Reading for Everybody.

Gisborne Times, Volume XXVI, Issue 2145, 21 March 1908, Page 2 (Supplement)

Reading for Everybody.

* DECLINE OF CONSUMPTION

IMPORTANT OFFICIAL REPORT.

Different views have been belli from to time as to the nature of consumption, and tho means by which it as communicated from one person to another. It was considered to bo hereditary; it was supposed to be in- - fectious; it was believed to he transmitted by diseased meat or milk i~£lt was for long regarded as the most fatal and destructive desease to which humanity is liable. Only of late years 'has our knowledge of the dread malady •become extensive and accurate; anil even now we have much to learn a- , bout. it. A valuable contribution to vho information we jmssess on the subject is the report “On Sanatoria I'c r Consumption and Certain Other Aspects of the Tuberculosis Question,” issued by the medical department of the local Government Board. A pretty full abstract from this limnortant document is given in the “Times.” ' Th? report was ordered in 1902 byMr W. H. Long, then president of tho Board, and. the work of prepar- ' ing it. was entrusted to Dr. Tunbrell Bulstrode .one of tho medical inspectors, and an eminent, authority on questions of health and disease. The report fills nearly 700 pages, and deals with every phase of tho subject. DECREASING MORTALITY Tho most striking fact brought out ' by Dr. Bulstrode relates to the mortality caused by pulmonary eonsiini- \ ption. It-is a common opinion that the disease is increasing; that the deaths resulting from it- aro growing more numerous from year to year. Tho statistics furnished by Dr Bulstrode- show that tho reverse is the case; that, the disease has for many years been steadily declining. So con- : siderable has t een the decrease during - the last half century as to point to , tho possibility of its approaching extinction. Dr. Bulstrode gives a chart of tho mortality from consumption ■ ip England, and Wales from 1851 to 1904, with figures for the earlier and , later.year added. In 1838 the deaths numbered .’>9,025 or 39.9 for every 10,- ’ 000 persons. In 1855, in a population ’ of between 13,000,000 and 19,000,000, 'the deaths were 52,290, or 27.7 per • 10,000. In 1906, in a population of approximately 34,000,000, the mort'al- ’ ity was 39,746, or 11.5 per 10,000. Thus in a half century from 1855 to - 1906 the mortality declined more than - half, and in the'6S years from 1838

t .to 1906 more than two-thirds. Should this rate of diminution continue for another 40 years, the disease would almost entirely disappear, it is significant that four important measures have had no uoticeable effect Upon the rate of diminution. These are the Public Health Act of 1875, Kock’s discovery of the tubercle bacillus in ISB2, the Housing of the Working Classes Act in 1890, and the commen--1 cement of the sanatorium movement and system of notification in 1899. :Twenty years before the earliest of •them the decrease in the rate of mortality had made good progress. The ultimate extinction of consumption, ’would what, has happened to--other, diseases—plague, leprosy, relapsing - land typhus fevers, and fevers com•municated by mosquitoes—all of which Dr. Bulstrode remarks, have, for the time at least, disappeared from Great

Britain. , addition to the steadily decreasing mortalitv, Dr. Bulstrode directs .attention to the ■ same remarkable changes in the age and sex conditions of the disease. The age of maximum .’mortalitv at which in the decade 1851-60,‘was 20 to 25 among males, and from 25 to 35 among females, is now from 45 to 55 for the former, and from 35 to 45 for the latter— a change which seems to indicate an increased power of resistance to the ailment. From 1851 to 1863 the greatest incident of the disease was upon females; from 1864 to both inclusive. the rates were practically the same, and after 1868 the incident up- _ on females became substantially less than upon males. Now males siiftei more from consumption.than.females extent of about four deaths per 10,000 of the population. ’ Another indication in the decline ol consumption is afforded by the results of post-mortem examinations of persons’who have died from other deeeases, or from accidents, both in itngland and in other countries. In many cases there is unmistakable that the diseased had been infected by consumption at- some earlier period, and have overcome the tendency to the formation of tubercles. - HOW COMMUNICATED An important section of the reportdeals with the question of how« consumption is communicated from one person to another. Dr. Bulstrode ghows that it differs in a marked manner from such manifestly .infectious maladies as typhus fever and smaltpox, and even the less communicable enteric fever. He considers that the best test of the infectiousness of the desease is furnished by the propor-tion-in which-those engaged in nursing or attending to consumption patients are attacked. In Great Britain these attendants seldom fall victims to the disease, a fact the more remarkable as the dates relative to their immunity are partly, from periods antecedent to the discovery •of the bacillus, and when no serious steps were taken to prevent infection either bv dust or droplets. Opinion is unanimous that tho extent of the danger to which thoso who attend tuberculous natients in hospitals of sanatoria are exposed is insignificant, compared .with what it is in cases of typhus, or smallpox patients. So remarkable is the difference that Dr.’ Bulstrode suggests that pulmonary tuberculosis should be classed by itself, as a conditional y infectious” or ‘‘sub-fect-ious” defease. He shows that no very - decisive data have been funushedhy cases of marriage between Wealthy and’ consumptive persons. On this point Whitelegge and jlfWlC» their text-book on ‘.‘Public Health, remark that “statistics even with the regard to the transmission of ulith isis between husband and V There is, hovvever, an nf evidence in support of the benei that unsuspected tubercular lesions are latent-in largo numbers of people, , -in some of whom they are capable ot Jbeing--aroused into mischievous activ’Dr. Bulstrode says that it is impossible to determine the precise importance which should be attacliec to direct infectoin, so long as the extent to which tuberculous as due to the drinking of tuberculous milk s undecided. As far as liability to infection is related to the number of • bad Hi taken into the system, the disease is more likely to be acquire from milk than Horn dust-borne baCil VALUE OF SANATORIA. With regard to the value oi -sanatorium treatment of consumption, it L impossible to draw any precise conclusions from the evidence s available. Many oi the institutions have only recently been opened. In many cases the condition of the pat fonts is not sufficiently known. In examining the figures relating to sanatoria., it is necessary to coiisiclei tho . method of selection as adopted in ' each. There is a need ot a umtoim system of nomenclature and classifiction with regard to the states of tho patients on admission and when discharged. The innumerable terms now used are so vague, and uncertain to render comparisons between different institutions almost v«hieless. It is no wonder .therefore, that tho sanguine expectations at .first formed as to the beneficial effects of sanatoria bare not been realised. At the same time Dr. Bulstrode shows that the -immediate results of Sana torium treatment are decidedl.y m coura'dng, as is largely the case at lies’t* jSjht a he expected!' (? the t 'S’results x Jjavo been obtained in cases a'Juuttcd •during the earlier stages ot the inal Midi-, and in advanced cases the improvement has been far less satisfactory. But oven advanced eases >- frequently appear to derive great benefit from the treatment, a tact in harmony with the experience of wr~

mor years in hospitals lor consumption and institutions for the euro of advanced eases. It cannot, however, be too strongly impressed upon tho public that- the earlier the disease is treated tho better are tho immediate results.

It is believed by the promoters of sanitoria that they would tend to diminish the general mortality from consumption, not only l>y their direct effects as life saving institutions, but also from their educational influence in promoting better domestic lighting and ventilation, and avoidance of tho diffusion of infective matter. According to Dr. Bulstrode, it cannot be affirmed that there is evidence to show that these expectations have been realised. If hotter results as far as the permanent arrest of the disease is concerned are to he obtained at-san-atoria. hotter machinery must bo devised for attracting cases at earlier stages of tho malady. This is very difficult. Tho .importance of early treatment is not sufficiently recognised, and under existing conditions the working elassees will not giro up work and leave their families to charity or the poor law unless they are compelled to do so, or unless satisfactory arrangements can he made for tho support of those dependent upon them during their absence. An important question is that of the notification of cases of .consumption to the health authorities. In England voluntary notification has been adopted in many boroughs; and experience of the compulsory system is limited to Sheffield, Bolton and York. In these cities it lias not been felt expedient to subject consumptive persons to tho restrictions placed upon acute infectious dcscases.

DRUCE CASE SEQUEL. •MARY ROBINSON’S CAREER, As the cable message .published recently states, it is not expected that tile prosecution of Mary Robinson for perjury in the Druco case will go on until the arrival in London of witnesses from New Zealand, due there on Thursday, March 12. An interesting history of Alary Robinson's career—very different, from what sho .previously gave tierself—was -put forward t>y Sir Charles Mathews, counsel for the Crown, at Bow-street Court on t'lio 26th January, when ho opened tho case against her. At tho Druco inquiry she represented herself to be a single woman, born in America in 1852, the daughter of John and Louise Alexandra Robinson, of Green Ilill, Alleghany Mountains; and sho said that she was taken as a girl of 10 to England in 186 L, when sho first met tho Duke of Portland. Jt is alleged 'for tlie Crown that sho was really horn at Wandsworth, England, on May 25, IS4I, the daughter of Janies Webb, police-constable. iSho was at school in London and in Yorkshire. As Alary Ann Webb she was married on March 17, ISG3, to William Robinson, of Leeds, butcher, where they lived till LB6S. In that year, according to her story an the Druco case, she mot Dickons in Boston, Massachusetts. If the newily-aseor-tained facts (all supported by documentary evidence) aro correct, .sho was not a- girl of 17 in IS6S, when sho said she entered tho Dmko’s service as outside secretary, but a married woman of 27, alroady tho mother of two children. In IS7O, as the deajdi cortificato of their first child, Kato Ellen, shows, Air and Airs Robinson were living.at Lead Hill, Worksop (a- town five miles distant from, Welbeok Abbey, the Duke’s seat), and Robinson’s occupation was described as that of a shepherd. Still, apparently, were the Robinsons resident at Worksop on March 26, 1572, when an infant son died there, three years of ago. On May 7, 1872, was born to William and Alary Ann Robinson (formerly Webb) a boy, Frederick William, at No. 1 Lead Hill, Worksop. That birth, was registered personally by tbo defendant; her name occurs in the birth certificate, and not only her name, but her signature. In the Druco case Alary Robinson said that sho was in tho Dttko’s service from 1868 to 1878, and that in 1881, two years ‘aftor his death, sho went to India and Hong-Kong, not. arriving in New Zealand till IS9S. Inquiries made by tho Crown tell a different tale. On Juno 16, 1874, Airs Robinson and her husband, with two boys, James and Fred, sailed in an emigrant ship, named tho Tweed, from London to Now Zealand. Where the defendant first went is not known, but by 1875 6no and her husband were in residence at Wiiin.ite, in New Zealand. On November 1, 1875, sho herself registered the birth of another daughter, Kate Ellen. This daughter is still (living; apparently she married Mr Henry Wheeler, a telegraphist, in New Zealand, on Alay 23, 1893.

Next comes a very interesting certificate, which records the birth of a daughter, whoso nanio was Aloud, upon May 4, 1S81; .parents, William Robinson’ and Alary'Ann .Robinson (formerly Webb), married at Leeds on .Alaroll 17, 1563. This daughter is held to be none other , than Alanile O’Neil, who appeared in the Druco case as Alary Robinson’s companion, and travelled with her from New Zealand to England to give evidence. In 1882, apparently, tho Robinsons were still at Wa ini ate, a boy, William being born on September 7, 18S2. Robinson ■ died at Waimate on August, 14, ISS4, at tlie ago of 50, and his certificate as John Robinson, tho name of the .father recorded in tho marriage certificate at Leeds. Tho statement is’made in regard to him that he had been- resident for 10 years in New Zealand nrior to his death, and the death, occurring in 1884, makes it plain tha.t ho had arrived in tho year 1874. A witness on his way from New Zealand was intimate with the Robinson family from the year 1878. He knew Airs Robinson, "he knew her husband, he knew the children. Sho was known ■there as Airs Robinson, and, as ‘far as his knowledge extends, Aliss O - Neil was known as tho daughter of William and Mary Ann Robinson, and was commonly called Miss Robinson. After the death of her husband Airs (Robinson kept boardinghouses at different places, amongst others New Brighton, where sho was burnt out. ' . , At Christ church Airs Robinson kept another boarding-house, which brings the record down to the end of 1906. At the end of 1906 her attention, would seem to have been attracted to certain paragraphs appearing in the newspapers in regard to_ tlio Druce-Portland case. She horscir had recourse to advertising. This seems to have been followed by some communication to her. She then niado a commu location to England, and was supnlieil with more than one cony of the Druce-Portland pamphlet. J.ho negotiations seem to have ended so far as New Zealand was concerned by her .leaving in February, 190/, for London with the object of becoming a witness in the case. According to her own report, various letters by Dickens and the Duke were stolon from amongst her papers during tho voyage. After her arrival in London proceedings were taken against the steamship-owners for damages for tho loss of the letters, but subsequently abandoned, tho owners of tho steamer receiving their costs. A cable message states that Airs Robinson disavows having taken these proceedings, and asserts that they were indited by Air Humber, solicitor for the Druco claimant, to cause a sensation. ’ Airs Robinson admitted at the Draco trial that she received £250 to go to England, and papers discovered by the Crown after her arrest show that she received £3 19s a week while in London for expenses.