PERIODIC EXAMINATIONS

Sun (Auckland), Volume II, Issue 371, 4 June 1928, Page 11

PERIODIC EXAMINATIONS

“PREVENTION IS BETTER THAN CURE” (Contributed by the Department of Health.) In urging: the necessity for a periodic physical examination frequent use has been made of the comparison between the human body and a machine. The automobile particularly has been pressed into service to convey the idea that the human mechanism, too, would profit by an overhaul at regular intervals. Periodic physical examination has been recommended for many years; the original suggestion, in fact, seems to have been made more than half a century ago, but only within comparatively •recent years has the movement received such impetus as to make it a real and important factor in the physical welfare of a nation. The reasons why health examinations are beneficial are so obvious that hardly any arguments for them is necessary. They are, of course, advantageous to the individual in that they serve to detect the beginning of organic disease or to discover the existence of definite physical impairments of which the person may have been unaware. Faulty personal habits of living, errors of hygiene and possible shortcomings in environmental conditions are frequently brought out. For instance, the opportunity of completely reviewing the physical conditions of recruits by military boards in New Zealand during the Great War, revealed the value and necessity of such examinations. In many of the employments, as classified, 70 per cent., and even in some cases up to 90 per cent., of the recruits were rejected from class A owing to certain disabilities and diseases, and these were men in the prime of life. The system of medical inspection of school children affords another striking illustration of ■ the value of the early detection of physical deformities and disease. As an authority has pointed out, there is a still more potent reason why the health examination movement is one of the nearest steps to public health. It is because public health has reached a stage of development where personal hygiene is getting to be more important than the control of I one’s surroundings, including in that | term both inanimate objects and other ' human beings. ! As the public health movement has j progressed, sanitary science has I triumphed over environmental conditions, and broadly speaking, over many of the communicable diseases. TT e sanitary engineering phase of public health in which pure water supplies, effective methods of sewerage disposal, sanitary production of milk, eradication of insect-borne diseases, improvement in housing, and similar engineering functions, so highly developed, has reached a point where now it is often a matter of routine. Of course, much yet remains to be accomplished. However, the seed has been sown and cultivated, the plant well nourished, with here and ther© a barren spot perhaps. Such diseases as typhoid fever are definitely on the wane. The death knell has been sounded for hookworm, malaria and yellow fever; diphtheria is being conquered; man has vanquished smallpox, though this insidious foe is ever watchful for the time when carelesseases have been recognised as health enemies as well as moral ones. TuberI culosis is losing in its fight on human ! existence. Infant mortality is also j succumbing. [ As these diseases and their death

rates go down, others rise to take their places. Cancer, kidney troubles, hea«~t trouble, diabetes, apoplexy and Ulier organic diseases seem to be cn *ne increase. The death rates from them are either rising or else the trend is stationary or only slightly downward. The secret is combating these maladies in every case is in an early diagnosis. The average span of life in New Zealand is increasing, but it would forge ahead much faster if the present knowledge regarding communicable diseases was universally applied. What is the periodic health examination? By a periodic health examination we mean the use of all those resources of a physician, by question, observation and tests, through the application of which he distinguishes between health and disease, when applied to persons who, so far as they are aware, are not suffering from any disability or disease. The phz-'sician is faced with a client, a pupil seeking guidance in health, rather than sought by a patient who believes himself to be sick. The health client comes to learn whether in his happy disregard of minor discomforts, or shall we say while inattentive to slowly-developing and insidious disease, he is as well as he is capable of being, and by a better adjustment to his fellows and to his physical surroundings, and to the obligations to his work and family, he may escape the too rapid advance of the habits at fifty which may have been safe and useful at 30.

When people are subjectively aware of disease, the time has usually passed for the most hopeful and effective curative or corrective treatment. Only by detecting tuberculosis, syphilis, cancer of tongue or lip, diabetes in the earliest stage, even when the patient is wholly satisfied with his apparent state of health, can wo most nearly approximate cure by the use of the medical sciences.

However, one should not be unduly and morbidly solicitous about one’s health and drift ingloriously into the ranks of the valetudinarians, a class so abhorred, according to Boswell, by Samuel Johnson. Yet at the same time, though death is a necessary and inevitable end, it behoves all individuals to avail themselves of every means to prolong existence at least to three score years and ten.