A study of the relation between the treatment of tubercular patients in general institutions and the reduction in the death-rate from tuberculosis : report / by Arthur Newsholme.

  • Newsholme, Arthur, 1857-1943.
Date:
[1905]
Catalogue details

Licence: In copyright

Credit: A study of the relation between the treatment of tubercular patients in general institutions and the reduction in the death-rate from tuberculosis : report / by Arthur Newsholme. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    5/30 page 415
    NKWSIIOLMK. Tni-:ATMKNT OF TUBKHCIILM’. PAiIFNTS. /fi:. disease, which sl ill remains the mosl imporlanl cause of death from disease. It has to be noted however that the gravest differences of opinion exist as to the teaching of the past. It is admitted by all that tuber- culosis is an infective disease, that if infection could be prevented, the disease could not occur. It is further agreed that in the presence of a given amount of infection the extent of disease developing in a community depends also on the resistance of its members. By some hygienists means aiming directly at the prevention of infection are regarded as of small importance relatively to means directed towards the increase of resistance. The experience of England is quoted in favour of the thesis that by means of social and sanitary improvement, and without any measures directed against tuberculosis as an infec- tive disease, an almost unequalled decline in the death-rate from tuberculosis has been secured. The success of the ‘‘ English Method ” is similarly quoted by French hygienists as the strongest argument against Sanatoria for Tuberculosis, when regarded not as a therapeutical measure in the treatment of this disease but as a means of preventing its spread. It is urged with some show of reason that the expenditure on Sanatoria will be disproportionate to the economic gain, and lhat public money will be more advantage- ously spent in preventing tuberculosis by means of improved housing and sanitation. It should be added in this preliminary statement of the problem, that it is not necessarily a question of choice solely between the Sanatorium treatment of tuberculosis and the adoption of general measures of sanitation. It may be that other means direct- ed against infection, as for instance the treatment of advanced cases of phthisis in hospitals, may have been in the past, and may be still more so in the future, one of the most important means of preventing the spread of tuberculosis. Whether this is so or not, will be seen as we proceed. My first duty is to analyse for each country the past conditions, so far as thev can be ascertained, which have been associated with a declining or a non-declining death-rate from tuberculosis. It will be convenient to discuss first those conditions which at first sight can only be regarded as having increased the resistance to disease by improved nutrition, etc. If abundant and cheap food is a predominantly important factor in the prevention of tuberculosis, a close inverse relationship between food and tuberculosis should be found when a general review of foods is taken. I am able to give the data for such a review from 1877 onwards from Government Blue Books recently issued. “ Index numbers ” are employed in the following table based on the retail prices collected by the Labour Department of the Board of Trade, of liread, flour, potatoes, beef, mutton, liacon, butter, lea and sugar;
    digitised image 1
    digitised image 2
    digitised image 3