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The protected lives they lead at such places as Papworth would
enable them to live with their families in a protected atmosphere
under constant medical supervision. Patients may live with their
families and work under sanatorium conditions. The nature and
hours of work are under the control of the Medical Director.
The tuberculous subject is thus relieved of a considerable degree
of anxiety and domestic worry, and is able thereby to maintain
the progress originally made. It is of course essential to explain
the whole principle of Colonisation to the patient so that anywrong
impressions he may have, may be corrected before he enters
a Colony. He is given to understand that unless he agrees to
colonise permanently he is really wasting the Council's money.
Nutritional Factor.
The nutritional factor in a disease like pulmonary tuberculosis
is equally important with the infective factor, and demands close
attention.
Impoverished nutrition means lowered resistance and extension
of the disease.
Close attention, therefore, has to be paid to the nutritional
factor in all cases presenting themselves for treatment. It is essential
that the patient should have a good appetite. The problem of
loss of appetite in certain cases is one which may be set with difficulties
and disappointments from the point of view of treatment.
There are a large number of medicaments, yet not infrequently
they prove to be of no avail. In the poorly nourished
patient with little or no appetite and a feeble resistance, the use of
Insulin in stimulating appetite has proved to be a factor of considerable
importance. Where all the usual measures have failed,
patients will often be found to be eating with a real appetite and
gusto by this method. Its indications and contra-indications,
however, are very definite and have to be strictly adhered to.
I would once again wish to express my deep sense of gratitude
to the Nurses and the Clerical Staff for their loyal and constant
help and co-operation, which have played no little part in the
successful working of the Clinic during the year.