The Daily News. TUESDAY, MAY 20, 1919. NATIONAL HEALTH.

Taranaki Daily News, 20 May 1919, Page 4

The Daily News. TUESDAY, MAY 20, 1919. NATIONAL HEALTH.

But for the war's demands on the manhood of the Empire, and the revelations made in the process of selecting fit men for the arduous work of our military forees, the large number of the physical defects would never have been known. That the number of military rejects was so large came as a shock to the community, especially as a considerable proportion of the unfit cases arose from preventable causes. It was at once obvious that when the time came to enter upon the work of reconstruction after the war, the problem of national health must be one of the first to which serious attention should be given, for it is the central problem around which all other problems revolve —the sun from which radiates the energy quickening into life all the forces planted in the race, yet it was left for a time of exceptional crisis to demonstrate the weakness of the manhood of the Empire. It is not a question of expecting the race to be composed of supermen; merely that the average should be sound in mind and limb, but the large number of C and C2 men came as an unpleasant surprise, while the presence of the A spirit in such men was nothing less than a tragedy. , We have, perhaps, come to regard certain men as belonging to a class of shirker only too ready to magnify and trade upon their physical defects for the purpose of evading service, some of whom resorted to despicable means to throw dust in the eyes of the Medical Boards* and openly boasted of their success, but in th'i first days of the war the opposite picture presented itself—lion-hearted youths, with feeble, distorted, ill-developed bodies, who could with difficulty restrain the tears of mortification when rejected on medical grounds Fine souls in poor bodies. Now that the period for reconstruction has arrived there is naturally keen concern as to what action is to be taken with regard to national health—the key to all other problems. Whatever forrc. this action—for action there must be—may take, it will profoundly affect the Empire for good or evil. Is a Ministry of Health, equipped with autocratic powers, to which we must give unswerving obedience, all that is required by a democratic State ? Have we cause, especially in view of the recent epidemics, to be satisfied with our present Government supervision of the public health? Or do we desire radical changes? If the present medical services are unsatisfactory, wherein does the fault lie ? These questions must be answered, and the public should also hear what the 'tadiiig members of the medical profession have to say. The celebrated British heart specialist (Sir James Mackenzie) in a recent address on the subject of "Assessing the value of ayiaj/'

<toms" said* M Tfc has been a great "distress to me for many years to •see how medicine is being di*ertled out of the true and proper direction." Medicine, according 1 to this authority, is where chemistry and astronomy were 500 years ago. He decries the domination of laboratoryism, maintaining that the right path is the study of symptoms so as to be able accurately to assess their value. He also contends that in spite of the fact that the text books are full of symptoms, there is not a single symptom that the body can giv.3 rise to that we know thoroughly and scientifically, understanding the mechanism of its production and the influence it has on the man's future." The reason for this serious state of affairs is attributed to the fact, that the physicians who teach the future practitioners do not see the beginnings of dis ease, but only the later, less hopeful stages, and that they themselves have never been taught "how to examine a patient to see what these symptoms mean," 1 dience the inability of the general j,practitioner, who has been ; badly trained for his task, j Prognosis, the judgment in I [advance concerning the duration, course, and termination of a disease, is what above all things the public desires, but this it cannot get. There may be an answer to Sir James Mackenzie's indictment, but there is no doubt it is of the greatest importance that the prognosis of disease should receive more attention. The dangers of a false prognosis are serious, and the question is: Are we yet within reasonable distance of a correct assessment of symp toms on which alone a trustworthy prognosis can be made? It is, for example, not only inflammation of the lung that we want to recognise; the special cause for such inflammation is what has to be sought for. Many physicians consider that the pathologist does not dominate the clinician, and plead for closer co-operation between I physician and pathologist so as to widen the outlook of both. Per- ! haps, after all, it is efficient treatment rather than accurate prognosis that patients require. To develop the powers of both the consultant and the general practitioner many changes are required, having for their aim wider cooperation and better co-ordination. A scheme has been elaborated by Sir Bertrand Dawson in his Cavendish Lecture. Some such scheme will, no doubt, ultimately be adopted. There is room for all, the observer and investigator of symptoms—clinical or pathologist —the bacteriologist and the hygienist, and it can only be by their marching shoulder to shoulder that they will arrive at the goal— National Health. At the same time there is a duty imposed on the State to see that the most favorable conditions prevail with regard to sanitation and facilities for safeguarding the public health. The chaotic state of affairs in the Dominion calls for a drastic overhaul. If the physical fitness of our manhood is to be ensured there must be constant supervision from infancy upwards.