Report of the medical superintendent of Yaws Hospitals.

  • Nicholls, H. A. Alford (Henry Alfred Alford) 1851-1926.
Date:
1878-9]
Catalogue details

Licence: Public Domain Mark

Credit: Report of the medical superintendent of Yaws Hospitals. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    for the reception of jaws patients, an i that ihe-e liospitaii sitoulil be • as , few in number as possible, una as large as the means of the colony would admit, ; for th« fewer the nurr.bor of hospitals, the less the chance of the diabase extendinj>, and the less ibe expenditure—and tho greater the uuraber of pitieiits under treilment, the sooner the malady would disunpear. l first it. was dec del to erect three hospitals ; oje near tow;:, one at I'lince Itapevts, and one a' the windward of the isltind. jt'innlly, it was determined that the latter should be dispensed with, and the patients bo brought from windward to the Inispit'jl near Rosean. It lemaiued then for those on whom the responsibility rested of choosing sit'^a for tho?e hospital)*, to select such 88 upon the whole app-;ared best suited for tha trealirent of yaws, uuder the special circumstanceii of the case. Taking into consideration then all.the require- ments absolutely demanded to ii hcspi'al iutended for the reception of pttients ia large numbers, and which have alreedy baeo submitled to the Government by tho puperiuiendent,—as the senior member of the medical profession in the island, and with such kiiowlddge us I may h.w© been able to gather during a pruotice of seme fcrty years, i came to the conclusion that t.'ie portiou of land at the mouth of the Conefield river was the most eligible for the large Central Hospital and this posi- tion I recommended to the losptotor. Dr. Nicholls. I should therefore wish it to be distinctly understood that I)octor Nicholls is not alone responsible for having selected this locality,—wh?iher judiciously chosen cr the reverse, the responsibility,. whate\er it may b?, attaches chiefly tc me, and which I willingly accjpt At. tiie same time, it must not be supposed thnt Doctor Nicholls selected this locality fro!ft my recommendation 'implv, bat fioni h's own judgment, ounsidening it the best under the conditions that could be oho-en. It. must nor, however, be understood that the land at the mouth of the Canefield river would have been recommendsJ an derlordinary circomstauce'' and with *be|nelectioD untrammelled by ceitam iiiiisputu • ble conditions. It should he borne in mind that the disease and the ircumst^nce* attending us (rpattneut- are special, and differ roatorlally fro.u tti® reqairemeois oiT kospitals t-stablished tcr the irealireut i>f disease geaerally. It »s iodispatable ihaK more sal-brious localities coaii be fouod on cur mountain slopes and su trails. buJ the indispeosable abundant supply of water cruld not. then oe obtuined audothsr requirement: fulfilled. The buildings foraieily used at i'rince llapeils as a yaw* bospital were again fitted ui> 'or the reception of che patients in the northero dis- trict of the island. Th6 results of the ireaturcs taken by the Government to tree the inland from. ya\V3 are very re->as3uring. ihat 236 o ses shuuld have been dismissed cured sin e the hospitals have been in full operation, and nearly the whole of the leeward fide of the island cleared of this Incubus, is a m^'asare of buocess that must be grati- fying to the public as well us th'» Gtvcrnmeat, and points unmiatakeab'y to the final extinction of the disease at no distant period. Fuhappily, several cases of dysentery have lately appeared in the ho4pUal. at Oanefieid, affecting chiefly the children, but the proportion of fatal cases has bseu such as to cause some anxiety. I have no desire to cabt censure upon any one, £ speak merely to the facts when I say that the oonetruction of the hospitals at Cane- field is ill-suited for the treatment of disease, especiallv when tb > subjects are weak, half-starved children, greatly reduced in strength from the presence of uis. case and want of care previous to admission, - and tbe transition from the close small huts in which ihey are tisually shut up at night to a long ward full of crevices and openings, with currents of air passing in all directions from the iloor and the sides, is not only likely to give rise to disease, but also greatly lessen the chance of recovering if proceeding from other causes ; and ahildren being more readily affected by morbid agencies than adults a'^e the first to suffer. I should wish specially to observe upon this point that it is not to be con- cluded that because dysentery has appeared in the Canefield Hospital therefore an improper position his been chosen for its establishment. Dysentery always exis'.s m this country, and may appear epidemically in any part of the island, along its ■bores ell round, or in the uplands, and a?or9 frequently and probably with greater intensity in the low>lyiog districts. I have found dysentery to prevail in the town of Roseau when no particular reasons could be assigned far it] appearance, certainly not essentially n^alaria according to the ordinary acceptation of the Word, that is—poison emanatiay; trom marshes or marshy land. On one occasion I had under treatment for dysentery a large proportion of the children in tbe convent during an epidemic, a locality froui its position as free from malaria as any part of the town, and notwithstanding the more than usual care taken of the children in this excellent institution. Daring the same epidemic a gentlemaa re- siding at Mime Uruce lost three of his family from this complaint Formerly when the barracks at that locality were occupied by troops, dysentery was for a long time the scourge of the soldiers. It prevails occasionally at Grandbay, and on the windward side cf the island, and to such an extent at times as to call for the interposition of tho Government, as the records of the former i:'>oard of Health would show.. It must not be lost sight of that oases of dysentery are met with in many parts of the island at prsssnt, and that the weak and diseased children biougbt