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FAMILIARITY BREEDS CONTEMPT
Lingering Death.
If during the summer there had been 100 cases of poliomyelitis and
24 deaths there would have been a hullabaloo; the newspapers would have been
full of it; I should have been inundated with letters and telephone calls and
frenzied requests for advice and protection. As you can see from Table 31 in
the statistical appendix, there were 100 new cases of tuberculosis and 24
deaths during 1954 but not a ripple stirred the calm of the Borough. Here is
a menace in our midst which ought to stir us to frenzied activity. It is about
the same every year; in 1953 there were 119 new cases and 28 deaths and so
it goes on year after year. If poliomyelitis exacts its penalties of paralysis
and even death, so does tuberculosis. In the case of every young person and
adult who gets tuberculosis, just think of the frustrated hopes, and lost
ambitions, the changed plans, the expense and worry, the protracted months
of idleness and lost earnings to say nothing of the possibility of a sentence of
death. Of all the infectious diseases, tuberculosis is the greatest killer, as is
easily seen from the first nine lines of Table 3.
We can eliminate tuberculosis from herds of cattle and render them disease
free; can we do the same with human beings ? We can indeed; and by the
same principles as we use in the herds. We must find the infected persons
and try to ensure that they do not infect anybody else. The main reason
tuberculosis smoulders on from year to year is because there are in the population
a proportion of people suffering from the disease who have never been
detected; even they themselves may not know they have it. They are in
addition to those who have consulted doctors or have been to the clinic and
are therefore known.
Many of the unknown cases are people past middle life, especially from
50 onwards. One of my records is that of a man who in 1940 was aged 56
and had a job as a caretaker. At that time he was not very robust and
frequently suffered from what he called chesty colds. Over the next five years
he was off work from time to time with his chest, but with the label given to
his complaint as ' bronchitis.' However, in 1945, he was notified as suffering
from tuberculosis and was then aged 61 He had to give up work. In the house
were his wife and one daughter in her early 20's. The man did not go to a
sanatorium, I forget now whether it was because there was no place for him,
or whether it was he would not himself go. However, his wife was a sensible
woman who understood the need for isolation and he was persuaded to
co-operate properly. He was given a separate bedroom and his appearances
when the daughter was about were kept to a minimum. He lived for 10 years
more until aged 71 and all that time he was probably infectious and a danger
to others. Somehow at these older ages, patients seem able to cling to their
disease and to life. The disease is not strong enough to kill off the patient
and the patient is not healthy enough to throw off the disease. The patient
lives in symbiosis with his infection, that is the organisms living on the human
tissues and both surviving. I think there must be many of these cases about
the town. Many never seek medical advice at all and for years and years go
about spreading tuberculosis to unsuspecting victims.
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