The Daily News. WEDNESDAY, JUNE 14. CONSUMPTION AND SANATORIA.

Taranaki Daily News, Volume LIII, Issue 327, 14 June 1911, Page 4

The Daily News. WEDNESDAY, JUNE 14. CONSUMPTION AND SANATORIA.

Although it is generally agreed among medical men that the greatest scourge from which humanity suffers—consumption—is preventive and eradicable, there is at present wide disagreement as to the benefits of sanatorium treatment. The matter is of such vital moment to' the community that no excuse need he offered for returning to its discussion. There seems to be no doubt that in many cases the person with either incipient or advanced consumption by sanatorium treatment reaches a stage of fitness which justifies his discharge from an institution. It seems to be proved that in these cases the disease is at least arrested, and that the education as to the conduct of the patient gives him a better chance of remaining well than he could have had without sanatorium training. We have previously mentioned the efforts being made in Australia tn combat the disease by notification and other drastic means, such as insistence on home hygiene and the segregation of patients in whom the disease is advanced. It is pointed out by eminent investigators that there can be no means of discovering the true value of sanatoria for the consumptive until a system is devised whereby the work done in the sanatorium is merely the preliminary to after observation, treatment, and the collection of data concerning the individual. The proved value of the sanatorium is that it is a school where habits are formed in patients who, although they may relapse on discharge, will not be so liable to communicate the disease. The Australian health authorities insist that early detection is the best available method of prevention, and suggest that systematic and compulsory examination of school children would not only lead to the discovery of cases of lung trouble but of other possible diseases. Tt is in the initial stages that consumption is most susceptible of removal bv natural means. The early training of the susceptible person to a knowledge of the fact that he can only communicate his disease through the saliva would be a blow to the disease from which it would probably not survive. The Australian •Medical Conference, in its report, particularly emphasised the points necessary to be observed by patients, insisting on perfect personal and general cleanliness, clean feeding, absolutely fresh air both day and night. It is extremely difficult to convince even well people that fresh air at night is of the highest importance either to sick or well. In dealing with the question of sanatoria, Dr. F. Porter wrote in the British Medical Journal:

"Am tJic results worthy of expenditure? The mnjoritv of sanatorium medical officers will ?io duibt answer in the affirmative, hut. T venture to differ, and would affirm that, we would fret. nenrct Hi" solution of this great, problem if the \asfc amount, of money spent annually were diverted to other channels, y Itl ay hp accused of vagueness in this statement,, hu' T can nirrch' hint, that prohnbly fifl per cent,, of all cows are tuberculous: that, inspection of dairies, meat markets, etc., is n farce, owing to the impossibility of the present staff of in-

speetors overtaking their work; that ] breeding grounds are being erected an- 1 nually in every city of the Empire." ] This wholesale condemnation says that ; while a State 'fights consumption weakly, , it helps its advance by permitting i "breeding grounds." In short, it produces its own recruits for sanatoria. The real hope of the fighters against consumption is in the awakening of the public conscience. The public conscience, in relation to the health of individuals, has yet to be discovered. The war against disease of any kind is principally a war against individual and collective ignorance, antipathy to control hatred of discipline, and carelessness of consequences to others. We have not yet reached a stage when the individual is more concerned about the health of his fellow man than his own. The person who inflicts bodily but curable harm on his fellow is punished, as he should be. He is taken to a place where it is impossible for him to do personal injury to anyone. The careless consumptive is a greater danger than the man who uses a knuckle-duster or a bludgeon, and the State—every State—has a duty to perform in making it impossible for him to inflict wholesale death. A while ago the medical superintendent of the Wellington Hospital spoke most strongly on the ill-effects of laziness among sanatorium patients. He alleged that the system simply spoilt them, and he was frank enough to say that it was a deal better to let nature remove a diseased human being than to paitch him up to become a loafer. Some recent information regarding the Frimley Sanatorium attached to the Brompton Hospital is useful as showing that a patient's progress is gauged by the amount of physical work he can do, and that the cure, if any, is the direct result of physical work in the open air. It is mentioned in the medical director's last report that the spirit of emulation in the performance of tasks is a help towards a cure, and that when an ambitious patient can fell a big tree he is pretty near to his discharge. The statistics of this sanatorium show that during last year, of the 41!) patients treated, the disease was completely arrested in 192 cases, and that 195 people showed improvement. The most curious ) item, however, is: "Forty-six per cent 'appear' to have been cured." That is, of.course, the sort of thing that makes some authorities doubtful of the utility of the sanatorium system. The "point that the disease is just as capable of arrest without the aid of sanatoria is apparent, but the educative aspect cannot be overlooked. The exceedingly small proportion of consumptives who . ever get to a sanatorium makes it necessary for preventive education to be ftpplied generally and not in spots. And ( there is no doubt that the Australian authorities have intimated the only way of dealing with the matter in a wholesale manner. The means are, shortly: Medical examination of scholars, compulsory notification of consumption, house-to-house visitation for the discovery of eases, insistence on hygienic conditions (particularly in regard to air and light), the segregation of bad eases, and an absolute prohibition against the landing of tuberculous passengers from overseas. Ultimately these matters will not only engage the State, but the municipality; ' and the time to be up and doin» is now.