that would involve the compulsory detention of the consumptive, or which would cause him to be regarded as a pariah and one to bo avoided, is neither human nor necessary, provided ho observes certain precautions which can be carried out in the homo as well as in the hospital; and. above'all, would it be unwise to enforce detention unless there is available ample, suitable, and, what is more important, comfortable accommodation, especially for those patients in the later stages of the disease." This year, he concluded, the death-rate from consumption was the lowest hitherto recorded in New Zealand—he believed it was the lowest in the world, but this should not allow, nor had it allowed, those responsible to relax their vigilance. It was for this conference to give a lead to the Dominion and those responsible for the local administration of tho Public Health Act, and, by this means to awaken interest in 'a campaign which would bo barren of results'if they failed to bring about co-operation nnd unity of effort. Tho deliberations of the conference were taken in camera.