THE EPIDEMIC

Dominion, Volume 12, Issue 150, 20 March 1919, Page 5

THE EPIDEMIC

HEALTH OF SHIPS' CREWS

NATURE OF DISEASE

DR. FYFFE SPEAKS OF ALCOHOL

The Epidemic Commission continued its < sittings in Wellington yesterday. Su John Denniston presided, and Mr. i). I M'Laron sat with him.. It is hoped tha , the taking of evidence in Wellington will be concluded to-day. , William Thomas Young appenrcd to < give evidence on behalf of the New Zea- i land Federated Seamen s Union, of which, he is general secretary. He said that the first intimation tho union had about the epidemic wert in September, aud it appertained to the Mrau-ft. the Mokoia, and tho fall ti. Tho information about the laluti camo through the Press, find was to the eftect that some six members of tho crewhiu di"-l of it after leaving the e=t Indies. Tho information coming from the Moa was that all of the crow except fwi went ashore at Papeete and got ntox cated, mostly on rum, were aftected with the disease. He would not expiess am oninionas to whether the immunity of tho four was duo to the rum, but he believed fho fnct was as stated. the Mokoia, coming from Australia, were nearly all sick. At the time this mformatioi< came the executive ot tlie unwu were sitting, and a resolution was fonfardetl to the Minister ot Healtli» K the danger of an invasion ot Spanish influenza; and suggestl g precautions for 'the pro'tection ot s pmnir such as the isolation of ships hom mfected ports, the fumigation ot ships at convenient ports, and fte inoculaion of crews against the disease. Oil Octobei 2i h replv was received from tho Minister The reply' was to the effect that the isolation of ships was impracticable, and that such drastic action was not necessary for a disease which was no moie than common influenza. As to inoculation tie reply was that there was not sufficient eSlence of the efficiency of this measure to justify its use. As to disinfection, the Minister replied that it would be of no value, as influenza was communicated only from person to person November 20 he wrote another letter motesting against the decision of the Government to allow shipping to move as usual, and pointing, IS yJ* lwd been in increasing the spread of the epidemic in New Zealand. Jhe letter mentioned' the specific case of the iMna 'a declaring that this ship, on which members of the crew were suffering, should not have been allowed to berth at Amklontl, and that no proper precautions vero taken to isolate the disease in Auckland when it had broken out th>-e. The letter referred also, t o the fact that members of ships crews weio neglected while suffering from the disease. and that the quarters wh oh men had to live were wretchcdlj baa. Witness produced other correspondence between the Minister and himseli. • Bad Quarters. no went on to enumerate tho demands mado by the union for the implement of the living quarters of ships, and read other correspondence on this matter. (Some of the correspondence was published at the tune, it was wrtteu) Witness said that the bad tory. accommodation, the lack of bathing accommodation the fact that men had to eat J their f<)()d in the same quarters in whicli. thej Jj®? shep 'wero a disgrace. It was not suiprisrog* that so many seamen had died from the sicltnces The numbers had never been given out, and they were difficult to discover, but he ventured he opinion that the number must be betwe»n four hundred and five hundred in New Zealand. Mr. Young went into details about the accommodation on certain ships, particularly as. to tho conditions created by tho proximity of lavatories. etc., to tho men's living quartcis. He admitted that improvements wore being made in modern ships, and ho meutio&ed particularly the Waitmno. described, also, with milch detail, tho dirty cmdition of living quarters on "witaesf said that' tho Monowai, from Auckland, was the ship which farst brought the disease in a severe form to this port. There were oleven men sick on arrival, and the master and four ot tho crow died. In the whole penou some fifty out of a total ot soventy-hvo moii were affected. , . He drew attention to. the provision in the agreement betwaen the union and shipowners for the cleaning of the quarters daily by men in working-time or al overtime rates outside of working-time. He said that so far as he know for ij members of the union died in New /ica* land ports and at sea, while nine mombers of tho union died st ports abroad. Of the 49 deaths 32 were ot stokehold •men and 17 of deck-liands, which, lie urged, was evidence that firemen s work wag destructive of men's health or coil- ' etitutions. These figures represented all the information that had come to tho union, but he believed there had been many deaths not reported.

Practical Difficulties. Mr. Young said that wherever the structural conditions of the ship would allow of the alterationa'demanded by ttio union being made, these alterations had been made. The total number of ships so treated was 47, including a few not belonging to the Union Company. Mr. Young concluded by making a* few' suggestions ,as _ the result _of the experience of . the union. These included enlarged air-space in tho men's quarters and, where possible, the provision of a separate room for each two mon, with chest of drawers and accommodation for clothes. Sir John Denniston asked whether these improvements would bo possible in all present ships. Mr. Young said it would "be very diffi. cult to get messroom in some ships. Sir John Denniston: Would it involve 6crapping those ships? Mr. Young: Perhaps it would be better to scrap ships than to scrap'lives. Sir' John Denniston: Oh, those are sentimental phrases which it has been very much a part of your business to nse. I am not asking whether it is better or not to do these things, but simply what will be the effect of doing them. Mr. Young: Of course, no one is going to suggest scrapping ships if it, can bo avoided at all. | Sir John Denniston asked whether all these suggestions were not merely connsels of perfection, proposing to mako standards which could not be lived up to, A law was rather different in that it had to be lived up to, and a law could not make unattainable standards. Mr. Young said that he had luid several conferences with the officials of the Union Company on projected alterations in ships, and in some vessels he had seen that it would be, very difficult, if not impossible, to .mako tho alterations. In some little vessels trading out of Wellington and Auckland it would not ■ be possible to enlarge the living-space. To Mr. M'Lareii: lie would prefer that health matters in a port should he con- ■' trolled by an authority representative of the Harbour Board, tho shipowners, the seamen, and the waterside workers, this committee to ho under the control of the Public Health Department, which needed advice on (ho practical requirements for shipping and port health pro- ■ cautions.

'A Committee Workßr. William Foster, headmaster of the Clyde Quay School, gave evidence as to the work of the Wellington Ea6t committee at the time of the epidemic. Ho presented a report from the committees of Wellington City (a report given full publicity at. tiie timo it was first issued) He did not suggest that the conditions, such as bad housing, which the committee found to exist had caused tin; introduction of the sickness, but it had aggravated its severity. Mr. Foster said that there had been no lack of voluntary workers, and not one penny had been paid to any voluntary worker in his district. 'Ho had been surprised to hear of demands for payment made by voluntary workers in other districts. The work of his nursing lielners was splendid, and he had a sufficient number of them, although all were very handworked. As the best possible preparation for other epidemics

lie would suggest that there be opportunities provided for the training of women in elementary nursingNot Like Influenza. William Kington F.vil'e, medical practitioner, president of tho British Medical Association in New Zealand, said that undoubtedly the bad foim of tho epidemic began after tho arrival of he Niagara. Thero had been sporadic cases of influenza and pneumonia in Wellington before that time, but' in the last two weeks ot October tho sickness took on a more serious character. Ho could not give tho dato exactly. The dsease then was not like ordinary influenza, at all. One of his own patient's had died in six hours after showing acute symptoms. That was in the third or fourth week of October. He had been through the big epidemic in London in 1889-90. This more recent disease was quite different and verv much worse than anything he had seen before. In the old influenza the patients sometimes contracted pneumonia, but in these later cases patients died of oedema of tho lung, and not of pneumonia. Ho hud made two postmortems, and these examinations bore out his diagnosis. The lung was filled with a thick fluid, and the patient was really drowned in tho secretions. It was very liko the condition of sufferers from gas poisoning at the front. Tho bacteriology of the secretion was not cer-, tain. The cause of the disease was probably the streptococcus, which stripped the mucous membrane from tho trachea and the interior o£ the lumg. Some streptococci were comparatively harmless, and others were very virulent. It was a pusforming organism. In all cases of which ho had experience' the cause of death was this serious affection of the lung. He was not at all sure that the disease was in; fluenza, although always the influenza bacillus was present. In tho big epidemic of 1889-90 in London he had never seen a case of oedema of the lung, although cases of pneumonia were frequent in tho ISB9-90 epidemic. He had seen several cases of oedema of the lung here, and nearly every case developing oedema died.

To Sir John Denniston: Ho thought it was quite possible that the sickness was caused by some now micro-organism and not by the streptococcus at all. To Mr. M'Laren: He had never 6een oedema of the lungs in troops except among ,the men suffering from chlorine gas poisoning. This last sickness was different from ordinary influenza in that it came oil more quickly, the temperature was higher at tho beginning, there was greater prostration, and bluenes9 of the face was more evident. The most important difference was in the number of patients contracting oedema of the lung, and) of the number of people who died • afterwards. Thero was no doubt presumptive evidence of the existence of another bacillus not yet described, but possibly the new serious featurfcs might be accounted for by added virulence of the streptococcus. Certainly the disease was hot ono ho had ever seen before, and it was most severe. . The Use of Alcohol. Dr. Fyffe wont on to speak of tho uso of alcohol in treatment of tho sickness. He would go so far, he said, as to say that it was the only drug that was of any use. A stimulative treatment was necessary, and alcohol did not in any way disagree . with the patient, as did other stimulants. It was given by the mouth, hypodermically, and by brandy packs. He mentioned the case of a girl suffering from acute double pneumonia. When he first saw her ho .thought 6ho could not possibly live an hour. Ho gave five centimetres, of brandy hypodermically, and a brandy pack. and.there was a quick drop iu temperature from 103 to below 100.. The most invaluablo drug in the epidemic was alcohol. It did not upset patients or mako them sick liko ether'or ammonia. Ilis experience was that people who were in the habit ot taking alcohol in moderation did not take tho disease. A man who was a hopeless soaker would, of course, die straight nway. _ The man who took. h;,i or three whiskies a day did not as a r'ulo tako tho disease. Indeed', ho thought a man who used alcohol in such moderation as fhis did not take these .acute diseases occurring in epidemic form. He was afraid that New Zealand would suffer acufely from tho fequalia of the disease, especially from tuberculosis.' Tlie disease lowered the general resistance of the body, and tuberculosis took quick hold of the tung. Ho had' seen already Bomo such cases. Ho had also 6cen a case of meningitis in a child, the result, ho thought, of a previous attack of influenza. He could offer no confident opinion about (lie advisability of prophylactic inoculation.

His opinion was that the only way to prevent a re-invasion of tho epidemic would bo by efficient quarantine, arid he thought this was possible in New Zealand. Ho believed the disease could dje carried in food and stores as well as in a living human host. He thought conditions would be improved if a medical officer wero appointed to control tho public health of tho city. Tho Commission sits at lo'a.m. to-day.