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12
Tuberculosis.
That the advanced case wants humouring, for his mentality
is often unstable and his ideas and fancies are queer. This state is
often aggravated if the patient knows he is doing badly. If he can
leave his bed let him do so, feed him with varied and tasty dishes,
and keep his mind interested on things outside himself.
That well-marked cases in young people usually run a rapid
downhill course, owing to an absence of natural or acquired
immunity.
That no curative properties can be ascribed to tuberculin,
nor does its effect appear to be so good without the adjuncts of
rest, good food, and fresh air. Tuberculin is not required at all
where the patient can be got to do graded work under medical
supervision, which at present is only possible in a Sanatorium.
That a number of gardeners appear among the patients, and
that the soil or manure they work in may be a contributory factor.
That patients should not be sent to a seaside resort, where
the sand " bloweth where it listeth." Sand is not a soothing
application to the inflamed throat and bronchial tubes.
That strong and influential "after-care" committees seem
to be wanted to follow up the comsumptive when he returns home. .
Also a tuberculosis " unemployment " bureau would be useful in
finding suitable work for consumptives who cannot, or are not
allowed, to follow their old occupations. The committee should see
that the patient— <
(a) Has a bedroom to himself;
(b) Moves to a suitable house ;
(c) Gets proper nourishment and medical treatment.
(d) Destroys all expectoration ;
(e) Convinces his employer that with reasonable care
he is not infectious.
That the question of employment after discharge is a
difficult one, with barriers of prejudice and ignorance to be first
broken down. On the other hand one has to balance the hope of
the patient taking advantage of his training and practising it,
against the risk of his not doing so, and thereby infecting his fellow
workmen. Is the risk justifiable ?