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113
RESULTS OF TREATMENT:
It is as yet too early to make other than general statements
as to the results obtained by treatment, whether at Sanatoria,
Hospital, or Dispensary alone. Tuberculosis is so persistent a
disease, and the danger of relapse so great, that at least three or
four years must elapse before the actual permanent results of
treatment can be ascertained. In the following tables, however,
an attempt is made to show at least the immediate results of
treatment, and succeeding years will prove whether these results
are merely temporary or not.
In considering these tables the following points must be kept
in mind:—
(1) Cases treated in Sanatoria are chosen for such treatment
as being either in an early and presumably favourable stage of the
disease, or because previous experience has shown that such treatment
is the best for a particular case. Hence the after-results of
sanatorium treatment ought to be good, as the cases are specially
selected on account of their favourable outlook. It must be
remembered, however, that the social conditions of the patient
on his return from the sanatorium may often destroy much of the
good that has been done, and relapse is frequently due not to
inefficient treatment, but to bad home conditions as regards
housing, food and work. These difficulties are present in regard
to all forms of treatment, and vitiate any accurate estimate of
results. As far as possible the Dispensary endeavours, by constant
supervision of the patient and his home, provision of
additional nourishment, advice as to work, &c., to diminish these
factors antagonistic to successful treatment, and to a large degree
succeeds, but their presence must never be forgotten.
(2) Cases treated at the Borough Hospital are usually either
advanced or chronic in type, and actual arrest of the disease is
rarely possible. Persons sent to Sanatoria are usually well enough
to be out of bed, whereas those admitted to the Borough Hospital
for the most part require prolonged treatment in bed. The five
shelters for male patients, however, are used to a considerable
extent for patients who have had a slight temporary relapse and
require a short additional period of institutional treatment. The
results of treatment at the Borough Hospital must therefore be
judged from a different standpoint from those at Sanatoria, and
the proportion of good results can never be high.