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Cases diagnosed as tuberculous have been dealt with in the
appropriate manner, but cases diagnosed as non-tuberculous have
been kept under observation at the Dispensary until they have
been persuaded, with parental co-operation, to accept Green Vegetables
and Fat as part of their daily diet. When parental cooperation
is inadequate, admission to Open-Air School or Convalescent
Home has been recommended, where the child may learn to
accept these articles of food. On discharge from these institutions
supervision is necessary to prevent relapse into the old
habits.
It is becoming more evident that the work of preventing
Tuberculosis is the work not only of the Tuberculosis Dispensaries,
but of all Public Health Services and all National Health Insurance
Services.
The welfare of the infant has demanded careful instruction and
guidance from the parents in its feeding and upbringing. The
same instruction and guidance are necessary in the rearing of the
child of school age. Further, it is suggested that panel practitioners,
when accepting adolescents as panel patients, and also
medical officers of industrial organizations should investigate the
food habits of each individual.
Investigations show that there is a widespread habit of eating
fish and potatoes without greens, and so little or no fat at
midday. When such a meal is eaten only once a week no harm
may follow, but if such a meal is taken daily, as many dyspeptics
do, or even four or five times a week, then there is a definite risk
of Tuberculosis becoming manifest.
When warning notices are published in the face of epidemic
diseases it is suggested that specific mention be made of the importance
of Green Vegetables in the maintenance of health, and
that no particle of green food, such as celery tops or outside leaves
of cabbages, be wasted either by housewives or bv greengrocers.
Further, if parents are unable to get their children to accept
Green Vegetables, they should be advised to visit one of the
Municipal Clinics or a Private Practitioner for advice.
1 he onset of Tuberculosis among unemployed appears to be
associated with loss of appetite due to mental depression, rather
than with food shortage. The provision of allotments or other
open-air work would appear to be the appropriate prophylactic for
overcoming mental depression and the loss of appetite, and at
the same time increasing the supply of Green Vegetables.
There is some evidence of a psychogenic factor influencing
the situation which requires further investigation, but it can be
said that individuals more easily upset and discouraged, either
through constitutional or environmental causes, show a greater
risk of developing Tuberculosis.
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