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67
By far the largest number, 65 per cent., went to consult a
medical man in the first instance for persistent cough, either
alone or associated with pain, wasting, or difficulty of breathing;
16 per cent, first saw a doctor because they suffered from severe
pain in the chest, probably due to a tuberculous pleurisy. In 9
instances the phthisis was discovered during the progress of an
attack of pneumonia.
In 376 cases enquiry was made as to whether the patient
knew the nature of the disease from which he was suffering—out
of all these, only 149, or less than 40 per cent., were aware
that they had phthisis.
It would appear that with many doctors there is a disinclination
to inform the patient that he has consumption.
Instead of this, he is told that his "lungs are touched," or
that his "chest is slightly affected."
For this course the following reasons are urged in explanation :
—If the patient is told he has phthisis, he may become alarmed,
exicited, or depressed, and this may react adversely on his
condition. If poor, he knows that to be affected with phthisis
means prolonged treatment, and he consequently becomes an
out-patient at a hospital or dispensary, and is treated gratuitously.
The very poor often think that their own private doctor may
safely treat their simple aches and pains, their stomach ache
and neuralgia, but consider, quite wrongly, that consumption
is too serious to be treated by a private doctor, and go to a
hospital to have the diagnosis confirmed, and for free treatment.
When, therefore, the patient is informed that he has phthisis,
the result often is that the doctor loses the case. From a public
health standpoint this is much to be deplored—it is a great pity
that the poor do not have more confidence in their docto-s in
this respect. It will be obvious that, if the patient is not told
he has phthisis, it is useless to expect him to observe the
precautions which are necessary to prevent the infection spreading
to others.